A month ago I started seeing a new primary care physician.  I was nervous after my first attempt at a PCP switch resulted in my wanting to run away in horror.  But I am happy to report that I adore my new doctor.  His name is Dr. Witana and he’s an internal medicine doctor.  When I told my brother that I needed to find a new doctor due to an insurance change he told me to look for an internal medicine doctor.  My brother has had his fair share of health issues  and saw tons of doctors until he went to an internal medicine doctor who helped him immensely.  He’s down over 30 lbs and feeling better than ever. So thanks, big bro for the excellent advice!

My first appointment was February 9th.  I called only four days prior and they were able to schedule me right away which was a very good sign.  I had all the regular nerves going into the appointment, maybe even a little more than usual.  But the nurses were nice and they sat with me for almost 40 minutes entering all of my information into a computer program that they use to store all their patient records.  They also had me answer a series of questions pertaining to my complaints.

By the time I got to see the doctor I felt at ease and ready to be open about all the issues that have been plaguing me.  The main issue I wanted to discuss was my weight and my anxiety that has been getting progressively worse.  Based on the series of questions the nurse had me answer the doctor started addressing another issue that I had no real intention of discussing with him:  depression.  He told me based on the my answers that I was considered severely depressed and that I had moderate anxiety.  He asked me where the depression was coming from and I immediately started crying.  He asked Ramses to leave the room so we could discuss things privately.  I explained that last year was extremely difficult what with Ramses losing his job and struggling financially but I revealed that I’ve had signs of depression since I was probably 12 years old.  I decided not to get into the issues from my childhood but I explained that being diagnosed with cancer as a (very) young adult effected me deeply as well as my infertility and my miscarriage.  He was very kind and gentle as he listened and comforted me.

He went ahead and prescribed me with an anti-depressant/anti-anxiety medication called Cymbalta and ordered a series of lab tests.  I left the office after over an hour spent with the nurses and doctor drying my tears and feeling optimistic.

I took my first Cymbalta that same night and two hours later a horrible headache set in and I threw up my dinner.  The week that followed was terrible.  I started researching the side effects of the drug and sure enough I had nearly all of them:  nausea, headache, fatigue, vomiting, trouble sleeping, night sweats, dry mouth, shakiness, and a general feeling of fogginess.  It  felt like I had a really bad flu.  The symptoms persisted for about 6 days without easing up.  I called the doctor on day 4 and he said to stay on the medication for a few more days.  And like magic on day 6 I felt great.  Also, on day 6 was the first test of whether or not the pills were doing their job when we woke up to find our that our little Kai had a huge swollen booty.  I surprised both myself and my husband when I handled the situation with complete calm and level-headedness.  It really was amazing.  Our little guy needed surgery but he’s 100% better aside from his unevenly shaved right butt cheek.

Early last week I went to the lab to have my blood drawn for the testing Dr. Witana ordered and went into to see him last Friday to go over the results.  It turns out that he had them run over 80 tests and this what they found:

• High triglycerides (fat in the blood)
• High TSH (thyroid hormone)
• High Blood Sugar (the early stage of type II diabetes)
• Borderline High Blood Pressure

The high TSH was expected.  As a Thyroid Cancer survivor my endocrinologist purposefully prescribes a high dosage of  thyroid hormone.  This is meant to suppress whatever minute thyroid gland that may still be in my system to reproduce.  And no thyroid means no thyroid cancer.  However, my new doctor thinks I should lower the dosage because the excess hormone may be effecting my pituitary gland.  He forgot to write a new script for the lower Synthroid so I plan on emailing him to discuss my concerns for lowering the dosage since I failed to do so in his office.  When I first saw him I told him that my endocrinologist is Dr. Dial and he said, “Oh!  Dr. Dial and I are good friends.”  Another plus for my treatment.

The high triglycerides, blood sugar, and blood pressure along with excess belly fat equal something called Metabolic Syndrome.  Which basically means that all my excess fat is effecting the way my body produces hormones and puts me at higher risk for heart disease and stroke.   It is also suspected that I have PCOS (Polycystic Ovary Syndrome) and that I am insulin-resistant.  Surprisingly or not surprising all of these things are related to each and all can be treated with the same medication called Metformin (Glucophage) along with a low Glycemic Index (GI) diet and exercise.  I was supposed to be tested for PCOS along with the other tests but the box didn’t get checked on the lab slip.  I will get more labs done this week and see the doctor again in a month.  I was familiar with Metformin and it’s treatment of PCOS and conception.  I told the doctor that I knew what it was and that it also treats insulin-resistance.  His response, “How do you know that?!”  He was pleasantly surprised how well-researched and educated I was on my health.  He explained that he loved when patients shared the same knowledge as their doctors because it leads to greater trust between the two.

I took my first Metformin last night and so far no real side effects.  After the Cymbalta hell, I am grateful for that.  Now I get to work on sketching out our meal plans and getting my butt on the treadmill.  This rhino need to turn into a unicorn!

Well, I did it again…  I procrastinated myself into a corner.   Every tax season I avoid the inevitable, my least favorite part of my job, the annual 1099′s.  It entails massive amounts of paperwork and endless data entry.  So, needless to say I dodge it like the plague, if indeed, the plague could be dodged.  This year I really screwed myself by putting it off this long and if I’d started last week I think I would have been OK.  But the lousy, lazy weather made me convince myself to play games on Facebook and just veg out.  Now every minute of my regular blogging schedule will be filled with accounting.  Joy.

I will be back on Monday, 2/1/10 with my target three blogs a week here at My Mount Everest.  I just got my new medical insurance card with the new primary care doctor.  So, come the 1st I hope to have stories of making my first appointment with him.  Hope everyone has a better week than me!  Signing off…

I do regret slacking off at work though.  I have a pretty big deadline looming and I have been bundled up in the office either blogging or  gathering animals in Zoo World on Facebook.  Eh.  I think I may take some work hoe with me this weekend to help ease the guilt a bit.

As I type I am listening to the pouring rain on the roof of my office.  It’s so nice to be inside and enjoying the rain.  But it’s horrible to be out in it.  The drive in this morning was terrible.  The streets near my house AND near my office were flooded and the freeway in between wasn’t much better.  Quite a stressful drive.  Then the walkway between my parking spot and the office was completely flooded.  I soaked my shoes, socks, and jeans walking through.  The socks and shoes have finally dried but the pants, not so much.  All I can keep thinking of is my nice warm bed, I can’t get there soon enough.

We got home around 9am and I went straight back to bed.  Ramses joined me and we slept until 11am.  When I woke up my nausea was gone but the migraine was in full force.  So, we lazied around all day catching up on TiVo and watching Chuck season 2 on DVD.  My headache finally went away around 7pm… 14 hours of brain splitting pain!

When I woke up yesterday I felt much, much better but I felt really sluggish.  Fast forward to this morning and my energy still isn’t back.  I think it may be a combination of being sick on Saturday and the rainy weather.  All I really want to do is curl up in bed with my husband, my boys, and a book.  Instead, I am stuck here at work staring at a huge inbox and a looming Jan. 31st tax deadline.  Joy.

Here’s hoping tomorrow is a better day, not expecting any sunshine but I’d settle for just a sliver of motivation.

The next day I called PacifiCare and changed my primary care doctor.  I did some research and found another doctor that was highly recommended through various websites.  The change won’t take effect until February but as soon as the calendar flips I am calling and making another appointment.  There is a chance that I won’t like this doctor either but I am willing to keep looking until I find someone I trust with my care.

I will no longer just except what is handed to me, I have to strike out and work for what  want.  Finding a new doctor is just a small part of this recent realization.  This new sense of self worth is radiating throughout me.  I deserve to be healthy, happy, and everything I have ever wanted to me.  This is huge for me.  I think this is what I have been waiting for.  It’s a little difficult for me to articulate but I feel it so strongly.

I’ve spent the majority of my life feeling like I deserved the lousy things that have happened to me.  I deserved to be abandoned by my father.  I deserved the cancer.  I deserved to be overweight.  I deserved to be infertile.  I deserved my miscarriage.  I’ve spent years feeling like I wasn’t worthy of having the life I wished for.  And the happiness I have found has felt like a fluke in many ways.  I had no idea how I was lucky enough to land such a perfect husband, a beautiful home, and my sweet pet-kids.  But now I feel like I deserve the good things.

I think the key to getting healthy is to truly believe that I am worth being healthy and that I am worth taking care of myself.  This feels right.

Umm… So, yeah… the new primary care doctor?  He’s not going to work out.  I had a clue as to what kind of doctor’s office this would be when I called to make the appointment.  As I mentioned in another post the phones were busy for more than 4 hours and when someone did answer I was put on hold for 21 minutes.  When we drove up to the medical building I noticed that the parking lot butted up against our favorite taco joint as evidenced by their highly- visible and freshly graffiti’ed dumpster.  Strike one.

When we walked into the tiny office it was packed to the gills with people, none of which were speaking English.  All the signs were in Spanish except for the big yellow one in the middle of glass separating the desk from the lobby stating “We do paternity testing!” yeah, so does Maury Povich, not exactly something to be so proud of.  I sat on the only available seat in the center of the room and filled out my preliminary paperwork with the late afternoon sun beaming in my face and half blinding me.  They had a small oscillating fan in the corner futilely attempting to cool the mass of people stuffed inside.  Oh, the sign on the door (pictured above) is exactly how I felt.  Strike two.

After the standard weigh-in and blood pressure check the nurse with the sharpie’ed eyebrows led me to an exam room.  It was spacious and cold.  Then the doctor entered mumbling “Buenos Noches.”  I kid you not,  he looked like he stepped off the set of a that Cheech & Chong movie, “Up in Smoke” from 1978!!!!  Tall, slender, long, curly hair, and bloodshot, watery eyes!  When I said, “hello” he realized I didn’t speak Spanish and switched to English, a slow, drawn out, just-took-a-big-hit-off-a-bong English but at least I could understand him.  He seemed nice but way more spacey than any doctor should be.  Strike three.

So, I cut the visit as short as possible telling him I only needed a referral back to my endocrinologist, knowing full-well I had no intention of continuing to see him.  I will see my endocrinologist in March or April and ask him then what primary care doctors he would suggest then start over again.  I am serious about getting my health on track this year and that means not settling for a doctor I’m uncomfortable with.

I didn’t visit doctors a lot when I was growing up.  We didn’t always have insurance and couldn’t afford regular visits, it was more like urgent situations only.  I first discovered the lump in my neck when I was 18 years old but my lack of experience visiting the doctor lead me to dismiss it.  I ignored it for 3 years.  And I only went because I was scared out of my mind about the lump that had grown to a size that made it difficult to breathe when I laid down at night to sleep.

I remember the precise moment that I decided to stop ignoring it and get it checked out.  It was my 21st birthday.  I asked all my friends to make me something or perform something to show me how much they loved me =).  We all got together that one of my best friend’s houses, they made me breakfast and then performed all the things that they prepared for me.  We were all having a really great time but in the back of my head I kept thinking that it could be my last birthday ever if I didn’t find out what the thing growing in my neck was.  After they sang to me I blew out the candles and wished for the courage to take care of my health.  Two weeks later I was sitting in a doctor’s office.

Since that fateful day back in 2000 I have seen more doctors, nurses, and interns than I can count.  And I have been fortunate enough to mostly receive good care from compassionate professionals.  But there is no shaking that fear.

There was a point in last night’s episode where the brand new contestants enter the gym for the first time to find their first challenge staring them in the face:  26.2 miles on a stationary bike.  I watched as their happy faces dropped and were replaced with grimaces.  At that moment I had a very strong reaction.  I got mad.  I yelled at the TV, “Come on, people!  If you think you can’t do it before you even try then you shouldn’t even be there!”  That is what they came there for, to be challenged.  But more importantly, to change their lives.  They were given an opportunity that hundreds of thousands for people would jump at.  And they were boohooing over having to bike a marathon, technically a half marathon since the miles were divided between the teams of two.

I realize that I am watching from the comfort of my living room and that most of them are not used to any physical activities at all but it’s the “I can’t” mentality that got them in the situation to begin with.  If I were in the situation where I came to a place solely meant make me lose weight my mindset would be right.  And to be fair not all of them had looks of horror on their faces and that is right attitude.  The “bring it on, ready for anything” attitude.

I am by no stretch of the imagination in shape but I am no stranger to pushing myself physically.  I’ve worked out with all types of people at varying fitness levels and I’ve seen many of them break and stop well before their true breaking point.  I can honestly say there has never been a workout I didn’t finish.  I would sooner crawl across a finish line than stop before it.  Sure, I may need to modify things in order to finish but I always finish.  It’s the starting I have issues with.  But once I am on that treadmill or in that gym I will go until it’s done.  Once I did 16 miles on our recumbent bike without a second thought.  Sure, my knees were shot for a week after (since I have a big tummy and short legs the fit of the bike is awkward) but there was no stopping me.

Now, what I need to do is find a way to use that fighting spirit to my advantage.  I need to get myself to start so that that “no quit” attitude can take over.  Being chosen to be on a show like The Biggest Loser would definitely work but that is not happening.  I need to find a greater motivation than a truckload of money and millions of people watching me.  The rewards of a healthy life are a far better prize than winning a game show.  I just need to keep my eye on that prize.

My health insurance stopped covering the physicians network I have been on for the last eight years. In the beginning of December I had to switch primary care doctors. Luckily, I found a new network that also covered my existing endocrinologist so I won’t need to stop seeing him. I made my first appointment with the new doctor for next Tuesday. I need to get him to approve my referral back to my endocrinologist and I just wanted to meet with him.

I am hoping that he’s a good doctor that will take his time with me. No offense to my last doctor, because I found him kind and approachable, but I felt like he never really listened to me. It seemed that every issue I went to him about was dismissed by, either himself or his nurse practitioner, as simply remedied by losing weight or taking the herbal supplements he sold. I went to his office a few years back because I was having terrible attacks in the middle of the night that included horrible stomach bloating and pain, back pain, vomiting, and chest pressure. The nurse told me to stop eating fatty food and get off the couch more often. After a year of more attacks I finally had one that landed me in the ER. After 8 hours on an IV drip, several shots of morphine, and nausea medicine a simple ultrasound confirmed that I had a large gallstone nearly the size of the gallbladder itself.

Granted, gallstones are a condition that often comes with obesity, it would have been nice to have a legitimate diagnosis a year prior since I have finally gathered the courage to see a doctor about my concerns.  When I went to see my doctor for the referral to have the removal surgery I expressed that I was concerned that they did not find the real problem it to which he replied, “Well, gallbladder attacks don’t usually include back pain.  Now, let’s talk about why you are so big.”  He scheduled me an appointment with one of his in-house nutritionists and I spent 8 months buying expensive meal-replacement shakes, bars, and various supplements.  I won’t even get into how expensive it was to go on the cleanse that is required once a year on the program.  All that being said the best thing I got out of that experience was meeting my lifestyle therapist, Jodi.  She touched my life in a profound way even if no substantial weight was lost.  She has since taken a different job within the same company and we keep in contact still.

When I called my new doctor’s office yesterday I received a busy signal the entire morning.  I finally got through at 3pm and was put on hold for 20 minutes.  Not a very good first impression but I am willing to give it a shot.  I will approach this new doctor differently than I have in the past.  He works for me, I am paying him, so I expect him to listen to me.  Plain and simple.  In the past, I was always content being dismissed because that must mean it’s not that important.

I spent a some time typing up my medical history as reference for our first visit and that was a sobering walk down memory lane:

Thyroid Cancer:

APR 2001         Partial Thyroidectomy (right lobe w/ isthmus) due to large lump on gland.  Diagnosis:  Thyroid Cancer (Papillary Carcinoma w/ a Follicular Variant.)

APR 2001         Complete Tonsillectomy.

MAY 2001         Partial Thyroidectomy (left lobe) to remove remaining thyroid gland.

JUL 2001           Radioactive Iodine Treatment I-131.  Treatment successful in eliminating all remaining thyroid tissue.

AUG 2001-        Monthly check-ups and lab work to measure Thymoglobulin levels.

AUG 2002

AUG 2002-        (5) Total Body Scans using I-131.  Results all normal.  (10) Lab work

PRESENT         ups to measure Thymoglobulin levels.  Results all normal.  (5) Chest X-rays.  Results all normal.

Gynecological Issues:

JAN 2002-         Yearly Pap tests all normal.

PRESENT

JAN 2006          Visited Dr. Bryan to express concerns regarding our inability to get pregnant.  Periods are very irregular when I am not on the pill and even after 10 years of unprotected sex we never conceived.

JAN 2006          Endometrial Biopsy.  Results normal.

JAN 2006          Ultrasound of uterus.  Results normal.

FEB 2006          Complete fertility lab work for both myself and husband.  All results were normal.

MAR 2006         Hysterosalpingogram (HSG).  During procedure technicians found the right fallopian tube blocked.  Attempted to clear blockage using dying agent but it did not work.

APR 2006         Visited Dr. Ojeda (Dr. Bryan left office) to go over results.  He verified that the right tube was blocked but said only one tube was needed to get pregnant.

APR 2006         Prescribed Clomid.

MAY 2006         Became pregnant on first round of Clomid.

JUL 2006           (3) Ultrasounds confirmed miscarriage (fetal demise.)

JUL 2006           Dilation and Curettage (D&C) preformed.

Gallbladder:

FEB 2008          ER visit due to gallbladder attack.  I had attacks for approximately 5 years before an ultrasound in the ER confirmed gallstones.

MAY 2008         Gallbladder removal.  Endoscopic surgery.

It felt good to get all that info out without any emotion involved.  Just the facts, ma’am.  I apologize for any TMI.  When I read back over it and thought of just how many tests and procedures I have been through in the last 10 years I realized that there have only been 3 crushing instances of bad test results:  The cancer diagnosis, the blocked fallopian tube, and the miscarriage.  In the big scheme of things that’s not a good average.  The majority of test results have been normal or better than I imagined.

I have some issues I’d like to discuss with this new doctor and I feel confident that I will have the courage to just put it all out there and not take “it’s just your weight” as an answer.  I want tests, I want confirmation, and if needed I want medication to help me feel better so that I can help myself lose this weight.

New year, new me.  Even though the New Year’s resolution to lose weight is trite, when inspiration hits I need to take advantage of it.  So here I sit still at the foot of this enormous mountain.  2009 was a rough year filled with unwanted changes and struggles to find my footing and the result on the scale is evident.  I gained 20 lbs in the last fourteen months or so.  It amazes me to think that in 2008 I was seeing a nutritionist and a personal trainer and I started this blog only to sit here typing a scant year later heavier than I have ever been.  I had all the tools in my hands for success and it just didn’t work out.  And I know why.  Although I had all the means to lose weight, I wasn’t ready.  My head was so stuck on the struggle of it all that I never did enough doing.  No nutritionist, no trainer can provide me the actual tools needed to get my big butt up this mountain, only I can do that.

Six months or so ago I started thinking about what, at the time, I felt was my catastrophic failure.  I beat myself up.  I could not fathom how I did not find success when I had every possible thing working in my favor.  Then I realized that even though things were on my side to make my success possible I was still sabotaging it.   Why?  Well, I thought long and hard on that question.  The conclusion I came to startled me.  I wanted to fail because I did not feel like I deserved to succeed.  I was given a second chance at life when I beat the cancer and what did I do with that chance?  I rolled it in bacon and threw it in the deep-fryer.  I have packed on 55 lbs since the cancer.  Granted I wasn’t at a healthy weight leading up to the cancer but one would think that being faced with my own mortality would have led me down a path of better health.  Next year I will celebrate 10 years cancer free and I will officially be “out of the woods” as my endocrinologist tells me.  But instead of celebrating my life free of health concerns I allowed myself to fall victim to all the life-threatening diseases that go hand in hand with obesity.  And I am finding it difficult to forgive myself for that.

I am angry.  But I think that’s what I needed to really make me want to change.  I’ve been pitying myself for a very long time.  And that pity has led to me to morbid obesity.  The one thing I fear more than anything is dying. I was forced to come face to face with that fear when I was only 21 and I am not kidding when I tell you that that thought is always in the back of my mind.  The thought of leaving Ramses alone kills me but the path I am on is  leading straight towards that fate.

So, this is me, once again craning my neck looking for that peak.  This is my last chance and failure is no longer an option for me.