Unless I got someone's else lab results...

I know. I'm horrible at posting. I promise to update everyone on my life and get better at posting regularly.

Short post. I'm confused. When I moved to Boston, I had trouble sleeping. I was in an unfamilar place, I was on a brand new schedule, and working long days. So I stopped taking the niacin regularly because when you can't sleep, you can't wait until you fall asleep to take it. And when you take it, and get the horrible flush, it makes it even harder to fall asleep.

So I assumed my cholesterol would skyrocket. I combated that with daily strenuous exercise and a really clean diet. I also walk a TON now during my commute.

When I met with my new primary care physician last month, I told her I had been really bad about taking the niacin. She was OK with it. She basically told me that while it has been shown to lower the numbers, it hasn't been proven to actually reduce risk factors for heart disease. So someone who takes niacin for high cholesterol may have good numbers, but still might have heart problems. She said we don't know enough, but that if my body wasn't adjusted to the flush after so many months on it, that I should stop. So I did.

And look what happened.

	2/11/2013	4/5/2013	5/22/2013	9/20/2013	Normal
HDL	72.5	69.4	72.9	66	45-65
LDL	202	219	175	151	0-130
Triglycerides	130	129	105	83	40-150
Total Cholesterol	301	315	269	234	135-200
Cholesterol to HDL ratio	4.1	4.5	3.6	1.5	3.5-5

Your Total Cholesterol of 234 is BORDERLINE
Your LDL of 66 is OPTIMAL
Your HDL of 151 is OPTIMAL
Your Triglyceride level of 85 is NORMAL

RATIOS:

Your Total Cholesterol/HDL ratio is: 1.55 - (preferably under 5.0, ideally under 3.5) IDEAL
Your HDL/LDL ratio is: 2.288 - (preferably over 0.3, ideally over 0.4) IDEAL
Your triglycerides/HDL ratio is: 0.563 - (preferably under 4, ideally under 2) IDEAL

On a related note, my thyroid levels are perfect. I haven't switched doses since...I don't know when. That's never happened! I've never forgotten how long it's been, because it's never been more than a few weeks!

Hello Stranger

So, I've been terrible about posting lately. I've been so busy that I honestly forgot I even had a blog for a little while.

Let's see, where shall we begin?

The most exciting news on the health front is that my thyroid has been consistently on good behavior since March. And and and and! My cholesterol is finally on the way down! It's still far from ideal, but it's getting a lot better. I still have the flushing reaction to the niacin, but I got smart and now take it just as I'm about to fall asleep, so most nights I'm already asleep before the reaction happens so I don't notice it.

I had a successful trip to Florida in mid-May. Lauren and Keith got married, so I took Thursday-Monday for myself. Of course, I'm still paying for all my expenses but it was so good for my mental health. I got to catch up with my former co-workers, visit with friends, work on my tan, cheer on my Bruins with plenty of Boston fans and transplants, and of course, see one of my favorite girls tie to the knot. Proof I was there:

I missed Rags a LOT, and it was the longest we'd been apart since 2008. I kissed him goodbye before I went to work on Wednesday morning and didn't see him again until I got home from work on Tuesday evening. Now, he look like an ewok and spent all week and weekend sweating and panting because I'm a horrible dog mother and haven't had him groomed in months. In my defense, his haircuts cost three times what mine do, so I do try to get as much mileage out of each one as I can. Then, when I finally returned from Florida and realized how badly he needed a haircut, the mobile grooming van we use crashed and was out of service for several weeks. We finally have an appointment this evening, so he will be recognizable again in about nine hours.

While in Florida, I noticed a giant bruise on my foot. I've noticed the same bruises on both feet before, maybe about six weeks earlier. I had gone out the night before and assumed I tripped or danced too hard or something. But this same exact bruise was back, but only on one foot. When I touched it, it was excruciating but also not really a bruise. It was some sort of mass that moved when I pushed on it. I got it in my head that it was a blood clot, and spent the next few days worrying about it. When it came time to fly home on Monday, I was in pure panic mode. I knew flying with a blood clot could turn into DVT which could kill me. Normally a cool, calm, collected traveler, I took my window seat at the last possible second before they closed the cabin door, and kept my foot/leg in motion for the entire three-hour flight to JFK. My chest was tight and painful, my heart was racing, and I was shivering yet sweating. I now understand what it's like to have a panic attack. I had a quick layover then a puddle jumper to Logan, where Juls picked me up and I could finally relax with a glass of wine.

I went to the doctor the next day, and she confirmed it was in fact a blood clot–actually a superficial thrombophlebitis. She said to take ibuprofen three times a day for a week (normally longer but with my ulcer history, that's the last thing I need) and keep it elevated when at rest but to stay active. That sounds like great advice, except it became so painful and swollen that I could no longer wear a shoe that touched the top of my foot. I was walking Rags two days later in the rain, and my foot hurt so dang bad that I had to take off my sneaker and walk the rest of the way barefoot in the rain, on pavement. The pain comes in waves and spurts, so I finally got an ultrasound on it Friday to ensure it wasn't moving or enlarging. Not at all shocking given my health history, the tech could not find the clot at all. She could clearly see how dark and swollen that part of foot was, and noticed how I flinched when she touched it, but it was now 4:30 p.m. on a Friday and I was told the doctor would review the report and call me Monday. It's Tuesday. Time to figure this foot out. Because my workout routine has taken a serious hit due to fact and cannot wear a shoe.

In other news, I am officially the 2013-2014 Junior League of Greater Springfield, MA Vice President of Membership. I'm busy planning summer socials, recruitment events, and trying to form our new member class for the fall.

I'm also busy planning Julia's bridal shower. I've been a maid of honor in a wedding before, but it was my cousin's wedding while I was in grad school at University of Florida, so I literally came up the day before the wedding and left right after the reception. My cousin and I haven't been close since we were little, so it was a nice honor but I told her up front I couldn't afford to throw her a shower or do any of the traditional bridesmaid things since I was busy with grad school 1,500 miles away. Now I get to redeem myself! I've received compliments on the invitations, and have been spending a lot of time talking to Julia's mom about ideas, since she's co-hosting with me. We're having it at a family friend's new home in a few weeks, and I just can't wait for everyone to RSVP so we can start really getting down to the nitty gritty details. The theme is a garden party, and we're using the three colors of our bridesmaid dresses–mint, pale blue, and, depending on who you ask or what you're buying, rosemary/aqua/teal, as seen below.

I'll do a full post of everything we make for the shower afterward, but the large pots will be for utensils, and the small ones will have a tiny foam ball that a wood skewer will stick into. I'll then affix food placards to the skewer. It'll look like a doily or flower, keeping with the garden shower and antique wedding theme.

Niacin Nightmare

Here's how my Sunday night went. How was yours?

My physician and the pharmacist were not kidding - niacin flushing is a nightmare. I took my 500mg pill around 9:45 p.m., knowing full well what I could expect. For about 14 minutes, I thought I was in the clear. Then suddenly I grew very, very warm and my skin began to crawl. I looked down at my arm and saw the proof. Naturally, I stripped to see if it was everywhere and oh boy was it. By 10:15 I was miserable, and by 10:30 I was inconsolable. It felt like a third degree sunburn - hot hot hot skin, burning, and chills. Fortunately, no itch. I was wide awake (another problem in itself) so I popped some Benadryl and within 45 minutes, it was finally taking the edge off. I fell asleep by 11:30, but the Benadryl still hadn't worn off when my alarm went off at 6 a.m., so I let myself go back to sleep unti 8:30.

Tonight, my plan is to some baby aspirin about 30 minutes prior to taking the niacin, but still keep the Benadryl close by. The aspirin reduces the flushing. However, the flushing means it's working, so hopefully my body starts adjusting to this new bedtime routine soon.

My Cholesterol Needs to Take a (Downhill) Hike

Want to be baffled? Then read on...

First of all, refresh your memory by reading out my annual physical in February. Yeah, numbers all over the place. So here are the steps I took at my physician's recommendation:
1. A bowl of low sugar oatmeal every morning with a tablespoon of ground flaxseed.
2. Six days a week of exercise.
3. Cut back on meat - I gave up all meat for five weeks. I couldn't make it through all of Lent, but I came within 10 days and still only ate meat a few times since then.
4. Limit dietary cholesterol - I ate a whole egg some mornings, or just egg whites other mornings. I still never came close to the 300mg/day limit my physician set even with the occasional slice of pizza, shrimp, or processed foods containing high amounts of cholesterol.
5. Reduce my beta blocker (propranolol) from 10mg/day to 5mg/day. This drug has been prescribed to me since February 2010 when I was diagnosed with Graves' disease to control my rapid heart rate. However, it is known to increase LDL (bad cholesterol), so I have been weaning off of it.
6. Increase intake of nuts, beans, olive oil, fish.
7. Decrease intake of sweets.

And what was the result eight weeks later? My total cholesterol went up by 14mg/dl. Are you f-ing kidding me?! I knew something was up as soon as my physician walked in the room. She gave me that, "Aw, too bad," look and said, "Well, at least your thyroid levels are good." Which was encouraging for about .2 seconds until I realized that they have been good before, but that never lasts for more than 6-8 weeks because my now-deceased thyroid is still a motherf****r.

The breakdown:

So, my triglycerides came down by a whopping 1mg/dl, but my HDL (good cholesterol) went down by 3.1 and my LDL went up by 17. How is that even possible, given all I've done to improve it?

Well, my physician and I are just as dumbfounded as you probably are.

My mom's side of the family has high cholesterol. However, almost everyone on my mom's side of the family has a poor diet and does not exercise that I am aware of. So I'm not going to accept that it's just genetics. It's bullsh*t is what it is.

I sat in her office and cried while she looked up every possible link between Graves' and radioactive iodine ablation and omeprazole and Synthroid and GI issues. Nothing.

So my options are 1. have a heart attack at 28 and croak. 2. start taking a statin. or 3. find other ways to lower my LDL. Taking a statin really is not an option as a woman of child-bearing age. Statins cause birth defects, in addition to a whole host of serious side effects on the individual as well. So my physician prescribed (well, recommended really, since it's OTC) 500mg/day of niacin, which is a B3 vitamin that has been proven to improve cholesterol. I am reading different articles on how it lowers LDL, and others about how it increases HDL. So I'm not really sure which it is, but I am willing to try anything that isn't a prescription drug. I've also decided to go meatless Monday-Friday lunchtime, and chill out on egg yolks and shrimp and other cholesterolly (yup, that's a word now) foods.

The niacin scares me a bit. It causes flushing, and is known to cause more extreme flushing in people with fair, sensitive skin. Not blushing, but flushing. Redness, itching, pure discomfort for anywhere from 15-30 minutes to two hours. So since I had three drinks (over the course of six hours, but still) last night trying to drown my sorrows, I decided it was best not to take the niacin, at least not for the first time, with alcohol in my system. I'll try it tonight.

I'm about as dejected as I could possibly be. This was the week from hell with work and my huge Junior League project being tossed out because of possible EPA violations and serious health risks. Not anything we did, but the organization with which we were planning to work, and there's no way in hell I was putting myself and my members at risk. It's unfortunate because it was six weeks of planning and going to take up my entire weekend - in a good way - but not anymore. Instead, I went out with a few of the ladies last night and have booked myself a $40 90-minute massage thanks to Groupon. I'm leaving shortly, because if I can't be making a difference in the community, at least I can try to ease away some of my stress because that ain't good for the ol' cholesterol levels either.

Oh, and for anyone who's counting, I've lost 11.2 pounds so far. I'm trying to end on positive notes whenever possible, since they seem to be few and far between lately. So there ya go.

Seriously Thyroid?

I had my annual physical yesterday. I actually didn't have one in 2012 because I got a job in Massachusetts and moved much earlier than I originally planned, and then when I got here, I had to go a month without insurance. Then I was trying to play catchup with my specialists and just completely forgot to get a physical.

First things first, I'm hypothyroid...again! My TSH is back up to 6. So we have to increase my Synthroid. Shocking. This may explain why I lost 7lbs in my first week of Jillian Michaels Body Revolution but haven't lost an ounce since then.

Secondly, my cholesterol is still through the roof. When I was diagnosed with Graves' disease, I spent a few days in the hospital. They ran every test under the sun, including a lipids panel. My total cholesterol was around 150. One year later, after being on propylthiouracil (PTU - an antithyroid drug) and propranolol (a beta blocker to lower my heart rate) for 12 months, my total cholesterol had doubled to 294. My physician assured me this was because of the beta blocker, since I was eating relatively healthy and had just started exercising again once my heart recovered from the initial thyroid storm. He told me not to worry about it, and my endocrinologist echoed that sentiment.

As of this week, my total cholesterol went up even further to 301. What?! This makes no sense. I spent the entire summer riding my bike every day and going to yoga, spent the fall eating like a bird because I was recovering from surgery and couldn't exercise much, and have spent the winter thus far exercising like a mad woman and eating insanely clean, staying at a strict calorie limit and not eating back calories burned. I have not once gone over the recommended 300mg of cholesterol per day, and rarely come even close to that. My mom's side of the family all has high cholesterol, but a lot of them are overweight and never exercise, so I'm not willing to blame it on genetics because I do exercise and I am getting my weight under control, slowly but surely.

The breakdown is:
Triglycerides 130 normal
HDL (good cholesterol) 72.5 high - which is good!
LDL (bad cholesterol) 202 very high - which is very bad!

The fact that my triglycerides are normal is suspect to me. My new/old (2003-2007, and 2012-present) physician wants me to cut my beta blocker dose in half. I have been asking to ween off this drug for a year but neither my endocrinologist nor my cardiologist were willing to help me do this since my resting heart rate was still pretty high. She says she has never seen such high cholesterol in a healthy, active 28-year-old. Gee, that makes me feel awesome. My brother nailed it on the head when he said, "That must be disheartening. You've been working so hard and eating well." No s&*%. Ugh.

We'll be repeating both the thyroid tests and lipid panel in eight weeks. I am on a strict low cholesterol diet until then (even though I was already watching my cholesterol intake) and am going to do as much as I can to get that LDL down - adding ground flaxseed to every meal possible including the oatmeal I already eat every morning with my breakfast, using only olive oil instead of butter, not making baking any sweets I might be tempted to eat, and keeping up with my six-day-a-week exercise program. Lent couldn't have come at a better time because fish and nuts help lower LDL and I've added a lot more of that to my diet to make up for the meat and poultry I've given up until Easter. All of these changes plus cutting my propranolol dose in half had better help or else I'm going to end up going on a statin at the ripe old age of 28.

Basically, all of my health problems right now can be attributed to Graves' disease. I wouldn't be overweight from six months on prednisone and constantly fluctuating hormone levels, I wouldn't have needed eye surgery for thyroid eye disease, I wouldn't have shin splints likely caused by being overweight, and I wouldn't have high cholesterol caused by a drug I need to keep my heart safe.

Because I was feeling so sorry for myself after getting my results, I went straight to the McDonald's drive-thru and got myself a shamrock shake. And since I had my last tetanus shot in 1998 and was long overdue, I had to get my Tdap yesterday, which kicked my butt. I spent the entire evening in bed watching TV because I felt so emotionally dejected, physically rundown, and my arm hurt like a motherf&$%#@. It still does, but I already did my workout for the day and survived.

Onward.

The 40-Day Vegetarian

I don't consider myself a practicing Catholic anymore. Religion just doesn't fit into my life, at least not right now. I do work for a Catholic school (where being Catholic or even Christian is not a requirement of course, that would be illegal), and I enjoy some of the traditions. Lent being one of them.

I have given up something for Lent for as long as I can remember. I'll never forget the year I gave up candy, sweets, chocolate, and ice cream. I was tiny back then, yet I still lost about 10lbs, which was actually disgusting to think about - losing 10lbs in only 40 days from cutting out sweets? Someone has a sweet tooth. Anyway, that was probably the hardest Lent give-up I've ever done. This year is likely to be harder.

I have decided to give up meat and poultry for Lent. I would never become a vegetarian for good. In fact, I don't think there's any one food group I would ever give up. I believe in everything in moderation. However, I'm trying really hard with food and exercise and not seeing the results I had hoped for yet, so I decided to give this a go.

So starting tomorrow - Wednesday, February 13 - I am abstaining from meat and poultry (beef, pork, and chicken are the only types of meat I eat). I am still going to eat seafood (fish and shellfish), but obviously that will get old if I eat too much of it, so I bought tons of beans, lentils, tofu, nuts, and vegetables over the weekend. Now I need recipes! Please share.

Note: If you're wondering why I am still eating seafood, the reasons are simple. First, I've giving up meat for Lent. For Catholics, who abstain from meat on Fridays during Lent, meat is defined as land animals only. Also, I am not confident enough in my cooking abilities yet to rely solely on legumes and tofu for protein - I feel like I would cave in and eat a cheeseburger if I couldn't have fish. Besides, the fish I eat is very healthy and rich in omega-3 fatty acids.

I had fasting lab work yesterday for my annual physical on Friday. I peed in a cup and had a few vials of blood taken, so I'm sure she'll be looking at my lipids (cholesterol & triglycerides), blood sugar, CBC, thyroid (duh, we know those numbers already), etc. Hopefully my cholesterol is good, but it skyrocketed after I started taking a beta blocker for my rapid heart rate caused by Graves'. I haven't had it checked in two years, so I'm anxious about the results. My diet for the last two months has been quite good, so hopefully that's offsetting the medication's effects. And hopefully I can start weaning off the medication as my exercise intensity increases and my resting heart rate drops.