Sunday, October 30, 2011

Progress

So today I am craving the strangest thing -- homemade biscuits with cane syrup. Perhaps my Mississippi roots are showing through, or perhaps when I am tired I crave the simplest carbs imaginable.

Whatever the case may be, this is a post about craving. The thyroid medicine is working, though a bit less than it did at first. I am sorry to say that the initial weight loss not only reversed, but now I gained three more pounds on top of that. :( It's very disheartening but there's not much to be done about it. It could be because on this medicine, I am very hungry. And it's hard not to eat when I feel really, truly hungry. So I think I need to go back to counting calories on Livestrong, because "listening to my hunger" or whatevertheheck has just ended in me weighing more now than I did a month ago. Ugh.

I am behind in my work because of some unavoidable snafus with Norah's sitter last week, and a teacher planning day. I am finding, though, that my secret weapon is planning ahead and thinking on my feet. I didn't think ahead as well as I could have, but I am getting more in the habit and the next time something like this happens, I will be able to handle it better. Taking care of yourself and your schedule is really a full time job!

So, rather than going nuts and trying to figure everything out at once, here is the slow-playing plan:

This week, focus on finishing the grades for tomorrow, then call the doctor on Tues or Wed to see if I need to adjust meds, do a gentle workout just 2-3 times in the week, just to keep moving, and track what I eat online without really changing what I eat, to see what I'm really taking in. Then, next week, look at the food diaries and see what I can improve. After the Greek Food Festival next weekend, of course. No use in being a zealot...

Overall, a little bummed that I am feeling sluggish and bad again, but not totally hopeless about it. The middles of my days are still much better than they used to be. The evenings are difficult again, though.

Oh, and I'm supposed to bring 24 home baked cookies to school for Chris tomorrow.

HA.

Tuesday, October 25, 2011

I'm Published! :)

Check out my article on Slack Lust! I am proud to be part of this month's issue!

Friday, October 14, 2011

T3 and Me

So now that it's been a full week that I have been on medication for my burned-out adrenals and my high reverse T3 count, I want to give an update:

I am taking Armour thyroid in what the ARNP calls a low dose, but it seems to work very well for me. Armour is different from Synthroid in that it contains both T4 (which Synthroid has) and straight T3, which is the biologically active form of the thyroid hormone. In other words, your body manufactures T4, but it must then convert the T4 into T3. TSH is a pituitary hormone that is involved in how much T4 your body produces, not T3. So you could have a normal TSH and T4 reading, and still have big problems because you don't have enough T3 for your body to actually use.

In my case, my body makes plenty of T4, but when it converts it, it turns some of it into T3, but also turns too much of it into Reverse T3. Reverse T3 is like those little plastic things you put into electrical outlets so that babies don't stick hairpins into them. It is biologically inactive, but it prevents real T3 from binding to receptors in cells, so it sort of "turns off" the cells to metabolic activity. This is why people with high reverse T3 feel exhausted and can't lose weight, even on low calorie diets.

So I am on Armour and Bio-Adreno (which is a bio-identical adrenal glad supplement that supports healthy adrenal function). I have also stopped eating wheat and dairy, and I don't drink caffeine anymore. I am limiting my sugar but I do eat fruit and I have had some dark chocolate and orange juice here and there. What has happened to me this week? Here are the highlights. :)

When I sleep, I feel rested. This is a really big deal for me because for several months now, when I slept, I would wake up just as tired as I felt when I went to sleep. And in the event that I got to sleep in, once every few weeks, it didn't really do me any good and just made it harder to sleep the next day. To actually wake refreshed is... it's kind of amazing. I wake up ready for the day. Not exactly bright-eyed and bushy-tailed, but I feel like the new day is a good thing and not just "oh geez, one more day to get through until I get to go to bed again."

When I eat, I feel nourished. I had been noticing for a while that when I ate, I felt like I wasn't really getting anything from the food. It's hard to really explain, but while I never really felt "stomach hungry," I felt "cell hungry," like my cells were crying out for something that they just weren't getting. I know it sounds crazy, but that's the best way I can think to describe it. Now, when I eat, I feel that I am really getting what I need. I am not sure the exact relation of this feeling to the medicine, but I have noticed it. I have also been craving really healthy foods, like the other day I just really needed a bunch of tofu and kale. Explain that.

My body handles food better now. It used to be that when I ate anything with grain, or with sugar, my body would just freak out. I recorded my blood sugar for a while, and I would get really, really low readings sometimes -- in the 40s and 50s. I would routinely feel awful if I didn't eat once every hour or two. I started with the medicine and was prepared for a hypoglycemic diet as well, but I have found, strangely, that I feel actually less hypoglycemic than I did before. For example, the other day I was just really feeling like I wanted a little glass of orange juice, so I thought, well, I'll just go ahead and have some. And I drank it, and I didn'thave a sugar crash 30 minutes later. That hasn't happened since I was in middle school, seriously. It was kind of amazing. I don't have to eat every 1-2 hours anymore -- I can eat every 3-4 hours instead, and I feel completely fine the whole time.

Other stranger effects. I have noticed some other more incidental effects. First, my memory is slowly getting better. It is not instantly repaired, unfortunately, but I have been recalling things that I normally would have forgotten. For example, I remembered to put a bag of paper towel rolls into the car and then actually give it to the art teachers at Chris's school. Normally I would have collected the rolls and then just never, ever remembered to give them to the school. I wish the memory recovery were more dramatic, because I really miss being mentally sharp, but it is getting better, and that's a start.

Emotionally speaking, I have a much longer fuse when it comes to getting frustrated and angry. I have had the normal challenging situations this week with my two little kidlets, and I have noticed that I have more mental space to decide how I will react -- my reactions are more thoughtful and controlled. This is really big. For example, at the store the other day C said he had to use the bathroom, and I was trying to get us to the restroom, and someone was blocking the entire aisle with their cart parked diagonally. I tried to do the polite thing but she wasn't taking the hint so I had to sort of drive all the way around her and between her and her cart, kind of like a really mundane sort of slalom. Just as I finally get around her, I hear Chris go "uh oh..." and we rushed to the restroom but he had already gone. Of course I have no extra clothes with me, nothing, but I got through the entire situation, including a broken hand dryer, a non-functioning paper towel dispenser, and a very clingy 18 month old, with very little emotional strife. It actually went very smoothly, in the context of how well your child wetting their pants in the middle of a grocery trip can really go. Chris got through it understanding that he had done everything right, and the situations just piled up to make it so he had an accident, and he recovered really quickly without being embarrassed. I didn't try to start a fight with the woman with the diagonal cart, although I was definitely irritated. It was really good to see a good outcome in a situation like that.

A strange emotional effect is that I have a wider range of emotions than I used to. It's strange. I feel a little more weepy, but not in an out of control way -- instead, if something happens and I feel like I need to cry, then I just immediately cry a couple of tears and then I'm over it for good. I guess it's more like I deal with my emotions right in the moment, rather than saving them up for weeks and then shutting down or freaking out. It's different, but it's not bad.

My memories are "waking up." This morning suddenly I started singing this old rhyme that we used to say when we were jumping rope in second grade.

She can wibble, she can wobble, she can do a split.
I bet you ten dollars you can't do this:
Close your eyes and count to ten
Open your eyes and do it again


There's a little bit more of that little blue-eyed girl back in me now, again, dancing in the double-dutch ropes, eyes shut, daring herself to get all the way to ten.

Friday, October 7, 2011

Adrenaline Junkie


I have been trying for the past 30 hours to get through a stack of drafts and give feedback. Normally this would take me about 4 hours total, but right now it is going a lot more slowly. Not relying on a jolt of adrenaline does mean that I can work at any time, but the work goes more slowly. I have to relearn how to be productive and disciplined with no rush of panic and no coffee to spur me along.

One upside of getting my stress under control showed up this morning as I was driving Chris to school. A huge pickup (quad cab, dual axles, etc) drove across Mahan Dr. and just stopped there, waiting for a chance to turn left, and I was headed right toward it. Now my former self would have cursed, honked, avoided the accident, gotten shaky, gotten a splitting headache, and then been completely exhausted and useless for the rest of the morning. Today, though, I just avoided the accident and went on my way. I was thinking, "Why do I feel strange right now?" and it was because I wasn't in that adrenaline-induced fight-or-flight state. I was just calmly driving on my way. It was weird, for real.

So back to my workload... How do I get things done without the rabid dog of panic biting at my heels?

The First Day

Just a quick update to say that the thyroid and adrenal medicine is working, that the new diet is working, that the lack of caffeine is working, that I am working! I don't feel like a busted machine anymore. Glad to start ticking again.

Wednesday, October 5, 2011

Reduce Stress by Reducing Stress... um okay


So today I had my long-awaited follow-up appointment, and I am on a supplement to support my adrenals so that they actually might be inspired to work a little bit, and *very excitingly* a natural thyroid supplement (Armour).

I have to order the Armour, which is "dessicated porcine thyroid gland," from a small mom-n-pop pharmacy that is only open 8-5, and since my appointment wasn't until 4pm, that means I have to wait until tomorrow to get my precious medicine! And of course I forgot to ask if that pharmacy takes my insurance. So many details.

The thing is, though, in order for the T4/T3 supplementation to work in eliminating the buildup of Reverse T3 in my body, the adrenals have to be working too, and in some cases the thyroid hormone supplementation will not work at all if the adrenals don't work, and in fact can tax the adrenals further, causing worse symptoms. Of course, in this delicate feedback loop, two things are true: low adrenal function worsens thyroid function, and low thyroid function overtaxes adrenals (which makes them then burn out and underperform). So basically what I am doing now with the supplementation is sticking a wrench into this terrible machine in which the adrenal function gets worse and worse, and the thyroid produces more reverse T3, until I am eating 800 calories a day and gaining weight, and unable to stay awake during the day but unable to fall asleep at night. (It's not that bad yet, but that's where I would be headed.) There isn't really a graceful way to halt the process, you just have to pick something and improve it, which will make improving the other things easier as well.

So in an ideal world, I could flood my body with all the right supplements and wake up completely fine, but it has to be a slow and gradual process. The hardest part of this for me, I predict, will be rehabilitating the adrenals, and here's why -- when the adrenals begin to underperform, you find yourself subconsciously doing things to violently jump-start them again. For example, drinking tons of coffee. Now, I have cut coffee cold turkey for the past two weeks, and I have done well with it. I am drinking a lot of tea, though, and I will have to cut that as well. No caffeine at all. That will cause stress in itself, but it will be all right. Not looking forward to it, but I have to do it. So I think I will be tapering off of that gradually.

Overall now, in order to get any adrenal function at all, it takes a pretty big event. Thinking about this, suddenly the last puzzle piece clicks into place when I try to figure out why sometimes I literally *can't* work unless I am under a tight deadline. I hate having things to do at the last minute -- I really hate it -- but when I try to sit down and work ahead of time, I am horrifically underproductive -- it takes me an hour to grade one paper, my mind wanders, I get antsy -- whereas when I am under a tight deadline I can knock out 4 papers in an hour, for four hours in a row, with thorough feedback and consistent grading that I am proud of. But I literally can't function that way unless I am scared about missing my deadline. This is a way of artificially stimulating the adrenals! To put myself in a state of panic over a deadline, so that I finally have the energy to meet it!

It's like the heavens opened up, and a light shone, and I understood why I have such a hard time working ahead. I am addicted to adrenaline, but every time I get an adrenaline rush, I need more and more of it while at the same time my body produces less and less. I guess some people like roller coasters, and other people like leaving 20 papers to grade until 12 hours before the grades deadline. To each his own, ha ha ha.

Looking at this, it's easy to feel overwhelmed, because I know that as I wean myself off of my punishing habits, procrastination addiction, caffeine, and drill-sergeant self-talk, I am going to have a few days or a few weeks when the only way I will get anything done will be through sheer willpower. No dark coffee or exhilarating panic to spur me on -- nothing to give me that lovely hopped-up feeling that I crave, because it is the only time that I am productive at all. Instead, I have to give that up in order to regain the ability to be generally productive, at any time of the day, any day of the week. It's worth it, but I know I am staring down some pretty gnarly grading sessions for the next few weeks.

This also means that I have to drop some of my bad habits, like sleeping as long as humanly possible before stumbling out to "greet" the day -- instead, I have to be one of those people who wakes up at 5 or 6, meditates and exercises alone, and then starts the day. I have to give myself a good, even, non-panicked start. I also might have to get some child care. Ugh. I am such a stingy person, you guys. You have to pry the dollar bills out of my hand. Paying someone so that I can work just goes against everything the tightwad on my shoulder is screaming at me. I've won battles with her before, though, and I guess I can win again. Health is worth investing in! (I will repeat that to myself a hundred times over through the next few weeks...).

I will have to start doing gentle exercise every day -- a walk in the evening while Ben sits with the kids. I really like walking, and it helps me sort my brain out, if that makes sense.

When I was doing the infant thing with Chris and then with Norah, one of the most difficult parts of it was that I never had time to do that "unpacking" of the day's events that you do when you sit down with a glass of wine, or take an evening stroll, or drive alone somewhere. It was just this other person's needs literally 24 hours a day. I had no time to process any information -- my memories were like boxes of receipts with no lids in a room with the fan on -- stuff blowing everywhere, total chaos. Some of that chaos is still with me, I think.

So when I go get my little T4/T3 tablets in the morning, they won't be an instant fix. I actually have no idea what the effect will be, because every patient responds so differently to it. I am doing a cortisol test tomorrow as well to try to pin down the extent of my adrenal problems, so that the doctor will know if stronger medicine is needed for them (cortisone? I think?). After that 24-hour test, I will start the adrenal support supplement. There are going to be zillions of those tiny annoying "lifestyle changes" that are so hard to really do, but this time maybe I'll be successful because so much is on the line. What it really comes down to is taking the power of my will and instead of focusing it on Achieving More Always, focusing it on Letting Go and Chilling Out. Not in an incidental, daily, don't-cry-over-spilled-milk kind of way, but in a real, pivotal, Truth-seeking kind of way. I have to take the power of idealism and use it to take me somewhere I actually want to go.

Join me on the winding, whiny road to health! :)

Spider Boy


One of the many joys of Netflix streaming is the fact that we can share shows that we used to watch with our children who are just emerging, dewy-eyed, from the forests of infancy. And by "share" I mean "force them to watch." For example, Norah and Chris have already been subjected to approximately 586 hours of Family Ties and Wings, and although she doesn't remember it except for having a vague desire to wear bulky sweaters with stirrup pants, Norah sat with me through quite a bit of Thirtysomething when she was first born.

But one thing that both the children and the parents enjoy here in the Happy Nash household is the 1994 Spider-Man series. Chris has become obsessed. He sings the theme song, studies the episodes, and then leaps across the divide between the two couches, swinging by a thread of invisible spiderweb. Spider-Man's interests are remarkably similar to his own; for example, Spider-Man needs ice water with a straw in order to make webs, and Spider-Man leaps "kind of like a frog but it's different."

I think the Superhero thing just has a certain amount of cache, but I noticed that in this show Peter Parker also narrates... everything. ("I'm walking to the kitchen, but I don't see Aunt May. Where's Aunt May? My arms! Their turning into large purple vines! The serum! I must have taken too much of the serum...") So maybe in that preschooler brain phase of really working hard to make sense of the world (and let's face it, that's an increasingly challenging task these days), this kind of super-literal narration might make the show really accessible and even turn it into a learning experience in some ways -- the voice Peter Parker uses to narrate his own thoughts is very different from the way he speaks out loud to others, and the facial expressions are exaggerated. By pumping up the subtext, Spider-Man opens a new range of human experience and emotion in a way that an almost 4-year-old can absorb and understand.

Also, there are mutated lizards with evil mechanical robot parts. What little boy wouldn't love that?

Sunday, October 2, 2011

HypoT Update

I finally got a call from my doctor's office on Friday, and it turns I have elevated thyroid antibodies and high reverse T3. From what I know so far (which might be an incomplete picture), the high reverse T3 is related to stress-related failure in the conversion of T4 into T3, and the use of T3 by the cells, although I am sure I do not understand exactly the way it works. Basically, "Reverse T3" is a slight variation of regular T3, which is the active hormone that regulates metabolism. So the reverse T3, which is sort of a placeholder "dummy" hormone, will block the receptors and not allow the actual T3 to bind and become active. So it's like a key that doesn't work being stuck in the lock, and you might have the key that works, but you'll never get it in the lock. In normal functioning, reverse T3 is created to slow down the metabolism when necessary -- for example, famine -- but sometimes when there is a lot of extended stress, the body will just sort of chronically produce too much reverse T3, so the metabolism keeps slowing down and slowing down until you get slow, tired, overweight, and really cold (95.9 degrees at one point last week). So the treatment is to clear all the extra reverse T3, and reducing your stress response with holistic changes and medication.

The elevated antibodies indicate some kind of autoimmune response, so I am interested to see what kind of treatment might be available for that, and how much functioning thyroid I have left.

I have to wait 8 more days for my doctor's appointment, which seems like not much in comparison to all the time I have been dealing with this trouble, but it seems like forever now that I know there is a problem and maybe even a solution out there waiting for me.

What I am dealing with now is some of the same types of symptoms as always, except now I am recognizing them rather than ignoring or downplaying them, thinking there is nothing really wrong with me. I'm coming awake to the distress signals my body has been giving out for so long, that I have been ignoring because I had been told that there was nothing wrong with me.

A bit of anger is coming up as well. It's been 18 months of my life, gone and wasted it feels like. I know that's an overstatement, but I have been operating at about 60% since my daughter was born. She doesn't even know who I really am, and I barely even remember it either. I am angry because I tried to address this problem at a time when I still could have had some breastfeeding time with my daughter, and when I could have enjoyed part of her infancy, but the doctor just tested my TSH and told me I was completely fine, and to get more sleep. Hypothyroid problems disproportionately affect women, and the symptoms are often dismissed because I suppose we expect that women will be fat, tired, and puffy whenever there is something vaguely "hormonal" going on -- childbearing, menopause, PMS, whatever. Women are brushed aside, and not just me -- look it up and you will see hundreds of personal stories of women who knew that they weren't healthy but their doctors just tell them to eat less and exercise more and take some antidepressants. The patients' expressions of what they know of their own bodies are ignored. In addition to this I guess I am also mad that I didn't pursue it farther until now -- that I didn't try harder to find out what was wrong before. Doesn't it seem backward that I should have to pursue a doctor who will listen to me and not tell me I'm just supposed to be fat and tired? Doesn't it seem like a doctor should want a patient -- even a female patient -- to have a better quality of life, rather than just getting used to things sucking just a bit more than they ever did before?

A lot of sadness comes up too. Sadness for the times that I have already lost with my family, for the past year of doing as much as I could, which was always less than I wanted to. I take my kids to the playground about 3 times a year. I haven't been to the beach since 2009. I don't do anything where I might run out of energy in the middle, so I don't do much. I am so used to being tired and sluggish that it's almost the new "normal" for me. I have to really focus to identify what's "not right" about me because it's been so long.

I am kind of curious about what might emerge if I get to start some treatment. I am curious if I will be able to keep up with the housework. I am really curious about whether I will be able to lose some weight and exercise enough to build muscle and things like that. I am curious about what my brain will be able to remember when I am not dialed down anymore. Do you know that yesterday I forgot about a birthday party that I had been planning to go to for weeks? That on Friday I confirmed that I was going, but come Saturday, I just didn't remember it, at all. That kind of malfunction is humiliating and really difficult to explain to other people. And that's the kind of shit I do these days, every day. But I never know when it's coming. I buy ketchup three times in a row when I already have it. I go to the store to get hot dog things for dinner, and I buy everything... except the hot dogs. I forget to mail a check for nine days, even though it's "on my mind to do it."

For so long I have been afraid that all of this was a signal of mental illness that I just haven't shared it with anyone. I assumed that the physical symptoms were all due to me being overweight, and I focused my energy on losing weight, which came to nothing. I assumed the mental symptoms were from a combination of sleep deprivation and emerging insanity, and I was hoping for a way to get past those things as soon as I lost the weight.

While I'm waiting for the next appointment I've kind of hit a wall where I stop trying. I don't have a reason to keep acting like it's okay, so I'm done with it. I'm exhausted and forgetful and only 25 lbs down from the day I got home from the hospital, after 14 months of dieting. I can't do half of what I used to be able to do. I'm spending all my energy doing my work and doing what I can for my family.

I know this is all sounding pretty dramatic, and I'm sorry for that. I know that this problem is not very big in comparison to other problems in the world. It's kind of overwhelming right now, though, to dig through all the things I have started to believe about myself (lazy, fat, disorganized, out of shape, boring, exhausted), and to see that some or most of them might be due to a pretty simple imbalance of chemicals. I'm kind of interested to see who I might get to be.

For a little more information on some of the stuff I am talking about, here are some good links:

High Reverse T3: http://misslizzy.me/reverse-t3-rt3-and-thyroid-reshttp://www.blogger.com/img/blank.gif
Adrenal Fatigue: http://misslizzy.me/adrenal-fatigue/
High Thyroid Antibodies: http://thyroid.about.com/cs/basics_starthere/a/antibody.htm

I am considering calling and trying to get an earlier appointment. I have been feeling bad for so long, I am ready to start getting better!!