Suck it, n=1 Sometimes I feel like the blasted n=1 equation that I'm supposed to embrace as a paleo devotee is really an abbreviation for...Read More
Report From The Midst
When last we left the riveting story of my ongoing adventures in functional medicine, it was August, and I’d just been to my first appointment with Dr. Amy Myers and Brianne Williams. To recap, in case you don’t want to revisit the whole post, I’d had blood, urine, and stool samples submitted to have just about every test imaginable done. Science!
I decided to see Dr. Myers because of my ongoing inability to lose weight – despite eating a clean paleo diet, lifting weights, meditating, walking, doing yoga, and sleeping in a pitch black room for 8-9 hours every night. In addition, my blood pressure was very high, and my energy was tanking. I felt my hypothyroid symptoms rearing up all over again. Basically, I needed a major look-see and tune up.
I’ve gotten some questions from kind-hearted folks about how I’ve been doing since then, and the answer is “only OK” and “I’m not really sure yet.” Because this is the part of the movie of my life that’s the montage.
You know that part in the movie where we see the hero working really hard to reach his goal. He’s sweating and striving and digging deep, and we all just know it’s not a question of if but when he’ll succeed? That’s where I am. Sweating, striving, and digging deep — as gently as possible.
In the movie, the hero’s transformation takes somewhere between two and four minutes and is set against an awesome soundtrack. At the end of his travails, he’s completely badass. Like this:
In reality, my transformation is taking longer, is far less sexy, and soundtrack is likely to include both Jane Eyre musical numbers, kundalini chants, and awesome ’80s tunes. But since so many of you have asked, I thought I’d give you an update on where I am, here in the midst.
NOTE: It’s also worth mentioning, I guess, that today is my Thyroidiversary, the 5-year anniversary of my thyroidectomy. On the upside, the thyroid nodules weren’t cancerous. YAY! On the downside, I’ve been on a rollicking medical adventure since then. If you want to read the whole story, you can start at this link. The posts appear in reverse chronological order, so if you read from the bottom and move forward in time, you’ll get the whole story as it unfolded over the last 5 years. I really want to give past-me a hug; that thyroid surgery was scary, man.
Elimination Diet & Food Sensitivities
Dr. Myers and Brianne put Dave and I on their standard elimination diet to we could get to a “baseline” while we waited for our food sensitivity blood test results. We were already avoiding most of the foods on the list, but just to recap, here’s what we were not eating: grains, soy, potatoes, sugar, eggs, nightshades (tomatoes, eggplant, peppers, hot peppers, paprika, chili powder), vinegar (except cider vinegar, which is OK), peanuts, and dairy. After three weeks super strict, we began reintroduction of foods one at a time, and then a few weeks after that, we got our food sensitivity test results.
The good news is that we’re cleared to eat all nightshades (Hello, again, Rogan Josh and Chocolate Chili!), but Dave might have an issue with eggs, so I’m avoiding them, too, in solidarity with him. With peppers and tomatoes back on the menu, eating at home feels like it’s pretty much back to normal for me. Eating out is, as always, a challenge and because we’re still in “figure it out” and “treatment” phase, we have to be especially careful about not accidentally eating gluten, soy, and dairy.
The results of the food sensitivity test were eye opening. First, it’s important to remember that you have to have been eating the food for it to show up on the test. My test didn’t indicate a gluten sensitivity, but that could be because I wasn’t eating any gluten leading up to the blood test. Second, because Dave and I both have leaky gut right now (ew!), the test could also indicate a sensitivity that’s the result of leaky gut, not an actual problem with the food. (We’re hoping that’s the case with Dave and eggs.)
If you’re curious about what my results were, you can read this PDF for all the details. (Get to know me better!) My big headline take-aways were that I have a very strong reaction to artichokes (who knew? who cares?!) and a mild sensitivity to corn (which makes me want to cry because popcorn is my favorite fun food).
We are on Day 82 of our elimination diet and this commitment to what’s basically a Whole30, minus eggs and all vinegars except cider vinegar, will continue until at least the end of December. I’ve never been super strict through the holidays before, so I have many cooking adventures ahead of me. Grain-free, dairy-free lasagna and grain-free Russian teacakes will be my big Christmas experiments!
Over the summer, I was beginning to feel that special kind of crazy that only hypothyroid patients really understand, and my suspicions were right. My T3 and Reverse T3 were wonky again. I’d already been taking 90mg of Armour Thyroid in the morning. Now I also take another 15mg in the afternoon. We can’t re-test my thyroid numbers again until early December, so for now, I’m just waiting to feel better.
High Blood Pressure
My blood pressure has been an ongoing issue most of my adult life, but it was higher in the last few months than it’s ever been, and it freaked me out. When they checked my vitals at the doc, it was 160-something over 90+. I’ve made a deliberate commitment to work on reducing my stress so I can bring my blood pressure down. In the last three weeks, I’ve been doing a special meditation suggested by my kundalini instructor Robin, and I’ve been drinking beet juice powder (mixed into rooibos iced tea) twice a day. My blood pressure has dropped 20 points! It’s still flirting with pre-hypertension, but I feel optimistic that it will continue to decrease if I stick with my good habits and lose more weight.
This is the sacred vessel I use to drink my beet juice cocktail:
Since I had my thyroid removed in November 2008, I’ve gained about 25 pounds. That is totally disappointing and discouraging, but I read something recently that really helped me with my perspective. We don’t get healthier by losing weight. We reach our optimal weight when we get healthy.
Being chubbier than I’d like right now is not a condemnation of my character or a sign that I’m lazy or an indication that I’m doing something wrong. It’s a symptom of my body not being as healthy as it could be — and I’m showing my body that I love it by treating it as tenderly as I can.
In the win column: Since I’ve been seeing Dr. Myers and taking a shit-ton of supplements and eating super clean and zapping the Candida (see below), I’ve lost about 8 pounds. Jeans that didn’t zip now fit on my body. Jeans that were tight now fit the way they should. The progress is slow — much slower than I’d like — but that little bit of success is making me feel optimistic that I will lose the excess weight as I continue to heal my insides.
Cortisol & Adrenals
My previous doctor had me taking hydrocortisone to help with my adrenal issues, but Dr. Myers wants to get to the root of the problem, so she’s weaned me off the hydrocortisone. In January, I’ll do a cortisol saliva test so we can see what my real cortisol patterns are. For now, I’m sticking with walking, strength training, and yoga — but I’m hoping to get back to running a bit when we know more about what my adrenals are doing.
So, gross. Dave and I both have Candida overgrowth. It’s nearly impossible to trace the path of exactly how we got it – previous antibiotic treatments? too much stress? cake and beer in Europe? — so I’m trying not to dwell on it too much. We’re on the path to correcting the problem.
Before I dig into what our treatment entails, I have to share this. If you were around in the ’70s, you might remember the singing group Tony Orlando and Dawn. They recorded a song called “Candida.” For real.
Anyway, Candida treatment. Our marching orders to kill off the excess Candida are a combination of diet (cider vinegar, no added sugar, a maximum of 1 cup of fruit and 1 cup of sweet potatoes per cay) and a 1-month run of a prescription called Diflucan. The doc warned us that taking the Diflucan might be rough because the detox process of killing off the Candida feels like the flu.
They were not kidding.
For the last three weeks, I’ve felt varying degrees of fatigue, moodiness, joint aches, and muscle soreness. Random crying and rapid-onset napping have also been common. It all culminated in an injured right knee two weeks ago that required icing and limping and wearing a brace and all manner of feeling vulnerable and crappy.
But the end is in sight: I have only three days of Diflucan left, and I’m hoping my outlook and physical being is going to turn around right quick.
NOTE: If you find yourself on the receiving end of a Diflucan prescription, you might want to ask your doctor to also recommend supplements for liver support, because Diflucan is hard on the liver — and no alcohol at all during Diflucan treatment! (The universe owes me a glass of sparkling, bubbly champagne to celebrate the publication of Well Fed 2 when all of this medical nonsense is over.) Also, taking activated charcoal, available at most pharmacies, can help ease the Candida die-off symptoms.
Various Other Imbalances and Annoyances
I’m not going to get into too much detail here because my particular imbalances are specific to me — BECAUSE I AM A SPECIAL, SPECIAL SNOWFLAKE. Because of the leaky gut, stress, etc., etc., I’m not breaking down and absorbing my food as well as I could be, so I’m low on iron, some amino acids, and Omega-3 absorption. I’m currently taking 16 different supplements at various times throughout the day. Dave’s calling it “Home Hospital” because we’re both on a schedule of sleep-eat-supplement-prescriptions that requires notes and alarms and timers and reminders and THERE ARE NO SEXY NURSES HERE TO HELP US.
The good news is that the majority of the supplementation has an end date. This is not forever. It’s just for now, to get us closer to the optimal health we’ve been pursuing with our paleo diet and other good habits.
A Happy Ending
From the midst of the montage, there are some bright spots: We have no autoimmune issues. The bloating I used to have at the end of the day is gone. My clothes are fitting better. My eyes are less puffy in the morning. We’ve learned we have a mold allergy – Austin has scary-high mold counts most days of the year – and our move to a new city later this year should help with that quite a bit. We’ve found a doctor that can help us get to the root of our issues. Nothing we learned is life-threatening, it’s all quality-of-life-threatening, which means, except for my thyroid hormones, it can all be treated with diet, supplements, and healthy habits.
This is all good news — and a definite work in progress.
I really like movies with a happy ending. I’m sure the cathartic tears and rueful laughter of this functional medicine adventure will end with real smiles all around. But we’re deep in Act II here; no happy endings yet, just optimistic foreshadowing.
For now, the happy ending to this post will have to be this photo: