An Unfat Kathy

They say every journey begins with a single step.

After a couple of reschedules on the appointment, today I took that first step on getting to be an unfat Kathy and sat down to talk about it with my doctor.

Well, actually she's a nurse practitioner.  And she's a fellow fat Kathy.  Almost.  She's a fat Katie.  She had Bariatric Surgery and then, all in the same year, she went back to school to advance her degree, got married, and moved from Pittsburgh to Cumberland.  And with all that stress, she gained most of the weight back.  I like that she not only knows the struggle, but she's right there in the trenches with me.  It feels like a whole different ballgame than when a skinny person is cheering you on...

I wasn't quite sure what to expect today, but it seems that in the beginning there's a lot of mental working out.  I came home with about 20 pages of 'homework' to fill out reflectively.

And it jumped right into the hard stuff.

The first thing was to complete a chart.  On the left side, it lists a series of weight ranges and across the bottom age groupings.  The task was to make an "x" for low and high weight in each age grouping and then draw a line connecting the dots.  Basically, it would be a Line Chart if you were doing it in Excel.  Next, you look at each point where the line is trending upward and add a note about the major events happening in your life then.  It was eye-opening to see the correlation between some big traumatic events and big weight gains.

For example, when I got my tonsils out (at age 29) I was raped at the hospital.  Whoever was taking me from the operating room to the recovery ward made a stop along the way and pushed the stretcher into the closed for the day pre-op area where you get undressed, meet the anesthesiologist, make the mark on what part they're operating on, and that kind of stuff.  I was in and out of consciousness... the paralytic drugs from surgery were still in effect so I couldn't move and I couldn't scream.  I remember dark eyes and black eyebrows between the green cap and mask.  And that I went home gooey and bruised far from where your tonsils are located.  That's when my hatred and distrust of all things medical-related began...  Almost to the day the following year I had to have a thyroidectomy.  I was so freaked out about being put under anesthesia that I postponed it 7 times.  That very frustrated surgeon kept asking me questions until I told him what bits and flashes I remembered.  He went many extra steps to assure me that I was safe in his hands.  And even then it took a truckload of Valium to get me to the hospital!  Then the cyst he thought he was removing wasn't a cyst at all... there were so many tiny tumors in the gland that it couldn't be saved.  He tried all day. My waking memory is him yelling into my eyeball that it was cancer, but "it's the good kind."

As if there's ever a good kind of cancer.

Between those traumas and the hell that hypothyroidism unleashes in your body, how could my body mass not balloon rapidly?  A few years later, add care of a parent suffering from a slow spiraling descent into dementia...  Then my knees started to go out and people around me didn't believe me when I said I was in pain and made jokes about it.  And there's the past 3-4 years that I'm just not ready to talk about yet.  Each experience was horrific in and of itself. And each used the trauma, fear, and distrust ingrained from previous events as a foundation for a more distorted image of myself.

Now begins the process of undoing that damage, both the physical and the mental...

I'm not sure yet what tools we'll use.  There are a number of surgical procedures that are an option as well as several different kinds of drugs and some heavy-duty lifestyle changes.  Stick with the journey and find out!

News From the Facebook Break

Overall, I think taking a break from Facebook has been a good thing.  Clarifying.

I had to login last night to find something and I found one friend in the midst of a cryptic meltdown, another left us hanging saying he'd gone to the ER with chest pains, and another had lost her sweet little dog.  I left sad.  I was sad that these horrible things are happening but even more I was sad that Facebook is the only way I know anything that's going on in their lives.  It made me wonder if we are really friends or something lesser with that label on it for lack of anything else to call it.  And if that's the case, it's just not good enough.

Time away has been educational.  The class I was dreading, I actually like.  And the one I had been looking forward to with some excitement, I really despise.  At least this term is half over now.  I'm still set to graduate at the end of August.  It only took 5 schools and 30+ years...

I've been doing some other than school reading, too.  And I think if you'll read these articles you'll walk away a bit smarter citizen of the world.  They might challenge your views and make you mad but sometimes truth comes to you in weird places.

• Yes, he says “magical” way too often.  Yes, it's an insult he directs at the liberal viewpoint in this piece about the Parkland shooting.  And if you are conservative, especially in deep on the right, you can wipe that smug smirk off your face.  Your side does the same damned thing.  And this kind of exploitation is morally corrupt.  Y’all need to just stop it!
• I would put a $5 bet that a majority of naturopaths and every traditional Chinese medical practioner on the planet is smacking their head and saying “Duh… ya think?” about this discovery of a new bodily organ.  
• The unintended consequences of getting it wrong run really deep.  You do need to read about China's former one-child policy.  If you're at all like me, what you think you know isn’t even scratching the surface of the political and social ramifications.

Jacky has been sick for about a week.  His sublingual lymph glands are hard and swollen, he's been packing on the pounds lately, and he feels so hot when I touch him.  Sometimes it seems like he wheezes but it's hard to call that a new symptom because he's always been breathy and melodramatic.  When he really needs to go potty, he's the one that will get right in my face and do a full body wiggle while he vocalizes "hhhhhoooooooouuuuuuutttt" like he's trying to say "out."  It's pretty hilarious but when he's such a goofball it also makes it hard to pick out behaviors that say this is what makes me think he's sick.  And the internet is no help.  The swollen glands could be anything from an allergy (we already have trees pollinating) to an injury (like from chewing on a stick outside) to a random bacterial infection to a thyroid problem like mine to cancer that would leave him about 6 weeks to live.  Sadly, I don't have unlimited funds to spend at the vet...  And he's eating, drinking, going potty, and sometimes playing with the other guys so I'm giving him a couple of baby aspirin night and morning to help with pain and inflammation and just trying to keep him active and comfortable in hopes it will work itself out.  And like chicken soup helps us feel better, chicken broth slurped from my big cup seems to do him good.

Reading about dog thyroid problems, which is somewhat prevalent in Dobermans, I learned they are treated with the exact same drugs I am.  But vets recommend breaking the pill in half and giving in two doses, morning and night, to keep blood levels more consistent. Makes sense.  And once again, veterinary medicine seems more advanced and patient-centered that people medicine.  I always said about our vet in Georgia, if he'd see me I'd go to him over my own doctor!

I’ve learned some new words, too.  Here’s a couple of them:

Pes (say w/long “a”) is a pretentious way to say foot, like that part you have running from ankle to toe.

Prepuce is the skin that covers your boy dog’s winkie.  (BTW if your groomer leaves a styled little frond of hair at the tip, and calls a Merkin, make them trim it off! It can cause all sorts of health problems like getting “it” stuck “out” which is a very bad thing and will require action from you that’s potentially quite disturbing. A Merkin is really a thing, a weird thing but… a thing, for people. If you want to know more, you’ll have to Google it for yourself. )

And I learned a couple of kitchen tricks!

If you are roasting cherry tomatoes, like for a salad, a very very slight dusting of powdered sugar preserves their bright red color and keeps the dish pretty.  Thanks for that tip, Alex Guarnaschelli!

Keep your plastic wrap in the freezer and it will come off the roll without sticking to itself.  You can actually get it to cover the dish just like Valerie Bertinelli did on her TV show.

Home Again

July 25, 2014

Toward the beginning of July, I told Derek I needed to go to the Emergency Room and seek out some help because I had a problem that was out of hand.  He yelled at me the whole way there for letting it go, but we had no money for me to go to the doctor in May and get my levothyroxine prescription renewed.  I knew I needed it, I knew where to get the care… I just had no funds available to pay for either the doctor’s visit or prescription and we all know that doctors and drug stores want their money upfront so I put it off hoping that things might turn around for us in the near term.  They didn’t.

At the ER I explained the situation with the medication and that between feeling like crap physically and mentally (lack of thyroid hormone also effects mental abilities) and being in crisis financially, socially, spiritually, and emotionally I was extremely depressed and had laid in bed that morning (and a few others I didn’t mention) wishing I could die and be free of all the pain and stress.  Never mind that I had no real intent, no plan and no way to carry it out if I did form a plan… that statement got me 4 days in a psychiatric unit for observation as a suicide threat.  Immediately I had to surrender everything I had with me:  clothing, underwear, shoes, purse, cell phone.  Everything.  Security came to inventory the contents of my purse. (Mental note:  Always keep your purse clean!  They looked at EVERY old grocery list, Church program, card, bill, note and receipt I’d mindlessly stuffed in there for months.)  And then they ran the metal detector wand over me front and back to make sure I didn’t have any weaponry on (or in) me.  I got one chance to let my family and friends know where I was… just 1 call on my own phone before it was confiscated.

Basically I was a prisoner.

I had 3 roommates while I was held in the psych unit.  Weirdly one shared my birthday and another shared my first name and last initial.  Odds of one seem huge, but both of those events?  The statistic has to be astronomical!

Most of the people there were just as normal as you and me.  Everyone had been crushed under their own problems, yes… but they were not the psychotic blubbering idiots of Hollywood’s imagination.  Most were friendly, smiling and concerned with helping me understand what was expected to fit into the routine.  There was a lot of singing and some of the most amazing gospel voices I’ve ever heard, on the radio or off.  Several people had college degrees and to help fill the long boring days I got into some discussions on topics like philosophy, myth, religions, botany, chemistry, food, and travel.  The thing I found most annoying was the television.  It was on 14+ hours a day.  It was loud and no restrictions on what was playing meant often there were violent movies filled with destruction, bloodshed and bad language.  Ironic for the setting isn’t it?

While the TV annoyed me, there were really only two things that I found particularly distressing.  One was that the atmosphere and protocols (especially men doing night-time bed checks on female occupied rooms) tripped flashbacks of being raped in the hospital following my tonsillectomy many years ago.  And that would set off a panic attack and send my blood pressure through the roof (imagine that!  Being in a constant fight or flight state of high anxiety is supposed to make me calm and happy?) so then they’d force more drugs on me.  It seemed like patients were (over)medicated for staff convenience because it’s so much easier to treat symptoms than solve problems.  The other thing that I found upsetting is that, like me, most of patients were being released (often against their expressed wishes and with open beds in long-term programs) into the very same environment that landed them in inpatient psychiatric care in the first place.

I guess there are really three things that bother me…  When I was released, the social worker instructed Derek to remove his gun from the home.  It’s in a locked case, with the trigger also locked, he has full control of both keys and there is no ammunition for it here.  Even if I could get through all those hurdles, I don’t know how to load or fire it.  It’s perfectly safe.  It still had to be removed as a condition of my release.  Yet no one questioned the drawer full of very sharp knives in the kitchen.  Or that there’s rope downstairs and my entire back yard is densely wooded.  No, that’s neither formation of a plan (I don’t like pain and I imagine both of those would not only ultimately fail, but hurt immensely in the attempt) nor a political statement.  I say it only to point out the hypocritical idiocy of our nation’s mental health care system.

Ok, maybe it is a little bit of a statement about gun rights because if I actually wanted to hurt myself, or someone else, I could find a way to do it.  Taking the gun out of the house was pointless.

Thinking about it, there are more things I could complain about but I’m ready to just put that chapter behind me, move on and figure out how to have a happy and productive life.  Now I’ve been home and doing some outpatient counseling for about three weeks.  There’s good and bad to that:

• My doggies still love me! And seem even more in tune with how I’m feeling on any particular day. On rough days they are happy to give extra snuggles and napping on the upstairs (guest room) bed is a special treat we’ve been indulging in most days.
• Derek has a new job. He started exactly 1 week after I came home. It’s the job he says he was born to do. And I have to admit I’ve never seen him quite so charged up about work. He’s selling cars, both new and used, at Carl Black GMC over in Roswell. The commute is a painful 80 minutes if there’s no traffic and he has good luck finding traffic lights green. But the upside is that he has the potential to earn a very good income. He actually sold his first car halfway through training AND after one of the other salesmen backed into it while he was doing paperwork with the customer. Impressive to close that one, huh?
• His long commute and longer work day leave me alone basically 23 hours every day. After being gone for 16 hours, he drags himself first to the shower then rummages for a bite to eat before going straight to bed. With no car of my own currently and a still small circle of local friends that puts me right back into the situation of isolation and loneliness that was a major factor in the depression to begin with.
• My finances are a mess. With no resources left, I’ve defaulted on my massive credit card debt. My once really great credit rating is now trashed. Every time the phone rings with a number I don’t recognize I feel a mixture of despair, panic and extreme anxiety. When Derek tells me he’s got a plan to deal with the credit problems, it helps me feel a little less like a total loser… until the next time the phone rings anyway.
• My Church family is helping by paying some essential bills (rent and utilities) and providing food until Derek is receiving regular paychecks. I’m more grateful than ever for the resources and forethought that went into the LDS Church’s private welfare system. I never imagined that I would have to use it and still say that being on the receiving end is not nearly as comfortable as giving. I always knew that Church Welfare was expansive and complete but I have a whole new perspective on it now. In all honesty, the meals I’ve made and eaten during the last two weeks are the most nutritious and varied in the past 2 years because of the amount and quality of fruits, vegetables and lean meats that were included.
• To help distract me from the loneliness, combat depression and help me focus while my brain chemistry stabilizes and adjusts to the medications I have a very detailed daily “To Do” list. Some days it exhausts me and other times I’m bored and catch myself staring off into space with not a single thought in my head. It’s slow going, but I am accomplishing at least the basic activities of daily living consistently, working my way through getting the whole house truly clean and creating a healthy and whole me.
• I’m taking the levothyroxine again and a low dose of Celexa was added to the daily regime. I’m hoping in a few months I can be off that one. I know I’ll never get off the levothyroxine (the need for it was something done to me while I was unconscious and couldn’t say no) but my firm intention is absolutely nothing more. I’m just not good at drugs.
• As a way to help re-achieve some level of self-sufficiency, I’m going to start an Etsy shop. For starters, I’m crocheting headbands to keep your ears warm in the cold, granny square potholders, sock-style baby booties and Christmas stockings for both people and their pampered dogs. My hope is to launch it mid-September with those few items and as I can get the materials to do it I will add to the offerings.

Falling through the cracks

We've all grown up thinking that if the bottom falls out of our world there's a safety net to catch us in the welfare and charity systems society has created over time.  More and more people are finding that isn't true.

I've been out of the paid workforce, and therefore without health insurance, since February.  About a month ago I needed to get my thyroid prescription renewed.  My doctor insisted on an office visit to do that but with no money I resisted.  I reasoned that having no income for nearly six months should qualify for a visit to one of the so-called free clinics that operate here in Salt Lake City.  Afterall, it was just a simple office visit... listen to my heart and lungs, check blood pressure, draw blood to test TSH and write the prescription... the same prescription I've taken for nearly 20 years.  Simple, routine, no big deal... right?  Wrong.

The first clinic I went to wouldn't see me because I'm not pregnant.  The one they referred me to wouldn't see me because it was an urgent care facility and their doctors won't write a prescription for a maintenance medication.  The next wouldn't see me because I live 3 blocks outside the demographic area they serve.  The next two wouldn't see me because I don't have a job so there's no pay stub for them to base their sliding scale fee on.  The next wouldn't see me because I'm not homeless.  And so on and so forth...  Every single one told me that in some way I did not meet their criteria for care.  Impressive safety net, huh?

In the end, I had no choice but to suck it up and pay cash to see my own doctor, who, after I got there told me that I had a credit balance because they had overcharged my co-pay by $5 on every previous visit.  I must have been there at a time when they weren't booked quite so back-to-back because he had plenty of time to sit and chat.  Though experience has shown me that I often know as much (sometimes more) about thyroid issues than the doctors I've seen, this doctor surprised me and admitted that medical school did not teach him about on-going care for a patient with a thyroid issue.  The initial diagnosis and treatment (if it required surgery or ablation) was part of the curriculum but not what happens after that.  He's on staff at the University of Utah Medical School and said it still isn't covered in today's schooling.

That admission sent me home to write a self-help booklet about living with hypothyroidism.  Unless or until it gets picked up by a publisher, I'm going to offer the same deal here as last time.  $1.95 and I'll email you the .PDF.  Leave contact information in a comment that when I moderate I will NOT publish for public view just use it to send you my address for payment.