Tammy Miles has been an RVN for 20+ years and currently works at Leeds Birstall Vets for Pets as a Veterinary Student Supervisor and lead mental health first aider. She has had many ups and downs as a veterinary nurse but never did she expect to experience her lowest point in her forties. Here is her story of how she coped with perimenopause as a full-time RVN, which led her onto a path of her own self-care journey.

The beginning

When I entered my forties in 2022, I had considered the possibility of some changes to my body, a little extra weight, a few more wrinkles, even the odd accident if I sneezed or coughed too hard. But little did I know, within six months of turning forty-one in March 2023, my whole world would turn upside down.

I would wake in the middle of the night with joint pain in my leg which would last a few days before moving to the opposing leg and then all of a sudden stop. The joint pain would switch between my limbs, neck and back. It could last for anywhere between two days to a week and then disappear for the same duration before starting again.

I would be sleep deprived not only from the joint pain but the night sweats, itchy skin and the busy mind wondering what on earth was going on with me.

Simple tasks that would be part of my daily routine became more difficult due to brain fog. I would walk into the kitchen and immediately forget what I went in there for. I would be in the middle of conversation with a colleague or friend and stop mid-sentence because I forgot my train of thought. The list could go on.

I could cope with the physical changes that were occurring to me, but the mental health changes I suffered were what shook me the most.

I had suffered with anxiety since being a teenager and although I had many ups and downs, I had managed to cope with the odd anxiety or panic attack and feelings that many anxiety sufferers like me contended with now and then. However, the anxiety that hit me around the same time I started with other symptoms in my early forties was crippling.

At this time, I was only nursing on weekends. My work during the week mainly involved training, clinical coaching of several student nurses and providing well-being and mental health awareness sessions for all colleagues.

I was struggling to get up in the mornings. Had no motivation to do anything. On the weekends I was nursing, I would have a panic attack every time I pulled into the work carpark. I would hide away in the toilet trying to desperately calm my breathing before I did my next consultation. I would internalise all my anxiety whilst trying to triage the next emergency patient that was brought into the practice. By the time I left the practice, I could not even recall the drive home because I was in such a terrible mental state.

Every time I worked a weekend, it was getting harder and harder to nurse without crumbling into a million pieces in front of my colleagues. I felt so numb.

Surely that can’t be me

Around October 2023, I was chatting to a colleague one day and telling them about my symptoms when she told me I was basically listing all the symptoms she suffered with since her mid-forties and asked me if I was perimenopausal. I did not think it was possible for this to happen in my early forties.

I had heard of perimenopause a couple of times but didn’t really know much about it. Menopause was a condition I had associated with hot flashes and mood swings that women suffered with in their fifties and sixties but that was the extent of my knowledge.

I started to research perimenopause and the symptoms that could occur when I came across Dr Louise Newson’s website, Newson Health. I came across her podcast and started to listen on my route to and from work. I couldn’t believe what I was hearing. All my symptoms that I thought I was alone in dealing with were being discussed by other women who had experienced similar issues.

The more I researched, the more I realised so many women were perimenopausal in their early forties and sometimes in their thirties.

Supporting each other

My colleague who had drawn my attention to perimenopause jokingly suggested I should arrange a menopause support group at work, so I did. In November 2023 I posted on our work teams chat that I was holding a perimenopause/menopause ‘Cuppa and chat’ group which I named ‘Let’s take a (meno)pause’ for any of the team who wished to attend, this included the gentleman if they wished to inform themselves and support their partner or spouse.

Several ladies attended the session where I introduced them to the Newson Health website, podcasts and the Balance app created by Dr Louise Newson where you can record a multitude of symptoms daily. I advised that this would come in handy when visiting the doctor to discuss symptoms and potentially seeking treatment if necessary. We would discuss our own symptoms, how we were feeling, what supplements or treatment was helping and generally being there to support each other so none of us felt we were going through this alone.

The menopause support group is now a monthly session held at work and has been ever since.

Treatment options

Now, I will be honest. It wasn’t until March 2024 that I went to my doctor to discuss my symptoms. I thought I could push through them, and physical symptoms as mentioned were manageable. But I desperately needed help with my anxiety and sleep deprivation as it was really beginning to take a hold on my work and personal life.

The doctor was wonderful, very compassionate and understanding. She recommended I start on SSRIs (selective serotonin reuptake inhibitors), a class of antidepressants that work by increasing serotonin levels in the brain to help mood, sleep and emotions. I was prescribed Sertraline which I started on immediately. I was always a little dubious about using medication to help my mental health but I could not allow it to take control any longer.

I also started therapy. Sadly, the waiting list through the NHS was too long so I did pay for it privately but it was worth it.

Change in career focus

Unfortunately, I also realised that as much as I will always love pets, my passion for nursing had dwindled. I didn’t feel the same about it as I did when I first became a trainee vet nurse in 2000 and as much as I tried to search for the passion I once had, it was no longer there.

I stopped working weekends as a nurse and dedicated more time during the week to my students. I provided more group sessions at work on mental health awareness, anxiety and well-being. I realised the more I worked with my students and the team, a fire started to ignite in me again, but this time it wasn’t for nursing, it was for people.

I love helping people, supporting them, being there for them, nurturing them and empowering them.

I had felt strongly about helping people for many years but it had never truly developed into a passion for me until I started to focus more on myself and my own self-care. Only then could I give the best of me to others including my family without the detriment of my own well-being.

Whilst I am not involved in the clinical aspect of nursing as much these days, I still dip into it now and then, mostly when training students. I did feel sad for some time that my passion for nursing had gone but I have realised that it was simply time to make some changes and nursing was no longer part of my journey.

My passion for people has grown in so many ways. I am a mental health first aider. Clinical coach/supervisor for all the nursing students. I support the nursing students not only with their journey to becoming an RVN but in their personal growth. I am currently studying a diploma in life coaching in the hope that I can continue to empower not only nurses, but anyone within the veterinary industry in achieving their goals and aspirations.

My self-care journey is still ongoing to this day and I allow myself the odd ‘wobble’ so to speak. I am also on HRT (hormone replacement therapy) which I started in July 2024 to help with my physical and mental symptoms. I still suffer from the physical symptoms but they are not to the extent I suffered with prior to starting the treatment. This story is only the ‘tip of the iceberg’ of what I endured over the last couple of years.

For those of you reading this and relating to my story, please do not wait to seek help like I did. Talk to someone. Vetlife, a friend, a colleague, a doctor, anyone who can support you and your journey back to self-care and finding you. You owe it to your amazing self to put your needs first.