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[Julia Dizzy]

Hi,
I am struggling with general anxiety lately and wondering whether to increase the gel or ask Gp for advice on anti d's.

I have always been a bit of a worrier, but worse since I had major bowel cancer surgery and chemo 2 years ago.
I had a clinical psychologist after the chemo who was helpful - and have previously had CBT but it doesn't really help me. I sometimes do meditation online but not much seems to help the clenching feeling in the stomach. I have taken Atenolol 25mg for anxiety for many years and take Omeprazole for the GERD. I had a gastroscopy 2 years ago which was clear at the time.

I am so far clear of cancer, my next check up and CT scan is in November, but the worry never really goes away even though I try not to dwell on it.

I am 67, been on HRT for last 4 years, 2 pumps Oestrogel and 100mg Utrogestan orally daily with 2 pumps Tostran a week.

So my question really is shall I try and up the gel by 1 pump and see how I go on with that, or shall I ask my Gp if I can try an anti d to help? Or increase the dose of my Atenolol to keep my BP down? Not sure on trying anti d's really if I'm honest, tried Prozac once and made me weird, have had Sertaline in the past once a long long time ago for 3 months and was ok enough to stop taking it after that.

Is there a good one that doesn't have a lot of side effects?

I also have a lot of joint and muscle pain all over and the chemo has left me with neuropathy in my hands feet and lower legs.

(I've just had to have a small crusty keratosis removed from my arm privately. My Gp had referred me to Dermatology back in May, but wouldn't refer under 2 week window as he said he didn't think it was sinister. Had an appt for November which was cancelled by the hospital with no chance of a future one due to lack of consultants(!).
So I went to my local Circle health group hospital and was charged £2145 for the 10 minute procedure, cut out and stitched, on top of the £200 initial consultant fee. It was costed as a day case because they put me in a private room to wait the 2 and a half hours I waited for theatre!! So that was extra stress!! My BP went up to 189 when I was having it done!! I have a follow up for the histology on that in a months time and hope it's clear. )

Any advice and suggestions of best way forward would be helpful, thanks.

[CLKD]

Criky that's a bit steep even 4 a private room  but it's done.  Once the report is returned,  hopefully 'nil of note', you can put that behind you.

Anti-anxiety medications for anxiety, anti-depressants for easing depression.  Some of the latter do help with anxiety.  In 2002 my GP prescribed betablockas: Propranolol : which helped me until 2020 when I stopped.  I have a go-to anti anxiety med to swallow when it takes over as well as anti-depressant medication.

Is the anxiety cyclical?  When is it worse, 4 me it was early in the morning 

I never worried until 48 hours B4 the next appt. on a 'what in case' basis 

Let us know how you get on. 

[Mary G]

£2000 odd for a simple procedure like that?  It would be cheaper to travel to Spain and see a dermatologist for about €80 and have a procedure for a couple of hundred (ish).  There are quite a few private dermatologists here who charge reasonable prices and speak English.  Same goes for all other types of medicine and dentistry.

Re the anxiety, I completely understand because I'm like that too. I really don't like check ups and always fear the worst.  You are already taking a medium dose of oestrogen so I would look at anti anxiety medication.  I'm not sure what is best (Sertaline is mentioned on here a lot).  I'm not sure on the science re anxiety but I would imagine it's possibly another manifestation of low/unstable seratonin levels which leads to different conditions in different people - in my case it's migraine auras.  Obviously HRT helps enormously but I found that as I got older, it's not enough to keep the migraines away on its own.

[CLKD]

Don't go abroad for dentistry.  If procedures go wrong ............  it may be difficult to find a dentist to take on repairs.  Even if it's cheaper!

Some find that keeping a mood/food/symptom diary of use. 

[Dierdre]

I'd go for the Sertaline, you had it before and was fine. Try it for a few months, enough to get you through the CT scan and waiting for results.

If you're doing well on the HRT regime other than anxiety upping it could upset the balance or it might take a while to feel any improvement. You could always up it if the ADs don't suit.

A couple of my friends take citalopram and not had any side effects. My doctor also recommended this to me but I've gone down the CBT route for now and I'll try them next if needed for my health anxiety.

[sheila99]

I would do it the other way round, I'd increase oestrogen and see if it helps. It's possible it may help the joint and muscle pain too. Do you have other meno symptoms that are either controlled or uncontrolled on the dose your on? Having anxiety that your cancer may return I think is a normal reaction, I think most people would feel this way. I've had anxiety over it too and this was just cancer in the dog not me (nearly 5 years now and she's still alive). I'm not sure hrt will cure 'normal' anxiety, it seems better for anxiety you shouldn't have (it cured mine), perhaps yours will need 'proper' anxiety medication. I hope you find a way forward and that you remain cancer free.

[CLKD]

Glad that your dog survived sheila99 

How much the anxiety/depression is affecting someone is a guide line for choosing appropriate medication.  If U weren't in peri what would you choose?  HRT can be continued with and once stable, other medication support can be eased off.

[Julia Dizzy]

Thank you all. 
Sheila99, the dose I am on controls the hot flushes and helps with VA. I suffered with horrendous ones for 8 years post menopause before I finally got HRT from an NHS Meno clinic at age 63.
Whenever I have tried to have a break, the flushes come back with a vengeance. I have been told I'm one of the unlucky ones who may have them for years!

It's annoying being anxious, I don't want to be!! So I may try and up the gel but also chat to my Gp this week.
Thank you again. x

[CLKD]

Let us know how you get on.