Estrogen deficiency and short term memory loss

I've been reading a book from the library called "Perimenopause" by Huston and Lank (2001).  It's comprehensive and written in an easy-to-read, almost conversational style.  Here are some quotes:

"It is generally believed that women live longer than men because of the cardiovascular protection estrogen provides."  This is the cardiovascular protection estrogen provides up to menopause, when the last estrogen and progesterone-producing egg follicle is released from the ovaries.  Haha, it's good to be girly.  Take that, boys!

"Memory and other thought processes depend on adequate estrogen levels.  Estrogen receptors in your brain cells receive estrogen molecules, which then improve the transmission of impulses from one neuron to the next.  In addition, estrogen use increases the actual number of functioning nerve cells.  The more neurons you have, the larger the network of functioning nerve cells, and the better your brain functions.  Estrogen supplements in elderly women have been shown to decrease the incidence of Alzheimer's diseases (AD) by 29% (Yaffe 1998), but in women who already have AD, estrogen does not slow the progression (Mulnard 2000).  Using single photon emission computed tomography (SPECT), it has been demonstrated that estrogen-deficient women have reduced blood circulation to the brain, particularly to the areas responsible for memory.  During hot flashes, such women have even further decreases in cerebral circulation.  In fact, these women had temporary vascular changes during a hot flash typically seen in women with milk to moderate AD (Greene 1998).  Hormone replacement normalized cerebral blood flow.  This suggests that hot flashes over time could contribute to neurodegenerative changes.  Women have brain glucose needs 19% higher than men and are more susceptible to diminished circulation (Baxter 1987).  This may explain the higher incidence of AD in estrogen-deficient women than in men."  Right.   Mental note - as well as being unpleasant, hot flashes are bad for your brain.  Of course I'll probably forget this in 5minutes time.

I've been prompted to read this book by noticing that my memory has deteriorated a little in the last couple of years.  Initially I put this down to grieving, but I'm now willing to blame it on the hormones a little more.  Or decrease in hormones.  There is a lovely graph in the book showing estrogen peaking in women at around age 35, and declining thereafter at a steep and steady rate until the last menstrual period at around 50.  Jeepers, I missed that starting window didn't I.  Where was I at 35?  Oh yes, that's right, my 35th birthday passed in a haze of mastitis and sleep deprivation, with newborn Keith and almost-2-year-old-Nicole.  No wonder I couldn't have cared less about what else may have been going on in my body.  I do remember a particularly exciting day when Keith was a couple of weeks old, when he slept for 4 hours overnight for the first time.  When I got up in the morning (5am) to start the day, I felt like I could run a marathon!  Later than morning, I exclaimed to my father-in-law "I had 4 hours sleep in a row last night - I feel fantastic!"  He shook his head in disbelief.  He couldn't believe I could be excited by having 4 hours sleep, and also expressed something like "I don't know how you women cope with this." Hormones, my friend, hormones.

After being pulled over by the police recently for driving an unregistered car (I'd forgotten to pay it) and being threatened by the retailer we buy gas from that they were going to cut us off (forgot to pay that too), I've realized that relying on memory alone isn't going to cut it anymore.  I've had to set in place systems to make sure these critical things get paid.  And it seems to be working thus far (I just hope I don't lose that diary!)

I went to the shops this morning for a few essentials (hot chocolate powder, sanitary products, iced coffee - yes it's that time of the month again), and when I returned to my car, I couldn't find my keys.  Puzzled, I sat in the driver's seat and pondered my next move.  I hadn't locked the car, you see, as I locked my keys IN the car not so long ago and had to call my husband to drive to rescue me with the spare set.  I sipped my iced coffee (ahhhhhh) and wondered if I should walk home, or mount a bigger search of the vehicle, and the shop I'd just been into.  And then I saw a glint of light reflecting from something next to the steering wheel.  Yes, that's right, I'd left them in the ignition.  In the unlocked car.  Oh good.  Luckily for me the  old Subaru is not on the top 10 list for car thieves.

As much as I complain about these monthly bleeds, I suspect I'll miss them when they are gone, or at least, miss what they represent - my ability to have more children.

Hormones.  Love them or hate them, they're part of who we are as human beings.  Gotta love them.


Yaffe, K.Y. 1998. Serum estrogen levels, cognitive performance, and risk of cognitive decline in older community women.  Journal of the American Geriatric Society 46:918-919
Mulnard, R.A., et al. 2000. Estrogen replacement therapy for treatment of mild to moderate Alzheimer's disease.  Journal of the American Medical Association 283:1007-1015
Greene, R.A., et al. 1998.  Comparison between cerebral blood flow in hypoestrogenic women and patients with Alzheimer's disease - a descriptive study. Neurobiology of Aging 19(4)S180
Baxter, L.R., et al. 1987. Cerebral glucose metabolic rates in normal human females vs normal males. Psychiatry Research 21(3):137-145

The Purpose of Suffering - part 1

Since Sophie died 17 months ago, I have thought a lot and read a lot about suffering, mostly from the point of view of the Christian believer, since that is what I am.

Two books that have been significant in my grief journey are "Stepping Heavenward: One Woman's journey to Godliness" by E.Prentiss, and "Desiring God" by John Piper.  

Elizabeth Payson Prentiss (Portland, Maine, 26 October 1818 – 13 August 1878) was an American author, well known for her hymn "More Love to Thee, O Christ" and the religious novel Stepping Heavenward (1869).  Read more about Elizabeth Prentiss here.  From the Wikipedia bio we learn that she was the 5th of 8 children, 2 of whom did not survive to adulthood.  Elizabeth herself bore 6 children, 2 of whom did not survive to adulthood.  This gave her real life experience for the central character in Stepping Heavenward, Katherine Mortimer.  The novel is set in the mid 1800's.  No antibiotics.  No physiological intensive care units.  Katherine believes deeply in the God of the Bible, and lives her whole life in relationship with Him.    Katherine's husband in the novel is a Doctor, and she would sometimes accompany him to visit the sick and the dying.  The take home message I got from this is that they accepted death as God's appointed time, and were not afraid to spend time with the dying person.  Katherine's father died from a blow to the head (accidental) when she was a teenager.  Her neighbour's child died from scarlet fever at age 4 (Nicole had the same infection at the same age, but she could take antibiotics for hers.)  Katherine's first child died from a microbial infection at the age of about 4.  What a heartbreaking way to live.  Believers were utterly dependent on God the Father/Son/Spirit for everything in their lives, including the lives of their children.  In our medically advanced first world society, I think I'd been living under the illusion that we are not as dependent as they were, but I have changed my view on that since Sophie's death.  Despite doing everything modern medicine told me to do in order to have a healthy pregnancy, I could not prevent Sophie's death.  Katherine reached a point in her life journey where she could say that if God should "ask" her for anymore of her children, she would be able to let go without anger, even though the death of her loved one would also hurt like blazes.

Katherine also spent several winters of her life incapacitated by illness.  Rather than viewing this as an inconvenience, she recognized it as a gift for a season, to immerse herself in God's Word, and so get to know Him better.  I remember another friend speaking in similar terms about the 2 years that she was incapacitated by Chronic Fatigue.  In our affluent western culture we are always in a rush.  Work - achieve - produce - spend.  I think that the enemy has deceived us into thinking that this is the way to joy/happiness.  IF we are forced to slow down we tend to think of it only in terms of loss of productive hours.

We also think that we don't need God because we have so much medical technology.  We think we are in complete control of our lives.  Medical technology is a wonderful gift, but are we valuing the gifts more than the Giver?  Of course it's only when we get to the point of valuing the Creator above all other things (yes, even above our spouse and children, should God grace us with them) that we find true joy.

Joy in the midst of suffering.  Enter John Piper's "Desiring God". find out more here

Piper says that suffering can be in the form of illness, accident, natural disaster, or direct hostility from another person.  Whatever the cause, suffering tempts us to doubt that God is Good.  Suffering temps us to doubt that God is sovereign.  Suffering tempts us to doubt that God is faithful, merciful, holy, unsearchably great.  Of course, Satan delights when we doubt any aspect of who God is, which is why he gets in our face when we are suffering and says things like "What sort of God would allow innocent children to suffer and die?"

John Piper says that when a Christian person holds onto the truth of who God is during suffering THEN those around can see the tremendous worth of Christ.  Why would we put up with or accept suffering if this life was all there is?  As Paul the Apostle said in 1 Corinthians 15 vs 19 "If in this life only we have hope in Christ, then we are of all men to be most pitied."

JP also says that in our sufferings we show a little of what Christ suffered in taking ALL of our sin upon him in order for us to be reconciled to God.

Our suffering does not change who God is.  It changes who WE are, or rather, it changes our understanding of who we are.

A few months ago a friend asked me how I felt I had changed since Sophie's death.  I replied that I had more patience than I'd ever had before, no question.  More patience with my own children, with my husband, with people in the carpark who steal my parking space.  It's not worth expending emotional energy getting upset about things that really don't matter in the long term.

In the last few months the patience has been overtaken by humility.  In realizing that I am not in control nearly as much as I like to think I am, I have learned to trust God more, trust my wonderful Ben more, listen more and talk less, and not express every opinion that I have, or even feel that I need to have an answer for everything.

All this musing is from my perspective as a Christian believer, and I acknowledge that many of my friends and family do not look at life from this perspective.  How do you journey through your grief and loss?  What do you take solace in?  Does it work?  What do you hold onto?  I would love to know your views.

Kangaroo Island, a Knitter's Guide - Part 2

View 1

View 2

View 3

Yarnbombing on KI

Let's get straight to the knitting story, shall we?

In the yarn bombing photo, you can see a rest-stop on the stair to the top of what's known as Prospect Hill, so named because Matthew Flinders climbed it to get a better view of the Island and surrounds to see what the prospects were.  The kids did count the number of steps (512 steps according to this website)  I've tried to encompass the 360 view in the other 3 photos.  The first one with the road is looking East back towards Penneshaw.  The second swings around to the SouthWest, taking in the rugged coast there, and the 3rd looks NorthWest across the lagoons towards American River.  Prospect Hill is on the narrow part of the island between the big blog and the littler blog (those are technical terms ;)

BUT back to the serious business of knitting.
What better to provide cushioning and beauty half way up the climb, than to have some yarnbombing (or yarn graffiti) on the resting seat and the balustrade itself.  I'm wishing I thought of it myself.  Now there's a thought - prepare knitting in advance for each road trip we go on, so we can leave something of beauty wherever we go......

Jerusalem Artichokes

Very Tall Jerusalem Artichokes

Looking up to the sky....

Thankyou to my fellow bloggers the Funky Frontyard Farmers (see their blog here) for inspiring me to give these JA's a try.

I think the foliage and flowers are beautiful in their own right.

This mass of flowers and stalks and leaves grew from 2 tubers (is that the right word?) that I planted last Spring.

Now that I know how tall they are growing, I am going to plant some as a curtain on one side of Sophie's garden, to make it like a secret room that you cannot see until you are almost at the front door to our home.  On the left hand side in the picture I think.  Or who knows, when we harvest the JA's, maybe there'll be enough for a curtain on all 4 sides, with a small doorway.  We'll see.

Current view from front door

 

Sophie's Garden is taking shape much more slowly than I thought (partly due to the price of water....*gasp*) but that's OK.  I had in mind that it would be ready to share with my wonderful community by the end of summer, but now I'm thinking that Sophie's 2nd Angel Day might be better, as the plants would have grown more by then, and the shape of the outdoor garden room will be more obvious.  I had lunch out there today, some homegrown tomato on some homemade bread.  Beautiful.

Kangaroo Island - a knitter's guide, Part 1

Ah - Kangaroo Island.  Place of no rabbits or foxes.  No fast-food outlets.  Life in the slow lane.  Sounding good already?
My wonderful husband, Ben, planned our trip to KI so that we would arrive on a Saturday.  This was so that we could attend the Farmer's Market on Sunday at Penneshaw (find info here on Penneshaw markets ) to support the local economy by purchasing locally grown food, and handmade items.  Because we were visiting off-season, that is, not in the school holidays, the pickings were a little slim, but still very worthwhile.
We went to the Community Market first - handmade crafts and second hand things like old garden tools, and of course lots of toys and books.  It was relaxing wandering around looking at all the creative output of different people.  And THEN - I saw it.  The last stall in the line.  WOOL.  Lots of wool.  All the colours of the rainbow.  Artfully displayed in baskets arranged in a semi-circle on the ground, beckoning me in.  Hanks and hanks of it.  I could tell by the uneven-ness it was hand spun and also hand-dyed by the look of it.  OH YEAH.
I made a quick left turn and zoomed in to the centre point of the semi-circle and feasted my eyes on what was before me.  I vaguely heard a voice behind me that sounded like my wonderful Ben ("Remember, Kate, we DIDN'T bring the trailer, OK........).   Trailer, schmailer.  I need wool, and I need it N.O.W.
I settled on one hand of pinky/red (fuschia, one might say) and one hand of lemon yellow for my good friend Liz, a knitting and sewing powerhouse.  The person who took my money for the wool told me that it was the best wool to be had on the island (in his un-biased opinion, I'm sure), from Leicester sheep.
When we returned to our accommodation, I untied my fuchsia hank with glee, and after seeking a volunteer to hold the hank for me, wound the fuschia into 4 balls.  I suspected it wouldn't be enough to make gloves for both Nicole and I, but would probably be enough to make "armies" which cover the wrist and palm.  Armies will be great for next winter, as wearing gloves is fine when you are not driving, writing, typing, cooking, or reading a book, or doing anything else work-wise about the place.  Unfortunately I had only brought crochet hooks with me, and not knitting needles (what was I thinking!) so had to content myself with crocheting the wool for a bit just for the pleasure of feeling it pass between my fingers and across the palms of my hands.   Aaaaaaaaahhhhhhh.    Wool.  I admit it.  I'm a yarn snob.  Natural fibres for me.

Armies for Nicole completed

Armies for Kate in progress

 DID YOU KNOW - you may not bring potatoes to KI, or soil that has had potatoes grown in it?  To keep diseases out off the island.  Same applies to bees or 2nd hand honey making equipment, or honey itself.
After visiting the Penneshaw Farmer's market, we had a dinner made from ENTIRELY local produce - Marron, spread with garlic butter and lightly bbqd, lamb chops (grown locally, low stress lamb), mashed potatoes, with broccolli.
MONDAY - we visited Clifford's honey farm and bought the mandatory honey icecream, as well as some other honey-related merchandise.  The Ligurian Bee was sent to KI from Liguria in Italy in the 1800's to establish a honey bee colony.  The colonies on KI remain the only pure Ligurian colony in the world.

Low stress lamb

Marron with garlic butter

We also visited the Island Pure Sheep dairy, and watched the sheep being milked.  Sheep produce about 1 litre of milk, twice a day.  There is no distinct cream in sheep's milk, so the milk is described as being naturally homogenized, so all the products are creamy in texture.  We tasted all the cheeses and yoghurts, and bought some for later eating.

TUESDAY - rest day.  Washing clothes.  Read books, had naps, did some crochet.  Took turns taking the kids to the playground (since kids don't seem to know the meaning of the word "rest").

View north from the Cottage

Keith on the dashers while Ben supervises

Nicole on the go-through tunnels

WEDNESDAY - a big driving day!  We drove from American River to the Raptor Domain on the south coast.  We all voted the Raptor Domain birds of prey show as the best thing we did on our visit to Kangaroo Island.

Ben with Kookaburra

The interactive show was captivating, and you could pre-order lunch before the birds of Prey show, eat it during the lunch break, and then stay for the Reptiles show afterwards.  We didn't, as we were on a schedule and hadn't anticipated 2 separate shows being offered.

Nicole and Kate with Kookaburras

Nicole with Owl

Tilka the wedge-tailed eagle

Kate with Kookaburra

Sophie Rose - One Year On

Sophy's Rose first bloom, October 2012

My blogs this week are likely to be a little disordered.

I tried to write this blog yesterday, on what would have been Sophie's 1st birthday, but there seemed to be a gremlin in the system and I wasn't able to access my blog.  Perhaps that was meant to be.

Sophie - an early scan

I heard the term "Angel Day" used this week, as opposed to birthday or anniversary, and I think I will adopt it from now on.  30th of October, Sophie's Angel Day.  I've been pondering the custom of celebrating birthdays - another year of our lives lived, and thinking about what a worthy tradition it is, since life is way more precarious than we in the western world appreciate.  Certainly way more precarious than I realized, before 29th October 2011, when an ultrasound confirmed that Sophie's heart was no longer beating.  It's worth celebrating every additional year beyond birth that our children live.  Before the discovery of antibiotics in the early part of last century, infectious diseases were the leading cause of death of children.  These days, if a child dies from a microbial infection, we in the western world tend to be surprised and outraged, and demand to know why.  Due to advances in medical technology, we think we have the "right" to a health baby, and a healthy life.  Medical technology is marvellous, but we do tend to think it can cure all, and things like pregnancy loss and disability only happen to other people, not to us or people we know.

In countries much less affluent than ours, people see death on a weekly or even daily basis, it is not a stranger to them, and I believe they are much better at accepting it, and dealing with grief.  In our comfortable world, we use family planning to determine the number of children we have, and medical technology such as physiological intensive care keeps people, babies included, alive, and sometimes they do recover and go on to live long lives.

Since I'm indulging myself today in this monologue, I'll go on to tell you that, had Sophie been born alive, she would have most likely only lived for a few minutes / hours, or gone straight to the neonatal intensive care unit and died there.  I've often reflected on how grateful I am that she died in utero, and we didn't have the added trauma of seeing her slowly slip away with many tubes attached to her.  But maybe we would not have minded that, as long as she was still alive.  We will never know.  You see, Sophie died from a viral infection.  When an ultrasound confirmed that her heart was no longer beating, it looked like a simple case of "cord accident", as the ultrasound showed that the umbilical cord was wrapped tightly around her neck several times.  A senior Obstetric consultant advised us to consent to an autopsy, since, in his experience, whenever there is a cord problem, there is almost always something else going on, and restriction of blood flow is simply the last straw.  He described to us that you can take an umbilical cord, tie it in a knot, pull it tight, and as soon as you let it go, the knot springs open again, due to the gelatinous Wharton's Jelly present in the cord.  The only case of death due to true cord accident that he had seen in his career (where no other cause could be determined) was a case where, due to a genetic anomaly, there was no Wharton's Jelly present in the cord.  And he was correct in Sophie's case.  Autopsy revealed that a viral infection ravaged her body.  She had severe anaemia, and evidence of inflammation and viral infection in every major organ in her body.  Yet despite this, she grew to a normal size, moved normally in the womb, had a heart rate within the normal range, and to all outside observers, was a normally developing baby.  Isn't the human body amazing that it can do all this despite fighting for its life?!?  Both Sophie and I were tested for all the microbes (viral, bacterial, fungal) that are known to cause sickness and death in babies, but none of the tests were positive.  And do you know what - even if the virus had been identified, and I lobbied the government to introduce viral testing of some sort for all pregnant women, it would not have changed the outcome for Sophie.  There is precious little treatment for viral infections, even in our medically advanced world.  Medicine can provide physiological support, but the fact that viruses hide inside our body's cells makes killing them difficult.

The odds in most Australian baby books tell us that 1/4 pregnancies end in a loss before 20 weeks, and 1/135 end in stillbirth (death in utero between 20 weeks gestation and birth). Pretty scary odds, that you don't want to dwell on too much when you're pregnant or trying to become pregnant.  Due to the nature of genetic recombination and assortment that occurs when sperm and eggs are generated, every individual that is conceived is unique, and contains a genetic code that has never before been tested.  You don't know whether that code is going to "work" or not.  It may, by chance, contain disruptions in genes essential to life.

When I was pregnant with Nicole, I used to be offended if people touched my belly without my permission.  Once Nicole was born, I sometimes took offense if people touched her and cooed at her without my permission.  But now I see things differently.  A baby that makes it from conception to birth, alive, has already run a tremendous race. These people (mostly women, mostly older than me) who desired to celebrate Nicole's alive-ness were much wiser than I.  They knew how precious life is.  They knew that a happy healthy baby cannot be taken for granted.  

Sophie, just born

Now I know too.

The Delica Exhaust Project

In mid 2011, we began looking for a replacement car, one that would accommodate 3 children's car seats across the back. Our beloved Subaru L-series is too narrow, and only has 2 anchor points anyhow.  We settled on a Mitsubishi Delica.   In Australia, Delicas can only be acquired 2nd hand, or as a grey import.  We went through JSPEC, an importer based interstate, and they did a brilliant job for us.  Sadly, Sophie died while the Deli was in transit to Australia from Japan, but we went ahead with it anyway, and we are really glad that we did.
Ben compiled a long wish list of things he'd like to modify to strengthen the car for the purposes we have in mind - i.e. 4wd adventures.  The back lift and bigger wheels/tyres happened pretty soon after we got the car.  The first time I took the newly lifted Deli to school pickup, many jokes were made about needing a step ladder to climb into the car, and the hazards of underground carparks.
Ben's current project is a stainless steel exhaust system.  It has a wider bore than the standard, and some other modifications to increase efficiency of the process.  With his relatively new TIG welder, Ben has bought stainless steel pipes of various shapes, and manufactured the exhaust pipe himself.  I know that Ben is clever, but I still love the fact that I can marvel at what he can do.When he upgraded the exhaust system on his red Ford ute a few years ago, he tried to sell it to me like he was saving the planet.
 

 "Kate, I'd really like to fit extractors to the ute, it'll make the exhaust much more efficient, with less damaging emissions."

 It sounded like a fang exhaust to me, and I teased him about it.  "Ohhh, maybe!" he admitted.  That's OK, boys like their fang cars, it nurtures the adrenaline junkie in them.

    Of course, when he mentioned the upgrade to the Deli's exhaust, "fang" exhaust did cross my mind.

As we relaxed with Ben's parents last night after dinner, Ben was giving them the progress update on the exhaust project.  Ben's dad asked him "So, Ben, what kind of muffler are you using for the new one?"  Ben smiled.  "What muffler?!?" he replied.
I knew it.  A fang exhaust.