A ‘Grave’ Situation

My new primary care doctor is thorough, for which I am glad.  At my annual workplace medical she examined my thyroid and asked me if she could run one other test that wasn’t on the list my work requires me to do.  I said ‘of course, whatever you think is necessary’.  But then my test results (TSH and Free T4) came back showing I had a hyperthyroid and she wanted me to see an endocrinologist to figure out why. Cue Dr google.  What is a hyperthyroid?  What does it mean?

Turns out I had all the symptoms I had put down to postpartum and getting older in general.

  • Tiredness – I was struggling to get up in the mornings, feeling exhausted having just slept;
  • Heart beating hard and occasionally very fast, I’m always on the verge of feeling like I’m catching some kind of cold;
  • Pain in my neck I’d put to sitting funny at my desk;
  • Chris had noticed I was always warmer than him (very unusual because I am constantly cold!!!), I was feeling warmer in the office despite it being very cold!
  • When I got sick it was taking me a lot longer to shake it off. I caught a summer cold and the sore throat persisted for over two weeks.
  • Random sore throats that would come and go quickly. I have a toddler who exposes me to all the germs in the world??!
  • Also hand and feet numbness which has been going on for two years, my old doctor ran tests back then, nothing conclusive, decided it was probably postpartum arthritis and I would get over it soon when I stopped breastfeeding. It never went away.  It just never got worse.
  • My new doctor told me off for being underweight, I told her that was not true the scales in the office must be off, my clothes hadn’t changed. Actually I had lost 5lbs and hadn’t noticed so I was close to being underweight on the BMI scale.
  • Finally, the last thing was that I was getting quite short tempered and easily irritable. At work one day recently I slammed the phone down.  I was really mad at someone who wasn’t listening to me.  Everyone came to ask me what was wrong!  It just wasn’t like me.

None of these things I felt worth mentioning to my doctor at my workplace medical because on their own are little thing, but in hindsight perhaps I should have.  I did mention being slightly tired but put it down to being a parent of a toddler.  When in reality, Aviana sleeps incredibly well and is not a little night terror, there is no reason really why I should be tired.

The endocrinologist I was referred to was not available until November (I was referred in July), I thought that was an insane amount of time to wait so I called around looking for a doctor who would take on a new patient sooner.  Eventually I found one who was available in September so I asked my doctor to send a referral to this one.  Like magic, she managed to get me an appointment with the specialist for the following week.

So the following week, the endocrinologist asked me a few questions and took an ultrasound of my thyroid.  He explained that there were a few things that can cause hyperthyroidism and we needed to investigate all of them.  He did an ultrasound and ruled out any masses – my thyroid was swollen on the left side – just where I’d felt the pain in my neck and ignored it.  I also was now able to see what my primary care doctor had felt – my thyroid was clearly swollen.  I just thought my neck was getting fatter!  I had some more blood tests taken and my TSH levels were getting lower and my T3 and T4 levels higher, only just slightly abnormal.  Another test, TSI, came back normal – this was the test that would have given me a clear diagnosis of Grave’s disease.  The endocrinologist told me my symptoms weren’t that bad because many people with advanced hyperthyroid would be sat shaking, anxious, heart racing with their eyes bulging out.  So whatever it was it was caught early, most likely its early onset of Grave’s disease, an autoimmune disease that attacks the thyroid.

The endocrinologist emailed me to say I had a choice (I have a choice?!): to wait and be monitored or to start taking a drug that would help control my thyroid.  Of course, given a choice I will always try the non-drug route.  But then in that time period I also found out my father had a stroke because his thyroid had stopped working and has been on thyroid medications since.  I mentioned it to the doctor and he changed his mind and told me given my family history, he would prefer I took the drugs.  OK so not much of a choice now.  So here I am on 5mg of methimazole every other day.  This is a very low dose given my blood test results.

Chris picked up my prescription and the pharmacist told him that these drugs take some time to get used to and can have some nasty side effects, they printed a detailed sheet for him to give to me.  That made me feel nervous.  I did some research online and many of the side effects included nausea, headaches, upset tummy, weight gain and pretty much all the other reactions someone may have to drugs in general.  I joined a support group on facebook and learned that it is best to take the medication with food before bed.  The first day I took it I was at a party, 20 minutes after taking the tiny pill I suddenly felt like the world slowed down, I couldn’t feel my heart beating as hard or fast that it felt really strange.  I felt like a weight had been lifted off my chest.  Chris told me I looked like I was stoned.  But that didn’t last too long.  Over the next few days I started to feel less tired, I had more energy and my heart was not pounding as hard.  I guess I was ill after all, I just hadn’t noticed it.

I bought a fitbit to help monitor my heart rate.  I’ve been taking the medication now for almost four weeks and my resting heart rate has come down a little bit….however I have started to do exercise again as I have felt like I’ve got my energy back, so maybe that’s related to the exercise or a combination of the drugs and the exercise.  In general, I haven’t any side effects – I put the weight back on immediately, but not excessively and I sometimes experience nausea a few hours after taking the pill, but it’s not terrible.

I spent a bit of time researching the thyroid and infertility.  It turns out that your thyroid can mess up your fertility.  I took a look back at my TSH levels that my primary doctor tested every year for my annual medical and there were high-normal.  My Reproductive Endocrinologist never tested my thyroid, but if she did or looked at my annual results from my primary care physician some RE’s would have considered my TSH levels for fertility too high and may have given me drugs.  Perhaps this all explains my unexplained infertility after all?  I found out that thyroid tests are now included in the standard workup at the clinic since I least went 4 years ago which I am glad about.  But that doesn’t really matter right now as we are not planning to TTC.  Our frozen embryo remains on ice.  Even if we did want to TTC, the drugs I am on currently are toxic in the first trimester so that would be problematic. Plus I would have to get my thyroid levels back to being normal before getting pregnant.

Oh did I also mention that thyroid problems are relate to IUGR?  May be another explanation for something so unexplained in my life?

My next monitoring appointment is Friday.  I’m hoping for positive news that the drugs are working and I don’t need a higher dosage.

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Break break break – end of breastfeeding

OK so it’s been a while.  I took a small social media and blog break. And then I took a longer blog break than I expected.  Why?  Because Aviana practically weaned herself and my hormones went crazy.  I decided to stop pumping at work and just breastfeed at home and weekends.  Well, that lasted for less than two weeks.  My body said NOPE, my milk supply tanked and Aviana, who also caught a cold at the time, said NOPE and became less and less interested in my milk, which then also caused my supply to tank.  That was really hard.  I wasn’t really ready to give up breastfeeding.

I knew it was a risk to stop pumping at work and in the evenings, but it was becoming too challenging to keep up, and people were less understanding for my time out pumping.  I am stronger than that to give a shit about what other people think, but it was tough.  When I did stop pumping, it was exhilarating.  I gained back so much time in my life and felt in more control at work. I saved time in the mornings not having to pack my giant bag of pumping related stuff.  I really needed that.  It did mean that I also lost the time I spent catching up with friends whilst pumping went back to work.

I have barely read anyone’s blog posts and for a while couldn’t do social media because my hormones went whacky.  Pregnant people? Nope.  Breastfeeding mothers? Nope. People all happy? Nope.  I couldn’t handle it, so I hid for a little while.  A couple of my friends are still breastfeeding and honestly was sad that my journey with Aviana had come to an end.

Aviana was also going through a leap, weaning, teething, eating less and having cold after cold (probably because she stopped breastfeeding) – she was pretty miserable.  Having stopped breastfeeding I was paranoid she wasn’t eating enough.  She was only taking 2 or 3 oz of milk at each bottle feed and became really picky over her food.  I was full of anxiety over it.  Thankfully, it seems to have only been a phase, and literally the day after I said to Chris should we phone the doctor about it (her weight was starting to drop off her curve) she became a different baby.  In the last week she has been gulping down her bottles and eating like a machine.  Why do they put us through this?!?!!!!!

It turns out it is normal to suffer hormonal related extreme emotions when you stop breastfeeding.  In fact, I discovered through my online research it can actually trigger post partum depression and anxiety.  I didn’t get to that point, but I was literally going to bed crying, for no apparent reason.  Knowing that it was normal with the change in hormones helped me a lot.  It’s funny because in the past I’ve come to my blog to talk about this kind of stuff, but this time I didn’t.  I don’t know why.  I’m a bit sad about that, but I really did feel the extreme end of my emotions.

Lots of good stuff has happened since too so, I’ll save those for other posts.  And for now, I’ll say HELLOOOOO!  How are you?? I’m so excited about Christmas.  I’ve missed my blog and my lovely blog friends too 🙂

In honor of my breast feeding journey here are some of my favourite pictures…

I need some answers!!!

Unexplained infertility, unexplained Intrauterine growth restriction (IUGR), unexplained bowel problems – aka Irritable Bowel Syndrome, the bucket for all unknown bowel problems. Now I'm potentially facing unexplained joint pain and stiffness…I really hope that doesn't become the case, because I'm going to be pissed if I don't get answers!

Today I went to the doctor's because I have been experiencing progressively worse joint pain and stiffness for the past 4 months or so. A couple of months ago at my annual medical exam I mentioned that I had been experiencing numbness and tingling in my hands and feet. My doc said it was probably carpal tunnel syndrome, it's not uncommon after pregnancy as the body changes shape to experience this. She told me to try ibuprofen and if that didn't make a difference to come back and see her. I tried the ibuprofen and it didn't work. Without any sign of improvement I decided it was time to go back.

I wake up in the mornings stiff and sore in my hands, feet and more recently, my knees. It's most painful in my hands and it takes about 10 minutes or so to warm my joints up to move properly. I get out of bed and hobble as if I'm an old person. It's not getting better, in fact I say it's just getting worse as I feel sore from it during the day now. This week my little finger on my left hand locked stiff after waking up, it only lasted a few moments. But still, that's pretty freaky. I don't dare pick up Aviana as soon as I've woken up in case I were to drop her, in fact I probably wouldn't be able to lift her anyway.

The doctor thinks it is probably postpartum related because I'm breastfeeding still and my periods haven't returned yet. She's running some tests to rule out other things like Rheumatoid Arthritis, but because I don't have other symptoms she doesn't think it will be that. That would suck a lot if I have that.

Whatever it is I really hope they figure out what's going on because I am BORED of doctors not being able to tell me why I get this crap!!

Wee wee wee – all the way home

Sooooo I may have been listening to too many nursery rhymes recently, but the little piggy nursery rhyme inspired my blog post title. Haha! Actually this blog is about weeing, not pigs or nursery rhymes. Namely, it’s about Postpartum Urinary Incontinence. That’s a thing…and it’s a thing that’s not really talked about much, but….*

  • 35% of new moms experience stress urinary incontinence in the postpartum period.
  • More than 50% of women have a diastatis rectus abdominis after pregnancy. (A diastatis rectus abdominis is the separation of the abs from their central tendon and is a leading cause of low back pain, stress urinary incontinence and pelvic organ prolapse.)
  • 20% of first-time moms show severe pelvic floor muscle injury after a normal pregnancy/delivery.

So it’s actually not uncommon. And this is what I am currently suffering from at 9 weeks postpartum. 

Have you ever found yourself avoiding running, lifting, playing or laughing with your child because you fear incontinence? This is some of what I have experienced. No one should have to put up with it. It sucks! And you shouldn’t wait to let it ‘Resolve itself’ either because it probably won’t wholly. I chose physical therapy to help me to get those pelvic floor muscles back to being strong again. I want to walk, lift and run again! I don’t want to wait a year. 

If you have it, You don’t have to put up with it and be led to believe it is normal. Yes, it is not unusual to experience incontinence after labour, but that doesn’t mean you have to put up with it. 

In France and other countries like the Netherlands and Australia, postpartum physical therapy is a common treatment to help women recover from the rigors of childbirth. Yet in the United States, women have a 6-week postpartum check-up and are told to resume their normal activities.  Another issue is that although women are encouraged to do Kegel exercises, doing so can make perineal tears worse. Knowing how to do the exercises correctly is really important to prevent further damage.

So when I told my OB about my incontinence issues she referred me to a physical therapist. Today was my fourth therapy session. These sessions are really helping, mostly because I have been educated in the whole pelvic floor muscle physiology, what muscles they are connected to, how to build the muscles and train my muscles to hold in the pee better before I cough or sneeze.

It’s all about building your good posture, a strong core, hips and glutes. Everything is connected and helps the pelvic floor muscles to build up nice and strong. 

It’s also about eating the right things… did you know that sweeteners are bladder irritants? Yup, all that tea, diet drinks and yoghurts don’t help my recovery. Honestly, these are hard to give up! Especially tea because coffee is also not good either for the bladder. Ughhhh. 

It’s also about relaxation. HA! Of course I have time to relax with a newborn baby. Ummmm not. But this is the best part of my physical therapy. Breathing deeply, legs up, heating pad on my abdomen and dim lights for several minutes. Stress apparently doesn’t help the bladder either. 

The physical therapy is helping, but I am still having a few accidents now and then. I’m now able to walk a couple of miles now and hold in the pee. Several weeks ago I was fearing taking Avian out for a walk further than down the road m because I needed to pee all the time. But I’m not quite at the stage of being able to run yet. So several more weeks of therapy is still needed. It takes time. It’s also hard to fit in my homework exercises with Aviana, especially any relaxation ones. It’s also meant that I have had to hire a nanny so that I can attend my appointments, but in the end that has been a good thing because I get a little break in the week for some me time.

I can understand why it easy to just get by with urinary incontinence and put up with it rather than going for physical therapy. 1. It’s an embarrassing issue. 2. You can buy pads to cope with it. 3. Some doctors will tell you that time will heal it, so you listen and put up with it. Then a few months later when you still have it, you never find the time to make an appointment to fix it. 

Ladies, it is normal to experience postpartum urinary incontinence, but you DONT have to put up with it. Also, if you want another baby later down the road then it’s also important to get those pelvic floor muscles back into shape before getting pregnant again. Don’t put it off!!! I’m glad I didn’t.

*source: pelvic pain rehab center 

5 Surprising things about my postpartum recovery

When I was pregnant I geeked up on my pregnancy, what was happening day by day, how my body was changing, how it was going to change over the 40 weeks.  I read books, blogs, downloaded 3 different pregnancy apps and read them like the Bible everyday. Some of the articles touched on postpartum recovery, but really I didn’t pay that close attention. So there were some things that surprised me when it came to my postpartum recovery I wish I had known a little about before so I wasn’t obsessively googling!

1.Urinary Incontinence. I learned about incontinence fast. And I’m not talking about the kind of incontinence you get when you laugh or cough and just a little bit of pee comes out. I’m talking about standing up out of bed and your entire bladder falls out from between your legs into a warm puddle beneath you, with no way of stopping it no matter how hard you think about it.  Apparently postpartum incontinence is very common (1 in 3 will women suffer) – so how come I had never heard of this before?! What’s more…it can take months to recover.  When the nurse told me it should get better within a few weeks, I believed her.  But now, I am not so sure.  It has definitely got better since the immediate week after giving birth, but I am no way near being fixed.  Chris had me sit on towels on the sofa and in the car, he even put multiple layers of waterproof blankets under my side of the bed (a picnic blanket with a waterproof bottom, and one of the pads we took home from the hospital!).  Fortunately I haven’t had any real big embarrassing accidents.  I’ve been working on my kegels (I did do these when I was pregnant BTW) and trying to stop/start the urine flow when I pee.  Sometimes I can control the flow and other times I can’t no matter how hard I try, this gets me upset and frustrated at myself.  Here’s hoping the nurse was right and this doesn’t last long.

2. Night sweats.  The first night home I woke up after an hour (because that is all my sweet one would let me sleep) and I was DRENCHED – as if I had jumped into a bath in my sleep.  Weirdly, I had even managed to shape my duvet into a wet ball and was cradling it like it was my baby (that’s another story!).  The same thing happened night after night.  I suffered night sweats when I took the Progesterone in oil during IVF, so I hazarded a guess that it is hormonal related.  Again, a quick google, and apparently night sweats is very common in postpartum recovery! It is the hormones aiding the body to rid of all the excess fluid no longer needed that was made for pregnancy.  Oh OK then.  Could have warned me so I could be prepared with a few towels by my bed! Just as well Chris put those layers down in the bed for my incontinence!

3.  Body changes.  OK so I knew my body was going to change after giving birth – No shit Sherlock!  But what I wasn’t prepared for was how MY body was going to change.  Suddenly, I could sleep in what ever position I wanted.  I had got used to bending at the knees when I picked up things from the dishwasher/bottom cupboard etc.  But now I could put my shoes and socks on without having to contort myself into a yoga pose.  All of these things changed gradually when I was pregnant and now the change back was almost instantaneous…I couldn’t get out of the habit of doing my pregnancy moves! I only needed my maternity clothes for perhaps 2-3 days after giving birth, it wasn’t long before I was  able to fit back into my pre-pregnancy clothes.  Yesterday I packed away my maternity clothes and I felt an overwhelming sadness.  I haven’t packed away my maternity trousers/jeans though because they are so comfy!!! I missed my pregnant body so I had a little cry, I don’t know why I felt like that because now I have more clothes I can wear!  Part of me was also deeply sad for myself as I wondered whether I would ever wear those clothes again.  It was hard to let go.

4.  Weight loss.  Speaking of body changes…within 3 days I was down to my IVF weight and within a week I was back down to pre-IVF weight.  Some of you are probably hating me right now.  But honestly I did not expect it to be that fast, I started to worry if that was even normal.  I must have lost my IVF weight when I was pregnant which would explain why I only put on a total of 12lbs.  Remembering that I felt guilty for Aviana being growth restricted (IUGR), this just reinforced my guilty feeling.  May be I hadn’t eaten enough when I was pregnant, may be I wasn’t nourishing Aviana.  I have so many questions about Aviana being IUGR and what this means for a future pregnancy if we decided to try again.  I am hoping that my OB will shed some light on this at my postpartum appointment with the results of my placenta testing.

5.  Phantom kicks.  It is the strangest feeling…I know there isn’t a baby in there, but I was still feeling ‘kicks’ for two weeks after giving birth.  Whenever I felt something I would rub my tummy as if Aviana was still in there.  So so weird.

None of these surprises are terrible (except for perhaps the urinary incontinence being rather a pain), just wish I knew about them before!