[Optimist1]

#1058737

Hi all – I was a facilitator for this group briefly a few years ago – under the name CathyCNM. I got well, got busy – and life moved on. I wanted to share my last 18 mo journey . . . because I got unwell, again. I am a nurse practitioner and decided to get into clinical practice (from education) again. I took a job managing a rural clinic about 100 miles away. In the winter the roads where bad (a Colorado mountain pass) – and my days were long – starting at 4 AM and ending about 10 PM. I had to work a second job, as my employer did not help with travel expenses.

The clinic needed a major systems change – and I am a change agent. I was able to bring about a shift that will save about 100,000 a year. I was successful but it was way more work than I thought I was taking on in the beginning.

So . . . back to Grave’s. I had RAI 4.5 years ago and stabilized within 6 months on my thyroid replacement. And, by golly, I stayed stable until the new job. I took the position in May . . . by fall, my energy seemed down, but I figured it was the stress. By winter, my dry eye seemed awful and I had less energy. Knew I needed a TSH but got too apathetic to put one more thing on my plate. In March – I got knocked off my feet with bronchitis. I was having palpitations and just feeling awful. Went for a TSH – it was about 8.

My endo thought I was not taking my replacement! But I told him the only explanation I had was the life shift. He said it could be. He slowly upped my dose – it took three times and was finally normal in late August. By then, I knew I needed to shift out of the job because my work was nearly done. I car pooled with others so my days started at 8 and ended at 5 again. By Sept – my levels were high (as in lowerTSH) normal. I was kept at the same dosage but thought I was probably beginning to need a lower dose again.

This week, after feeling pretty irritable and tearful for a few weeks, I went for a TSH. 0.023. Back on my original dose starting today.

I am sharing this because, even as a nurse practitioner, I was unaware that stress and long days could throw Grave’s into such a tail spin. Please – if you are making significant changes to your schedule and lengthening your work days – get your levels checked more often. I have probably been in normal range about 30% of the time that I have had this job. It has impacted my sick leave need – I have never taken so much sick time off in my life!

I resigned (on very good terms) this week. I am moving back to teaching locally and online for a nursing program. It seemed to agree with my Grave’s better. I am also starting a wellness coaching business (this is not a plug) – out of a desire to improve my own wellbeing. This year is a lesson I wanted to share with all of you!

[Kimberly]

#1169724

Hello – I remember you! Major kudos to you for deciding to make changes in your life to help reduce the pressure you have been feeling. I get tired just *thinking* about going to bed at 10 and then getting up again at 4!

I read the original "Blue Zones", but haven’t read the "Thrive" follow up. I’ll have to check that one out!

Take care!

[Optimist1]

#1169725

Thanks for remembering me, Kim! I think – of all my physical limitations – Grave’s is the biggest. But, it is also teaching me better wellness habits.

I knew the job was not a match almost a year ago but hung in there to try to get it shifted before I left – it went to downsizing, which increased the stress with a lot of staff pretty angry. I just know enough to know the value of a positive workplace. I have options!

I love Thrive – really has some nice wellness pieces. And . . . wellbeing – which is bigger. Interesting what impacts work has on us. I am up after midnight – exhausted but not wanting to give up. Can’t wait for this to pass. Sleep is another important part of wellbeing so I shall give it a shot ” title=”Smile” />

[genuinruby]

#1169726

Cathy, thanks for sharing your "update". I recently came to the conclusion that Stress in a person with Graves can cause serious fluctuations in TSH levels. It was suggested to me today that I need to get focused on a routine, and really stick with it. Little things that would not make a normal person flinch can cause me much anxiety and frustration which I feel is not "normal" but, I don’t have the tools to make it go away. So, I am going to try and focus on more of a routine and see if it helps.

[snelsen]

#1169727

Hi Cathy, how nice to hear from you! I had the same job experience in one of my jobs as a clinical specialist. The job was a 300% time job, not 100%. I recognized the stressors, and acknowledged the job was not the right job for me–but not soon enough. i felt like I was failing everyone if I resigned. But soon realized the impact it on my health. I resigned, too, on moderately good terms. I think they knew they would never find anyone who would be willing accept this job, and that they knew they would have to make at least to jobs out of what I was doing, if not three! But my levels (and I!!) were all over the place, and settled down when I got a reasonably sane work life.
Your experience is important, and will be very helpful to other folks.
Shirley

[Optimist1]

#1169728

@ Ruby and Shirley – Reading your stories about the need for a stable routine make my day. Shirley – your situation is very similar. In fact – they thought it would be a piece of cake to replace me . . . several people turned down the hours. Now it is a rotating team – once every month or two apiece. I was rotating up for 4 days a week, paying my own gas and lodging – and, food on the road, of course. I put 2 mos salary/yr into expenses. No one else will do that. I, too, left on pretty good terms (this is my last week – one more overnighter up there). Some relationships stressed, as I cut back twice over the last 6 mos and have another job. I think they expect me to give it the same commitment as when I was full-time because what I gave in the first place was undervalued.

Interesting that I started a nurse-midwifery practice here 20 years ago – got it started with a lot of work. In the end, new blood took over. Now there are 4-5 CNMs sharing the load and only 10% more births than I did alone – and they make double (each) what I did.

So, Grave’s personalities? ” title=”Smile” />

[Bobbi]

#1169729

Some — perhaps a lot — of research has shown that stress has an influence on the immune system. A lot of times, stressful situations seem to suppress the immune system: for one thing, it has been shown that people tend to get sick after very stressful periods. ANYTHING that causes reactions in the immune system, whether to enhance it, or suppress it, will affect our numbers if it goes on long enough. Most of us assume, if we have had RAI or surgical removal of our thyroids, that our thyroids are completely "gone." This is not necessarily true, even if we went hypothyroid after the procedure. There can be "some" thyroid tissue left. With thyroidectomies, for example, surgeons try to protect the parathyroid region, and the region around the nerve that services the vocal chords. Evidence of this can be found in the fact that thyroid cancer patients have thyroidectomies AND huge doses of RAI to make sure that all thyroid cells have been eliminated. If there is some thyroid, alive and kicking, then it is possible for our numbers to fluctuate with immune system changes. If we have minimal amounts of thyroid left, minor changes in our replacement hormone can "fix" it.

A second piece of information: it is impossible to avoid stress. We can try to structure our lives to avoid some types of unnecessary stress, but we cannot avoid seasonal stresses, deaths in the family, the birth of new children (whether ours or our children’s) etc.

Just recognize that if you are going through major stress from some cause or other, it might, temporarily at least, throw your numbers off, especially if it goes on long enough.

[catherine]

#1169730

Hi there

Thanks for all your posts re stress…I think I need to take heed, and remember to keep doing so! I’m not in that place at the moment but know I am one for going there. The couple of months leading up to Christmas are always work hectic for me along with the usual Christmas crazy!

I also took it upon myself to start studying again last October. It’s not the first time I’ve studied part time on top of my full time and what can be a somewhat demanding job, I don’t usually last very long with it due to the anxiety and memory problems I’ve encountered in the past! However during a brief reprieve from my GD syptoms following diagnosis last July I figured at 37 if I was going to give it a final attempt now is the time (as I’m looking at approximately 6 years to qualify).

So for now it’s a day at a time with the study…see how far I get. I’m limiting myself to an hour and a half in the morn before work and Sunday mornings at home. I make sure I leave work at a reasonable time most days and I have regular holidays booked for the remainder of the year!

I’d read stress is a major player with GD but reading your first hand experiences today has reminded me – thank you.

Catherine
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