Sleep and FitBit

I recently saw my primary doctor and complained of symptoms of hypothyroidism: tired, low energy, and irritability. He told me my thyroid levels were fine and suggested I needed a sleep study. The sleep study is scheduled for March.

I wore my fitbit to bed for the first time last night. I was in bed for 9 hours, 13 minutes (that may seem like a long sleep, but, I have found more sleep fights brain fog). Slept 8 hours, 28 minutes. Restless 41 minutes, awake 6 minutes, and had a 92% sleep efficiency. This isn't the same thing as a full sleep study, however, it is reassuring that the number doesn't indicate anything bad!

I am looking forward to seeing what the sleep efficiency becomes when averaged over a period of time instead of just one night.

December Update

Life gets busy and moves on. The thyroid cancer (that once was center stage) fades and drifts into the back ground. There have been many things I have wanted to write about on this blog, but other priorities have taken over. And that's the way it should be. We move on instead of dwell. We focus on new challenges.

My bloodwork at the end of November said I was slightly hyperthoid, but all my symptoms were hypothyroid.

The doctor cut my thyroid medicine from 175mg to 150mg on weekdays and 175mg on weekends.

I then met with my primary doctor and gave him my symptoms post "crash". I am tired all the time, no energy, brain fog, and short tempered. He diagnosed that I may have a sleeping disorder and has referred me to a lab for sleeping test. That test will happen in March.

My weight is up 50 pounds since I started having thyroid issues. I have been able to keep 6 pounds off after surgery, and I know I need to get the rest off. I suspect that if I am having sleeping issues it is related to the weight. And if I can drop the weight, I should be OK.

The challenge however, because I am so tired I sleep more. I sleep more, so I don't have much time to work out. And I look to bad snacks to try to snap me out of the feeling of being tired. All of that is bad and is a rut that may be difficult to get out of.  Perhaps this sleep study will help.

Aside from feeling tired? Life is back to normal. It is crazy and hectic and busy and that's OK. My wife has been an excellent partner and coach. When I get too tired and feel like I can't move, she kicks me in the butt and gets me going. There is plenty of work to do with the kids, the family, and around the house and it is good I have someone who can keep me going.

Weight spiral and crash

A change happened somewhere between 8 and 10 weeks post op. It was caused either by a change in my thyroid medicine dosage, or, by the "Crash" everyone talks about.

What is the crash? After a Thyroidectomy, you may go through a 6-10 week honeymoon period where your natural thyroid hormones are still in your body. At the end of this period, people describe the crash as being tired, fatigue, and brain fog. The post-crash period can last sometimes 18 months or longer as the doctors try to get the medicine levels correct. The post-crash time takes so long because the medicine adjustments can only be made every six weeks due to the half life of the medicine.

So... there I am. Ten weeks out and the crash happens.

Up until that point I felt on top of the world! I had lost 14 pounds and was planning to loose more.

After the crash, my energy disappeared and I was very tired. That resulted in three things:

1. Being tired, I slept more. If I didn't get at least 8 hours sleep, I suffered from brain fog. I can easily sleep ten hours and wake feeling like I only got six.
2. Because I was sleeping so much, I didn't have time to exercise very much
3. Because I was so tired I looked for pick-me-ups to shake the cob webs from my brain. These usually involves comfort food and high sugar treats.

And this the downward spiral. Less exercise, bad eating habits... and when I did exercise I lacked the energy for an intense work out.

I was very proud that I lost 14 pounds. But now 3+ months post-op, I have gained ten of that back.

I start each week determined to fix this. I know what to do and how to do it. But plans quickly fall apart as I struggle to get out of bed in the morning, and am ready for a nap after work. I know the saying: to get energy you have to use energy; but this is different.  It is a feeling of exhaustion.

My next blood work is in a few weeks and hopefully that provides insight into medication adjustments. In the meanwhile, I will just keep pushing myself as hard as I can to do what must be done.

Low Calcium Follow Up

In my last post, I described the aftermath of (what I believe to be) food poisoning. Here is the update.

Measuring how tired you are is difficult because it could be attributed to three things: you are tired, you think you are tired, or you medication is off. How can you tell for sure?

Imagine being at the store st someone asks "Are you feeling OK? You look sick!" Even if you were feeling fine before, just that comment will insert doubt, if a second person says the same thing? You will find yourself coming down with illness symptoms. There is some psychological occurring. The same can happen when being tired. If you tell yourself you are tired, or others remind you that you haven't had much sleep? You'll find yourself yawning by 10am.

Another aspect to being tired is having your medication be off. Too many people surviving on thyroid medicine are all too familiar with this.  Months and sometimes years can go by and you'll never snap out of it until the medicine is magically adjusted to an optimum level.

Finally, you might just be really tired. As we age, or levels of energy change. Or perhaps sleep is more restless. Or perhaps there is less of it.

Which ever the case, it can be difficult to self diagnose being tired.

After being sick from food poisoning, I was tired all day long. I could not get enough sleep and often took naps in the afternoon. 14 hours, 10 hours - it didn't matter how much sleep I got.

This lasted for six days, and then passed. It has been almost two weeks since I became sick and I feel great! I am back to seven hours sleep and tons of energy all day long.

But it is concerning. A relatively minor illness could pull be down so far, and it could last for so long. I have never experienced anything like that before. And I am glad it is behind me!

Scary Situation: low calcium

I had a scary situation happen to me today while shopping.

I had a meatball sub last night for dinner. Unfortunately it didn't agree with me and I suffered all night. I wasn't sure if it was going to come up or our out... And it finally came out through massive  Diarrhea. 

6am arrived and I took my Thyroid medicine as I always do, and went back to sleep.

 14 hours after going to bed, and 18 hours after eating the suspect meatballs, I woke up. Tired and low energy, but I had survived the meatballs.

I had no desire to eat anything until 24 hours after the meatball sub. I started feeling weak and light headed, so I ate just a normal meal, nothing special.

25 hours after the meatball sub, I went to the store to get a few things with my wife. While at the store, I started feeling tired. The light headedness, which had dissipated while eating, returned. My lips felt numb and my heart felt like it was racing.

My wife was talking to me at the store and I wasn't paying attention because the overhead store lights seemed to be... moving.

"Are you OK?" She asked.

"No," I answered.

Was I dehydrated? Was I low in calcium? Was I still sick?

We sat at a bench in the store while she retrieved her emergency roll of Rolaids and I took two. She then left me to purchase a bottle of water, which I drank.

My wife checked out of the store and drove us home. On the way home I had two more Rolaids.

Perhaps an hour after the incident I felt OK. Still tired, but OK. I am not sure what caused it - dehydration, calcium, or illness - because all three can have those same symptoms.

That was scary - I have never had that kind of an episode before. I am a big tough guy, I usually power through anything. For me to take a knee meant there was defiantly something wrong.

Changing levothyroxine

I am almost two months post-op and my doctor is increasing my levothyroxine dose. My last bloodwork numbers were:

TSH. 3.01   (.27-4.20)

T4 Free. 1.41.  (.9-1.7)

The doctor wants to keep the TSH closer to the lower half of the normal range (between 0.5 and 2).

As a results I will be increasing from 150mcg to 175mcg. I am not sure I am thrilled with this change because I feel really good. I have some times were I feel down in the dumps, but that is t often and it usually doesn't last long. My energy levels are high and I don't feel tired. Also, I have learned that TSH means less that Free T4 - in other words, if my T4 is good, that is what is important. I understand that if TSH is too high it could promote thyroid and/or tumor regrowth, but it isn't high - it is in range.

My next blood work will be in two months. In the meanwhile, stay tuned and I will let you know whether or not this change was good for me.

Second Postop Appointment with surgeon

Yesterday was my second post op appointment with the surgeon. 

Everything is good. He said my scar isn't silver because it goes some sun exposure, but he doesn't think that will be a problem. He did recommend massaging it more.

He doesn't believe I will need RAI, but said he would defer that decision to the endocrine Doctor.

I will see the surgeon every six months and they'll make decisions about additional tests in the future, but for now everything looks fine!