Lipstick excellent Graves' antidote

Like the famous Graves' ophthalmopathy sufferer at left, I find that grooming makes up a little bit for the loss in pulchritude. I don't know what Babs uses, but I like Revlon's "cherries in the snow," myself.

I also did something I swore I would never do: got hair highlights. Pregnancy made my hair all one color and I have missed the highlights, but swore I would never hit the dye bottle. Now all that is out the window, and I have all these nice caramel streaks.

What next? I read someplace that Graves' patients do well except for two things: car accidents and divorces. (Note to self: practice having patience with everyone, and do a better job with your son than Babs did with hers.)

Waiting

Here's a new photo of the eyes, just to show the mild lid lag when looking down. Sorry about displaying the nose hairs, but I guess all God's children got them.

The uneven closing, which started a week or so after the swelling, was what really bothered me. I associate noticing it with working a shift on the med-surge floor where I had nursing clinicals. Every time I looked down to write on my clipboard, the left lid seemed to sag shut, when in reality it was the right not closing as easily.

My eyes are hurting me worse, feeling sandy; I just bought another $36 worth of eyedrops since I blew through what I have. Tears Naturale and Liquigel work fine for the day, with a healthy squirt of LacriLube in at least the right eye at night. It does not always stay shut. LacriLube is a tube of petroleum jelly with mineral oil, and tends to have moisturized the face by morning. My husband sort of likes the sheen, for what that is worth.

The prednisone makes me feel sick, full and totally unwilling to eat anything. Can't wait till that's done.

Had a lab draw yesterday. I don't expect to be euthyroid yet, based on my crazy heart, which periodically rattles its cage with erratic beats.

Slogging through the snow

My endocrinologist told me not to exercise while recovering from the mild hyperthyroidism (which still seems to be simmering, masked by the InnoPran). Well nuts to that, I finally said, and took my son up the hill in our back 40 for some sledding. I thought I would keel over from the sheer effort needed to walk through shin deep snow up that hill.

Then the sled wouldn't slide because the snow was all wrong, but that's another story.

Anyhow, here comes my husband, trucking along in snowshoes with a pole, zooming past my floundering figure. That is just so unlike us. He flounders, I zoom, ordinarily.

After he got back tot he house, he sent our son out to me with snowshoes. Well, that turned everything into cake. So maybe I'm not as debilitated as I feared . . . I just needed my own pair of snowshoes.

Update: 1-5-07: Last night, about 2 hours after I climbed that hill, my heart started beating like the drum solo in "Take Five." All kinds of crazy beats, probably PACs, or premature beats of the upper heart chambers. You know, that skipped beat and then the extra hard thud of the heart. With runs of 6 and 7, it got me a little nervous, although it calmed down during my sleep.

This has happened before, on days when I would walk the length of a parking lot and up and down the halls of my school (I like to park far away from doors). By the time I sat down and got my computer booted up, the PACs came on for a few hours, despite a full dose of beta blockers.

Now, how does that work? I know that exercise boosts secretion of thyroid hormones, but the heart beats erratically because the excess thyroid hormone causes more epinephrine and norepinephrine receptors to form, not because of a flood of thyroid hormone per se. I wonder what the mechanism of this reaction to exercise was—new beta adrenergic receptors formed within hours? A delay in blocking? Some other hitch in the pharmacokinetics of the propranolol?

Anyhow, it is not fun to have your heart keep you awake.

The dreaded pred

For the past two days my double vision has gotten worse, and so has the tic and the lid retraction, so I refilled my prescription for a prednisone burst. 60 mg. for 4 days, then 40 for the next 10. It has some effect, which I only realized after going off of prednisone a couple weeks ago and getting more swelling. It also had the added (and unusual) side effect of wiping out my appetite.

But the thing bothering me is a narrowing field of vision that is not double. I still can do most work and read without moving my head too much, but if I look 40° up from the horizon, now I see double. One image slides below the other and goes cocked counterclockwise a bit. It used to be better—more toward the utter limits of my visual field.

I see that my clinical assignment for the coming semester is at the same hospital and with the same teacher as before. None of us were supposed to get the same hospital assignment, but I did, almost certainly because some sympathetic instructor wanted me to have a more manageable level of stress.

Let's just hope I don't scare the patients with a piercing, wall-eyed glare . . .

According to Mary Shomon's book, Living Well with Graves' Disease, only 38% of people with double vision have it go away on its own. Poop and double poop.

Is it hot in here, or is it just me?

When in September the heart palpitations and hot flashes set in, I of course wondered if I weren't in for an early "change." And at 42, it was not unreasonable to expect menopause to be 8 or 9 years off and hot flashes to begin years earlier. My nursing class was orienting to a hospital for clinicals when I about melted in a series of hot flashes, and no one else felt too warm. I asked. It was then that I realized something was going on.

Another problem I noticed having was with fine motor coordination. Once, I was giving a PPD test, which is an injection placed delicately between layers of skin on the inner forearm. My patient was a rather nervous lady with schizophrenia, so I was trying to distract her from her distress at being poked with a needle while simultaneously sliding it in. Well. My hands shook so that the needle popped right back out of the skin and I had to do it twice. Poor lady. The same problem happened any time I had to flush an IV, replace a bandage, or anything requiring close work. The patient and sometimes the instructor would be looking, too, so it seemed even more of a problem. (Add sweat droplets rolling off the end of my nose to complete the picture)

I don't know how many times I said, "I don't know why my hands are shaking, because I don't feel nervous!" Once, a watchful spouse asked me if I were nervous as I irrigated and packed her husband's decubitus ulcer. I felt so embarrassed, because I really was not nervous; I had been dealing with wounds and bed patients in one way or another for over a decade.

During that time I also had to start my first IV. I was dreading it, but for some reason it went in slick as anything, thank goodness.

The full monty, January 2008

This is just a front-on photo of the eyes. The right eye is the most troublesome, with a lid that closes hard, restricted gaze and lots of puffiness. It is especially bad today. The left eye seems mostly normal to me, except for redness, grittiness and puffiness.

Sometimes, at the end of the day, the lid seems to retract more and I get a bit of a stare. It seems dependent on stress, oddly enough.

I'm really hoping that a few months from now I won't be posting something drastically worse. I'm hoping that this is a repeat of 1993, if indeed I had GO back then.

Google-eyed all my life

Just for comparison, here is a photo of myself at age 20. Think it's possible that a Hertel exophthalmometer would have measured 22–23, as it does now?