Finding The Answers: Mono and My Tonsils

recovering from tonsillectomyMy, my, my. It has been a crazy few months. Crazy difficult.

I haven’t felt like myself for months. Starting in May, around the time I went to Vegas, I began feeling extreme fatigue. I’ve dealt with fatigue several times before, but this was significantly worse. I though it was caused by a vitamin deficiency, so I got all of my lab work done. But everything came back unremarkable, and the rapid mono-spot test came back negative. My doctor ordered additional tests, and there was still no answer to why I was so dang tired.

I’ve struggled with depression and anxiety for years, and the summer months tend to be difficult for me. I will get into a summertime slump, and try my best to just make it through my seasonal mental health woes. This summer was difficult, but it didn’t feel like the past few years. I had a hard time staying awake through a full day at work. Despite my best attempts to focus and be productive, I felt like my brain was in a continual fog. I would get home from work, zone out, and not accomplish anything else for the day.

Stress was high because our family knew that a cross-country move was on the horizon. Taylor was transferred to Detroit in March, and it became evident that our family needed to relocate to be with him. I wore myself out trying to apply for jobs for months, and nothing was working out. I was discouraged, in addition to feeling like a blob of fatigue.

In late August, some friends invited me to try a yoga class. I’ve heard that yoga is good for stress reduction, so I figured it couldn’t hurt. I didn’t love the class, but I gave it a good effort. The next morning I woke up feeling toxic. Over the next few days, I started developing swollen glands and a one-sided sore throat. I don’t know if this was caused by the yoga, or the toxins released by the stretches, but the timing is suspect.

recovery from tonsillectomy

As the pain and swelling worsened, I decided to get checked out at urgent care. The rapid strep test was negative, but the swelling was large and abnormal. I was diagnosed with peritonsillar abscesses, which can be caused by both bacteria and viruses. I went through courses of IV antibiotics, antibiotic shots, two rounds of oral antibiotics, and a whole lot of steroids. I spent weeks in pain, in bed, and missing work. I visited with my ear, nose, and throat doctor, who said that if they abscesses didn’t resolve themselves on their own, surgery was the next step.

Over a weekend, things got worse. I was in more pain, the swelling increased, and I was very dehydrated. I went back to urgent care, had another negative strep test, and the doctor diagnosed me with infectious mononucleosis. He ordered a large battery of viral testing, told me to avoid contact sports and saliva contact with people, and urged me to get a tonsillectomy ASAP. A few days later, the results came back. I indeed had mono, even though my earlier rapid strep test was negative. I was positive for herpes simplex 1 virus and Epstein Barr virus, with an active infection for 5 months. The only way to resolve the mono was to get the tonsils removed. As soon as my ENT could get me in, I had a surgery date scheduled.

I will not lie. The tonsillectomy was horrible. I wrote a very detailed post about the nitty gritty of an adult tonsillectomy on my other blog. Two weeks of pain, discomfort, swelling, and misery. But it also was a turning point for me – I knew life was about to get much better. I started to feel a spark in me that had been absent for half a year. After months of unsuccessful job hunting, I started getting job interviews. And then I quickly was offered a job. Things were starting to fall in place for our family to move, and we’re now in the thick of the moving process.

I haven’t been writing about my weight loss surgery much because my other health concerns have been far more important lately. I feel like I’m in my groove as a bariatric patient, and there’s not a lot of new things to write about. I have gained about 15 pounds through this mono/steroids/surgery/moving debacle, and I’m looking forward to being back on a schedule once we’re in our new house. I still feel the effects of mono fatigue, so I’ve been very careful to not overdo it with exercise. I do some moderate walking, but avoid anything excessive. I have far too much stress to manage to push myself physically.

I apologize if my future posts are less frequent. I haven’t give up this blog, but I also have greater responsibilities to fill my time (like my new job). I still plan to lose more weight and document it here. My journey is far from over.

But for now, I’ve at least figured out why I’ve felt so awful for half of a year.

My ER Visit in Vegas

in the ambulance for hypoglycemiaReactive Hypoglycemia. It’s serious stuff. And when it comes on, you have to stop EVERYTHING and take care of yourself.

I experienced my worst RH crash in Las Vegas earlier this month. I was in Las Vegas for New Media Expo, and was taking advantage of every chance I had to network, party, and enjoy my time in Vegas. Before I had my surgery, I didn’t have a lot of stamina to keep going and going at conferences. I would catch a few speakers, then go back to chill in my room. Go wander the expo halls, then chill in my room.

At NMX, I pushed myself to go ALL DAY LONG.

I partied too hard…which is funny for a girl who didn’t touch a drop of alcohol to say. I made the stupid mistake of staying up for 23 hours to play and party, then only slept for 3 hours. Latent insomina has been killer for me since I returned home from my trip to London, and I have a hard time sleeping in past 5:00 am. Once I was awake, I went to the hotel gym for a workout (since I knew it would be the only chance I would have for the day). Nothing too strenuous because I was tired, but I worked out nonetheless.

I went to a networking breakfast after, but apparently I didn’t eat enough. While I was in Guy Kawasaki’s keynote, I started feeling the evil crash of reactive hypoglycemia. Dizziness, double vision, sweating, and they chills. It was time to eat again – NOW.

I gathered my belongings, and walked to the closest place that had anything edible – the hotel convenience store. I got some Nutter Butter mini-cookies and some peanut butter M&Ms, trying to get a little protein in (with not a lot of great options). I took my snacks to the big padded hallway bench and started munching. But the double vision and dizziness got worse, so I laid down on the bench. A concerned conference-goer saw me and grabbed casino security. Security brought the EMTs over, who had me suck down part of a tube of glucose gel. It’s tough with gastric bypass patients…because not enough sugar will keep you crashing, and too much will make you have dumping syndrome.

waiting in the emergency roomTen minutes after the glucose gel, I wasn’t having much improvement in my symptoms. The EMT’s called the paramedics to give me an evaluation (and to bring a blood glucose monitor). By the time they pricked my finger and checked my blood sugar, it was back up to 90. I was getting frustrated and anxious because I usually feel so much better within 30 minutes of eating, but it wasn’t getting better. The paramedics decided to load me up on the gurney, give me some oxygen, and take me to the ER.

I felt sick enough that I couldn’t walk or form very many coherent sentences….but I was able to use my phone. I had the paramedic take my picture while we were on the way to the hospital, and I Instagrammed it with the #NMX hashtag because all these people at the conference saw the commotion with the EMT’s, but couldn’t communicate with me. Social media was the best way for me to keep people updated on my progress. At the hospital, they took a few vials of blood, gave me an exam, and hooked me up to an IV.

Over the next 3 hours, I spent most of it asleep in my curtained off area in the ER. I wasn’t able to eat or drink while they figured out what was happening, but they sure pumped me through of IV fluids. The emergency staff didn’t know much about gastric bypass patient protocol, let alone reactive hypoglycemia. After finishing my 3rd bag of fluids, I was given a diagnosis of fatigue and severe dehydration. My electrolytes were all out of whack, and my body was shutting down. It’s possible it wasn’t RH that made me feel so sick, but I’m pretty sure it was a factor.

nicole in bed recoveringI was discharged from the hospital with a strongly-worded charge to “take it easy.” Someone telling me to “take it easy” is like speaking Mandarin Chinese- completely unintelligible. I was at a fun conference, for heaven’s sake! My sister drove me back to the Rio from the ER, and while I was there, I wanted to talk to a few people to let them know I was okay. So even though I did walk around the expo, I only stayed about 10% as long as I wanted to. I drove my car back over to my hotel, then crashed for a 2 hour nap. I met up with some friends at Mon Ami Gabi at Paris for dinner, then skipped the official conference party. I spent a little time with some friends at the bar, then got so tired so quickly I had to be walked across the street to my room. I slept like a log that night.

The rest of the conference I drank lots of water, ate more often, took breaks often, avoided walking everywhere, and went back to my room to rest a few times. I didn’t go to every session, nor did I go to every party and activity I was invited to. It was tough to limit myself, but it’s what I had to do.

Next time I’m at a conference, I’ll do better about pacing myself…especially if I’m still dealing with daily RH symptoms.

Harder Than Expected

Over and over, I’ve heard people say some iteration of this idea: “Having weight loss surgery is taking the easy way out.” But I’m here to tell you – it’s tough. Life as a weight loss surgery patient has been much more difficult than I expected.

The last six weeks have been hard. Knock my socks off difficult. Throw in the towel tough. Along with the surgery-type challenges, there have been a lot of other situational stresses to deal with.

The biggest recent obstacle has been our family’s move. It’s stressful to move for everyone, and even when you have people helping you, it’s a big undertaking. I’ve moved six times in the last six years. I feel like I should be a pro mover at this point, but I seem to get more anxious with every moving experience. With the ongoing fatigue I’ve had, I felt my capacity to get things done was a drop in the bucket. My husband was the rockstar of the move, packing and lifting far more boxes than I did.

nicole's black eyeThe day we packed up the moving truck, I had a box springs mattress whack me in the head. It had been leaning against the wall, but it lost balance and landed on me as I was sitting on the floor. The wooden frame got me pretty good and knocked me out. I probably should have been checked out for a concussion, but I was too worried about moving. I worked through the dizziness because I felt like I had no other choice. The swelling from the hit eventually gave me a bruised eye socket.

And what happened the day after we moved into the new place? The sewer backed up. We were lucky that none of our personal belongs were ruined with the flood, but had to leave for a few days so crews could clean up, tear out carpet, and let things air out. Staying in a hotel right after a move wasn’t exactly restful. We’re glad to be back in our new home.

What else? I’ve been at my new job for a few weeks, and I really like it, but I feel like the fatigue I’ve felt recently is making me far less efficient than normal. It’s harder to focus and make it through the weekday. I thought that I’d feel more energetic at this weight.

Speaking of weight, I’ve been in a plateau for a few weeks. I was SO excited when I got under 300. But it’s been bouncing between 301.5 and 298.0 for over 2 weeks. At 298.0, I was officially 75.3 pounds down. Hopefully now that the move is over, I’ll be able to get into a better groove with my weigh loss. I haven’t been exercising much, and I am ready to have the strength to do so.

I’ve got an appointment with Dr. Smith tomorrow. I’m hoping to get some answers why I’m so tired. My guess is that I’ve got some nutritional deficiencies. I’ve been struggling with depression and anxiety, which seems to hit me hard every summer, so it might be time to switch up some medications.

A few people have asked me this week “Do you regret having the surgery?” I’ve had a lot of mixed feelings because I have had some complications and obstacles, but I don’t regret it. It’s given me the ability to make better decisions for my health. My body looks better than it has in several years, and I’m pleased with the results so far. I need to be patient with myself to keep doing the right things for my health. I haven’t been perfect with my eating habits, and it’s hard to overcome the temptations to use food as a crutch when things are hard. The difference is that surgery has given me a good tool to limit my ability to eat when I succumb to food to cope. If I’d been able to eat like a “normal person” through the last few weeks of the move, I probably would have gained 10 or more pounds. Instead, I’ve been bobbing between the same 3 pounds. I know I’m in a rough spot, but I also know it’s temporary. I just need to keep taking life one step at a time.

 

Hibernation

Every day since surgery, I’ve dealt with challenges. Usually the challenges are related to my body and the things that I can eat. Lately, it’s been a much more difficult battle mentally.

My body has changed a lot over the last 4 months. I’ve been through major surgery, I’ve dropped a lot of weight, I’ve likely had some nutritional deficiencies, and  all these changes take a toll.

Before surgery, I was given “the Bible” from my surgeon’s office. It’s a comprehensive binder full of information with food lists, side effects, warning signs, and facts about the different post-op stages. I read portions of the book daily for the first few weeks, but hadn’t picked it up for a while.

There is a phenomena called “hibernation syndrome” that is really common with gastric bypass patients. Patients are going through so many changes, and the body is getting used to far less food intake, and it causes fatigue and depression. People don’t feel like going out of the home or interacting with other people as much. It usually hits patients within the first few weeks after surgery, and gets better after about the 6 week mark. I didn’t really notice it at that point in time, but the last 3 weeks I’ve felt a lot different. I feel exhausted all the time, have been sleeping more, exercising less, and don’t feel like doing much. I don’t know if it’s directly surgery-related, or just due to other stress in my life.

I am going through a transition phase currently. I ended one job, started a new job, and I’m preparing to move.  So far I really like my new job – I think it’s a great fit, and I like the work that I’ll be doing. But there is always some anxiety about starting a new job and being “the new person”. I’m also a bit stressed because one of the perks of the job is a well-stocked fridge of drinks and a cupboard of treats and snacks. There are some “good” things that I can have, but there’s a lot of stuff I have to avoid. It will take a lot of will-power to avoid the foods that I know I shouldn’t have, but tempt me just because they are THERE. I’ve stocked my desk with some “safe” items that should satisfy me when the office treats are calling my name.

As for moving, we’re getting ready to move from our apartment in the Salt Lake valley into my parents’ basement in Lehi. It will be closer to work, which will be nice, but further from the city and airport (where I usually am at some point each week). It will be an adjustment to living in such close proximity to my parents and brother. However, it will help us tremendously financially. We’ve on a bunch of payment plans for my medical bills, in addition to all of our other monthly expenses and student loans. We’ll be able to position ourselves much better financially, but it will be a difficult loss of independence.

In happy news, I hit the 70 pound loss mark. I’m at 302.5, which is the least I’ve weighed since I lived in Atlanta in 2009. At that point in time, it was the most I’d ever weighed. I went on a pretty intense weight loss plan that didn’t yield a lot of weight loss, but instead threw my metabolism off for months. Pretty soon I’ll be to my “Michigan weight,” then my “California weight” and then to the weight I was when I married Taylor. Today he told me that when I get below 200, he’s taking me to Hawaii. Sounds like a great deal to me!

Forgive me if my posts are less frequent then usual, it’s been really hard for me to even turn on the computer. Once I’m off work, the last thing I want to do lately is get back on the computer. It’s a tough trade-off since most of my biggest supporters are online.

Hopefully this fatigue “hibernation” slump will be temporary. I’m going to make an appointment to see my surgeon and get my lab work done. If I can feel better just by figuring out if I’m deficient in a nutrient or two, it might explain why I’ve been so darn tired lately.

 

Some Days Are Harder Than Others

Some days I have a lot of energy. Some days I don’t.

While I was on FMLA, I had the luxury of resting, lounging, or sleeping as much as I needed to. Being back at work doesn’t allow me to follow my body’s cues when I’m needing to rest. If I push myself at work, that means I pay the consequences at home.

I got to work just after 8. By about 1pm, I was SO tired. I had eaten a light lunch of minced up deli turkey with some melted Laughing Cow cheese. I didn’t even finish half of it before I got shaky and nauseous. I ran to the restroom and lost my lunch. When I returned to my desk, I was dizzy and lightheaded. I figured my blood sugar was too low, so I had a few sips of juice and water. Five minutes later, I lost that too. I didn’t feel safe enough to drive home, so I sat back in my chair and tried to get my bearings. I left shortly after.

Because I wore myself out so much, I easily fell asleep and took a 3 hour nap. When I woke up to eat, I had a hard time keeping down soup. I had a hard time keeping down water. I felt too tired to do anything but lay in bed and be on my computer a little bit. As the night has dragged on, my body has broken out into hives. This is the 3rd time it’s happened since surgery, and all three times have been on days I’ve overdone it.

In an attempt to avoid reckless vomiting and widespread rashes, I REALLY need to listen to my body and stop before I’m too worn out. I’m trying to work myself (slowly) back to full time hours, but I really can’t handle more than 4-5 hours without rest. I have the option to work some hours from home, but by the time I get in bed to nap, my mind is gone for the night.

Food diary:

  • 2 oz Light yogurt
  • 3 oz Protein shake
  • Deli turkey and Laughing Cow wedge (lost it)
  • 1 oz Pomegranate Blueberry Trop50 (lost it)
  • 2 oz cream of vegetable soup
  • 2 oz marinara sauce, cooked mushrooms and melted cheese
  • 1 TB peanut butter