Somewhere around 44, I noticed my heart doing this weird fluttering thing at random moments during the day. It could happen when I was standing at the grocery store just getting something from a shelf. Or, sometimes it happened while I was watching TV. No warning, no real rhyme or reason.

Then I consulted “Dr. Google” one late night at 11pm and diagnosed myself with three different heart conditions, and the possibility of a couple of others before turning off my iPad and deciding that I was just too tired to care at this point.

But it turns out it was perimenopause.

Here's the thing about perimenopause: everybody knows about hot flashes and irregular periods. That seems to be the the starter pack for perimenopause. But the actual symptom list is actually pretty long, can be random, weird, and half the time doesn't sound remotely hormonal, which is exactly why so many of us spend years thinking something else is wrong with us.

So consider this the list nobody handed you on your way out of your 30s.

The ones that actually surprise people:

That's sixteen. But wait…There are more. The point isn't to memorize a list, it's to recognize the pattern: if a handful of these hit around the same few years, hormones are worth putting on the suspect list before anything else.

Why this list even exists

Estrogen isn't just about periods. It has receptors all over your body, in your brain, joints, skin, gut, even your gums. When it starts fluctuating unpredictably in your 40s, the fallout shows up in places that have nothing to do with reproduction, which is exactly why so many of these symptoms get dismissed or misdiagnosed. A recent survey on perimenopause found that nearly all women in this stage report crushing fatigue as a top complaint, not hot flashes. Fatigue doesn't scream "hormones" the way a hot flash does, so it gets chalked up to stress, aging, or "just being busy," when it's often the same root cause.

What to actually do with this info

Bring the list, not just one symptom, to your next appointment. Doctors are trained to treat isolated complaints. A cluster of seemingly unrelated symptoms that all showed up around the same time in your 40s is a very different conversation, and it's one worth having on purpose.

I never did get a straight answer about the heart flutter until I mentioned it in the same breath as the fatigue, the brain fog, and the fact that I'd started crying at Hallmark channel commercials. Suddenly it wasn't six random complaints. It was one very obvious pattern, and somebody finally said the word out loud.

Turns out the canned food aisle wasn't trying to give me anxiety. My hormones were just a roller coaster.

There was a time when leaving the house meant you were simply gone. No phone, no text. No location sharing. No little dots showing somebody was typing. No expectation you'd respond in five minutes because your phone was obviously within arm's reach.

You just left. Nobody called the police because you hadn't texted back. There was usually a vague plan. "Going out with Lisa tonight." "When will you be home?" "Later." Somehow, that counted as a legitimate answer that nobody questioned.

The landline had one very useful feature nobody appreciated at the time: you could walk away from it. If someone called and you weren't home, they simply didn't reach you. They might leave a message on the answering machine, if you had one. And somehow we all seemed to be okay with this.

Now, being unavailable requires an explanation. We carry the notifications everywhere: voicemail, text, Messenger, then the follow-up. "Did you see my text?" Yes. I saw it. I was enjoying the revolutionary experience of having a day and not responding immediately and participating in my day.

When Did Being Reachable Become a Full-Time Job?

I love my phone. I like knowing where my daughter is, using Google Maps, reaching someone fast in an emergency. I'm not throwing my smartphone in the trash any time too soon and going back to rotary dialing.

But somewhere along the way, we accepted that carrying a communication device means everyone has access to us whenever they want it. That part I'm really not sure about.

Because here's what we didn't know we had: stretches of time when nobody could interrupt us. You got up, drank your coffee, and were simply inside your own day. Nobody wrote books telling us to be mindful. Being unavailable was just how life worked. If you were at dinner with someone, the world couldn't electronically barge into the conversation. If you drove somewhere, you just drove there, and listened to the radio while you did.

We Were Allowed to Be Bored

Standing in line. Waiting for a table. Sitting at a red light. You didn't fill every second, you just stood there and let your brain wander. At breakfast, you'd read the same cereal box for the fortieth time because it was simply what was in front of you. Boredom occasionally produced something: an idea, a memory, a solution to something you'd been chewing on.

Now the phone comes out the second nothing is happening. Scroll, check, refresh, repeat. I'm not convinced we're better off for it.

There's also a strange guilt attached to communication now. Someone texts, you see it, you don't answer, and the unanswered text becomes a tiny obligation trailing you around the house. Congratulations, you now run a correspondence department. But maybe not answering isn't rude. Maybe you're working, or tired, or just don't want to talk. That used to be allowed. I think it still should be.

Don’t Get Me Wrong…I'm Not Suggesting We Go Backward

Getting lost was actually getting lost. If your car broke down, you'd better hope there was a pay phone nearby. I'm not romanticizing all of it. Because sometimes it was downright inconvenient or dangerous when you couldn’t get to a phone. I'm just saying gratitude for modern technology doesn't require handing over every minute of our attention.

So maybe being unreachable deserves a comeback. Not dramatically. Nobody needs to announce a digital detox or move into a cabin and churn their own butter. Just stop treating every notification like a summons. Leave the phone in another room. Finish dinner before you answer the text. Let somebody wonder where you are for a while. We managed it for decades. They'll be okay.

So if you text me and I don't answer right away, don't worry. I'm probably just pretending it's 1987.