Wednesday, August 31, 2011

T4 hormone replacement inadequate in patients with hypothyroidism

There's a new article proving* that T4 hormone replacement (Levothyroxine) is inadequate for producing T3 in the body. Popular believe among doctors was that because T4 is converted into T3 in the cells of the body, and not produced by the thyroid, that all you needed to replace was T4. Not so, says a paper published in the Journal for Clinical Endocrinol Metabolism. The big payoffs for adding T3? Well, weight loss and lower cholesterol, "without detected differences in cardiovascular function or insulin sensitivity."

Damn. Probably shouldn't have let my old doctor talk me into stop taking it years back. Time to call the new one.


*(double-blind study)

Tuesday, August 30, 2011

Feeling "high" - the positives...

This is scary for me, because this is a topic where I can easily be judged harshly. But I feel this is important to talk about. I take several medications for my pain, both narcotic and non-narcotic. Both have side effects that would be considered desirable to people who are looking for an escape from reality. These side-effects, I have to admit, are desirable to me as well. But my motives are very different. Unfortunately motives and intentions aren't something that can be verified with a test. It's an act of trust every time a doctor hands over a medication that can create a "high." I enjoy those side effects, I won't lie. But let me tell you why...

I woke up this morning and I was feeling terrible. I took my non-narcotic on schedule like I was supposed to, but it wasn't enough. I had to change clothes because the elastic, even though it wasn't tight, was painful on my skin. The weight of the pants was hurting my hips and lower back even thought they were a light cotton knit. My hands and feet were aching and it was difficult to walk and type. I took a narcotic pain pill and waited for the pain to subside.

Normally, the medication just evens me out. If I limit my activity, I can manage. But this time, the medication actually made me feel better than my "normal" levels (slightly better than house-bound). I walked outside and notices that I felt a slight floating feeling and my skin was tingling pleasantly. It took me by surpise: I was a little buzzed. I was amazed. I was joyful. I was actually feeling a high.

I know what you're thinking. But the high wasn't my goal...

I don't do movement for fun. I do movement for purpose. I don't have enough spoons to waste them on "silly" activities. But this time it could be different. The high told me that I had freedom do to MORE. If I'm high, I've got extra medication in my system to burn. Physical tasks that are normally impossible for me I can now do. Ironically, it's safer for me to take "risks" with my body.


It felt sooooooooooooooo good. I was able to enjoy my body. I was able to enjoy movement freely. I didn't have to ask myself, "Is this going to hurt?" I knew from the high that it wouldn't. I could move like Jagger. Later, I didn't have to hold the railing walking down the stairs. I could skip down them. And I did. Spontaneously and without a second thought. The freedom is magical. I'm not in it for the high. I'm in it for what the high lets me do.

I love to do physical exercise, cardio-vascular fitness, cooking, sculpture, and all sorts of other projects. But I just can't. Not because I have some sort of catastrophic thinking. I can't because I have too many things I have to do. I need to be able to take care of my responsibilities. If it falls outside of that, I can't be wasting spoons on it. If I do an activity for fun, it can rob me of my ability to do something I have to do. That's not good.

I want to live up to my obligations. So the fun gets cut. The exercise gets cut. The art gets cut. I rely on quick food rather than cooking a real meal. I take the short-cuts I have to, so that I don't undercut what's really important: keeping a roof over my head, clothes on my back, a working car in the driveway and food in my belly.

And I don't know how to explain that to my doctors. I know the DEA is all to willing to yank their license and take away their livelihood. I've had doctors that have left the pain profession because the pressure was too much. I don't want to put my doctors in that position, but honestly, I am undermedicated for pain. I need the big guns. But who is willing to put their life career on the line for a stranger? Not many.

So I live as best I can. And I relish the days that I feel the "high." Because then I can move without thinking. Without worrying. Without wondering how much this is going to cost me later. Because it won't. I can engage with others and join with them instead of just watching from the sidelines. I can be a part of---an active participant in life again.

I can feel normal again for a little while.

Yeah, I'm high. And I'm a better, more effective person because of it. Getting high doesn't automatically turn people into sloppy addicts, sponging off of everyone around them chasing a fix. I'm chasing responsibility. I'm chasing functionality. The high helps me get there.

How is high bad then?

Wednesday, August 24, 2011

My pain & my strength

Imagine you're in a locked in a closet with a whole bunch of flies buzzing around. And you're naked. When the flies land on your skin, you act immediately and quickly to get them off. You wave your arms to keep them from getting close to landing or if they buzz too close to somewhere sensitive like your face. But even if none have landed on you, you're in a constant heightened state of anticipation and reaction. The buzz around annoyingly and you can find no peace, other than just passing out.

Now imagine that that constant buzzing is your body. It's not external, it's internal. And when one of those "flies" decides to "land" on the skin, it's not just highly agitating, but sharply painful. That's what my pain is like. I can tell where my pain is likely to manifest based on where my body is currently buzzing, but that's just a guess. I can ignore the buzzing to a certain extent. It's certainly easier when there's something to distract me. But that only works on the buzzing, not the "landings."

The other way my pain will manifest is in a "Princess and the Pea" way. If I stand on my feet for more than a few minutes, it feels like I've been working an eight hour shift on my feet. If I try to use chop sticks for a meal instead of a fork, my hand go from operational to "I just gave 6 hour-long massage sessions" by the end of the meal. It's as though my body wants to crank every sensation to 11 (when the volume is only supposed to go to 10).

Ironically, this detriment of mine has made my highly competitive in other areas. When me and my friends go to high altitude, they slow down and have a really difficult time maintaining a steady pace. I on the other hand know how to keep going. I'm so used to operating when I feel like crap that pace and push through. They'll loose all steam and nap frequently. I don't need to. We're equally tired by the end of the weekend, but over all, I manage better.

That all changes once we get back down from the mountains: they get energy where I don't recover... But it's comforting to know that I do have skills because of my illness that others don't. It's really empowering to have some area of my life where I excel exactly because I'm broken. That there is value in my brokenness that has made me better than "normal" people.

I have a deep well of strength and endurance that doesn't get to shine a lot under normal circumstances. So it's easy for me to forget that it's there. I remember what "normal" was like, and I want so badly to get back there. My efforts, because of my pain, so frequently fall short. The buzzing interferes with my ability to enjoy anything. There is so little freedom. But I've learned, through my endurance, how to do remarkably well, considering. The fact that I can even get close to normal is pretty amazing.

And if somehow we could find a way to make the flies disappear and make my body less of a Princess... If my normal beats "normal" at ten thousand feet... Wow. I would be able to do mind-blowing feats of endurance. Logically then it must follow that if the only thing that's stopping me is my disease, I'm pretty amazing right now. Because I haven't let it stop me completely. And it should. Normal people would rest under my circumstances. But I endure.

That's awesome.

Got into CU Endocrinology!!!

And here I had scheduled an appointment in my calendar to check who had received records. !@*#, that was fast! Last time it took over a year to get me in to a neuroendocrinologist. Apparently when you have documentation to support the fact that you're a medical unicorn, the right people do pay attention. My appointment is for Sept 9th. Wow.

I haven't even begun treatment (which may, in fact, be its own nightmare, but who cares!) and already I can feel the relief of hope being in sight. And the not-so-noble side of me grins widely at the number of plates of crow I get to serve. I am among the partakers, because as I've said before, I never thought I'd see this in my lifetime.

Holy moley... The receptionist even sounded excited to leave me a voice mail. Last time I talked to them it was an absolute "NO!" to seeing one of their GPs. Oh, how the tides have turned!!

It's delicious.

Tuesday, August 9, 2011

Different Diagnoses - More than 100 medical disorders can masquerade as psychological conditions

I would argue that because it's become so "easy" to medicate anxiety and depression thanks to Big Pharma, that doctors frequently don't even consider the two symptoms. In some cases, I've run across doctors who want to blame my disease on the anxiety or depression rather than the other way around. There seems to be this pervasive magical belief that "bad thinking can make you sick..." Or that if there's a psychological component involved at all, well, now that you can check the little box on the diagnosis form, job done! Ship the patient to the head shrinker. The doctor's rush to fulfill his/her professional paperwork obligations, leaves them overlooking their patient obligations of a full investigation.

Confusing Medical Ailments With Mental Illness "An elderly woman's sudden depression turns out to be a side effect of her high blood-pressure medication.

A new mother's exhaustion and disinterest in her baby seem like postpartum depression—but actually signal a postpartum thyroid imbalance that medication can correct.

A middle-aged manager has angry outbursts at work and frequently feels "ready to explode." A brain scan reveals temporal-lobe seizures, a type of epilepsy that can be treated with surgery or medication.

More than 100 medical disorders can masquerade as psychological conditions, according to Harvard psychiatrist Barbara Schildkrout, who cited these examples among others in "Unmasking Psychological Symptoms," a book aimed at helping therapists broaden their diagnostic skills.

Studies have suggested that medical conditions may cause mental-health issues in as many as 25% of psychiatric patients and contribute to them in more than 75%.

[From Confusing Medical Ailments With Mental Illness]

If doctors were criminal investigators, they won't last past their first trial. In criminal proceedings, you're not allowed to just present a theory and then find the evidence to support that theory. All evidence must be collected, and all theories of the crime must be explored (even the ones that look like dead ends). Just finding a culprit isn't enough. You've got to prove it was that baddie rather than any of the other possible baddies out there.

But this would take an investment of time that doctors just don't seem to have. I don't know why that's the case... whether it's a doctor shortage, or bad time management within the system, or some sort of crappy incentives that drive our doctors to act this way. Whatever it is, patients are ending up the victims. We need to change this.