post-parathyroidectomy #2

Oct 30, 2010

Well, severe depression has dogged me daily since the surgery (parathyroidectomy this year, not RNY last year).  My test results are all normal for thyroid function, parathyroid function, etc (and in fact my calcium is now maintaining at 9.5 which is perfect).  It could be something physical the tests don't see, but personally I think it is a combination of a biochemical reaction to the percosets they gave me for post-op pain, and a psychological reaction to that and to losing my job.

The fatigue that dogged me for many months prior to RNY and returned in the last 6-8 months may be related to the depression, or the depression may in part arise from the fatigue!  It's a bummer, because I felt like a million bucks for months after RNY.  I can't help but think that it's coincidental that I felt that could while I was in ketosis and not after, but I always think I"ve got it figured out (like with the parathyriod) and then it turns out I haven't.  Going with chronic fatigue or fibromyalgia - might be accurate but doesn't really help because there's not much they can do for that, and the origins are mysterious, which I find frustrating.  I feel like I haven't turned over every rock just yet.  I know they have meds for CFS and FM that might help, but only if i actually have the disorders (and no guarantee then), and i hate being on meds.  to me it's still treating symptoms and not the underlying problem.

my iron levels since surgery (and possibly before) are at the very low end of the range, and my RDW (red blood cell width) is at the high end of the range.  Neither is off range, but those ranges are arbitrary.  Both kind of generally pointn toward some mild anemia, cause unknown but could be i need more iron.

My RNY RP tells me not to worry about it, because the values are "in  range," but she's not the one walking around feeling like shit all the time.  Pretty much all my doctors just look at me and shrug.  They don't like mystery fatigue, it appears.  I had been avoiding iron supplementation because i have asmptomatic hep C and iron levels in the blood can trigger activity in that chronic disease.  However, I'm at the point (have been for a while) where the degree to which this fatigue is interfering with my ability to function (e.g. work, and function at home) so severely I don't care.  So I started supplementing iron at 75-100mg daily a few days ago.  I actually feel better, but that could be placebo.  We'll see how I do through the next few weeks.  I start a 2nd job November 8th and how I handle that will be pretty telling.

since i started supplementing the iron, though, i've gotten a little constipated and now--suprise!--a little rectal bleeding for the last few days.  i'm keeping an eye on it hoping it will go away, and taking magnesium to loosen up my bowels, which usually works well.  yes, i should get it checked out regardless.  i should get an endoscopy.  a lower GI.  i'm overdue.  i am stubborn and resistant to doing anything that takes up large amounts of my time and promises to be uncomfortable, even if that means taking stupid risks, what can i say.  assuming this doesn't progress in to something that need immediate attention - i will make some calls to schedule the test.  the problem is my day job is not very forgiving of time off.  and right now i need the money.  not want; need. 

on the up side, i've been walking dogs for the last couple of months and that means walking roughly two or more hours a day, sometimes briskly, often uphill.  i enjoy the work, i don't make a fortune doing it but it gets me outside and active and i love the dogs.  and, i've lost at least ten pounds since i started it.  i get paid to work out, that's how i look at it.  which is probably the only way i am every going to get this level of activity going in my life!  it's part-time, takes about 25-30 hours of my week, and leaves me pretty exhausted is the only problem.  but, being over a year out from surgery and having been stalled quite a while, and finally dropping some more baggage -- very exciting stuff.  so i'm very attached to this job for more than the meager paycheck it provides!

i have a 2nd job in the works for three evening shifts a week working resi with recovering addicts.  it's a good environment, i believe is going to be low-key, and i believe if i take really good care of myself i can manage the two jobs.  that means staying on top of my hydration and supplements, eating enough protein, etc etc.  and hopefully this iron supp will make a difference.  another things i can try, is folic acid supplementation; folic acid can also help with anemia, if in fact i am experiencing fatigue due to borderline anemia.  everything i have seems to be just inside the boundaries established by medical science as diagnostic - my weight pre-RNY, my thyroid, my parathyroid, etc. etc.  The only that matters to me is how I feel.

Anyway this is life One Year and 4 months out (roughly). 16 months.  If you ask me, I would do RNY again in a heartbeat.  I have struggles.  I do dump, and i do get reactive hypoglycemia, but only when i eat much sugar.  I didn't want that, but as it turns out it does help me make better decisions about what I eat.  I do struggle some with feeling physically uncomfortable eating some foods, although I rarely ever get nauseous or "stuck" anymore, I feel hungry a lot and yet don't want to eat much when i do.  Food often turns me off.  So I've learned to live feeling somewhat hungry and unsatisfied much of the time.  The key is I've learned to live with the feeling.  I accept it. It doesn't bother me like it would have pre-op, and food doesn't rule my consciousness.  I'm not ravenous, and I'm able to eat a lot of foods - really almost anything.  I have iron pouch.  Given the choice between the constraints on how I live now, and what it was like pre-op, and my weight loss, I'll take this lifestyle in a flat second.  I'm only 16 months out - not years - I know that.  I'm just glad I have no regrets.  

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