Osteoporosis Won't Break Me

  Osteoporosis. That is an interesting word to hear at 37 years old. That's what I got. I had to do a bone density scan last week. Not just because my broken foot is taking its sweet time to heal, but I am also very thin, malnourished, and I have ovarian failure. Yup. You read that right too. Ovarian failure. These are two things someone in their thirties rarely has to think about. This is now what I face. Although a little frightening, I see this challenge as a learning opportunity. It isn't a great deal of fun for a man to read about ovaries so I will keep that short and simple.

  For years I have had irregular periods. For a few years I was treated for ovarian cysts and that worked out great. When we moved from a metropolitan area in Texas to a rural area of New Mexico I kind of brushed it off not wanting to find an OB-GYN because, let's face it, who does? After 2 years and a serious lack of periods I finally broke down. I would love not to have one, but I am smart enough to know it is not good to not have them. There is not a chance of pregnancy. I had my tubes tied back in 2011 due to my fragile health. I found an OB-GYN. After a detailed exam and discussion she knew things might be more complicated. She ran some blood work and called back a few weeks later to notify me that I have ovarian failure. What's that?

  Well, I had been warned since my early thirties that many auto-immune diseases cause early menopause. My assumption was that may be what is causing me to be irregular. I have never heard of ovarian failure.  The Mayo Clinic refers to it as ovarian insufficiency. That word again, "insufficiency". Seems to be one of my running themes. Basically, my ovaries are not producing enough estrogen and/or eggs. This is not normal for women under 40. It is different from menopause in that women with ovarian failure or insufficiency can have periods on and off and possibly even get pregnant during this time (not me). Women who have premature menopause  stop having periods completely. Glad we got that sorted out. So the next question is what do we do about that?

  The doctor talked about hormone therapy and a few other things. All of which I listened to but barely understood. This is not in my wheel house and I have never even researched them. I am such an information junkie, I am usually ahead of the curve. She then explained she wanted to consult with an endocrinologist (specializes in hormone and hormone glands) as well as my primary care physician to go over options for any possible treatment. Her concern, of course, was starting something that may be dangerous considering my complex medical history. She heard I broke some bones in my foot so she decided to have a bone density scan done.

  I had to go to the local hospital. All diagnostic imaging is done there in our small town. That is a scary experience during COVID and I have been there several times since I broke my foot for different scans. A side note to this is the woman who checked me in was not wearing a mask. It is state mandated and it is a hospital. That made me uncomfortable. The scan took hardly any time. She did have to take my official height. I am proud to say I am officially 5'3". I am the tall one in my family haha Due to the pandemic, results get to the doctors faster. Radiologists are not having to do as much since healthcare is focused on necessity right now. The very next day the OB-GYN called to let me know I have osteoporosis.

  Now that was not what I was expecting. I am pretty good at being prepared for a new diagnosis. My gut instincts are good at knowing even before I consciously know myself.  Not this time. Because it is not something that was on my radar and no one in my family has really talked about it, I honestly had no concrete idea on what the different bone diseases/disorders meant. She explained and I listened, but I can't relay what she said. I don't think it registered at the time. Again, she wanted to consult with my endo and primary care doctor before starting any treatment, but some treatment is needed. I do take a calcium supplement and vitamin D because I do not absorb them naturally. She believes some hormone treatment may be necessary at this point.

  Osteoporosis literally means porous bone. Bones do have a blood supply. They also have two very important cells called osteoblasts and osteoclasts. The osteoblasts break bones down. Osteoclasts rebuild. Diabetics already produce more osteoblasts than osteoclasts which is why it takes longer for our bones to heal along with poor circulation. In osteoporosis there are also more osteoblasts than osteoclasts causing the body to lose more bone than it can reproduce. This makes the bones porous and brittle. Sometimes something as little as a sneeze or minor bump can cause a bone to break. The main concerns are the spine, hips, and wrists. I have read that even just sitting there a vertebrae may crumble. How do you protect yourself when you are a 37 year old mother?

  Strength training, impact exercises, and nutrition. So, we know I can only do so much nutrition wise. I eat as healthy as I can within my limitations. My body does not absorb all nutrients. I take supplements to help, but it is not a fix all. I am limited in protein intake due to my gastroparesis. Most of us know, protein is crucial for repair and development of the body. That one gets me. I have always exercised. In the past ten years it has really only consisted of long walks and yoga. Since my broken foot I have had to become more creative. I do a lot of floor or chair work which really strengthens your arms, abs, butt, hips, and back. Little did I know, that strength training is exactly what is necessary for osteoporosis. Score one for Lauren. The impact exercises will come in due time. They are things like walking, running, and jumping. But at least I know. Now, I can be sure to do a variety of exercises even beyond my foot injury. 

  I have mentioned this before, but I found some great content on YouTube for "hurt foot" workouts. Donovan Green (Dr. Oz's trainer) and Caroline Jordan are my two favorites. They make chair cardio videos. Caroline also makes floor barre and total body non-weight bearing workouts. I have come to really enjoy them. I used to be a long distance runner and basketball player. These workouts get me to that level of intensity. Who would've thought? Walking and yoga are peaceful, but nothing beats a runners' high. I am strengthening muscles I didn't know I had yet are so crucial to preventing injury. They have even gotten my shoulder feeling great. I had a labral tear last August and have struggled through physical therapy and more to rehab. These exercises really strengthen your posture muscles in turn strengthening your shoulders. I highly suggest you try it before you knock it, especially during this pandemic. It will reduce anxiety, help you strengthen, possibly lose weight (if needed), and as my son puts it, "It's somethin' to do". I recruited him for my evening routines. It has changed my life for the better.

  That is what is so cool. We all say, "there is always a rainbow at the end of a storm" or "the sun will come out tomorrow" yet it is difficult to really internalize. We also know there is power in positive thinking. Well, the shoulder injury and then the foot injury seemed horrible, but have now proven to actually be a blessing. They have made me really slow down. I tend to push myself beyond my limits then pay for it. These injuries have reset my mind reminding me to not push so hard. They also brought me to new exercises. I learned I really enjoy things I normally passed up. That has made me rethink trying other new things in other aspects of my life, These two trainers are incredible at educating while not judging. They are motivational. I have learned to be compassionate with myself. I am constantly reminded to be grateful for how incredible the human body is. It is one of the rare things that can heal and get stronger. I am better at pushing away negativity. I am better at focusing on my health. That helps all else fall in to place. 

  As I sit here with my foot propped up and no end in sight, I do feel thankful. I am excited for the day I can walk again because that just means I can add more to my arsenal. I will never get bored with the variety of exercises I can do. I may not be competing anymore, but I think I am stronger than when I was. I talk about exercise so much because I love it. Movement is medicine. Having a bad day> Exercise and get endorphines. Feeling tired? Exercise and get endorphines. Bored? Don't eat. Get up and move. The endorphine rush is real. The best natural remedy on earth. As long as you are doing it right and for the right reasons, there are only good side effects. Even as sick as I am, I think I was born with far too much energy and I have to get it out some way. 

So, welcome osteoporosis and ovarian failure. I am here to fight and win. 

A New Chapter?

Although I would rather not think about any of this right now, I'd like to update you all on our most recent findings. 

This week was the conclusion of the testing my GI had set up to determine what was going on with me digestively.  Let me just say, the preparation for many of these tests is near torture so I am so glad they are over.  I suppose if this is an open forum and I am trying to connect with others who may be dealing with similar issues I need to be honest and open as well.  I had a small bowel follow through, a hida scan, an abdominal ultra sound, blood work, stool samples, a colonoscopy, and an upper endoscopy.  All of which, except the stool sample and blood work, required fasting of some sort.  Some required additional preparation, non of which was enjoyable.  When you are suffering, you are willing to do nearly anything to relieve the pain.  That's what I did.

At this point, there was no evidence of Ulcerative Colitis or Crohn's disease.  That was our biggest fear and the doctors initial thought.  The biopsies are still out so we will know for sure once we get them back.  That is a relief.  What they did find was my immune system attacking (surprise, surprise) the parietal cells of my stomach.  Leaving my stomach a beautiful disaster.

Parietal cells secrete gastric acid and intrinsic factor.  Intrinsic factor deals directly with the absorption of vitamin B12.  The inability to absorb B12 is called pernicious anemia.  The treatment is usually B12 supplements taken sublingually or by injection.  Gastric acid is a digestive fluid.  Gastric acid plays a key role in the breakdown and digestion of proteins, by activating digestive enzymes.  Together the enzymes and acids unravel the long chains of amino acids found in proteins. 

The doctor immediately checked my B12 levels, but I have been on B12 injections for a few months now based on a blood test that showed antibodies against these parietal cells.  I suspect the levels should be normal and I will continue the injections.  As for the gastric acid, we were told there is no replacing it.  My stomach did show a lot of damage so I was placed on a medication to heal it.  I understand this medication is normally used to treat stomach ulcers.

I was told at the conclusion of the final scope that a referral was going to be sent to an immunologist.  At this stage of the game, the goal is to stop the immune system from attacking healthy organ systems and continue fighting foreign invaders.  In a few weeks I will have follow up appointments and get the final results of all the tests.  The GI doctor seemed positive and said, "We're on the right track."

I have mixed emotions about this all.  I assume anyone would.  On one hand, I am happy that they actually found the source of this unyielding pain.  I am glad there is some validation.  At some point, you start to feel crazy feeling so sick with no answers.  I am also glad to be heading in the right direction to having the full picture of my health.  On the other hand, I am overwhelmed and frightened.  I was looking forward to some relief from the pain and discomfort.  I knew that would be unlikely if it turned out to be UC or Crohn's so when I heard the intestines looked good I was excited.  To know that there is no way to replace the gastric acid is rough because I know the lack of digestion is causing the pain.  Bundle that along with the lack of absorption of key nutrients leads to feeling pretty run down quite often.  I am frightened by what the immunologist may find.  I realize I should compartmentalize.  Looking at this as a whole is too overwhelming.  But human nature....well, I'll say my nature, is to plan and prepare...and worry I guess.  My way of dealing with this is to lay it all out, even the "unimportant" factors, and then compartmentalizing and move on.  That's what I'll do here.

I have been so self conscious about my physical appearance.  Let's face it, what woman isn't.  I feel very vain and superficial for feeling this way, but I will not deny it.  I have acne.  I hate it.  I learned that this is a symptom of the antibodies attacking the parietal cells.  Now, I know it will not clear up so I will have to learn to deal with a teenagers face in adulthood.  I have also had a very straight framed body.  With the most recent weight loss, I feel like a little boy.  That ultra thin hungry look is not what I go for.  Add that to the fact that I cannot wear clothing that is too tight or restricting on the abdominal area because it just puts too much pressure there, makes me feel sloppy.  I am in definite need of a fashionista to find some comfy, but flattering clothes.  That's enough vanity for today.

Now moving on to the physical aspects.  I am overwhelmed and frightened by the fact that they can continue to "band-aid" the pain, but it will never be resolved.  I am learning to eat slowly and chew very well.  I am so limited, at this point, as to how much and what I can ingest.  Many woman would be happy to be worrying about being too thin or being forced to eat less and be conscious about what is in your mouth, but it is not something that I enjoy at all.  Our culture and society is inundated with food.  Social gatherings, holidays, dates, movies, etc all involve food.  It is an integral part of our lives.  To me it is nothing but the enemy.  I was hoping this would not be the case for the duration, but the harsh reality is, it will be.  Rough road to be looking down.

So, I take all of this.  The good, the bad, and the ugly.  The truths, the uncertainties, and the predictions.  Gather them all in a pile.  I will take it and put it at the back of my mind.  When something needs to be accessed, it'll be there.  In the meantime, I wait.  I focus on my family.  I focus on my gorgeous son, who, by the way, turned 6 yesterday.  I take his smiling face and incredible heart and mind and I run with it.  Soak it up.  Keep my eye on the prize and leave the rest to God.  The burden is too big to carry so I imagine lifting it off of my shoulders and throwing it to Him.  I imagine my own father, who passed from complications of Type I diabetes nearly 24 years ago, looking down on me.  I feel him smiling down on me and guiding me.  I long to hear his voice.  I would love to ask for advice.  I know he is listening.  I know he is talking to me.  I just look for the signs.  I embrace my parents love and support.  I appreciate the warmth of my sister who lets me lose it whenever I feel the need.  I admire my husband for his strength and unyielding love throughout this all.  And I remember, no one is put on this earth to suffer.  It only enhances the good in life.

Moments of Weakness

The month of October has hit me like a ton of bricks.  I knew the 5 weeks following my first gastroenterologist appointment would be difficult, but I never imagined it would be this hard.  For the past several months these digestive issues have only worsened.  They are at a point where they affect every aspect of my day every day.  There was about 6 or 7 days at the end of September that I was blessed with some relief, but the fear was never far behind.  Testing will be done (hopefully) by the end of October so I was prepared for no relief until thereafter. 

In recent posts I have talked about my primary care doctor showing more signs of concern.  She is a bulldog, and I love that about her.  She does not want to leave any stone unturned.  In addition to the 4 tests the GI set up for me, my primary added a few additional scans.  At first thought, I was pleased.  There have been some doctors who tested for one thing, and when nothing was uncovered they would excuse the symptoms.  That usually only created a more devastating realization later.  So, I am glad my current primary is more thorough.

To put this in perspective for you I will give you a glimpse of my schedule of appointments.  (Because these are GI issues I will leave out details to save my own pride) I met with my GI doc on September 16th.  He scheduled a test for September 22 as well as October 24.  Both of these are out of town and fasting.  (Fasting is a Type I diabetics worst enemy)  In addition to these tests I have to have blood work and samples dropped off around October 16.  My primary decided I needed two additional tests.  I was scheduled for October 10 & 12 for these.  Again, both fasting.  These are all scans of some sort, not blood work so the fasting is not immediately resolved.

I dealt with the appointment on Sept 22 with the help of some amazing friends.  I left that appointment feeling like I could conquer this.  I thought, "the next five weeks of testing won't be so bad, and at least I'll have an answer soon."  Boy, was I wrong.  I fasted after a rough weekend for the appointment on October 10.  I get to the office and find out the machine went out on the prior patient.  "We are not sure how long it will take to fix.  If you want to go home we can call you as soon as it's up.  It could take all day."  This was at 9 in the morning.  I declined and reluctantly rescheduled the appointment for October 14th (another day of fasting). 

This morning I woke up fasting for a scan that was scheduled for 1pm.  That, in itself, is difficult for a healthy individual.  While I was showering and mentally preparing to get through this day, my phone rang.  The gentleman wants to push my appointment out another hour.  Apologetically he explains, "they completely overloaded me today, I just can't do it sooner.  Unless, you'd like to reschedule?"  In my head I am thinking, "It would've been easier if this had been earlier in the morning, but the thought of ruining another day with fasting is too much."  So, here I am waiting an additional hour to go to this scan.  I was also told by the nice gentleman to bring an iPod or something because the scan takes about an hour and a half to two hours.  Great!  Two more hours with no food. 

I know it sounds like an oxymoron for me to complain about having to fast when I already struggle eating to begin with.  It would be nice if I could go about my days with no food to avoid the GI symptoms, but I am diabetic.  Fasting only adds to blood sugar issues.  Also, I am still losing weight.  I am pretty sure fasting is not on the recommendation list for better nutrition.  Bottom line of it all, my life is being dictated by my symptoms and appointments. 

I feel completely out of control.  I do try to be as positive as possible at all times for the sanity of my family as well as myself.  There are so many factors I have no control over, I have to let those go.  The problem I am having now is, these uncontrollable factors are affecting my life far too much.  They talk about depression being severe enough to treat if it starts affecting your daily life.  Similar comments have been made about addictions.  If they are affecting your daily routine and responsibilities, they need to be addressed.  What do I do when tests, appointments, and symptoms are so severe I no longer feel like my days are my own.  I can barely schedule anything of my own choosing in the midst of all of this.  Add to that my husband and son who need me.  I would rather spend a day doing homework and running from practice to practice for my 5 year old than spending the day at a doctor's office while his aunt takes on my son's schedule.

Everything in moderation is something I hold dear to my heart.  I am allowing this anger and frustration to flow at this point.  I am allowed to be less than perfect.  Today I chose to let go.  Although I know there are policies, procedures, schedules, rules, regulations, etc. that affect how any business is run as well as health care facilities, I believe this is a huge short coming.

 It is now at a place where I am no longer looked at as a person.  I am a number or a name on a schedule.  The symptoms, pain, suffering, daily struggles are non-existent to these workers.  I understand that completely with my short career in health care.  You have to separate yourself in order to do your job properly.  You must find a balance.  These are still patients...PEOPLE with families and lives outside of this scan or that test.  It is not a haircut we can continually reschedule or a nail appointment that needs to be pushed back. 

I feel like there is no one out there that relates to me.  I feel like an outsider in my own world.  How do I work through these issues without sounding over dramatic and selfish?  Who do I talk to about this stuff without feeling like they are just humoring me?  Where do I turn? 

I pray.  I talk to my husband and family.  I stay in the present moment when I am with my son as much as I can.  I continue to do things I enjoy to have a sense of self in this mess.  I am thankful for the blessings in my life.  I try to learn from ever difficult situation I face.  At this moment in time I feel like screaming from the Empire State Building, "I learned the lessons.  I am trying to do the best I can.  Please, give me a break!!"  I just need some time. 

I wish every minute of everyday that someone out there will have the answer.  Maybe some doctor or some researcher has seen something similar to my case and has an approach that may make my quality of life a little easier.  I want my focus to be on my son and my family more than my obligations created by my health.  Sometimes it is good to really feel what you are feeling! 

Then you stop.....Live for today, pray for tomorrow.