Monthly Archives: November 2005

My thyroid.

(I originally wrote this on May 30, 2005. I have made some minor changes.)

I remember the moment when I knew something must be wrong with me. I mean, besides the anxiety and occasional hypochondria that plagued me. I was sleeping a sporadic 10 hours a night (2 hours there, 4 hours there, etc), needing 2-3 hour naps every day I wasn’t attending class. This particular day, I had fallen asleep in the library for 2 hours between classes.

Earlier that year, I dismissed my increased fatigue to a combination of starting 2004 with a 6-week long cold/sinus infection, along with catching up on sleep lost while I had been commuting/working 12 hours a day for almost three years and grief from dealing with a sudden death of a friend. Then came the missing period that turned into a 4-month-long pregnancy scare, so there was insomnia and weird sleep schedules. Another sudden death happened, this time a friend’s child, and my insomnia got worse. I hadn’t been able to exercise because I was so darn tired and achy all the time, so I gained back the weight I had worked so hard to lose only 3 years before following a pre-diabetic warning.

But that day in late October, I knew something had to be wrong when my intended 15-minute catnap turned into a 2-hour nap, complete with drool. I made the appointment for my annual exam the next day but was told it would be a 2 1/2 month wait. Meanwhile, I was convinced my psych meds were just going funky on me, so I had them switched.

When things didn’t improve before my annual, I started to suspect PCOS. I’d heard lots about it and given my history of hyperglycemia, weight distributed at the waistline, mysterious pelvic pain, and irregular periods, I thought that had to be it. (Though it didn’t explain my needing to be bundled up in clothes on Christmas Day when my in-laws’ radiant heat was on overdrive.) Even my doctor thought so.

But nope, it was hypothyroidism. I thought at first, oh shit, this sounds like the perfect hypochondriac’s disease – fatigue, muscle and joint aches, sensitivity to cold, short-term memory loss, irregular periods for women. One of those silent diseases that when treated can be very manageable, but when untreated can practically ruin your life despite not having many symptoms that appear outwardly to others.

Even though I had planned on going back to work when 2005 started while I waited for news from nursing schools, Greg and I decided that I should work on getting well and just take the classes I’d enrolled in for the semester. I was afraid of getting a job that I couldn’t handle due to a still uncontrolled disease. I was afraid of not being able to handle nursing school due to this same uncontrolled disease, so I put off applying anywhere else until it was too late. This silent disease that many people don’t understand.

Then I got copies of all my labs from five years back, about when I started feeling like a hypochondriac with all my aches and pains. I had been subclinical all that time, though I couldn’t attribute anxiety to the thyroid problem as that had been around from a young age. See, there had been a different standard back in 2000 and 2002 for TSH levels when I’d had it tested before and I had fallen within that standard but not within the new 2003 levels. I spent a few weeks feeling like I’d lost five years of my life, especially since I had subsequently been given the official type 2 diabetes diagnosis, but my psychiatrist and new endocrinologist were very helpful in their clinical explanations of hypothyroidism.

Now that things appear to be under control with my thyroid, I can laugh at my lingering “brain farts” of putting things in the fridge that belong in the pantry or throwing away a whole onion that I just chopped up to put in the evening’s meal. It wasn’t funny when I was trying to memorize bones and physiological processes, but I got through anatomy & physiology just fine nevertheless. Despite some lasting symptoms, I feel the best I’ve felt physically since I graduated from college in 1998. I know that I need at least 8 hours of sleep, preferably more, or else I desperately need a nap. Doing yoga seems to help with the muscle and joint pain that happens after the long walks I take to control my blood sugar. There are emotional issues left over from long ago, but I’m ready to work on them more than ever.

I know there are worse diseases and conditions out there, but man, when you’re in the midst of something like this, it can sometimes feel like the world caving in. And as you crawl out, you realize how lucky you are that it’s something that can be controlled rather easily. Compared to the diabetes, it’s a cakewalk.

Welcome to my endocrine system.

In January of this year, I was diagnosed with hypothyroidism. I spent much of 2004 with fatigue and amenorrhea along with a significant weight gain. The weight gain was especially difficult as I had lost 35 lbs in 2001 due to pre-diabetic blood glucose levels and now I’d gained it all back AND MORE. The diagnosis also explained some hair loss, cold intolerance, and short-term memory loss (aka “brain farts”) I’d been experiencing. By May, my levels had normalized with daily oral thyroid replacement hormone. My periods had returned to normal and my energy levels were on the rise.

In March, I was diagnosed with type 2 diabetes. My primary care physician said that I “got the short end of the genetic stick” and that I had spent just a little too much time being overweight for my family history. (No one, even those with weight issues, had been diagnosed before age 60, which really scared me with the diagnosis coming less than a month before my 29th birthday.) I never had an obese BMI, but I stayed well above my ideal weight for six years. Although I had lost weight with the pre-diabetic warning in 2001, I hadn’t lost all the weight I should have…and then of course, gained it back with the help of a European honeymoon (= yummy baked goods) in 2002 and fatigue from the hypothyroidism (= no exercise) in 2004.

My HbA1c (a test that determines how many sugar molecules are getting stuck to red blood cells) was 6.4 in March. Normal, non-diabetic levels can range from 4.0 to 6.0. Diabetics should have theirs under 7.0. My fasting blood glucose was 136. Normal, non-diabetic level is under 100 (although that was recently changed from under 110). Pre-diabetic levels are anything under 126. I also had an oral glucose tolerance test, which checked insulin resistance. You may be familiar with this given to pregnant women to test for gestational diabetes. This showed some abnormality indicating full-blown diabetes, but not anything overly concerning, as I wasn’t going to be drinking super sugary pop anymore.

My PCP wanted to put me on oral diabetes medication right away, but I chose to wait until I saw an endocrinologist. In the meantime, I monitored myself with my type 1 diabetic husband’s blood glucose monitor. By the time I saw the endo, I had a good idea of what foods to avoid. (Yes, my husband is a type 1 diabetic, which means he does not produce any insulin and is dependent on insulin shots. We have told our five cats that they are not allowed to become diabetic.)

He thought I was doing well with diet and exercise alone. I had started 4-5 30+ minute walks a week in January, which was already helping my levels and had managed to lose several pounds. Very importantly, my blood pressure reading at this appointment was 110/74 – the lowest I’d seen it in quite awhile. I had never seen it that low at my primary care provider’s office, where I was consistently seeing 130/90 type readings over the previous five years.

After meeting with the dietician in May, I felt even more confident that diet and exercise was helping…so much that I lost a little motivation to keep doing all that walking. I had another blood test in late June that showed that my HbA1c was down to 5.7 and my fasting glucose was 124, which brought that motivation back up. I also got the results of my cholesterol testing, which was better than it was in 2000 and 2002. I met with my endo again in July, who told me to keep doing what I’m doing and see him again in January. Blood pressure was still doing well at 100/70.

Today, I am monitoring every fasting blood glucose (first thing in the morning) as well as before/after dinner most days. I have a pretty good idea of what numbers I should be seeing so that if they start to run high, I can troubleshoot why that might be. It can be stress or a sign that my period is on its way or that I ate too many “bad carbs”.

I have now lost 40 lbs since January and hope to lose 10 more. Slow but steady… the best way to keep it off permanently. I exercise at least four days a week, but usually five or six. I drink lots of water to help stay hydrated, both for lower blood glucose levels and for the dry Colorado air. I watch what I eat, of course, by trying to keep my carbohydrate intake in check. A carbohydrate must have at least 2 grams of dietary fiber and no more than 6 grams of sugar per serving, as well as no more than 45 total grams of carbohydrates per serving. Goodbye rice, hello couscous! Oh, and you know how Wilford Brimley has done oatmeal commercials in the past? Oatmeal kills my blood glucose levels. Take that, Wilford!

I turn 30 five months from today. I hope to be much healthier in my 30′s than I was in my 20′s. This year has been a good introduction to a healthy decade.


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