Day 185: Blood, Sweat and Urine

Last week I went for what I thought would be a routine check-up with a new endocrinologist. The one I've gone to for 12 years doesn't take my new insurance and I finally decided she couldn't be the only good endo in NYC. My Hashimoto's medication ran out twice and the old endo obliged with a refill at first, but eventually said she couldn't responsibly give me more Synthroid without a blood test; fair enough. So, I had no choice but to find a replacement.

Looking for a new doctor produced one dead end after another. Referrals were hard to come by. Doctors didn't take my insurance. Practices were full. Finally I decided to let go of my obsession with finding "the best" and just give it up to the Universe. How good did my endo have to be? I mean, it's a blood test. The computer reads the results. I could treat myself if the state would let me.

When I was at the running doctor's office, I saw the card for an endo who'd already negged me months before based on my insurance. I decided to stop by the nice receptionist's desk on my way out and see if she had any suggestions. She gave me a main number for a totally inconvenient hospital where they had a bunch of endocrinologists on staff. "Someone there will take you. They have to." I had visions of waiting on a clinic line with Welfare mothers and elderly Medicaid patients. I needed the blood work done though, and I was too tired to go another route, so I called the line and let the operator assign me randomly to the doctor with the first appointment - 2 months later at 10am on a Friday. Smack dab in the middle of an important day but, "OK, Universe..."

The doctor I was randomly assigned to, as it turns out, is phenomenal. Not only did she spend more time with me than I think any doctor has before, demystifying the quirks of metabolism, but she is also one of the doctors for the NYC Marathon, and has many serious runners in her care. She just ran the NY Half Marathon herself, the one that I volunteered at in March; so, she gets it.

Within a few moments of our discussing my goals, she gave me the bad news. If weight loss was an objective, I'd have to put that off until after the Marathon. She explained that the amount of carbs and calories I'll need to consume to stay healthy while I train will far outweigh (no pun intended) the amount I need metabolically, so more than likely, I will gain weight over the next 6 months not lose it - even if I'm running for 42 miles a week.

The doctor asked me about 3 times if I was sure I wanted to do this... if I was sure I was prepared to choose Marathon training over weight loss, because with a low glycemic diet, she was pretty sure she could make me lose weight, barring any underlying metabolic issue we weren't aware of yet. I thought about it and said yes, I choose running.

The doctor said she wanted to run some tests on me to check my insulin, cortisol and ghrelin levels. I could have an adrenal or pituitary tumor that's been interfering with my wellness. She said she thought it was unlikely, but considering the way I reported eating, she had a mild concern. I thought of my friend having said to me just the night before, "You eat like a bird!" Sometimes I don't; but mostly, I do. It was important to check what was going on. This doctor was making my former doctor look like a real slacker; and I began to feel somewhat ashamed that I hadn't gone and insisted on all these tests myself sometime ago. I was always just so busy, and I felt fine, most of the time.

One of the tests would involve collecting my own urine for 24 hours. I was given a 3 Liter bright orange bio hazard jug with a handle and told to refrigerate the thing, and not miss a single pee! You can't cart the thing around with you so... that means staying close to home for a full day. Then I fasted for 12 hours for the blood tests and went to the lab this morning at 7AM for the 14 different blood test that were ordered.

When I arrived at Quest Labs on E. 57th Street, where I've been going every 3-4 months for the past 12 years for my little 2-second thyroid blood test, I signed in and met my phlebotomist who scanned the order. "This is a lot of blood!" she exclaimed, her eyes bugging out a little. "You might want to split this into 2 visits..." "No, let's just do it. I don't have time," I said back, irritated that we were running so many tests. Was this really necessary? Then I checked myself and felt grateful for the existence of tests. Hopefully, nothing wrong; but I would soon know and that was a little bit exciting. Information is good.

I've been known to pass out when giving large amounts of blood, so I asked for some ice to hold on my neck, which usually helps. They didn't have any, so we ran some water but it never got cold. I considered running out to buy a can of cold soda at a deli, but then my eye hit the bio hazard jug on the counter, still cold from having sat over night in my refrigerator. It was now wrapped in a plastic bag, and condensation was beginning to form on the plastic.

"You know what, I'll just hold my urine to my neck." I'm nothing if not practical

So there I sat hugging a cold orange jug of my own urine to my chest and neck, listening to the nice lady tell me about her new Cairn Terrier puppy as she drew vial after vial of blood. When she was done, I said thank you and left to get some breakfast across the street at a diner. I ordered my usual - an egg white omelet with veggies, toast and coffee. Two bites into the egg and I began to gag. Sometimes eggs make me gag but salt mitigates the problem. There wasn't any salt in reach on the counter, so I just ate the toast, and had them wrap the rest to go. Really, not the most fun morning so far.

I won't have the results of all these tests for 2 weeks. I'm not expecting anything major to be unearthed, but we shall see. In the meanwhile, I've got a lot to think about and research. And a lot of running to do. Four miles tonight, hopefully in the Park if it isn't too hot, dark or humid when I get home from work. I'm really excited to get back to my routine, which has me running 20 miles this week; back to volume. My new endocrinologist said that running for 30 minutes is the equivalent of taking 10 mg of an SSRI anti-depressant (something like Prozac), and it goes on from there - 1 hour is like taking 2, etc. (I love fun facts like this and my new doctor was full of them.) That means I'll be getting 40 doses of natural anti-depressant before Sunday evening! You are going to want to hang out with me!

I wonder what the results of the tests will be. For now, I'm just going to carry on as usual and enjoy my ignorant bliss x 40!

Addendum: I ran 4 miles in the Park tonight, beginning at 8:15PM. It rained for about 15 minutes of it. It was dark and a little scary, and I loved it. There were other people out there but sometimes I was completely alone. My iPod lost its charge after about 5 minutes so I had to run with my thoughts, the sound of my feet, the sound of the police cars circling. It was amazing.