HIM: If you've been eating well and exercising as you report, it's not clear why you continue to be in the obesity bracket.
HER: I thought 'bracket' was a March Madness thing.
HIM: Yes. It's also a term for me to categorize the weight of my patients.
HER: I'm in a new category, I guess!
HIM: It's harder to lose weight as you get older.
HER: I've battled weight forever. This is new. It's in the middle. My middle used to be the best part of me.
HIM: Common menopause symptom.
HER: It can’t be menopause. I'm thirty-nine!
HIM: My notes show that I encouraged you at your last visit to take a look at online webpages for aging women…In light of your lack of initiative, I can tell you that perimenopause can affect women in their late thirties to mid-forties.
HER: “Can” seems vague. Maybe I just need a test to check for gluten intolerance.
HIM: It’s tempting to want to fight Mother Nature, but there’s no cure for the inevitable maturing trajectory. Luckily, decreasing stress has proven helpful.
HER: Stress is unavoidable when you have perimenopause symptoms early.
HIM: Studies show that parenting late in age causes symptoms to be exacerbated. I’m not sure if that impacts you or not, as I’m not your gynecologist.
HER: I wanted kids younger. But…no partner then.
HIM: The trend in women waiting until later in life to parent while they focus on the self is liberating, undoubtedly. But your body may not know the difference between your dreams and reality.
HER: That seems harsh.
HIM: I had a patient who waited until she was fifty-three to have her first child. A year later, I removed a tumor the size of a grapefruit from her uterus. The cancer got her anyway, died when her child was five. But she’d spent time abroad in her thirties.
HER: I’ve had three miscarriages.
HIM: That story checks out.
HIM: It's common for older women to lose babies.
HER: I thought maybe it was harder for me to conceive because of my abortion.
HIM: Possible. The body does not like reproductive betrayal.
HER: I’d also thought it was because I lost my period back when I had an eating disorder.
HIM: Combination of factors, then, stemming from self-destructive tendencies. You'll let me know if I can help you with anything else today.
HER: I’ve had this chronic pain in my right shoulder. It makes it hard to sleep. I’m sure you’ll tell me that sleep is important for weight loss and perimenopause stuff.
HIM: The ideal sleeping position is on your back. Sleeping on your front increases digestive disorders. Sleeping on your side increases upper body pain.
HER: I have to sleep on my side because I'm on the sofa because I moved into a studio after I left my husband.
HIM: The financial struggles of marriage and domestication can be neutralized with the help of a counseling professional. This region has many that are renowned.
HER: I'm not married anymore. I literally said.
HIM: For the next time, if there is one. Online dating services can assist in that. You may already know, the pool shrinks as one ages.
HIM: I would tell you to pursue chiropractor services while you save money for an improved sleeping arrangement, but you have an HMO requiring referrals. That’s a long process.
HER: That's a shame.
HIM: Here's the flier with the food portion guidelines and reminder to practice breathing deeply.
HER: Thank you. See you next year.
Liz Lydic’s work has appeared online in McSweeney’s, Typishly, Rougarou: A Journal of Arts and Literature, Little Old Lady Comedy, and is upcoming in Ruminate Magazine. She was a finalist in So to Speak’s 2022 contest in fiction. By day, Liz is an Admin for a municipal hazardous materials program in the Los Angeles area, where she lives with her daughter.