Hot Flash Forum!
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sas-schatzi -- outside temp was about 68F.
Fortunately I was within spitting distance of my yard when it happened, but I wasn't carrying my cellphone. In future I'll certainly do that.
I only "went down" one time, and I was completely in control when I did it. I didn't collapse. I sat down as a precaution against fainting. This was the worst episode I've had but there have been many others in many situations -- indoors and out, as I described, including showering. As far as I can tell the episodes always coincide with a hot flash, which is why I think it's a hot flash that's pushing me over the edge into heat illness.
The main thing that was different this time was the confusion. I walked the wrong way to get into the house -- I was quite confused, though it only lasted a few seconds.
Unfortunately I don't know what my skin or body temperature was, and I don't have any sense of my heart rated being slow or fast. Might have been, but I didn't notice.
The only thing that's different recently in my health history is that I started taking 5mg Biotin each day for my fingernails. But I can't find any known side effects of that so it's probably unrelated. Also, I should have mentioned that I'm 59.
I know everyone will probably be annoyed with me over this, but I'm reluctant to see a doctor over it. At the moment I'm dealing with hip pain and have had 2 Xrays, 3 blood tests, and 2 MRIs and the doctor doesn't know anything more than before. I don't think I've ever had a doctor figure out the reason for anything that I couldn't figure out myself, and I'm tired of tests that yield nothing.
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I take Effexor for the Hot Flashes. Mine are so overwhelming then they occur. I take 75mg a day and I guess it does diminish the amount of hot flashes. I do get them 3 or 4 times a day, or if I get too warm from the weather. It's been a hot summer and I can't go without the air conditioner and a glass of ice water on hand. I was just informed by my pharnmacy that the insurance will only pay for generic effexor. I'm really nervous about this change and wondering if anyone has been affected by this with SE's that are worse than the hot flashes. I hate change and it's bad enough on the Tomoxifen, but having the insurance screw with my Effexor is so frustrating.
Barb
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Cyclepath-----that's why I said you need a Sherlock Holmes. To often if a doc can't figure it out in the 10 minutes allotted. They either refer you out or just say something stupid like let me know if it happens again. Either way you are out their door.
I so would like to get at the beginning of your symptoms from the very first time you noticed them. Could be years ago. Could have been recent. Could have been that day. Could be all.
So Sherlock cycle path, Make a history
1. Any past hx of similar or near similar occurrence-----was there anything similar then to today's occurrence---- all the w's and h's who/what when /why/ how/ how much/how often-----any similarity in temperature, distance of activity, drugs
2. Any hx within the last year. same as above, may sound redundant, but until you see it in print, you may not see a connection.
3. the day of the event. analyze the hell out of it for everything you can remember.
I reread your post you sat down once outside the gate and once inside the gate. I used the word collapse. When the body is having a crisis---the symptoms of nausea and lightheadedness precede the event in so many cases. When I said the bodies alarm system is already going off , the first symptoms you felt were those, But i suggest that the alarm system was already activated and making numerous adjustments.
The feeling of fainting, if you get to a flat position ASAP. It does multiple things. Flat +legs elevated at 45to 60 degrees, you have an increased blood return to the heart. That put's a stretch on the myocardial fibers and causes them to contract more forcefully. This is called the Frank-Starling mechanism or starling/frank depends on which part of the country your from. This stretch coincides with the pressure receptors in the atria the aorta and the carotids ,that sends a message to the medulla. The medulla has the respiratory, vasomotor( blood vessels), and sympathetic/parasympathetic nerves. The medulla then sends messages out to all need organs by nervous innervation to do Something. It may send a message or receive a message from the pituitary/hypothalamus to do their thing. By being or getting flat when the body tells you are about to faint. You help it in two ways. You make it easier for all the work that the different messages are trying to accomplish ---easier. For example sudden low blood pressure-----medulla tells the heart to speed up it's rate, the increased stretch on the myocardial fibers cause the heart muscle to contract more forcefully---those two actions will increase cardiac output. This is a good thing. At the same time the medulla is sending a message to the blood vessels at the arteriole to clamp down, that will increase peripheral vascular resistance. Those three together will bring back up your blood pressure. In the meantime the message to the adrenals says to put out more adrenaline to give support where ever in the body that noradrenaline is being used up too fast and needs help. Basically adrenaline is the cavalry. Also, the liver is being activated to release glucose stores, so that the cells have enough energy to work.The pancreas is releasing glucogon to stimulate the liver to convert glycogen to glucose to back up the glucose that is being released Glycogen is the next waive to back up the glucose that is being used up rapidly' The kidney is being told to stop filtering fluids out and begin reabsorbing them to supply the body with needed fluids. The Gi system is told to stop digestion. All the body sphincters are instructed to tighten up. Particularly so we don't pee or poop ourselves. If you will notice in animals they will evacuate themselves at the first sign of trouble. We're not quite attuned to the signals. Our vision becomes more acute. Blood in the body is shifted away from the skin to skeletal muscles and the organs of necessity----heart,brain,lungs liver, kidney. In text books, it referred to as the Fright or flight mechanism. You see a mastodon or a robber you are scared and want to get away.
What does this have to do with fainting?Something happened---------you at this point don't know? The reason the body knows to get flat , is it senses we are going to pass out. Once we pass out all the protective mechanisms can do there work as I said earlier ------easier because we are hopefully now flat. Secondly,if you are flat(legs elevated), you can't fall. The fall may hurt you worse than the faint.. You try to tuff out the faint ------faint anyway and break something in the fall.
So, if you feel faint get on the ground fast with legs up the wall or on a stump, or up a tree------stay there until ALLsymptoms are gone. Unless you had the dreadful luck to fall on a fireant hill. Then roll like crazy away from it. A little well directed humor.
You got up before all symptoms were gone and had to sit down again. Your body wasn't ready. Your confusion came because all the protective mechanisms for the brain had not done it's work yet. O2 from respiratory stimulation, Increased transport of glucose and oxygen to the brain through the vascular system. Your mind kept telling you to get to the house. Good thought , but you needed a few more minutes.
The need to figure out now, is what is causing this, you have had the s/s before, now you have them again. Serious sleuthing has to be done, so that it doesn't happen again
If your PCP is not willing to sleuth this out and recognize that an answer must be obtained. Then start making phone calls to the best nurses you know, and ask them who they think is the best doc they know to figure out unusual situations. Nurses know who the brilliant docs are and they know who are the worst. Just start it with I need the most brilliant internist you can think of. Don't waste time with details. tell them your in a hurry. Then once you get to the most brilliant, they know who are the other most brilliant in each specialty. Or if you have one doc already that you perceive to be brilliant, ask them for the most brilliant internist. At this point this brilliant Internist becomes your PCP. Doc's that are really good doc's refer to the best doc's. You can even use this question" I want the best Sherlock Holmes doc there is, not your golf partner"
Your beginning symptom was what you associated with heat exhaustion, but you said the temp was 68 degrees. Unless you had done seriously strenuous exercise. The s/s's don't match. But if you throw in a drug that changes the story. Again sleuthing, details are important.
I know this is very long, it is my attempt to get you to take control of the situation and recognize, you need to write a good hx of past and present and find a good ,preferably, brilliant doc.
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Sas -- I don't have time to respond to your whole post now, but while I didn't sit down on a fireant hill yesterday, it was the next best thing: a bunch of nice dry stickers. The trail behind my house is mostly stickers in the summer! That was why I got into the yard and house as quickly as possible. I felt I needed water and I needed to lie down.
Hillck: The common thing here is being a little bit overheated from light to moderate physical work or a warm shower, and then getting a hot flash. So something like driving isn't an issue.
I decided to stop taking the Effexor for now. (The docs don't care whether I take it or not and I'm already on the lowest dosage.) I think it helped for a while but may have started to increase the hot flashes. There were 5 last night that woke me up, which means I'm probably getting about 15 per day. That's too much, IMO, if one is taking a med to reduce them.
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Sas, yes I can do a little bit on the serotonin syndrome. I actually have taught about these drugs, so can pull something together, but not tonight. Tonight I am absolutely exhausted... have been back at work full-time (had been off for 2 months) and trying to get ready for students next week, syllabi not even NEAR being done.... and not sure if another course got added to my teaching load... ugly rumors about that.... anyway, yes, I will get on it. Just be patient for a day or two!
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Today has been hot flash hell!!!!!!
Every hour or twice an hour..... arrrrrggghhhh!!!
Thanks... I feel better.....
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2 days back on arimidex for try #2... can the headache come back so soon??
HMMM the hot flashes are bad here too 
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Last night was my first experience with hot flashes. Woke up in the middle of the night in a pool of sweat, after a few minutes, I was freezing. Fell back to sleep, then again woke up to the same. I have been on tamox for exactly 2 weeks. Is this what I am going to be dealing with for 5 years?
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N3ypb----no hurry. I'm thinking that we just need it to be able to be referenced, when someone later on says there going to quit. It such a serious subject.
Suebak please try to read from the beginning of the thread. I think it will give you allot to work with. After almost 9 months I see a very big difference with the flashing. I did however, go through Arimidex >>>Femara>>>Aromasin (9 months). I quit the other two b/c of too many s.e.'s. If you have too many s.e.'s on one try one of the others. I thought I was going to have the worst s.e.'s with Aromasin. Are you on Norvasc or cardizem? Opps must take AM meds
The se's were so bad for me with the first two., I cried the whole day when I took my first Aromasin. But I had asked to switch ONC's and he effectively begged me to take the"a". I figured, how could I ask for a new ONC , and then not do what he asked.
The point being is that there are three drugs in the group. If one is causing you trouble then try one of the other ones
The importance of reading from the beginning is many women here have tried different things to cope with not just flashing , but other s.e's. If you don't read from the beginning, you may miss something that will have worked for you.
As a group we have identified many things, that we have not found in the literature. This is very significant. For example, Rennasaus found that an extended form of a betablocker works for her versus taking the same pill twice a day. Shannon found that Menopret which is Black Cohosh works for her (still hope it is Shannon). Even on this past page we were able to caution a member to not quit Effexor cold turkey b/c it's dangerous.We periodically write educational things for the group. AS above P3pyb is going to write a piece on Serotonin Syndrome which is a highly dangerous situation to just quit The SSRI's and SNRI's.
God luck and good reading
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SAS -- I really will try to respond to your long post later today. I've just been slammed. These are the times when I wish I had a job, since volunteering is so much work!
hillck -- I'm aware that one is supposed to go off slowly and have medical "permission," but the docs have told me I can just stop taking it any time I wanted because my dose was so low. Actually, it turned out that yesterday was the SECOND day I didn't take it, though the first day was inadvertent. Although it's probably coincidental, last night I wasn't woken up by hot flashes even once. A huge relief.
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Hillck-------my Dh came off Zoloft in one week instead of 5. He lost all feeling in his arms and legs.
The neuro testing said that in time he would get back the deep muscle feeling to a degree, but that he would not get the feeling back in his skin.
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Sherlock cyclepath-----not going anywhere
Since I did a thing on the sympathetic /parasympathetic nervous system. It only fair to do a little but on the chemoreceptors. This is specialized tissue in the carotid(Oxygen, pH, Carbon dioxode) and aorta(oxygen/ carbon dioxode) that does a chemical anaylsis of things . It sends messages to the medulla. Then the medulla again, does it's thing by activating all those things I mentioned yesterday to bring the body back into balance. When the blood sugar is to low, again the medulla sends out all the messages to activate all the alerting mechanisms in the body.
It's quite fascinating, that this internal mechanism takes such good care of us. It's like we have this mini lab inside us and all the saftey forces. But again, we at times don't know what problem is causing all the saftey forces to go into action. Thus the sleuthing. If the person is a known diabetic the obvious thing is to check blood sugar. Can't check who suggested Bloodsugar, it was a reasonable suggestion. Someone would have a problem in the hospital----three things were automatically checked---blood sugar , bp, and oxygen saturation. If all three of those were normal then the work got a liitle deeper in sleuthing. The challenge as Holmes would say 'The games afoot Watson"
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Cycle-path, you need to see Dr. House, LOL! Not to make light of a serious situation. You need to see the doc, I will just restate what others have said that have a great deal more medical knowledge than I. I have had symptoms like yours, although less, but it is 106 degrees in Dallas and this was after physical exertion, so definitely heat related or water consumption needed. Blood work, at a minimum, would be something to start with.
Also, beyond the Effexor, have you stopped any other meds or vitamins or even food? It is concerning to me that even Wikipedia will tell you to slowly go off a seratonin uptake drug like Effexor, but your docs didn't say that. You need to see other docs, IMHO. Are you willing to gamble your life on this? That is the potential question you have to face. I woudln't be, but you must make your own decision. The fact that it is something that keeps recurring, to some degree, makes it more serious than if it happened once, to me. Also, I think Renn suggested writing SE's and symptoms on a calendar so you can begin to make sense of it, great idea!
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Evening Primrose Oil was the magic trick for me.
My Oncologist told me about it during chemo and ignored him not wanting to put anything else in my body. After chemo, I had my remaining ovary removed and was now in surgical menopause at 40. A woman on here (in addition to my Oncologist) also raved about the Evening Primrose Oil so I gave in and tried it. AMAZZZZZING! It even helps with the muscle aches/leg aches also that Tamoxifen and other things can cause.
My co-worker started to take it and didn't refill the bottle when she was done and she started the brutal hot flashes and feeling yukky all over again!! I'm telling you...give it a try. Ask your dr, of course, but I only hope someone will listen because it's helped me so much and maybe it would help you too.
Just don't take it at night. It hydrates you from the inside out so you will have to go to the bathroom a lot. I made that mistake the first time taking it...who knew?
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cs34 - OK, how do you take it? How much? Where do you get it? Any SEs to be aware of? I am not having any help from the clonidine and am looking for something else to try.0
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Suebank I actually had really bad hotflashes and then they went away. I went probably 2 to 3 months without them and in the last week they are back. I want them to go away again. I have been on Tamox since the beg of Feb
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As much as I thought the Clonidine was working for my hot flashes , and then wasn't working, I have finally decided that it works minimally. I am willing to keep taking it, but would be interested in supplementing it with other( natural) remedies such as primrose oil etc (which I did take long ago for PMS I think) to perhaps enhance the Clonidine.
cs34 You don't specifically mention if the primrose oil helps with hot flashes. You might not have flashes, so maybe it's not an issue for you, but I would be interested to know.
At my last onc visit, she suggested vitamin E for flashes, I think 800IU, but that hasn't made any difference for me.
I also had a question a few pages back that I never had response to. Does anyone know or have an opinion on what the difference is between Menopret and plain black cohosh is. I would hate to spend extra $ just for a name. Thanks everyone!!
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Wenweb - that is a very valid question and I don't have the answer to it. I understand that Menopret has actually been discontinued, so I'd like to hear what a possible replacement would be.
I'm due for exchange surgery on Monday (yeah!) so now is not the time for me to experiment with new drugs. However, I am concerned that I'm taking Zoloft (200 mg for anti-anxiety) with the Tammi. I have read that Zoloft interferes with the effectiveness. I believe my MO poo-poohed that when I was prescribed Tammi. I see a therapist who recommended Zoloft (and Lexapro before) prior to BC dx. I will be asking my BS, MO, and psych about it at next appointments in couple of weeks. I used to take Lexapro and switched to Zoloft to reduce sexual side effects and weight gain issues. I have now read all through this thread, and maybe this isn't the place to ask. I know a lot of people are taking Effexor, which I am interested in as it relates to hot flashes. I have them all through the night, in the morning when drinking coffee/after hot shower, and randomly in the TX summer heat. Any questions, comments, observations would be welcome! I also plan to see a holistic doc sometime in Sept to see what they have to say.
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wen - on the menopret box it says that it is a proprietary formula that is equivalent to 42.mg of regular black cohosh root. Look on the box underneath the supplement facts.
Also wen, the clonidine was drying my eyes at night and since it just wasn't making any difference I stopped taking it.
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Omaz Thanks for the info. Also, very interesting about the Clonidine and your dry eyes. I have dry eyes, but by only taking .1mg per day (or some days only 1/2 that) my eyes have been okay. I do take extra measures for the dry eyes though. The Clonodine has made my mouth more dry which usually go hand in hand with dry eyes. It's a conundrum to me, but I'll take what I can get.
supersally Thanks for your response as well. I know that Effexor is one of the only meds that can be taken with Tamoxifen. I tried it briefly for depression as well as hot flashes and I had sexual side effects. I was on a very low dose, but was not willing to give up one of the small pleasures left in my life. I'll take hot flashes over sexual side effects any day. Good-luck with your exchange surgery.
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Supersally: I agree with wenweb re: Effexor. It seems to be prescribed an awful lot and (I think) is a pretty powerful drug. I'm going to ask DH what his opinion is on the Zoloft/Tammy combo ... will let you know!
I'm not sure what else was in the menopret besides the black cohosh. Many women have had luck with the latter.
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well ladies, I finally got through all the pages and wow what a treasure trove of knowledge! My hot flashes have subsided in the year since I've finished chemo and started tamox. However, I still have warm spells throughout the day, and need a fan blowing right on me to sleep through the night. Although I still do the covers on/off/on/off boogie, I've adapted or something, it doesn't wake me up completely anymore.
Yogic breathing does help, and I have a small hand-held folding fan in my purse for times I can't get to an electric fan. I know my triggers are alcohol, sugar, caffeine, and stress. Haven't given up any of those completely but cut way back.
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I consulted a naturapath who told me to take Nature's Answer Black Cohosh, it is Root Extract like the Menopret (40mg) I already take a Calcium and she said that was enough. It needs to be a standardized extract form of Black Cohosh...which is why the Black Cohosh I took from the drug store did nothing and the Menopret and the Nature's Answer work. Good Luck finding it.
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ShannonR Thanks for the info. I use the "standardized" guide when purchasing supplements. I guess that's that answer I was looking for!0
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Badger---so happy you have joined us fully(all the reading) you are such a treasure for knowledge and searching.There are many like minded people here. After reading DR Freedmans article who has studied flashing for 25 years. I think we have identified stuff he hasn't. Opinion please?
On cohosh Some pages ago I randomly chose a menopret page and just reposted it here. So it's back there somewhere.
I take Savella it's in the same family group as Effexor/cymbalta/pristique. All are SNRI' versus SSRI's I take it in less than recommended dose of minimum 50 mg twice a day(BID). I take 25 mg bid. My choice, Most drugs scare me. So I will take a smaller dose than recommended. I mentioned that doc rec'd I cut Norvasc in half. Symptoms on Aromasin lessened. Bp still low. May cut Coreg down a bit. Why Bp is now low??? Can't find a connector. Flashing is less though Yeah. Just feel warm all the time?? But I like that. In florida. Dreadful heat, but keep house temp at 80 b/c of $$$$ Stopped using that wonderful fan, I recommened way back. I have to find out about watt use. Added 450 kwh to bill in one month, but son was home twice LOL. Oh my, he's coming home this weekend, better put a lock on the thermostat !!!!
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supersally: " I have had symptoms like yours, although less, but it is 106 degrees in Dallas and this was after physical exertion, so definitely heat related or water consumption needed."
Please tell me more. Did it coincide with a hot flash?
"Blood work, at a minimum, would be something to start with."
Yes, I've had blood tests. Nothing.
"Also, beyond the Effexor, have you stopped any other meds or vitamins or even food?"
In another post I mentioned that I recently started taking Biotin, but I can't find anything about any sorts of Biotin side effects, even at high doses.
"It is concerning to me that even Wikipedia will tell you to slowly go off a seratonin uptake drug like Effexor, but your docs didn't say that."
I don't know how I could take a lower dose than what I was taking. I was taking 1/2 of the smallest available dose. Unless I just licked the pill, I can't reduce it much more.
My docs have told me it's ok to stop taking it. So I did.
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sas: I'm finally getting to your post.
"I so would like to get at the beginning of your symptoms from the very first time you noticed them. Could be years ago. Could have been recent. Could have been that day. Could be all.
So Sherlock cycle path, Make a history
1. Any past hx of similar or near similar occurrence-----was there anything similar then to today's occurrence---- all the w's and h's who/what when /why/ how/ how much/how often-----any similarity in temperature, distance of activity, drugs"It has only happened once, so there's no history.
2. Any hx within the last year. same as above, may sound redundant, but until you see it in print, you may not see a connection.
3. the day of the event. analyze the hell out of it for everything you can remember.I wrote here everything that happened. There just wasn't anything else. A hot flash came on and, I believe because I was already pretty warm from walking, it put me "over the edge."
"Your beginning symptom was what you associated with heat exhaustion, but you said the temp was 68 degrees. Unless you had done seriously strenuous exercise."
Right, but what happened was the hot flash. For me, it doesn't matter what the ambient temperature is when I get one because I'm immediately in a furnace.
So, I was walking the dog and got a little bit warm from the exercise. Then the hot flash came along and added itself to my already warm temperature, and I was over the edge. From what I understand, and very briefly, heat stroke happens when the body can't cool itself. When I'm sitting down and I get a hot flash, it's annoying but since I started out pretty cool I can cool back down without a problem.
Or when I'm exercising and I start to get warm, sweating and blood coming to the skin surface allows me to cool myself.
But when my body is already doing those things, and THEN I get a hot flash, I think the system can get overwhelmed. And I think that's what happened to me. Normally one gets heat stroke when the body can't cool itself because the ambient temperature is too high. But in my case my body was already working to cool itself, but instead of becoming cooler, I actually got hotter due to the hot flash kicking in.
In a way, I wasn't in 68 degree weather, I was in a 110 degree hot flash. And while I wasn't really killing myself walking the dog, I was working harder than I ever would have considered working if the REAL temperature had been 110 degrees.
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SAS: I didn't realize you are on Coreg! Can switch to the extended release and see if that helps with your flashes?
Shannon: Thanks for finding out from your naturapath what brand of black cohosh is best now that menopret is not available. Very helpful!
SuperSally: In a pharmaceutical nutshell: Zoloft and Tamoxifen compete for the same metabolizing enzyme in the liver.
cycle-path: For what you are saying, it does sound like the hot flash pushed your body over the edge. Still, a call to your physician is in order.
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Sherlock Cyclepath--------good job 1. It never occurred before------important info. 2 .no answer to that -----so apparently there was no occurrence before that within the last year--------important info 3. your analysis of what happened on day of occurrence is highly important.
So, we have a one time occurrence. At a 68 degree ambient temp. And you were walking the dog , not running him. Since you didn't include distance ---will assume usual walk. But there was a sudden onset of symptoms. We don't need to repeat them here. But write down sequence for doc. Important doc's listens , but not well enough. If you write sequence of occurrence , you will get better response. Watch his eyes you can tell if he is paying attention to what you have written. If you get the sense he didn't really read it ==ask him if he noticed mickey mouse. If he goes back to read it you will know he didn't absorb what you have written.
SO now you have established no prior history--------- this makes your doc's job easier When you see them it may help to print this post or write down this post.
What you have created Sherlock Cyclepath. is---------1.there was an occurrence 2. it was unusual to you. 3. you can now relate with signs and symptoms, specific to that day
Write down occurrence for PCP. I suggest your PCP. A Pcp these days are almost always board certified internist---either md or do----bottom line they had to pass the same board certification. A PCP Has a broader knowledge than specialist, believe it or not. Once a specialist gets into their field , they don't have time to keep up with other fields. They act in a cooperative manner----to compliment each other when working on a case that involves both disciplines, But bottom line there is to much for one person to know.
You have a start. You have created a history. You know this is a new occurrence except for your response in the shower, Now you have something to work with Namaste Sheila
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The last wicked hot flash I had was at the hairdresser's about a month ago. I was under a plastic cape, tied snugly around the neck, and started sweating like a pig. Hairdresser brought me a hand towel to mop off with, quickly finished trimming and whipped off the cape so I could get some air. phew! I'd rather have hair down my shirt than do THAT again!
cycle-path I think you are on to something re: 110 degree hot flash versus 68 degree day.
I'm headed for the kitchen and a glass of wine so I'm sure to be warming up soon.
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