"Treat the disease, you win some, you lose some. Treat the patient, you always win."
~Patch Adams~



Wednesday, April 23, 2014

Hobbies.....

A very quick post this morning, but I thought this was important to share. As many of you know, I am a knitter (and I can already knit post surgery on my arm, just in very short sessions of about 15 minutes at a time.)  Check out this article in the Washington Post about the possible health benefits of knitting or other creative pursuits.

If you are wondering what this has to do with hormones.....plenty.  Engaging in a relaxing, creative activity calms the  mind, which in turn reduces stress.  I can tell you from experience that when I am super stressed, my cortisol (stress hormone made in the adrenal glands) goes way up (not good), and I burn through my hormones a lot faster (also not good because it's harder to get to my optimal levels.)

Speaking of reducing stress.............I have a fun weekend planned, including seeing Bruce Springsteen in concert tomorrow night.......oh. yeah.  Can't wait, my stress level has been through the roof lately and I'm ready to break out from the routine for a bit.  I likely won't post again until early next week, so I wish you a great weekend!

Sunday, April 20, 2014

Happy Easter!

I hope this finds everyone having a wonderful day, filled with all good things and a day that will leave you with good memories.  I had nothing special planned for today, but yesterday got together with friends for lunch and catching up.....so it has been a good weekend.  Friday and yesterday were rainy and miserable here, but today the sun broke through in the early morning, and it has been a nearly perfect day weather wise.

Went to the surgeon on Thursday for a post operative visit and suture removal.  Ten days post surgery, the scar, while large and conspicuous, is healing so much better than it did when I broke the arm last summer.

(Remember, this picture was taken only 10 days post operatively)

This surgeon definitely took more time in suturing the wound (36 stitches), and he obviously took his time in bringing the edges of the wound together carefully, which makes for less keloid tissue (the red, raised scar tissue you often see months or even years after an injury.)  After I had the first surgery in August, the physical therapist suggested that I use silicone strips to aid in wound management.  I got a package from Amazon.com (the strips are commonly used post C-section by new moms), and while I think they did help some with preventing keloid tissue from forming, they did not stay on well, and were inconvenient to use.  This time I am going to stick with using Vitamin E oil on the scar several times per day, and massaging the scar gently a few times a day to prevent adhesions.

I can make a light fist, although my thumb is still a little slow to react when I bend it.  I think that will just take time for the tendon and muscles that work the thumb to recover from the trauma of being moved around during surgery.  I'm getting some of the "zinger" pain that is indicative of healing.  I am restricted to "very light" activity with the arm.  No heavy lifting or heavy use. I can knit; I took a small project with me to the surgeon's office last week and worked a few rows while I was waiting.  The muscles in my arm still have a ways to go.....so for a while, I will be knitting in short sessions, but at least I can do it. Knitting for me is very relaxing and meditative, and the lace patterns I follow to make shawls exercises my brain.

The Friday before the most recent surgery, I had hormonal blood work done, and predictably, my hormone levels are a little off.  My estrogen level stayed pretty consistent, but both my testosterone and progesterone levels had somewhat tanked.  Stress makes a person burn through their hormones faster, and not just emotional stress (which I have had plenty of with all this arm business!).  Physical stress, like elevated pain levels, will also cause hormones to be burned faster.  My testosterone level was still over 60, which is on the very low end of "optimal", but Dr. Carr prefers my level to be up around 90.  I'm not able to inject my own testosterone because it goes in my left arm (and it's my right arm that's injured), so one of my guy friends injects it for me.  He was on vacation one week, and I was in surgery the next, so we missed two doses, which is rare.  He injected me last Monday (Dr. Carr upped my dose just a bit to get me back on track) and so I am confident my levels will get back to "really optimal" within a few weeks.  Testosterone level is vitally important, as it is the "healing" hormone, and my levels being up will help the fracture in my arm to heal.  I sent Dr. Carr a file of the x-rays as soon as I got home from the doctor's office, and he said he could already see bony callous forming, which is a sign of healing.  I am absolutely confident that without the bioidentical hormone balance, my recovery would be a lot more difficult.

One of the things I have found frustrating with these surgeries is that when the anesthesiology department calls for their "pre-op" questions and "discussion" ------ they insist I have to stop all supplements up to 7 days before surgery.  I understand the need for some supplements to be discontinued, especially aspirin (I take one each day for cardiac health), Vitamin E, and fish oil (both of which can cause issues with bleeding). The only reason they tell patients to stop all supplements is for their convenience, so they don't have to go through the list and tell patients which ones are really likely to interfere with the surgery/anesthesia.  In my case, with two surgeries in three weeks, I have been off and on my supplements for more than a month, and it shows in my blood work.  My Vitamin D level went from 87 to 60, and my DHEA dropped to about 165 (optimal is 200-400....mine is usually right around 300 or so.)  Other levels were off too.  What is annoying is that, especially in the case of the DHEA and the Vitamin D levels, these are substances that promote healing.......and they need to be at optimal levels to get me back on track!  Check out this article from Healio.com on Vitamin D levels.

If you have not yet had a DEXA (bone density scan), and you are over 50, I strongly, strongly urge you to get one.  If you have one you will know if you have a bone density issue systemically, you and your hormone specialist can address it and get you on the right track with hormones/supplements and weight training exercise.  I had had three bone density studies done before I broke my arm last summer (the most recent until then being in 2009), and I asked my pain management doctor to order another on one me last September just to make sure there was not an issue of systemic weakness in my bones.  I detailed the results in a blog post from last October for your reference.  I've more than once talked about how everyone should have a one page medical history with them at all times, with surgical history, medications/supplements and hormones taken regularly, and emergency contact numbers.  I put a copy of the DEXA scan on the back of my medical history to give to the staff taking care of me at the one day surgery center.

I'm getting stronger each day (physically, emotionally, and spiritually), and outside of not being able to do workouts (which is making my back a little crazy......I need to rebuild my core strength!) I'm just about back to what I consider a "normal" schedule.  I can tell my stamina is still a little off, but I remind myself that it has only been 13 days post op.  It will get there, and we are going to have a beautiful, sunny and mild week here in the Carolinas, which is good for the spirit.....spring this year has come in fits and starts, and we even had a light frost last week.....unusual in the Southeast.    Enjoy!

Tuesday, April 15, 2014

She's baaack.....

Hi everyone, I am back from  my latest round of orthopedic surgery (see posts below for the full story).  I'm feeling better each day, the arm aches but it's not intolerable, and most importantly, I was able to drive 3 days post surgery.  I couldn't drive for 9 days before the surgery, and I am very independent, so being grounded was tough on me emotionally and spiritually.  I am blessed, however, to have wonderful friends who were more than willing to take me where I needed/wanted to be (never underestimate the power of a fresh haircut, eyebrow waxing, and mani/pedi to lift sagging spirits.)  I've been out for several walks around the neighborhood, and hope within a few weeks to resume at least a partial workout schedule.

I got really sick to my stomach post surgery this time, and I have no idea why because I have tolerated anesthesia well in the past.  I started getting sick about 6 pm (we were back from the hospital by about 1:30 pm......the minute I opened my eyes in the first phase of the recovery room, they were trying to get me out of there post haste.)  The nausea lasted through the late evening, and although I was able to keep a little bit of ginger ale down during the night, I lived on toast and vanilla protein bars (I like Power Crunch vanilla, no nuts, 13 grams of protein, and only 4-5 grams of sugar) for several days post operatively.  I have found the bars to be less expensive ordering through Vitamin Shoppe, and free shipping over $30.  My stomach still feels sort of off, but getting better each day.  I think if they drew blood on me right now, it would come out the colour of ginger ale and be bubbly.

I received a "care" package from my wonderful friend Katie. She knows a thing or two about nausea, as she is undergoing chemotherapy for breast cancer.  She had mentioned to me a while back that a lot of her friends used "Gin-Gin" candies to help with morning sickness nausea, and that she kept a bag of them in the knitting bag that she takes to chemo.  A week before the surgery (the most recent surgery) she sent me a great package from Amazon, and included in it were three bags of these "Gin Gin" candies.  I tucked them in the drawer next to my favourite chair, and asked my friend Karen (who has taken care of me all three times I've had surgery in the last 8 months) to bring me a bag of them Monday evening.  The Gin Gins are a hard candy, about the size of my thumbnail, and three pieces are only 35 calories.  They really, really helped with the nausea, and I am going to make absolutely sure I have them in the house at all times!  They are delicious too, and with such a low calorie count, a non guilty treat.  Each piece comes individually wrapped (I had to cut open the little wrappers as my hand movements were limited and they were tough to open), so now I also keep a few in my purse.  This is what the bag looks like:


And they are available through Amazon.com.  I hope none of my readers ever need them for nausea, but I wanted to share this tip!

I will be back later in the week with a "hormone" related post, I have a couple articles to share with you.  I know a lot of folks, particularly here in the Southeast, are really suffering with what I heard termed as "Pollenocalypse" (pollen apocalypse)....very bad seasonal allergies.  I have said it before, but prescription strength progesterone has all but eliminated my seasonal allergies.  I haven't taken allergy medicine in almost 8 years now, and when I first moved to North Carolina, my allergies got worse because the foliage and flora here is more abundant and different than it was where I grew up in Central New York.  Dr. Carr explained it to me that allergies are a form of failure of the immune system, and that the progesterone strengthens the immune system and is thus better able to fight off foreign substances like pollen and other allergens. I will attest to progesterone strengthening the immune system; I have had maybe two very light colds in the last 8 years, and that is it.  I'm out and about in the world nearly every day, touching doors, grocery carts, gym equipment (God, I wish when people are sick they would stay home from the gym.......it makes me crazy to see people sneezing on the equipment) so I am certainly exposed to a variety of germs.  I haven't gotten a flu shot in 8 years either, and have had no problems with the flu.

For those of you who observe, Happy Passover, and for those of you who observe, blessings this Holy Week and may your Easter be wonderful (and include a little chocolate!)

Sunday, April 6, 2014

Gym policies................

I have repeatedly talked about the benefits of exercise, and the importance of both aerobic exercise and weight training (particularly important for strong muscles and strong bones.) For the last 9 years, I have been a member of the Lake Norman branch of the Greater Charlotte area YMCA.  They are the closest facility to my home that has a pool, and water aerobics is good for strengthening my back, and also for flexibility.  

As of last week, I am no longer a member of the Y............their corporate bureaucracy and incompetency  intolerable.  Below is the email I sent to cancel my membership:



On March 14, I called the Lake Norman branch of the YMCA and asked that my membership be put on hold because I was having surgery on March 17.  I was told I had to come to the Y in person to put my membership on hold.  I found out about the surgery late in the day on March 13, and I had workmen at my house ALL DAY on March 14.  I called in because it was not possible to come in that day.  When I was told I had to come in, I  decided to  just waste the two weeks of membership fees to save myself a hassle. By the way, I wasn't able to use the pool facilities for two weeks before that because I got a skin rash from one of the  Lake Norman Y's pool area's disgustingly moldy water noodles, so that's four weeks of wasted dues.  Yes, I reported it to the front desk, and I was given the customary corporate line about how "we will certainly look into it."

I was not able to use the gym for two weeks post surgery.  Last Friday, I re-broke the arm the arm that was operated on, I am now in a heavy cast, CANNOT DRIVE, and am not  having surgery until April 7.  Since the Y is so inflexible about putting a membership on hold, I decided to cut down on the amount of money I am wasting on dues and  I would just cancel my membership.  I called the corporate office, and (why am I not surprised) told that I have to go in person to my local branch to fill out the paperwork.  Before even allowing me to explain that I am not able to come in because of my injury, I was transferred to the Lake Norman branch.  Whoever I spoke to told me that I needed to call you between 10-2 and also email you at this address.  The person on the phone stressed that I need to do both, because apparently I have nothing else to do except jump through the YMCA corporate hoops.

I AM UNABLE TO COME INTO THE YMCA BRANCH AT THIS TIME.  I can't drive, and while I am blessed to have a number of people drive me while I am injured, they are busy driving me to doctor's appointments, the hospital and other NECESSARY appointments. This fiasco ( I find it astonishing that I am the first Y member to have an injury that prevents them from coming in to a branch to fill out corporate's precious paperwork) is simply not worth the unnecessary stress this has caused.  

I am cancelling my membership effective immediately.  I want the paperwork either mailed to me, or scanned and attached to a return email for my signature.  Please do not bother me with a telephone call, I have grown weary of the time wasted listening to the corporate pablum spit out by branch directors/administrators.  I clearly understand that the YMCA's mission is to make it so difficult for members to suspend/cancel their memberships that they will give up and just keep having the dues taken out of their bank accounts, but I live on a fixed income ... and cannot afford to pay for something I cannot use.

(signed)

I sent the email to the membership coordinator, and the next morning I received a return email from her telling me she had cancelled my membership.  No paperwork for me to sign.....so all their bureaucratic run around was nonsense.  Despite my request not to be called........yep, Friday morning I received a call from Ben, the "executive" director of the branch.  It was corporate pablum, and a stress I did not need or want.  I tried to explain to him that I did not want to take the drastic step of cancelling my membership, I just wanted it put on hold while I was recuperating.  I had very much hoped to be back to gym workouts by the end of April at the latest. What a mess.  

The point of sharing this with you is that if you belong to a gym...........be damn sure of what their corporate policy policy is regarding suspension and/or cancellation of membership.  This has been an utter nightmare for me, and since I was never given the paperwork the Y insisted was so important, I have absolutely no proof (beyond the membership coordinator's email) that the membership really has been cancelled.  Most of you reading this blog will, at some point, need to take time out from the gym for medical reasons, and I would hate to have one of my readers go through a similar hassle.  

This and that......

I have surgery scheduled tomorrow morning to repair the (re)fracture of my right wrist.  Details in the posts below on the saga of my right arm.  Needless to say, I am frustrated and beyond upset (I can only imagine how my stress level is affecting my hormone balance right now-----I had hormonal blood work done Friday, but I'm having hot flashes indicative of low progesterone.)   I wanted to post today, since I'm pretty sure I'm not going to be doing much at the computer this week!

First up, from The Age.com, an  article about the progress on a genetic blood test that will predict the age that a woman will reach menopause.  This could be immensely useful not only for women trying to plan families, but also for women who wish to start (bioidentical) hormone therapy before they reach menopause. Often a woman can predict their menopause transition based on when their mother experienced menopause, but if the mother has had a partial/complete hysterectomy, is dead, or is not the daughter's birth mother, or several other factors, daughters are left to guess at when they will go through the menopausal transition.

I'm so stressed out right now I want to eat everything in sight, and much of it isn't healthy.  I'm craving Brach's malted milk Easter eggs (and Brach's is the only acceptable brand.....I'm picky).  I know that music can calm me down or wind me up, and right now Pharrell William's song "Happy" is one of my favourites. Check out this article from Huff Post Healthy Living about using your iPod to help manage your emotions.  During my "downtime" this week, I need to hop on iTunes and listen to the songs on the sample list.

As I have detailed before, I take estriol cream for vaginal dryness.  The medical term is atrophic vaginitis, and here is a list of symptoms from The Mayo Clinic.  I got a new prescription for the cream a couple months ago, and when Greenfield Pharmacy sent me the cream, they neglected to send the adapter for the jar, which is necessary to get the cream from the jar into the vaginal applicator.........and Greenfield forgot to send the applicators too!  I called and very sweetly and politely asked for the supplies needed to administer the estriol.  Got them in the mail a week later.  I called Greenfield Pharmacy to refill the prescription a couple weeks ago, and it never occurred to me to ask them include the jar adapter (mine has a tear in it from putting it on and off the jar every time I use it) and some syringes.  The bottle arrives Tuesday, and......you guessed it.....no supplies.  I called the pharmacy, explained the situation.  First person either had no idea what I was talking about or didn't want to be bothered, so she switches me to another person.  I explain the whole issue again and the tech says "well, we'll see what can be done."  I was furious, and I called them back five minutes later and told them not to bother, I would get the supplies elsewhere.  The compounding pharmacies tout their superior, personalized service, but it has been my experience that they are no better than the big box pharmacies, and in most cases, are worse.

I have a couple more articles to share with you, but this post has taken me forever to type, and I need to go ice my arm again (story of my life this week.)  Enjoy this first full week of April.......I hope that it's spring wherever you are!