Monthly Archives: September 2012

Cold Feet: The Thyroid Chronicles, Part I

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I’ll start by telling you that I suffer from latrophobia, fear of going to the doctor.  Though I haven’t undergone counseling to figure out the root causes, I think this fear took hold during childhood.  Growing up in a tumultuous household, I was a bedwetter, and I found it humiliating that during my annual physical, Dr. E felt compelled to “examine” my nether regions, looking, I assume, for signs of rash. In those days you didn’t question doctors and parents didn’t ask kids about their feelings.  Even though for many years, on the eve of my check-up I would parade around the house with homemade picket signs which read:

I HATE DR. E!!!!!!!

my mother didn’t pick up on my discomfort or, if she did, didn’t think it was worth alleviating.

It was the mid-1960s, after all.

(You’ll be happy to know this is one of the issues we resolved on her deathbed.  Dr. E was apparently a celebrated pediatrician and my mother thought she was acting in my best interests).

When I became an adult, I dreaded going to the doctor for a different reason:  the weigh-in.  In some crazy, retro, pre-feminist way, I managed to transform what is supposed to be a partnership caring for and maintaining my body/machine into a self-created moral test of my character.

Even though I’m older and wiser now, I still avoid going to the doctor unless I am in desperate need of a Z-pack of antibiotics, have a sports-related injury or am having my annual Pap smear or mammogram (they don’t weigh you for those).

In other words, I don’t get an annual physical.

When I first started noticing that my body seemed different, I assumed the ravages of age and perimenopause were taking hold.

Certain friends who shall remain nameless here have gained a bit of weight around the middle, many have joked about forgetfulness (including my dear friend C., who forgot to feed my cats over Labor Day weekend.  They were hungry for more than just affection when we got home). Broken nails, my friends have seen a few.  Let’s face it, we’re not as young as we used to be.

Reference material nerd that I am, earlier this year I felt compelled to purchase Dr. Christiane Northrup’s book The Wisdom of Menopause and keep it on my bedside table for a little light reading about hormonal changes. As I read through the section on mid-life weight control, something in Step Five:  Get Your Thyroid Checked jumped out at me.

Cold Feet

My feet are always cold, even in summer.  As I read through the rest of the possible signs of hypothyroidism, I realized most of them could apply to me. (It kind of reminded me of one of those quizzes in Cosmopolitan:  Ten signs that tell you he’s cheating.  By the time you finish taking the quiz, you are convinced that he is).

I added getting my thyroid checked to my mental medical to-do list, along with the colonoscopy I should have had last year, but of course, I didn’t do anything about scheduling either one of these important, potentially life-saving tests. (No, JDM, I have not had a shingles vaccine.  No, sister-in-law D., I have not had a flu shot either).

On vacation this summer, I awoke each morning, more bloated than the next.  It felt like more than an excess of tequila and tortilla chips, and, as I thought about it, the problem had been worsening for months.  Was I suffering from cellular inflammation or an overabundance of fat-accumulating hormones, such as insulin?   Was my thyroid the culprit?

Even dogs can suffer from hypothyroidism

There was only one way to find out.  Feeling very mature (in a good way), I called my Ob/Gyn’s office to schedule my annual Pap smear and mentioned that I also wanted my thyroid checked.  The young receptionist wanted to verify my insurance coverage and gave me the name of an insurance carrier we haven’t used for years.  “No,” I said.  My carrier is C**, the same one I had last year.  “You haven’t been here for three years,” she said coldly.

I felt like Ingrid Bergman in Gaslight.

I had to wait till I got home to comb through my insurance documents, call my insurance company and check all of my calendars for the past three years to prove that I had seen that doctor last year and the year before that.  When that turned out to be fruitless, I called the doctor’s office again to ask them to check my physical file.  This time the receptionist was more understanding when she informed me that there were no notes in my file after 2009.  “I know how you feel,” she said sympathetically.  “I was born the same year as you.”

I was not surprised to learn that a faulty memory is another symptom of hypothyroidism.

The plot and my waistline thicken

The weeks I had to wait for my appointment felt interminable, but I tried to make them productive.  I gave up alcohol, tried to stay away from carbohydrates and made sure to adhere to a regular exercise regime in spite of my achy joints (another symptom).

I researched doctors and made an appointment for a physical with one who looked promising (in my own latrophobic defense, apart from my Ob/Gyn, whom I have seen for seventeen years, I haven’t been able to find a doctor or a practice that impressed me with professional, high quality care).

One day while out for a run, I tried to pinpoint what had changed over the past six months to make my symptoms, especially the weight gain, worsen.  I’d started making and eating granola on a regular basis, but it seemed hard to believe a cereal mix could be so potent.  Then I remembered.  Around six months ago, after being diagnosed with a herniated cervical disc, I received two epidural steroid shots and also took oral steroids. Because I have trouble remembering things, I made a note on my iPhone to do some research.

At home, a quick search on the Internet suggested there could be a link between the steroids and my thyroid. (Searching for things on the Internet reminds me of writing high school essays: combing the available research materials for snippets of information to support my thesis).

Next week I will see my Ob/Gyn and hopefully be that much closer to figuring out what, if anything, is wrong with me.  Who knows, my symptoms might just be the normal by-products of aging, which require a change in my behavior, nothing more.

But at 51,  I think I’ve finally learned my lesson.  Now, more than ever, it’s important to stay on top of your health, if for no other reason than to have a baseline to work with if something is really wrong.  Perimenopause and menopause can cause some surprising symptoms (remember pregnancy nosebleeds?).  It’s worth talking to a doctor about them, instead of suffering in silence.

Check back with me in a few months to see if I’ve scheduled that colonoscopy.

This week, four diplomats were killed in Libya and my nephew was deployed to Afghanistan. As a proud former member of the Foreign Service, who served in the Near East and South Asia bureaus, my heart is with those who dedicate their lives to promoting international understanding.

In their wonderful new book Jerusalem, chefs Yotam Ottolenghi and Sami Tamimi, a Jew and a Muslim who grew up in the western and eastern part of that city, talk about food’s ability to break through religious and cultural boundaries.

Twice this week I made Ottolenghi’s recipe for Figs with basil, goat cheese and pomegranate vinaigrette from his book Plenty.

Historically, figs have been revered as a symbol of peace.  I can’t think of a better thing to eat. And they’re good for you too.

Shall I Compare Me to a Summer’s Fig?

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If I were a real food blogger, I’d be writing about late summer Italian plums, figs and tomatoes, the last blackberry cobbler of the season, about eggplants and the fact that by late August my apple tree was already brimming with fruit as red as a seductress’ lips.

I’d be telling you that for the first summer in thirteen years, I made no jam from berries I had picked myself, but luckily was able to use Susan Herrmann Loomis’ recipe for apricot jam from her lovely book On Rue Tatin (a nice read when you are suffering from the doldrums) with the remnants of the ten-pound box of apricots I bought in Eastern Washington on the way home from a camping trip in Idaho.

I had big plans for these apricots, but a certain teenager ate most of them on the road from Quincy to Seattle.

I might mention all the terrific Mexican food we ate at the Columbia River Gorge and the fact that I got to eat at three restaurants I’d always wanted to try:  the fantastic Pok Pok in Portland, Aziza, the San Francisco restaurant owned by Mourad Lahlou, author of Mourad’s New Moroccan, one of my favorite new cookbooks this year, and the iconic Zuni Cafe, where the famed roast chicken did not disappoint. Two weeks in a row, after dining at Aziza, I made Mourad’s piquillo almond spread, a real crowd-pleaser.

I might sneak in a mention of some of the books I finally got around to reading on vacation (The Night Circus, The Tiger’s Wife and, at the behest of Daughter #1, The Hunger Games trilogy).

I could tell you that it is bittersweet to realize that with the passage of years comes the realization that I will never have enough time in a season to make all of the favorite dishes we have compiled,

especially since I can’t resist adding new favorites, such as the Garum Factory’s Avocado Salad with Pikliz.

Finally, I might point out that if you have an abundance of Italian plums or figs, you could do worse than to turn to Dorie Greenspan‘s Baking from my home to yours  for inspiration (check out her Fig Cake for Fall and Flip-Over Plum Cake) and that if you are having a big gathering of friends on Lummi Island for Labor Day, people will be impressed if you whip up a big paella (even if you think you could have done a better job seasoning it).

But I’m just a broken down hybrid mid-life blogger taking advantage of a few free minutes on this, my 51st birthday, to muse about the differences between turning 50 and 51, opportunities found and lost this summer, our family’s newfound preoccupation with hair and the fact that as I progress further and further into that undefined hormonal state known as perimenopause (and perhaps because of all my fine summer dining), I am beginning to resemble a fig and am longing for the vitality I had when I turned 50.

Today was the first day of school, so if ever there was a birthday that was not all about me, this was it.  You should see our downstairs bathroom.  It’s a mess of hair straighteners, hair product, curling irons, nail polish remover and metallic blue nail polish, some of which has spilled onto the top of the toilet bowl, where it will probably remain for eternity.

I wanted this, my friends remind me.  I wanted Daughter #1 to feel comfortable with her femininity and to embrace her beauty instead of hiding it. I love the new nightly ritual of Daughter #2, our resident fashionista, patiently straightening her sister’s hair, of watching the two of them in the bathroom at 6:30 a.m., determining how much mascara is too much, of seeing how much fun they both have with clothes.

I also want to be able to leave the house without having to factor in 45 minutes of primping every time.

Instead of a day of self-indulgence and an unbroken train of thought, my birthday (it is now the next day) ended up being about making time for other people:  a 6:30 a.m. call from my nephew, who will soon be deployed to Afghanistan and a call that interrupted my much-anticipated chance to exercise from my brother, who told me about the Bruce Springsteen concert he had just attended (he was seated next to Chris Christie).

You can take the girl out of Jersey but…

There was the farewell conversation with our elderly neighbor, who has been a part of our lives for seventeen years and is leaving her home for a retirement community, and there was teen roulette.

As anyone who has more than one child knows, a good day is one in which all of your kids are content. More often than not, if one has a good day, the other doesn’t but, like a game of roulette, no matter how you bet, there is no proven strategy for beating the odds.

I held my breath to see how the first day of school would turn out.  I didn’t have to hold it for very long, because Daughter #1 started school at 11:30 and Daughter #2 finished at 1:00.  We went out for a Starbucks refresher, which is as magical to my daughters as my breast milk used to be, and Daughter #2’s impressions of her first day of middle school at a new school came spilling out.  When we went to pick up Daughter #1 at her friend’s house, I quickly scanned her face for signs of how the day had gone.  Then off to the swimming pool for her swim team tryout, which had been a disaster the day before, and this time was a smashing success.

It was only as we sat down for sushi and Daughter #1, now a seasoned veteran of middle school, regaled us with funny stories,

that I let the psychic energy of the day dissipate and I relaxed and remembered it was my birthday.

We came home to presents, lemon tart and dog poop on the stairs.  And then, as the hair straightener came out and my daughters took up their respective positions of straightener and straightenee, we listened to Michelle Obama’s speech about hard work and personal responsibility and contributing to the well being of society.

We’re gearing up for a new school year, a new array of seasonal foods to inspire us, a new   soccer season and new books to read (including my birthday bounty:  Alif the Unseen by G. Willow Wilson and Jerusalem by Yotam Ottolenghi, author of Plenty, one of my favorite cookbooks this year).

All in all, it was a pretty good summer, a pretty good first day of school and a pretty good birthday.

All’s well that ends well.