Ugh, will it EVER get light today?

Answer, No, if the weather forecast is anything to go by. We are set in for a day of 8/8 cloud cover and day-long drizzle. Should be fun walking the dog in this...

Like many people in the northern hemisphere, I suffer from SAD - Seasonal Affective Disorder. You may know already if you've got this  because it means you basically want to hibernate all winter - you can't wake up, you can't keep your eyes open, you can't get enough sleep no matter how much you sleep, you eat lots and gain weight, and you generally feel low and depressed. Uncontrollable, reasonless weeping is another clue. February is about the worst month, but December and January are no picnic either.

It was my doctor, some 12 years ago, who noticed the connection between my depression and winter. As, once again, I sat in his office, weeping and sniffling, he looked thoughtful and started tapping into his computer. "Do you realise?" he said, "that you come in for your anti-depressants every year between September 15th and October 15th? It's like clockwork. When do you stop taking them?"

"April," I said. "Come to think of it, it's April every year."

On that occasion, I departed from his office with a prescription for MAOIs - the old-fashioned type with which you couldn't eat yeast and red wine and Twiglets, but the connection with winter was too strong to ignore so I decided to buy a lightbox. Like many people, I'd heard about them but been put off by the price - even then they cost over £300 and good ones haven't gotten a deal cheaper, considering all it is, is a box full of daylight-spectrum bulbs. But just a few days of using it and I was feeling like a different person.

Since then, I've managed without anti-depressants in winter but instead chosen to deal with my SAD by other means. Firstly there is the lightbox, to which I am glued like Linus with his blanket all winter, and even on dull days in summer. For years, it was set on timer to come on at 5.45 in the morning, right behind my head as I lay in bed, and I would then sit and read till about 7.30, then get up and go about my day - leaving for work at 8.00 or 8.30. This was enough light to keep me going throughout the working day, but now that I work from home, so I have my lightbox set up on near my workstation and it's on all day, but set a little further away.

The cats love this thing - in fact I've lost one to a cat snuggling up to it and pushing it off the desk.

In case you've never seen one, a lightbox gives out 'full spectrum' light that imitates daylight. It's a bright white light that is very strong - usually about 10,000 lux - and you have to sit within about 18 inches to get the full benefit. The further away you sit, the longer you must use it.

Our second mode of attack is to have daylight fluorescents all over the house, particularly in the office, where there's a bank of five of them. Daylight fluorescents aren't full spectrum but they're a good blue light that makes you feel like you're in the open, as opposed to the greenish pall of normal fluorescents.

Nowadays, to rid myself of that sluggish got-to-hibernate feeling in the mornings, I also have a Lumie Body Clock. This comes on gradually, like dawn, over the course of 90 minutes and the theory is that by the time the alarm actually rings, you're properly awake. It is a hell of a lot better than being woken by the alarm - you wake up gradually and naturally, as if being woken by the sun. Like the lightbox, it gets the feline seal of approval and half the time my view of it is blocked by a cat, soaking up the false dawn. If you live in the US, there are daylight alarms by Hammacher Schlemmer that even wake you up with nice smells, but sadly these aren't available in Europe.

One further trick for banishing winter is kind of corny, but it also works - birdsong on a CD. I keep this playing all day long in winter, and so cozy and bright is our office, with its yellow blinds, tweeting birds and brilliant lighting, that it can be a real shock to walk out onto the landing and find it's a dark winter day outside.

The final tip, if you have an IPhone, is to download a background sounds app. Rather than an alarm clock, these days we're awoken by 45 minutes of dawn chorus that sounds totally genuine, followed, at 8.00, by the sound of a Japanese wooden flute. A better way to greet the day... 

As I am now well and truly in pre-menopause, I thought it was time I dealt with some of the issues surrounding it. So number one on the list is the dreaded hot flush.

My mum suffered terribly with these, for about 10 years. We'd be walking round town and she'd come over hot and faint, dizzy and sick, and have to sit down. I got very used as a young girl to dealing with her, as she used to panic in these moments. She began her menopause young, at 36, with the whole thing finished by 40, but her flushes continued for years.

Since we are very similar types physically, I was rather dreading going through the same routine, but my early menopause has been shelved by 15 years of the Pill, so I reckon I'll only be having it a couple of years younger than most women.

The hot flushes are a bitch, though. I was troubled with them briefly a couple of years ago and took Evening Primrose Oil for a few weeks until they went away, but they returned with a vengeance a couple of weeks back, and this time they were pissed off.

No-one ever told me that they feel like the flu. Not 'hot', but a raging torrent of intense, burning fever, with your heart palpitating and your head pounding, something like a panic attack. They were coming every 50 minutes and lasting about four minutes, which was taxing, to say the least - no sooner had I got over one then another one was up on the horizon. 

Increasing my dose of EPO didn't work, so I began to search around for other solutions. I can't have HRT, and would be wary of it even if I could, so I asked around my older girlfriends and came up with two herbs - Borage oil and Black Cohosh. The Borage oil has worked pretty well and the little sods are now down to 2-3 weak flushes a day, of short duration, and about the same at night. 

The night issue is a thorny one, though. I invested in some wicking pyjamas (review to follow), which are great, but suddenly both our memory foam mattress topper and our goose feather duvet seem impossible to tolerate. I haven't quite decided on the solution yet, but I think it might well be a wool topper (the memory foam needs replacing and the DH has always hated it), and a wool combination duvet for its better wicking qualities. 

Will report back. 

Today I underwent an ultrasound-guided breast biopsy, so thought I would write it up to explain what's involved, in case any of my readers has to go through it.

Why

The reason is that a change to an existing cyst was found on my annual mammogram. It may or may not be something to worry about, but there's no way of telling without taking a tissue sample, so the next step was to have the biopsy. 

Before the procedure

I was given a drug called Atarax to take on the evening before the procedure, and again on the morning of the procedure. It's an anxiolytic - reduces anxiety - but also an anti-histamine and reinforces the pain relief. It absolutely knocked me for six, and I was warned that someone else would have to get me to and from the hospital. I also had to have a blood test the week before, to check that I coagulate properly, which might be an issue for some, and you can't take any form of aspirin-like drug, which might cause bleeding. 

How to prepare

The morning of your biopsy, don't use any perfume, deodorant, talc or lotion on the relevant breast or armpit. These can cause 'artefacts' and skew your test results. Wear a bra, as it helps to hold the dressing in place, and take a squishy coldpack with you, to apply afterwards. I wore a sports bra, which is both soft and supportive. You obviously have to remove the upper half of your clothing, so a skirt and top is the easiest clothing - getting into a comfortable position is more difficult in jeans. I wore a knit skirt.

What happens

The kind of biopsy I had was ultrasound-guided, because the lump was fibrous. If it's more of a hollow or fluid-filled cyst, you might have a fine-needle aspiration done instead, where a long, thin needle is pushed directly into the breast, without anaesthetic, and a fluid sample taken. 

In the ultrasound-guided procedure, you lie on the couch and have your normal ultrasound examination, so the radiologist can see exactly where the lump is, then you have to get into a position where he or she can use the ultrasound device at the same time as inserting a needle. 

My radiologist was male, and assisted by a female nurse. I was asked to lie on my side, then twist to about a 45 degree angle, with my left arm above my head. This was quite difficult and I was glad of the yoga session I'd done that morning. 

After being cleaned with alcohol, then dressed with betadine, my breast was covered with a disposable sterile paper sheet with a hole in it, to isolate the wound site. The lidocaine injection stung like a bee, but didn't last long, and then the radiologist pushed and prodded around a bit to spread the injection fluid. This didn't hurt, but you do feel a bit like a piece of meat. 

One thing that did amuse me a bit was that he put the ultrasound device inside a sterile rubber glove in order to use it. 

Then a small cut was made through which to insert the biopsy needle. This is ENORMOUS - like something you'd expect to use on a horse - which was slightly alarming. Although it is about a foot long, most of it, however, is holder - the needle itself is about five inches long, and it goes up and down, grabs some tissue, with a loud clicking sound, and then withdraws. You don't feel any of this, and it isn't reinserted each time, put pushed through a cannula-type device that remains in place in the breast.

Three tissue samples were taken in my case, and each took about a minute (little bits of bloody tissue were dropped into sterile pots, yuk), then the cannula was withdrawn and the radiologist applied a lot of pressure to stop any bleeding. The wound was then dressed with a clear dressing, something like clingfilm, which I can shower in (though I won't). 

I then got dressed and went and sat in the waiting room for about ten minutes, and then my dressing was checked to ensure there was no bleeding. The radiologist was surprised that I'd brought a coldpack to prevent a haematoma, but said it was a great idea, and I've been glad of it as the day has worn on. I haven't needed a painkiller yet, but will probably take one for sleeping.

Afterwards

I now can't do any lifting or sports for two days, though I can go swimming on Thursday evening as usual - the dressing can come off on Wednesday.

So, I now have a week or so to wait for the results, and will go back for another consultation the week after next.

Yesterday was a scorchingly hot day in Normandy - about 31 degrees in the shade, which made it the hottest May day since 1953, according to Meteo France.

A good day, then, to decide to do a 7km hike? Well, maybe not. I'd planned a riverside walk, through woods, in the shade, but a field of cows and my dog wasn't good combination, which meant a detour down some very hot, dusty, unshaded roads in full and blinding sunlight in order to get back to the river. 

Nevertheless, we ended the day feeling fine and the reason was that we had enough water. A litre (with a little salt) on each of us, and another two in the car.

How much water do you need?

The worse advice I was ever given, about 15 years ago, was to only drink when I was thirsty. I've got used to simply ignoring thirst - I simply don't recognise it when it occurs. If I only drank when I was thirsty, I'd never drink at all.

And telling someone 'eight glasses a day' isn't much help either. Assuming that's an 8oz glass, that's 64oz of water a day. But not all people, whatever their weight or lifestyle or location, need this exact same amount of water. 

Better methods are to drink until your urine runs clear, or to calculate your needs by body weight then amend for lifestyle and diet. If you're not active, you need half an ounce per pound of body weight, and if you're active you need more, which means that at my current weight, 133 pounds, and only moderately active, I would need 8.3 glasses of water per day. That equals 1.8 litres.

Unfortunately, I know from bitter experience that if I drank this little water, I could kiss goodbye to a bowel movement for EVER. The causes are that I like a glass of wine with meals, I have coffee for breakfast, I walk a brisk 3 miles every morning and I follow a high-fibre diet. All of these things mean I need more water.

You too may need more water if you do ANY of the following:

* Live in a hot climate. 

* Eat high-fibre foods such as wholewheat.

* Eat dried foods such as dates and raisins.

* Eat a lot of cheese. 

* Eat a lot of starchy foods such as root vegetables.

* Take daily exercise that makes you sweat. 

* Drink alcohol or caffeine. 

* Take saunas or steam baths (this one is never listed, but they make you sweat - you need to replace this lost water). 

As you can see, the average Western lifestyle might lead to you needing more water than you might realise.

Signs you may be dehydrated are:

* Headache. At the first sign of a headache, try a good glass of water rather than a painkiller. 

* Heartburn. 

* Unspecfic pain such as low back pain. 

* Constipation. 

If you have any of these symptoms, start first by modestly increasing your water intake by half a litre a day. Don't overdo it, as your kidneys need time to adjust to the extra work they'll have to do. The main reason people have become ill from too much water is drinking too much at one go.

What if you hate drinking water?

On the bright side, 'water' can be found in forms other than 'water' as such. Fresh fruits and vegetables are generally pretty high in water, especially above-ground veg such as salads, broccoli, cauliflower, peppers, courgettes and aubergines. Herbal teas can count towards your water intake because they don't contain caffeine, and so can modest amounts of fruit juice (that word was 'modest'). But don't count drinks with caffeine, or fizzy drinks (sodas). In fact, if you can, cut sodas out of your life - your body will thank you for it.

Obviously, 'wet' meals such as soups and stews have a lot of water in too. But if you follow a diet of white-bread cheese sarnies and chips with a beer, watch out...

How to work it out

It took me some time to work out a method of water consumption that worked for me, but here it is.

* I calculated my needs by body weight = 1.8 litres. 

* I added up the things in my lifestyle that can cause dehydration and there were three major ones: exercise; high-fibre diet; alcohol/caffeine intake. 

* For each factor, I added back in half a litre of water. 

Total = 3.3 litres of water. This is about what I drink a day 'as water', and it seems to work for me. Others may find they need more or less. But yesterday I drank over 6 litres because of the heat and I needed every bit of it.

How to get it down

Personally, I find plain water quite difficult to drink, and having sips during the day, as you're recommended to do, just doesn't work for me. I suffer from reflux, following a car crash, and if I sip all day, it gets much worse. Instead, I drink my water at set intervals throughout the day. I also drink it warm, which makes it easier to get down, and with a little cider vinegar added for both flavour and for health reasons (it's anti-inflammatory). It goes like this:

* On rising, two 400ml glasses.

* An hour later, following exercise, two 400ml glasses.

* Before lunch (about 12.30), two 400ml glasses.

* Before dinner (about 7.00pm), two 400ml glasses.

Total = 3.2 litres.

Plus, I drink:

* Water during the day if I feel thirsty. 

* After dinner, a pot of herbal tea. 

* Nothing after 9pm at the latest (to prevent reflux). 

This is the method that works for me, but I can't stress enough that people must listen to their individual body's needs. I drink a LOT of water for my body weight, and others may not need to. But if you suffer from constipation, or headaches, or back pain, do think first and foremost of drinking a little bit more.

Came across a concept here that I find kind of strange - 'gaining'. People who want to gain as much weight as possible.

Rather like trying to lose as much weight at possible, this seems rather unhealthy to me. I would imagine that it's better to stay at a stable, natural weight for your height and level of activity rather than beating yourself up one way or the other. And surely deliberately making yourself obese will kill you in the long run?

Still, interesting reading, especially for anyone who's ever felt browbeaten by the diet brigade - so many women diet down to 7-10 pounds lower than they're really happy with, and some gainers, it would seem, eat very healthily, just too much of it.

Weight, though, is one of those things that is always a question of balance. For instance, I gained about seven pounds over Christmas. This is normal - I gain at least this much every year, then shed it again in the spring. But this year I kept an eye on it because last year I gained 27 pounds, due to the winter being very cold - and I didn't manage to shift it all.

A modest amount of winter weight gain, I always feel, is a natural process, and one that I observe with my animals, who all plump up quite deliciously in the winter months, then get skinny again as soon as the weather gets warmer. 

But only when the weather is crying out for salads and gazpacho will losing weight be a natural process, not a starvation diet. And the kinds of 7km walk I did last Sunday also help it to drop off fairly easily.

For me, the balancing act is that I look my absolute best at 8st 3lb (optimum weight for my height), but can't be arsed because that means watching every damn thing I eat. At 8st 12lb I can eat everything I like, but feel a bit too flabby. Maybe 8st 7lb will be a good compromise this summer - and the good news on that is that suddenly a whole raft of my clothes that didn't get worn last year would become available again as if they were new.