Friday, June 25, 2010

Answers and more questions

Okay, I FINALLY got my test results back on Tuesday: everything is in normal ranges. For two of the tests, my scores were pretty much in the dead center. For the last, it was toward the lower end of normal but not so much so that it was cause for concern.

I have answers, but I still have more questions. I was up at this week's weigh-in ... it wasn't entirely unexpected but really, can one blowout meal cause that much of a gain? No. I still think there is SOMETHING going on, and while it's not my thyroid, I don't know what it could be.

But I have bigger fish to fry right now: my mother's health. She has been feeling puny (that's a Southern phrase) for about 2 weeks. She went to the doctor last week because she could not kick a feeling of nausea. It would just come in waves but never so strong as to actually make her upchuck. Just that awful feeling of "I'm gonna be sick, I'm gonna be sick, no wait, yes, no...." So the doctor gave her some Phenergan and sent her home. By Tuesday, she still was sick, same symptoms, so she went back. He was concerned enough to send her for a chest x-ray, thinking that she might have some pneumonia. She is also having trouble breathing.

Those test results came back -- in only a day, but hey, I'm not bitter.... Oh, no. It's not pneumonia. It's pericardial effusion -- or in layman's terms, "fluid around the heart." So they sent her home with some diuretics and instructions to change up some of her medicines (dosages, timing, etc.) and to start moving.

Okay, I'm thrilled that she's now being forced to get off her rump and do something. But let me also tell you: everything I have read about this condition is like, "Further testing is needed to determine the cause of the effusion." Apparently there are different fluids meaning different types of conditions. So can someone tell me just why a test isn't being called for, post-haste?

I get the idea of managed care. Really. I do. In the past two years, both working in HR/Benefits and with my own medical needs, I have learned more about health plans, etc. etc. than I ever imagined needing to know. I get that insurance would prefer to try step remedies - if a lower cost, easier-to-the-patient idea will work, use it. Like you wouldn't use a tourniquet on a paper cut. I get all that. But I do. not. get. at. all. why you wouldn't call for a test when it is so obviously needed. I just went through it myself -- why'd my test results take two weeks? Because they had to be sent off to a specific group for testing, otherwise my insurance would not cover it. I'm still wondering if they'll cover it all because I had a similar test done just last July (11 months ago). It wasn't the exact same test -- that was a TSH, these three were the TTR, T3, and T4. Just different enough that it might be okay.

This isn't a political rant about healthcare legislation. This is a rant about the state of health care in general, not just in the US. Why is it so difficult to get the answers we need without having to prove ourselves? THAT, my friends, is just as sorry as not being able to get coverage because it's too expensive. I am tired of some CFO making a decision about my health instead of me and my doctor. I am tired of having coverage or payment determined by an underwriting manual instead of a doctor saying, "Yes, this is necessary, so cover it. Period." If you've never read The Rainmaker by John Grisham, do so, because it will give you a good perspective on the subject. Yes, it's fiction, but with so much of Grisham's work, I wonder how much really is fiction. Same with Runaway Jury - if half of what was presented as the scientific data in the trial scenes is based on actual scientific research, then my God, why would you ever light up?

Okay, I'm coming down from the soapbox now. It's Friday, it's a good day, and I am going to make the best of it. I am going to arm myself with all the information I need to make not only good decisions for myself but for those I love as well. And if I have to advocate for change, so be it.

Friday, June 18, 2010

Wishin' and Hopin' and Thinkin' and Prayin'.......

I have been able to rearrange my schedule in order to attend the 5:30 meeting on Thursdays. It's a different group, but they seemed very nice so far. And I discovered that one of the 5:30 members (who had been attending the 7:00 a while back) is moving to Europe on a 3-year transfer assignment. WOW! Lots of changes in store for her - and smart girl, she has already found where WW meets in the area to which she's moving! You go!!!! Sara, wishing you all the best, and please stay in touch!

In fantastic news, my weight was down. Not by much -- 0.4 pounds -- but I will take every single ounce or fraction thereof I can get. It's nearly 2 sticks of butter gone! I made a real effort this past week to listen to my body's hunger signals instead of those little signals from my head..... the ones that say, "What a day! You've earned a little wiggle room...." or "Man, this workout is something else; you can eat a little more today." Well, no, not really - not if I want to continue to strive for success. I didn't always succeed but I did much better.

Speaking of workouts.... "The Dave One" (as I call it) isn't getting any easier but it's definitely making a difference. I've had several people this week ask if I'd lost some weight. Well, no, but I certainly notice some changes. Clothes that were tight even a few weeks ago are now hanging better on me. There are portions of me which have begun to tone up even more - my physical therapist noticed that immediately about my legs the other day at our appointment. Those leg presses and curls and the abduction walk are having a positive impact on me! By the way, "abduction walk" doesn't mean that I snatch some unsuspecting person off the street and force them to exercise (although perhaps given the obesity epidemic in the US, we should consider the idea!) The calf raises and stretches leave my legs a little sore that night but healthy by the next day. All told, it's a fantastic feeling! Now, do I relish the workout itself and golly gee cannot WAIT to hit the gym? I'm not that insane. But when it's all said and done, do I have a feeling of great accomplishment? You bet! And that, more than anything, feels so good!

As of 5:30 PM on Friday, June 18, I am still waiting for the lab test results from the full thyroid panel from last week. I've called my doctor's office three times since yesterday -- and I'm not the nervous Nellie type. In fact, I've done a pretty decent job so far in not trying to dwell on it. But I also don't want to start wondering if the news is bad. No news is not always good news. I am a cautious optimist. I hope for the best, and yet know that I need to be prepared sometimes for the worst. I'm not quite up to pacing and chain-smoking just yet (well, at least the pacing portion). So I sit and wait and cross my fingers and offer up prayers and play some music and do my best just not to think on it. Kind of like Necie in the Ya-Ya books: I'm just thinking myself some pretty pink and blue thoughts...... Again, I don't know what the answer will be, but I know that no matter what, I am in good hands.

Sunday, June 13, 2010

Which Are You Feeding? (and an update)

I weighed in at work Saturday morning, and I’m more or less holding steady. Part of me is happy about that, since I had some binge-y moments this week. In reflection on those moments, I know how it happened. On Tuesdays, I eat dinner at work (4:30 PM) in order to make my schedule work for a committee meeting each week. I don’t like this, since I usually finish lunch around 12:30. 4:30 is a little too soon for a full meal. By 10:00, I’m starving and shoveling in whatever's not nailed down (and that’s even with snacks at the meeting). So now, I’ve decided that I will simply have to stop and pick up something on the way to the meeting and eat it then. I hate the idea of spending money instead of taking something from home, but you do what you have to.

And this week, I tended to listen to my "head hunger" instead of my "body hunger." I wasn't really caring whether or not I was physically hungry, but wanting to satisfy my emotional hunger instead. I was letting my mind outfox my body. That was especially evident on Thursday night. I was perfectly physically satisfied, but mentally and emotionally starved for something. I fed the wrong need; this hunger didn’t need physical food but some sort of affirmation or reassurance.

Amazing, huh? After four years, I still fall victim to the old ways of thinking. I’m just proof that it can still happen to anyone. Even with knowing all those good habits to follow, my old brain followed the wrong internal circuitry. So this week, I will be taking extra precautions to listen to the right signals.

***

I went to the doctor on Thursday for consultation and answers. I mentioned that I do have some of the signs they mention for hypothyroidism or Hashimoto's, but not all. If I am fatigued or sluggish, it's only when I've gone until I just cannot go anymore and then crash! If nothing else, I have become a perpetual motion machine. Sitting still kills me. I also don't have a "sluggish system" – nosireebob, 50 grams of fiber a day pretty much helps with that. Pale, dry skin? I give white a bad name, folks. And dry, well, yeah, but you know, mostly seasonal and I'm older now. I understand.....

But I do have the low tolerance for cold temperatures. The A/C is on because it was 90+ degrees outside and it's starting to get humid. And usually I'm wearing a cardigan anyway (surprisingly, I'm not at this very moment, but I am cool). I sleep in yoga pants and a tee (either long or short sleeved) year round. Wasn't that long ago that I slept in a short-sleeved tee and shorts, and broke out the longer pants just for winter. I have two pairs of flannel pj's that get quite the workout each winter. In the winter, as I told Dr. H, I literally back my rump up toward the gas heater and get my butt warm. For some bizarre reason, my butt is always cold in the winter. Can't explain it.

Unexplained weight gain? Really, Doc, just read my blog posts since February of this year. Nearly every week is a lament about that. I have been consistently stuck about 5 pounds above goal for months now. There's a reason and that's part of what all this is about.

Irregular cycle? Well, DUH! That's what set this whole process in motion back in 2006. Irregular cycles have been sending me to doctors for years. I should have seen one in my teens -- not for irregularity in timing (oh no, that was no problem), it was all the pain and other stuff. It took me until age 27 to realize that all those things were not normal. And since 36, I haven't been "normal" in any regard to that.

Shoulder pain and stiffness? Just ask my chiro. The adjustments help but within days, it's back to the pain, and it's not just in the joints of the shoulder. It's my neck and upper back. My trainer has a few moves put into my routine to help me develop better shoulder/upper back strength so that the poor traps (i.e., the ropes that go from neck across the top of the shoulders) don't tote the whole load..... best of luck there. I still hurt. A large chunk of the excess skin that needs to be removed is all up front -- chest, midriff, the "I had all 19 of the Duggar kids at once" abdomen. Not to mention the backfat and now-practically-nonexistent derierre. Oh, and God no, let’s not forget the saddlebags that are my arms and upper legs (to the knee), and even a small portion above the calf.

These things are what have sent me looking for answers. I know, beyond any doubt, they're connected. I need to know what just what my body is trying to tell me. That need had me once again on a doctor's table. They checked my heart rate twice, once by hand and once with an oxygen saturation monitor. Same number both times: 56. (And great oxygen absorption, too, at 99%). The heart rate is low – for most people, but for me, it was considered "athletic" range. ME? ATHLETE? I still chortle. They were pleased.

He seems to think most of the issues may be interconnected, and the overall thing is the HUGE weight loss. I also said, "Oh, before I forget, by the way, I meant to show you this last time...." I have a cyst on my shoulder. I hadn't really paid much attention to it but I noticed it about 18 months ago, I guess? It doesn't seem to have grown or anything but who knows... He looked at it and said, "Oh, probably nothing, but just keep an eye on it." I said, "Do you need to do a biopsy or anything?" His response, "Eh... I don't know."

He went to his office and came back and said, "You know.... I'm going to go ahead and have (Nurse) draw up the orders for a full thyroid panel anyway. I don't think there's anything there, but I agree. Answers are helpful. And uh, depending on what the tests say, I may do an incisional biopsy of this cyst."

If ever there were a loaded word in the English language, biopsy is surely one of them. It sounds odd, but I am so glad that work was busy on Thursday afternoon and all day Friday, insanely busy as it was. And I’m thankful that I had things to keep me occupied this weekend. If I hadn’t been totally occupied, I might have simply wasted hours thinking about the “what ifs.” As it is, I’m sitting here on Sunday afternoon, and the word is a little less scary. I’m not as freaked out as I would have been had I dwelt on it for long ... but I’m also not out on my lawn cheerfully asking, "Gimme a B!!" either. I’m waiting, patiently, and trusting that in the Master Plan, all will be well. Julian of Norwich’s very famous quote comes to mind: "All will be well. And all will be well. And all shall be exceedingly well."

So I’m waiting to see what happens, in a lot more faith and trust than I am used to exhibiting. I’m not saying that I’m not worried or scared or concerned, but I’m not going to dwell on it. It will be what is meant to be. And all will be well, in every area where I wish to be healthy.

Saturday, June 05, 2010

Knowledge and power

I'm not sure I have a lot of words of wisdom this week. I'm not feeling very wise. I'm not discouraged, but I am .... well, I'm not sure there's a good descriptor for it. Baffled. Angry. Inquisitive. Perplexed. Not-Quite-But-Awful-Close-to-Helpless. Determined.

(For what it's worth, the one on the list that kills me is the "helpless" phrase.... don't even get me started on my absolute dread/dislike of "helpless"!! I don't believe we're ever without help, whether it's from others or divine assistance. Help is always there. But it's the only way I can really describe the feeling.)

I am still up, weight-wise. This week, I used 25 of my 35 weekly extra points. I use those extra very infrequently, but I did this week. Was it too many? Not enough? I know that maintenance is ongoing and one of those constant experiments to see what may work and what may not. But I hardly think that using 5/7ths of those points was enough to send me up that much? And yes, it was (sorry fellas) The Week Just Before. But water retention? No. Trust me. I spent all day Thursday wearing a path from my office to the ladies' room. AND WAS STILL UP.

I want answers. Plain and simple.

For the last two checkups (last fall and this spring), my primary care physician has expressed concern about a low pulse rate. His concern is that it could be indicative of a thyroid issue. Last spring and summer, I was plagued by some other issues, and in the effort to get to the bottom of those, one of my doctors ordered a thyroid test. It came back normal, so a change in meds was in order. Fine. And the low pulse rate could be attributed to overall good cardio fitness, perhaps. But in discussions with a friend, I learned about an autoimmune disorder in which the thyroid is involved. Her sister was diagnosed with it, and her sister's thyroid tests all come back in normal ranges -- which they shouldn't, given the nature of this disease.

It made me ponder things. I'm not saying that there's a definite medical issue and have that be an excuse. If I'm screwing things up and gaining weight due to inattention or some fault of my own, THAT'S FINE. I can solve that somehow. I can keep tweaking and experimenting and finding ways to make it work. I'll know then that it is all me. But if there is an underlying medical problem, well, I want to know that too. Knowledge really is power. If I know, then I can work to solve it or alleviate it or do something other than wring my hands and think, "What did I do? What didn't I do? I've done everything right that I know to do. WHAT IS HAPPENING?"

I have an appointment for next Thursday with my family doc, and I am going to show him the information I have found. I am thinking that with the issues from last summer (okay, really, from most of my adult life on that front) that I need a full panel, I need to have real answers. If my goal really is improved quality of life through healthy living, I owe it to myself to know my body, both its strengths and weaknesses. I need to find what is in my power to change and accept what I cannot control and change.

I hope I can follow the example of my aunt Peggy. My aunt Peggy is one of my she-roes. She has faced adversities that I cannot begin to imagine: losing a child who was only age 2, facing breast cancer, a late-in-life diagnosis of diabetes. Her response to roadblocks is a marvelous example: a moment or two of silence, some deep breaths and then an "Okay, so what do I need to know, what do I need to do, to make this better, to learn to live with it, to move forward?" I sometimes sign off posts with "Ever forward" -- it's a gag line from the Dragnet movie in 1987 that makes me laugh, but it's actually a great outlook on life: ever forward. And that's how my aunt Peggy operates. One foot in front of the other and just move forward.

And that's all I want right now: answers. Something I can see, hear, touch on a piece of paper, something that will help me move ever forward. Something to let me know what is and isn't in my capability. I don't mind being told nothing's wrong. In fact, the words would thrill me because then I'D KNOW. I'd know that whatever's causing this gain is totally within my power and grasp to change. If I'm told, "Wow, you have this and we need to get you on some meds to help you out," then fine. It's one more prescription in the arsenal. And I can deal at that point. Ever forward.

Knowledge is power. And I need the knowledge to keep me from that helpless sensation that I so dread and loathe.

Here's to knowledge and power. Here's to never settling for a shrug of the shoulders. Here's to the determination to delve in and to find out more about the gift of our own bodies.