No More Veganism

This has been a very eventful week regarding my health.

HYPOTHYROIDISM
The tempest began with a visit to my favorite endocrinologist who told me my thyroid has more or less failed and therefore prescribed a daily dose of thyroid hormone to take orally every morning. We guessed on the dosage, she said she could start me super low (.25) but was pretty sure I'd eventually need more (.5 or .75). I told her she might as well give me the bigger dose already (bigger relatively, some people take up to 3mg I think) and so I've started on .5mg of Levothyroxine every morning. As she suspected taking this pill had pretty visible affects in my energy and mood. I found myself able to survive a whole day of rehearsals and shows without the usual moodiness, at least for the first day or two. By the third day, however, I found myself feeling a bit dodgy again. I'd find myself getting lightheaded whenever I stood up too fast, my muscles felt achy just from climbing stairs, I felt weak and then late at night I started feeling very nauseous, which is a sign of...

ADDISON'S DISEASE
My endocrinologist warned me that taking the thyroid pill, though necessary, may speed up the progression of the Addison's disease which has been present in each of the blood tests I've done over the last several months. Up until now, however, my adrenal function has remained fairly normal considering the insane amount of antibodies present in my blood. But inexplicable nausea (especially considering my blood sugar was fine) was a big red flag for me. She said if I experienced any such symptoms to immediately take an oral hydrocortisone pill. I did, and almost immediately my nausea went away and my energy returned in force (along with an abundantly good mood I left somewhere in last September).

 (did you know that when you have both Hashimoto Thyroiditis and Addison's disease it's called Schmidt syndrome?)

What does this have to do with veganism???

Well, to quote wikipedia:

"To form cortisol, the adrenal gland requires cholesterol."  

Cholesterol comes from animal products. My adrenal gland isn't dead, it's just not working very well, and I'm not helping it by starving it to death.

"You need to start eating meat again."
"Okay."

So my 40 or so days of veganism has come to an end. I've had fish thrice, yogurt twice, and a half a chicken since the appointment (the chicken made me a bit ill). I won't forget what I learned though... although I may save it for another post.

The past few days:

April 10, 2012 - First day of Thyroid pills
9:30 -> 142 Way to f***ing high! Took 2P and 2N w/cereal 140c, chips 10c, banana 27c. Took thyroid pill at 1:00. At 3:00 had Larabar 26c.
4:34 -> 108 Had apple then went on 2 mile run (knee hurt) then took 4P w/ CHIPOTLE burrito bowl 110c.
6:54 -> 112 This is good! It means the Prandin is still doing something despite my C-Peptite being at an all time low of .48 during my most recent blood test. At 8:30 had grapefruit 25c and peanuts 5c.
10:55 -> 66 Took 1P and 2N w/greens 18c, squash 30c, salad 30c, yams 90c and Juice 24c.
3:42 -> 186 Poor planning of my meal, I drank the juice because I felt low because the yams hadn't finished cooking yet. Took 5L.

April 11, 2012
11:06 -> 100 Better. Took 2P and 1N w/cereal 140c, pb toast 19c.
4:52 -> 63 Took 4P w/ Black Eyed Peas and kale 180c, then apple 18c, kiwi 10c, pumpkin seeds and peanuts 8c. At 9:30 had apple 18c.
12:25 -> 63 Took 3N w/salad 30c, squash 40c, yams 60c, carrots 30c, potato 40c and just about exploded from a stupid amount of starchy foods.
4:00 -> 140 Took 5L.

April 12, 2012 - First day of Hydrocortizone
10:37 -> 95 Took 2P and 1N w/cereal 140c, apple 18c. At 2:30 had Larabar 331c and grapefruit 24c.
5:17 -> 70 Took 3P w/brussels sprouts 18c, rice 40c, fish, apple 18c, peanuts and pumpkin seeds 10c, apple 18c and kiwi 20c.
12:15 -> 89 Feel weak and nauseous, took a hydrocortizone and 2N w/dumplings 100c, b sprouts 25c and salad 20c.
5:45 -> 102 (don't judge me) Took 5L w/carrot 8c.

April 13, 2012
12:35 -> 98 Good, consistent. One more # like this and I'll go up to 6L at night. Took 2P w/cereal 130c, then apple 18c then kiwi 10c.
4:55 -> 72 Took 1P w/PUR-BIRD 1/2 chicken 5c and roasted cauliflower 15c, pb and banana 58c and two homemade gluten free bacon bourbon chocolate chip cookies 37c.
12:25 -> 89 Took 1P and 1N w/ indian veg 20c, quinoa 60c and kale 6c.
2:25 -> 114 Pretty dang good, had a carrot 8c and took 5L.

Day 115

Hypothyroidism

The newest condition I've added to my collection. They came as part of a package deal. Get one, the other three are complimentary. Even though I haven't been officially diagnosed, my endocrinologist insinuated that there was little doubt when last we spoke on the phone. My TH levels were low, my thyroid was underproducing. The only thing keeping me from an official diagnosis is another set of blood tests and a $400 in person evaluation.

I have no doubt of my condition however, I've been feeling the symptoms daily for over a week. The symptoms in some ways are worse than the symptoms I experienced with diabetes... in some ways.

For over a week now my mood has been much like the weather in Hawaii. The morning starts perfectly, another day in paradise. The sun is bright, the water warm, people are outside, life is good. Then sometime around lunch usually, sometime a bit earlier, sometime a bit later, the clouds roll in consuming the whole archipelago in torrential rainfall, the sun disappears almost completely, and even though it only lasts an hour or less, and even though you know that the sun will return again, for that period in the darkness, you wonder how you've made it this far and how in hell you can possibly make it through to the other side of the storm.

And I know it's chemical. I can almost feel that it's chemical. I have no reasons to be in daily anguish. Frustrated from time to time, sure, maybe even bored, occasionally fatigued, angry at situations or peeved by circumstances, but weak and ill and despairing to the point of wanting to cry?? Nothing in my life adds up to those emotions, and yet they return almost daily, triggered by the most inconsequential of things.

I feel like a small business owner under the repressive finger of a mob run protection racket, harassed and assaulted daily, and spending the rest of the time living in fear of the next visit, haunted by the memory of the last. My will-power and body awareness serve like a broken shield and rusted armor against the attack. I'm reminded of what I long thought was the MacMillan crest, a man with broken sword fighting off his enemies (turns out the sword was only broken on our crest).

I've chosen to write from a place of happiness to be as fair as possible to my experience. Anything I write during my afflicted hour would sound more like a Sylvia Plath poem than an original of mine. But this shouldn't last. Later this week I'll have my second blood test and a week later I'll see the doctor for the inevitable results and will likely start medication that night or the following morning.

And a glorious side affect of the medication is increased energy! (or one of the symptoms it alleviates is lethargy) Which means that once I start taking thyroid hormones orally I'll also start running several times per week.

Dailies:

12:01 -> 105 Took 2 Prandin with cereal 120c (coconut yogurt is higher in carbs than soy), apple 35c, fake coffee 5c, peanuts and pumpkin seeds 6c. At 4:30 Larabar 27c. At 6:30 another 24c.
8:07 -> 71 Took 3 Prandin at 8:40 with dinner of brussel sprouts 20c, portabello mushroom 4c, celeriac 30c, cabbage 35c, quinoa 60c, yam 50c.
12:23 -> 245 Dang it! Waiting so long to eat made me super hungry although a mere 190 carbs shouldn't really be a problem for 3 pills. I decided to take 1 unit of Novolog so that i could finish the yam 50c and have a small salad 30c without going any higher. I also took 3 units of Lantus in anticipation of a weird day tomorrow. If I'm lower than 140 when next I check I'll have another mini snack. Feels good to be full, thank you bolus insulin.
2:21 -> 218 Well... still high, but going down a little. If this keeps up I may have to relearn my carb: insulin ratio. I guess I'll go to bed sans snack and trust that 3 units of Lantus will put me in the sweet spot come tomorrow early. Why early? Oh yeah... 'cause this playah is rollin' to the Hamptons tomorrow! Hollah!!! Although this idiot will rely solely on Prandin and fasting to keep my blood sugar in a good range until Tuesday night.


Day 96

Blood Work: Part 4

I got my blood results today. This is the fourth time I've had blood work done. The first time was with my initial visit to the doctor. The second time only a few weeks later. The third was six weeks after that, and the fourth (most recent) was last week, three months from my initial diagnosis. There's no point in building suspense, I have to take the numbers and the results as a quarterly check in, to see how I'm doing. As always seems to be the case there was some good news and some bad news. The good news was good, the bad news... well, you'll see. (I'm recording these from memory, when I get a copy of the blood work I'll copy edit to make sure all numbers are accurate.)

GOOD NEWS:
Hemoglobin A1C: 6.1% This is amazing news. If I can maintain this number for life it is unlikely that I'll ever experience diabetic complications. Other than a freak high or low, complications are the biggest fear/concern (or should be) of all diabetics. A 6.1% A1C means that my average blood sugar level is about a 126.

Total Cholesterol: 126 Also amazing news. Cholesterol levels are a great indicator of heart and artery health. Even a level of 150, though well below the acceptable level as stated by the American Heart Association of 210, has been shown to increase your chance of heart disease. When I first got tested I was a 170, which is a good number for an American, but a bad number for a diabetic who is determined to live a long healthy life. A 126 on the other hand is amazing! I have to attribute this to my new dietary choices.

BAD NEWS:
C-Peptide: .53 This number will continue to fluctuate, a symptom of type 1.5 diabetes, and one of the biggest challenges I'll face in the next few months/years. The number indicates how much insulin my own body is producing. As this number increases so does my natural insulin production making my blood sugar more stable. As this number goes down (.5 is low) I'll be prone to higher and higher blood sugar levels. In response to this number my doctor put the responsibility of treatment in my hands. In her own words she reminded me that I knew how the Lantus and Novolog and Prandin worked, and to search for a balance with any combination I felt appropriate.

TH: Low. I forget the actual number, but this represents the hormone produced by the Thyroid. Mine is hardly producing at all. I am now the proud new recipient of hypothyroidism (more on that later). She's going to give me two weeks and then have me repeat this blood test. If the results stay the same or get worse I'll have yet another pill...to take daily...for the rest of my life.

So the good news is after a mere 3 months, the things that are in my power to control have been controlled. I've virtually disease proofed myself against a host of complications, and proved to myself that I'm smart enough, willful enough and strong enough to do that.

The bad news is that for the unforeseen future I'm shooting at a moving target when it comes to blood sugar regulation. I'll have to be flexible and alert. And the next few weeks may be rough. Hypothyroidism can cause sluggishness, fatigue, depression, etc. I fear a weekend trip to the Hamptons is only a temporary fix.

Dailies:

11:30 -> 138 That's the highest fasting level I've had since February 4th, not a great sign. Took 2 Prandin with cereal 110c. Walked several miles.
2:44 -> 123 That's better, I guess I'm still producing some insulin. Took 3 Prandin with black eyed peas 100c, apple 30c, clementine 9c, grapefruit 26c, lentils 20c. At 6:00 had bagel with pb & banana 55c
6:50 -> 117 Woah! Awesome, that right after having a bagel too! Had a piece of bread with hummus 20c. Performing as Joey. At 8:30 I had a cupcake 12c, pumpkin seeds 6c, and bread with jam 16c. At 12:00 I had a shot of tequila and a Larabar 26c.
1:54 -> 105 Great! Took 2 Prandin with salad 30c and brussel sprouts with cabbage 30c. If I'm above 150 before bed I'll take 2 units of Lantus with a little snack.
3:21 -> 104 Wow! Looks like the Prandin is still working today. I'll have an orange 20c and some blueberries 16c and go to bed.

Day 91