Journey to Omaha II

Before I post my monster update (seriously, I'm typing it now), I realized that I inadvertently (or maybe subconsciously) left out a diagnosis I received  in February that I want to fill you in on.  Prior to going to Omaha the first time, I'd been sent a packet of information (by PPVI Institute) to evaluate me for Thyroid System Dysfunction.  Now, I was already on Thyroid medication for hypothyroidism, but this dysfunction is kind of tricky.  I would like to educate you a little bit about it (because I think it is important and fascinating all at the same time) as explained in the information packet sent to me. If you're not interested in the medicine behind the reality, skip the quote and pick up after it.  But I'm telling you, it's fascinating (and you can understand it - I'm absolutely not medically inclined and I understand it.)

"Thyroid System Dysfunction (TSD) is a controversial condition in which the patient may have a large number of symptoms that are ultimately associated with abnormal function of the thyroid gland.  However, in this condition the normal thyroid function studies that the doctor runs on blood tests are usually within the normal range.  The ability to diagnose this condition is said to rest on the ability to take a series of body temperatures because the diagnosis - at the present time - is made in part upon the identification of the average body temperature being below 98.2 degrees Fahrenheit.

 ...It is controversial because the American Thyroid Association has taken a specific position on this condition indicating that they believe it is nonexistent...

 Theoretically, this condition is caused as the result of chronic stress.  Under the conditions of chronic stress, the adrenal glands respond by manufacturing a large amount of Cortisol.  Apparently Cortisol inhibits the conversion of Thyroxine (Thyroid hormone - T4) to Triiodothyronine (the active thyroid hormone - T3).  Cortisol favors the conversion of T4 to Reverse T3 (RT3).  Reverse T3 is similar chemically to the T3 hormone but it is inactive.  That is to say, it has no physiological activity.  If the stress is prolonged, a condition referred to as "Reverse T3 Dominance" occurs and persists even after the stress passes and Cortisol levels fall.  Apparently RT3 can act somewhat like Cortisol and block the conversion of T4 to T3.

The conversion of T4 to T3 is very important.  It occurs both in the liver and in the individual cells throughout the body.  While T4 is produced by the thyroid gland in response to Thyroid Releasing Hormone (TRH) - a hormone produced in the hypothalamus - and Thyroid Stimulating Hormone (TSH) - a hormone produced in the pituitary gland, the thyroid hormone itself (T4) is not a very active hormone.  The conversion of the T4 to T3 is important to obtain the effect of the thyroid hormone.  When this relationship changes with a production of a predominance of Revers T3 (RT3), there is the development of multiple symptoms related to thyroid dysfunction.

This Reverse T3 Dominance is the cause of the hypometabolism which is associated with decreased body temperature.  In the case of any hormone activity, there need to be chemical receptors within the cells to bind with the hormone in order for the hormone to be effective.  The RT3 and T3 both bind to the same receptors.  However, when there is an increased amount of RT3 relative to the amount of T3 (once again the active thyroid hormone), then the receptor sites become blocked by the RT3 and the various chemical reactions associated with the body slow down.  When these reactions slow down, the temperature drops because these reactions normally will give off a certain amount of heat and they are the source of heat within the body.  As these reactions slow down, less heat is produced and the body temperature decreases.  This drop in temperature slows down enzymes in every cell of the body... Ultimately, this is the bio-chemical reason for the thyroid system dysfunction."

I haven't talked about this much with anyone, because it is kind of heavy, but my mom and my sisters knew a little bit and Andy, well he knew just exactly how much I was struggling.  I want to talk to you about this now because it is important to me that this information is out there for others who may be struggling similarly.  Get ready to get to know the real me:

I was exhausted every morning, even after a full night's sleep.  I would fall asleep while reading to Ruby.  I took naps while she napped pretty much every day.  I chalked it up to "being a parent of young kids"  and "getting older." I was grumpy, snappy,  irritable, and unreasonable many days throughout each month (not PMS, but 10-15 days throughout the month.)  I was depressed, unmotivated, overwhelmed, and so many, many times I felt like I had completely lost the ability to control my emotions.  The devil enjoyed playing with my doubts, making me feel like a terrible person who, if I just practiced more self-control, could "get over" this.  Those 10-15 days each month were so dark and difficult.

I know what some of you are thinking, you "know" me, and you just don't see those things.  You see my Facebook posts, my blog, and you think that I couldn't possibly be describing myself.  But I can assure you that you didn't know the whole story.  There were good days and bad.  You knew the "good day me."  On those good days, I could be productive and loving and patient and I could blog and post on Facebook.  That's the me I let people know.  On the good days, I could make light of the bad.  But on the bad days, I couldn't see the forest for the trees.  Those days I would get absolutely nothing done above keeping everyone alive and fed and clothed.  It was all I could do to make it through the day without curling up in a fetal position on the bed and sleeping.  I felt like I was crazy with all the ups and downs.  I had no idea how I would feel or react to things.  On the good days I could be so patient but on the bad days, the littlest, stupidest things set me off into that dark place, unable to control my emotions no matter how hard I tried (and seriously, I.tried.hard.)  I never knew which kind of day I was going to have.  On the good days, I couldn't understand why I felt so horrible on the bad days.  I hated how I felt.  I hated how I treated Andy and the kids (but mostly Andy.)  I couldn't stand the person I'd become, yet I couldn't figure out how to not be that person.  The thought that my life would always be like that scared and depressed me even further.  I can't imagine how hard I was to be married to.  And yet, despite the me I was so much of the time, the bitchy, grumpy me, Andy loved me.  Loved me even when I didn't love me.  I could not possibly be married to a better man for me.

Now, because of our background in the Couple-to-Couple League method of NFP, I had maintained daily basal temperature readings (with breaks during pregnancy/nursing) since shortly before we got married, and I knew my temps bad always been low (most recently, in the mid to lower 96s pre-ovulatory, barely getting to the mid 97s post-ovulatory - when temperatures rise in reaction to progesterone)  And the temps had always puzzled me (because they can indicate thyroid problems) but my blood tests had always come back pretty much normal.  And here I was reading this informational packet on TSD and going "That is ME!"  This disorder that the American Thyroid Association believes is nonexistent - perfectly describes me.  The temps coupled with the fact that I checked off two dozen of the  symptoms associated with Thyroid Dysfunction (everything from moodiness, low libido, irritability, depression and fatigue, to low-self esteem, miscarriage, and cold intolerance) made me think that perhaps Dr. Hilgers had stumbled onto something that would change my life.

I had a moment of clarity reflecting on my symptoms  in a worksheet from Dr. Hilgers sent with the TSD informational packet (some of the questions: "Compared to a normal person, what percentage of a normal person do you feel?" and "Compared to the way you felt before developing all of these symptoms, all things taken together, would you say you feel (10-90%) of what you felt then?") You mean all these things that I've been feeling.  This person that I've become could all be related to my thyroid?!  In trying to remember when it was that I last felt "normal," I realized that I hadn't felt like "myself" since we miscarried the very first time way back in 2008.  It seemed to worsen after each miscarriage, and had reached a fever pitch after we miscarried in August 2012 and I stopped post-peak progesterone intervention so that Dr. Hilgers could get an accurate hormone profile through a month-long blood panel. I'd long thought it was hormonal, but had no idea it could be related to my thyroid.

I filled the packet out and actually hand delivered it the first day I was in Omaha.  On Monday, February 11th the nurse called to let me know that I qualified for the treatment for Thyroid System Dysfunction.  I picked my prescription up at Kubat's Pharmacy (the only pharmacy in the nation who compounds the active T3 hormone under Dr. Hilgers' protocol) when I was in Omaha again on Valentine's Day.

We are still in the process of getting my dosage correct, but I cannot believe how much better I feel.  My temps are still working their way to a more normal range, but I've had temperatures in the 98s sporadically!  I don't even know when my temperature has ever been in the 98s (except for when I have a fever...)  And on the days that my temperature is up, I can seriously feel it.  I feel like the me I knew I was deep down but couldn't be.  I have a normal amount of energy.  I feel rested.  I can handle life.  Things still upset me, but I can deal with them and move on.  I feel "normal" and normal feels wonderful! It is my hope that as we approach the right dosage, I will have more and more of those "normal feeling" days.

I am very hopeful that we will someday be able to successfully carry pregnancies again (and you'll learn more about our answers in the next post) but if nothing else comes from this, I feel like I am getting my life back.  I don't dread the rest of my life now.  I hope that I can one day be the wife that Andy deserves and the mother that Ira and Ruby deserve.  Because they deserve the very best.

Lastly, I am so, so grateful for a doctor who is willing to research problems that certain associations call non-existent.  Because for me, that non-existent condition was a reality that was wreaking havoc on my life.