the quiet revolution

Ten days after my last update, life took a sudden and unexpected turn. Riding my bike home from work, I was stopping at Queen Victoria Market to meet friends for dinner. I never made it.



A moment's inattention crossing the tram tracks - a slow-motion accident as my wheel slotted in and locked - left me crumpled on the road. Bruised, grazed, but otherwise seemly ok, I got up, grabbed my bike, and finished crossing the road on foot. That's when I noticed I was bleeding. Just a little veinous ooze from my right leg. Safely on the footpath, I rummaged for a band-aid to cover the wound, and realised a plaster wasn't going to do it: I had fat cells festooning my leg where the skin had torn open. Oh dear, that was going to need stitches. Meanwhile, I needed to stop the bleeding and keep the wound clean. My little first aid kit yielded no suitable dressings, so I plugged the wound with a tampon, stuck in place with plasters. Perfect!

I texted the friends I was meeting; they came to find me and accompanied me to a first aid station, where the would was checked, cleaned and properly dressed and I was instructed to get myself to the hospital for a tetanus shot and stitches. We took an Uber to Emergency and waited. The hand I'd landed on was pretty bruised and swollen, but the leg didn't really hurt. It seemed I'd got off lightly. Five hours later, as the Emergency Doc was finishing my stitches, I discovered I couldn't push my weight up with the bruised hand. Doc suspected a fracture and sent me off to x-ray. The results were inconclusive, so she put me in a just-in-case cast and sent me home, a little after midnight.

Two days later I turned 40.



Over the next 3 weeks I played a frustrating game of "is it fractured", with an MRI eventually confirming that yes, I had fractured my scaphoid - a little bone in the wrist at the base of the thumb which, it turns out, is an utter bastard to heal. I'd already been in a splint cast for 3 weeks, and now I'd be in a full cast for another 6. At least I got to choose the colour this time.

Almost 9 weeks after the accident, the cast blessedly came off. Gods casts are disgusting things: there's nowhere for the dead skin, sweat and bacteria to go, so they just form a paste on top of your skin. Delicious. A quick wash of my festy forearm - now incredibly touch sensitive and atrophied - and i was off to x-ray, where they discovered... still fractured! Eight weeks had not been enough to heal me. Tears were shed.



Another 5 weeks then, this time in a plastic brace that I could blessedly take off to wash and stretch, and was much easier to get about it. Still, the rules remained: no lifting anything heavier than a tea cup; no driving.

I pretty much live on my own. I have a housemate around 2 nights a week, but otherwise it's just me. I'm still not that well connected here in Melbourne. You can imagine just how feasible the "no lifting" business is, and just how restrictive "no driving" can be (particularly the first month, when I couldn't really walk due to the stitches in my leg). My mental and physical health did not cope so well.Last week I had more x-rays and a CT scan, and yesterday - 93 days post-accident and on hospital visit #7 - they finally set me free. Fractured no more, all activities restored. So now it's time to strengthen my skinny, hairy hand, re-teach my wrist and thumb how to bend, and put my life back in order.

It'll be a few months yet until the wrist is "normal", but don't underestimate the amazingness of having two functional hands.

So, this week work took me to Flinders Island. It was the last major deadline leading up to my holiday and the point where I finally started to relax, knowing I'd done everything I really needed to and had plenty of time left to pack.

The trip went really well and Flinders Island is truly beautiful: I'd like to go back for a few days to explore and to climb Mt. Strzelecki. It was, however, a long trip, with the drive to Launceston Tuesday night then up early for a dawn flight to the island and a dusk return to Launnie, followed by the 2 drive back to Hobart. The plane was a little twin-prop 18-seater, which was much fun to fly in.

Unfortunately on the return flight I was sat in front of a cougher. There's a horrid respiratory infection that's been doing the rounds in Tas that I'd thus far avoided. No longer. I am sick. Flinders Island Flu.

Do not pass Go, do no collect $200, SICK. I'm running a fever and want to do nothing more than collapse in bed for a few days. It's not to be, however, as tomorrow I fly to Sydney, then Monday morning I'm off to Santiago. Today, instead of sleeping, I'm dragging myself through the packing process (it's going exceedingly slowly) and doing my best to keep moving. I've jumped on antibiotics and am filling myself with garlic, lemon, ginger, chilli and honey. All I can do now is hope I feel a little better in the morning.

Meanwhile, here's a little Flinders Island magic from my flying visit. I'll catch you all when I'm back in August.

xoxo

Hello again. My hard drive has gone phut so I have borrowed the work lap top overnight to catch up on the digital world. Thankfully I'd backed everything up about a week ago, and I really did need a new computer but I could do without the expense right now. I may see how long I can muddle along with the borrowed lap top, but I do miss Photoshop!

I've been in a wee bit of a slump these last two days: a combination of crashing back to reality after a wonderful Melbourne trip and a general lack of sleep. My sub-conscious is being very annoying right now, doing the mental equivalent of digging into the bottom drawer and the back of the cupboard to see what emotional debris have collected in the corners. I understand it's a reaction to recent events and perfectly healthy, I'd just prefer if it didn't result in semi-lucid dreams and broken sleep.

Is it just another toni-quirk or do other people have a subconscious that likes to test their true feelings on an issue by throwing up a range of scenarios and evaluating any emotional response? Bah, even my subconsious is a scientist: test, test, test.

So I've been sleeping badly, distracted and a little frayed around the edges. I may have even indulged in a little sulking and eating of chocolate. This evening, though, I've given myself a stern talking to and set about looking after myself properly. If I'm going to insist on living this crowded and complicated life (as it seems I am, since every attempt to slow things down a little is quickly abandoned when something shiny comes along) I'm really going to have to take better care of myself and find some self discipline. That means eating properly, sleeping properly and giving myself time and space to work through assorted cares and concerns.



So tonight I went out into my sorely neglected little garden and picked a bucket-load of kale, made lacework by an infestation of cabbage moths^[1], and cooked myself a mountain of kale and mushroom dahl. Shortly I'm going to go tackle the dishes and the washing, then settle down with a mug of sleepy tea and think a little.



Uncertainty around my employment future weighs heavily (desipite having plans for scenarios A, B & C, scenario D - current job ends and alternate job prospect fails - remains a concerning prospect). As much as there are many other things I'd like to invest my energy in, it seems now is the time to focus on my career and doing what I can to build my employment prospects. At least I have a fair idea where I actually want to take my career now: a better position than I was in 6 months ago.

Life is complicated, but it's also full of beautiful things and wonderful people. If I'm going to survive it all I'm going to have to get better at the whole balance thing. I've got to look after myself if I'm going to keep running. *grin*

Much love!




[1] Because I'm a hopeless hippy an ecologist I dislike using poisons in the garden and generally just accept a portion of my crops will be lost to the snails, bugs and grubs that are meant to be in a garden. Sometimes, however, things get out of balance (especially as establishing a well balanced garden with the birds, bugs and lizards to eat the pests takes more time than one generally gets in a rental) and action must be taken. So today vast quantities of kale were picked, the caterpillars and eggs removed (the laciest leaves will wind up in stock) and the remaining plants coated liberally with derris dust. One day, however, I will have a proper balanced garden!

Ooh, speaking of, I made my first batch of tomato relish for the year on Monday; a colourful mix of yellow Snow White and purple Black Cherry toms. Should be good!

I knew I'd been pushing it, my mind, my body, my spirit. I came home from Melbourne teetering on the brink of total exhaustion, ready to collapse. Yet I did not stop.

More change, more challenges, more rapacious consumption of all life has to offer.

I've started a new job, new office, new career direction, new routine.
I've worked with my careers advisor, mapping what I want to do, where I want to go.
I've sought feedback and constructive criticisms from my previous workplace, deconstructing my ego and learning painful lessons.
I've hiked and danced and moved until my body would do no more.
I've grieved for the loss of the good times Alex and I shared, for the dreams that never came to pass.
I've sought out friends and social engagements, strengthening my little circle.
I've thought about and pondered my relationships, in all their splendid complexities.
I've decided that I am exactly the person I choose to be.

And in the process of doing, learning, choosing and loving I have pushed myself too far. Physical, mental, emotional collapse.

Now it is time to exhale. To retreat a little, fold in on myself, gather up my loose ends and weave them back together.

I need to remember how to rest, how to give myself the time and space I need to process everything I've learned. Reminding myself that taking down time is a need, not an option; that it's ok to let go for a little while. It's so hard when I feel like I'm missing out on moments of living; that opportunities and adventures are passing me by.

I need to love and care for myself.

I can't remember the last time I slept properly.

x

...to hypothyric town!

Tired. Epically tired, and permanently cold. Body feels like somebody doubled my density then replaced all my ligaments with old rubber bands. Back hurts. Feeling sooky and whiney.

I want to curl up in bed for a week, preferably with someone providing tea and cuddles on a regular basis.

*makes small, pathetic noises*

So, it looks like the radiation might actually be working. Hooray. Quickly too, by the feel of it. Only 2 weeks ago my thyroid levels were peaking, now they've plummeted.

Have made the executive decision to go off my meds - doesn't seem to be much point in suppressing thyroid function any more. Hopefully this will give me a short reprieve from the tired and acheys. It will at least remove one complicating factor from the equation: now what I am feeling should directly relate to what my body is doing. Will let the doctor tell me off for it tomorrow (he doesn't like it when I make his job redundant. I only go because I can't get the blood test results directly).

So here's to nuclear power, doing it's job and making me feel ick.

Go you little isotopes, go!

Part 1 is HERE

It's been an interesting few months. I've been to talk to the doctors at the nuclear clinic, my potential surgeon and my endocrinologist about my options for further treatment. And in the mean time, my thyroid levels have finally come down into the normal range, and even slightly low, for the first time in almost a year. It's been lovely to have a few weeks of feeling like my old self and I have relished every minute of it. But it's over now; I'm on my way up again, but at least time it's intentional.


To your left is Dr. Hummer. Well, that's not really his name (it's Dr. Wilkinson), but it is his obsession. He drives a Hummer (yes, you guessed that much, I know). He gets articles in the newspaper about why he drives a Hummer (click here!). He has model Hummers in his office (it's true!). He even has Hummers on his official office stationary (evidence provided on request). He is also the man who will be cutting me open should I opt for thyroid removal in Tasmania. His main speciality/earner is gastric banding and he does his consultations in full scrubs. I'm told he's a very good surgeon. He's removed thousands of thyroids. But he's not removing mine, not yet.

We had a good chat though, Dr. Hummer, Alex and myself. I learnt that the parathyroid glands are four little pea-sized spots on the back of the thyroid. I learned that these little glands are very easy to damage as you pull them off the thyroid and try to preserve their neural connections and blood supply. I learned that you really don't want to mess with parathyroid function - that's your calcium, phosphorus and magnesium regulatory system - and I learnt that even if they're successfully preserved in surgery there will be some disruption to function that will likely require monitoring and treatment for the next three months. On the plus side, no more thyroid. On the minus side, three months of feeling crappy, and still a small chance of permanent damage to the parathyroids or the vocal nerves.


To your right is Dr. Keady. She's the nuclear doc. Alex and I had a long and detailed discussion with her about why the last lot of radio-iodine didn't really do much and what our options were. Dr. Keady listened and was thoughtful and took my perspective on board and came to the conclusion that the first dose had at least done something (my goiter is smaller and I had an initial reduction in T3 and T4 levels before spiking again then remaining high), so a much higher second dose should really do the trick. We're talking 600 MBq, the maximum outpatient dose (as opposed to the 250 MBq they gave me last time), and approximately three months to complete thyroid ablation. Provided, of course, that there are no surprises and complications, and even then we're talking perhaps 90 % confidence. And we'll have to do another technetium scan ($270), to make sure there are no more surprises. But there's no cutting, no hospital stay, no anaesthesia, no two weeks off work to heal, no risks to the parathyroids and no $4 000 hospital bill.

So, we have:

Guaranteed thyroid death + risks of surgery + risks of anaesthetic + risks to parathyroids + risks to vocal nerves + hospitalisation +time off work + whopping great bill + 3 months of feeling crappy

VS

90% likely thyroid death + a few hours in clinic + 0.01 % increase in risk of throat cancer + no time off work + affordable bill + 3 months of feeling crappy (technetium scan pending)

So yes, I chose the nuclear option again. It seemed so much more straightforward and if I'm going to feel crappy for three months either way, I'll take the non-bleedy option, thank you.

But of course it's never clear-cut or straightfoward, is it?

( Surprises, complications & pretty pictures )

At 2 o'clock today I head back to the hospital to take my radio-active pill.

There's no turning back now, but neither is there any guarantee it's going to work. In three months' time I might be giving Dr. Hummer another call.


My thanks to the staff at Regional Imaging Tasmania - Calvary Hospital for letting us take photos of all the goings on.

Officially Not A Good Day today.

Not only did I fail at sleep last night, I totally failed at today.

I did actually make it into work, where I proceeded to burst into tears in front of my colleagues.

Then a couple of hours later I managed to crash and burn whilst still at work. I had to be helped to the sick bay for a lie down as my body decided to shut down and hit me with a massive hit of adrenaline at the same time. There's nothing like being too weak to stand unassisted whilst trembling uncontrollably for an hour to really make your day.

Alex had to be called to take a taxi out to the office so he could drive me home. =o(

Evidently somebody's still a bit thyrotoxic.

Last week wasn’t a very good week.

In fact, it was an awful week, and there are yet more to come, as it take a long time to get off-the scale thyroid hormones under control again.

I’m a long way from control at present. A sudden sharp spike has hit seemingly related to this virus that still won’t go away. But what does that really mean?



This is what Grave’s disease is. Auto-immune over-stimulation of the thyroid gland causing the excess release of thyroid hormones (T₃ and T₄). This causes a cascade of effects in the body including raised heart rate and blood pressure, raised adrenalin levels, racing metabolism and tremor. I can’t sleep, can’t think, am utterly exhausted and worst of all, have little control over my emotions. When you’re hyperthyric (thyrotoxic) you’re instantaneously thrown into a state of anxiety and depression.

It’s been 4 years now since I first got sick. I don’t talk about it much because I don’t like thinking of myself as sick, and because I don’t want it to be an excuse for apathy and lethargy. I don’t talk about it because people often don’t understand – I don’t look sick – and I’m worried people think I’m a hypochondriac, or that I’m being dramatic.

I take my little pink pills twice a day, and generally that’s it.



Three months ago I had radio-iodine treatment. I went to the nuclear medicine centre and was given a capsule full of radioactive material to swallow, and I thought that was that. Done, dusted, thyroid no more.

It worked so well. A few weeks afterwards I was feeling the best I’d felt in years. I had energy, stamina and focus, and I finally felt like I was getting my life back. The next blood test was perfect: T₃ and T₄ levels smack- bang within the normal range, and for the first time in years my body was producing Thyroid Stimulating Hormone. I was getting well!

I think that’s mostly why I missed the warning signs that I was getting sick again. I thought my thyroid couldn’t produce enough hormone to make me sick anymore, so when a little bit of depression crept in and I started having trouble sleeping I found other things to blame. After all, things weren’t going well at work and I was feeling pretty lonely.

Then everything escalated and I found myself having panic attacks in the middle of the night, feeling like a spring so tightly wound that the metal starts to crack.



So now I’m more heavily medicated. As well as the iodine uptake inhibitors (the pretty pink pills) I’m taking calcium blockers (the bright orange ones) to soothe the effects of too much adrenaline. Sleeping tablets mean I get at least a few hours of solid sleep a night, and now I’m feeling somewhat better; like I’m not about to crack. It’s just that I’m so very tired…

If I’d have noticed sooner, it wouldn’t have got so bad. Last week’s blood test shows levels in the red again, and not a trace of TSH. I don’t know why; no-one really understands what causes Grave’s disease or why the immune system suddenly ramps up its attacks. My specialist says to give it another 4 to 6 months for the radio-iodine to do all it’s going to, and then we see if I need another dose.

More blood tests, more medication, more missed work and more wondering if it’s ever going to end.

It's been a rough few days. We're both sick, I'm off work, and a lack of things to do has lead to too much introspection, angst and emotional upheaval. Consequently we're both feeling a little physcologically delicate this evening; a bit lost, lonely and isolated, a little inadequate, impotent and vulnerable, and still frustratingly sick.

What do you do when you're under attack from the might-have-beens, should-have-beens, could-have-beens? How to find a smile when you're feeling all at sea? Take one rubber ducky, some water and detergent. Just a little smile, ok?

I'm not in work for a couple of days. There's not much point when I can't focus on a computer screen for longer than 10 minute bursts. (And even then I wind up with a headache and shallow depth of field for the next half hour. Consequently, I'm writing this post in very short bursts). I have 2 shiny new astigmatisms (so neither eye would feel left out), as well as deteriorating distance vision to add to my shonky near-sight. It makes me wonder how I failed to notice my vision was worsening until it got to the point where I can't really function - surely I should have noticed something earlier? Of course, in hindsight I can tell you that my vision's been off for a couple of weeks now (even though my hindsight is no longer 20:20). Of course, my boss expects me to spend my day doing work in 10 minute bursts, but it's not worth the head-ache. I'll just have a busy few days once I get my new specs (Wednesday, apparently, after finding an optometrist with super-fast turn-around times, and damn spunky they are too). Hooray!

Annoyingly, my eyes aren't the only area of bodily failure at present. A catalogue of individually-insignificant symptoms suggests my thyroid hormone levels have dropped a little too low (this isn't a bad thing, when you consider I was thyrotoxic for almost 12 months. The medication is finally doing it's thing, it's just challenging to balance it in just the right range by adjusting medication and considering the interplay of diet, exercise and the interacting hormonal interference of PCOS) so it was off to the pathologists again today for another vial of the red stuff to be drawn and analysed. I should get the results back on Wednesday, or maybe Thursday. *sigh*

It's a frustrating process, getting everything right, made even more so by having a month or two where everything balanced out and I got to feel strong and healthy for the first time in years (or perhaps ever). Losing my health again so quickly after finding it, well, it's enough to make a girl stabby. I've just got to keep believing that all these little wobbles are bringing me one step closer to permanent good health. Which reminds me, I've got a physio appointment on Wednesday too (what an action-packed life I lead), where he'll hopefully give me an all clear on the knee incident. After a month of forced R&R I'm looking forward to a bike ride or a proper swim with mildly alarming levels of anticipation.

So what's girl to get up to with all this not working, no reading or writing, don't bend the knees to much lifestyle? Let's just say that the remaining weeds in my garden have taken to cowering at my approach. And tomorrow, I'm going to tackle the last two year's unsubmitted tax returns. Eeek!