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Proper Progress Report: First official labs since surgery

06 Jul

I finally had my first significant labs done.  My endocrinologist had me wait until the end of June to get my labs so that she would be back in the office to take a look at them.  Considering the last time she was out of the country and the medication mishap that occurred, I didn’t mind waiting an extra couple of weeks.

To my surprise, my labs came back as follows:

T4 (Thyroxine Free) 1.1 ng/dL  (Ref Range 0.7 – 1.8)

TSH (thyroid stimulating hormone) 9.63 mcIU/mL (Ref Range 0.55 – 4.78)

So obviously, my TSH is about twice what is considered the upper end of normal.  What surprises me is that my T4 is pretty much right in the middle.  I was feeling pretty fine, sure, a little bloated more often than not, but a small price to pay considering all the things I was fretting about pre-surgery.

What I’m confuses me is that it’s not as though my thyroid is not producing enough and therefore my pituitary gland says “make more TSH”…  I don’t have a thyroid, I take a consistent dose of T4 that goes into my body every day.  I wonder if it’s just the shock of the gland disappearing or lifestyle functions that interfere with absorption…  In any event, they raised my dose from 112mg to 137mg, which I began on June 30th.  I’m curious to see how this will affect me.

Here are the lifestyle modifications I’ve made thus far:

  • Wake every day at 6:30 a.m. to take Synthroid pill, go back to sleep for 2-3 hours, wake up and have lemon-water (try to do this daily before breakfast or coffee) then coffee.  I’ve been drinking coffee every day and many times feel as though I need it, and that bothers me.  It’s all borrowed energy and the adrenals are what pay the debt in the long run, so maybe it’s good that I’m getting a higher dose.  The reason I get up to take it is that I feel better than if I take upon waking and watch the clock while my stomach growls, or worse yet, have to run off somewhere without being able to get a healthy breakfast.  I don’t know if it’s in my head, but I feel better if I go 2-3 hours between pill and anything other than water rather than the suggested one hour.  Yes it’s a pain in the arse, but you can be sure I think it’s worth it to take such measures.  A person can get used to pretty much anything.  Ever watch Hoarders where one spouse is a hoarder and the other lives with it for a decade or two?  It could be worse….
  • Avoid Soy.  Okay, this is something I was already doing for the most part before the surgery for non-thyroid related reasons, but I’m continuing to do so.  Previously, I’d eat fermented soy which limited me mostly to tempeh, but now I avoid that as well.  Sure, on the rare occasion I’ll eat a square or two of junk tofu ( Asian style from the farmer’s market cafeteria line), but it’s really only three squares every few months.  Avoiding soy means more than just avoiding tofu and edamame.  It means avoiding most salad dressings (I like to avoid Canola as well for the Omega 6 overload) and packaged food.  If it is in a box, it’s more than likely got soy in it.  Again, I was already doing my best to avoid processed food, but now I have even more incentive.  Making your own salad dressing is super easy and you have greater control of what you consume.  Something I’m in favor of already.
  • Not avoiding a high fiber diet.  This is something I refuse to modify, not that it was suggested by the doctor, but two of the things I eat a lot of are listed as interfering with the absorption of Synthroid on the brand’s website.  One is walnuts and the other is high fiber foods.  Now there is no f-ing way I’m avoiding those!  That would mean reducing the amount of fruits and vegetables I consume and that is the most ridiculous notion.  They’ll just have to increase the dose.  Oh wait, they did.
  • Keep my Synthroid in the refrigerator.  It is HOT y’allz!  I don’t care where you are in the country (except the pacific NW), it is balls-frying-on-the-pavement hot!  My old apartment and my new digs are similar in that the air conditioning does not really cool the joint down when it’s 106 degrees outside… and inside.  According to my research, Synthroid readily degrades when exposed to heat, so I keeps it in the fridge, yo!  That is, until the night before I take it, then I place it in a little shot glass next to the bed so I can wake up, take it (with a full glass of water), and lie back down and (sometimes) fall back asleep.
  • That’s it!

So, my lifestyle hasn’t changed that much.  I still have weird sensations at the incision site.  It feels itchy at times, like it’s being stretched at others, and then there’s that weird pinchy, burny feeling that I believe is my nerves growing back together.  All in all, it’s not too uncomfortable.  I forget it’s there most of the time, which is a vast difference from being hyper-conscious of my enlarged thyroid 100% of the time.  It’s been just three months and the ‘surgical ridge line’ has completely flattened out, though it’s still quite red.  I find I don’t wear necklaces these days because I feel like the scar competes with the necklace and it just looks cluttered, like I’m wearing two necklaces.  Hmph.

I haven’t really been putting anything on it other than sunscreen, which I’ve been lax about, but it’s not like I’ve stepped outside other than to walk to my car or work.  It is HOT y’allz!  When it feels itchy, I’ll rub some of my shea/coconut concoction that I sell in the winter time on it because it’s too rich for any other part of my body in the summer.  I did buy Mederma, but I’ve only used it about 4 times.  I guess I just don’t really care enough to make it a priority.  I figure I can get around to it when I get tired of looking at it.  Really though, putting an acid-peel type substance on a fresh surgical scar just feels counter-intuitive.

I think my least favorite thing is the strange sensation when I yawn.  Since there’s no thyroid there to separate my trachea from my neck flesh/skin, when I yawn, it feels scratchy and weird when my neck skin rubs on my trachea.  I bet you’re working up an appetite, huh?

On a related topic, I was listening to an episode of The Moth podcast whilst making a batch of soap this evening and there was a story told by Jennifer Fitzgerald in which she does her best to “slut it up” in an effort to get a boyfriend to prove her parents wrong (funny story, that’s why you should listen) and the captain of the wrestling team ***SPOILER/VULGARITY ALERT*** shoves her hand down his pants and she exclaims “Jesus Christ!  It feels like chicken parts!”  Tantalizing, no?  I had a good laugh at that one…

Progress report so far:

  • zero pounds gained (aside from normal fluctuations)
  • zero pounds lost
  • mild occasional bloating – not the worst case scenerio
  • frequent stomach aches – not inclined to think this is thyroid related, but thought I’d mention it
  • plenty of energy to do the things I need to do and the body tells me when it’s time to rest
  • some annoying short term memory malfunction – again, not the worst case scenerio
  • fairly stable mood – no pronounced depression or anxiety
  • dosage increase 6.30.12 – will update accordingly

Most days are good, others, I feel like I’m just hanging on, trying not to fall over the edge, but mostly, they’re good.  I think that’s the best that anyone could ask for Total Thyroidectomy or not.  So, I guess I’m doing fine.Image

“A little perspective, like a little humor, goes a long way.”
Allen Klein

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2 responses to “Proper Progress Report: First official labs since surgery

  1. Jen

    July 6, 2012 at 5:32 pm

    Yay! So glad you are doing so well! I came across that whole “avoid high fiber” warning while doing some of my obsessive research earlier this week, and thought, WTF?!? Hmmm…so for breakfast, since I think calcium blocks absorption levothyroxine too, I could eat….meat and white toast? Uh…no…

    I have been thinking about things like when I will take the levothyroxine and will most likely be doing something similar since I like to eat immediately when I wake up.

    Anyway, thanks for updating…I am sure you are busy getting on with your life, as you should be, but it is really good to hear the recovery details. Take care!

     
    • houffenglaarfert

      July 6, 2012 at 7:49 pm

      I know… that’s so dumb and I refuse to make myself sicker by changing that. I eat mostly vegetarian and stay away from milk in general, so I’ll eat oatmeal (not in this heat), fruit, eggs on toast… Honestly, a banana with peanut butter is quite filling and that’s often my go-to. Or I’ll make my dessert-for-breakfast frozen fruit “ice cream”. I will stick some kale in it too, which has calcium, but I’m not worried about it. To me, the benefits of a good diet far outweigh the added absorption of synthroid. I’d way rather wake at 6:30 than process up my diet.

       

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