3 Weeks Post-Surgery: Mostly Good (Even the Cancer Part)

Three weeks ago, I went to the hospital for surgery. They removed half of my thyroid, because it had developed nodules (what they call thyroid tumors they suspect are benign) and had swollen up enough that it pressed against my trachea, and the nerve that controlled my vocal cords. I was having trouble breathing, at times, and my voice had started to go froggy. Of course, there was the year, going on two, before that of me starting to go downhill physically  – tired all of the time, gaining weight, struggling to stay on task or complete things on time – but after dealing with a doctor who insisted it was just me being a woman, getting older, I’d found one who was actually willing to do lab work and sort it out. I was diagnosed with anemia, and started medication for that. Aside from the pressure on my throat, I should have been on the mend.

I didn’t quite feel it, though. A little better… but still, something was wrong.

We agonized over the decision to cut out part of my thyroid. It’s a simple, safe, outpatient procedure, except that it’s still surgery, which is never guaranteed 100% safe. My SO and I talked it over, made plans for dealing with what would come next if I didn’t make it out okay, and decided (supported by my surgeon’s opinion) that it’s better to get the swollen part of my thyroid out now before it got bigger and did some real damage. I felt it, a literal lump in my throat, every time I swallowed. Every time I tried to exercise and had to breathe harder. When I laid down for sleep, and the lump shifted a little, pressing on a new spot I hadn’t yet learned to ignore.

Your thyroid is a butterfly-shaped organ that lies flat, for most people, and has the volume of a peanut on each side. My right side wasn’t visible from the outside, so you wouldn’t know unless you saw a sonogram that it was the size of a jawbreaker, and growing. Inside were two nodules; the bigger one had been biopsied three times since it was found three years ago, and declared benign, though I was told in 2013 that it was collapsing and would get smaller – we discovered in May that it had actually gotten larger.

The smaller one was labeled “suspicious” by the sonogram tech during this round of tests, but was .1 mm too small for a biopsy to be considered necessary, according to the current medical guidelines, so I was told not to worry. We’d wait, they said, and check on it again next year.

If I hadn’t opted to remove the larger side of my thyroid, that nodule would still be there. Continue reading

The Quest For Sleep

Since leaving my day job, I’ve had severe insomnia. I assumed it was stress related, and worked on reducing my stress, but also cut down on caffeinated sodas (which has other health benefits as well).

But I’m still not sleeping. I have good days, a couple of good nights of sleep, and then I lose control of it again. I either am “awake” during the day, but too tired to do anything useful, or I sleep poorly during the day and am up late, exhausted and useless. Finally, I talked to my doctor, and we did a bunch of tests.

He thinks there are two main culprits: my ADHD, and a couple of decades of bad habits with caffeine. I have had insomnia my whole life… (Ironically, several months ago I gave up the medication I was taking for my ADHD, because it was too expensive, and kept me up at night.) Most likely, my current bout of insomnia isn’t actually new.

My doctor said that my day job helped mask the serious sleep deprivation by giving me structure. I had to get up at the same time each day, without the option of going back to sleep during the day, so I compensated by consuming several caffeinated drinks each day. And, in the evening I was pretty much useless. But at least I was going to work. Once that was gone, I lost my anchor. And giving up soda cut down on how much caffeine I was drinking, which made me more tired —

Why didn’t that help me settle into a good night’s sleep? Because I push myself too hard. I forced myself to be awake to get things done, and compensated in unhealthy ways: more coffee, and overeating. Both of which interfere with sleeping, too. See, caffeine stays in your body up to 24 hours, and when not keeping you awake, it can still keep you from resting, by making you wake up more often during the night.

The solution is to make a big change, and then give it time to work. (It’s the being patient part I usually have trouble with.) The plan?

1) Get up at the same time every day, even when I’m tired.

2) Go to bed at least 7 hours before the alarm is set to go off. (8 is better.)

3) Start the day with one caffeinated drink. And that’s all. No more! Not at all, not the rest of the day. None.

4) Resist the urge to nap, eat too much, or caffeinate during the day.

5) Whenever possible, if I feel sleepy during the day: exercise.

6) Accept that I am going to be tired for a week, maybe a couple of weeks, until I get settled and my sleep cycle resets.

Now that I’m going back to freelancing, that last one is the hardest. At a day job, if I struggled through sleepily and was a zombie at night, okay, I’m still getting paid. When I work for myself, if I take time off to be a slug, not only do I feel lazy and useless, but I’m not making any money. I can’t afford to take time off.

But I’m going to be 42 this year. I’d like to be just hitting the halfway point of my life, instead of nearing the end — and if I don’t stop the “quick fixes”, who knows how badly that’s affecting my health? I have a chance to turn my life around now that I may not get again any time soon. In that case, it’s an easy choice.

I’m setting my alarm, going to bed early tonight, and getting up on time tomorrow. I’ve got a caramel dessert-like coffee drink waiting in the fridge. I’m giving myself permission to take it easy this weekend, and next week too. Maybe next month, if I have to.

They say you can’t put a price on your health. I’m about to trade my income for my self, and find out.