body image walk

there's this walk I take - maybe 1.5 miles each direction - that takes me through several different neighborhoods. Here are the student ghettos that I hate so much, then there are family houses with a few doubles/apartments, then totally run-down and abandoned, then hospital, then abandoned except for groups of guys who stoop sit. That's the part that kinda gives me the creeps each time - that if I were to scream, there's literally nobody to hear me. Blocks and blocks of flooded and/or burned houses that are abandoned. And I see cars that drive slowly through - some of them, the trucks, are looting the houses, but the others - the lowriders with booming music - are more sinister. Not that lowriders with booming music are sinister the vast majority of the time - I just mean in this neighborhood, how they drive around and around and around, sometimes following me - they're up to no good.

Usually I run into way friendly folks who wave hello and wish me a great day and comment upon my exercising.

Today was the funniest. I'm walking - I had just turned around in the last, totally abandoned part after walking past two creepy male stoops - one with six guys and two dogs, the other just two guys but really loud. A woman was walking towards me, swinging her arms wide and talking. Either she was talking to me and getting some cardio walkout with her walk, or she was crazy.

So I took off my headphones and said, "What's that?" as I kept on walking.

"You're out here gettin exercise just like me," she said. "But don't you be losin those hips! Hips are what it's about now! Hips are sexy!"

As I walked past, I got to hear about all the physical attributes which I should not be losing, as she patted it on herself. She ended with the butt - which is either (I couldn't quite hear) important for "our" sex or just for sex.

She spoke with the zeal of a West African missionary (trust me, they're zealous). When I said, "OK, but, well now, I could stand to lose quite a bit," she shouted, "NO!"

She wasn't crazy and she wasn't scary - she was just really adamant, and it cracked me up. It was like being back in Senegal, except the whole part where I understood what she was saying because it wasn't in Wolof. Both women and men there insisted that my body type is THE image of beauty and I shouldn't change a thing, except maybe get yet more hip and butt.

So, no more exercise for me. But, also no more sugar for me - it affects me hard, and I don't need anything else messing with my moods. Because of my hyperthyroidism but slow metabolism, research says I'm probably highly insulin resistant.

Drats anyway.

Which reminds me of another problem with going to Liberia - it always pisses me off when I go to Africa and I live on a diet of less than 1000 calories per day (porridge for breakfast and one more meal of rice and vegetables with fish or chicken - the most calories are from the palm oil) and do not lose weight. Bless my metabolism, it adjusts down. And while I do a lot of walking, it's too bloody hot and humid to do it fast enough for cardio benefits.

Sigh.

pulse: 63

This is excellent news for me! My heart rate used to always be on the slow side, but with these thyroid problems they were regularly clocking it at 100.

Normal women's: 75 or so.

I've been pretty good about exercising of late, so hopefully this healthy pulse will maintain. Woo! My heart is really the only thing I worry about with the hyperthyroidism - because it's really unknown the effects of extremely low TSH (thyroid-stimulating hormones) on pre-menopausal women. On post-menopausal - major effects on heart and bone density loss.

Major benefit to being overweight - less bone density loss.

So maybe as long as I exercise and stay fat, my body will be fine.

free condoms

I rode up the elevator to the 3rd floor today to get my thyroid blood tests. It wasn't so much that the walk to the clinic wiped me out, which it did. It was more that I was afraid of the dizziness and metal/concrete stairwells. I suppose if I'm going to fall and crack my head open one of the best places to do it is in a health clinic, but it's not on my list of things to do today. Getting over this damn flu is.

I've never taken the elevator there before. A big sign at some office said, "Free Condoms" and then I noticed a candy bowl full of them.

[I hate condoms. I like them for other people, but not for me. But, the doctor said I'm not allowed to get pregnant with my thyroid like this, so I guess we're back on condoms.]

So I grabbed one of each kind, and I'll be back.

It's all part of my plan to get my money's worth. Also in the elevator was a woman who needed directions to the women's health clinic. She was probably about my age and was bitter that the university wouldn't allow her to decline health insurance. No, she didn't have any other insurance. I gotta wonder what she's thinking, and I'm glad that universities force insurance on people.

But I chatted up the lab tech and she said that the health insurance doesn't cover STD tests unless there are obvious symptoms. That is the stupidest thing I've heard. Most STDs don't show symptoms, especially in women, and the only way to avoid some possible serious damage is early treatment. Instead of encouraging that responsibility, it's punished with steep price tags. Even with my HPV, it would have cost a lot of money to get tested for it - even though less than a year ago I tested positive for one that is likely to end in cervical cancer, the insurance wouldn't cover it. Crazy. And in general, I'm less than thrilled with the women's health because of other things they didn't test for - in part because I'm 20 years older than their typical patient.

But overall, the health care I've received so far has probably saved me what I paid in premiums plus what that woman on the elevator paid (my deductible for the $200 bone density test was only $20 - I heart insurance). Plus I have the benefit of knowing that I'm covered in case of emergency.

Though, that's not always enough. Kim's daughter got a very bad infection in high school and was hospitalized for about a month because of it, and Kim had to pay $25,000 - the insurance covered almost $300,000, but still that's a lot for her to pay out of pocket.

That's a lot of condoms. I better go back every day to fill my pockets.

pulse: 78

That's fantastic news for me. It's not down to my "normal" below 60, but that's WAY better than the 98 I've been at. It doesn't feel like my heart is beating out of my chest. All very good.

And I got a draft of my second issue done last night, which means all I have to do is write my statement of facts, argument summary, issue statements, and then revise the whole damn thing. That's my goal before leaving town Saturday morning, and then I can set it aside for two days and come back to it on Monday with fresh eyes and hopefully it is something workable rather than total crap.

Ugh, ok, time to get ready to go pay to volunteer.

day 8

Today was my first day without a nasty headache, and I was in a good mood all day. Yay, decaffeinating.

My chocolate cravings are stronger than ever, though. Ugh.

And I have to face the Ultimate Dilemma: when I go out camping this weekend and we have smores - do I have one?

I mean, it's not like I gave up C&C for Jesus or anything - this is all about my health. And that in mind, one won't hurt me. Am I cheater then? Who cares - it's my rules I'm cheating on. I just hope I'm not like Avery, making up new rules as I go along.

I think it'll be a fun trip. The trip leader was way nervous - this is clearly his first time doing such a thing. The group seemed nice. We're leaving earlier and getting back later than I anticipated, and my weekend is now completely destroyed, but that's ok - it gets me motivated to get everything done RIGHT NOW.

Chinese doctor

I did go to a Chinese doctor - Lara's, in fact.

I was on their treatments for a month and they made me feel way worse in all ways, so I stopped.

And he told me that for both my thyroid and fibroids, they can't treat me for that - that I need Western treatment and they could help with recovery. Which is not much help for where I am now.

thyroidville

My heartrate has accelerated out of normal range - resting it's usually 90-100 now. "Normal" is about 70 - and mine has always been lower than that (I am a marathon walker after all). It never gets below mid-80's, and I check it compulsively (right now it's 94). it's also not always regular. And my chest hurts.

And otherwise, I feel generally out of sorts. Now I can really tell that my body isn't doing well. I was ready to call the doctor and see if I could get either radio-iodine or surgery over spring break.

But then I start doing more research.

First of all, I am *not* the only overweight, hyperthyroid person. In fact, it's not uncommon. Nobody knows for sure exactly why, but "experts" think what I think - that the thyroid hyperactivity increases hunger dramatically. In me it does. Sometimes I eat fast food, enchiladas, chocolate cake - high fat, high calorie foods - because it's the only thing that makes me not hungry. I get so hungry that I can't function, and nothing "healthy" takes the edge off it. The only way I can eat "healthy" is to eat constantly. And all this while my metabolism is significantly lower? ARGH! Losing weight is a losing battle - and for me it really doesn't matter much if I'm exercising 10 hours a week or not.

And more on that - people who get treated for hyperthyroidism gain weight - most of them at least 8 pounds a year for the indefinite future. Most at risk? People who were overweight before treatment. The doctors told me that I wouldn't gain weight; in fact, things would even out better. That's just not true from what I read - and it doesn't make any sense.

AND - there's no guarantee that I'll feel better after the treatment. All sorts of people never get quite "right" - and once you've killed your thyroid, it's gone.

I have no idea what to do, and it's very frustrating.

So I can kill my thyroid and balloon up to 300 pounds and face all those obesity problems. Or I can try to ignore my heart pounding in my chest so loud it distracts me just like I ignore all the work I need to do. I just wish I could ignore hunger like that.

Maybe I'll email her and ask her if I can get a prescription for beta blockers - maybe that will help. I just don't want my heart to explode - that would be quite bad for my future.

wages of caffeine sin

Maybe you've seen those movies where the protagonist either helps or is a junkie trying to come clean. The sweating and swearing, the DTs, the agony of withdrawal.

Yup.

How does one cup of coffee a day create such an addiction? It's crazy.

I can't look at the computer screen too much, but I surf for other local races. I have fantasies of being able to run a marathon before I leave here ... but who am I kidding? I can't even stand upright without mindnumbing pain. Walking the five steps to my door to put my shoes on - just thinking about it causes waves of nausea.

Of course I'm the Sam Spade sort of protagonist, and no ibuprofen for me. Nothing to ease the pain of the withdrawals, the wages of my caffeine sin.

ONE CUP A DAY. Seriously, that's all I drink. Maybe once every two weeks I have another cup, but never with caffeine after noon. Maybe once every two weeks I have a Diet Coke. And while I may live for chocolate, it too is not a daily consumption. And that amount leaves me here in shivers. I can feel blood coursing through my veins, seeking out the caffeine rush. Crazy.

I can't study, I can't really be on the internet, and I can't read for long. I can't go to bed now. What the hell am I supposed to do besides suffer?

I'm confused - I think Lent is 40 days, but Crescent City Classic is the day before Easter and it has a banner that says there are 43 days left. If I could focus my eyes on a calendar and remember the order of numbers through this mind-splitting pain, I'd figure it out. But, I guess I'll just stay confused until there's a better day.

Tomorrow I get my hair cut for like the first time in a year. And then I'll go buy a stupid suit.

let the decaffeination games begin

Last night it started, the headaches.

This morning my eyes are blurry and my balance is a little off because my head feels foggy.

But also last night was the first time I made it to bed at a "reasonable" time (around 10 pm). For the past month or so I've had a really hard time going to sleep before midnight/2 am, with resultingly later wake-up times.

That's not necessarily a good thing. That means I'll never be able to be on coffee again - that as long as I'm of even the one cup a day habit, my sleep will be screwy.

not as easy as it was

When I woke up this morning it was pouring rain - icky, grey weather and I didn't want to venture out.

After spending hours emailing and procrastinating, however, I looked out and suddenly it was beautiful. So, back to Plan A. I put on my walking shoes and out the door I went. It's two miles to the post office, so I thought I'd do that and back and call it good. For me that's burning less than 300 calories, but it's better than nothing fo sho.

I'm sore. My muscles are rebelling and didn't like it one bit. In 30 minutes I have to walk the mile to school and my legs aren't too happy. Tough.

It's discouraging, how quickly I lose muscle tone. I walk every day to school and frequently more. In Senegal I walked miles and miles a day. Of course, that was at the pace of a Senegalese woman = not very fast. I walked a marathon two years ago. Why is four miles causing hamstring grief?

Because I'm a big baby, that's why.

And now I have to walk the 5K on Sunday, just to do it (or as Tiff says, good homework procrastination). Next year I can do the half marathon. They call it Mardi Gras Marathon, but it's after, so it should be the Lent Marathon. Denial Marathon.

Now I got a pot of red beans on, to let it sit while I'm away at class and hopefully be about ready when I get back. Yummilicious and lots of protein.

Lenten season

yes Gail, to answer your question, refined sugar is off the table, except for jam which I'm temporarily allowing to get me by.

I am doing baby steps. I have some decaf coffee left and half and half, so I'll drink that until it's gone. And I'm drinking regular tea, though preferring green and herbal.

The basic rule is - nothing from a vending machine. Which isn't hard - I've used a vending machine maybe three times since I got here. Actually my diet is pretty good - I normally eat lots of fruit/vegs and always lots of whole grains. Just, now, no baked goods, candy, chocolate, and no coffee. Shouldn't be too hard, though I'm not usually thrilled with denial.

Then once I've gotten over those cravings, I'll move to cutting portion size further. The thing is, I eat a lot of things like broccoli stirfry with brown rice - so even though it's healthy, when I eat enough it's still high-cal. And I don't know what to do about a hyperactive appetite on a hypoactive metabolism. My body wants far more calories than it handles - and I'm not talking junkfood usually, though sometimes I really crave junkfood because it's the only thing that can make me not hungry anymore. So, I'll need to be really good with regular snacks.

I just wonder - if I purge sugar & caffeine from my body, will that positively affect my thyroid function? I figure it's worth a shot. There's four weeks until my next appointment, so plenty of time to be cleansed. And no colonics for me! Ew.

bones are good

My bone density is better than normal. I gotta tell you, I'm loving looking at this graph that shows me in the "best" range.

So, my shrinkage is probably from bad posture and all that. Yoga should help - I've heard people can appear to gain height, just from decompressing their spine.

I wish I could get a heart scan but that's probably pretty expensive and insurance won't cover. I just want to see that everything's all good. Because if it is, I'm sticking with my thyroid the way it is.

no thyroid doomsday

OK, sorry, Jen - didn't mean to stress people out.

The thyroid storm is very unlikely, and if it happens here that's fine. Doctors at the student health clinic know my condition and my endocrinologist is on the ball, and now I've done enough research to have a sense of how to recognize. The only question I still have is how long the symptoms last before they get critical. Do I have three hours? 36? Three days?

I'm not worried about it happening here. I dig on stress - it lowers my blood pressue. BUT, there are different kinds of stress. The stress that is now beckoning me to read Property because my prof humiliates people - good stress. The stress that compels me to rush about doing 5 million things on most given days - good stress.

There are only really two bad stresses for me. The first was teaching - that feeling of utter hopelessness when a student had made a really bad choice and was headed off to juvie or jail. And the constant administrative/NCLB pressure combining with that - bad pressure because it never let up and was out of my control. The other bad stress is when things are bad with Dayton. It's just the nature of love, I guess, that I'm really vulnerable to him. I'm not used to being vulnerable so I don't handle it very well. It definitely takes its toll on me. My typical blustering in to fix everything just doesn't work.

Today I have my bone density scan. (Now I read, then class, then post office, then hospital, then pro bono work, then meet Canadian at Port of Call, then maybe laundry, then study - there's my whole day. Sigh.) The doctor said it probably won't tell much because of my age - but the thyroid problem I'm having usually happens in older people "after a long history of non-toxic goiter." Like 50 years of it - which I definitely haven't had. I guess I'm a quick study. :) But it'll make me feel better to know - and if my bones are fine, then I'm not in a rush with thyroid treatment.

When I had the biopsy this summer, the doctor drained the nodule saying it was decomposing cells. So here's what happens, I'm starting to piece together. For whatever reason, maybe my TSH receptors on my thyroid don't work right, my thyroid feels compelled to produce thyroid hormone without being told to - that's T3 and T4. My T4 has always been fine; my T3 sometimes is a bit high and sometimes on the high range of normal. As far as I can tell, no TSH is not a problem - it's just that doctors get worked up about it because that means the regulation mechanism (thyroid-pituitary) isn't working properly.

But what if my body regulates itself differently? What if it grows larger to produce more hormone when necessary but then decomposes that when it's not necessary? There are times in my life when I do need the energy of three people to make it through the day - what if my thyroid kicks into gear and makes it possible? What if "treating" that is just really being ungrateful to the one gland who always is there for me?

Honestly though, if things don't get better on their own I will eventually have to have treatment - my thyroid is large and it makes swallowing sometimes difficult (like right now - must be the recent appointment - it doesn't like to be poked and prodded). Talking too much gives me a sore throat. That would seem to make surgery the better option because they could actually remove that obstacle. BUT with surgery there's the chance I can lose my voice altogether (or get a way sexy husky voice), and it's pretty common that they cause permanent damage to the parathyroid glands - which regulate calcium and other really important functions. So then I'd be on synthroid for the rest of my life AND all sorts of other stuff. And have 9 cm pirate's scar across my neck.

Alcohol ablation (where they shoot ethanol into the thyroid) might be an option, but it's not done here - so if I do that I'll probably do it in summer when I can get to Mayo Clinic a few times. Because it's such a rare treatment in the US I can't find much info on it. In Europe they don't do radioactive iodine because it's radioactive and there's real concerns about that. If I were 80 and this were my only health problem, I'd be like, "I'll do it today." But I'm not even 40, and I might someday carry a baby. The radiation I'd be getting is like Chernobyl (not right up close, of course, but that's the analogy they gave) and I do know of those negative effects. I don't want to get cancer later because of this. More importantly I don't want to have a baby whose health is compromised in any way because of it - how unfair would that be? "Here, I gave you life, but your chances of cancer are really high and your thyroid will never function properly. Welcome to the world!"

So anyway, no doomsday. Chances of a fatal thyroid storm are very minimal.

Chances of being called on in Property today and knowing nothing about fee simple absolute, however, are very good. Hm ... maybe I can use my "condition" to my benefit somehow. "I'm sorry, I'm unprepared because if you stress me out I could die." It's not like that at all, though, so no worries.

I'm just really annoyed with my thyroid for not increasing my metabolism! I should be able to eat all the damn kingcake I want without retribution! Life is so unfair.

now i understand ...

why my endocrinologist is freaked that I'm refusing treatment and could go into thyroid storm:

"Mortality/Morbidity: Thyroid storm is an acute, life-threatening emergency. The adult mortality rate is extremely high (90%) if early diagnosis is not made and the patient is left untreated. With better control of thyrotoxicosis and early management of thyroid storm, adult mortality rates have declined to less than 20%. "

Well, those odds aren't so good for me.

the heart

The heart has been on my mind a lot of late.

My friend Tiffany, who's a bit younger than me, told me about the heart attack she had last year. Thank goodness she's ok and able to tell about it!

My thyroid problem can cause several serious problems, but the most serious is weakening my heart from causing it to overwork, so the doctor always asks me about if I have any palpitations. (No, though my resting heart rate is significantly higher than it used to be. I am going to start yoga and see if it helps.)

I just relearned CPR, which is of course all about the heart. And I know I'm jaded about having to retake it, but every time it's different - they keep researching and learning new things so we get different directions.

And now this very interesting article about stress cardiomyopathy. We really can die of a broken heart. I sometimes wonder about the emotional stress in my relationship with Dayton and if that exacerbates my health problems. Yeah, maybe I just like somebody to blame. Isn't that why there are men around?

protein tip of the day

1/2 c dry oatmeal - 5 grams of protein (150 calories)! That's more than a tablespoon of peanut butter (4 grams, 100 calories) and almost the same as an egg (6 grams, ~70 calories).

I'm always looking for non-animal sources of protein. The more protein I eat the better I feel and the less hungry I am.

Chernobyl in my neck

If I get the radioactive iodine, here's what they say:

"I am going to take a vacation in the United States immediately after I finish my treatment. Any special precautions needed?

The United States has recently instituted radioactive monitoring devices at some public buildings and transportation venues, which may be activated by patients recently treated with radioactive iodine. Patients planning on traveling to the US within a month of treatment should take a medical letter from their physician attesting to their diagnosis and treatment."

Great. I'll make checkpoints light up.

I told K about the side effects today and she said, "Oh, yeah, you would definitely need to wait a year before having a baby. Otherwise people'll be like, 'Oh there's [insert my name here] and Glow-worm!"

toxic nodule

Today was my appointment with the endocrinologist after last week's scan.

I wish I could post the pictures here of the scan - it's way cool. And depressing. I have a toxic nodule - basically the left side of my thyroid has taken over, sort of a mutiny, and decides to create its OWN hormones rather than listen to my pituitary. Hm - doesn't take orders? Why doesn't that shock me that I would have glands like that. The picture was really clear, and even my untrained eye saw immediately what was going on.

So, I have three treatment options. One, they cut my neck open and remove my thyroid and I go on synthroid for the rest of my life. Two, they give me radioactive iodine which kills most of my thyroid and I go on synthroid probably for the rest of my life. Three, I go on medication now that requires monitoring liver function and other possible side effects and may eventually have to have options one or two.

Also, I can't get pregnant as long as my thyroid is this whacky - all sorts of side effects possible to the baby. And, if I do option #2 (the best), I can't get pregnant for at least a year. (Yet another reason to ditch what's-his-face.)

But, I don't want that to force me into a permanent procedure. So, we decided to continue with observation. I like the endocrinologist. I know she wants me to treat it because she's worried about it getting really bad really fast without warning, which can cause some serious heart damage and the like. ("Thyroid crisis or storm is an acute worsening of the symptoms of hyperthyroidism, which may occur with infection or stress. Fever, decreased mental alertness, and abdominal pain may occur, and immediate hospitalization is necessary.) While I've started showing some symptoms, I'm not full-blown.

I haven't found anything on-line about a natural way to cure this. And I'm not talking herbs or anything, but dietary and lifestyle changes I'd do. What if I start yoga and destressing all aspects of my life (is that possible while in law school?) (or - is it possible for me?)? What if I was really good about daily exercise and healthy eating? I've gained 8 pounds recently - and I know I've been lazy since I got back and got that nasty cold, but that's an awful lot of weight pretty quickly.

And I convinced her to sign off on me getting a bone density scan. She and the other doctor don't believe that I've shrunk over an inch in 20 years, but I have. Hopefully it's not a sign of bone density issues, etc. - but it could be a symptom of the hyperthyroidism which would make me more receptive to immediate treatment rather than waiting. She's not sure the insurance would cover it but she said she'd code it for best possibility. Either way, even if I have to pay out of pocket, I'm doing it this week. (I know that medical care in New Orleans now has a really bad rap - but this is honestly the best and most expeditious care I've ever received in my life anywhere.)

This all probably also means that I shouldn't leave for three months this summer. If I could thyroid storm, or if we're trying to adjust my synthroid levels, either way I don't want to be too far away from her.

Damn it all.

side effects

Trying to figure out why my face is breaking out now after clear skin for awhile - it's because I went off the doxycycline (malaria prophylaxis).

Teenagers use it for years to control acne. Apparently I need it now, more than 20 years late.

urethra geiger counter

Today my urine becomes radioactive.

I will skip PAP's class to go to the hospital to take a radioactive pill. Tomorrow I go back for them to do an uptake scan - see how much of the radioactive iodine my thyroid takes up and where. All the info says how important it is to flush, wash hands thoroughly, etc.

I'll be glad when this is all over and my pee will no longer be considered HazMat.