Saturday, June 16, 2012

The Difference Between a Flush and a Hot Flash

In the book Fifty Shades of Grey, Anastasia Steele devotes a lot of time to flushing. This is not even close to one of the book’s themes.  I would probably not have noticed this particular feature if I did not have carcinoid cancer.  Skin flushing is a sudden reddening of the face, neck, or upper chest. Flushing is a normal body response that may occur when you are embarrassed, angry, excited, or experiencing some other strong emotion.  In the above book, Anastasia’s flushing is due to these reasons.

I started flushing in my mid-40’s; not very often – maybe once every 2-3 months. It would occur for a few minutes, almost always at mealtimes - either breakfast or lunch.  Since this was a seemingly random occurrence and I was starting to experience perimenopausal symptoms, I thought that the flushing was part of this hormonal change of life.  I could feel burning and the heat flow up to my face.  I could tell I was red even if no one said, as they sometimes did, “Wow Beth, your face is quite red”.  It was clear and noticeable but it only lasted a few minutes and then it would not recur for a few months.  There was no sweating involved, just a stinging/burning feeling, similar to getting slapped.   After a few instances of this flushing- and having some friends say that they don’t think it is from perimenopause - I considered that I might have a food allergy since it only happened around mealtime.  I tried to remember what I had eaten that would cause this flushing but I was not tracking closely. There did not seem to be any trigger foods. 
 
Below is a picture of me and my Aunt Judy – we had gone to lunch to celebrate her 80th birthday.  This was in 2010, right around the time of my carcinoid diagnosis.  I am clearly red and it is right at lunchtime – a typical occurrence for me.


I started taking Sandostatin LAR in January 2011 and I have not had a flushing incident since, at meal or any other times.  I still get red and sweaty at the gym, as I always have. This redness is accompanied by sweating so I do not consider this flushing. 
  
I did not get the typical menopausal hot flashes until about 12 months ago at age 52.  This feeling is quite different than a flush.  When getting a hot flash, I get immediately sweaty, mostly around my hairline and neck and this can spread so that I feel sweaty all over.  The hot flashes seem to be worse when the weather is warm – i.e., they seem to take a break during the winter.  Hot foods, such as soup and tea can also exacerbate them.  I have moved to iced drinks instead of hot ones.  I also have hot flashes at night and they can disturb my sleep.  There is no flushing or redness associated with my hot flashes.
 
My ob-gyn said hot flashes can go on for 5-10 years and that it is good to wear layers so you can take them off, have heavy and light blankets on the bed so you can shed them and if you use an electric blanket, make sure it has dual controls.  I feel like my internal thermostat has gone haywire as the hot flashes can happen at any time with no notice.  This is quite normal and all my female friends in the same age range are having some version of this so we can all gripe together.

I think it is important to understand how to recognize flushing versus other symptoms.  Suntans, regular blushing/flushing as described above, rosacea or other conditions might cause you or your health care professional to think you are flushing due to carcinoid when you really may not be.  Alternatively, flushing due to carcinoid can be mixed up with other conditions as well. 

10 comments:

  1. Dear Beth,
    THANK YOU!!! I have spent the better part of the past week searching for some help discerning a hot flash from a flush. I was unable to find it until I happened upon your blog, and I want to say thanks, friend!

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  2. Beth,

    I too have carcinoid cancer. But I were also had ovarian cancer so my symptoms reversed. I had the menopausal hot flashed starting in 2002 and could never seem to get my hormone replacement adjusted properly. I also had the mealtime flushing. During one of my visits to receive hormone implants they saw the complete flushing episode. This was 2008. The nurse took my blood pressure and it was 190/110 and then when to flush was gone it was back to normal. I also took my temperature during one of these flushing episodes and it raised 4 degrees and then returned just as quickly.

    I was officially diagnosed with carcinoid in 2009 after a series of 9-11 different test and procedures. I was treated with surgery and do not take any of the sandostatin's.

    After the surgery till about early 2011 the flushing episode were almost nonexistent, they are returning. Slowing I can see each one become stronger. The redness is now in my face, neck, shoulders, arms, chest, back and abdomen. Before surgery the redness made it to my legs.

    There is a difference between HOT FLASH and FLUSHING.

    Good luck to all who have this amazing disease.

    Janet

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  3. Kristen Stewart is perfect actress to play anastatia steele.
    Anastasia Steele

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  4. I have had about 5 flushing episodes in 2 months, always in the middle of the night, always on a weekend, always with diarrhea. I was prescribed an Epipen, but am thinking this may be more than just flushing or an allergic reaction to an unknown item. Anyone else have diarrhea with flushing? My episodes last about 30 minutes and I take Benadryl to relieve them. The one time I didn't take Benadryl I passed out.

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    1. Hi Julie! I just came across your reply while researching flushes for my own symptoms that a doctor is concerned about. I know it is almost a year later, but I hope you saw the appropriate doctors. Flushes with diarrhea can be a sign of cancer. Particularly medullary thyroid cancer. Saying a prayer for you that it's just coincidental symptoms, but those two together are specifically listed as the only real warning signs. May God Bless you and keep you healthy!

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    2. By the way...My name is Tammy. It came up as Unknown. Not sure why it didn't register under my Google account.

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    3. Please see a NET Neuroendocrine specialists. Sounds like NETS aka Varcinoid syndrome, especially with the diarrhea.

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  6. I had diarrhea gas pains and a distended belly and then I could feel the heat in my face I looked in the mirror and my face was beet red. I am 45 years old at the same time I thought I might be perimenopausal. After the diarrhea subsided same day I started bleeding again I had a second period this month which I've never had happened before. I am very worried as I put my symptoms and WebMD and they said carcinoid syndrome which as you know is related to the cancer. However, I also researched perimenopause and hot flashes and they said hot flashes can either be wet or dry associated with the hormone changes of perimenopause so I'm concerned as I am alarmed now that you definitively said a hot flashe is different than a flush because a hot flashe is ALWAYS sweaty and wet. whereas, a flush is not. I think it may differ from person to person. At least I hope so.

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  7. I've had all the symptoms of carcinoid for about 9 years, maybe more. Diagnosed as IBS but have the diarrhea, trouble breathing, lightheaded. I thought that was histamine intolerance, but now flushing has started. It is the same as hot flashes I had just at the first of menopause. I have been through menopause for about 15 years now. My flashes are beet red neck and chest and zero sweating. Very frustrated and still feeling miserable. I have a dr. appointment next month.

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