Today is a good day and I am supremely grateful. I cried when I walked the dog this morning for the joy of having a rare good day. This is the second time I have had a good day in 7 months. It is only on a good day that I can begin to express the sheer horror of the bad days, because it is only on a good day that I can see clearly; that am well enough to begin to express how much I struggle for the other 361 days of the year. That is why I am taking the time to write this now. Why is today a good day and why do they come around about 4 times a year? Because that's when I tweak my medication and invariably you get a bounce on day one, two or three, until things begin to settle. I should add that I have those extra 3 good days because my endo only has time to tweak my medication once a year and the other 3 are me taking it into my own hands. I must write quickly, then.
I woke up this morning feeling alert. It wasn't hard to get out of bed. Getting out of bed is usually a supreme chore. I showered and that wasn't hard either; it was actually pleasant. It is not usually pleasant, it is just another thing to get done in my grey world. Truth be told, I often don't shower, because it is too much of an effort and takes too much energy, which is probably better spent on anything else.
I walked the dog, looking forward to our walk, because I had the energy for it. I walked quicker than usual. Instead of being a little annoyed that the dog lost his ball (searching for it is one of his favourite things when he mislays it) I enjoyed watching him enjoy the task of attempting and failing to work out where he'd left it amongst the scrub. There goes another ball!
I got back and rather than being faced with even more brain fog and exhaustion following walking the dog, I had the energy to contemplate starting a task. And it is this one, writing about bad days from the perspective of a good day, for my future self.
Mostly, today I am grateful, but I am traumatised. I am traumatised by the fact that I feel normal about 4 times a year and I'm traumatised because it makes me realise how much I struggle with every single little task for the other 360 days. The brain fog is crippling. If I use too much mental or physical energy, I will be capable of nothing other than staring into space and will face an even worse day tomorrow.
To compound this, some doctors and endocrinologists do not think my condition exists. They think everyone is fine on levothyroxine only or that patients have "high expectations" of treatment. They are worried that T3 can lower TSH, and connect low TSH with a higher associated risk of stroke, osteoparosis or heart attack in the future. Today, I can tell them (they won't listen) that I would choose one single month of feeling like I do today, followed by death, over a hundred years of feeling like I did yesterday; yesterday is my "normal" and today, whilst I'm somewhere else, i'm here to tell you what a horror show it is. I'm here to beg you to throw your TSH orthodoxy to one side, because with it, you deny me a life worth living.
To my former work colleagues. Every time I said how exhausted I was following a weeks' work, you tried to tell me that it was normal, given that I hadn't worked in a proper job for a while. Going to bed even more exhausted than usual at 8pm on a Friday, or after a rare trip to the office on a Tuesday and taking 2 days to recover to some kind of space where you have the energy to cook a simple dinner, or walk the dog, or enough brain power to watch something on TV properly (I can't even concentrate on my beloved Arsenal on a really bad day) is NOT normal. It does not comfort me when you try to normalise my experience. It makes me feel like you think i'm just whinging. This is not remotely normal. Don't pretend it is. You make me feel that I can't even talk about it, because you are not even trying to understand. Do you realise that your attempts to normalise my situation mean that I have to deal with feeling socially isolated, because it means I can't share my reality with you.
To my previous boss. I resigned when you said "you must come into the office on Tuesday, but I'm concerned you are telling me we're not getting value for money from you on the Wednesday". No, you weren't getting value for money on a Wednesday, because you were making me more unwell with your Tuesday. I'm glad for you that you don't understand. I genuinely hope that you never understand. But I do hope that you will grow and learn to treat people like me with more compassion. The look on your face when I admitted that I self-medicated. Crazy, isn't it? Because in your world, doctors are there to help, and the doctors know best. I used to live in that world too, before I got hypothyroidism. I see my endo for a dose tweak once a year. Laughable, when this cost me my job, but that's the state of the NHS post-Covid and there's little I can do about it.
You know the really sad thing about this? The really sad thing is when I'm having a worse day than a normally bad day, I blame myself. Anxiety and depression are side-effects of inadequate medication (they're also side-effects of an inadequate system for people like me; can you imagine being told it is in your head by doctors and endocrinologists in this state?). I blame myself because maybe I didn't eat as well as I could have yesterday, because I was too bloody exhausted. I blame myself because maybe I forgot to take my vitamins. Or I blame myself for taking a long walk, because walking was my joy and I have an active dog. And honestly, because i feel so bad, for months at a time, I start to wonder if it isn't actually probably a bit normal for my age and gender after all, because tired, grey, brain-fogged exhaustion is my normal.
I hope, doctor, work colleague, whoever you are, that you can see how incredibly hard it is to live in this world of chronic fatigue, brain fog, and self-medication, because the system is too underfunded and under-researched to help? And for more fun, thyroid treatment in the UK is particularly hit by the geopolitics of heath and big pharma. It'd be fascinating if it weren't me living it. To add to that, sometimes the system is misogynist (this disease impacts far more women than men and symptoms are therefore frequently dismissed as "normal for your age and gender") and sometimes it is plain ignorant. I have experienced the gamut. To make this trickier still to navigate, one of the main symptoms of this nightmare is the inability to express yourself and feelings; the thoughts don't form properly, the words don't come, but the feeling is there... it is just trapped inexpressibly in the fog. So can you imagine how hard it is for me to talk to you when I'm struggling, doctor, colleague? I can't explain myself well, because when I am struggling, which is most of the time, I am barely able to function. The lights are on, but...
If I haven't whinged enough yet, the other thing I would like you to understand, is the loss of identity. I woke up today and I felt like me, like Lotika. I have not had that feeling since 2nd August, when I had it for one day alone, just like now, most likely. The good days are so momentous that I remember them. I'm pleased to discover that I still exist. I'm still in there somewhere, under the wrong levels of medication, the fog, the exhaustion. The woman with fire in her belly, the woman who thought quickly, the woman with something a bit edgy about her; a chip on her shoulder too, probably, one that I've not had the energy or strength to pick up and carry of late. All those things made me good at my job. Can you imagine losing the very characteristics which earned you your living? Can you imagine what that would do to your confidence, let alone your ability to put bread on the table, contribute financially, contribute to society through taxation, through well, anything.
This brings me on - friend, doctor, colleague - if you think I am whinging, to the list of things I have lost to this disease, inadequately treated, over the last 8 years: my career, my job, several teeth, my figure, jogging, weightlifting, yoga, friendships, my love of life (my get-up-and-go got up and went) travel and whatever else it is that having a little disposable income brings... access to culture, perhaps; peace of mind, perhaps; that feeling of security, independence. But most of all, I lost myself.
To balance it out, because having whinged for this long, I will say that there are some good things about this. Seriously. I am kinder, more understanding and more compassionate towards others as a result of having to live this way. If I'd met someone like me 20 years ago, the chances are I might have suspected they were trying to play the system. (For what it's worth, I don't qualify for benefits as far as I know, so I don't "gain" from this situation in any way.) Now, that's the last thing I would think. I think the system is broken and until we can fix it, compassion is key.
Every little task, on a "normal" day, for 360 days a year, is a major exhausting event and trauma for me. So, yeah, your commute into the office once a week nearly killed me, because it came on top of getting out of bed, taking a shower, doing the job, all of which were supremely exhausting anyway. So, sorry, not sorry, ex boss. Endo, of all of them, you are the one I have some compassion for. I can't imagine how you are struggling to catch up on your case load and at least you prescribe T3 on the NHS, which makes you one of the enlightened ones. And you even listen. But please can we medicate me to a life worth living, rather than a TSH which makes YOU comfortable? What about ME? For some reason, this disease, is all about you health professionals and what YOU are comfortable with and not about us patients. I am here, on a good day, to tell you that I believe I have a right to feel well all the time. GP, please just run thyroid function and vitamin tests when I ask for them; maybe every 3 months unless I prefer otherwise? Future work colleagues: yeah, I know it is easier to believe that I am crazy than that a supposedly 1st world country, our beloved NHS, treats some people this way because they have the wrong condition. That's the sad reality. Believe me or don't believe me, but whatever you do, don't try to normalise this and don't gaslight me.
Is this really so much to ask?
Lotika
(Sorry this is a bit long and I didn't edit it - I wanted it to run from the cuff somehow)
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For what it is worth, having tried various T4/T3 combos, I've come from my prescription (112.5 T4 2 x 5 T3) to an intermediate position of 62.5 T4 and 10 T3 (together, in the morning, and occasionally 5 T3 in the afternoon when I remembered; I didn't find it seemed to make any difference whether I did or not as it doesn't seem to do anything for me in 5 mcg doses these days) and now 50 T4 and 10 T3 in the morning and 10 T3 in the afternoon... Long story. I spent a long time thinking that I needed a decent level of fT4 in my body, but I looked over the history of my thyroid test results and given that my conversion is awful on T4 only, I came to the conclusion that my body probably wasn't doing anything useful with T4 and have felt no worse for dropping it down... and a lot better (so far) for taking 20 mcg T3 a day! Fingers crossed it continues, although experience tells me to doubt it. Still, every dose you try is progress, isn't it?