Cold Feet: The Thyroid Chronicles, Part I

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.

Pain in the Neck

It’s 6:30 on a Friday morning and daughter #1 and I are sniping at each other.  I want to be sure she has everything she needs for the ski bus she will take from school to Snoqualmie Summit later in the afternoon.  Skis, poles, boots, helmet, gear bag and food are all piled up by our front door, just as they are every Friday morning.  But this morning, I am bitchier than usual and daughter #1 is rolling her eyes and refusing to go through the checklist with me, though we both remember her maiden ski bus trip last year, when we packed everything except the ski boots, an omission she did not discover until she was on the mountain, ready to go.

I am bitchy because I haven’t slept for the past several nights, due to a pain in my neck.  I’d like daughter #1, who is 13 and can’t always control herself, to stop being a pain in the bleep and cut me some slack.  It doesn’t happen and we part on unfriendly terms.

Later, after I have been diagnosed with a herniated disc, pumped full of steroids and set up with a physical therapy regimen, I will have the foresight to send her a text apologizing for my bitchiness.

Still later, when she has been strapped to a backboard and rushed down the mountain in an ambulance, I will look at her texted response to my apology:  “I’m sorry I was a whiny schmuck.”   Me: “I’m glad you’re my whiny schmuck  :).”  Her:  :).

The next day we are walking companionably together in stiff-necked glory, me, whacked out on steroids and pain meds and a muscle relaxant, her, a little sore and just beginning to realize what might have been.

She tells me she dreaded making the call to us that night, knowing we would be upset.  I tell her how helpless we felt because we weren’t there to comfort her and about the confusion of receiving several truncated calls from the ski patrol, her ski instructor and a chaperone who happened to be a doctor, trying to piece together what had happened and assess her situation.  She’d fallen and somersaulted, landing on her back, while learning mogul safety, but had managed to ski herself down the mountain (good sign) before realizing she felt dizzy (bad sign).  As a precaution, she was strapped to a backboard and it was determined that she should be taken by ambulance to the emergency room.  The experts deliberated over which one, and we reacted to each possibility: the one nearest our house (good sign), the one at Seattle’s largest trauma hospital (bad sign), and finally, the one closest to the mountain (good sign).

She tells me what it was like to be immobilized on her back in a screaming ambulance, crying, with no one but an awkward EMT to comfort her with small talk.

I tell her about rushing to the hospital, a 45 minute drive from our house, with her pajama-clad frightened younger sister in tow.  On the way, something smashed into our windshield, aimed at my heart.  “Have we been shot????” Jeff was rattled by the sudden impact.  Indeed, there is a bullet-like hole on the outside of the glass and it seems hard to believe it could have come from a rock.

By 11:00 p.m., backboard just a memory,

we are at a drive-through Krispy Kreme at a strip-mall in Issaquah laughing at the strangeness of our situation and allowing the first waves of relief to sink in, along with the sugar.

Though I am unable to turn my head toward the backseat to smile, we agree that this was the mother of all gazumps.

Daughter #2 suggests I can bog about this.  I feel a twinge of guilt over what we may be turning into.

The pharmacist calmly explained all the possible side effects of my meds.  My friend Diane, a nurse, puts it in plainer terms.  “You’re going to be bloated and bitchy and miserable.”  I already feel that way 11 days of each month, thanks to my perimenopausal PMS, which is kind of like PMS on steroids and which I have learned to manage with exercise, smoked salmon, red wine and my private reserve of dark chocolate.

I keep it on a special shelf in the freezer.

Now that I am experiencing perimenopausal PMS and am on steroids, I realize that my previous forays into moodiness were a walk in the park compared to this new dimension of craziness.  I have never suffered from chronic depression, nor have I ever taken anti-depressants.  I have a new-found empathy for those who do.

My funny family is able to make light of Mom’s ‘roid rage and Daughter #1 buys me some Doublemint gum to cool me down. But, though I stop taking the muscle relaxants after the first one, and limit the pain meds to just one at bedtime, my consciousness is altered, like a mid-life follower of Timothy Leary, though I drive a minivan instead of a magic bus.

I take a four-mile walk on a glorious sunshiny day and my iPod astutely shuffles to Katrina and the Wave to help cheer me up.

It doesn’t work.

It’s been a long time since I’ve had the intensity of feeling one experiences in middle school, when the mountains can seem more beautiful than they ever have before

yet you question your place in this world.  I have a new-found empathy for those who feel these extremes and also have to navigate the intricate social dynamics of the school lunchroom.

As the pain lessens and the meds wind down, I am regaining enough healthy perspective to understand that we dodged a number of bullets.  That fateful Friday would have been the 17th birthday of my friend Beth’s son Ian. There was a madman with a gun terrorizing a neighborhood to our north, where residents were advised to stay home behind locked doors.  There was an accident at our Sunday Farmers Market, resulting in the serious injury of a baby. I think the moon was full.

Our insurance will pay to get the windshield fixed. Daughter #1 is planning to go skiing again on Friday and I’ll be up and running again in no time. Over the years, we will re-tell the story of Daughter #1’s ambulance adventure when she comes home from college for the holidays or whenever we pass a drive-through Krispy Kreme kiosk.

In the grand scheme of things, I am grateful that in the end, this turned out to be nothing more than a pain in the neck.

Though many things can cause them, herniated discs can also be a by-product of aging. I’m grateful to my Facebook friends who stuck their necks out for me by sharing their stories and favorite remedies.  Thanks to Nancy Schatz Alton, a member of the Ballard Writers Collective and co-author of The Healthy Back Book, which jump-started my efforts to take charge of my own recovery.  Thanks to Christina Wilsdon, witty writer and animal aficionado, for suggesting Treat Your Own Neck, by Robin MacKenzie.  Thanks to my neighbor Shannon for the nightly laser treatments, to Diane for the frankness and the heating pad, and to Liz and Paul for the promise of a rotisserie chicken and cookies.

In addition to drugs, physical therapy and ergonomic office arrangements, everyone agreed that dark chocolate has charms to soothe the savage beast.   Some kindred spirits also felt that the pair of pink shoes I’ve been ogling would certainly have profound therapeutic benefits.

Finally, I haven’t felt much like eating because of the water retention, and have felt even less like cooking, which, if you know me, you know signals that my stars (not just my neck) are out of alignment.  But this morning, while thinking about anti-inflammatory, all-around good for you foods, I remembered this wonderful salad from the cookbook Turquoise: A Chef’s Travels in Turkey by Greg and Lucy Malouf.  Afiyet Olsun! (Turkish for enjoy your meal)

Green Olive, Walnut and Pomegranate Salad

3/4 cup walnuts, toasted for 5-10 minutes in a 350 degree oven.  After cooling, pour the nuts into a towel and rub well to remove skin.  Then coarsely chop

1/2 cup pitted green olives, washed and coarsely chopped

1/4 unsalted shelled pistachios, coarsely chopped

1/2 cup pomegranate seeds

2 small shallots, peeled and finely diced

1 red serrano chile, seeded and finely diced

1Tablespoon shredded flat-leaf parsley leaves

1 Tablespoon olive oil

I Tablespoon walnut oil

splash of pomegranate molasses

juice of 1/2 lemon

sea salt

freshly ground black pepper

Combine all ingredients in a large bowl and toss gently.  Let stand five minutes before serving so flavors can meld.