So…first, I was right about loving my doctor!! I needed his attention and he got that and gave it to me!! And did so with logistical concerns (like realizing that I was coming to him with something that we needed more time than he was scheduled for) and good science and openmindedness all wrapped in to his approach.

The summary – he agrees that this is not something that I should just be rolling with at this point and, yes, the symptoms are mostly vague, but we're going to scrub up and dive in. I'm making appointments with Endocrinology and Neurology, going back to the nutritionist to learn exactly what caught her concern when she looked at my blood work the first time we met, getting a full slate of blood work done again, and tracking everything so that I have data for all these approaches. And following up with him (with more time) so that we can sort out the various pieces and have a outline of what might go with what, which will help me navigate the lenses of the specialists in a more savvy way.

This is all that I hoped for with this appointment. I knew there weren't going to be answers. I wanted this medical partner. I do believe that even finding something I don't want to find would be better than just living in unknown…though let's hope for finding something simple or even just clearly diagnosed and managed!

Thanks to many of you who have shared your experiences and pockets of knowledge. I do have to remember not to borrow too much trouble (or fall over the cliff of hypochondriac), but beyond those things is a heap of information that is certainly a big component of a research phase!!

I know I've mentioned that I am extremely capable of a thorough research phase and that is very true! As with so many established methods of mine, I want to make a few adjustments here. I'd like to take in that paying this kind of attention takes time and energy and I need to make priority space for it. That doesn't just happen…doesn't just get crammed in! But it is way easier to say that than to consistently, thoroughly do it. There is A LOT OF CRAP out there ready to OOZE into freed up pockets of time! And this balance between the substantial lists of things I want to do, things I have to do and learning how to relax better is a constant negotiation. (Isn't negotiation such a sweeter word than battle?)

And I have more to say about that, but this is the scoop on the physical front!!

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I have an appointment with my primary care physician today – the first in quite a while and I feel like I’m preparing for battle, except I don’t know 1) where the fight is, 2) who I’m fighting, 3) if I’m the general or a lieutenant and 4) if this is the fight to stick with or if I’m starting a drawn-out-to-what-point-please-wake-up-and-pull-the-troops skirmish.

So, my friends, I’m going to use this blog to give a physical update and summary and try to get my head around it.  If you have any insight – I welcome it!  And if you have been with me through all this, please feel free to let me know if I’ve described the symptoms accurately.  I don’t want to be over-dramatic!

Emotional things aside for the moment (though I know they are factors) – here is the physical summary:

I lost 150-ish lbs over 10 years.  Starting with weight watchers, then a gastric bypass surgery and finally 6+ months of Medifast.  I did this between the ages of 29-40 (stage of life also being a factor here).  The major components of a gastric bypass surgery are limiting the food that I can intake and also changing the way that my body absorbs food and nutrients (because the first many inches of the small intestine are bypassed and no longer process food).   This all went swimmingly for 4 years, but it’s effectiveness for weight loss stopped at around 215 lbs (down from 290 pre-surgery and 320 at my peak).  The choice to do Medifast was careful and thorough and done with doctor and nutritionist input who had no concerns about how it would combine with the gastric bypass.  Medifast is a hugely restrictive, carefully balanced diet…800-1000 calories/day, less than 100gms of carbs (which should be a state of mild ketosis), all Medifast-formulated foods except for one meal of lean protein and vegetables per day.

I started Medifast in April of 2011, lost about 60 lbs.  Six months in (pretty much exactly), I started having trouble.  Increasingly worse dizzy spells – some that made driving unsafe and, over the course of 10 days or so eventually stopping really any physical exertion.  It happened to come at the same time as “that time of the month” (sorry, but it’s relevant!  And will be a part of the discussion below!) and so I blamed it on that until it didn’t go away when my period was done.  I went to the doctor and they immediately advised a change to the Medifast program – putting more carbohydrates in and raising the calorie level.

Now, here is where my emotional down-spiral began and a solid year+ of stress certainly has increased, exacerbated and confused the physical issues.  Still, that aside for now…

Since that time, I have consistently experienced significant periods of fatigue and dizziness, often accompanied by a slow-down of my mental processing (stuttering, slowed decisions and reactions, even blurred speech and drunk-like behavior in a few cases).  Those around me can tell the start of these swings when my face blanks out (and sometimes pales) and I start losing my train of thought.  Then, if left unchecked, I will feel unsteady on my feet, not comfortable driving and similar physical symptoms.  There have been times when it is just fatigue/dizziness and not the mental disconnect, but they go hand-in-hand about 50% of the time.

Just last week, a new thing showed up.  The dizziness had been back for about a week (again in conjunction with my period, though that is not always the case) and I was particularly low after a long day and a choir rehearsal – even though I had eaten when and what I was supposed to.  As I ate some soup and waited to recover, I noticed that my palms and fingers were distinctly blue.  If I moved them around for awhile, they would get a little pinker, but then I would hold them out and watch them darken – kind of alarmingly!  This lasted about 90 minutes and hasn’t reoccured, although neither has a low like that.

A Random List of Potential Factors and Thoughts:

• The periods of dizziness and energy fluctuation have come and gone throughout this entire 15 months, but they so far keep coming back.  I cannot determine a clean connection with stress, nutrition or menstruation.
• When everything first happened, I was told that it takes 3 months for nutritional deficiencies to develop and 3 more months for them to make themselves known (either in symptoms or in bloodwork).  That seems pretty pertinent to me given that I started Medifast and had the onset of all this 6 months later.
• We have run a ton of bloodwork and tests (especially in the October 2011 – January 2012 timeframe).  Accordingly to my primary doctor, all the values came back in the normal range and we could not pinpoint any possible solution.  According to the first visit with the wholistic nutritionist that we are currently seeing, she pointed out several values that she believed to be concerning given my particular situation.  Since then, she has backed off that stance, but her original response was to say that she wasn’t surprised that I hadn’t been feeling good for a year…which made a heck of a lot of sense to me!
• I did also have a major surgery in June with a major recovery that of course complicates the issue.
• My doctor (the same one that I’m seeing today) – concluded that I should “buck up and barrel through” given the normal test results.  I have learned the hard way that doing that results in a worse physical state, not a better one.  It does not feel like a good solution to me and, besides, here we are a year later and these issues are still impairing my ability to function normally.  Now, we can take issue with the fact that I may need to change my understanding of functioning normally, but I would rather have investigated further before I do that.
• We are still making major nutritional changes and decisions and surely my body is in flux with that.  The healing center that we are going to has us on two tracks – one is a food plan that is very specific about what kinds of foods to eat when throughout the day.  It is whole food based, heavy on lean protein and vegetables, based on body composition and blood type and primarily designed to even out blood sugar.  The second is to determine and address various intolerances and food-related insensitivities/allergies.  We were tested for those and are undergoing 8 weeks of avoiding everything that showed up on the list – the theory being to allow the body and the immune system to stop spending time fighting things that it doesn’t like and heal itself.  At the end of that period of time, we retest and should see a smaller list of foods that the body truly doesn’t like much.  Unfortunately, the 8-week list includes all the foods that we are all bombarded with these days (gluten, corn, soy, dairy, cane sugar) and others like eggs and peanuts.  Which not only makes for a really tough adjustment of our daily living and eating, but also constitutes another major nutritional change.
• Various people (including my therapist, vocal therapist and others with peripheral experience with these symptoms) have suggested a full thyroid investigation (endocrinology), neurological consult, gynecological (there’s a whole thread of thought on peri-menopause and it’s role in here) among other things.  Dizziness, though, is often a sub-clinical symptom…too vague to do anything with…so how much of a goose chase is this going to be?

Here’s my bottom line (though maybe it shouldn’t be?) – something very physical happened in October 2011.  And, underneath all the stress and surgeries, that physical distress has continued to be present for more than a year.  Did the major diet change or weight loss trigger something?  Did something get uncovered?  Did peri-menopause decide to act unconventionally and choose a single week to descend upon me?

I’m starting to enter a full research phase with this – tracking my blood sugar to get a baseline and see what happens during low periods, tracking our food, tracking my period, tracking the dizziness.  And…seeing my doctor. I have no idea what to expect from him, but he’s a very good listener/communicator and I’m just hoping for a partner in this phase and some direction about where/if to start investigating further.

This is a huge blog, I know, and not very engaging – but as usual, it is helpful to me to write it out.  And I haven’t talked about the physical in some time.  So thanks for enduring the details!

A whole ‘nother life ago, I worked at the University of Maryland (College Park).  I spent about 10 years there, “falling up the ladder” as I called it.  It was supposed to be my day job while I pursued my performance career, but this was no waitressing gig!  I started as a Research Assistant in the Fundraising Research office of the University of Maryland System headquarters the summer before my graduate program in opera began.  Within 2 years, I was the Assistant Director there and in 2 more years, I came over to College Park as the Director of Advancement Research.  I was 25 years old and suddenly in charge of building a research staff that grew to almost 20 people and a budget of nearly $1 million over the next 7 years.

But after four years of that job, I decided that wasn’t enough and I sought out the Office of Organizational Effectiveness and became an internal consultant for the University (in addition to my primary job there).  I was trained in a whole slate of organizational development consulting – including communications, strategic planning, facilitation, leadership coaching and change/transition management.  I loved it!  It’s where I started to realize my personal core skill set:  creativity, organization and that being-good-on-my-feet thing!

When I was laid off from the University, I formed my own independent consulting firm – yup, limited liability company status and everything! – thinking that I would use this as my primary source of income.  I called it Icarus Evolving – based on a concept that I loved so much that I’ll digress to tell you about it.  As the Greek myth goes – Icarus was the son of a master craftsman, Daedalus, who built wings from feathers and wax so that they could escape Crete.  As they took their first flight, Daedalus warned Icarus not to fly too close to the sun, but once they were aloft, Icarus forgot in his excitement.  He flew too high, the sun melted the wax and Icarus fell into the sea that now bears his name (the Icarian Sea).  It was an daring, incredible feat, based on masterful skill and innovation, and compromised only by a very human moment up there in the sky.  As humans, we evolve.  The fittest survive, yes, but the fittest learn from experience.  They keep the things that work and shed the things that don’t.  I wanted my clients to have the ability to innovate and take risks, to follow momentum and not be afraid of change and adventure and then to also be prepared, follow their strengths and keep their wits about them as they flew.

Great idea, no?  And, of course, at the same time, N. and I formed our game design business (Cheese Weasel Logistics), and I went full bore after my performance goals.  I wrote my first cabaret show and recorded a CD and all of that turned into Plunge! Cabaret which was also a fully formed company within the next two years (making three concurrent companies if you are counting – complete with budgets, taxes, business licenses, and the like).   For awhile, I was determined to have a career stove with 3 front burners.  I remember distinctly a working retreat that I had with a friend who was also building a consulting company (we were going to partner together) where I fought and fought for all 3 of my burners…and I ended up in tears (a fairly rare occurrence in my life at the time) as I realized that wasn’t going to work in real life.

Rather than continue with the life story…where am I going with this?  Always a good question and, as usual with these blogs, I don’t know when I start writing.  Lately, I’ve been simply staggered by the amount of change happening in my life right now.  It’s odd to be staggered now, isn’t it?  I mean…things have been in flux for well over a year now.  But things have been caught up in crisis for so much of that time.  Physical, emotional, relationship-ial crisis.  The crisis feel is lifting, which is wonderful and lets me breathe and see clearer.  And what I see is that every big change that it happening is not only ongoing, but actually in prime time right now.

THE DOCKET:

• N.’s transition is really just taking off.  Just moving from theory into daily practice.  And that, all on it’s own, is a huge thing for us both – encompassing physical and emotional energy, time and money.
• We are in the first stages of exploring a huge nutritional change – in the ongoing effort to solve the physical issues that I’ve been having for 15 months and for better health for us both.  I need to write more about this, but the dietary changes are massive and so our every meal requires our attention.  This, of course, follows on the heels of a major physical transformation (and surgery) for me.
• The vocal node that I struggled with 5 years ago is back (which really should be no surprise given my physical and emotional condition) and that means vocal therapy and daily attention to my speaking and singing habits.  Huge.
• And, finally, citing my described history (above) of multi-burner tending, I realize that I need to assess that pace of life because I don’t have the energy or the time that I need to devote to my (and our) physical and mental health.  So, I’m deeply engaged in figuring out how to realign.  How to include more things that both energize and relax me – the things that work.  How to shed things that don’t.  This is a task that aims to change 25 years of habit.

Just a few changes, right?  And me…swimming about in them  with the only real tool that I’ve come up with being to not panic and let all the pieces just be around without grabbing for too much structure too soon.  And…10 years ago, I was going about as an organizational consultant with a focus on change management.  Really?!!  Really!  What the hell did I know?!  Had I actually experienced significant change myself?  I mean, I suppose in some ways, but certainly not change that was hard like this or emotionally charged like this.  I loved the name and the idea of Icarus Evolving, but always thought of myself more like Daedalus.  The innovator, the master and the one who kept his head.  Turns out that Icarus and I have WAY more in common.  Only, I am lucky enough to be here evolving…learning from my human moments.  Perhaps, one day, I too will have a sea named after me…let’s just hope that it’s not because I crashed into it!