Friday, August 4, 2017

To My Health, Part 1

I did not intend on blogging today, but an unplanned nine-hour layover in Pleasant State seemed as good an occasion as any to whip out the laptop and pen an update, so here it goes. In a way, this is a good thing; my hectic journey back to Arctic State was sure to preclude writing for a while, and there are, as always, things to be said.

This summer was a good one. I don't mean that it was particularly enjoyable, or that I engaged in many worthwhile pursuits, as it wasn't and I didn't. Cash strapped and undertaking certain labors during the extended holiday, I was pretty much bound to my apartment. A trip to Confederate City with my father failed to materialize. So, too, did planned ventures to Humid State and Northern State, and the two months of Russian lessons to which I'd been looking forward fizzled when I realized I couldn't feasibly afford them. But this summer, like last, brought to a head certain things I'd needed to confront, and it also concluded with the resolution of two significant ongoing health problems (or at least put me on the road to that resolution).

Some of you may remember, from the recap I wrote at the end of 2015, that beginning around the start of graduate school I experienced the onset of a traumatic mystery ailment.  This unnamed problem slowly drained me of energy, left me sluggish and mentally slow and physically weak, and caused hair loss and digestive issues to boot. 

I had no way of knowing, when in June 2014 I first realized I'd become slightly more forgetful, that I was embarking upon a years-long struggle whose progress would parallel the insane stress of earning a master's degree. That struggle, by the way, had nothing to do with fighting the problem itself--but everything to do with fighting the ignorance, arrogance, and occasional negligent stupidity of doctor after doctor who was convinced I just needed "more sleep." One tried to put me on anti-depressants, assuring me I could be depressed even if I didn't realize it. Another, when I pointed out I was losing hair, remarked sagely that I had "a lot of hair for a man." 

It was a year and a half in before any of these eminent geniuses thought to run a basic autoimmunity test, in keeping with symptoms I would later learn were textbook indications of autoimmune disorders. The physician who finally thought to look in the most obvious place was not an impressively self-important specialist, but a humble family doctor. And she found it.

In January 2016 I was diagnosed with Hashimoto's disease, a hereditary condition in which one's immune system attacks and gradually destroys one's own thyroid. Because the thyroid regulates everything from metabolism to brain function, the gland's gradual decline leads to impairment in these areas, resulting eventually in the weight gain, hair loss, brain fog, and chronic fatigue from which I'd been suffering since shortly after I turned 26.

As it turns out, this illness has been making periodic cameos in my father's family for generations, and while my carrier father did not develop the condition, my grandmother, great-grandmother, great-aunt, and cousin all did. You will notice that all these people are women; Hashimoto's is about ten times more common in females than in males. Your boy BB got lucky.

Not, however, in his choice of endocrinologists, as diagnosis did not end my odyssey. Early-stage Hashimoto's is tricky to treat, because the medicine used for that purpose is liable to cause heart attacks if administered too heavily, and there are varying views as to when exactly it's  safe to begin therapy. 

Even after the disease had progressed enough to push me into partial thyroid failure--which, mind you, has just been an exorbitant amount of fun--two separate doctors told me they would wait for the gland to completely die before they did anything at all. Medical guidelines be damned.

At the close of July, however, I wound up in front of a physician whose head was not lodged firmly in her own asshole. It was a refreshing change.

"Tell me about your family history," she wanted to know. "Who else has this?"

The prompts were focused and relevant.

"Are there other autoimmune conditions in the family?"

"How has your digestion been?"

"What is your energy level like?"

"How are you doing with weight?"

I've seen half a dozen endocrinologists. She was the first one who asked these questions instead of reciting my lab numbers off a page. And then she made a decision based on her patient as opposed to a print-out.

"None of these numbers, by themselves, are worrisome," she informed me. "You have the Hashimoto's, but it's still in the early stages. We don't even need to test for that again, because once it's there it's always there. And your thyroid numbers are abnormal, but only slightly. You're still in the subclinical range. What concerns me is the combination of the Hashimoto's, the family history, the symptoms, the thyroid numbers, and your age. You're not that far outside the norm, in general. And these results would be normal if you were sixty."

Her intelligent blue eyes narrowed.

"But you're not sixty," she said. "You're a young person showing numbers that are pretty much normal, but not what we usually expect to see in a young person. So you're not in a bad position right now. But I think you're headed that way. And we want to get ahead of that if we can."

A great number of things suddenly made sense to me.

"My grandmother was thirty when she had to start medication," I offered. "I'm twenty-nine."

And a typical age of onset, just for reference, is after fifty.

"It can work that way," she replied. "In certain families there are patterns."

"Since I am young," I put forward. "And we're intervening early, is there any chance my system could kind of, you know, right itself?"

She grimaced slightly, but told me the truth. 

"I don't want to say it never happens," she responded. "There are cases like that. But generally that's not how this works. Usually the trend is for things to get worse."

I respected her for that.

I also respected her for treating me as a human being, and for being proactive where others were complacent. I respected her for assessing my whole situation, in context, and for acting appropriately.

"Let's see if we can get a handle on this."

And just like that, this struggle was no longer mine alone. 

A little more than a week ago, I started thyroid hormone replacement therapy, ingesting in pill form the synthetic chemical I will almost certainly have to take for the rest of my life as my body gradually loses the ability to produce this substance on its own. 

This doesn't magically make everything better, of course. It can take months before the medication is effective at easing symptoms, and the progressive nature of Hashimoto's disease means that, especially in the early stages, my doses will likely be adjusted multiple times. Attention to diet and exercise is a major component, too, and I will hereafter need to be much more mindful of what I eat and how I exercise. But there's no hope of fighting this thing without medical intervention. Now I have medical intervention.

And in six months, or maybe a year, when my medication is optimized and I've made the dietary changes that have to be a part of recovery, I can be healthy again. I can spend a day out without having to go home and lay down. I can get seven or eight hours of sleep, not nine or ten, and make it through the day without folding in on myself at 2 p.m. I can hit the gym and actually see the results of my hard work. I can be, well, me again.

Last week I wound up, by total happenstance, on the campus of Major University, where I completed my bachelor's degree six years ago. The visit hadn't been planned and I realized, in short order, that I was not ready for it. The main road through the grounds took me parallel to a familiar running track and directly past student apartments where I'd formed countless happy memories, a number of which came rushing back at me unwelcome and unbidden. I could feel the sun on my arms, the wind in my hair, the smile on my face. In my present day, I could feel the tears stinging my eyes.

The last time I was there, I lived there. The last time I saw that trail I was twenty-three, trim and energetic, a lean-muscled stallion pumping across campus and trailing a shimmering golden mane behind me. I thought nothing then of running five or six miles at a stretch, then heading over to the dining hall with my teammates, all of us still clad in ridiculous neon-orange booty shorts. Because why the hell not? Because I looked good and I knew it. Because I wasn't tired. And for years now, I've been tired.

I don't ever expect to be that person again, that boy of twenty-three. That can't be. 

But I do want to feel what I felt then: vital and confident and youthful and tight. As a man of twenty-nine should be able to feel. I've just taken a huge step in that direction.

A second huge step also came this summer. But that, my friends, is why this post will have a Part 2.