You Are Feeling Very Sleepy…

A number of Tamoxifen’s possible side effects:

Excessive tiredness

Depression or anxiety

Weight gain or loss

Increased bone or tumor pain

Thinning of hair

Hot flashes

Some symptoms of stress can include:

  • Fatigue
  • Depression
  • Excess eating or smoking
  • Poor memory
  • Increased alcohol consumption
  • Anger/hostility
  • Difficulty making decisions
  • Frequent mood swings
  • Negative thinking
  • Distractibility
  • Feeling overwhelmed or helpless
  • Muscle tension or pain
  • Change in sex drive
  • Stomach upset
  • Sleep problems

Signs of Menopause

Sleep problems

Mood changes

Weight gain and slowed metabolism

Hot flashes

Chills

Thinning hair and dry skin

Change in sex drive

In late July, I visited my rock star gynecologist, Dr. C., and we were discussing how I was feeling. Considering the stress I was under thanks to being let go from my position in late June–as well as understanding the side effects of Tamoxifen (on top of recognizing the impact of menopause) it didn’t seem that far fetched that I would be moody, have rapidly gained back much of the weight I had lost in the spring, have issues with sleep, have muscle aches, and feel EXTREMELY tired, exhausted frankly, finding it hard to concentrate. Life can wipe a girl out, right? Dr. C was sympathetic and we compared our stressors, but she also ran my blood work–and made sure it included looking at my thyroid numbers.

The numbers came back concerning, but considering my age and none of the usual risk factors showing up in my history, she was more concerned about doing an ultrasound and uterine biopsy to see what was going on after a couple of post-menopausal menstrual periods, than delve into possible thyroid issues.

Thanks to end of summer scheduling conflicts for her and a new job with a waiting period for insurance and sick days to kick in for me, I didn’t get in to see Dr. C again until early October. The extreme fatigue continued, as did the weight gain and moodiness bordering on depression. But, come on! There was an extreme amount of stress going on in all areas of my personal and professional life, not the least of it being that my new job starts at 7:15AM…

Hypothyroidism signs and symptoms may include:

  • Fatigue and sluggishness √
  • Weight gain√
  • Depression√
  • Increased sensitivity to cold√
  • Constipation
  • Dry skin√
  • Brittle nails√
  • Impaired memory√
  • Puffy face√
  • Muscle aches, tenderness and stiffness√
  • Pain, stiffness or swelling in your joints√
  • Thinning hair√

The test results came back in early October: hypothyroidism. And it really didn’t hit home right away what this meant. In early November, I wrote in the post, Comfort in the Overlap:

Oh, yeah, and the blood work that Dr. C had done in late July and again in October showed that I have hypothyroidism so when I went to the new primary care physician about my pre-surgical clearance, I was given a prescription for Levothyroxine. Trying to wrap my head around the idea of needing to take this medication the rest of my life is kind of a trip, but first things first.

I began taking this synthetic drug Levothyroxine after the appointment, but truthfully, I was more obsessed about the other stuff–ie. the really weird stress test to the outpatient D & C–than dealing with the diagnosis related to my thyroid. Eventually, when all of the other hoopla calmed down, I started to want some clarity and understanding, so I started to do my research on hypothyroidism.

Simply put, hypothyroidism (underactive thyroid) is a condition in which your thyroid gland doesn’t produce enough of certain crucial hormones. Ok, so? As Carolyn L. Todd wrote in her Self article last year:

Having an underactive thyroid proves that even your smaller organs can have a mighty effect on your health. As you read this, a tiny butterfly-shaped gland at the front of your neck is commanding a slew of your body’s most important functions. This powerful organ is called your thyroid gland, and it influences things like your heart rate, digestion, mood, menstrual cycle, and energy levels—essentially various factors of your metabolism, which is a fancy way of saying the way your body uses energy. As you can imagine, if you have an underactive thyroid, things can feel pretty out of whack.

Hmmm…maybe my life being out of whack isn’t all about how the world is impacting me, but how my body is interacting with my world? Has the lens that I view my world fogged over and I didn’t know that it had even happened?

I was fried, but trying to press on anyway.

That’s how I felt going into a 5-day Thanksgiving break and again a month later going into a 2-week Christmas break. A couple of the symptoms of hypothyroidism really were noticeable for me, but the extensive and intense fatigue has been the most significant–and the one hardest to get people to understand…including myself. I slept a lot over Thanksgiving break and also over Christmas break.  I continued to row as Recovery on Water transitioned inside, but I had to basically hit a pause button on my ‘training’ to race and take a detour into rowing for the exercise, where rather than celebrating improvements in my times or distance, I had to focus on feeling good about showing up and getting a workout in. Not the same kind of adrenaline rush there, folks.

I started to notice some improvements with the help of the medicine, but I really wasn’t feeling like ‘me’ going into the holidays. The whole situation was so subtle! We always struggle to get the tree up and decorated, but this year the process took 3 weeks!!!!! I traditionally put off holiday cards until the last minute, but always rally. Until this year. Nope. No New Year’s cards either and I couldn’t even send last ditch Valentine’s cards. I went to our ROW holiday party in mid-December and while in an environment where I am usually really happy and move around from friend to friend and socialize, I was feeling isolated and monopolized Coach Sheena’s time discussing her father’s progress since he was diagnosed with thyroid cancer–trying to find understanding and hope in regards to my own condition. I’ve found that if I push too hard in an erg workout–because I am feeling closer to my old self–it can lead to feeling wiped out if I don’t give myself time to recharge with a nap. Imagine needing to pull your car over so you can take a quick nap while running errands mid-day on a Sunday, because you pushed it a little too hard during your feel good Sunday morning row? Not fun.

A two-week Christmas vacation definitely helped balance things out, but it didn’t take long to start feeling tired and moody and ‘not quite right’ when I headed back to work. I had a discussion with Coach Lily early in January at a practice about being frustrated that after more than 2 months on Levothyroxine, I was still feeling fatigued and out of sorts so consistently–and worried that my symptoms were all in my head rather than the dosage not being quite right. Her story of having mono–but not knowing she did–while rowing competitively in college helped me feel hopeful.

When I returned to my doctor mid-January, with new blood test results in hand, I had lots of questions and because of our prior interaction, I wasn’t feeling all that confident about finding any answers. However, the appointment ended up being extremely beneficial and Dr. K and I were able to bond. We were able to have a really good conversation–with plenty of give and take–and come to an understanding of one another. This understanding was definitely lacking in our prior visit. Anyway, mainly, I wanted to know what in the world had caused my hypothyroidism and if the dosage of my Levothyroxine was correct. Turns out my hypothyroidism is because of Hashimoto’s disease. And

What is Hashimoto’s disease you might ask?

According to Cleveland Clinic:

Hashimoto’s disease is a disease that affects the thyroid gland. It is also called Hashimoto’s thyroiditis, chronic lymphocytic thyroiditis, or autoimmune thyroiditis.

What causes Hashimoto’s disease?

Hashimoto’s disease is an autoimmune disease, which means the body’s immune system is attacking its own cells and organs. Normally, the immune system protects the body against infections caused by bacteria, viruses, and other harmful substances. In Hashimoto’s disease, the immune system makes antibodies that attack and damage the thyroid. As a result, the thyroid gland becomes inflamed and hypothyroidism can develop.

Great. My body has been attacking itself. Wonderful.

The good news is that the synthetic drug Levothyroxine is effective in the majority of users, but it does take time for most people to adjust to its use. I started with a 50 microgram dose for my first 3 months and now we have raised it to 75 micrograms. The literature–from the American Thyroid Association to the Mayo Clinic to the Cleveland Clinic give pretty cookie cutter, one size fits all advice, which is good for the basics, but this becomes an issue if your body doesn’t snap itself into shape. Should I freak out and feel that everything is failing when after 4 weeks on the new dosage, where I’ve been feeling gradually better and catching glimpses of an energetic me (including having a really positive weekend), I woke up on this Presidents’ Day Monday feeling tired and unmotivated, wanting to just snuggle back under the covers? If I leaned solely into the above sources, I would start to think there is something wrong. But then I find the American College of Endocrinology’s site–that has been given a ‘Best Blogs of 2017–Thyroid Disorders’ by Healthline and I feel better when they say, “thyroid hormone acts very slowly in some parts of the body, so it may take several months after treatment for some people to see an improvement.”

Things are improving–it is just taking time and I can be an impatient person.

Speaking of time, I have commitment issues when it comes to certain ‘lifetime’ commitments. I was 36 before I got married, I have never had a tattoo because they are too permanent and let’s not talk about my work history. I am the responsible sort so I can take on things for extended periods of time, but I sure have a hard time making those ’til death do us part’ kinds of commitments. Embracing the idea of a lifetime commitment to hypothyroid medication is going to take some getting used to. However, I don’t have much of a choice since

There is no cure for hypothyroidism, and most patients have it for life…

Hypothyroidism may become more or less severe, and your dose of thyroxine may need to change over time. You have to make a lifetime commitment to treatment. But if you take your pills every day and work with your doctor to get and keep your thyroxine dose right, you should be able to keep your hypothyroidism well controlled throughout your life. Your symptoms should disappear and the serious effects of low thyroid hormone should improve. If you keep your hypothyroidism well-controlled, it will not shorten your life span.

Looking forward to feeling this condition is in control!

 

 

 

12 thoughts on “You Are Feeling Very Sleepy…

  1. JoAnn, I’m so sorry you are dealing with this, but it sounds like you’re doing all the right things and eventually you will feel back to normal. I’m sorry you inherited the autoimmune disorder gene (must be that Cooper side), but hope you are feeling back to normal soon. Hugs! xox

    • Marilyn, thank you so much for your continuous support! You are, simply put, awesome. Give me another month, and I would love to set a monthly ‘date’ with you and Carolyn and whoever else wants to weigh in about the Coopers, ancestry, health, etc., so that we can start comparing notes more regularly. I really think the whole possible Cooper autoimmune disorder thing might actually not be that far fetched…and I think it might be very linked to the Adams side of of the family. At least we have an idea of what’s going on with me…Barb has some whacky stuff going on that remains a mystery. Anyway, loved that you all were able to get some good skiing in last month!!!! 🙂 Much love! xoxo

  2. Oh Baby! All We can say is we love you! So sorry you are having to deal with all this! Sure hope you’ll be feeling like your old self soon! We already know you are a fighter!

  3. Pingback: Weekly Round-Up: The Patient Expertise Edition | Journeying Beyond Breast Cancer

    • Thanks so much for including me in this edition, Marie! I’m very curious if other BC patients have experienced hypothyroidism and Hashimoto’s after their cancer diagnosis with the fatigue masked by Tamoxifen, menopause, stress, etc. Thank you for all you do in supporting this super cool writing community! xoxo

  4. Fatigue is a pain in the ass! Actually, that is too specific. It’s such a non-specific issue in terms of cause that it’s hard to work out. As you’ve experienced, everything can cause it!

    I’m so sorry you have Hashimoto’s but I’m glad that it is now being addressed, albeit slowly.

    I’m even more impressed with your rowing!

    • Thank you Elizabeth, for weighing in–and your support! Fatigue sucks!!!!!! I love how you say, “it’s such a non-specific issue in terms of cause that it’s hard to work out.” It helps me feel that this isn’t my mind playing head games–which means a ton. 🙂 I’m happy too, with the rowing. I’ve been trying to maintain my endurance while trying to figure out this whole hypothyroidism/Hashimoto’s thing hoping that when I can, I am able to start being competitive again. Can’t wait! 🙂 xoxo

  5. Hashimoto’s Disease?? I am glad that you explained the past tests leading up to this diagnosis because if you titled this blog , “Hashimoto’s Disease,” I would have had some um, non-PC jokes…how did they get this name??? And, Jesus, how did you get this??? After everything else?? I did not go into work (never get there anyway by 7:15 am!) today because Daniel had a stomach virus. ick Please take care! You can beat Hashimoto!

    • Well, the one good thing about Hashimoto’s has to be that I’d never heard of it before either and so it kinda sounds mysterious! 🙂 The name simply comes from the guy who discovered the disease. Stress is not a cause of this disease, but I swear, last year’s drama (especially leading up to the first blood test that spotted hypothyroidism in July) seems like it was over the top and a likely culprit. Whatever. They really don’t know what causes it. Loverly… The medicine is helping and I’m slowly making adjustments to my life, but I’m impatient! 🙂 Also, I’d been working on that post for awhile, but hadn’t realized just how isolated I was feeling about everything. The support I’ve received for this post has meant a ton!!! Getting a new job has to move into a very top priority. 7:15 and 9 hour days do not make this experienced educator happy. Hope Daniel’s virus only lasted a day or so. Hey, where are you headed for spring break? When is it? I want to come to Columbus before May 4th and stop at Denison to visit my former student Belen. 🙂 Miss you! xoxo

      • Come visit !!! We will be back from spring break…found cheap airfare from DC to Lima, Peru on Avianca Airlines…driving to DC April 18 and will be back the 26th. A short, simple trip; mainly staying in nasca. Come !

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