Stuff Doctors Know

Dear Diary, 

This month I learned stuff from doctors.  Good stuff.  Stuff I didn't know, and was surprised to learn.  That doesn't happen very often.

1  Thyroid stuff

During my annual physical my doc told me my TSH count was too high.  This is always the case.  TSH is a hormone that your brain creates to tell your thyroid, Hey.  You . Go make some thyroid hormone.  Then the thyroid makes its hormone, and the TSH drops down to norma

l.  If it's high, that means your thyroid isn't working, so your brain is constantly nagging it, go make some thyroid.  Okay, I'll say it again: go make some thyroid hormone.  Go do it now.  Hey.  I'm talking to you. TSH rises.

That's why if TSH is high, it means your thyroid is low.  I already knew this.  I was diagnosed a few years ago with Hashimoto's disease, and I take thyroid hormone supplements, which get raised about twice every year because whenever they test it, my TSH is too high.

What I didn't know was that hashimotos disease, being an auto-immune disease, has flare-ups.  These flare-ups mean that thyroid will suddenly create thyroid hormone.  When the flare-up is over, more of the thyroid is destroyed, but during the flares, I have more thyroid hormone than I'm supposed to have.  Too much thyroid hormone over the short term can result in irritability or anxiety, sleeplessness, rapid heart beat, sensitivity to heat, sweating, tremor, fatigue or muscle weakness, or increased bowel movements.

I. Did. Not. Know. That.

Throughout most of my life I've been a pretty optimistic person, a little nervous from time to time due to trauma in my past, but overall, pretty happy.  Then, about the same time as my thyroid started failing, I became depressed, fatigued, couldn't get enough sleep.  At the same time, I would have spans of time where I was irritable, had trouble sleeping, etc., etc., etc.  I just chalked it up to the obvious fact that I was, indeed, going insane.

So that's thing number 1. ===============================

Thing 2: Dieting stuff.

Thing number 2 had to do with Dr. Drama, who I wrote about before and who has redeemed himself since then by being extremely helpful and nice (though I still think I could arm wrestle him).  I was mentioning during rounds that I often had trouble remembering to track my food, and he said, before you eat anything, take a picture of it with your camera phone.

Apparently this advice is already out there but I hadn't seen it.  My first thought was, BRILLIANT! So, I'm still sucky at tracking my food, but I have lots of odd pictures on my phone now.

And so this is a sampling from last week:

 

 

 

This week's sampling should be better.  Himself the Baboo is out of town doing soldier stuff for 3 weeks, and when I'm alone, I eat fish and greens, which he hates.  So we'll see how I eat for 3 weeks.

...
 

Sexism?

Dear Diary,
Not long ago I posted on Facebutt that I was buying toys. My cycling friends assumed I meant cycling gear, and my running friends assume I meant running gear, but no--I was buying toys.

One of my goals for 2014 is to become a proficient Play Therapist. I work with kids, after all, and they don't always have a good emotional vocabulary. It's not really fair for me to dig deep into their psyches because they won't be in the hospital long. Play therapy is a way for them get some of the stuff out of their head where it's been stewing and screwing with their emotions. Some of these kids were flown down from northern New Mexico to be admitted, which may have been the only time in their life they were on a plane. Some are just freaked out because they are in a mental hospital.

One of the methods is using a sandtray. It would take too long to explain how it works, and I trust that you can google. Just in case you are curious enough to google, I will mention that I am a directive play therapist.

Now, using a sandtray involves collecting miniatures. Ahh, the miniatures. Here's to my new addiction! >clink< But that's another entry, for another day.

t also involves sand, in fact, 50 lbs of it. And so it was that one morning recently I was at work, trying to carry my purse, lunch bag, gym bag, and two twenty-five containers of sand AND swipe my badge to get in, all at once, because otherwise I'd have to make two trips, and what a pain in the ass THAT is because, after all, I. Am lazy. As I approached the last security door, I set one container of sand down and nudged it along with my foot, and just as I approached my locked office door a doctor I work with walked in behind me, and commented on all that I was attempting to do. This man is taller than I am, appears to be healthy, and is a few years younger.

"Hey, can you grab that for me?" Pointing my face toward the package on the floor.

"No," he sailed right by me, "it's too heavy." And away he went.

I watched him go, thinking he was joking for a moment. I had, after all, helped him out day before--his badge wasn't working, and when he asked if someone would escort him down through two locked security doors, there was a long moment of silence and staff members who looked at each other and breathed silently, not me. I always want people to feel good, and to be happy, and so I walked him out. And not 12 hours later this doctor breezed by me, No, it's too heavy.

I was still a little open mouthed in rounds. I sat down and just looked a him. "Too heavy?" I asked.

"What? I only got six hours of sleep last night." He considered the matter closed.

Nurse Nancy, who is 36 weeks pregnant, blurted out, "how much sleep do you want?"

He protested and insisted on what I imagine he believes to be a generally robust countenance, and leaned forward and opened the curtains. "This room is depressing."

I asked DreadPirate her thoughts on the matter. "He clearly has autistic social skills," she said.

Later, I started thinking about other coworkers who had people come move boxes for them, which I don't do. I was thinking about the doctor I saw, six weeks ago, I have to say it, but i think most other women your age would have snapped a bone.

Sandtray monsters.

And now, well now I just can't look at this guy the same way. Isn't that crazy? This is a highly educated collegue whose fund of medical knowledge I have always admired. He isn't usually a rude person; in fact, he often bribes me to perform onerous tasks he'd rather not do by offering me chocolate.

Maybe it was the discourtesy of it.  Maybe I would have been just as surprised and bothered if it had been a healthy female--it seems courteous, all, especially when someone has requested help.  if it had been me, I might have said, No, but I can get the door for you - will that help?

When I really stopped to consider the matter, though, I have to admit that the fact that he is a healthy man is what changed my view of him. Now, when I see him I'm wondering if I should help him across the street. I pity him. Ugly thoughts fill my head. Why, you're just barely a man, I think to myself.

Is this Sexist? Maybe. I know, in my heart of hearts, and I am a very capable person. Unusually capable. I also have lived with a man for 15 years who is even more capable, and who can outlift me, outrun me, outswim me--in many ways he has heavily skewed my idea of what it means to be a man.    I also know that if he had chanced upon a female colleague juggling fifty pounds of sand, among others--a fellow soldier, mind you--he would have sprinted to help her.

"Blame women's lib," Baboo said jokingly.

Am I sexist?

"Hey can you get for me?"

"No. It's too heavy."

What do you think?

...

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Minutia.

Dear Diary,

On the first day of the first week of Ironman Boulder training, I was sitting at my kitchen table creating an orange rind barrier to block my blind cat, who was determedly headed for my plate. My favorite morning breakfast, which I like to eat every morning, when I can, consists of an orange, divided into thirds; a banana, divided in half; and a hard-boiled egg. The egg is halved, and has a few drops of truffle oil on it followed by a sprinkling each of herb salt and smoked paprika. I eat, in strict order; 1/3 of the orange, 1/2 of the banana, 1/2 of the egg, repeat, finished by the last third of orange. Because I have food rituals. One of these days I'll describe my rules for eating snickers, M&Ms, and grean beans.

In an uncertain world, there are some certainties I enjoy. My food rituals are among them.

Blind kitty stared at me, or rather, pointed her face in my direction. Eventually, thwarted by the barrier of foul-smelling orange peels, she leapt off the table, trotted toward me, and leapt back on the table, knocking over my coffee. Dammit. It's hard enough making my coffee properly because for every pot of coffee Sweet Baboo puts in EIGHT scoops of coffee, thereby ensuring himself a large pot of espresso. I add hot water and my favorite creamer. I made another cup of coffee for myself.

It is the minutia of these mornings that keep me inside, managing them, rather than outside running. But today would not be one of them. I carefully strapped my Garmin on, dressed in clothing would start me out on a cold morning, and loaded a music list into my music player. My favorite running jacket, my compression injinji socks, my Altra Boca AT trail shoes, my favorite knickers from Target, running bra, and top. The minutia, carefully arranged into rituals, I'm mindful of each moment because of the details. Today, i focused on the details that woukd get me out the door, not keep me inside.

I hit the trails for a little over three miles, which were slow and painful. I ran a loop that Sweet Baboo worked out in the foothills, over trails. It's a fun run. There's sharp uphills and downhills, long uphills and downhills, and some flats. The first part is mostly uphill, and then rolling, finishing with and long, winding downhill. My lower legs are still pissed about all the downhill pavement running I did last weekend, so it hurt.

At one point during my run I hit a high point in the climb, and look down over the city, where street lights are still on. The sun is up on the other side of the mountain, but not on mine, yet. There are some small, white flowers that I think are a primrose growing alongside the trail. The first of the cars arrives at the trailhead.

More minutia: the sigulare, the higher dose of advaire, and zyrtec that my doctor put me on. 30 seconds a day that make this run possible. For the first time in months, I can breathe and don't feel like I'm drowning.

The second day there was no spilled coffee, and the run hurt a little less, and I think was about two or three minutes faster. The cold morning was bracing. The coffee was energizing. The shower was steamy. By the time I finished drying my hair, the sun was streaming through the window.

And then I went to work.

 

 

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Thunderstruck.

Dear Diary,

I started writing this while we were driving from Tulsa, Oklahoma to Branson, MO for the first of a marathon double weekend, the last weekend in March. Sunday's marathon was in Arkasas. Marathons (or longer) #53 and #54 net me states #26 and #27. We missed the plane Friday morning, and so the result was that we took a MUCH later flight and pulled into our hotel at 2:30 am the morning of the marathon.

And so it was that I decided that this was not a race. It's a training run, the end. And so it was that I found myself at 2:30 am in Branson, Missouri staring at a billboard for the Statler Brothers while Sweet Baboo looked for the confirmation number for our reservation.

I am not a red state chick. I was raised in Alabama and Texas, but I think most would agree that I think my behavior during the 2012 elections has cemented my status as a flaming liberal. For some reason, I am always afraid when I got to red states. Afraid, I think, because of talking heads that say things like, "lock and load." But it's never what I fear. I think that, for the most part, we are all much more alike than we are not, and that it's the media, liberal AND conservative, that has a vested interest in keeping us afraid of other. I don't want to take all your money and give it to deadbeats. So please don't shoot me. And don't bother trying to run me over, either. That ship has sailed.

Have I mentioned that i got hit by a car?

I say this because Brian Regan does this bit called, "I walked on the moon." Go ahead and watch it. I'll wait.

So i have discovered that "I got hit by a car" is the marathoner's equivalent to "I walked on the moon." They can talk about tendonopathy, IT band syndrome, sprained ankles...all that goes away when you quietly say, "I got hit by a car."

So the Missouri marathon was tough. It was eight loops, and the loop had a 200 foot climb in the middle of it over about a quarter mile. That little climb doesn't seem like much at first for a girl living in the mountains such as myself. But by the time I approached the bottom of the hill for the sixth time, i found myself standing there, looking up, muttering, "fucking hill.' I was also have an issue related to having tied my shoes too tight. Or maybe it was that they were new, and so were my socks. Not what you're supposed to do, right? I'd bought new things right before the marathon, and wore them for the race, i'd never had an issue before now. The run was actually in Reeds Spring. Himself did the 50k in 4:51. Then he walk/jogged my last loop with me. Very nice people, beautiful weather, nice course,

and

a very weird medal.

Then we drove to Fayetteville, AK.

On the way there, I saw the biggest church I have ever seen in my life, and I'm from Alabama and Texas.

 

 

I took the earlybird start, just for fun. A few rollers, and then I ran down, down, down. I always have misgivings when i spend that much time descending--inevitably, one has to ascend before it's all over.

Most of this course was on paved bike paths. There's a lot of them in Fayetteville, which by the way is a VERY. Ice little town. Since I took the early start, i got to watch the frint runner blow by me about mile 7 or so. Sweet Baboo ran by me around mile 15.

There are songs that I listen to while running that I don't listen to at other times. There's always that one song that I back up listen to over and over again. It's never the same song. It's that song that gets me to the finish kine. Later on, on another run, I'll go back to that song but it never has the same effect.

Throught this marathon I continued to have issues with my right foot, and then with my left as well. Ow, ow, ow.

For this marathon, the song was "Thunderstruck." I listened to it over, and over, and over. Thankfully, the end was not at the start. There was only a little climbing at the end. The finish line was nice, and then they put the biggest medal I've ever seen around my neck.

Srsly. This thing is 5 inches by 5 and weighs about a pound.

Then we headed to the airport and flew home.

The week following was brutal. I got in a couple of power hikes, and did three days of weightlifting, but mostly, I was recovering. It wasn't until today that i able to run, really run--11 mikes. They were treadmill miles, because I wanted a giving but flat and easy surface.

My foot still hurts, and I've got pain on the front of my shins from all the downhill running on pavement I did. I'm a long way from the type of condition I was in the last time I did a marathon double. I feel, well, Thunderstruck. Thunderfucked. Something.

But, as of today, I'm up to being able to run ten minutes at a stretch, pretty far from where I was at the beginning of 2014. booyah!

After a week of recovery I find myself at the cusp of Ironman training. Three months of build, and then a taper in July. This will be my last Ironman, so I want to make it count. Since I won't have the advantage of higher elevation--Boulder is the same elevation as Albuquerque--I'll have to make this training count.

Countdown to Boulder: four months.

...

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I'm back, and this time, i mean it.

Dear Diary,

Three days after i was hit and two days after my last post, I tried to jog gently across the street on the way to a meeting. OW. I continued to stand at my standing workstation, and walked between a half to a full mile a day, slowly, but I had a sharp pain whenever I toed off, in maybe the fibularus longus? I suck at anatomy

I went to see th doc. My new doc is with the 377th medical group now that Sweet Baboo is active duty. It's a large clinic full of practitioners wearing combat fatigues. I was seen at EXACTLY 0700. There's something comforting about providers who have medical training in addition to combat and firearm training. Everyone says "m'am." My prescriptions, three months' supply of Advaire, thyroid meds, and other meds, were handed to me in a plain paper bag, no charge. If this is government-run medicine, I'll take it.

I remembered more about the accident. The driver gunned it as I was crossing the street, and I remembered being surprised that the car was picking up speed as it came at me, I still don't remember much until I landed on the other side of the hood.

The doctor clarified that no, i wasn't in a car when I was hit. Then he felt both legs. "There's no swelling, no discoloration, and they both feel exactly the same," he muttered. He ordered an x-ray, which was negative. I was already mending. I could power walk, which I couldn't do three days before. The doc said that, in his opinion, most other women my age would have snapped a bone. "Fitness and luck," he said.

Two days after that, I had a Thai massage. Two days after that, I took a few tentative shuffling jogging steps on the treadmill, and the next day I shuffle-jogged a mile on the trails behind my house. A few days after that, I ran. After that day I never felt pain in that leg again. The next week, I was up to two miles a day, then three miles a day, and on March 22, yesterday, I ran-walked seventeen miles. I still need walk breaks, but they're getting further apart.

My facebook description says:

Anything's possible. I can climb a mountain, swim across a lake, go 62 miles on my own two feet. I can live happily ever after...

To this I add,

even if you hit me with a car.

I now consider the Unfortunate Car Incident of 2014 to be closed.

...

I turned 49 last week. Getting old doesn't bother me. Being four years away from the age my mother was when she was diagnosed with dilated cardiomyopathy does. I try to remind myself that a) I am far healthier than my mother was, even when she was in her twenties, b) my mother never exercised, and c) I suspect she had undiagnosed hypothyroidism. Mine was diagnosed, and is treated.

As it comes early in my family, menopause has come and gone for me. Here is what has made life livable: Small fans. Black cohosh. Salted carmel sport gels. Injinji compression socks in pink. Wicking clothing. A panasonic epilator. It's the little things.

This next weekend, I'll do a marathon double, hopefully, and pick up two new states: the Forest Gump challenge in Missouri, and the Hogeye in Arkansas.

I'm back. And barring further car incidents, I'm picking up speed.

...

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Unbreakable (?)

Dear Diary,

More thinking out loud about it, and then I'll shut up.

In the week following my mishap--and I'm reluctant to call it anything more than that because of my general dislike of drama queens--I've eaten at Panda Express nearly every day and gained three pounds. Honestly, i hit that drive through line with a certain amount of resolve, i will not have starch, just vegetables and meat but then she says, over the loudspeaker, "rice or chow mein?" And I robotically reply, "chow mein". Then I order honey walnut shrimp and Shanghai beef. And an eggroll to eat on my way back to the office.

Also, Sweet Baboo had a cold when all this happened, so now I have that too.

I had, initially decided that I must have just been tapped. I had one bruise, one scrape, and one sore leg that is getting less sore by the day. An article I read stated,

"The bumper and the hood typically hit the person's legs and hips, meaning broken bones in those areas are very common. Depending on how fast the car is going, the patient can be thrown and then head injuries and internal injuries are quite common...if there are injuries to the blood vessels or major tissue damage then there could be amputation...injuries can be complicated, sometimes taking months to recover from or worse. Some patients are permanently disabled because of this. They are unable to go back to their livelihoods."

On Wednesday, I tried a quick, ten-foot jog to cross a street. After the first two painful steps I tried a nice long power stride. OW. Then I tried to just walk briskly. OW. Then I settled for limping across the other six feet. I walked a mile with the treadmill set on 2. Limping itself isn't so bad because you get attention and sympathy, but it's exhausting and hard on your back. That day, I reluctantly made an appointment to see a doctor about my leg.

found while looking for info on fractures.

Thursday, I tried to jog again. I wouldn't say my leg barked so much as it let out a deep, throaty warning WOOF, the kind that Great Danes make. But, I was able to take a few strong strides, pain-free. I walked a mile with the treadmill set on 2.5. Throughout the week I continued to stand at my standing workstation, with occasional breaks spent perched or leaning on a stool. My family doc once told me, "the worst thing you can do to most injuries is to completely immobilize them."

By Friday, I could walk normally, briskly even. I did not try to jog--no sense in poking the ferret. But by then I had decided, this must not have been much if a hit, because if I had, wouldn't I have snapped a leg? Wouldn't there be numerous mentions of contusions and lacerations on my chart? I thought this until I asked Dreadpirate what she remembered, and what she told me was that about twenty or more yards ahead of me, she heard the sound of the car hitting me over her ipod and the sound of me hitting the ground. "I didn't expect that a body hitting a car would be so loud."

Sweet Baboo, and the docs I work with, reminded me that I do a lot of weight-bearing exercise, especially on my legs. I do Olympic lifting at least twice every week, and running daily. I stand in my office and don't do much sitting except at home. I'm not your typical woman pushing fifty.

Now, a pessimist might point out that if I weren't so active I wouldn't have been out there anyway, running in front of inattentive drivers. I would argue that i could have just as easily been walking across a parking lot, from my car to the store or work, when I was hit. So the take away message here is this: get out there and start moving and lifting weights.

I've spent a week perseverating and processing and thinking about this and I've decided that as of midnight tonight, time's up. Suck it up, princess. Walk it off soldier. Drink some water. This race we call life is still ahead of you and you haven't reached the finish line yet, so keep moving.

...

 

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THUMP.

Dear Diary,

I have discovered the six words guaranteed to get you sent home. The words nobody argues with. I know these words because I said them today. First, I had told my boss I wasn't feeling well, and I was going home aound 1:00.

"Are you sick?"

"No...i'm feeling a little weird, and kinda anxious." Then I said the words: I got hit by a car.

"When?"

"yesterday."

"And you were in a car? Right?"

"No. I was out running."

Blink. Blink.

"You were hit? By a car?" [emphasis on HIT and CAR] "Are you okay?"

"Yes. Mostly. I think so. I mean, nothing's broken."

Since I was just standing there, and not in a body cast, I suppose it was a strange thing to hear. No, I wasn't in another car. No, I didn't hit my head. At least I don't think I did. I didn't black out, but wham, it happened really, really fast. What I was able to piece together was that the guy was stopped behind the stop sign watching for oncoming traffic--coming from his left--and since nobody was coming he gunned it just as I shuffled--from his right--into the intersection.

All I remember was one moment shuffling up the hill on #2 of the hill repeats. I had my head down, watching the ground, and suddenly a green bumper in my periphery. I put my hands out and had a split second of surprise when the car didn't stop. Then, THUMP: I was tumbling over the hood and I was on my right side in the road, looking up at the back of a green car, with the improbable thought, "does he know he hit me?" Then car stopped, abruptly, and the guy jumped out, running towards me, shouting.

I know he was shouting, asking if I was alright, and so was the passerby who happened to be an off duty EMT. I know that now and I knew it relatively soon after, but at that very moment... All I knew, there on the ground, was that something horrible and fucking scary had just happened and these guys were standing above me, shouting at me, and I WANTED TO GET THE FUCK AWAY FROM THE SCARY AND AWAY THE SHOUTING so I tried to get up but OW, OW, fucking OW MY LEGS so I lurched over toward the nearest safe looking place, the curb and threw myself at it and sat down.

And the scary shouting guys followed, still shouting. I told Dreadpirate the next day, if I could have run away, I would have.

Within a few seconds my head cleared and the terror faded, and I knew that I was pretty much okay, and those guys were wanting to know if I was okay. I forgot about the terror of that moment until the next day. I looked up and saw Dread Pirate running down the hills towards me. She had heard the thump, turned around, and saw me lying in the road. She ran to me, shouting, what the fuck happened?

Somewhere during all this I pocket-dialed Sweet Baboo. I didn't know I'd dialed him, and he listened, puzzled, hearing my voice and then people asking me about allergies, blood pressure, etc. The off-duty EMT called 911 and the police were there in seconds. The guy who hit me seemed genuinely freaked out, asking repeatedly about me, even after they cuffed him because, well, he had two warrants. The ambulance was just a few seconds behind them.

This, to me, was horribly embarrassing. It seemed like such a rediculous fuss. I was sitting upright. I didn't have a head wound. There was just WAY too many people there. For me. Or maybe I was just uncomfortable with all the people standing around me, so close.

They checked me over, and wanted me to go to the ER to get cleared, but I decided I would have Dreadpirate take me and then I would call Baboo to come get me. Not long after deciding that my phone rang. "I'm on my way." He'd heard everything. By this time the EMTs had bandaged a nasty scrape on me wrist, examined the growing bump on my shin--gonna be a nasty bruise--and checked me all over. I was lucky. Somehow I'd been hit in just the right way, tumbled over the hood just the right way, landed just the right way on the pavement, all without getting seriously injured.

My friend SWTriGal once saw me take a spill running down a mountain path and declared it perfect. It was the best fall I've ever seen. Maybe I have a knack for this.

At the ER, they asked me that pain question. Scale of 1 to 10 ? I don't know how to answer that. Mile 50 at Javalina 100, I wanted to say, I don't know...a 4? Later on, I read that was "mild". So I was fine. I was joking about it. There was a sense of unease, but mostly, I was joking about how now, I have a story to tell.

I even forgot about the terror of those five or six seconds after it hit me until around two in the morning when I suddenly woke up, staring at the ceiling, thinking, holy fuck did I got hit by a car? I had a growing unease until around mid-morning when it came back, mixed with a small sense of shame because, after all, nothing was broken, and I was fine, so SUCK IT UP, PRINCESS. Except, I was in a fog. I couldn't concentrate. I looked at stuff on my computer and it didn't make sense. I didn't want to eat. I started feeling panicky. And then I remembered those moments after the car hit me.

So I told my boss I was going home. She wrote down the number of our EAP and insisted I consider calling them. I decided I wanted some Panda Express, except that, I looked in my purse, right at my debit card, and couldn't find it. I couldn't see what was in my purse. So I went home, and took a hot bath. By then my shoulder and neck were feeling stiff and spasmy. My left leg, where the car hit, hurts like crazy if I try to perform any torque on it, but there's no bruising or swelling.

So that's my story of getting hit by a car.

For the record, Sweet Baboo has been hit by a car. And a city bus.

Even in freak pedestrian accidents, he outpaces me.

...

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