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!