Thyroid Update

I saw my endocrinologist today for the first time in two years. Since my last appointment, I'd mostly been euthyroid, meaning that my thyroid decided to start acting like a normal thyroid and do it's job properly. Then suddenly last year, it decided that, no, it was tired of that shtick and would be a slacker again, thank you very much. So we'd been keeping in contact via phone calls and faxes.

Since I worked at a hospital and had easy access to a doctor, I got the doctor in my department to order the lab tests I needed and got the blood draws I needed while I was at work. Then I just faxed the results to my endocrinologist. She'd called me, let me know her thoughts, adjust my meds, etc. Lather, rinse, repeat.

It wasn't SUPPOSED to be two years lag time between appointments, but her office is out in the 'burbs, not easily accessible via public transit, and she's kind of a pain in the ass to get to. But, you know, not having a job kind of made that easier. Yay, I guess. Heh.

My thyroid levels are great, and my thyroid itself (she always does an ultrasound) is small (which pleases me in a ridiculous kind of way) and abnormal, but in a normal kind of way, given the kind of thyroid disease that I have.

However, she's worried about my sugar levels. I had a random mid-day glucose level several months ago that was 144 (normal is under 100). So she had me do a fasting blood test last week. This one came back as 98. But my HA1C (this gives you a six-month history of your blood sugars) was 5.7 in July. The range for at-risk for diabetes (what the CDC used to call "pre-diabetes) is 5.5-6.4.

So since I'm JUST under the norm for glucose AND I'm in the range for "at-risk for diabetes" AND I'm in one of the high risk ethnicities for diabetes (hello, one of the downfalls of being Asian) AND we don't know my family medical history, we're choosing to be very conservative about this.

As soon as she said this, I said, "Yes, I need to weigh less, watch what I eat, and exercise more." She smiled and said, "Clearly, you've heard this before." I said, "I have, but Doctor, here's the thing. It's very frustrating. I worked REALLY hard and lost 14 pounds before I even met you. Then I got the thyroid problem and gained it all back plus two pounds. And I won't tell you that word I used when that happened, because it wasn't polite. And that's how I got diagnosed thyroid. Then you stabilised me. I joined Weight Watchers, and I lost 10.4 pounds. Then I suddenly gained it all back. That's when I realised my thyroid problem was back again. I'm not trying to avoid responsibility for my health or my weight. In fact, I've tried REALLY hard and worked REALLY hard to BE responsible, but I feel like my thyroid sabotages me EVERY time, and that's really freaking frustrating."

So she told me that for awhile, since my thyroid is erratic, we're going to test my thyroid levels every three months to keep a closer eye on it. So instead of being REactive, we can be PROactive. So instead of gaining 10-12 pounds and then knowing that my thyroid is acting up because I'm gaining weight, we can know that my thyroid levels are off and that I MIGHT gain a couple a pounds if I'm not careful in the coming weeks. And she talked to me about taking control of my thyroid and not letting it control me.

In the end, I felt like she really listened to me and that we made a plan together that made sense.

WIN!

More sick stuff

For those of you who are tired of hearing about me droning on about being sick, skip this post. And as a buffer, here's a pic to protect you from the sick wank.


Okay, now, for the rest of you.

Here's an idea of how I'm doing these days.

Yesterday I went grocery shopping by myself. On the way home, I passed a road sign. A road sign that has been there for years. It hasn't changed. Nothing different about it. Yet it made me cry. What was it? Just a sign that read:

Walt Whitman Bridge
No Toll in This Direction

I have no idea why it was so tear-inducing. It was JUST SAD!!!!! As I said to my therapist today, "It's like, you can just get on the bridge and go and no one cares and there's NO TOLL!"

Go figure.

But here's the overall trip in the nutshell: Go to Target. Find out there are no frozen foods. Go slightly postal on manager. Go to grocery. Find adorable toddler to smile at and wave to. Chat with toddler's mom. Get teary-eyed about how cute the toddler is. Forget cheese. Park cart to get cheese. Lose cart. Pass random cart and note that shopper bought same taco sauce I did. Panic that I lost my cart. Pass same random cart and note that shopper also bought same same taco shells I did! Wonder how the fuck loses a cart in less than three minutes. Pass same random cart and note that shopper also bought the same BREAD I did... oh. My cart. Cry in dairy aisle. Check out behind toddler and mom. Smile at how cute toddler is. Pull self together. See bridge sign. Cry on way home.

At work, I am grateful for my theatre minor because I feel like I pull off the Greatest Acting Job ever. I have started to isolate from friends more because I feel like they can't possibly be able to stand one more story about how depressed I am or how tired I am or how sick I am or how sick and tired I am of being sick and tired.

Once I get home, I'm so exhausted from acting at work all day, I just Come Undone. Completely.

Although, I did have a victory this weekend. Despite my best efforts, I was unable to sell my spots in my Wendy Johnson sock classes this past weekend. So I went. It was hard. And exhausting. And frustrating. And annoying. I can't say that I'm completely happy that I went, but I don't completely regret it, either. This, my friends, is a victory.

I would like to say one more thing, especially to my local friends. I know there are many of you experiencing Life right now. Losing jobs, losing relationships, moving, etc. And I wish I could be there for you. And I'm trying. And I'll be there as much as I can. But I refuse to promise more than I KNOW I can deliver. I will, however, promise to do what I can.

And, as always, I do love you.

Sick and tired, literally

Apparently, my Vitamin D levels are so drastically extremely severely low that my PCP and my endocrinologist felt the necessity to call me and let me know how dire things were. My Vitamin D is 13. Bare minimum people should be at is 32.

My doctor said that at this level she generally puts people on prescription D, but since it's mid-July she's going to try something else. She wants me to try 3000 IUs (international units) of Vit D per day (for comparison, the RDA is 400 IUs) and a minimum of ten minutes of "midday summertime sun" per day.

I spoke to the pharmacist today and he recommended getting 1000 IUs and taking them three times a day, with fatty foods. WITH FATTY FOODS! A silver lining! For those of you playing the at-home game, this now puts me at popping twelve pills a day. And that doesn't count the "as needed" meds for my allergies, asthma exacerbations, nocturnal leg cramps, etc.

The issue is that not only is vitamin deficiency generally not good, but the intersection of vitamin D deficiency and thyroid problem is particularly bad. So that's why all the arm flailing and phone calls between doctors in the past few days. Also, the severe deficiency tends to explain the ongoing achiness, fatigue, and depression despite the thyroid levels getting better. This makes me happy because it means that (1) there's a reason and (2) my most excellent doctor went looking for a reason for my continuing complaints of general malaise.

Now, for the good news:

My glucose is just barely elevated, but this should come down as I lose weight, which is expected to happen as my thyroid levels are controlled. My A1C is 5.9, which is the cutoff for the acceptable range. This gets me out of the pre-diabetes range (YES! this is a major victory, as this is why I went into Weight Watchers), and this is expected to keep going down as my thyroid is controlled. Seriously, folks, MAJOR VICTORY here.

My overall cholesterol is good, although my triglycerides were jacked, but we think that was due to the non-fasting test so no one is panicking. The HDLs were a bit low, but this should also change as the thyroid is controlled, I'm less fatigued, and can exercise more.

Also, Dr. Second Opinion called me Saturday morning. He confirmed that the ultrasound showed absolutely no pathology whatsoever. He sounded as frustrated and annoyed about this result as I am, which pleases me (which may be warped). He said that, unfortunately, we may have to wait for the next episode. If it happens when he's in his office, I'm to call him and come to his office immediately so he can examine me and figure it out post-haste. If it's after-hours or on the weekend, I'm to go to the ER (I've already decided I'm going to his ER). Although this might not sound like good news, I like that (1) he called me on the Saturday of what was supposed to begin his two-week vacation and that (2) he seems just as determined as I am to find an answer.

Hashimoto's

The first thing I did when I went to work today was to see if my lab results were back yet. They were, and it was a good news/bad news situation. The bad news is that my thyroid is, indeed, acting up. The good news is that I don't have a NEW health issue to worry about.

I'm very frustrated that since joining Weight Watchers, I'd lost a little over ten pounds. And in just over two weeks, I've gained almost all of it back. Weight gain is a pretty typical symptom, as are the other symptoms I've been experiencing: raspy voice, constant fatigue, feeling cold, depression, and inability to concentrate.

I called my endocrinologist and was told that her next available appointment was 02 October. I made the appointment, but decided to explore other options. I'll skip the details, but I was able to work out something with my endo. I faxed her my lab results, and she ordered my chart from the archives (I haven't seen her in 26 months). She'll decide if she feels comfortable just calling in a prescription for me or if she'll try to squeeze me in.

I hadn't seen her for so long because I've been euthyroid for awhile - meaning that although my antibodies were elevated, my TSH (thyroid stimulating hormone) levels were normal. This is a somewhat normal pattern for Hashimoto's patients - having an underactive thyroid, then the thyroid decides to do its job... hell, sometimes it even becomes *too* active. In fact, that's what happened to me. I eventually became hyperthyroid (rather than hypothyroid, which is how I usually present) before my thyroid decided to settle down and act right.

All of this makes me VERY happy that I decided to drop my calculus course a couple of weeks ago. Depending on how long it takes me to get in to see Dr. El-Hajj (and I LOVE her - she writes down all of her instructions and explanations; the patient goes home with the original and a carbon copy goes in the chart), this could get slightly worse before it gets better.

The doctor who wrote the order for the blood test told me today that he was impressed I was so tuned in to my body and was able to pinpoint the culprit. That was kind of nice to hear.

In the meantime, one of the things that typically plagues affects my interactions/relationships the most when I'm symptomatic is difficulty with memory. So please be patient with me as I try to remember to revert to some of my coping mechanisms - carrying my book with me at all times, writing copious notes/to-do lists, etc. If I forgot something, it's not personal; I promise.

And thanks for all of the support. I wouldn't know what to do without you!

Le Sigh

Some of you know that 3.5 years ago, I got really sick. I was constantly tired. I couldn't walk anywhere. I couldn't speak. I passed out if I laughed too hard. My hair stopped growing. My periods stopped. I couldn't brush my hair without a break. I gained over 25 pounds in just over three months. My resting heartrate was sometimes around 130. My voice was raspy.

Then I was diagnosed with Hashimoto's thyroiditis. Basically, I was hypothyroid. For those of you who don't know a lot about the thyroid, the thyroid is like the thermostat of the body. And my thermostat decided it didn't need to tell my body to regulate itself. I was started on thyroid hormone replacement, and (as my endocrinologist predicted) it took me about 1.5 years to feel completely normal again.

Since I dropped my calc class, I've been exhausted. Not exactly how I expected to feel; I kind of thought I'd have MORE energy, be MORE rested, etc. I've noticed in the past few days that if I talk for more than about ten minutes, my voice gets kind of raspy. I've gained over four pounds in the past two weeks.

So I called the M.D. in my department at work and asked him to write a TSH (thyroid stimulating hormone) order for me. He brought it to a meeting we had this af, and I went to the lab after the meeting. My blood was drawn and I'm waiting for the results now.

On one hand, if my thyroid is acting up again, that's a good result. It's the devil I know, and going back to taking Synthroid every day won't be a huge burden (considering how many other pills I pop every day anyway). But it'll be a bummer that things are acting up again since it will take awhile for things to get back to normal. OTOH, if it's NOT my thyroid, that will suck because it will mean it's something ELSE. Something NEW.

So I guess I'm rooting for my thyroid acting up. Yay.

Lab results should be in tonight or tomorrow.