Being there for others

Georg Greiner, a German scientist and doctor, way back in the 1880s, is credited with first describing ‘brain fog’. In the language of the time, he described this state as a ‘fogging of the light of reason’ and the ‘clouding of consciousness’ – two descriptions which to my way of thinking, sound so much more illuminating and compassionate than ‘brain fog’. So, while we might think about ‘brain fog’ being a relatively new phenomenon, brought into prominence by the Covid 19 pandemic and the spectre of long Covid, the term and what it represents has been around for a long time.

For some people it can be a passing inconvenience; for others a very debilitating and long term problem and can seriously disrupt people’s ability to work or undertake even the simplest of daily tasks. Whether it is a short term or long term problem, ‘brain fog’ should not be confused with the memory loss and cognitive decline associated with dementia. During the 1990s it was most often associated with the conditions of chronic fatigue syndrome and fibromyalgia. As noted above, as well as being associated with long Covid, it has also more recently been described as a common symptom of the menopause. And last week I felt extremely menopausal.

Of course, I wasn’t! Whilst there is such a thing as the ‘male menopause’, this is a term dreamt up by the popular media. The real associated male health problem is andropause and although like the menopause, it is a condition associated with reduced hormone production, the systems and impact on a man’s life are very different to those experienced by many women travelling through menopause. What was making me feel ill was simply jet lag.

For the first time in as long as I could remember, last week I struggled with jet lag. And my jet lag mimicked some of the signs and symptoms of ‘brain fog’. At times I struggled to focus and concentrate, I felt totally exhausted, I was even more irritable than normal, had real sleep issues and I felt utterly deflated. Doing anything physical, however small, was a trial. I moved like an old man. I felt really out of sorts at times. However, gradually over the week, all the symptoms, apart from the tiredness began to fade, leaving me feeling more like my old self.

Like many minor health complaints, it was self-limiting and time, rest, good food and sleep all helped. However, whilst the menopause is a natural physiological event, last week really brought home to me that many women going through the menopause will often experience similar symptoms over a much longer period, a lived experience that is likely to be very debilitating over time. When one considers that the average age in the UK for women to experience menopause is 51 years old, the impact on people’s lives can last for many years. It is a growing problem. It is estimated there are some 13 million women who are currently peri-or fully menopausal in the UK. That is equivalent to one third of the entire UK female population.

We also know that up to 50% of women, aged 45-65 years old, go through the menopause without ever once consulting a healthcare professional, despite the fact that women also report that the menopause had caused them problems at home and work. Likewise, it’s true that there is a big market in over-the-counter medications that people can use - how effective these might be is probably down to the individual.

Whether a woman self-cares or seeks the help of healthcare professionals to manage their menopausal symptoms, women in the workplace should expect to have a range of reasonable adjustments available to them in order to mitigate against unnecessary sick leave or absences. Apart from the duty of care we all have towards our colleagues, putting in place practical and emotional support as well as training managers to become ‘menopause aware’ makes sound financial sense. Last year it was estimated that the economic cost of sickness absence, informal care giving and health-related productivity losses was over £100 billion a year. Inevitably some of these costs will reflect women working in organisations where little is available to support those experiencing menopausal issues. I’m very proud to say that, in my NHS Trust, we took the decision to put in place a range of supportive measures, most important of which was the training of line managers to enable them to respond in an informed and compassionate way to colleagues experiencing menopausal problems on a day-to-day basis. There are many resources available to help organisations find better and more effective ways of supporting their staff through the menopause.  

Last week, I also experienced, indirectly, that support. I had been asked to take part in a memorial service remembering the 22 people who lost their lives six years ago in the dreadful Manchester Arena attack. The service was last Monday morning. And I wasn’t feeling at all well. However, we held the service outside in the sunshine in a quiet and secluded spot on the hospital campus. Colleagues who had been on duty that night and who helped so many were part of the group gathered to remember. As we prepared ourselves for the service, my fatigue melted away, by 'brain fog' cleared, and by the time I came to read the memorial poem, I felt like a different person. The feeling didn't last but in that moment, just being with others is all I needed to feel myself again. It is the little things that can sometimes make the biggest difference, although we won’t always know this at the time.