Tuesday, September 25, 2012

Surgery Day

The day has finally arrived. I have to admit, I'm not nervous at all. I have butterflies, but they're from excitement and "let's get this over with."

I'm hungry. Not starving (yet). But definitely parched. I want a huge glass of water. I get a sip when I take my medicine, and I'm holding off on that for as long as I can. I can also brush my teeth as much as I want, which makes me think I can also gargle or at least swish some water around my mouth and spit it out.

To face my hunger and pass the time (because of course I couldn't sleep past 7:30), I'm going to make my favorite pumpkin muffins. I'll have to assume they taste delicious and anxiously await one tomorrow morning, or even tonight if I feel up to eating.

I took this picture yesterday so I can remember what I look like. To refresh your memory, I'm also including the "before before" picture that the surgeon is using.


Signing off! My next post will either be as a woman with my old eyes, or as a woman with double vision but still has her old eyes.

Monday, September 24, 2012

Get in my Crockpot

Saturday evening:
I know I won't be up for cooking much (if at all) next week, but luckily I have not one, but two crockpots. I got some inspiration and menus from Aimee over at Six Cents and got everything I needed today. I already had all the seasoning and condiments except for steak sauce, but I needed almost all of the produce except carrots, and all of the meat.

I decided on Scalloped Potatoes and Ham, Savory Pepper Steak, Cilantro Lime Chicken, Sloppy Joes, and Salsa Chicken. I got my peppers (3), onions (2), garlic (2), broccoli (2), celery, and then some lemons (3), baking potatoes (2) and gigantic apple grown in Glastonbury, CT - I will have to take a picture of this thing, it's enormous - all from a farm on the edge of town. They have a $10 minimum debit card purchase and I got all that and still couldn't make $10. She let me get away with my $9.73 purchase. I love buying local!

I also needed to go to Target for freezer bags and a few other things (like the jersey sheets I mentioned in an earlier post, so that I don't slide down my bed when the head of it gets elevated an additional 4" on top of the current 4" elevation). I don't usually shop at Big Y, but a few things I needed for this cooking project were on sale and thanks to Wicked Good Deals, I knew I could score some free red wine vinegar. I love red wine vinaigrette on my spinach but it's annoying to keep buying it, so now I'll just make my own! I went to Stop & Shop last because that's MY grocery store. I love that I don't need to interact with a single human if I don't want to. I scan and bag my own groceries as I shop, can order deli meats via a kiosk or my phone and pick it up from a little bin, and use the self-checkout lanes. I'm not antisocial, but grocery shopping is my time to think, plan, and follow all my crazy lists while searching for the right coupon in my coupon sorter, so I like to just be left alone. Of course, Stop & Shop had no cilantro from the Cilantro Lime Chicken and the skies were turning dark so I decided I'd get it tomorrow. Of course, it never rained.

Everything but the kitchen sink, I mean meat.

I made up the Savory Pepper Steak and Sloppy Joes bags. Next time (as in, tomorrow), I will chop all my veggies first. I had to leave raw meat out for a little longer than I would've liked because I was chopping veggies mid-recipe. Since I had already browned the meat for the Sloppy Joes, I tasted the final product and it was SO good. I can't wait to try it hot, after simmering in its own juice for eight hours.

Tomorrow I'll tackle the other three. I was tired and hungry, so I had to call it a night around 7.

Sunday afternoon:
I couldn't sleep this morning. It was probably a combination of getting 13.5 hours of sleep Friday night and my excitement/anxiety about surgery. So at 6:30, I finally stopped fighting it and just got out of bed. Once the stores opened, I went and got the last of the things I needed, and was back in my kitchen cooking up a storm by 9:30. OK, I didn't actually have to cook anything yesterday, but I made the final three meals. The only thing I will have to do is slice up 12 small potatoes and add them to the ham recipe. Apparently, when you freeze raw potatoes, they turn black. The grocery store was all out of the frozen scalloped potatoes, so I'll just have to prepare them the day we decide to eat the ham. And when I say "I will," I mean, someone will. If I have double vision or even blurry vision, I don't think I will be holding any knives. Oh, and the avocados have to be peeled and sliced for the Cilantro Lime Chicken. I'm most excited for the Sloppy Joes, so that will probably be Wednesday's dinner.

Here is the freezer as it looks now, complete with my Coldstone Birthday Cake Remix just waiting to be devoured (don't worry, it was...about 3 minutes later):


 

Monday night:
I think I'll be nice and put one of the meals that doesn't require extra work in the crockpot tomorrow morning so that my dad gets a nice home-cooked meal after sitting in the hospital for probably 6-8 hours with me tomorrow night. I don't see him liking the Salsa Chicken very much, so it'll probably be the steak.

I have a whole hour that I can eat or drink and guess what? I'm full, and sick of peeing every 10 minutes, so I think I'm going to call it a night and fast for 17 hours plus surgery and recovery instead of only 16 hours.

Saturday, September 22, 2012

Hello Autumn, Goodbye Hair

I've been wanting to cut my hair for a while. When I took a few inches off in January, I liked it. But then it grew and grew and grew and I still liked it, but I had less time for it. It has been really bothering me at night when I sleep, ending up in my mouth, eyes, wrapped around my head, or just ripping out when it gets stuck under my shoulder and I try to move my head. I also knew that next week, my ability to do my own hair or even care about it would not exist. I can't get my eyes wet after surgery, so I have to wash my hair in the sink for a week. When your hair goes halfway down your back and you wash it in the kitchen sink, it ends up way down the drain where the garbage disposal is. I don't even want to know what's living down there.

So, off it went. I also love my new stylist Angie at Scruples. She was so nice and understanding of why I want to cut it but why I needed her opinion as how to best frame my still-puffy face without drawing any attention to my face.

Here's the before and after:


No, I wasn't stoned after my haircut, just tired from a long day of beauty (I got a pedicure with clear polish since I can't have any color for surgery) and four retail stops (more about that in my freezer meals post tomorrow or Monday), all while following the Florida game via the ESPN app on my phone. Also, my eyes really hurt since when I smile, they don't close like normal people's do, and I did a lot of smiling today.

It's much healthier and thinner. I have very fine hair, but a lot of it, so it weighs a ton. She used thinning shears so that it feels lighter and will submit to my flat iron with a better attitude. I know I look younger, but right now, I'd rather have a hairstyle that makes me look young because my fat face and big eyes make me look older. I've always looked 5-7 years younger than I really am until my eyes changed.

Friday, September 21, 2012

Here We Go...

*Note: I already wrote this in my online support group but I'm too lazy to rewrite it for the blog crowd.

Just left my oculofacial surgeon's (Dr. C) office my final pre-op appointment. My dad came with me, since he'll be my primary caregiver once I get home. The surgeon offered to let me choose to stay overnight (I have an afternoon surgery) or go home. I said I would like to go home, but that if the pain is quite severe or I end up needing 24-hour IV steroids, I will stay. I hope I can go home - I want real food, my own bed, and a MRSA-free zone.

The big news of the appointment is that he is confident I will not need a lateral wall decompression on either eye. No visible scars! He actually just came back from a conference in Argentina and spoke to several surgeons about my case, and he decided based on where most of my swelling has occurred, the lateral wall removal will provide little, if any benefit. He still plans to have the ENT surgeon (Dr. S) endonasally remove the medial walls and orbital floor. I forgot to ask, but I wonder if that means Dr. C won't be doing much other than directing the ENT surgeon…? He is not used to patients as young as me, and he wants to make sure he doesn't make my life at 27 (I'll be 28 in two weeks) any worse than it already is. My social life has taken a huge hit since TED reared its ugly head.


He is very concerned that based on how small and deep-set my eyes were before TED, he will need to remove a lot of bone and fat and thus increase the risk of double vision. I reassured him that I am OK with this risk - I want my old eyes back. I also have a very good support system in place - Dad and brother at home, Mom lives an hour away and will be there for the surgery, and my boss and co-workers are fully supportive and will make any accommodations necessary to help me work despite any side effects the surgery causes. I want to keep my job and they don't want to lose me, so my job isn't at risk, but I worry about my ability to work if I have double vision.


I will see Dr. C for follow-up on Post-op Day Two (Thursday) and Dr. S on Day Six (Monday). I already raise the head of my bed 4 inches, and plan to put pillows under the head of my mattress as suggested by Shirley. I will have a mini fridge at an arm's length for ice, snacks, and water. I have a warm air humidifier on my nightstand since I cannot blow my nose (or lift, bend over, or go upside down) for 10 days. I downloaded audiobooks and will set my iPhone to read messages out loud to me starting the morning of surgery. As for the 14 hours I have to fast before surgery, I have chapstick (I heard dry mouth/lips is worse than hunger) and a movie downloaded on my iPad.


I'm not nervous, although I know the risk of double vision should alarm me. I'm just so excited to get my old eyes back, and to put this first of many steps behind me.

Thursday, September 20, 2012

Someone Get This Girl a Coffee

Actually, please don't. I'm on Day Two of a caffeine-free life. I should say coffee-free life because I'm still having my daily (small) piece of dark chocolate, but I had my last cup of coffee on Tuesday morning. I'd been drinking decaf for the week prior, and I thought Monday was my last cup, but that afternoon this low pressure system moved in and gave me my third migraine ever, which lasted well into Tuesday night, so Tuesday morning I absolutely needed that small decaf with milk from McDonald's (I hadn't made any coffee, thinking I'd be fine). Yesterday went surprisingly well. I weaned myself the right way instead of quitting cold turkey. Now I won't have to deal with a caffeine withdrawal headache in addition to my dying thirst and outrageous hunger Tuesday morning when I am forced to start fasting 14 hours before my surgery...thanks surgeons.

Of course, in the past few days, Starbucks felt it appropriate to start launching their fall drinks. The salted caramel mocha is my absolute favorite coffee, hot or cold, from anywhere. Salted caramel or salted chocolate is probably my favorite combination of flavors, so I put down my "Dunkin Donuts-only" flag during the colder months and enjoy the wonderfulness of this beverage. So I've decided that on our way home from the surgery center on Tuesday, I'm going to request we make a stop at Starbucks. I realize this may be impractical, as I may be nauseated, possibly barfing, and definitely very hungry. So I might have to wait a day or two before I'm really ready, but I want it to be my first coffee after surgery.

Speaking of life after surgery, I found out my employer has not been giving me the sick time I should have been getting since I went full-time in April. When I inquired as to how much sick time I have saved up, I was told 0.40 hours. Um, what? We accrue sick time at 1.25 days per month, and I've been full-time since April and haven't taken any sick days, so that made no sense. It turns out someone screwed up. I'm also still listed as "PT Communications Coordinator" in our employee directory even though I am most certainly here 40+ hours a week and my title has been Marketing Communications and Public Relations Coordinator since April. And since I haven't been here long enough to qualify for FMLA, I have to use my sick time, personal time, and vacation time (in that order) for my medical leave. I pray I won't use it all because it all adds up to about 3 1/2 weeks and if I run out, then A. I have no time off until July 1 except for the sick time I accrue and B. If I'm out longer than I have paid time, then I start getting my pay docked...yikes!

My rear end is still surprisingly sore. I can sit now, which is progress, but after an hour or two on my special cushion, it hurts to cough, sneeze, or attempt to stand up. I'm much happier laying on my side but I'm not allowed to do that at work, and standing gets tiring and hurts my back since my computer/keyboard/mouse are on my desk, which is between my waist and knees when I stand.

My final pre-op appointment is this afternoon with the main surgeon on my case - the oculofacial surgeon, Dr. C. He will be the one doing my additional surgeries, whereas the ENT surgeon is only needed on Tuesday's surgery for his skilled ability to get sharp objects up one's nose. My dad is coming to this appointment with me so he can meet the surgeon ahead of time, who will explain the actual procedure (I'm still not entirely sure how it works) and give us clear post-op instructions - most of which I already know. I have a warm air humidifier in place since I can't blow my nose for 10 days, I have the head of my bed raised 4 inches and will put extra pillows under the head of my mattress the morning of surgery (I think I need jersey or flannel sheets though, because I already slide down the bed as is with plain cotton), and my uncle is supposed to dropping off his mini fridge that I'm borrowing so that I have water, snacks, and ice within an arm's reach of my bed during recovery. I do best alone when I'm sick or recovering from something, so after Post-Op Day One, I'm hopeful everyone will go back to work and leave me alone once they're convinced I can medicate myself and get to the bathroom without dying. And although this 50/50 chance of developing double vision scares me, my biggest concern is the fact that I can only lay on my back (not sides or stomach) for several days...I haven't been able to lay on my back since I fell down the stairs almost two weeks ago and fractured my tailbone in two places. Even with Percocet I couldn't tolerate the pressure, so this is going to be fun.

Not sure how much posting I will do next week, but I plan to take photos (or have someone take them of me) so I can document my recovery progress that I will post once I am able.

Friday, September 14, 2012

Let's Get Physical

I had my pre-op physical today with my primary care physician. The last time I saw her was sometime in the first half of 2007. Then, she was relatively new and I wasn't entirely sure about her. She prescribed me Demerol for pleurisy two years in a row, and Demerol is really fun. Let's be clear - I needed it. Pleurisy is inflammation of the tissue that lines the lungs. It's not as severe as pneumonia but it's known to be a hell of a lot more painful. But Demerol? That stuff is hardcore. So I liked her, but I secretly thought she was too easy to get drugs from and worried what addicts might get out of her.

She walked in today with a big smile and said, "I remember you!" I was thrilled that she recognized me because, well, most people don't who haven't seen me since 2007. My eyes look completely different, which has changed my overall appearance, and I have gained weight, especially in my face. Our appointment was just a technicality to make sure I wasn't going to die on the operating table. I already had a clear EKG and a normal 48-hour Holter (heart) monitor test, and normal thyroid labs finally, so I knew I would be good to go. I was expecting her to give me a hard time about my weight but instead she just wanted to know how the last five years have been because, as she could clearly see from my medical records that were transferred, it has been a crazy five years health-wise. She said I am her first patient who needed orbital decompression, but that she just diagnosed a female in her 20s last week with Graves, and thinks it is becoming more common. I can see that - acute stress is a known cause of Graves and with the economy and job market so awful, it's no surprise our health is being affected.

She said she'd be happy to take over my labs and Synthroid dosing/monitoring from here on out, and that was a relief. I miss my Florida endocrinologist a lot and now that I'm no longer on the brink of death (at least not because of my thyroid), I think it's time to start letting a general practitioner monitor those issues instead of a busy endocrinologist who focuses most of his day on diabetic patients.

I was so pleased that she has matured and learned a lot. She remembered that I worked for the hockey team, and kept asking me all sorts of questions about my health issues, the upcoming surgery (most physicians know very little about thyroid eye disease and its treatments, especially orbital decompression), and my personal life.

In Florida, I had so many specialists that I actually chose my primary care physician based on his nurse practitioner, since I knew she'd be the one I'd see most often. I loved her, and there is something to be said about female physicians and midlevels in the family medicine/general practice area. All of my specialists have always been males, and I think that's pretty typical. Both of my surgeons are males, but I am so glad that my primary care physician is as nice as I remember but obviously more experienced and knowledgeable.

She cleared me for surgery and wished me well. I will see her for my actual annual physical sometime after I'm recovered.

Thursday, September 13, 2012

High Cookin'

I should be disallowed from any sort of food preparation while under the influence of painkillers. A few months ago, during my awesome second-degree sunburn, I took the Percocet I was prescribed for the excruciating pain. I vaguely remember wanting a hot dog and starting one on the grill. I burned one hot dog and two buns to charred, unrecognizable-ness, and never even left the grill. I think I eventually got one done, but I remember offering one to my dad and he was like, "Um, no thanks. I'll make one myself."

The spicy salad I couldn't eat.
Today, I suffered through six hours of work. I alternated between sitting on my hemorrhoid cushion (I did not know this cushion was also used for that and I am SO embarrassed to be carrying it around campus now) and standing, and finally gave in and told my boss I needed to home and take a pain pill. She is awesome, and understood. So I did just that. Around 6:30, I woke up still groggy from my drug-induced coma, and decided I was hungry. I had this brilliant idea to make a salad with blackened scallops. Fortunately, my dad just just taken two pork chops off the grill; one had my name on it. I still wanted salad, so I made a bed of baby spinach, shredded carrots, mozzarella cheese, and, I was about to add Catalina dressing and the pork, but saw the jar of salsa in the refrigerator and thought, "Hmm, that would be healthier and yummy." I saw HOT on the jar, and even though mild salsa makes me cry, I still thought it would be a good idea. I slathered it all over my pork and salad, too. I ate it in bed, because I still can't sit right. I took one bite and thought it was good. But by bite two, my mouth was on fire and I realized how bad this dinner was going to be. I poured myself a glass of my new favorite product (Horizon organic chocolate milk) but it still couldn't curb the heat. I eventually scraped all the salsa off the pork but the salad was ruined.

At least I didn't attempt blackened scallops. Hot oil and drugs don't mix, kids.

On a somewhat related note, I had to tell Blogger to add "Percocet" to my dictionary since I'll probably be writing about it quite a bit in the coming weeks.

Tuesday, September 11, 2012

Breakfast of Champions: Decaf Coffee & Percocet

That was my breakfast today at 9 a.m., when the 2 a.m. Percocet finally wore off. I have officially gone and broken my butt. I was on my way out to yoga Saturday morning. I was wearing my yoga pants with a cute Gator top, and decided to put on my brand new blue & white polka dot flip flops from the UF Bookstore. I grabbed my iced coffee that I was still drinking, my purse, and yoga towel and walked down the stairs. Except I missed the last four. Because my hands were full, I had nothing to break my fall. My coffee (thank goodness it was cold) went everywhere except on me, and I immediately rolled over onto my hands and knees because my butt hurt so bad. My dad rushed over and I shooed him away, like when you stub your toe and you have a Tourette's moment and start cussing - I just needed room to breathe. I got up, brushed myself off, and was like, "OK, I'll just walk this off." I ignored the pain, got in my car, and went to yoga.

Bad idea. I mean, I was able to do almost everything except boat pose and a few others. I had to put all my weight on one butt cheek during all the sitting poses, when what I really should have done was go home. I pushed through class, then went to my pre-planned pedicure. I deserved it. My feet were a mess and I have been really stressed and anxious about my upcoming surgery. So I did the same thing there - alternating cheeks. The poor guy doing my nails kept thinking he was hurting me so I finally told him I had fallen down the stairs and it wasn't his fault. I spent the rest of the day in bed, complete with leftover Percocet from my second degree sunburn and wrist tendinitis (are we sensing a trend here?). Sunday I went to mom's to watch the Patriots game. I spent most of the time either standing or laying. I couldn't sit unless I was kneeling down or sitting with one leg under me.

In my X-ray outfit
Work on Monday was brutal. By lunchtime, there was no longer a comfortable seated position. I stood at my desk, hunched over trying to type. When our entire server, internet, email, website, etc., went down around 3, I decided it was meant to be so I went to the walk-in clinic. I stood the entire time I was there, except during the excruciating X-ray session. When the X-rays were over, the doctor came and got me in the exam room and said, "Come look at this." Oh, great. Sure enough, she pointed to a complete break at the very end of my tailbone, and a crack a few centimeters above it. The crack went all the way through. I was ordered to stay home for the rest of the week (that won't happen), to use Percocet every four to six hours, to use a cushion when I do sit (this cushion cost me $25 and a 10-mile drive to a medical supply store in the ghetto), and to basically take it easy. She said I should be fine in time for surgery, but some coccyx injuries cause pain for months or years. I think I'll be fine, but there's no way to fix it - the bone will heal itself in the broken position over time. Only me...

On a positive note, I have no appetite and the Percocet works better (for me) on an empty stomach anyway, so I'll probably lose a pound or two during all this.

Happy Invisible Illness Awareness Week!

30 Things About My Invisible Illness You May Not Know
1. The illness I live with is: Graves disease and thyroid eye disease (TED).
2. I was diagnosed with it in the year: 2010.
3. But I had symptoms since: 2009.
4. The biggest adjustment I’ve had to make is: Not being able to eat whatever I want or go weeks without exercising.
5. Most people assume: That I have big, pretty eyes or that I'm surprised. Or that I eat too much or don't exercise enough.
6. The hardest part about mornings are: Waking up in pain.
7. My favorite medical TV show is: It was ER, now it's sadly Grey's.
8. A gadget I couldn’t live without is: My iPhone. It helps me track my calories, exercise, and stay connected to the Graves Disease and Thyroid Foundation support forums wherever I am.
9. The hardest part about nights are: Sleeping with the head of my bed elevated with risers and pillows because I tend to slide down my bed during the night.
10. Each day I take 7 pills and vitamins.
11. Regarding alternative treatments I: Unfortunately know that none exist for Graves disease. People have attempted, failed, and died.
12. If I had to choose between an invisible illness or visible I would choose: Invisible. I wouldn't change a thing, actually. I prefer to educate people when they pass judgement or say that I look fine.
13. Regarding working and career: I quit the job I was working when diagnosed. I spent six weeks traveling, relaxing, and just generally healing. And then I started a job I loved, and to this day, that remains my favorite job. I only left because I moved 1,500 miles to be closer to family and friends. However, it is so important to find a job where A. you have great insurance and time off benefits and B. have an understanding boss and co-workers.
14. People would be surprised to know: That no one in my family has any known thyroid issues. They almost always run in the family, so I guess I've started the trend for future generations.
15. The hardest thing to accept about my new reality has been: That I had no control over it. I don't like giving up control.
16. Something I never thought I could do with my illness that I did was: Meet other people who are going through the exact struggles I am.
17. The commercials about my illness: Don't exist.
18. Something I really miss doing since I was diagnosed is: Again, eating anything I wanted without gaining weight.
19. It was really hard to have to give up: Drinking an occasional glass of wine and exercising - I've had to do this several times, for weeks or months at a time, to protect my heart.
20. A new hobby I have taken up since my diagnosis is: Yoga. It was the only exercise I was allowed to do for the first six months and then I fell in love with it.
21. If I could have one day of feeling normal again I would: Just enjoy a day without thinking about my eyes, my thyroid (or lack thereof), or my weight/appearance.
22. My illness has taught me: That you never know what someone is going through behind closed doors or under their healthy-looking exteriors.
23. Want to know a secret? One thing people say that gets under my skin is: "You look different." or "I didn't recognize you." It makes me cry.
24. But I love it when people: Tell me I'm still beautiful, with the extra 30 pounds and bulging eyes. It doesn't happen often, not even from my best friends or family members, but my Mom and good friend Sean tell me all the time - they are my saving grace.
25. My favorite motto, scripture, quote that gets me through tough times is: Hebrews 11:1, not because I'm religious but because I believe that what is going to happen, will happen, and I have little control over it, so why not just enjoy the ride and learn from the experience?
26. When someone is diagnosed I’d like to tell them: "This sucks" instead of "You're going to be fine" because yeah, you will be fine but it's going to take a hell of a lot of sacrifices, changes, pills, and medical interventions to get there.
27. Something that has surprised me about living with an illness is: How judgmental people can be without knowing a single thing about you. Even doctors not familiar with thyroid issues have told me to lose weight. I would if I could, a-hole!
28. The nicest thing someone did for me when I wasn’t feeling well was: Stop giving advice and just let me be. There are few things more annoying than receiving unsolicited advice, especially for something you cannot control.
29. I’m involved with Invisible Illness Week because: People need to understand that you don't have to look sick to be sick.
30. The fact that you read this list makes me feel: Like you had some time to kill, or you're a stalker.

Monday, September 10, 2012

Embracing Normalcy


Despite being only 27, I’ve had more than my fair share of medical issues, especially during the last three years. I’ve been spoiled with a good medical team, and I’m convinced that makes a difference in one’s recovery. I hear horror stories of people with doctors who have no bedside manner, are downright rude, discount their symptoms as imagined or exaggerated, or worse, dismiss them as patients altogether. I’m fortunate to have been blessed with good, caring, knowledgeable doctors and nurses. Until now.

One of the worst parts of leaving Florida was leaving my endocrinologist. I cried in his office the week before I moved when I informed him it’d be our last appointment together. He was so kind and caring, but also very smart and experienced with Graves disease. He was the one to tell me my bulging eyes were not an infection or allergies like the ophthalmologist tried to tell me (OK, so he was the one idiot in my Graves journey) but in fact thyroid eye disease. He sent me directly from his office to the neuro-ophthalmologist’s office so that I could begin immediate treatment on my eyes – ‘roids, and not the “get big and strong” kind. Just the “get fat and acne” kind. My endocrinologist (we’ll call him Dr. L) acknowledged every symptom or side effect I had, and either attributed it to my thyroid, or sent me to the appropriate specialist. He was the one to tell me my difficulty swallowing was not due to the tumor on my thyroid but probably to acid erosion and a constricted esophagus – a lot of tests and a little bit of anesthesia later confirmed this.

I had appointments scheduled with two different endocrinologists when I moved home – Dr. H and Dr. K. Dr. H was in the big medical group where my primary care physician is, and Dr. K spoke at last year’s Graves’ Disease and Thyroid Foundation annual conference, and I liked that. When I met my eye surgeon, I mentioned both doctors and he told me his own story of Hashimoto’s (another thyroid disease) and that he really liked Dr. C both personally and professionally. So I canceled my appointments with Drs. H and K and made one with Dr. C. I liked him, except when he got out his thyroid model and started explained thyroid function to me. Hi, buddy. I’ve had Graves for two-and-a-half years. I am an informed patient. More than that, I’m an advocate. I’m active with the Foundation, and have read more peer-reviewed articles about thyroids and eyes than a lay person should. Regardless, he was just doing his job and everything else about our appointment was great. He agreed that not everyone feels good with the same thyroid levels – that I might feel better on one end of the “normal” spectrum or the other. He said it’s not just about lab results but also about how I feel. Thank you!

Well, I haven’t seen him since. They canceled the two-month follow-up appointment saying it wasn’t necessary. Still, I was sent for labs every six weeks. Within a week, his office would call me back to tell me I was still hypothyroid, and to up my replacement dosage. This process was working for me.

And then I had my next set of labs done August 29, first thing in the morning. A week later, I called the office looking for my results. No dice. I called the next two days in a row – still nothing. The receptionists kept telling me they were leaving messages for the nurse, who would call by the end of the day.

Finally, in Saturday’s mail, I received a piece of paper I have never seen before. It basically said: Your lab results were normal. If you’re on thyroid replacement, stay on the same dose. The End. Um, this doesn’t work for me. I needed to know what the actual results were (they test three different thyroid hormones), and when I could get them checked again. So I planned to call a fourth business day in a row when his nurse finally called me during my drive to work this morning. She gave me the results, and I requested she send me hard copies of all my labs since becoming his patient. She said he wants to see me back in six months, and will check my levels again then. Wait…in six months?! No, no, no. That’s too long. This is the first time in three years that my labs have come back normal. I have been tested at least every two months since then, but usually every six weeks. I am so not comfortable waiting six months to see if my body is working correctly. Especially since it is a proven fact that physucal and psychological stress can cause thyroid levels to fluctuate, and with my major surgery just two weeks away, a lot could change between now and March 2013.

During our 20-minute phone call, the nurse (Joyce) kept putting me on hold to talk to Dr. C. He said A. yes it’s fine for me to have a flu shot B. my surgery won’t affect anything C. the fact that I still feel hypo (tired, weak, bloated) is due to something else and D. my levels will not change at all in the next six months.

I am tempted to tell him to suck it. I think a new endocrinologist is in my near future. This is just ridiculous. I realize I may be more informed and thus more easily concerned than other patients, but this is my health we’re talking about. If my insurance is willing to pay for a $25 blood test every six weeks, why wouldn’t my doctor let me have it?

In the end, the nurse agreed to send me a slip I can take to the lab and get my levels checked whenever I want...but just once. She said, “If it comes back normal again in six weeks, where do we go from there?” as if I refused to believe I could ever be euthyroid (normal thyroid levels) again. I said, “Then great. I will be happy to continue my current dose with labs every six months.” Sheesh! Is it so much to ask that we don’t wipe our hands of my thyroid issues after one normal blood test despite 15-20 abnormal tests in three years? Apparently so. At the end of the day, I was shocked but pleased that my results came back normal. I don't feel any different or better than I did when I was severely hypothyroid, but sometimes symptoms can lag a bit. I will be thrilled if I never have to change my dosage ever again, but that isn't realistic for Graves patients.

Thursday, September 6, 2012

Eyeballs and Deviated Septums (Septa?)

Originally, I thought my upcoming eye surgery would be considered cosmetic. I was delighted to learn that since my eyeballs bulging out of my head is caused by my thyroid and I could eventually go blind due to pressure on my optic nerve, it is considered 100% medically necessary. So I had to rid myself of the idea that, while operating on my eyes, my surgeon could also remove this tiny little annoying skin tag that showed up in the last few years on my right eyelid. He can't - because that's cosmetic and the rest of my surgery is not.

Yesterday I met the ENT surgeon who will be doing the first half (the first hour) of my surgery. He will go up either nostril, remove my ethmoid sinuses, and then remove the bone between my nose and eyeball - on each side. He might also need to remove some bone from below my eyes. He told me there is a risk of spinal fluid leak, ongoing sinus infections, blindness, death, etc. But mostly he said it will be sore for a few days, I can't blow my nose/lift anything heavy/or go upside down for 10 days. And he advised leaving my nose ring out for now (I'll explain in another post). I took my dad with me since he'll be my nurse, and so there was another set of ears to hear everything the surgeon said in case I misheard something. I am 27, but I realize that I look 17, and the surgeon talked directly to my dad while describing exactly how the procedure would go. I wanted to be like, "Hi! Patient over here!" but then I realized I had better not piss the guy off before he cut millimeters from my brain. He looked up my nose and told me I have a slightly deviated septum on the left side, but that it wouldn't matter for the surgery. My ears perked up right away, because I have always hated my nose. It's skinny but I hate my profile because of how long and pointy it is. Everyone always says, "But it's so cute!" kind of like they say, "But they're so big and pretty!" about my diseased eyes. Whenever a celebrity has a nose job, she chalks it up to having breathing problems due to a deviated septum...so now I have an excuse! I really don't think I'd have the nose job, especially now that I need two or three medically necessary facial surgeries, but at least I would be able to make a claim for why I need one. I always wondered why one nostril was slightly bigger than the other - I thought maybe my nose ring made the left one smaller somehow...? Maybe this explains my need to blow my nose at least once every 30 minutes because it's dripping like a rain spout in a hurricane.

Anyway, the surgeon wanted a CT scan of my sinuses to ensure nothing would get in his way. After forking over another $100 on top of the $20 co-pay for the appointment, I was strapped into a machine and told not to move. Hello? I am "twitchy," as my b*tch former boss used to constantly remind me and everyone around me. And the surgeon is the one to press the button to activate the CT scanner, so I had to sit there without moving for 10 minutes before he had time to come press the button, let the scanner do its 12-second (not kidding, it took 12 whole seconds) job, and then review the scan to decide my sinuses would be fine. Good to know. I don't know what would have happened if the scan showed my sinuses would be an issue.

My surgery is now official as in Sharpie official. Before this appointment, it was only "penciled in" on both surgeons' calendars as well as the hospital's OR schedule for that day. At 1 p.m. on Sept. 25, I will hop my naked self from a gurney to the operating table and then forget everything else. The surgery should take two hours. I have to be there at 11:30 a.m., and I can't eat after midnight before, which is so not fair. That's what time morning patients have to start fasting. I've done some research online and a lot of people said that you're too nervous/anxious to be hungry, but that the thirst/dry mouth/dry lips is the worst. So I plan to bring chapstick and beg for an ice cube or two.

My real concern is my caffeine addiction, so starting on Tuesday (two weeks before surgery), I'm going to start weaning myself off. Only temporarily, but completely enough that I don't have to deal with a caffeine headache the morning of surgery. Any tips? I think I'll buy some decaf and start doing1/4 decaf and 3/4 full-caffeine, then after few days 50/50, till I'm completely on decaf only, and then start doing smaller portions (I only drink one 16oz travel cup each morning) until a few days before surgery. I want to be caffeine-free by Saturday, so then I am "clean" all weekend, Monday and Tuesday. Hopefully I feel well enough Wednesday morning for a big cup!

My pre-op appointment with the eye surgeon is the Thursday before surgery. My dad will come to that, too. Both of my parents will be there for the surgery...I'm glad we can all be adults about it. Well, maybe I shouldn't count my chickens yet.

On an unrelated note, I just finished "Gone Girl." So good but I hated the last chapter! I highly recommend it to anyone who likes a good girly thriller. Next? "Bared to You" by Sylvia Day. Probably another romantic/abuse novel because it came up on Amazon as, "Oh, you liked 'Gone Girl?' Then you'll like these books, too."