pktechgirlbackup: (pktechgirl)
The surprisingly socially aware Cracked has an article on stupid habits you develop being poor. I had two thoughts when I read it: One, that's not about low income, it's about volatile income. Two, that's perfectly describes what I do with whatever you want want to call the combination of energy and focus that allows me to get anything done, ever.

I really, really identified with the feeling that whatever you do, you're going to end up tired (broke) again soon, so you have to spend this energy (money) as soon as you can. There's no concept of prioritizing because that will slow you down, and no concept of saving because it never seems to stay saved. Logically I know that can't be how it works, but my energy levels seem so exogenously determined that it breeds learned helplessness.

This suggests that ADD meds are useful beyond their primary effect of giving me energy. By providing a chemical reassurance there will always be energy, they create an incentive to use it carefully, the same way a guaranteed income could (theoretically) improve quality of life through increasing stability without costing much.

While we're using financial metaphors for health issues, let's talk about debt. I had a huge amount of physical and emotional debt stemming from a lifetime of malnutrition. Depending on how you count I started trying to pay that back 3 years ago (with cortisol and an artillery of vitamins) and started doing so effectively nine months ago (with HCl, and some vitamins). In many ways food/nutrients felt a lot like money and energy, in that my gut believed every morsel could be the last, and it needed to be spent as quickly as possible. This worked better than you would think, because my body listens to Dave Ramsey and its panicked spending took the form of paying down debt. It's not always the optimal thing to do, in health or in money, and I may not always have picked the optimal debt to pay, but it helped some and there was no chance of making myself worse off.

But I think that recently I paid off that debt, and am ready to start investing. The problem is that bodies are like old-timey economies; there's no bank that is happy to accept exactly as much money as you have for arbitrary, unspecified periods of time. There isn't even a mattress to store nutrition under. Either you invest it now, or you let it go. But investing takes commitment: if you get halfway through a project and run out of money/nutrients, you've not only lost everything you put in, but probably more besides. Potentially a lot more. And then once it's built, you have to maintain it. You'd be stupid to build anything unless you knew you'd continue to have the income to support it.

While I was in debt I could get away with throwing vitamins around haphazardly, knowing there was some decrepit organ somewhere that could be propped up with them. Now that I'm out of debt, I have a much more difficult task: convincing my body the nutrients will keep coming forever, or at least until the new structure has paid for itself. This is a very different challenge.

PS. I would like to state for the record that however challenging my medical issues have been, there are lots of people who have it as bad or worse in addition to being poor, and that is a lot harder than what I lived through.
pktechgirlbackup: (pktechgirl)
The Vyvanse got less and less effective as time went on, and it was impossible to tease apart how much of that was physical acclimation, how much was psychological, and how much was the additional strain from gastro-intestinal ragnarok. Now that the stompocolypse is over, we can better analyze.

First, it did not go quietly. I finished on 10/30. But that was just the stomach/large intestine apocalypse. My doctor has been on my back to do a test for the small intestine since we met in May, but it involves both several steps and fasting and I don't cope well with either of those things. But I wanted it done and I was already taking a long weekend for Samhain and I decided to just do it, and the agony it induced justified time I've ever pondered fasting but decided I couldn't do it. I was very literally shaking by the end of it. That was Saturday morning, and I spent the rest of the weekend recovering. I also took the weekend off from Vyvanse as well, and then started my new, higher dose on Monday.

Here is what I have noticed so far:

  1. Even with the raised dose, it is not quite the magic of my first few days on Vyvanse. That is unsurprising but still disappointing.
  2. Despite the lack of super powers, the dose is high enough to disrupt my sleep. That's well within expected parameters and it may well dissipate, but I miss the time when everything was wonderful at no cost.
  3. And by no cost, I mean no side effects and a nominal amount of money from me. I looked at what Vyvanse costs retail and Jesus I have amazing insurance.
  4. It appears to cost the same no matter what your dose is. Maybe they don't have to worry about pill splitting for schedule II drugs? It annoys me that the FDA has defined any variability in how much I take in a day as fraud of one form or another.
  5. I've stopped using the HCl pills, but use a lot digestive enzyme pills.
  6. My aversion to protein and ravenous desire for fiber that came in the last days before gastromaggedon haven't changed much. I'm nudging myself to eat protein, but it's hard going. What I really want is fiber. All the fiber. Soooo much fiber. I feel like I'm trying to slow down the food in my GI tract.
  7. I stopped wanting junk food about halfway through stompocolypse, and that's stuck around. It has been replaced with a desire to eat all the grapes in the entire world. Grapes have fiber.
  8. Also, for some reason, salmon, which work has steadfastly refused to provide me in the quantities to which I wish to become accustomed. Of course, I was done with salmon after two pieces of sushi, which is not so impressive compared to that entire bag of grapes I just ate.
  9. Between the slow release meth and the four horsemen moving through my stomach, my adrenal glands (never the strongest) were shot. I was really afraid I had pushed myself back to where I was in 2009, and wouldn't be able to keep taking the pills that make my brain actually work. The fear is bad enough I am just assuming that if my doctor AND the lady at the health store both this completely untested herb will help, it must be true.
  10. After three days off I'm feeling a lot better. I was already planning on one dark day a week, I might up that to the entire weekend, at least for now.
  11. Two medical professionals have commented I just look healthier. It's possible they're confusing healthier with thinner (I'm down 25 pounds from June, which is 5 pounds below what I think of as my set weight), but I'd believe my skin and constitution look better too. Maybe I don't look quite so overwhelmed all the time.
pktechgirlbackup: (pktechgirl)
I've been on stimulants of some sort twice before- cortisol for hypoadrenia (I spent the first night vibrating like a hummingbird and didn't eat or sleep a week and then it was pretty much like normal except I could wake up in < 2 hours) and suadfed + armor thyroid + cortisol (doctor said it was okay, but three hours pacing around the office followed by collapsing under my desk say she was wrong). Vyvanse doesn't feel anything like either of those, or the jittery feeling my doctor warned me I about. I do not feel sped up at all. There is a mild lightheaded feeling, similar to after a good workout, and my back has a lot less pain and tension.

I was way more productive at work today, but I was also much, much happier. I could actually stick to what I was doing and produce something. I don't even want to look at facebook because it's so noisy. I didn't put on music all day either. It's easier to get into pleasure reading. Even when I was taking a break, I stuck to one thing a time rather than jumping back and forth.

But the biggest difference is that a problem I didn't notice I had is now gone. It used to be any time I had a thing I wanted to do (say, code a thing that does a thing), and it took a second or a step longer to complete than I thought it should, I'd feel like a failure. It should be done, why is it not done, it's not done because I'm stupid. It was the GTD loops theory, that your brain doesn't understand the concept of "working on", it just knows what should have already happened. But I only felt that while I was working on the thing I needed to do- there is no deadline or end goal to reading tvtropes, so I wasn't failing at it.

Things like e-mail or even facebook used to give me a little productivity ping, which was awesome. Real projects never gave me that on account of the constant low level feeling of failure.* I haven't done the exact math, but it feels like I'm getting the exact same number of local productivity hits as I was before, but now they're in a thing I actually wanted to produce. I think this explains some of my compulsive phone use in meetings- the second we weren't making progress towards The Goal I had to go find something I could Accomplish, even if that thing was liking a picture of a cat in a boot.

I haven't tested it with the co-workers with no indoor voices yet, but other people and their associated noises felt easier today. Exchanging mandatory pleasantries no longer feels like people are stealing from me. My ability to sit still and connect with my body** has gone up, which is pretty much the opposite of what I expected. I'm naturally more aware, and I can connect and listen deeper without feeling overwhelmed.

It's supposed to be a 12 hour pill, but it very clearly starts wearing off around 8 hours in for me, and is gone by 10. Suddenly everything is hard. I'm back to fucking around on the internet. Nothing sounds fun.

*A friend of mine more or less banished the sims from her life for this reason. It's major selling point was a quick hit of productivity. Do you know when that is most fun? When there is a large, unpleasant but mandatory thing you are avoiding.

**not a euphamism for masturbation


Oct. 3rd, 2013 08:12 am
pktechgirlbackup: (pktechgirl)
Long story short: I started treatment for ADD yesterday*. I've joked about having it for over a decade, when I went to a psychiatrist it was high on the list of possible diagnoses, but for a while it looked like the magic food pills would cure it (it being a lot easier to focus when your body isn't constantly on the edge of starvation). Recently, that hit a wall. Why this happened is an open question. I initially blamed the open office, but I've been in it for months. Psychiatrist suggested it was a side effect of all the dietary + digestive improvements I've made recently- that there's a mass die off of the bacteria that thrived under the old regime, and that this is stressful for everyone but especially for me because of my bad copies of the MTHFR gene and also I was starving for 25 years, and that one possible side effect of this is worsening sound sensitivity and less executive function. On one hand, this sounds like the kind of bullshit naturopathic practitioners use to explain away anything they don't want to deal with. Sort of an eastern "it's stress." On the other hand, I did start spontaneously sucking down massive quantities soda after three months of not missing it.

My doctor's attitude on the whole ADD thing boiled down to "yep, those are a lot of symptoms. Take these pills and see if it helps. If it doesn't we'll try something else, if it does keep taking them, but stop every once in a while to see what happens."**, which is exactly what she would have said if she didn't suspect ghost bacteria were causing the problem. I like this doctor

Yesterday was day one of taking Vyvanse, which is in the same family as Ritalin and Adderall (ampthetamine salts), but more on a more gradual release schedule, which makes it both more effective therapeutically and less useful recreationaly. My observations so far:

  • it's significantly less powerful than cortisol, in that I'm not vibrating my leg while quietly saying "zoom zoom zoom" under my breath for minutes at a time. There is sort of a lightheaded feeling, but I'm not jittery.
  • The DEA has arranged a catch-22 so archetypal they should be congratulated and then hanged. Schedule II prescriptions can not be phoned in, you have to physically pick them up. That's okay, because for the first few months I have to see my doctor every 30 days anyway. Eventually she will be allowed to write me Rxes for three months at a time. But not one Rx with two refills- three different pieces of paper, which cannot be given to the pharmacy ahead of time. Because if there's one thing ADHDers are good at, it's not losing things they won't need until a month from now.
  • I am typing very fast.
  • Frustrating work things have not magically become easy. I am not even focusing on them for any longer than I was before. .
  • OTOH, I went 7 hours without checking facebook or my non-work e-mail.
  • I am drinking a lot of water. Hard to tell if that's a dry mouth, responding to dehydration, or I'm newly able to sustain the focus to get water refills.

I don't know whether I have a serious problem that I have mostly been able to mitigate with substantial gifts (primarily in the raw intelligence department), at the cost of a lot of hidden pain, or if I'm buying into the pharmaceutical-industrial complex's idea of what a worker should be, and drugging myself to uphold their ideals when what I need to do is simplifying my life. On one hand, I have wonderful friends and a job that is so much better than what most people have that it, in a statistical sense, doesn't exist. I'm not, Hyperbole and a Half style paralyzed by ADD. I'm not wetting my pants because I can't focus long enough to get to the toilet. I'm not the friend of a friend whose ADHD rendered him unfit for any employment beyond target. For fuck's sake, I graduated from one of the most difficult universities in the country with a double major in two of their hardest subjects.

On the other hand, I'm functionally incapable of feeding myself anything that takes more than 2 steps, the only reason I don't have a Bernard Black style meltdown when asked to mail a letter with a stamp is that I don't have the energy, and I job-hop at a rate that would be prohibitive in any other field. My social interactions are significantly hindered by the fact that I react to boredom like most people do physical pain- and oh, the fact that they actually are painful due to the misophonia, which is entangled with attention issues. I feel like I have a lot of potential that is twisting in on itself until it chokes, and that is not the same as feeling like I'm disappointing my corporate overlords. I don't need to be as severe as any of the examples in the previous paragraph to benefit from help. How I did at school 10 years ago does not negate how I am doing at work now.

So I will take the pills and see how it goes. They will probably be less revolutionary than the magic food pills, but maybe they will help.

*ADD technically doesn't exist anymore, it's been rolled into ADHD. But I'm not hyperactive, and my symptoms best match inattentive-ADHD, which I am considering renaming to "AHDH for lazy people".

**This is pretty much the only psychoactive medication for which that is a good idea.
pktechgirlbackup: (pktechgirl)
Is this that emotion you humans call cope?

Between the HCl and the wake-up grapes, I feeling pretty amazing. I had a really stressful week at work, something that would previously have consumed my life and required a ton of processing. And now... it was stressful, I didn't like it, but it seems smaller and far away. And there is a lot of power in having the worst thing that could happen happenand still being fine.

For a more controlled experiment: my HOA president is an ass in certain very predicable ways. He criticized me in a way he's criticized me before. Last time I got super worked up about how unfair it was. This time... fuck it. He can't actually make me change, and until he cooperates with me he's just making more work for himself.

The last time I had this abundance of resilience was when I was on cortisol. There are three really definitely valid* treatments for hypoadrenia, of which cortisol is the most severe. It makes a certain amount of sense- "you don't have enough cortisol, here, have some", but it's also the kludgiest, because it limits your body's control over its chemical balance. If the problem is your body *can't* control your chemicals, possibly because it has been attempting to do so for so long with so few resources and is now completely burnt out, it's the best option, but there are side effects. Weight gain, insomnia, facial and chest hair in women*, diminished immune response, etc. I went off cortisol even though I wasn't fully better because I was well enough that the side effects weren't worth it.

The one-step-removed treatment is DHEA, which your adrenal glands make into cortisol. This is an excellent solution if the problem is DHEA deficiency (I don't know what causes that) and your adrenal glands are healthy enough to use it. Because your glands are still in control, it's far less likely to lead to cortisone excess, but it's not sufficient for real hypoadrenia. I've been on and off it a few times, and it was helpful for a while and then it wasn't.

The even-more-removed option is to consume raw animal adrenal glands (they make nice sanitary little pills of them). These contain a small amount of all the coritsol precursors plus the exact proteins that make up the adrenal glands themselves (well, the exact proteins that make up cow adrenal glands). The idea is that it provides targeted support to help your body repair the adrenal glands, and the cortisol it contains is a fringe benefit.

I've had lingering hypoadrenia symptoms ever since I went off formal treatment, but really did not want to restart it. Cortisol was right out, and even DHEA and raw adrenals just didn't feel right. Until ~5 weeks after I started the HCl tablets. I really felt like taking Iron and Raw Adrenal. 3 or 4 weeks after that, almost immediately after I started breakfast in bed. DHEA started seeming like a good idea, so I'm giving that a shot.

*As in, the have obvious mechanisms that explain why they are helpful, and may even have had studies done, as opposed to random plants that are shaped like adrenal glands.

**which has persisted even though I'm no longer on the drugs. Whoo hoo!
pktechgirlbackup: (pktechgirl)
I've talked before about how I hate how modern/Western medicine focuses on treating symptoms rather than root causes, and in particular ignores nutrition beyond some vague food pyramid that is based primarily on who gave the most money to senators on the right subcommittee. So I went a doctor that actually listened to me as a whole person, and focused on nutrition as a fix for them. Initially in pill form, but hoping to transition to real food eventually. Only that never happened. It helped (I have more energy and didn't get sick at all last winter, as opposed to my usual average of "all winter"), but only temporarily. I was taking more and more supplements until I just gave up and stopped all of them. One would work for a while, and a different problem would crop up, and it just felt like symptom whack a mole. I couldn't go 90 minutes without eating without feeling awful, I'm eating mostly hyperpalatable crap and have to bribe myself to get through a meal with protein, which I nevertheless find incredibly stressful. I don't understand why I freak out if food doesn't taste good, why can't I eat for nutrition like everyone else?

Five weeks ago I went to a nutrition-focused psychiatric ANRP about a possible anxiety disorder. She listens to my symptoms, including the supplement whack a mole, and suggests I have low stomach acid (hypochlorhydria). Dr. Internet tells me there's a fancy test for this involving swallowing a pill containing a radio transmitter and some sort of pH meter, which I kind of want to do just to have a tiny science lab in my stomach, but the ANRP just told me to try taking the treatment (pills containing stomach acid, plus pepsin, an acid-activated enzyme for digesting meat) and see if it helps.

Oh. My. G-d.

Now that I know what it's like to *not* feel ill after eating food with protein or fiber, I can recognize that that's what I was experiencing before. I felt deeply ill any time I anything with real nutritional value, but was pushing my awareness of it away because I couldn't deal with it. Or I was sucking down soda because it was the only way my body could ask for more acid. It also explains:
  • Why I could feel like I was starving and disgustingly full at the same time
  • Why I have always felt so food insecure even though I've never been more than a car ride away from all the food I could ever want.
  • Why I've always been such an insanely pick eater, and found trying new foods so stressful.
  • Highly suspect this has something to do with my salt addiction
  • Why I became a vegetarian at age 6 in a house full of meat eaters.
  • The fascinating variety of subclinical hormonal disorders I have and the fact that curing one just leads another one to pop up somewhere else.
  • Why feelings of fullness were more dependent of food temperature than volume or nutritional level.
  • environmental allergies

Clearly I was able to extract some nutrients because I'm not dead, but I'm honestly not sure how. I'm still working out the exact dosages, but I easily take 200 pills in a week, where the bottle says 1 - 2/meal. I needed 180 mg just to eat a pear. I haven't even been counting how many I'm taking with this protein shake I'm drinking right now, but it's more than 1 gram of betaine HCl per gram of protein. ARNP hasn't ruled out a bone fida anxiety disorder yet, but that's only because she hasn't talked to me in three weeks. It is abundantly clearly to me that the actual problem was the psychic load of feeling that I was going to starve, and borderline malnutrition.

There's a few lessons I want to draw from this. One involves an Inception joke about going deeper: I thought I had found the ultimate problem by taking nutritional supplements, but never looked at why I had a deficiency. The second is that gastric bypass can easily induce hypochlorhydria because it cuts out the acid producing section of the stomach, so don't do that. The third is about will power. I, and others, constantly beat me up over my poor eating habits. I felt really ashamed that I had so many problems. And I suppose things might have been slightly better if I'd powered through the nausea and fatigue and blood sugar induced bitchiness and eaten perfectly anyway, but I wasn't doing those things because it would have left me miserable and friendless and quite possibly unemployed. The problem was not lack of will power or moral fortitude, it was a g-ddamn chemical.

The fourth is that I can eat 12 Wendy's Chicken Nuggets without needing a single pill, and I think this tells you a lot about the food content in fast food.
pktechgirlbackup: (Default)
With my departure from martial arts, I have a lot more free time. More than that, I have more mental energy and schedule space than I have in years. The effect is bigger because last time I had this much free time I had a substantially weaker endocrine system.* It feels way, way more like getting out of a long term relationship than it should. I want to get out and try lots of new hobbies without committing to any of them. And unlike the relationship-equivalent, it's totally not tacky to document a hobby search in detail.

Today I went to a circus arts class. There were five parts: acro, tightrope, juggling, trampoline, and aerials. I would enjoy being good at any of these, even tightrope, even though it doesn't look that cool and is really pretty painful. But acro and aeriel weren't really fun as an inflexible beginner. Juggling was fun, and might actually be a good flow state thing, but taking a class in it seems unnecessary and possibly even counterproductive.

Trampoline was the clear winner. I grinned my way down the first tumble. It's entirely leg strength, which is my comparative advantage. More flexibility would be better, but trampoline didn't throw my limitations in my face like acro did. I'd consider a prolonged fling, but the only classes available would cramp my lifestyle, and I'm just not in the mood for making compromises right now. But worth looking at after I've sown some more oats.

Next day update: ow the back of my legs. Which is great, because like most women that musculature is comparatively under developed on me. But it's weird, because karate hadn't had that effect on me in years. I think it's a combination of building up the relevant muscles and your body recognizing and avoiding this that will tire you.

*For the curious: I'm off of all prescription drugs, still taking DHEA (cortisone precursor) and some normal vitamins. I'm not optimal, but I'm a lot better than I was, and at this point the drugs do more harm than good.
pktechgirlbackup: (Default)
I took two months off of sparring due to a knee thing- I'm fine, but it was the safe thing to do. When I got back, I had really severe problems with nausea, to the point of leaving the mat to try and throw up. And I wasn't acclimating. Turns out nausea is a symptom of hyperthyroidism/thyroid medication overdose, albeit not one of the common ones. The most common symptom is weight loss, which I didn't have. The second most common is anxiety/sleep disturbance, and I didn't have a control group for how anxious I should be when buying a house, moving, and fighting with the landlords from hell. So based on the nausea alone*, we halved my dosage.

My soda consumption rose conspicuously over the last month or two. I don't know why, it just did. Some of it was the caffeine, but when I used up all the Pepsi in the house, I moved on to my non-favored uncaffinated sodas that I'd stocked for moving. Four days after the dosage drop, I completely lost my desire for it. In retrospect, I was probably using the carbonation to fight nausea. The rise in junk food consumption that started with the move also subsided. And this is why I get so, so nervous when people talk about will power, weight and food: yes, self-control a factor, but its presence causes us to ignore a lot of other factors.

Either my thyroid glands coincidentally recovered around the time I moved, or my old thyroid dosage was right for the old apartment but too high for the new place. That could be because the stress of moving kicked up my adrenal glands and confused everything, or because I've replaced the stench of mold and decay with hardwood floors and air.

*I'm supposed to have bloodwork but it's taking a long time for reasons that are boring.
pktechgirlbackup: (Default)
When I went on cortisol (for the hypoadrenia), I immediately felt better. In fact, I immediately felt awesome in ways that were somewhat frightening. For the first week, I didn't need to eat, I was sleeping 4 hours a night, and my apartment was *spotless*. This backslid into a much healthier "better than when I started", but never near the highs of the first week.

The first week on Armour Thyroid, I didn't feel a bit of difference. But slowly, I noticed that while my energy level was the same, I wasn't eating much sugar, and I'd dropped caffeine entirely. And while the much celebrated thyroid medication weight loss hasn't materialized, I'm almost positive I'm gaining muscle. My quads are more defined, there's a bigger shadow when I flex my bicep, and my bra bands are fitting tighter while the cups are looser. I am extraordinarily happy with this outcome; it could only be more perfect if it increased my flexibility as well.

This week, I got sick. I think I recovered faster than I would have without Armour, but without a control universe I'll never know. What I do know is that Sudafed is an entirely different drug now. I used to be able to take it before bed no problem, now I totally see how it's related to meth. Also, even if the pharmacist says sudafed and ibuprofen will not interact with your thyroid meds, and your doctor says to take cortisol when you're sick, do not take all three of them. You will be super jumpy for an hour and feel awful when the cortisol wears off.
pktechgirlbackup: (Default)
adrenal fatigue update ) I explain this to my doctor, and she agrees to accelerate the thyroid drug schedule to "start tomorrow." Her feeling is that if it's the wrong drug for me I will know almost immediately because I'll feel icky, and smart girl that I am, I'll stop taking it. If I feel awesome on it, then we know that this was the problem. If I feel no change, we'll run more tests.

I bring up the ease with which my doctor prescribed thyroid medication because I want to contrast it with the difficulty experienced by Megan McArdle and my friend Ivan. Both had histories of thyroid disease. Both are clearly experiencing symptoms of those diseases (in McArdle's case it's progressive, in my friend's case it appears to be cyclic). Neither can convince their doctor to give them medicine to treat it. In Ivan's case the doctor clearly didn't listen at all, because his major complaints were "I lack the energy to exercise and I'm sleeping 16 hours at a stretch", and the doctor's response was "exercise more and sleep better." And this was a prestigious endocrinologist Ivan's wealthy doctor father pulled some strings to get an appointment with.

I'm not sure why thyroid medication is so hard to get. Yes, too much of has negative consequences (heart issues and loss of bone density), and yes, as Requiem for a Dream showed us, it is abusable as both a party drug and weight loss aid**. But much like pain medications, I don't care if people shorten their own lifespans to look hawt. I don't think your heart health is a public good*** Holding someone's medical care hostage to the fact that some other people might abuse the medication is a failure of care.

I still don't see why the government gets to weigh whether or not I can buy a toxic-only-to-me chemical at all. If you're worried about poisons, flavor-label dangerous enough to be concerning****. And of course, anti-infectious disease agents remain public concerns. And I think there's a very legitimate role for the government to verify purity. But it's impossible to test whether or not every drug isn't *someone's* best option, and a fool's errand to try. Insisting that each new drug be at least as good as drugs already on the market removes price competition and ignores human variety.

Nope, still no pithy summary for my anti-regulation rage.

*To be fair, everything can be a sign of hypothyroidism. For example, I had been wondering why, if I had hypothyroidism, I had such lustrous hair. Dry or thinning hair is one of the primary symptoms. Today I went in for a haircut and the first words out of the stylist's mouth were "you know that's not dandruff, that's oil.", which would explain why the anti-dandruff shampoo isn't working. I looked it up, and it turns out that oily scalp is *also* a sign of hypothyroidism. And while it keeps my hair very pretty (except for the ends, which never got enough oil and so had gotten quite dry), it is really problematic for my scalp.

**Side note: the drug they used in the movie was Synthroid, I'm on Armour Thyroid.

***, and I will maintain that believe even if we get nationalized health care, because even a protracted battle with heart disease ending with your death at 60 is cheaper than a protracted battle with Alzheimer's at 90.

****The liquid SSRI used to treat my neuralgia was blueberry mint flavored, but I think that was so I could verify I had the right medication.
pktechgirlbackup: (Default)
The author of The Immortal Life of Henrietta Lacks keeps saying "having his way with her" when she means "he raped her" and it's driving me nuts. The first time she does it, it's in regards to an adult man and a 12 year old girl. Later, it's that same girl (slightly older now), fighting off her male cousins tooth and nail from "having their way with her." Now, there is a point between enthusiastic consent and full rape, but neither of these are it. Had these men succeeded (and they frequently did, although maybe not with this girl, although I kind of suspect they did and she's just not saying so), that would be rape.

I'm not a fan of euphemisms in general, but it strikes me as particularly bad in this case, because it reinforces the idea that rape is when a stranger jumps out of the bushes with a knife and violently penetrates a woman's vagina with his penis, and anything short of that doesn't count. My mom used the exact same phrase to describe Levi Johnston's alleged rape of Bristol Palin. As numerous people have pointed out: Bristol's social environment doesn't consider that story rape, and it's rooted in a thought process that goes: "Sex is bad, men will always want sex, women either don't or have more self control, therefore it's women's job to limit sex. And that makes it a personal failing on her part if unwanted sex occurs."

Doing some extremely fine line reading, I suspect the author is deliberately softening her words at the request of the family. There's evidence to suggest that Lacks didn't want to marry her husband (and first cousin, who grew up like her brother as both were raised by their grandfather), and that it was some combination of uwanted sex and/or pregnancy that led to the marriage. I respect the author's desire to respect the family: they were extremely mistreated by doctors and reporters for decades, they have no benefit of a doubt to give anyone new. It's entirely possible Lacks wouldn't want it to come out that her family was inbred and rape-prone, and if the author had just left it out, I think I'd be okay with it.* But it does a disservice to everyone else on the planet to call rape something other than rape. If it's in there, you have to call it what it is.

*Although if I were the ghost of Henrietta Lacks trying to keep some skeletons in a closet, I think I'd start with the fact that my widower did nothing while the husband of the woman he was banging molested our daughter in the backseat of the car while he (my widower) was driving. The book also makes numerous mentions of him cheating and bringing home STDs, which makes me think maybe he wasn't given a vote in what to censor.
pktechgirlbackup: (Default)
When my doctor prescribed me hydrocortisone, it was in 20mg tablets. Not a big deal when I was taking 50mg, but now I'm at ~5, or I would be if pill splitters could reliably do quarters, which they can't. A skilled operator can get halves pretty reliably, but not quarters, and even the best will lose some to powdering. My doctor gave me the 20mg pills anyway because there was a shortage of the 10s. "Why is that?" I thought quietly to myself. "Surely if you can make one you can make the other. And it's a generic medication made by many manufacturers. Why aren't they boosting production?" It turns out the answer is they're not allowed to.

WTF mate? Apparently you have to tell the FDA how much drug you're going to produce, and you can't up it without permission even if it's a leukemia drug and the FDA just shut down your competitors' plants so doctors are being forced to give patients sub-optimal treatments for their cancer.

The one thing that bugs me about this article is that it doesn't go into much detail on the review process. If all you have to do to produce more lifesaving medication is e-mail the FDA, I'm still against it, but it wouldn't account for the shortages on its own. Unfortunately I don't have access to the list of limited access drugs, but everything I've seen mentioned is off patent, which gives me the sneaking suspicion that it's not financially lucrative to apply for- either because the profit margin on generics is so low to begin with, or because you're required to give a discount to certain medical providers that target the poor, and can cherry pick who you distribute to first. Which doesn't let the federal government off the hook, because they're the ones making it expensive to produce more for no valid reason, if they want a thing they should raise taxes and pay for it, not mandate that it be sold below cost.

I'm still trying to figure out why they have the limits in the first place. Some of it is the DEA wanting to limit abuse, which starts me on another rant about how we'd rather have people live in excruciating pain (or have their ADD undertreated) than have some other people enjoy something inappropriate, but I doubt a chemotherapy drug can be used recreationally, and presumably 20 mg tablets of hydrocortisone are easier to abuse that 10 mg tablets. I refuse to be one of those libertarians that thinks the government does stuff just to be mean, but it's sure looking plausible here.

Good news though: new job gives me interlibrary loan access to the university library, which has Overdose, a book on prescription regulation I've been coveting for a while but was not quite ready to purchase or pay for city-library interlibrary loan. For a bit I felt guilty about using this for non-work purposes, but then I realized I could just donate to either institution an amount that was more than it cost them to fetch the book for me (almost, but not quite nothing) but less than it would cost me to get it through public library interlibrary loan ($5, plus it takes more time to pick up the book). It's a win for every one.
pktechgirlbackup: (Default)
My cortisol numbers are looking good during the day but I lack the morning spike I should have, which is consistent with my symptoms. I restarted hydrocortisone on Monday to treat this, after a two month break. This shouldn't be permanent, just a little extra boost to help my adrenal glands. Restarting after a break is interesting. Recording the symptoms is complicated because I started naltrexone* the same time, and that one is disrupting my sleep as well.

At first, I got a milder version of the everything-is-AWESOME effect I got the first time around. I got four or five hours of sleep the first night and I felt GREAT. It didn't last- I'm basically back to normal now, and even had to make up a little bit of sleep. For the first few nights, the sleep was Not Normal. You know that stage right before you fall asleep, where you're safe and warm and calm but not quite gone? That lasts for some time between minutes and hours, it's hard to tell. I'm waking up faster, but not blindingly fast. Also, yay, I'm stretchy again. I didn't lose any flexibility when I went off hydrocortisone, but my rate of increase slowed tremendously. It was back within eight hours of taking it.

I seem to be coping with stress better. On the minus side, the cortisol induced appetite, which took months to kick in the first time, showed up almost immediately.

Meanwhile, there's a reason herxheimer was the word of the day. I'm on several immune system aids. Prior to starting them, my left throat lymph node was continually swollen. That hasn't gone away. But now my nose is running too. It could be allergies, but... it's only on the left side. I've never had a unilateral runny nose before.

*Note for the medically curious: if you google naltrexone, the first thing that will come up is its use in treating heroin addiction. That's not why I'm taking it. In extremely low doses it's also an immune system booster. The idea is that it very briefly blocks your endorphin receptors for a short time period while you're asleep, triggering your body to make more endorphins. Because you have normal endorphin receptivity for the rest of the day, this ups your functional endorphin level, boosting your immune system. Some people sleep better on it, it appears I don't, although it's hard to tell because last time I tried it my hydrocortisone dose was too high, and right now I'm still acclimating.

Blue skies

Apr. 12th, 2011 06:34 pm
pktechgirlbackup: (Default)
Talked with doctor yesterday. My nutrition numbers have moved from "how are you not dead" to "phenomenal", even the measure of my protein intake, which means I don't have to push myself to eat more meat. My hormones have been two steps forward, one step back. My cortisol, progesterone, and DHEA numbers are improved but not perfect, my thyroid is awesome, but my estrogen has moved from borderline to too high and my testosterone is way too high.

This is apparently not unheard of- the whole system got used to working with minimal amounts of cortisol and DHEA, and it needs to re-equalibriate. I'm going back on small amounts of morning cortisol because my afternoon numbers are good but my morning numbers are not. Man, I had forgotten how awesome this stuff is the first week. I'm basically nibbling the smallest piece of the pill I can: That evening I already noticed an increase in my flexibility and I slept five hours last night,

I've had a single chronically inflamed lymph node for a while, she thinks it's a chronic low level infection. She's ordered a test for it but has already begun treatment (pau d'arco. That's a Not Kidding Around Herbal Medication, don't take it without talking to a doctor). There's also some other adjustments to my vitamins and meds, but I won't be making most of those till the exact orders are mailed to me.

I'd just like to put in a plug for doctors listening. I brought up several minor symptoms that I most doctors, and together they fit in with each other and larger symptoms to help her tailor my treatment.
pktechgirlbackup: (Default)
Stopped taking hydrocortisone entirely today. Felt somewhat weak during martial arts, but I believe that had more to do with barely eating or drinking anything beforehand.
pktechgirlbackup: (Default)
Until very recently, certain kinds of hunger would make me an absolute bitch. I thought I controlled it, but in retrospect I probably didn't. The best I could do was start mechanations to get myself food as soon as I knew it was coming. This is when friends were authorized to yell at me to eat if I seemed unreasonably upset- which was important, because once the low blood sugar kicked in, I often didn't want to eat. I thought this was a blood sugar issue, but tests- even tests taken when I was suffering from the I-haven't-eaten-bitchiness- disproved it. Turns out, this is a symptom of adrenal fatigue. My doctor even said I could use my reaction to hunger as a bellwether for if I was taking enough hydrocortisone.

Friday I experienced absolutely no anger while out my friends and I dithered over which was restaurant to go to, even though I was hungry, had just lowered my dosage the day before*, and was in the first stages of a nasty cold. And it only occurred to me that this was weird because I offered hunger as an excuse for how tired I was (in retrospect, it was probably the cold). So I'm probably good to lower my dosage again as soon as I adjust.

*which can lead to temporary problematic drops in coritsol levels even when it's the right thing to do, and may in fact have contributed to getting sick. So no lowering the dosage until I'm well over this.
pktechgirlbackup: (Default)
Pro tip: if you're taking medication, and one of the things the medication is supposed to do is speed the transition between "asleep" and "functional human being", keep it on your night stand. If it needs to be taken with food, keep some snacks there. It only took me three months to figure this out. Thus far it feels fantastic, but I started a potentially very helpful new vitamin the same weekend so it's hard to tell.

It's rapidly becoming moot though. I was originally at 15 mg hydrocortisone/day, which very rapidly went up to 50 once I stopped hearing my mom's voice about the weight gain* and just listened to my symptoms. My doctor told me I could go higher while sick or after dental work, which at first I was very much looking forward to, but it turns out that cortisol is not meth, taking extra is not fun, you just sleep poorly**. Around Christmas I connected the dots and realized that my recent trouble getting to sleep could be cortisol related, and lowered the dosage (with doctor's permission) to 40 (they're 20mg pills, so 10 mg is the smallest adjustment I can reliably make). Two weeks later it felt high again, so I lowered it to 30. I asked the doctor if we should maybe do a test before lowering it again, but after starting DHEA (a cortisol precursor/antagonist***) over the weekend, I went down to 20 today.

*I kept weighing myself for a month after I started and my weight stayed exactly constant. A month after that I'd gained 10 pounds, arguably much of it muscle. I stayed strong and didn't care. A month later I've gained another 10-15, some of it muscle, but some of it not. This would be another reason to think maybe my adrenals are recovered and I don't need to supplement, although it's not the primary one.

**This is why I think 50 mg was the right initial dose: I had no sleep problems on it at first.

***science does not understand biochemical pathways particularly well.
pktechgirlbackup: (Default)
Adrenal fatigue is kind of a fringe diagnosis, so I was happy when my friend's very mainstream endocrinologist listed it as a possibility (I'm not happy my friend is sleeping 16 hours/day, obviously, just happy he might get it treated). Except said doctor is not ordering a cortisol level check and is not prescribing hydrocortisone. It appears he's using Adrenal Fatigue the way doctor's used to use Chronic Fatigue Syndrome: a way of repeating your symptoms back to you without actually inducing any action on their part. Aargh.

My finger was ugly enough today that I went to the doctor (got x-rays, haven't heard back yet). I hate this doctor, but I couldn't see the next one on my list until I'd had a new patient visit, so I had to use her. I figured it couldn't be too bad, since this was a simple mechanical issue. That office is where I developed a new theory: humans do not believe they can be cured by someone who doesn't care about them, by which I of course mean I do not believe I can be cured by someone who doesn't care about me. Oh, intellectually I understand the doctor can read an x-ray and tell me if I need a splint or not, but I *believe* she's thinking "this is the nut case that asks me to back up my assertions with data" and it's affecting my care. And I'm not sure that's so unreasonable- my friend above's treatment may be suffering in part because the doctor flat out doesn't believe he's sleeping as much as he says he is, and it's hard to tell marginal symptoms to someone you believe is trying to rush you out of the room. So now I'm going to try paying for concierge medicine, even though my insurance won't cover it.
pktechgirlbackup: (Default)
My doctor has agreed that I should try lowering my hydorcortisone dosage. It's
not definitely going to stay lower, but it turns out that having too much feels
a lot like having too little, and the extra I took when I was sick demonstrated
that I definitely should not be taking more, so it's worth seeing if I can get
the same or better results with a lower dosage, especially since hydrocortisone
is a Not Kidding Around drug. The timing isn't fantastic- she just adjusted my
vitamins two weeks ago, and while overall it's been helpful, the switch included
two things in the "this will get worse before it gets better" category, which
could screw up my assessment of the lowered dosage. Neither should effect the
biggest potential negative side effect from the cortisol- trouble getting to
sleep. So today I'm going to do my usual symptoms check in:

  • I am itchy. My skin is dry and I have developed a mild sensitivity to my
    laundry detergent. It looks like I'm developing new moles, but that could be my
    imagination. Doctor says that can be a side effect of either of the "worse
    before it gets better" things. Actually, she's pretty sure she knows which one
    it is, but it's the more important one, so she wants me to give up the other
    (which is definitely temporary) first. I've decided to compromise on "neither"
  • I am much more energetic during the day. Not at super-power levels, but
    better than I was a month ago.
  • I think I'm sleeping better at night. I'm also sleeping a lot- 9 hours,
    plus maybe 15 minutes of reading my RSS feed in bed before I get up. Okay 30.
    And it's fifteen minutes between consciousness and phone. I blame the cats for
    that, but the truth is, I do it even when they're not there.
  • I am having some trouble getting to sleep. This is either or symptom of too
    little cortisol (giving me the hypoadrenic "second wind" right when I should be
    going to sleep) or too much (for obvious reasons). Or it could be something
    entirely unrelated. Definitely one of those three.
  • The one rolfing session I had was super amazing effective.
  • It's hard evaluating the emotional side effects. I have no problem
    acknowledging the vitamins for giving me energy or reducing inflammation, and
    it's easy to see that hydrocortisone makes me cope with stress better, but
    beyond that, I feel like I'm a calmer, more mature, less-high strung person
    because I've experienced emotional growth, not because of some stupid pills.
    And I have the perfectly reasonable argument that there's very obvious emotional
    growth that I can point to, and that I was doing a lot of that before I started
    any of these vitamins and we lack the technology to chart maturity
    quantitatively enough to look for an inflection point.

  • Inflammation- down from the worst, but not actually improving. Again
    suspect "worse before better" meds.
  • My focus isn't great at work, but that's to be expected after two weeks
    off. As you can tell, my focus when writing is astonishing, and I've lost quite
    a lot of my ability to multitask when watching even stupid TV. It's not that I
    couldn't write e-mail while watching Hoarders if I really wanted to, it's that
    doing so annoys me
  • I'm back to mostly not wanting simple carbs. Not as extreme as during the
    superpowers phase, but reasonable.

  • My body is at the point where it will actively ask for meat, but only if
    it's one of the kinds I ate as a child. Next step is to convince it that
    breaded chicken tenders are literally the exact same thing as chicken nuggets,
    except bigger. There's a delicate balance here where I'm more inclined to try
    new things when I'm hungry or craving a particular nutrient, but if I go even a
    smidge beyond that my stomach goes into protective mode and has to be
    willpowered into eating anything.

  • This combines really well with my body neglecting to tell me it's hungry
    until I'm near starving. I am still relearning how to listen for hunger
    signals, and to start preparing food before I actively crave it. Get it
    together, stomach.

  • I'm experiencing much less body odor than I used to. For a while I worried that it was in fact my sense of smell that was going, but I confirmed at martial arts today that it was not.

  • My motion sickness is getting better, although that could be because I'm better about taking the magnesium now.

  • My neuralgia got worse for a few days. I did not like this at all.
pktechgirlbackup: (Default)
My doctor just changed my vitamins, so I might as well make my notes on hydrocortisone before those really kick in:
  • I have more energy than I did before the treatment, but not nearly as much as during the first two weeks.
  • Ditto for focus- better than before, but no longer at super human levels.  It's showing up in subtle things, like now I no longer read blogs and watch movies at the same time.
  • Inflammation issues are better than before but still absurdly bad, which is okay, because while hydrocortisone is an anti-inflammatory, I'm not taking it for inflammation, and the dosage of cortisol need to treat my issues is prohibitively high.
  • For the first weeks I gained muscle at a stupid high rate.  Since then it's plateaued quite a bit.  It's hard to tease out the possible overtraining, diet, and illness issues here.
  • I am gaining flexibility at a much faster rate than previously.  Obviously the martial arts are helping here, but there's no way 3x/week martial arts is as good as when I was doing 6x/week yoga, so hydrocortisone gets some credit.
  • The structural integration I was getting became vastly, vastly more effective.  I dropped from once a week to every other week and we're actively considering going to every three or four weeks.  We make a lot more progress each time.
  • For a few months (starting before the hydrocortisone) I took melatonin, the chemical your body produces as it gets dark, to get to sleep.  I upped the dosage quite a bit when I first started the cortisol.  A few weeks ago I realized it wasn't helping and stopped taking it.  My doctor confirms that needing melatonin to get to sleep while suffering from adrenal fatigue, but finding it counterproductive after raising your levels of cortisol is a well known pattern.   So to review, taking a stimulant made me stop needing a sleep aid.  The human body is weird.
  • Speaking of cortisol and sleep:  I'm allowed to up my dosage (up to double) when sick.  Double was too much, but I tried 40% more (the lowest easiest way to split the pills) and felt exactly the same during the day.  It wasn't till later I connected this with sleeping unbelievably poorly at night.   Melatonin did nothing to help  Lesson:  going from low -> normal does not produce the same effect as going from normal -> high.  Once I adjust to the new vitamins I'm going to experiment with lowering the dosage.  It's tricky because the vitamins affect how well I absorb and use the cortisol.
  • I was back to needing a really long time to wake up, we'll see what happens now that I'm off the melatonin and not taking an excessive amount of hydrocortisone.
  • For a while I was eating really well- mostly produce, no simple carbs at all, slowly introducing meat to my diet.  I could literally feel my body removing scar tissue, absorbing the nutrients, and building something better.  Then I got sick, started eating carbs, lost the rebuilding feeling and never really got back on track.
  • There's a related issue where my hunger signals have changed I'm just flat out not eating enough.  I'm still working on that.
  • My weight stayed ~constant for the first six weeks.  Then I stopped measuring.  Two months later I've gained 10 pounds, muscle/fat/bone distribution unknown.  If that continues forever it's probably bad, but I genuinely don't care at the moment.
  • It's hard to measure these things scientifically, but my level of "cope" seems to have increased significantly.
  • This isn't related to the cortisol, but I just got back from vacation and holy crap did my cats miss me..


pktechgirlbackup: (Default)

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