SLT Round 3

A new year always feels like a sort of blank canvas to me, and I was feeling pretty hopeful about how this year would at least begin to transpire. 10 days in, I am nicotine free and that hasn’t been much of a challenge. I’m convinced these quitting (anything) experiences are mostly determined by your mindset; the first few days were mildly uncomfortable and I pretty easily moved on from whatever “cravings” (moreso it was this time or that I’d habitually be vaping). The whole point of leaving this behind was to not think about any of this shit anymore, so I’m pretty pleased that I go for long spans of time without it popping into my head. For anyone who wants to quit smoking, drinking, whatever else, I highly recommend Alan Carr‘s books – I quit actual smoking many, many years ago that way and it was a first-time success. Like most experiences, if you go in thinking you’ll suffer and ultimately fail, that’s probably what will happen.

More importantly (at least for now), what hastened my walking away from nicotine was that I spent my entire holiday break sleeping like shit, which was unfortunate considering I deliberately made no plans so I could rest and reset after a very long year. A day or two after Christmas, my skin started feeling slimy, which is not a good sign in my experience.

In 2014 after an uphill battle with an Anchorage endocrinologist and a $10,000 bill, I was finally (correctly) diagnosed with silent/lymphocytic thyroiditis. It was a pretty traumatic experience that did not lessen my hatred for the medical establishment: the doctor was 100% sure I had Grave’s Disease and immediately tried to schedule me for radioiodine ablation. I said fuck THAT, and paid for my own radioiodine uptake scans (I had shit insurance, lesson learned). My second flare was in 2019 after a mysterious viral infection, and I was pretty grateful to be able to go to Mayo Clinic and talk to someone who isn’t a pompous ass. That year, I was supposed to go on an epic trip to Peru to Inti Raymi and a long and brutal hike… unfortunately that did not happen, as I was assured I would not come back alive… womp womp. In fact, I initially started feeling the symptoms in Istanbul, halfway through a long trip. So that wasn’t great, but I learned I can mostly live my life with this… just not, you know, grueling hikes at 14,000 feet.

Ultimately my treatment options are ablation, thyroid removal, or nothing. I chose nothing, as the other options result in a lifelong commitment to taking synthetic thyroid hormones and I hate the idea.  I was told at Mayo that the only way to avoid these flares is to have a boring, routine life, which is obviously not my thing. So, this is not totally unexpected, but there is always a chance I will spontaneously not have to deal with this anymore, and my fingers are crossed for that. It is more likely that one of these times, my thyroid will completely burn out and I will end up on daily medication anyway (this is genetic and autoimmune; my mother has the more common variation of this disease). I will say, additionally, having an overactive thyroid is quite unpleasant. You spend your days and nights feeling like you’ve smoked a pound of meth, and/or are being chased by a hungry lion. But, I digress.

I can’t independently order blood tests in Colorado, so I had to go to my primary care office (I have one here solely to get bloodwork done, because nothing medical can ever be easy). Every time I’ve gone through this, I’ve had to argue with whatever generalist I go see who tells me there is nothing wrong, I am just high strung, or anxious (this must be some holdover from olden days when all women’s health issues were “nervous disorders”). It’s a particularly special experience to already hate going to the doctor only to have it implied that you’re a hypochondriac. This time I was told because my weight is stable, my thyroid is fine – if it wasn’t, I’d have lost weight. Charming. He finally acquiesced and I had my blood drawn (“I’ll order a TSH w/ Reflex, Free T4 test… I used the technical term because you’re so experienced” – direct quote). Truly, I hoped he was right, as arrogant as he is, and most doctors are — unfortunately my results came back on Friday and they are the worst I’ve ever seen them. I sent them off for further instructions, which I hope are just “wait it out.”

Now that that humiliating experience is over, I will be spending at least the next 6-8 weeks feeling like shit, guaranteed. On the plus side, so far my symptoms are not as bad as they have been in the past: my heart rate is elevated but stable, the insomnia sucks but I’m used to it; the sweating is what has always disgusted me the most, and that is particularly bad this time: the first time this happened, I could not even hold a coffee cup, I was shaking so violently. I’m anxious about how this will impact all of the things I have to do at work, but I’ll live. I am mostly just sad for myself, though I recognize it might be a good time to be grateful that I have gotten this far with minimal upsets: it was always improbable that it would hang on for this long. I’ve elected to let it die a natural death, which it will eventually: typically this condition starts with hyperthyroidism, then hypothyroidism – I have not managed to catch the hypo phase on a blood test; I seem to just revert to normal. I’m additionally grateful that in yet another complete coincidence, a friend of mine told me to submit my tests to Mayo Clinic and that they’d take me as a patient, as metabolic disorders outside of diabetes are rare. He was right: I was accepted immediately. It’s amazing how much one happenstance conversation can do for another person.

In any case, there’s not a whole lot to do here and now. On the plus side, I’ve already been cooking a ton (I made a really delicious quiche last weekend), and I can eat everything with pretty much no consequence to my weight; this would be much more exciting if I were a binge eater. I am still going to the gym, though with a less strenuous routine than typical. What can you do? As my parents say all the time, it is what it is, and right they are.

I will do my best to be positive despite the fact that this situation makes me feel oddly ashamed: that I didn’t take care of myself sufficiently, that I am not healthy enough, that I have a decrepit body and a piece of shit organ that doesn’t work. This is a good opportunity to stick to my much loved 2023 schedule of crawling into bed to read at 8pm and “taking it easy,” whatever that means. I have finished a few books, but I am sure I will write again sooner than later.

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