perimenopause

By Susan Goldberg

The clock radio in my younger son’s bedroom is gaining time.

At first, it was a couple of minutes a day. I’d tuck him into bed at night and notice that the time was off, and sigh, and reset it, syncing it back to my iPhone. I assumed that a child had accidentally pressed the minute button, or that one of the cats had walked across the clock — originally purchased by me at the age of 14 from Consumers Distributing — pushing it ever so slightly into the future.

Except that it happened every night, every bedtime, until I finally clued in that the clock, after more than three decades of service, was dying.

“I think it’s time to replace this thing,” I told my son one evening. He protested. He liked the clock radio, perched like a loaf of bread on his dresser. He liked the way it made mornings come earlier. He thought it would be mean, not to mention environmentally unfriendly, to get rid of it over something as trivial as a few minutes each day, to throw it into landfill when we could just reset it each night.

I was inclined to agree. The frugality of his position, his make-do attitude, appealed to me. I, too, liked the clock. It reminded me of the 19-year-old cat we’d recently lost. She had held out for so long, years and years of the same routine: sleeping in her red chair in the corner of the living room, making her slow way up the stairs each winter afternoon to the same bedroom that housed the clock, basking on my son’s bed in the warm light of the southern exposure. She deteriorated so slowly that it was hard to really notice it: the way she weighed a little less, shed more fur, took a little longer to climb the stairs each time. Until a week before she died, when her decline sped up markedly: her eyes suddenly milky, her gait stiffer and wobbly. I found her, one evening, on the floor in my older son’s bedroom, tiny and gone. We wrapped her body in one of the boys’ old satin baby blankets and buried her underneath the rhododendron bush in the back garden, next to the previous dead cat, also wrapped in a satin baby blanket.

In the past week or so, though, the clock seems to have taken its cue from the cat, speeding ahead each day not in increments of a few minutes but dozens. It’s 2:08 PM as I write this; the clock’s display currently reads 3:21. After years of perfect health followed by incremental degeneration, it has suddenly upped the ante. The curve of its demise has turned sharply upward; has become visible, measurable, pretty much literal in its countdown to the inevitable end, when we unplug it and put it in the box with all the other e-waste.

These days, some days, I feel like that clock.

Like this: One morning this past summer, I sat down to journal and realized that the words were blurry on the page. I’d been journaling nearly every morning for more than 20 years, the same Hilroy 5-subject notebooks, the same Pentel RSVP fine-tipped ballpoint pens, and all of a sudden it was almost intolerable, the way the words fluttered subtly on their light-blue lines, the way the pen strokes seemed to bleed.

Or this: at the end of the same summer, I was besieged suddenly with waves of nausea, unexplained, unbidden. Almost daily, I’d close my eyes and breathe through the sensation, sour and shaky: the clammy skin and dizziness, the tightening of the ligaments in my neck. It felt like morning sickness, although there was no earthly way I could be pregnant.

Now, all of a sudden, I am the person with four pairs of reading glasses: bedroom, office, kitchen, purse. For more than 40 years, since I learned to make sense of print, I could easily read the words on a page, and then one day I couldn’t. And now, I have a prescription for Zantac, admonitions from my doctor to cut back on caffeine, alcohol, mint, onions, garlic, fatty foods. I’ve been diagnosed — after a series of highly invasive and unpleasant tests involving tubes and barium and fasting and suppositories — with reflux. The sphincter between my stomach and esophagus is weak, loose; stomach acid slips past it and up into my throat, burning it just a little bit each time.

“And that’s what’s making me nauseated?” I asked my doctor. It seemed incongruous.

She nodded. “The body,” she said, “doesn’t always have the best ways to tell us what’s going on.”

I thought of all those nights, countless nights, in the past few years, when I woke up, chest tight, feeling like I couldn’t catch my breath. The tightness was familiar: it was the same feeling I’d had since 11^th grade math class, when I began doubling over in pain around exam time. “What are you worried about?” my doctor had asked me, not unkindly, when I went to see her with my teenage complaints. She diagnosed me with math stress and suggested Tums, trying to relax.

The reflux diagnosis — which came on the Friday before my 46^th birthday — felt on the one hand like a relief: I was heartened to know that there was a physical, medical explanation for what was going on (and that the explanation was not, say, cancer), that it could be treated through medication and “lifestyle modifications.” On the other hand, I found it oddly unsettling, even a betrayal: for years, I thought — because my doctor had told me as much — that my gastrointestinal issues were all in my head, purely the result of anxiety. All those times I woke in the middle of the night feeling sick with what I assumed was worry, when I tried to soothe the burning in my chest with calming self-talk (or, in a pinch, Ativan or sleeping aids), I could’ve just taken a Zantac and waited 20 minutes.

It’s strange, to rewrite that kind of story about oneself. Yes, of course I was anxious: about math class, my mother’s cancer, my separation, every other stressful event in the intervening three decades. Yes, stress triggers reflux; the two aren’t entirely unrelated. But I had never thought to ask about, and no one had told me, that its manifestations had physical causes, that I could do something more than breathe through the nausea or up my meditation practice (and be stressed at my lack of initiative when I didn’t).

Most unsettling, though, was that sharp upward curve in symptoms. Arguably, I’ve had reflux since my mid-teens. And then, in August, my body — like the clock — upped the ante, hastened the decline, doubled me over with a queasiness I couldn’t identify and finally couldn’t ignore.

I can see, already, how the same story could, probably will, play out with menopause. Right now, it’s still, mercifully, on the horizon. Despite everything I’ve read in my Facebook perimenopause group, I have lulled myself into thinking that it will be a smooth transition, unnoticeable: cycles that will gradually shorten until they one day disappear, without drama, without fuss.

Logically, of course, my assumption makes no sense: a series of increasingly shorter spans between periods doesn’t lead to a gradual cessation but, rather, to one long, unbroken bloodbath. My friends’ testimonies bear this out, as does math. What I should prepare for is that sudden, dramatic onset of symptoms: headaches, chin hairs, weight gain, insomnia, hot flashes. It’s not like I haven’t been warned. I was born with a finite number of eggs, and, one day, the last one will be released and then, suddenly, there will be no more. (Each month, I am half-amused and half-irritated at my ovaries’ persistent hope that this time might just be the time. “What exactly about my life,” I ask them, “makes you think that what I really need right now is one more baby?”) And yet I persist in imagining that I can get it “right,” that with regular exercise and (even) less coffee and alcohol, and some well-chosen supplements, I might be able to avoid all of that, to continue along my straight and narrow path toward menopause rather than slamming into that sharp, sudden curve of night sweats, broken sleep, the 10 pounds (more?) that will appear over the course of four months, no matter how many carbs I don’t consume.

It will feel sudden, but it won’t be. Just as, although I persist in thinking of the nausea as coming out of nowhere, really it’s the culmination of decades of acid, the slow weakening of muscles, associated nerves finally frayed that nanometre too much. Ditto, I imagine, with my vision: it’s more dramatic to think of my need for reading glasses as sudden, but isn’t it really the culmination of years of gradual decline? Aren’t we all dying from the moment we’re born? What’s that saying? Even a broken clock radio is right twice a day.

Can we really prepare for the passage of time? More specifically, can we really prepare for the number it does on our bodies? More and more, I’m inclined to think that I’m asking the wrong questions. You don’t really prepare for decline. You confront it, the way you confront grief, in stages: At first you deny its possibility, and then you ignore its symptoms, and then you rail against it, compensate subtly for it, think you can overcome it. Finally, with more or less grace, you get used to it, incorporate it into your daily life. The curve flattens out, becomes the new straight line. Until you’re hit with the next curveball.

I think of my friend J, whose own stomach upsets were, in fact, cancer. Ovarian. I’ve watched her move through precisely that cycle: ignoring or putting up with the symptoms until she had to drive herself to the hospital, puking in the parking lot from the pain. Her initial impulse to “get cancer right”; to arm herself with information, make the best decisions, to leverage every ounce of privilege and training and gumption she possessed (and she possesses all those things, in spades) to be the best cancer patient ever, to elude (or at least best manage) side effects, to stay in control of this whole thing. As a friend and fellow perfectionist, I have watched how cancer, how the system itself, has steadily countered these impulses. Ovarian cancer, her doctors told her, is now considered a chronic disease, one more damn thing to incorporate into daily life. I think of my own mother, diagnosed at 37, dead at 59, the decades in between and how she, how we all, learned to incorporate the disease and its possibility into each day. What she taught us, what I see in J, was how to live in a state of grace, gritty and hard-won though it may be.

If you’re lucky — and I think I’m lucky, so far, knock wood — you notice the grace within the grit. In the midst of your various declines, you begin to notice some sharp trends toward the better: how the friends you have now are the best friends you have ever had. How you are so much happier living single in your own house than you ever were married in it. How wonderfully sharp the reading glasses render the words on the page, your reflection in the mirror — now you can see every chin hair in high definition!

Your focus sharpens in other ways: now, all of a sudden, you no longer have any patience for the friendships that drain your energy, and give them up, revel quietly in the space their absence creates, the increased calm. How you stop beginning your sentences with the phrase I think or I might, and start saying I want or I am. Or I did — because you’ve stopped asking permission in advance. You have enough money: to buy a new clock radio for your son, for plane tickets when you really don’t want to drive, for new lingerie (not the utilitarian stuff) when perimenopause makes you spill out of the old bras.

You unplug the clock from its outlet and can’t quite help running your hand over its 1980s-brown plastic casing. You were so young when you bought it. You feel a bit silly, laying it down gently rather than tossing it into the box with all the other digital and electronic detritus: the immersion blender your former mother-in-law gave you one Christmas, an ancient cell phone with a cracked screen. You think of every milestone the clock witnessed, the way it kept the time, held the space, even and unruffled, all those years. If you had one handy, you might have wrapped the clock in a satin baby blanket. You think, but don’t quite say out loud, the words Thank you.

Susan Goldberg’s writing has appeared in the New York Times, Ms., Catapult, Full Grown People, Toronto Life, Stealing Time, TueNight, Today’s Parent, and a variety of anthologies and websites, as well as on CBC, to which she is a regular contributor. She is the coeditor of the anthology And Baby Makes More: Known Donors, Queer Parents, and Our Unexpected Families. She lives in Thunder Bay, Ontario.

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