A Value to Silence

My dad in 2015, ready to "coffee" in his pajamas.

I am turning into my dad.

I have had a week of chronic insomnia. I don't have issues getting to sleep, I have issues staying asleep. I'll often wake around 1 or 2 am and be awake for 3 hours or so, falling back asleep an hour before I have to get up.

Each night I go to bed hopeful that I am so incredibly exhausted that I will sleep through my witching hour. But this week my brain has made it difficult to fall asleep and woke me back up around 1:00, no matter that I only finally fell asleep at 11. 

My dad was a chronic insomniac as well. Except it seems to me that he embraced it as a part of his life. He was a manager at J.I. Case in Racine, WI, in the 1970s, and they had a lot of issues with downtime on the lines that he'd been charged with solving. Later in life, when I was a working adult and we would spend time together, he told me that he did his best thinking in the middle of the night. He would turn the problem over in his head, look at it from all angles, and would often come to what was the best solution. Sometimes he was so motivated by what he'd just solved that he would go to work shortly after, so he could set the idea into motion. That meant that he sometimes arrived at work at 3 or 4 am, long before the day shift had started their work. This gave him respect in the eyes of the line workers, as he was the only "suit" who ever beat them to work. Those were the same days when he would arrive back home at 2, a little before the day shift finished their day, so it was a treat for us that dad was home early. All I knew as a child was that dad was home early, I didn't know he's already put in a nearly 12-hour day. 

Later in his life, when he was retired and living in the log cabin in Arkansas, his days and nights were his own. And yet, somehow, he often woke in the middle of the night. His brain, like mine, if not given a problem to solve at that hour, will create a problem out of something that isn't to give you something to think about. When I was pregnant with our first-born, her entire nursery design, colors, furniture, patterns, got planned between 1:00 and 3:00 in the morning. Designing and painting a nursery is obviously not an urgent "problem," but that's when my brain decided it should be thought about.

One day he and I were talking on the phone and he was telling me that he and his wife Terry had woken up early in the morning. They were both just lying awake in bed, so they chatted for a while, then decided to get up. They put a pot of coffee on, he made some Southern sausage with eggs, they had breakfast and talked about the day ahead. And then they went back to bed and decided to start the day later.

I asked him, "Wait, what time did you go back to bed?"

"Oh, it was probably around 6:00," he replied.

"So what time did you get up?" I asked.

"I think it was about 3," he said.

I remember laughing at the time. "Dad, 3:00 isn't the morning, it's the middle of the night!" His attitude was that morning was whenever you decided it would be.

And so here I am, at 4:30 in the morning, sitting in my living room, writing this post, having finished my first cup of coffee. The blinds on the windows are open as we have a snowstorm starting, and if it were light out I would be able to see it coming down. My dad would have loved our new home, our location with woods and fields, and wildlife all around. Unlike his extroverted daughter, he did not shy away from silence. He could sit in his darkened living room, a cup of coffee in hand, say nothing and take in the stillness. 

For the first time this week, I slept through my witching hour and managed to get more than 4 hours of sleep in a row. I woke up unreasonably early, at an hour when I typically would have said "it's the middle of the night." And even though I still only got 5 hours of sleep, they were consecutive. Wow! I am refreshed.

And so here I sit in a darkened living room, a fireplace flickering away, cup of coffee beside me, while the rest of the house sleeps.

Good morning, Dad. 

When NOT to Tell Someone You're Doing "Well"

The year I turned 40 I was diagnosed with Hashimoto's disease. Oh My God!! you say, are you okay?!

I'm so okay I forgot to mention it to some members of my family.

Hashimoto's is an autoimmune disorder in which your body attacks your thyroid, reducing the amount of hormone produced naturally by the body. The treatment? Take safe and common hormone replacements to bring the body into balance. But also see your endocrinologist often for a simple blood test in which your hormone levels are monitored so your doctor can determine when you need to step up the hormone replacement dosages, because your body keeps attacking your thyroid until you need full replacement hormones.

For six years I have been seeing my endocrinologist, and once had him bump up my dosage. And then, two years ago happened.

In fall of 2016 at my regular check-up, I reported that I was feeling tired and run-down. I could nap every day, was tired every afternoon, stopped working out because I couldn't get myself up at 5 a.m. anymore to fit it into my day. My chart indicated that I had gained 7 lbs in one year, probably a combination of fewer workouts and more sleeping. But, my dad had also just passed away, which added a new level of stress to life, making all of the above explainable as well.

They drew blood for the blood test, and a week letter I got a letter that my levels were within normal range, and that based on my report the doctor did not see a reason to make an adjustment, see you next year.

I found myself back the following November, giving the same report: I'm tired. I sleep a lot and could sleep more. I don't have the energy to work out. And my hair was falling out in copious amounts. I could see my scalp through my hair and it was devastating. Others said they couldn't tell, but I could and it bothered me.

I had also read the book "Hashimoto's Protocol" by Izabella Wentz, a pharmacist who self-diagnosed her own Hashimoto's in her late 20's. When she reported to doctors that she had no energy she was told that "people slow down as they age." She retorted, "Really?! 29-year-old's slow down?"

This time I had the blood draw done in advance so we could discuss the results at the appointment. But the doctor (and truthfully, I) forgot that I'd done that so we didn't check the results. The doctor walked into the room and said, "Hi how are you?" To which I replied, "Well." Because, as the CEO of a company I used to work at says, replying by saying "good" is not proper grammar. (I partially blame him for my two-year mistreatment.)

I then proceed to tell the doctor of my woes. I'm not sleeping well and can't sleep enough. My hair is falling out. I lack the motivation to work out. My thinking is fuzzy. I am sluggish and can tell I've gained weight. This year's report? Another 11 lbs, 18 lbs in total in two years. I have never gained this kind of weight in my life in such a short period of time. Does this sound like me? No.

He informs me that hair loss is not a symptom of Hashimoto's, nor is the kind of insomnia that I experience.

Really? It's all over in the support groups, the book I'd read, anecdotal stories others with the condition had told me. Well, he informed me, RESEARCH indicated that it wasn't, despite all of that "other" evidence.

He does a blood draw, because I stupidly forgot I'd been there the week before for a blood draw (it was an early morning appointment), and a week later I get the same form letter: levels are within range, no change needed.

Did he not hear a word I said?

Turns out, he didn't. I called the clinic several times and when I didn't get a return phone call I drove down unannounced and had a confrontational face-to-face with him about it, both about the missed blood test and my oral report which he ignored. He finally agreed to make a small adjustment to my dosage, and within a week I felt improved energy.

After this experience I changed from an endocrinologist to a whole health doctor, who informed me that my endocrinologist never tested my T3 hormone level, a key indicator in treating Hashimoto's. I had read in Izabella Wentz's book that this was a common oversight—most endocrinologist's only test the T4 hormone.

My new physician and I also got a chance to review my endocrinologist's notes from the last two visits. In both reports, he wrote "Patient reports feeling well." He noted the weight gain, but not a single word about how I was actually feeling.

I realized that my very automatic greeting of  "well" after hearing the words "How are you?" is what he wrote in his report, and he hadn't listened to a single word I said.

So...word to the wise: if you are talking to your doctor, make sure s/he is clear if what you are saying is a GREETING or a REPORT. There is a real difference.

How am I doing now?

Great. My new doctor, Dr. Richard Sinda, is fantastic. I feel listened to. I am feeling better. He and I review my results together, because he knows I'm a data geek and like data, even though half of it goes over my head. He adjusted my hormone replacement dosage and started a new one because, now that we're testing my T3 level, we learned that it was also low and needed support. I also started a bunch of other supplements and vitamins to improve my overall health. As he says, "I don't want to know how much Vitamin C a human needs to prevent scurvy, I want to know how much Vitamin C a person needs to be in optimal health. There is a different between a lack of sickness and optimal health."

As for the weight, well, I now have the daunting task of losing it. I know what I need to do, I just need to do it. Move more, eat less (and better food choices). Hopefully it will come off as quickly as it went on, I'm giving me two years because that's the healthy way to do it.

So that's the latest. For anyone who is diagnosed with Hashimoto's, I highly recommend Izabella Wentz's book. I did not follow the protocols she recommends, though I am sure that if I did the weight would just fall off. Her dietary changes and supplements were a bit daunting and seemed overwhelming to implement, which is why I sought a whole health doctor who helped me implement the ones that made sense for me.

One more lesson learned that the person who can best advocate for your health is YOU. My health languished for two years; it could have been longer had I continued with my same doctor and hadn't advocated for myself. I'm glad I finally made the change needed for my own health.

Sleepless No More

I am sitting in a darkened house with a cup of coffee, looking out at a winter wonderland, piano music softly playing from our living room speaker. I am finally doing one of my favorite activities that has been absent for too long: writing.

These quiet moments are rare.  For years I have suffered from insomnia, which means that on weekends I "sleep in" until 8 or 9 sometimes, catching up on the sleep I missed earlier in the week.  Weekends I finally get a full 8 hours of sleep, even though it takes me 12 hours to do so. Usually by the time I'm up the girls are up and the day's activities have begun.

Today, they are still in bed and it is quiet. I began writing at 6:30 a.m.

I had been in a slump this summer and part of this fall, though others couldn't tell. My Fitbit that I got for my birthday in the spring informed me of how very little sleep I was getting, yet at the same time how much. I would awake in the morning thinking I'd barely slept 3 hours, only to find that I had slept more than that but hadn't thought so.

But really, what's the point of knowing you got seven hours of sleep when you feel like you got three? Knowing that I'd gotten more sleep than I thought would energize me for a time, until physical fatigue set in. I'd convince myself that I really should be able to function; after all, I got seven whole hours of sleep! But I still felt exhausted because the sleep was so disjointed. I would wake up around 2:00 most every night. Some times I fell right back asleep, but most nights I would lie awake until at least 4:00 if not 5:00. Occasionally I was up for the day.

Morning meetings are a bitch when you've already been up for 8 hours by the time they occur, much less afternoon meetings. People at work thought I was a morning person, but that was only because morning was actually my afternoon considering the time I got up for the day.

My wise husband, who has talked to me over the years about my sleeplessness, finally convinced me to do something different about it than what I'd been doing before, which was, really, nothing. I had read every resource about getting good sleep, followed every recommendation. I went to bed at about the same time, have a bedtime routine, used lavender,  tried melatonin, insert well-intentioned person's advice here. I had tried over-the-counter sleeping pills but they made me groggy upon waking. Despite all attempts, like clockwork my eyes would pop open at 2 a.m.

My doctor informed me that if I hadn't been waking up in the middle of the night previously that I would start to do so, as women in "my stage of life" often have hormones fluctuate mid-sleep cycle and for some it causes insomnia.

What kind of walking zombie was I going to become?

I finally tried something I had never done before, something that was always a last ditch effort for me: a prescription sleeping pill.

What a novel concept, right?

Sleep aids are one of the most commonly prescribed medications, and I only finally decided to consider them.

My mother has always been hesitant to take prescription medications. Her life's experience led her to have no trust in pharmaceutical companies, and her skepticism is not unfounded. Just like any parent/child relationship, her values have rubbed off on me.

My mother expressed concern that sleep aids cause long-term memory loss and confusion. But guess what else does: lack of sleep. And here I was, wasting hours of my life attempting to sleep while not having the energy to get my exercise in, being cranky with my family, masking my fatigue at work, and never trying a sleeping pill.

After discussing options with my doctor and expressing my hesitation at taking Ambien, which was his recommendation, he finally convinced me to try it with one caution: Never, EVER take it if I've had any alcohol at all. Yes, sir. (And then he and I compared our favorite wines.)

The first night I took one I let my husband know to be on the look out for any weird behavior, and that if the kids needed something in the middle of the night he was on-call. I dutifully took a sleeping pill and went to sleep.

I woke up with my alarm at 6:30.  I was refreshed, not groggy. I cannot describe to you the feeling of having a full night's sleep for the first time in what felt like eons. All day I walked around with a giddy smile on my face. I couldn't believe how good I felt!

It's been a few months now since that first experience, and I am a changed woman. I sleep through the night. If I awake in the middle of the night I fall back asleep usually within 30 minutes.

I started doing my fitness routine again, first just on weekends (when I used to get my catch-up sleep), and then rising earlier during the week as well. I'm back up to exercising three times a week, and I feel AMAZING. Exercise gives me strength and energy, and I'm thrilled to be getting the rest needed to be back at it.

I feel like my life is back on track. It's incredible what sleep can do for a body.