Hiking tips, dementia and menopause: The week in Well+Being (2024)

Join a hiking group: Hiking groups are golden. You can meet others who are like-minded, and you never know what you might learn. I learned how to cook because I went to Culver’s Gap with a North Jersey hiking group. Hiking with others gives you an opening to this world and allows you to build on the hiking experience in a safe place. For people of color, there are hiking groups such as Blackpackers, Hoods to Woods and Outdoor Afro. Hiking is not just for White people. Let’s dispel that myth.

Learn to use your trekking poles: Using trekking poles correctly is important. It’s a different motion going uphill vs. downhill. The majority of people around me when I’m hiking have no idea how to use their poles. Watch a YouTube video. I happened to learn from someone in my hiking group.

Let someone know where you are: It’s really important to check in. Leave an itinerary with a friend and make plans to check in with them. If you don’t show up past a certain time or date, they will notify search-and-rescue.

Make noise: Make yourself known in the forest so animals know you are coming through. Say: “Hey bear, I know you’re out there! Hello, nature!” Whatever makes you happy, even if it’s a loud “Woo!”

Don’t try to smell good: Don’t go into the forest wearing perfume or deodorant. It’s not a natural smell for the forest, and it attracts bears.

Bring a GPS device: I attach a small Garmin to my backpack that I can use to check in with friends or call for help. The time I fell down the ice gully and had to be rescued, I had an ice ax and a Garmin. I was able to save myself because I could communicate with rescuers and remain calm. I carry a Garmin on day hikes, too. Something as simple as a broken ankle can be serious if no one is around.

In case you missed it, today I had a really fun live chat answering questions about menopause. The reader questions were terrific. It was disappointing to hear how many women have not been given satisfactory care from their health providers — largely because their providers seem uninformed.

One of the main takeaways from my chat was the importance of women feeling empowered to ask questions and seek out educated providers. Fortunately, the North American Menopause Society has a great website at menopause.org, which allows you to search by Zip code to find a qualified provider near you.

Here’s one of the questions we discussed.

I’m turning 44, and it’s like a light switch has flipped in the last year: I’m SO GRUMPY. (Might also be politics/election, or perhaps those are exacerbating factors.) This coincides with my periods getting heavier and closer together. A friend suggested — gently, from a distance — the irritability might be perimenopause. If so, is there anything that helps with it? Or do I just need to get therapy and/or emigrate?? Asking for myself, my poor spouse and my dog, who’d like to shed his winter coat per usual without getting eye daggers from yours truly.

Women in their 30s and 40s are noticing perimenopausal changes such as fatigue and irritability, but doctors often dismiss their complaints. There’s some fascinating research by the research consortium Women Living Better that asked more than 1,300 women age 35 to 55 to answer questions about their menstrual cycles, stress, overall health and well-being. And they asked women how often they reported “not feeling like myself.” It turns out that uttering the phrase “I’m just not feeling like myself” may actually be a reliable clinical indicator that a patient is experiencing the earliest signs of perimenopause. If you’re interested in learning more about this, we wrote a story about it: Not feeling like yourself? It could be perimenopause.

The good news is there are prescription and nonmedical treatments that can help. Cognitive behavioral therapy may be an option, for instance. What’s important here is that you need to realize and believe that feeling grumpy is not a character flaw — it may be due to changes in your body chemistry.

Seek help to find relief, but also give yourself a break. Take a look at your life and consider whether you’re taking on too much. Are there responsibilities you can shed or friends you can ask for help? I think a big dose of self-compassion is also in order here. For me, during times of high stress, taking a moment and asking myself “What do I need right now?” is a helpful way to be kind to myself and work my way out of an irritable mood by identifying the source of my discontent. And the great thing about dogs is they love you no matter what!

My mother-in-law was recently diagnosed with cancer. What steps should patients like her take to make sure they get the best care?

When my mom called to tell me about her lung cancer diagnosis in 2017, my brain struggled to keep up with what my ears were hearing. Phrases came in isolated fragments: “shadow on a chest X-ray,” “doctor says I need a biopsy” and “malignant.” Suddenly, I was cast in the cancer drama, playing an unfamiliar role: Rather than oncologist calmly providing information, contextualizing a diagnosis and developing a treatment plan, I was the son of a patient, trying to get answers.

Over the next few days, after the shock had passed, I helped my mom devise a plan. Here’s what we came up with and what I advise my own patients to do, including getting a second opinion from a pathologist, who examines the body’s tissues to distinguish normal from abnormal.

Many patients skip this step, but mistakes happen. In a study my colleagues and I conducted through the National Institutes of Health, which involved more than 900 patients with suspected myelodysplastic syndromes, a bone marrow cancer, pathologists with expertise in this condition disagreed with the diagnosis given by pathologists who weren’t experts in the diagnosis 20 percent of the time.

Even more troubling, 7 percent of patients who received the wrong diagnosis also received the wrong treatment for their cancer.

That is why it is just as important to seek a second opinion from a pathologist, to confirm the diagnosis, as it is from an oncologist to verify the best treatment plan.

Here are a few things that brought us joy this week.