I visited my ND today to discuss my latest blood test results. She wasn't concerned about my low WBC because it was still in the normal range. She did suggest that I get another CBC after 3 months, to check whether my wbc is still in range. We both decided against LDN, because it exacerbates the effect of thyroid supplements. Finding an effective thyroid dose took me a year. So I don't want to mess with that. However, she agreed that I could take IAG (arabinogalactans) again to fight and prevent colds. I've had 2 colds since returning from Maui in late October and might be getting my husband's cold, which he got from a coworker. I gave him a dose of IAG as soon as I got home, because hesbeen home sick for the past 2 days.
After looking at my toenails, my doc suspected I may need to continue treatment for 6 months. She previously recommended treating my chronic toenail fungus with oil of geranium mixed with DMSO 2x daily for 3 months. However, considering I had that problem for many years, 6 months of treatmet is more realistic. SIGH
The really good news was my blood pressure (120/75), pulse (85) and temperature (98.8). Those were my first really normal readings ever. However, I suspect those were a tad inflated because I had just eaten lunch before my appointment. Nevertheless, those reading show that my thyroid supplement is finally the right amount and type (T3 only) to resolved my hypothyroid symptoms.
Thursday, November 15, 2012
Thursday, November 8, 2012
Blood Test Results
I received my lab test results. My vitamin D3 level decreased a bit, but is still within the 'normal range' according to the lab range. However, I know that's not optimal and could explain my frequent respiratory infections (2 colds in the last month). So I increased my daily supplements from 1000 to 2000mg of D3.
My CBC had few surprises. Everything was normal, except my WBC, which dropped even more during the past year, and my MCHC which slipped below normal again. My WBC level was right at the bottom of the normal range.
The surprise was the TB blood test (IGRA or interferon gamma release assay). That was negative for the tb bacteria. I was surprised that I could get a negative blood test result after getting 2 positive skin tests as a child and another positive blood test when I was in my early 20s. However, I'm happy that I won't have to take long term antibiotics (6-9 months) to treat latent tb. Also I can't explain my low WBC with latent tb. However, I did take vancomycin (to treat c-diff) for several months. Vancomycin can sometimes cause neutropenia (low neutrophils) which lowers the WBC. I never had low WBC until after I took Vancomycin for an extended period. Nevertheless, I don't understand why my WBC would continue to drop 3 years after I took vanco and also was treated with LDN (to raise WBC) for several months. I need to talk to my ND about my decreasing WBC.
My CBC had few surprises. Everything was normal, except my WBC, which dropped even more during the past year, and my MCHC which slipped below normal again. My WBC level was right at the bottom of the normal range.
The surprise was the TB blood test (IGRA or interferon gamma release assay). That was negative for the tb bacteria. I was surprised that I could get a negative blood test result after getting 2 positive skin tests as a child and another positive blood test when I was in my early 20s. However, I'm happy that I won't have to take long term antibiotics (6-9 months) to treat latent tb. Also I can't explain my low WBC with latent tb. However, I did take vancomycin (to treat c-diff) for several months. Vancomycin can sometimes cause neutropenia (low neutrophils) which lowers the WBC. I never had low WBC until after I took Vancomycin for an extended period. Nevertheless, I don't understand why my WBC would continue to drop 3 years after I took vanco and also was treated with LDN (to raise WBC) for several months. I need to talk to my ND about my decreasing WBC.
Monday, November 5, 2012
November Update
Several months have past since my last blog. So I'll try to update all the issues I mentioned in previous blog posts:
Since early August I've taken the same thyroid supplement dose (55mg of liothyronine or T3) daily in 4 divided doses (17.5, 12.5, 12.5, 12.5). I previously thought 4 divided doses would be challenging. However, I actually felt better with doses spaced every 3-4 hours during the day. My energy and mental focus were more stable with 4 doses, than 3 doses, which I tried a few times at the 55mg dose. I have experienced no hypothyroid symptoms since I stabilized at that dose over the past 3 months. Best of all, I have normal energy, body temperature and regularity every day. Finally!!
On Labor Day I bought new car after keeping my old Toyota Van for almost 25 years. My husband actually wanted to sell his 1990 Plymouth Voyager and get a smaller communter car. He assumed I always wanted to keep my van, which I used for my watercolor painting business (a/c fairs, juried show and gallery deliveries, hauling supplies, etc.) for 15 years. However, prior to getting the van, I owned/loved my Mazda GLC, but lost it in a divorce settlement after 10 years. So after my husband looked at and didn't like his first 2 choices (Toyota Prius and Honda Fit), I suggested we look at Mazda 2's. I told him that I would trade in my van, if we got the right car (what I really wanted LOL). Long story short: We bought a new red Mazda 2 together (each of us paid 1/2). We advertised my van online and heard from a buyer the next day. Within 24 hours I sold the van. However, my husband wasn't sure he wanted to sell his older car. He also saw how much I loved the new car. I decided to pay him back what he paid for the Mazda so that I would own it outright. I drive it at least 3x a week, compared to maybe driving my van once a month after I retired from my watercolor business about 10 years ago. It's so nice to have a small car that fits me (I'm only 5'3.5" and about 100#), rather than a big van.
After year of attending (and even joining) a local church, which had Baptist roots, but purported to be a 'community' church with no denomination, I tired of the constant shame and sin focussed sermons. We also served every Sunday cleaning up the sanctuary as well as attending a membership class, but still didn't know many people or feel even slightly connected. My husband tired of hearing my dissatisfaction with the church's consistently negativemessage, which differed from what I had recently read (books by Wayne Dyer, Anita Moorjani, the Dalai Lama and others). So we agreed to try Seattle Unity after a long absence from Unity. (We were married by a Unity minister on Maui and then attended Bellevue Unity for a year before moving twice and ending up at a Seattle church for many years before trying a more local church.) I was sooo impressed by the love and acceptance I felt from Unity members on the first Sunday. I was also interested in the many activities offered during the week. We tried a midweek service, which I loved. However, I was more impressed with a study group for A Course in Miracles. I read that book (669 pages of heavy text) in 2 months and now continue to attend the study group once a week. Briefly, ACIM changed me emotionally, spiritually and somewhat physically.
In October we again flew to Maui (7th? trip) and stayed for a week, which was not long enough to really unwind and enjoy. We had to follow a schedule to do everything we wanted to do in a week. We even skipped a few favorite activities. We did see Ulalena (musical about the origin and history of Maui). After a week however, I was happy to return home to my new car and ACIM group. (I brought macadamia nuts for all the members!)
Unfortunately I also brought back a bad cold (despite taking DHEA every day) from Maui. After we returned (and I was very sick), my husband read an article which explained latent tb (which I've had since childhood). Although the tb bacteria doesn't infect the lungs in latent tb, the bacteria are alive and multiplying. Only because macrophages and white blood cells surround and keep tb bacteria in check, tb is considered 'latent'. However, I've had low white blood cell counts for the past several (4?) year, despite my ND's efforts to improve my immunity through increased vitamin D, thyroid supplements, betaine hydrochloride supplements (for digestion), DHEA supplementation and even 3 months of low dose naltrexone (LDN), which was the only treatment that actually raised my WBC count from 3.0 (below normal) to 6.2 (mid normal range. However after 3 months w/o LDN, my WBC dropped back to 4.2. That was a year ago. So I asked my doc to order another WBC and a TB blood test. (I had positive skin tests during childhood, after I was exposed to my aunt's active TB.) I had the blood draw for those tests just this morning. So I won't know the results for a week.
Our garden is almost finished for the season. We still have some grapes, brocolli, carrots and leeks. I'd like to resume sewing. I still have fabric and lots ideas. However, I want to clean up the flower and garden beds before the weather turns too cold and rainy which may happen next weekend. Since I mentioned an unresolved issue (TB and CBC tests), I'll most likely post again this month or next month. I can't imagine posting more often than once a month though. I'm just too busy living to have time to post.
Since early August I've taken the same thyroid supplement dose (55mg of liothyronine or T3) daily in 4 divided doses (17.5, 12.5, 12.5, 12.5). I previously thought 4 divided doses would be challenging. However, I actually felt better with doses spaced every 3-4 hours during the day. My energy and mental focus were more stable with 4 doses, than 3 doses, which I tried a few times at the 55mg dose. I have experienced no hypothyroid symptoms since I stabilized at that dose over the past 3 months. Best of all, I have normal energy, body temperature and regularity every day. Finally!!
On Labor Day I bought new car after keeping my old Toyota Van for almost 25 years. My husband actually wanted to sell his 1990 Plymouth Voyager and get a smaller communter car. He assumed I always wanted to keep my van, which I used for my watercolor painting business (a/c fairs, juried show and gallery deliveries, hauling supplies, etc.) for 15 years. However, prior to getting the van, I owned/loved my Mazda GLC, but lost it in a divorce settlement after 10 years. So after my husband looked at and didn't like his first 2 choices (Toyota Prius and Honda Fit), I suggested we look at Mazda 2's. I told him that I would trade in my van, if we got the right car (what I really wanted LOL). Long story short: We bought a new red Mazda 2 together (each of us paid 1/2). We advertised my van online and heard from a buyer the next day. Within 24 hours I sold the van. However, my husband wasn't sure he wanted to sell his older car. He also saw how much I loved the new car. I decided to pay him back what he paid for the Mazda so that I would own it outright. I drive it at least 3x a week, compared to maybe driving my van once a month after I retired from my watercolor business about 10 years ago. It's so nice to have a small car that fits me (I'm only 5'3.5" and about 100#), rather than a big van.
After year of attending (and even joining) a local church, which had Baptist roots, but purported to be a 'community' church with no denomination, I tired of the constant shame and sin focussed sermons. We also served every Sunday cleaning up the sanctuary as well as attending a membership class, but still didn't know many people or feel even slightly connected. My husband tired of hearing my dissatisfaction with the church's consistently negativemessage, which differed from what I had recently read (books by Wayne Dyer, Anita Moorjani, the Dalai Lama and others). So we agreed to try Seattle Unity after a long absence from Unity. (We were married by a Unity minister on Maui and then attended Bellevue Unity for a year before moving twice and ending up at a Seattle church for many years before trying a more local church.) I was sooo impressed by the love and acceptance I felt from Unity members on the first Sunday. I was also interested in the many activities offered during the week. We tried a midweek service, which I loved. However, I was more impressed with a study group for A Course in Miracles. I read that book (669 pages of heavy text) in 2 months and now continue to attend the study group once a week. Briefly, ACIM changed me emotionally, spiritually and somewhat physically.
In October we again flew to Maui (7th? trip) and stayed for a week, which was not long enough to really unwind and enjoy. We had to follow a schedule to do everything we wanted to do in a week. We even skipped a few favorite activities. We did see Ulalena (musical about the origin and history of Maui). After a week however, I was happy to return home to my new car and ACIM group. (I brought macadamia nuts for all the members!)
Unfortunately I also brought back a bad cold (despite taking DHEA every day) from Maui. After we returned (and I was very sick), my husband read an article which explained latent tb (which I've had since childhood). Although the tb bacteria doesn't infect the lungs in latent tb, the bacteria are alive and multiplying. Only because macrophages and white blood cells surround and keep tb bacteria in check, tb is considered 'latent'. However, I've had low white blood cell counts for the past several (4?) year, despite my ND's efforts to improve my immunity through increased vitamin D, thyroid supplements, betaine hydrochloride supplements (for digestion), DHEA supplementation and even 3 months of low dose naltrexone (LDN), which was the only treatment that actually raised my WBC count from 3.0 (below normal) to 6.2 (mid normal range. However after 3 months w/o LDN, my WBC dropped back to 4.2. That was a year ago. So I asked my doc to order another WBC and a TB blood test. (I had positive skin tests during childhood, after I was exposed to my aunt's active TB.) I had the blood draw for those tests just this morning. So I won't know the results for a week.
Our garden is almost finished for the season. We still have some grapes, brocolli, carrots and leeks. I'd like to resume sewing. I still have fabric and lots ideas. However, I want to clean up the flower and garden beds before the weather turns too cold and rainy which may happen next weekend. Since I mentioned an unresolved issue (TB and CBC tests), I'll most likely post again this month or next month. I can't imagine posting more often than once a month though. I'm just too busy living to have time to post.
Sunday, July 15, 2012
Summer Update
I haven't posted for awhile. So I'll update my hypothyroid recovery progress and add some day to day news.
After abstaining from DHEA for several weeks, my hypothyroid symptoms decreased while taking 52.5 mcg of T3. When I began to experience cold symptoms (sore throat, sinus pain, etc.), I took a 2.5 mg sublingual DHEA dose at least an hour after my T3 dose or late at night. The DHEA gave me immediate relief from cold symptoms. So I use it when needed, rather than taking a daily 2.5 mg sublingual dose. That seems to work well, because 52.5 mg of T3 daily has eliminated hypo symptoms for almost 3 weeks now, even while taking the 5 mcg tablets (which supposedly have too much absorption blocking cellulose). I will use my last 5mcg tablet tomorrow. So I'll try using 50mcg doses with the 25 mcg tablets. (I can easily split the 25s into halves, but have more difficulty cutting those into quarters to make up 50mcg total daily dose with 3 smaller divided doses.)
I've enjoyed the warm summer weather which helped all our garden crops (strawberries, blueberries, raspberries, grapes, brocolli, beans, lettuce, leeks, carrots, tomatoes). I played tennis, enjoyed walking around our local lake and taken some day trips. We usually plan a vacation in the fall, but enjoy local activities during the summer. I also continued to sew summer tops, but plan to begin some sun dresses after I finish some alterations.
I plan to see my doctor either after I stablize on my T3 dose or just before I run through my current prescriptions, whichever comes first. I'll give her a copy of Paul Robinson's book "Recovering with T3", which taught me how to use T3 only to eliminate my hypothyroid symptoms after T4 only and T4 plus T3 didn't work.
Monday, May 28, 2012
DHEA Blocks T3 Absorption
During the past few weeks I experienced more constipation, which is my most obvious symptom of hypothyroidism. Since I had been taking 50mcg of T3, I hesitated to raise my dose again. Instead I scanned "Recovering with T3". Miraculously I read about the author's experience with drugs which can block T3 absorption. Those drugs include hydrocortisone, DHEA, alcohol, and some antibiotics.
I began taking DHEA sublingually last December (almost 6 months ago). When I refilled my prescription in late March, I told the pharmacist that I still had immunity problems (cold symptoms). So the pharmacist suggested that I raise my DHEA dose to improve immunity. After I raised my dose to 4.0mg in early April, I experience greatly improved immunity (no cold symptoms no matter what else I did). Perhaps I got more vitamin D on sunnier days.
However, I also began to have more hypothyroid symptoms during April. So I raised my dose of T3 over a 6 week period from 42.5mcg to 50mcg. I experienced temporary relief (from constipation, low body temperature and fatigue) with each increase. However relief was short lived. After 2 weeks on 50mcg I began having more severe constipation, which was not relieved even by extra magnesium. (I already followed all the usual 'regularity' rules of fluids, fiber, exercise, etc. for years but nothing consistently resolved irregularity until I began T3 thyroid supplement therapy.)
After reading about drugs which block T3 absorption, I decided to abstain from DHEA to see what happens. The very first day without DHEA, I had relief from irregularity. If the DHEA increase blocked my T3 absorption, while I slowly increased the T3 dose, I wonder whether my current T3 dose (50mcg) may prove to be too high. I need to watch for hyperthyroid symptoms, while I'll abstain from DHEA until I notice immunity problems.
Thursday, May 17, 2012
Good Results with 50mcg T3
I've finally adjusted to 50mcg of T3 (liothyronine) only each day. After back and forthing between 47.5 and 50 total mcg of T3, I finally experienced hypothyroid symptom relief without incurring hyperthyroid symptoms. I tried 3 divided doses of 50mcg for a week. However, I still had low energy between my 2nd and 3rd doses each day. So I began experimenting with 4 daily doses again. That works well as long as I can space my doses either 1/2 hour before or 1 hour after meals. Even when I take the last dose after 8pm, I still sleep soundly. Best of all that total (50mcg) dose completely resolved my irregularity problem.
So I can finally stick with one prescription (25mcg tablets), rather than needing a 25mcg and a 5mcg prescription to get the appropriate sized doses. I'm splitting 25mcg pills in half and taking 4 halves daily 3-1/2 to 4 hours apart. That keeps me evenly warm and energetic, but doesn't cause heart palpitations. I hope I can stick with this dose for awhile. I've taken T3 only for 19 weeks now (almost 5 months). So I suspect my natural T4 very suppressed (as well as my TSH) and all the synthetic T4 cleared from my body 2 months ago.
I plan to see my doctor in late June or early July after a month or so on the 50mcg dose. By that time I should know whether I've stabilized (complete symptom relief, but especially normal regularity) on the 50mcg dose. Then I'll request a new prescription of 25mcg tablets (2 daily). I just hope I don't need to increase again (and need those litte 5mcg tablets to get the necessary amount). Maybe I should 'manifest' (ala Wayne Dyer's approach) 50mcg in 4 divided doses is my longterm stable T3 dose. Of course I'll give my doc a copy of "Recovering with T3' to convince her that I don't need T4 (as well as my history since early January of taking T3 only).
Friday, April 27, 2012
Liothyronine Dosage Changes
After doing well with 42.5 mcg of liothyronine (T3) in 3 divided daily doses for 5 weeks, I noticed obvious hypothyroid symptoms (my usual constipation, fatigue and low body temperature). So I tried increasing to 45mcg (in 3 divided doses) for 9 days, but still didn't experience complete symptom relief. Then I tried 47.5mcg (in 3 divided doses) for 3 days.
I have always wanted to try 4 divided doses with 25mcg tablets, which would eliminate the necessity of 2 prescriptions (one for 25mcg tablets and one for 5mcg tablets). So after only 3 days on the 47.5mcg level, I decided to try 50mcg in 4 divided daily doses. Unfortunately I slept in the first day and took my first pill late, which moved all my subsequent doses later. I took my last dose about 8pm and didn't sleep well last night. However, I suspect reflux from a high fat with onions dinner challenged my sleep more than feeling too warm or hyper from the late t3 dose.
Nevertheless, I tried another day of 4 divided doses for a total of 50mcg today. Perhaps because I didn't sleep well last night, I didn't feel more energetic with 4 divided doses. I also suspect the doses are actually too small to provide symptom relief. Trying to schedule 4 divided doses around eating meals and taking supplements (especially magnesium) is more difficult than my 3 divided doses which I've taken for almost 4 months now.
Sooooo ... I'll backpedal tomorrow and return to 3 divided doses of 47.5 mcg, which I really didn't give a fair trial. Coincidentally I started having more hypo symptoms after 13-14 weeks on t3 only. That makes me suspect that T4 has completely cleared from my body and I rely only on my T3 supplement for thyroid hormones. That makes me wonder whether I will eventually need as much as 50mcg daily. I also could try the circadium method of taking my first t3 dose a few hours before I normally get up. I've tried that method a few times, but I usually don't return to sound sleep. I need sound sleep as well as thyroid supplements to feel energetic the next day. However, for now, I'll return to 47.5mcg in 3 divided doses and give that a week before I consider another increase.
Thursday, March 8, 2012
Rx Comedy of Errors
The prescription refill saga continued all day yesterday. I said in my last post that I called my pharmacy to order a prescription refill request. Because I needed to change the total amount and dosing directions, I was referred to a pharmacist. She heard my request and promised to fax my refill request to my doc's office.
I left several messages with my doc's assistant to alert him about my refill request from my HMO pharmacy. At 4:30pm I finally connected with that assistant, who said he never received a refill request fax from my pharmacy. I told him that I needed the refill soon, because I would soon run out of my current prescription. So he promised to call my pharmacy and tell them my refill request, which they could fax to him. After getting my doc's signature, he would fax the request back to my pharmacy the next morning. Then they could fill the prescription that day, which means I could pick up and pay for both prescriptions with one trip.
The next morning I had not heard from my doctor's assistant. So I didn't know whether he connected with my HMO pharmacy and ordered the refill request fax. So I called my HMO pharmacy again (actually their call center at a different location). I told them that my doc never received the refill request fax promised by the pharmacist on Monday (around noon). I was then told that pharmacist was a 'floater' (didn't work fulltime). I said that her status wasn't an excuse for not doing her job. Then I asked why I wasn't referred to a fulltime employee, but didn't get an answer.
Nevertheless another pharmacy call center worker took my information and promised to send another refill request fax to my doc. After I talked to her, I received a call from my doc's assistant. He told me that he had received the refill request fax. Now he was awaiting my doc's approval and signature on the request. Then he would fax that back to my HMO pharmacy. So I should get my prescription filled on Thursday.
After I talked to my doc's assistant, I received a call from the pharmacy call center worker who promised to order my refill request fax. She told me that the pharmacy had faxed the request to the wrong doctor (one whom I'd never met or visited). So she ordered another refill request fax to my doc. I told her that my doc's assistant had received the refill request that he ordered. So we were just awaiting my doc's signature.
Later I called my doc's office to ask whether my refill request had been faxed back to my pharmacy. The receptionist said the doc was very busy with patients and hadn't signed the request. So by late afternoon my doc had still not signed or return faxed my request. At that point I knew that I wouldn't get my prescription that day, because my pharmacy often doesn't have enough pills to fill orders. So they need to order more pills from the call center. So they don't have enough pills to complete te order until afternoon on the following day.
Because I had a different prescription, which supposedly had been filled on Tuesday and was at my pharmacy, I called the pharmacy to verify that prescription was actually at the pharmacy, rather than waiting for more pills to fill the order (or misplaced somewhere in the pharmacy, which has also happened a few times). Per usual I couldn't talk to the actual pharmacy personnel. I got someone else at the call center. However, afer a long conversation, she convinced me that I would save money, hassle, and mistakes by ordering prescription refills online in the future. That would only work if the dose and amounts were the same, not in the present situation.
Before I left to walk to my pharmacy to pick up another prescription, I checked my HMO's website, which shows when prescriptions are supposedly filled. I noticed that my new prescription had the correct total amount (135 pills to cover 1-1/2 per day for 3 months). However, I only had 1 refill, instead of the 2 refills my doc usually gives me. So I again contacted the woman at the pharmacy call center, who had ordered the refill request which was sent to the wrong doctor. I told her that I didn't have enough refills on the order and asked if she knew what happened. She told that my doc had changed the amount from the 135 I had requested to cover 1-1/2 pills daily back to the 90 which my previous prescription contained. The call center person knew I wanted 135 per bottle/prescription. So she changed the prescription to obey my doc's order for 3 months of 90 each but still satisfy my request for 135 pills for each prescription. That meant I'd only get one refill, which also meant I'd face another week of hassles after only 6 months of my prescription.
So I called my doc's office and asked the receptionist if she knew why my doc changed my refill order. She said my doc thought 135 pills for each prescription was too much. Apparently she had not talked to her assistant, to whom I explained that I took 1-1/2 pills daily, which would deplete my prescription in less than 3 months.(That already happened with my last prescription.) So I needed 135 or 1-1/2 times the original 90 pills in each refill. I asked if my doc could correct the original refill request fax by changing the refill number. I also told the receptionist that my doc could call me at any time on my cellphone during the next 2 hours. I never received a call from my doc. However, the next time I saw my HMO's website record of my prescriptions, the description for the second prescription showed 2, rather than only one refill. That matches the number of refills for my first prescription of the same thyroid supplement.
Maybe I should clarify, that I have gotten (for the previous 3 months) 2 prescriptions with 2 different amounts of T3 thyroid supplement. I wish I could just get one, but I would either have to count out many small amount pills daily or I'd need to split the larger amount pills into tiny increments which wouldn't be very accurate. While I'm still adjusting my thyroid supplement levels, I want the flexibility of 2 different total dose pills, from which I can assemble my 3 daily divided doses Right now my first morning dose is larger than my second midday and last afternoon dose. Who knows what I'll need in another 9 months? I may be on an even dose which I can divide. Meanwhile I have enough different sized pills to assemble my daily thyroid supplement dosage needs.
.
I left several messages with my doc's assistant to alert him about my refill request from my HMO pharmacy. At 4:30pm I finally connected with that assistant, who said he never received a refill request fax from my pharmacy. I told him that I needed the refill soon, because I would soon run out of my current prescription. So he promised to call my pharmacy and tell them my refill request, which they could fax to him. After getting my doc's signature, he would fax the request back to my pharmacy the next morning. Then they could fill the prescription that day, which means I could pick up and pay for both prescriptions with one trip.
The next morning I had not heard from my doctor's assistant. So I didn't know whether he connected with my HMO pharmacy and ordered the refill request fax. So I called my HMO pharmacy again (actually their call center at a different location). I told them that my doc never received the refill request fax promised by the pharmacist on Monday (around noon). I was then told that pharmacist was a 'floater' (didn't work fulltime). I said that her status wasn't an excuse for not doing her job. Then I asked why I wasn't referred to a fulltime employee, but didn't get an answer.
Nevertheless another pharmacy call center worker took my information and promised to send another refill request fax to my doc. After I talked to her, I received a call from my doc's assistant. He told me that he had received the refill request fax. Now he was awaiting my doc's approval and signature on the request. Then he would fax that back to my HMO pharmacy. So I should get my prescription filled on Thursday.
After I talked to my doc's assistant, I received a call from the pharmacy call center worker who promised to order my refill request fax. She told me that the pharmacy had faxed the request to the wrong doctor (one whom I'd never met or visited). So she ordered another refill request fax to my doc. I told her that my doc's assistant had received the refill request that he ordered. So we were just awaiting my doc's signature.
Later I called my doc's office to ask whether my refill request had been faxed back to my pharmacy. The receptionist said the doc was very busy with patients and hadn't signed the request. So by late afternoon my doc had still not signed or return faxed my request. At that point I knew that I wouldn't get my prescription that day, because my pharmacy often doesn't have enough pills to fill orders. So they need to order more pills from the call center. So they don't have enough pills to complete te order until afternoon on the following day.
Because I had a different prescription, which supposedly had been filled on Tuesday and was at my pharmacy, I called the pharmacy to verify that prescription was actually at the pharmacy, rather than waiting for more pills to fill the order (or misplaced somewhere in the pharmacy, which has also happened a few times). Per usual I couldn't talk to the actual pharmacy personnel. I got someone else at the call center. However, afer a long conversation, she convinced me that I would save money, hassle, and mistakes by ordering prescription refills online in the future. That would only work if the dose and amounts were the same, not in the present situation.
Before I left to walk to my pharmacy to pick up another prescription, I checked my HMO's website, which shows when prescriptions are supposedly filled. I noticed that my new prescription had the correct total amount (135 pills to cover 1-1/2 per day for 3 months). However, I only had 1 refill, instead of the 2 refills my doc usually gives me. So I again contacted the woman at the pharmacy call center, who had ordered the refill request which was sent to the wrong doctor. I told her that I didn't have enough refills on the order and asked if she knew what happened. She told that my doc had changed the amount from the 135 I had requested to cover 1-1/2 pills daily back to the 90 which my previous prescription contained. The call center person knew I wanted 135 per bottle/prescription. So she changed the prescription to obey my doc's order for 3 months of 90 each but still satisfy my request for 135 pills for each prescription. That meant I'd only get one refill, which also meant I'd face another week of hassles after only 6 months of my prescription.
So I called my doc's office and asked the receptionist if she knew why my doc changed my refill order. She said my doc thought 135 pills for each prescription was too much. Apparently she had not talked to her assistant, to whom I explained that I took 1-1/2 pills daily, which would deplete my prescription in less than 3 months.(That already happened with my last prescription.) So I needed 135 or 1-1/2 times the original 90 pills in each refill. I asked if my doc could correct the original refill request fax by changing the refill number. I also told the receptionist that my doc could call me at any time on my cellphone during the next 2 hours. I never received a call from my doc. However, the next time I saw my HMO's website record of my prescriptions, the description for the second prescription showed 2, rather than only one refill. That matches the number of refills for my first prescription of the same thyroid supplement.
Maybe I should clarify, that I have gotten (for the previous 3 months) 2 prescriptions with 2 different amounts of T3 thyroid supplement. I wish I could just get one, but I would either have to count out many small amount pills daily or I'd need to split the larger amount pills into tiny increments which wouldn't be very accurate. While I'm still adjusting my thyroid supplement levels, I want the flexibility of 2 different total dose pills, from which I can assemble my 3 daily divided doses Right now my first morning dose is larger than my second midday and last afternoon dose. Who knows what I'll need in another 9 months? I may be on an even dose which I can divide. Meanwhile I have enough different sized pills to assemble my daily thyroid supplement dosage needs.
.
Wednesday, March 7, 2012
Rx Refill Problems
I felt really well on 42.5mcg total T3 yesterday. I took 15mcg early morning, 15 mcg 5 hours later and 12.5 mcg 5 hours after that (5pm). I had even energy levels until about bedtime (10pm). I slept well and had no regularity problems this morning.
However, I'm still waiting for my pharmacy to fax a refill request to my doc's clinic to okay my different presciption of 1/2 of a 25mcg tablet 3x daily, rather than 2x daily, which was my prescription level over 3 months ago. So I need a new total amount per prescription as well as different dosing directions. Ironically, I'm telling them what I'm already doing and they're printing the directions on the bottle as though I needed to know that. Of course pharmacists assume that doctors are gods and patients are idiots, rather than the other way around. SIGH
I called my pharmacy with the refill/dosage change request on Monday. I spoke to a pharmacist who said she would send the fax to my doc's office. My doc's office has a 24-48 hour turnaround time for prescription renewals. So I expected to hear from my pharmacy or see on my online prescription page that the prescription was ready sometime today. When that didn't happen, I called my doc's assistant. He never received the fax from my HMO's pharmacy. So he promised to call them and remind them of the refill/dosage change request and call me back. Over an hour later I still haven't heard from him. I tried calling my pharmacy and got put on hold indefinitely. I want to keep the line open to receive my doc's assistant's call. However, I also want to learn what happened at my pharmacy with my refill request fax. GRRRRRR!!!
Good thing I started this process of hurry up and wait on Monday, because I will be totally out of my 25mcg tablets after Saturday (3 days away). Fortunately my pharmacy says my prescription for the 5 mcg tablets is ready. I want to pick up and pay for both prescriptions at the same time. I sure hope they don't lose my 5mcg prescription by the time my 25mcg prescription is finally ready. (That happened 2x before. My pharmacy loses new prescriptions, filled prescriptions and now refill requests. What next?!!!
However, I'm still waiting for my pharmacy to fax a refill request to my doc's clinic to okay my different presciption of 1/2 of a 25mcg tablet 3x daily, rather than 2x daily, which was my prescription level over 3 months ago. So I need a new total amount per prescription as well as different dosing directions. Ironically, I'm telling them what I'm already doing and they're printing the directions on the bottle as though I needed to know that. Of course pharmacists assume that doctors are gods and patients are idiots, rather than the other way around. SIGH
I called my pharmacy with the refill/dosage change request on Monday. I spoke to a pharmacist who said she would send the fax to my doc's office. My doc's office has a 24-48 hour turnaround time for prescription renewals. So I expected to hear from my pharmacy or see on my online prescription page that the prescription was ready sometime today. When that didn't happen, I called my doc's assistant. He never received the fax from my HMO's pharmacy. So he promised to call them and remind them of the refill/dosage change request and call me back. Over an hour later I still haven't heard from him. I tried calling my pharmacy and got put on hold indefinitely. I want to keep the line open to receive my doc's assistant's call. However, I also want to learn what happened at my pharmacy with my refill request fax. GRRRRRR!!!
Good thing I started this process of hurry up and wait on Monday, because I will be totally out of my 25mcg tablets after Saturday (3 days away). Fortunately my pharmacy says my prescription for the 5 mcg tablets is ready. I want to pick up and pay for both prescriptions at the same time. I sure hope they don't lose my 5mcg prescription by the time my 25mcg prescription is finally ready. (That happened 2x before. My pharmacy loses new prescriptions, filled prescriptions and now refill requests. What next?!!!
Tuesday, March 6, 2012
Uncertain about 40mcg T3
I'm uncertain whether 40mcg of T3 (in 3 divided doses) is enough. Maybe I haven't been on that dose long enough (continuously for 7 days) this round. I originally did that dose for 9 days. Then I reduced the total to 37.5 for a day. Then I tried 40mcg a few more days and again reduced it to 37.5. After getting more serious constipation, I increased the dose back to 40mcg for the past 6 days. However, I've noticed more irregularity, really icy hands in the afternoon and more fatigue just before dinner. So today I added 2.5mcg to my second (midday) dose. That means 15mcg when I first get up (about 7am), 15mcg 5 hours later and then 12.5 mcg 4-1/2 hours after that. I'm either taking too little at my midday dose or I'm waiting too long for my midafternoon dose. I'll see how the dose increase affects me today. Already, one hour after taking that second increased dose, I feel wide awake and warmer, but also a little jittery inside. I'll definitely wait 4-5 hours before taking my next dose.
Meanwhile I'm awaiting my doc's clinic to okay a refill request from my HMO pharmacy for my 25mcg T3 prescription. I requested a dosage change (3x a day, rather than 2x a day at 12.5mcg each dose). That will give me 135 tablets for 3 months, rather than 90 (which only lasts 60 days instead of 3 months). I considered making an appointment to see my doc and explain my divided dose and T3 only treatment strategy. However, if she will okay the dose change w/o making an appointment, I'll save $$$.
Eventually, maybe after 12 weeks w/o T3 or when I'm at a stable dose, I'll explain all this to my doc and loan her my copy of "Recovering with T3". She has been very permissive with allowing me to determine (raise or lower) my own thyroid dosage according to my signs and symptoms. She says that I'm the only patient whom she will allow to determine their own dosage and just tell her how much I'm taking, because I pay close attention to my body signs and symptoms, unlike her other patients.
Meanwhile I'm awaiting my doc's clinic to okay a refill request from my HMO pharmacy for my 25mcg T3 prescription. I requested a dosage change (3x a day, rather than 2x a day at 12.5mcg each dose). That will give me 135 tablets for 3 months, rather than 90 (which only lasts 60 days instead of 3 months). I considered making an appointment to see my doc and explain my divided dose and T3 only treatment strategy. However, if she will okay the dose change w/o making an appointment, I'll save $$$.
Eventually, maybe after 12 weeks w/o T3 or when I'm at a stable dose, I'll explain all this to my doc and loan her my copy of "Recovering with T3". She has been very permissive with allowing me to determine (raise or lower) my own thyroid dosage according to my signs and symptoms. She says that I'm the only patient whom she will allow to determine their own dosage and just tell her how much I'm taking, because I pay close attention to my body signs and symptoms, unlike her other patients.
Wednesday, February 29, 2012
8 weeks of T3 Only
Tomorrow I will complete 8 weeks on T3 only. Supposedly I will have cleared all supplemental T4 from my system by then. So I won't have any T4 interference (or depend on unpredictable T4 conversion. I have tried 40mcg of T3 (in 3 divided doses) for 2 weeks and 3 days. However, on 3 of those days I returned to 37.5 mcg of T3 in divided doses. Each time I returned to the lower dose, within a day or 2 I experienced constipation, sometimes with hemorrhoidal bleeding. So I'll keep trying the 40mcg with 3 daily divided doses for awhile. I take my first (largest 15mcg) dose when I wake up, another (12.5mcg dose about 5 hours later and the last dose (12.5mcg) 4 hours after that. With a late afternoon dose I'm ready for sleep (I'm appropriately exhausted) around 10pm and sleep soundly for 8 hours. As long as I keep my first and second dose 5 hours apart, I don't have heart palpitation sensations, but I do feel energetic, warm and regular during the day.
Saturday, February 25, 2012
Back to 40mcg T3
After a day or 2 of 37.5mcg of T3 (my previous dose), because I worried about heart palpitations, I noticed hypo symptoms (esp. bleeding hemorrhoids from constipation). I faced a lose-lose choice (bleeding hemorrhoids or heart palpitations). So I looked through "Recovering with T3" to see what the author said about heart palpitations. He said that symptom could be caused by taking T3 doses too close together (among other things). Since I take my largest divided dose (15mcg) when I first get up in the morning, I considered how soon I take my next (smaller 12.5mcg) dose. Then I tried taking that 5+ hours after the first dose, rather than 4+ hours later. The first day I took my 2nd dose 5+ hours later, I didn't notice any heart palpitations.
I continued taking my 2nd dose at least 5 hours after my first dose for a few days. The hypo symptoms disappeared as did the pounding heart sensations. So I'v been back on 40mcg (with 3 daily divided doses) of T3 and doing well for the past few days. If I stay on this dose until I see my doc and request a new prescription, I may need 5mcg pills to get an even 40mcg daily (with divided doses of 3, 2-1/2 and 2-1/2 mcg). 25 mcg pills would need to be divided more than is practical for a 40mcg total.
Also I finished 7 weeks without T4 two days ago. I've read most people need only 8 weeks to clear T4. So I'm approaching my maintenance T3 dose. However, I really won't know for sure until I pass that 8 week mark. Since blood tests are useless for determining appropriate T3 dosage, all I have are signs (blood pressure, pulse, body temp, etc.) and symptoms (regularity, energy, feeling warm and healthy).
I continued taking my 2nd dose at least 5 hours after my first dose for a few days. The hypo symptoms disappeared as did the pounding heart sensations. So I'v been back on 40mcg (with 3 daily divided doses) of T3 and doing well for the past few days. If I stay on this dose until I see my doc and request a new prescription, I may need 5mcg pills to get an even 40mcg daily (with divided doses of 3, 2-1/2 and 2-1/2 mcg). 25 mcg pills would need to be divided more than is practical for a 40mcg total.
Also I finished 7 weeks without T4 two days ago. I've read most people need only 8 weeks to clear T4. So I'm approaching my maintenance T3 dose. However, I really won't know for sure until I pass that 8 week mark. Since blood tests are useless for determining appropriate T3 dosage, all I have are signs (blood pressure, pulse, body temp, etc.) and symptoms (regularity, energy, feeling warm and healthy).
Wednesday, February 22, 2012
Heart Palpitations
The higher dose(40mcg total daily) of T3 has done wonders for my previous irregularity problems during the past 10 days. However, I've become much more aware of a strong heart beat during the past few days. I don't want to lose the )digestive benefits, but I worry about possible heart palpitations. So I'll try a lower dose (37.5mcg total) starting tomorrow. Maybe that first dose of 15mcg is just too high, but I only raised my total dose 2.5mcg. I've read that the first dose should be the highest, because the longest time elapsed between the afternoon and morning dose. Nevertheless, I want to see what happens with heart palpitations on a lower dose. I may try the higher (40mcg dose) the next day so I average somewhere between those 2 totals. I'd hate to lose all the motility benefits I got from the higher dose, but I don't want palpitations either.
Yesterday I took my blood pressure and pulse at a local pharmacy's blood pressure machine, before and after I took my afternoon T3 dose. Before T3 dose (4+ hours since previous dose) my blood pressure was 102 systolic, 56 diastolic and 82 pulse (I'd walked 30 minutes to get to the location which would have raised my heart beat). 15-20 minutes after I took my afternoon t3 dose, I measured blood pressure and pulse on another machine at another pharmacy (less than a block away). That time my blood pressure was 104 systolic, 65 diastolic, and 78 pulse (I sat and tried to relax a minute or two before taking that reading, which may have lowered my pulse.) Either the second machine was more accurate (the pressure cuff felt tighter) or t3 works quickly to raise my blood pressure.
The last time I measured blood pressure at a local machine within a few hours after taking my t3 dose, my blood pressure was 115 systolic, 72 diastolic and 73 pulse. What a difference a few hours between doses can make. That explains why I feel colder and more tired just before I take my next planned t3 dose.
Yesterday I took my blood pressure and pulse at a local pharmacy's blood pressure machine, before and after I took my afternoon T3 dose. Before T3 dose (4+ hours since previous dose) my blood pressure was 102 systolic, 56 diastolic and 82 pulse (I'd walked 30 minutes to get to the location which would have raised my heart beat). 15-20 minutes after I took my afternoon t3 dose, I measured blood pressure and pulse on another machine at another pharmacy (less than a block away). That time my blood pressure was 104 systolic, 65 diastolic, and 78 pulse (I sat and tried to relax a minute or two before taking that reading, which may have lowered my pulse.) Either the second machine was more accurate (the pressure cuff felt tighter) or t3 works quickly to raise my blood pressure.
The last time I measured blood pressure at a local machine within a few hours after taking my t3 dose, my blood pressure was 115 systolic, 72 diastolic and 73 pulse. What a difference a few hours between doses can make. That explains why I feel colder and more tired just before I take my next planned t3 dose.
Wednesday, February 15, 2012
Overlooked Signs and Sumptoms
After rereading "Recovering with T3", I realized that I overlooked subtle signs and symptoms that I didn't have enough T3 around 5 weeks after I stopped taking T4. So many people on realthyroidhelp.com and the author of that book warmed me that I might need even more T3 after most of the T4 had cleared my system. However, I had not started at a low level of T3. I started at the last T3 level which relieved my symptoms, but stopped working after a week or so, before I stopped taking T4.
After abstaining from T4 for a few days that level worked beautifully. I was energetic all the time (esp. after switching from 2 to 3 daily divided doses), I was more 'regular' than I'd ever been (except when I had diarrhea with C-diff), and I didn't get cold hands and feet just before my next dose. Nevertheless, all that slowly changed after 5 weeks w/o T4. I started having more and more regularity problems. I felt tried more often. Normally simple tasks seemed too challenging. I spent lots of time onlihe, because I didn't want to start any projects. I wanted to go to bed. My hands were icy cold more often than they were warm. I gained 3 pounds, then lost one. Then my weight started to fluctuate 2-3 pounds every day. My weight rarely fluctuates from day to day.
I assumed that 37.5 mcg dose would carry me through the entire T4 clearning process. Of course, I really didn't calculate how long I'd need to clear. Because I'd only taken 50 or 25 mccg of T4, I may not need an entire 8-12 weeks which people who started with higher t4 doses need.
So after 5 days of higher dose T3 (40mcg in 3 divided doses), I'm back to normal regularity, having energy most of the day and feeling warmer despite cold, rainy weather outside.My weight is still fluctuating by 2 pounds from day to day (2 pounds down one day, 2 pounds up the next). I wonder whether adrenal hormone differences (cortisol) now cause my weight to shift with water retention differences. I'm uncertain whether I'll need another dose increase after 6 more weeks, when I'll reach the infamous 12 week marker. At that point most people who abstain from T4, have completely cleared T4 from their systems.
At this rate I'll need another T3 prescription before I reach the 12 week mark. I have 2 open 5mcg prescriptions (90 tablets each). So I can use those to assemble my 40mcg dose. Perhaps I'll try 4 divided doses again. (4 doses of 2-5mcg tablets would be easier than splitting pills into thirds.) I hope by the time I see my doc I will have stabilized my dosage. So I can request exactly what I need, rather than trying to assemble appropriate doses from the pills I received from a lower dose prescription. Oh well, at least I have the open (several refills) prescriptions.
After abstaining from T4 for a few days that level worked beautifully. I was energetic all the time (esp. after switching from 2 to 3 daily divided doses), I was more 'regular' than I'd ever been (except when I had diarrhea with C-diff), and I didn't get cold hands and feet just before my next dose. Nevertheless, all that slowly changed after 5 weeks w/o T4. I started having more and more regularity problems. I felt tried more often. Normally simple tasks seemed too challenging. I spent lots of time onlihe, because I didn't want to start any projects. I wanted to go to bed. My hands were icy cold more often than they were warm. I gained 3 pounds, then lost one. Then my weight started to fluctuate 2-3 pounds every day. My weight rarely fluctuates from day to day.
I assumed that 37.5 mcg dose would carry me through the entire T4 clearning process. Of course, I really didn't calculate how long I'd need to clear. Because I'd only taken 50 or 25 mccg of T4, I may not need an entire 8-12 weeks which people who started with higher t4 doses need.
So after 5 days of higher dose T3 (40mcg in 3 divided doses), I'm back to normal regularity, having energy most of the day and feeling warmer despite cold, rainy weather outside.My weight is still fluctuating by 2 pounds from day to day (2 pounds down one day, 2 pounds up the next). I wonder whether adrenal hormone differences (cortisol) now cause my weight to shift with water retention differences. I'm uncertain whether I'll need another dose increase after 6 more weeks, when I'll reach the infamous 12 week marker. At that point most people who abstain from T4, have completely cleared T4 from their systems.
At this rate I'll need another T3 prescription before I reach the 12 week mark. I have 2 open 5mcg prescriptions (90 tablets each). So I can use those to assemble my 40mcg dose. Perhaps I'll try 4 divided doses again. (4 doses of 2-5mcg tablets would be easier than splitting pills into thirds.) I hope by the time I see my doc I will have stabilized my dosage. So I can request exactly what I need, rather than trying to assemble appropriate doses from the pills I received from a lower dose prescription. Oh well, at least I have the open (several refills) prescriptions.
Monday, February 13, 2012
2.5mcg T3 Dose Increase
Enough freezing and irregularity problems! I increased my T3 morning dose to 15mcg for a total of 40mcg daily dose. I'll have to continue at that dose for at least 3 days to determine if it changes my hypo symptoms. I'm disappointed that the previous dose stopped working as well. However, that t3 dose without t4 kept me symptom free for over 5 weeks. That's a lot longer than any previous T4/T3 combo dose.
I also communicated w/ the author of "Recovering wtih T3" about needing to raise the dose that was so helpful for so long. He told me to just keep increasing my T3 slowly as I needed to eliminate symptoms. Maybe I'll eventually reach a dose that only requires one prescription. LOL Previously I've had 2 prescriptions of T3 to give me both 5mcg and 25mcg tablets, which I needed for my original 30mcg daily T3 dose. However, I needed to increase that dose during the past 6 months. So I ended up taking 3 half tablets of the 25mcg tablets and not using the remaining 5mcg pills. Continuing my current 40mcg dose will allow me to use up the 5 mcg tablets before I see my doc and request a new prescription. However, I really don't know what my daily dose will be in mid March.
I also communicated w/ the author of "Recovering wtih T3" about needing to raise the dose that was so helpful for so long. He told me to just keep increasing my T3 slowly as I needed to eliminate symptoms. Maybe I'll eventually reach a dose that only requires one prescription. LOL Previously I've had 2 prescriptions of T3 to give me both 5mcg and 25mcg tablets, which I needed for my original 30mcg daily T3 dose. However, I needed to increase that dose during the past 6 months. So I ended up taking 3 half tablets of the 25mcg tablets and not using the remaining 5mcg pills. Continuing my current 40mcg dose will allow me to use up the 5 mcg tablets before I see my doc and request a new prescription. However, I really don't know what my daily dose will be in mid March.
Sunday, February 12, 2012
Hypothyroid Approaching Week 5 w/o T4
One week ago, as I completed 5 weeks of T3 only therapy (stopped taking T4), I started to experience more hypothyroid symptoms, though not nearly the level I experienced while taking T4 and T3 together. First I noticed more difficulty with regularity to the point that a hard stool broke a hemorrhoid (bleeding) 2 days ago. Slowly I noticed more afternoon fatigue and then feeling cold more often, even before I needed my next T3 dose. I'm uncertain what all that means. However a few members of realthyroidhelp.com suggested I might need to increase my thyroid dose after much of the T4 had cleared my body. I'm now approaching 6 weeks free of T4. For some people 6 weeks is long enough to clear T4. I had only been taking a 50 (or sometimes 25) mcg once daily dose of T4 before I stopped. So maybe I'm close to 'clear'??? Whatever happens, I wanted to journal my increasing hypo symptoms.
Nevertheless, despite not getting enough sleep the night after my birthday 'observed' day, I haven't gotten another respiratory infection. (I used to get colds whenever I spent time away from home with other people, because I was soooo susceptible to viral infections.) So the DHEA is really helping to improve my immunity.
On my 'observed' (one week delayed celebration of my) birthday (after the bleeding hemorrhoid experience), we went into town to shop, see a new movie and enjoy a dinner out at PF Chang's. I spent the rest of my Christmas gift certificate at Express for new pants and jacket (casual suit). We saw "Big Miracle" with Drew Barrymore. The script was based on a true story about whales stuck under the ice in northern Alaska. I was very pleased with that movie which included comedy, romance and drama. I didn't imagine I would feel so sad when the baby whale died. (I told my husband Iwouldn't cry at the movie, but I didn't know the whole story.)
We enjoyed our meal at PF Chang's. However our waiter looked like a 'deer in headlights' when I told him I had 7 food allergies. His eyes glazed over and he told us we couldn't have any of the condiments, though I've often eaten the allergy free hot mustard. Despite sending my allergy allert card to the chef and our past experience with safe meals at PF Chang's that waiter's demeanor had me worried. So I suspected the sauce on my entree. (We can't eat any soy.) Then I had to wait almost 10 minutes for the manager to consult the chef to reassure me that the sauce was safe.
Meanwhile my dish got cold. Also the vegies were undercooked, despite my request to overcook them. I'm very honest when restaurant staff ask me how my dinner is. I told them. As usual PF Chang's compensated my dinner. As usual my husband gave them a tip the amount of my comp'd dinner. SIGH Oh well, being so upset, I ate so little that I had enough leftovers for 2 meals at home.
I normally love eating out, but I got contaminated with soy during December. During January, I learned that my favorite entree at our local Mexican restaurant contained a 'bit of wheat flour' in the sauce. That explained why I got so sick after my last visit there. So I was rather wary of eating a meal at a restaurant where the waiter seemed both clueless and frightened by my 7 allergies. I normally don't encounter that reaction to my allergy allert card.
Nevertheless, despite not getting enough sleep the night after my birthday 'observed' day, I haven't gotten another respiratory infection. (I used to get colds whenever I spent time away from home with other people, because I was soooo susceptible to viral infections.) So the DHEA is really helping to improve my immunity.
On my 'observed' (one week delayed celebration of my) birthday (after the bleeding hemorrhoid experience), we went into town to shop, see a new movie and enjoy a dinner out at PF Chang's. I spent the rest of my Christmas gift certificate at Express for new pants and jacket (casual suit). We saw "Big Miracle" with Drew Barrymore. The script was based on a true story about whales stuck under the ice in northern Alaska. I was very pleased with that movie which included comedy, romance and drama. I didn't imagine I would feel so sad when the baby whale died. (I told my husband Iwouldn't cry at the movie, but I didn't know the whole story.)
We enjoyed our meal at PF Chang's. However our waiter looked like a 'deer in headlights' when I told him I had 7 food allergies. His eyes glazed over and he told us we couldn't have any of the condiments, though I've often eaten the allergy free hot mustard. Despite sending my allergy allert card to the chef and our past experience with safe meals at PF Chang's that waiter's demeanor had me worried. So I suspected the sauce on my entree. (We can't eat any soy.) Then I had to wait almost 10 minutes for the manager to consult the chef to reassure me that the sauce was safe.
Meanwhile my dish got cold. Also the vegies were undercooked, despite my request to overcook them. I'm very honest when restaurant staff ask me how my dinner is. I told them. As usual PF Chang's compensated my dinner. As usual my husband gave them a tip the amount of my comp'd dinner. SIGH Oh well, being so upset, I ate so little that I had enough leftovers for 2 meals at home.
I normally love eating out, but I got contaminated with soy during December. During January, I learned that my favorite entree at our local Mexican restaurant contained a 'bit of wheat flour' in the sauce. That explained why I got so sick after my last visit there. So I was rather wary of eating a meal at a restaurant where the waiter seemed both clueless and frightened by my 7 allergies. I normally don't encounter that reaction to my allergy allert card.
Thursday, February 2, 2012
Postponing Birthday Celebration
Tomorrow is officially my birthday. However, I plan to postpone celebrating for another week. My husband usually takes a day off work to celebrate (shop, see an art installation, eat out, etc.) on my birthday. Unfortunately, he's the project manager for a huge clinic move which begins tomorrow. Also I have a great coupon for a favorite store which doesn't begin until a week from tomorrow (birthday). Most of all the new exhibit at SAM (Paul Gaughan) doesn't begin until a week from today. So I might have a minor and a major celebration this year.
Actually I'm not looking forward to celebrating this birthday. My dad died almost 4 months after turning that number. My mom died 15 months later. I know my health is much better than theirs and I've improved a great deal since I was diagnosed with celiac disease almost 8 years ago. Nevertheless, my parents' ages at their death continue to haunt me
Fortunately warmer sunny weather is forecast for tomorrow. So I may take a long walk to our local mall. Today I earned a rewards discount certificate from the store where I got my laptop. I considered returning the sleeve I bought after purchasing the laptop, because I liked a more expensive, more colorful sleeve, but hestitated to spend that much. The certificate makes the more expensive sleeve more enticing. So I may exchange one sleeve for another tomorrow.
I'd also planned to make key lime pie for my birthday from a gluten, dairy, soy, egg, sugar free recipe, which I saw in one of my allergy free baking books. Instead of eggs, the recipe substitutes avocado. So the pie is much healthier than traditional key lime pie with eggs (and my other allergens). Best of all, the crust is a press and chill cooky crust and the filling is blended and poured into the chilled crust. The time consuming part is peeling and deseeding 5 avocados and juicing and zesting 6 limes. SIGH Oh well, I get to use my ergonomic zester and my powerful (Ninja) blender which we purchased before Christmas.
Then next week we'll see the SAM exhibit, shop and eat at my favorite allergy friendly restaurant (PF Chang's) and celebrate too many years and one week older.
Actually I'm not looking forward to celebrating this birthday. My dad died almost 4 months after turning that number. My mom died 15 months later. I know my health is much better than theirs and I've improved a great deal since I was diagnosed with celiac disease almost 8 years ago. Nevertheless, my parents' ages at their death continue to haunt me
Fortunately warmer sunny weather is forecast for tomorrow. So I may take a long walk to our local mall. Today I earned a rewards discount certificate from the store where I got my laptop. I considered returning the sleeve I bought after purchasing the laptop, because I liked a more expensive, more colorful sleeve, but hestitated to spend that much. The certificate makes the more expensive sleeve more enticing. So I may exchange one sleeve for another tomorrow.
I'd also planned to make key lime pie for my birthday from a gluten, dairy, soy, egg, sugar free recipe, which I saw in one of my allergy free baking books. Instead of eggs, the recipe substitutes avocado. So the pie is much healthier than traditional key lime pie with eggs (and my other allergens). Best of all, the crust is a press and chill cooky crust and the filling is blended and poured into the chilled crust. The time consuming part is peeling and deseeding 5 avocados and juicing and zesting 6 limes. SIGH Oh well, I get to use my ergonomic zester and my powerful (Ninja) blender which we purchased before Christmas.
Then next week we'll see the SAM exhibit, shop and eat at my favorite allergy friendly restaurant (PF Chang's) and celebrate too many years and one week older.
Friday, January 27, 2012
Short-lived Change Resistance
Within 24 hours I became quite proficient with my new laptop. I only resisted my husband's offer of a mouse. After learning to use the touch pad on my new laptop, I didn't want to get dependent on external 'gadgets'. I'm still missing the 'backspace' key which is inconveniently placed on this tiny laptop. Maybe they assume my typing skills are so good that I seldom need to backspace. LOL I am proficient at typing, but this new, tinier keyboard takes some adjustment. My next learning project is Windows Office 2010. I had a much older version on my old desktop. Actually everything on that desktop was very old (and very slow).
In other news I passed the 3 week mark on T3 only therapy. I'm still feeling very well (warm, energetic and 'regular'). I tried reducing my afternoon dose from 12.5 mcg to 10 mcg, but I really noticed the difference. I don't feel as energetic 3 hours after that lower dose. Or maybe I'm fighting another cold. I'll eliminate that with a bedtime dose of arabinogalactin. I can go to bed with a cold and wake up healthy after taking that.
I'm still awaiting response from the minister who oversees groups at my church. I emailed her that I wanted to start a gluten intolerance/celiac disease support group at my church almost 3 weeks ago. Last Sunday I spoke to her in person reiterating what I said in my email. However, I didn't hear from her again this week. Oh well, I have plenty of clothing alterations to keep me busy (not to mention yardwork when the weather is warmer) until I get the go ahead for my group from the church.
In other news I passed the 3 week mark on T3 only therapy. I'm still feeling very well (warm, energetic and 'regular'). I tried reducing my afternoon dose from 12.5 mcg to 10 mcg, but I really noticed the difference. I don't feel as energetic 3 hours after that lower dose. Or maybe I'm fighting another cold. I'll eliminate that with a bedtime dose of arabinogalactin. I can go to bed with a cold and wake up healthy after taking that.
I'm still awaiting response from the minister who oversees groups at my church. I emailed her that I wanted to start a gluten intolerance/celiac disease support group at my church almost 3 weeks ago. Last Sunday I spoke to her in person reiterating what I said in my email. However, I didn't hear from her again this week. Oh well, I have plenty of clothing alterations to keep me busy (not to mention yardwork when the weather is warmer) until I get the go ahead for my group from the church.
Thursday, January 19, 2012
2-1/2 Weeks on T3 Only
Although I've read that most people need 8 weeks of T3 only therapy to clear the T4 from their bodies, I feel better after only 2-1/2 weeks. I suspect changing from 2 divided doses to 3 divided doses has helped most. I used to get an afternoon low energy, even though I took T4 upon my doc's suggestion, to prevent those energy crashes. Not only did T4 not keep my energy and body temperature level, but also I seemed to need more and more T3 to cope with hypo symptoms all the time I took T4. Now I have leveled off with a dose of 37.5mcg T3 in 3 divided doses.
Best of all I recently ordered and received in the mail yesterday a book entitled "Recovering with T3' by Paul Robinson. In that book, the author describes his journey to trying T3 only therapy. Then he details how he used T3 therapy to completely eliminate his hypo symptoms.
In other news, I finally got a lightweight laptop (13.3" screen and 2.4 lbs. with an 8 hour battery life). So I'll be converting what I have on my old desktop computer over to my new laptop in the next several days. Part of me is resisting the change. I've had a desktop computer for many years. My current model is rather slow with weird peculiarities (like getting hung up on one window when it first starts sometimes). A small, lightweight laptop signals the end of an era for me.
I got my first desktop computer back when I was a freelance artist, selling my paintings at arts and craft fairs, galleries, juried shows and special commissions. I really resented the time I had to spend on the computer for my business, because I prefered to paint. However, I couldn't afford a manager. So I had to do my own taxes and other business chores on my computer.
I stopped painting about 10 years ago. At first I missed the arts and crafts fairs, where I had lots of friends who were either other artists or customers. I didn't miss the hassle of setting up my booth for those fairs. I didn't miss hauling paintings to galleries and back home after they didn't sell. I didn't miss the stress of wondering whether my paintings would sell or win prizes at juried shows (which almost guaranteed sales). I didn't miss thinking about painting 24/7.
After I stopped selling paintings, I felt useless, because I wasn't earning money from a job, albeit self-employment for many years. Volunteer work (first leading a ThinWithin group at my church and then leading a celiac disease support group) made me feel more productive. However, complications of celiac disease influenced me to resign from leadership of that second group as I focussed on my own health recovery.
Recently I reached a new level of physical health. So I'm ready to consider volunteer work for my church (possibly leading another celiac disease/gluten intolerance group and/or working with a group which feeds, clothes and provides overnight shelter for homeless women in our area). So a newer, lightweight laptop seems appropriate for this phase of my life. Nevertheless, letting go of old rituals (like turning on my computer when I first get up, because it takes awhile to warm up) makes me feel sad ...
Best of all I recently ordered and received in the mail yesterday a book entitled "Recovering with T3' by Paul Robinson. In that book, the author describes his journey to trying T3 only therapy. Then he details how he used T3 therapy to completely eliminate his hypo symptoms.
In other news, I finally got a lightweight laptop (13.3" screen and 2.4 lbs. with an 8 hour battery life). So I'll be converting what I have on my old desktop computer over to my new laptop in the next several days. Part of me is resisting the change. I've had a desktop computer for many years. My current model is rather slow with weird peculiarities (like getting hung up on one window when it first starts sometimes). A small, lightweight laptop signals the end of an era for me.
I got my first desktop computer back when I was a freelance artist, selling my paintings at arts and craft fairs, galleries, juried shows and special commissions. I really resented the time I had to spend on the computer for my business, because I prefered to paint. However, I couldn't afford a manager. So I had to do my own taxes and other business chores on my computer.
I stopped painting about 10 years ago. At first I missed the arts and crafts fairs, where I had lots of friends who were either other artists or customers. I didn't miss the hassle of setting up my booth for those fairs. I didn't miss hauling paintings to galleries and back home after they didn't sell. I didn't miss the stress of wondering whether my paintings would sell or win prizes at juried shows (which almost guaranteed sales). I didn't miss thinking about painting 24/7.
After I stopped selling paintings, I felt useless, because I wasn't earning money from a job, albeit self-employment for many years. Volunteer work (first leading a ThinWithin group at my church and then leading a celiac disease support group) made me feel more productive. However, complications of celiac disease influenced me to resign from leadership of that second group as I focussed on my own health recovery.
Recently I reached a new level of physical health. So I'm ready to consider volunteer work for my church (possibly leading another celiac disease/gluten intolerance group and/or working with a group which feeds, clothes and provides overnight shelter for homeless women in our area). So a newer, lightweight laptop seems appropriate for this phase of my life. Nevertheless, letting go of old rituals (like turning on my computer when I first get up, because it takes awhile to warm up) makes me feel sad ...
Tuesday, January 10, 2012
Reverse T3 and T3 Only Therapy
My husband has been taking Naturethroid (so called 'natural') thyroid supplement for about a year. He increased his dose but still has symptoms (extreme afternoon fatigue and brain fog). He resumed using caffeine pills (he hates the taste of coffee) to get through the day. I know his thyroid supplement isn't working for him. However, I also know he had a rather high blood test result for reverse T3.
So I did some research on reverse T3. I learned that disproportionate amounts of reverse T3 can block T3 receptors so that T3 supplements can't treat hypothyroid symptoms. Normally T4 converts into 40% T3 and 60% reverse T3. However, if the proportion of Reverse T3 (RT3) is higher than normal, all that RT3 can block T3 receptors and prevent normal metabolism (energy, body temperature, regularity). So I asked my husband to get another set of thyroid blood tests including his RT3.
He hasn't yet received his RT3 test result. However, my research on RT3 made me wonder if I might have that problem. I learned that treatment for RT3 involved stopping all therapy involving T4 and just using T3. During the past 15 months of my hypothyroid treatment, I initially took T4 only supplements, which did nothing to relieve my hypothyroid symptoms. So I asked for a T3 test, which showed my free T3 was below normal, and then requested a T3 supplement in addition to my T4 supplement.
My initial dose of T3 relieved my hypothyroid symptoms. I was warmer, more energetic and more regular. Then my hypo symptoms returned ... fatigue, feeling cold more often and constipation. So my increased my T3 dose and decreased my T4. That helped to resolved my hypo symptoms. However my next blood test showed my T4 levels were low, which concerned my doc. I asked why worry, because I obviously didn't convert T4 to T3 very easily, which was why I didn't do well on T4 only therapy. My doc explained that I had some T3, although it was very low, which suggested I converted some T4 to T3. (However I've since learned that the thryoid gland does produce a small amount of T3, outside of T4 conversion.)
So I increased my T4 again, while keeping the same T3 dose. Then all my hypothyroid symptoms returned. So I increased my T3 and decreased my T4 (but just took a half dose). Again that combo decreased my hypo symptoms ... for awhile. Then after a few weeks on that dose (25 mcg total daily T3, 50 mcg total T4), I again experienced constant fatigue, chills and constipation. So I slowly increased my T4 to 30 daily and kept my T4 at 25 daily. I had taken divided doses of T3 (early morning and mid afternoon) for almost a year, but was still experiencing afternoon energy crash. When my symptoms returned on 25 T3 and 50 T4, I raised my T3 to 30mcg daily and later to 35mcg daily. I never had any overdose (hyperthyroid) symptoms, but I feared getting those when I was using 30+mcg of T3. So I lowered my T4 to 25mcg. I really doubted it helped much anyway. Again my hypo symptoms disappeared for awhile, but I still had the afternoon energy crash. My doc had told me that T4 would carry me through the day so that I wouldn't get that afternoon slump. So I increased my T4 back to 50mcg and continued the T3 at 35mcg. Again my hypo symptoms returned. I kept thinking I just didn't have a high enough T3 dose, even though lower doses had worked for awhile.
After I read that the treatment for excessive RT3 was taking T3 only, because T4 produced both T3 and reverse T3, I wondered whether I also had an RT3 problem. My doc never tested my RT3. However, my initial free T4 test was normal, but my free T3 test was low even after taking T4 supplements for 3 months. I thought I didn't easily convert T4 to T3. However, my experience showed that every time I took T4 with T3 I had to keep raising the T3 dose. I didn't know whether an RT3 test would be accurate at this point (after 15 months of thyroid supplements).
So I just decided to stop taking T4. I also decided to take my T3 doses 3-4x daily rather than twice daily. The first day of 4 doses was a disaster, because I took my 4th dose too late at night and didn't sleep until 8 hours after I took that last T3 dose. Then I decided I really didn't want a nighttime dose, which could interfere with my sleep. So I started taking 3 even doses of T3 at 7am, 11am and 3pm (4 hours apart). That has worked well for the past 3 days. My energy level is even all day until bedtime when I start feeling sleepy. Then I sleep very soundly all night. Also I've been very regular while taking less magnesium than I previously took. I'm still getting cold sometimes. However the weather did turn really cold and I haven't dress differently for that colder weather. Nevertheless I'll keep using this triple T3 dose approach with no T4.
According to the RT3 literature, after 8-12 weeks I may even need less T3 to prevent hypo symptoms. Whatever ... I'm happy to finally prevent my afternoon energy crash, keep warm and stay regular on the same dose for awhile.
So I did some research on reverse T3. I learned that disproportionate amounts of reverse T3 can block T3 receptors so that T3 supplements can't treat hypothyroid symptoms. Normally T4 converts into 40% T3 and 60% reverse T3. However, if the proportion of Reverse T3 (RT3) is higher than normal, all that RT3 can block T3 receptors and prevent normal metabolism (energy, body temperature, regularity). So I asked my husband to get another set of thyroid blood tests including his RT3.
He hasn't yet received his RT3 test result. However, my research on RT3 made me wonder if I might have that problem. I learned that treatment for RT3 involved stopping all therapy involving T4 and just using T3. During the past 15 months of my hypothyroid treatment, I initially took T4 only supplements, which did nothing to relieve my hypothyroid symptoms. So I asked for a T3 test, which showed my free T3 was below normal, and then requested a T3 supplement in addition to my T4 supplement.
My initial dose of T3 relieved my hypothyroid symptoms. I was warmer, more energetic and more regular. Then my hypo symptoms returned ... fatigue, feeling cold more often and constipation. So my increased my T3 dose and decreased my T4. That helped to resolved my hypo symptoms. However my next blood test showed my T4 levels were low, which concerned my doc. I asked why worry, because I obviously didn't convert T4 to T3 very easily, which was why I didn't do well on T4 only therapy. My doc explained that I had some T3, although it was very low, which suggested I converted some T4 to T3. (However I've since learned that the thryoid gland does produce a small amount of T3, outside of T4 conversion.)
So I increased my T4 again, while keeping the same T3 dose. Then all my hypothyroid symptoms returned. So I increased my T3 and decreased my T4 (but just took a half dose). Again that combo decreased my hypo symptoms ... for awhile. Then after a few weeks on that dose (25 mcg total daily T3, 50 mcg total T4), I again experienced constant fatigue, chills and constipation. So I slowly increased my T4 to 30 daily and kept my T4 at 25 daily. I had taken divided doses of T3 (early morning and mid afternoon) for almost a year, but was still experiencing afternoon energy crash. When my symptoms returned on 25 T3 and 50 T4, I raised my T3 to 30mcg daily and later to 35mcg daily. I never had any overdose (hyperthyroid) symptoms, but I feared getting those when I was using 30+mcg of T3. So I lowered my T4 to 25mcg. I really doubted it helped much anyway. Again my hypo symptoms disappeared for awhile, but I still had the afternoon energy crash. My doc had told me that T4 would carry me through the day so that I wouldn't get that afternoon slump. So I increased my T4 back to 50mcg and continued the T3 at 35mcg. Again my hypo symptoms returned. I kept thinking I just didn't have a high enough T3 dose, even though lower doses had worked for awhile.
After I read that the treatment for excessive RT3 was taking T3 only, because T4 produced both T3 and reverse T3, I wondered whether I also had an RT3 problem. My doc never tested my RT3. However, my initial free T4 test was normal, but my free T3 test was low even after taking T4 supplements for 3 months. I thought I didn't easily convert T4 to T3. However, my experience showed that every time I took T4 with T3 I had to keep raising the T3 dose. I didn't know whether an RT3 test would be accurate at this point (after 15 months of thyroid supplements).
So I just decided to stop taking T4. I also decided to take my T3 doses 3-4x daily rather than twice daily. The first day of 4 doses was a disaster, because I took my 4th dose too late at night and didn't sleep until 8 hours after I took that last T3 dose. Then I decided I really didn't want a nighttime dose, which could interfere with my sleep. So I started taking 3 even doses of T3 at 7am, 11am and 3pm (4 hours apart). That has worked well for the past 3 days. My energy level is even all day until bedtime when I start feeling sleepy. Then I sleep very soundly all night. Also I've been very regular while taking less magnesium than I previously took. I'm still getting cold sometimes. However the weather did turn really cold and I haven't dress differently for that colder weather. Nevertheless I'll keep using this triple T3 dose approach with no T4.
According to the RT3 literature, after 8-12 weeks I may even need less T3 to prevent hypo symptoms. Whatever ... I'm happy to finally prevent my afternoon energy crash, keep warm and stay regular on the same dose for awhile.
Tuesday, January 3, 2012
DHEA Side Effects and CD Group
I've been on sublingual DHEA for one month now. Immediately I noticed I stopped getting cold symptoms. I haven't had one cold during the past month. So DHEA seems to improve my immunity. Just as I heard/read DHEA can cause oilier skin and hair. However, I haven't gotten acne (other than one strange bump on my upper chest/bottom of my neck). Nevertheless, that's all good for me, because I've had dry skin and hair all my life (perhaps because of hypothyroidism).
I'll stay on my current 0.25ml (2.5mg) daily dose of DHEA for at least 3 more months. (I love the cherry flavor! LOL) I'll also love not having to take a daily dose of arabinogalactin (prebiotic powder) to relieve cold symptoms. Amazingly my husband brought home (from the office) a cold, which I didn't get. I gave him some arabinogalactin powder and he recovered within 24 hours from severe cold symptoms. That arabinogalactin is great stuff, but it does cause gas and bloating (like most prebiotics) every time I take it. I need the extra oil in my hair and skin (which DHEA causes), but I won't increase the dose, because I don't want to have to wash my hair everyday.
I've decided to start a gluten intolerance/celiac disease awareness group at my church. I know there are other members with gluten intolerance (or celiac disease), because they offer gluten free communion bread. I had to negotiate with the worship team leader to get some gluten, dairy, egg, soy, cane sugar free communion wafers so that I could participate. I haven't had the 'bread' part of communion since I was diagnosed with celiac disease (and then those other 6 allergens) in 2004. I actually served communion at our previous church, so that I would have to obviously pass up communion bread. Nobody ever notices what the servers do, unless they have a special ceremony for servers, which happened once, much to my embarassment. A fellow server just couldn't understand why I couldn't take the gluten containing communion bread no matter what I said. SIGH
Anyway I feel well enough (and motivated enough) to share my experience and knowledge about gluten intolerance (and related food allergies) with a small (hopefully) group at my church. I don't want to talk about food allergies so much, because there's a huge controversy about whether delayed reaction (IgG or IgA mediated) allergies are 'real' allergies, compared to immediage reaction (anaphylactic or IgE mediated) allergies. I know that they are all caused by immune reactions, which tells me they're allergies, not intolerances, which are caused by missing enzymes (like lactose intolerance). However, I know many people believe their (rather uninformed) doctors' opinions. Also they have been tested with some rather questionable allergy tests (saliva or skin) and are convinced they have many allergies. I don't know why someone would want to restrict themselves based on questionable test results. 7 food restrictions are plenty for me!
Nevertheless, I want to get some end of the year and new year chores done, before I take on leading another group. So I may wait another month to start the group.
I'll stay on my current 0.25ml (2.5mg) daily dose of DHEA for at least 3 more months. (I love the cherry flavor! LOL) I'll also love not having to take a daily dose of arabinogalactin (prebiotic powder) to relieve cold symptoms. Amazingly my husband brought home (from the office) a cold, which I didn't get. I gave him some arabinogalactin powder and he recovered within 24 hours from severe cold symptoms. That arabinogalactin is great stuff, but it does cause gas and bloating (like most prebiotics) every time I take it. I need the extra oil in my hair and skin (which DHEA causes), but I won't increase the dose, because I don't want to have to wash my hair everyday.
I've decided to start a gluten intolerance/celiac disease awareness group at my church. I know there are other members with gluten intolerance (or celiac disease), because they offer gluten free communion bread. I had to negotiate with the worship team leader to get some gluten, dairy, egg, soy, cane sugar free communion wafers so that I could participate. I haven't had the 'bread' part of communion since I was diagnosed with celiac disease (and then those other 6 allergens) in 2004. I actually served communion at our previous church, so that I would have to obviously pass up communion bread. Nobody ever notices what the servers do, unless they have a special ceremony for servers, which happened once, much to my embarassment. A fellow server just couldn't understand why I couldn't take the gluten containing communion bread no matter what I said. SIGH
Anyway I feel well enough (and motivated enough) to share my experience and knowledge about gluten intolerance (and related food allergies) with a small (hopefully) group at my church. I don't want to talk about food allergies so much, because there's a huge controversy about whether delayed reaction (IgG or IgA mediated) allergies are 'real' allergies, compared to immediage reaction (anaphylactic or IgE mediated) allergies. I know that they are all caused by immune reactions, which tells me they're allergies, not intolerances, which are caused by missing enzymes (like lactose intolerance). However, I know many people believe their (rather uninformed) doctors' opinions. Also they have been tested with some rather questionable allergy tests (saliva or skin) and are convinced they have many allergies. I don't know why someone would want to restrict themselves based on questionable test results. 7 food restrictions are plenty for me!
Nevertheless, I want to get some end of the year and new year chores done, before I take on leading another group. So I may wait another month to start the group.
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