Cortisol & Childhood Trauma: Medical Mystery Update

I didn’t want to post about this until something was working; it was too hard to wait, while doctors talked to each other and labs came in and the pharmacy waited to get a medication in stock. My labs show some evidence of over-active thyroid, but the endocrinologist I saw surprised me by looking for, and finding, low baseline cortisol levels. Our first appointment was long, because she asked for my life story behind the bare medical facts. It’s long, especially when my dad’s mental health comes up. I had never seen an endocrinologist before, so I just went with it. I wasn’t surprised when she sent more for more labs and told me to come back after she had the results.

I was surprised when my next visit revealed her suspicion that my diagnosis would actually be low cortisol. She gave me a three-page handout on low-dose cortisone treatment for this, but told me she would wait to call in the prescription until after I had done one more cortisol test. This is a blood draw that has to be done before 9:00 am, while fasting (just putting off breakfast and no late-night snacks). I cracked a joke about torturing me with all these early tests.

“I am not a morning person,” I said.

“That’s because you have low cortisol,” she replied, and left the room.

This shook me up. I have not been able to get myself on a regular sleep schedule, well… ever. The anxiety meds were supposed to help with that. The SLEEP AID was supposed to help with that. Nothing has worked. Not even having a baby who became a toddler who does not sleep past 7:00, and 7:00 is a sleeping-in day. Her theory is a good one, because cortisol is supposed to peak at 7:00 am. It’s part of what helps us wake up!

I had no idea about the healthy reasons we produce cortisol–I knew it only as “the stress hormone,” a trigger for adrenaline. I thought of it as bad, because a spike in cortisol means panic. Anxiety attack. I knew that very high levels could harm a developing fetus, because this was one reason I decided to remain on my anti-anxiety medication during pregnancy. If anything, I would have guessed that my cortisol baseline would be very high, all the time. But then, I remembered seeing a post on Facebook, a link to a TED talk about childhood trauma and health, later in life. I googled and found it. This is a transcript of Dr. Nadine Burke Harris’s talk and this is a link to an ad-free video of her speaking about “How childhood trauma affects health across a lifetime” – I’ve embedded the YouTube version, here, for our convenience.

Here’s what knocked the wind of out me:

In the mid-’90s, the CDC and Kaiser Permanente discovered an exposure that dramatically increased the risk for seven out of 10 of the leading causes of death in the United States. In high doses, it affects brain development, the immune system, hormonal systems, and even the way our DNA is read and transcribed. … What kind of trauma am I talking about here? I’m not talking about failing a test or losing a basketball game. I am talking about threats that are so severe or pervasive that they literally get under our skin and change our physiology: things like abuse or neglect, or growing up with a parent who struggles with mental illness or substance dependence. [emphasis mine]

Here I was, seeing my psychiatrist, midwife, general practitioner, and an endocrinologist, because my life around my monthly cycles had become hellish. And here was this video, suggesting that it could all go back to life with my dad, particularly those last four years, when I lived alone with him, as his paranoia deepened into psychosis. “Lock the doors and the windows. Your mother is going to try to kidnap you.” And I did.

The day I heard the low-cortisol theory, I went to therapy (thank goodness for therapy) and threw a tantrum. WHY did everything go back to my father? Did this mean that he was still an abuser, still in control, after I hadn’t even spoken to him in almost two years? I actually wished that a hormonal shift had been caused by having a child, because that had nothing to do with my dad. He’s never met my child. I was angry.

And then, I watched this speech, and I was relieved. It wasn’t that my dad was winning. It wasn’t my fault. I hadn’t given in to him. It just happened. My father’s mental illness began before I was born, and it got worse as I grew up. My brain and body responded just as Dr. Burke Harris describes:

Well, imagine you’re walking in the forest and you see a bear. Immediately, your hypothalamus sends a signal to your pituitary, which sends a signal to your adrenal gland that says, “Release stress hormones! Adrenaline! Cortisol!” And so your heart starts to pound, Your pupils dilate, your airways open up, and you are ready to either fight that bear or run from the bear. And that is wonderful if you’re in a forest and there’s a bear. … But the problem is what happens when the bear comes home every night, and this system is activated over and over and over again, and it goes from being adaptive, or life-saving, to maladaptive, or health-damaging. Children are especially sensitive to this repeated stress activation,because their brains and bodies are just developing.

A little more research into cortisol, specifically, revealed that while a child going through that trauma usually has a high baseline level, the adult who is no longer in that situation will often have a low baseline level of cortisol, but the minute we encounter a stressor, cortisol skyrockets. We still react to stressors as though we are seeing a bear in the woods, even if all we face is the prospect of going to the grocery store.

My third and fourth cortisol tests came back low–not “subclinical,” which would indicate a disease like Addison’s disease, but near the bottom end of the “normal” range. This range is skewed, because we do not test the cortisol levels of people who feel good. The same problem exists for thyroid testing. Many patients are told to go home, that there is nothing wrong with them, because testing does not show dangerously high levels. We may not be suffering from a dramatic, textbook illness, but our suffering, fatigue, headaches, insomnia, muscle aches, whatever it is that brought us to that specialist in the first place, well, that suffering is real. It deserves attention. My psychiatrist sent me to this specific specialist because she wants to know why a patient suffers, regardless of what the lab numbers say.

My specialist’s theory, about me having low cortisol “because of the trauma” (her words), is cutting edge. I’ve had time to ask a lot of people with a lot of childhood trauma in their backgrounds, and no one has heard of this. But here’s the thing: it’s working.

I started taking the first of the low doses of hydrocortisone last week. I cut a pill into four pieces and took 1/4th each day for three days. Then, I doubled it. Then, I took half a pill after breakfast and a quarter after lunch. But here’s what happened: the second day I started this treatment, I began to need sleep at night. The next morning, I woke up on time, by myself. That hasn’t happened every day, but I’ve been carefully listening to my body. On six of the past seven days, I have felt tired between 8:00 and 10:00 in the evening, and I have woken up, on my own, without even my child’s voice (or feet in my face) to help me up. I have had energy during the day. The fatigue that once kicked in a few times a day, leaving me feeling like I couldn’t move a muscle, is gone. It’s just gone. I can take a nap at noon, and wake up at 1:00pm, replacing my old habit of getting up at noon and napping from 3:00pm until 6:00pm. I don’t even know what to do with all this time! What a fantastic problem!

I don’t know why, honestly. I don’t know why a tiny amount of cortisone is helping. I don’t know if this will help my anxiety, or help me reach and maintain a healthy weight. I have about 10,000 questions for my next appointment. I want to know if the plan is for me to take this stuff forever, or if my body and brain can heal.

I do know that this specialist is doing something brave and remarkable in trying this treatment with me. It’s a low-risk treatment, but as I said, it’s a cutting-edge theory. She falls into a movement Dr. Burke Harris describes in her talk:

The single most important thing that we need today is the courage to look this problem in the face and say, this is real and this is all of us. I believe that we are the movement.

Me, too. I’m in.

It’s Time to Change My Behavior, Too

This morning, I talked to Nathan about all the behaviors that have contributed to my anxiety. Basically, it all comes down to this: acting on an obsession with pregnancy, whether it’s taking my temperature every morning or taking a pregnancy test a full week before my period is due, is not helping. I charted my temperature and other fertility signs long enough to know that I have a pretty textbook cycle. Nothing to worry about.

I’m not saying that I won’t worry. But I am going to make sure that I have fewer things to worry over. The chart? Gone. Along with the temperature readings that “should” go up or down and the daily tracking of every possible symptom, I’m also giving away my ovulation predictor tests. I’ve said goodbye to my internet friends on the Fertility Friend message boards, those lovely and brave and strong women, because I found myself checking for new things to worry about every five minutes.

I may not be able to “just relax” or “stop thinking about it” but I can certainly cut down on the information I give myself to obsess over.

I have a feeling that once I start nannying and after we adjust my meds, it’ll be a lot easier to think about something else. But at 4:00 this morning, I would have given anything just to think about anything else for two minutes. I don’t even know how to explain how it’s possible to think about “Am I? Am I not?” for FIVE HOURS. But somehow, I did. No more.

I’ve been compiling a family history, so that I can know whether we should look out for anything heritable that might show up in my health or in our future child’s health. You would not believe how healthy these people are. Except that a lot of us are crazy, there’s hardly a sick one in the bunch! My mother is one of fifteen children and my father is one of eight children and including all these aunts and uncles and both sets of grandparents, I have not come up with one case of heart disease, one early heart attack, one diabetic, one epileptic, one woman plagued by miscarriage. We don’t even have dementia in the family, it would seem. Now, I know this makes no real true sense, but I figure that if we are blessed genetically to have avoided all the terrible predispositions to disease that are out there (Parkinson’s, Huntington’s, Breast Cancer), then this mental illness thing? Not so bad. The only heritable condition that I worry about passing on to my future child in my set of DNA is a tendency towards anxiety and depression. And you know what? If that child ever experiences mental illness, I intend to be modeling healthy ways to live and function fully, no matter what hits.

I am determined to stop letting my anxiety over nothing (honestly, I can’t even put a name to a fear, it’s not miscarriage or anything–like I said, no family history of anything to indicate any risk of anything) rob me of my sleep. As lovely and loving family members have pointed out, this is a pretty normal thing to worry about. I’m giving myself some room to worry. I also want a baby like I’ve wanted nothing else, so it makes sense that I’ll be thinking a lot about it. I am going to worry and my mind will circle this topic, yes, but I am not going to obsess. I’m not going to take tests compulsively. I’m not going to count anything anymore. And that is what I can do to take control back from this stupid disorder. Take that, GAD!

Product Review: I Love My Prenatal Vitamins

*This is not a sponsored post. I received no money or even a free sample for writing this.*

My nutritionist didn’t give me a list of prenatal vitamins, she just told me which bottle to buy: New Chapter Organics Perfect Prenatal. And something about the chemistry of it all means I also have to take their Bone Strength supplement, too. I don’t know exactly why, but I trust Jan. And she knows that we don’t have tons of money.

  • The downsides?
  • I have to take three a day. But I can take two with dinner, so it’s really just morning and evening. And I take medicine three times a day anyway.
  • They’re on the expensive side. About $25/month when I bought a big bottle (192 pills). Plus about $20/month for the calcium. And that’s after a heavy discount from on the prenatal and on the calcium supplement. BUT! I did just find a whole trimester’s worth of prenatal pills (270) on Amazon for $54.65. Let’s hope that price lasts, because I’ve still got half a bottle from my previous purchase.
  • The glass bottles break if not shipped properly. sent me a brand new bottle immediately, though, and I didn’t need to even show them the pictures of the broken bottle.
  • I have to clip my nails more often. I supposed that’s a good thing–they’re strong, more calcium, etc. But I’m not a manicure girl.

Here are the positives (warning–this may contain too much information if you’re squeamish):

  • No smelly pee. This is super important, actually. Smelly pee after swallowing a vitamin means that you are not absorbing your vitamin/supplement. As my friend’s doctor likes to say, “You’ll just have really expensive pee.” If I need to take three pills a day to actually absorb this stuff, then that is just fine with me!
  • No burping. If you’ve ever swallowed a pill and then burped and tasted the pill later, you know why this is up at #2. GROSS!
  • They’re small! Seriously. My anti-depressant capsules are bigger. No horse pills, here.
  • They are made of food. For real. Organic food! I try to eat as much organic food as possible and will up my game on that while actually pregnant. So my prenatal should be organic, too. It is going into my body three times a day, after all. This is how New Chapter puts it:
    • Organic Formulated with Organic Ingredients
    • Probiotic Cultured with Beneficial Live Probiotics
    • Whole Bioavailable, Easy-to-Digest Food [Easy-to-Digest = no burping up vitamin taste]
  • Probiotics. These are mostly good bacteria that help us digest food. They are expensive if you buy good ones separately. They are soooo good for the tummy. My tummy is happier since I started taking these.
  • They come in glass bottles. No plastic, no BPA.
  • Naturally Gluten Free & Vegetarian. I don’t care about keeping gluten or meat out of my diet, but neither gluten nor meat belong in my vitamins.
  • Between the Bone Strength supplement and the prenatal vitamin, I’m getting enough Vitamin D3 to stop taking the extra supplement I started when the blood test came back low in June. Same with iron.
So, if you are in the market for a good prenatal vitamin, I highly recommend this one. I’m pretty sure it’s actually healthier than a lot of the actual food I eat. But let’s not get into that today…

Rethinking Sports… “Just Do It” For The Kids.

I have fond memories of playing catch with my dad. I enjoyed softball for awhile. I even had fun on the soccer team for a whole year, thanks to my friend Jessica. But, true to the polarized mind of the teenager who sees only in black and white, if I were the “Smart Girl,” then I most certainly was not going to be athletic. (Kids did actually use “Smart Girl” to taunt me. I still don’t know why that was such a bad thing.) Team sports at my school were dominated by girls who played down their intelligence. I remember one girl who did well in school and in sports, but I don’t think it’s a coincidence that she participated in things like running and swimming–teams, but more dependent on individual achievement than basketball and volleyball, the girls’ sports that really drew crowds.

My niece is old enough to participate in sports, already, and it’s really important to me to encourage her in both school and athletics. I think I missed out on a lot of fun, but I also envy people for whom physical activity comes naturally. I want my niece (and nephew!) to want sports to be part of their lives, for all the obvious reasons, but also to keep them safe. Check this out: [quote]Although sports and physical activity are a part of girls’ and boys’ lives in and out of school at varying levels, girls tend to be less active than boys. The sports, education, youth development, and out-of-school time fields can provide opportunity for girls to engage in positive, healthy physical activity.[/quote]

        • In 2005, a much higher percentage of adolescent males participate in vigorous physical activity than do their female peers. Within all racial and ethnic subgroups, activity levels for males are between 13 and 19 percentage points higher than for females. For all grades, activity levels for males are between 10 and 20 percentage points higher than for females. (, Child and Youth Indicators Databank: Vigorous Physical Activity by Youth, 2006)
        • In 2005, more high school females (72.2%) than their male counterparts (56.2%) did not meet currently recommended levels of physical activity—doing any kind of physical that increased their heart rate and made them breathe hard for a total of at least 60 minutes per day. (Centers for Disease Control, Youth Risk Behavior Surveillance—United States 2005)
        • The more physically active girls are, the greater their self-esteem and the more satisfied they are with their weight, regardless of how much they weigh. Eighty-three percent of very active girls say that physical activity makes them feel good about themselves. (The Girl Scout Research Institute, The New Normal? What Girls Say About Healthy Living (2006))
        • For girls ages 11-17 it is the perception of being overweight, not just weight alone, that inhibits participation in sports and physical activities. (The Girl Scout Research Institute, The New Normal? What Girls Say About Healthy Living (2006))
        • For teen girls, being both physically active and a team sports participant is associated with a lower prevalence of sexual risk-taking behaviors. (Kulig, K., Brener, N. & McManus, T. Pediatrics and Adolescent Medicine, 2003)
        • A study of school reading texts found that boys were represented in physical activities 65% of the time, while girls were represented 35% of the time. In addition, boys dominated throwing and catching activities, while girls dominated dance and swing-set activities. (Henschel-Pellet, H.A. Research Quarterly, 2001) —Girl Scouts of America

All of this makes sense to me–if you are aware of the amazing things your teenage body can do you’re bound to have a more accurate perception of what it looks like–except the part at the end about school texts. I do not want my niece or nephew or any kids I may have to be reading in their darn textbooks that boys are the real athletes. But even if they do, I figure that the women in their lives can counteract that image. How? Well, I’m not sure it’ll work, but I have two ideas, so far.

One: I’m going to participate in watching sports. Turns out, I actually enjoy it. I always was a competitive person! I’m starting now, so that I know the rules by the time our future children see us watching football together. Nathan did spend about eight hours watching NFL football yesterday, and I’m not sure I want to set that example. I do want them to see us watching his–now our–favorite team. (The Jets. He grew up on Long Island. I grew up watching the Vikings, but I’ll just own up now to not being very loyal… and to liking the Jets cheer better.) I love the ritual, and I still find it adorable that my normally un-superstitious husband has to wear his jersey and eat more or less the same foods every Sunday. To be fair, the Jets almost lost the time he forgot his jersey, and they just barely won after he remembered to put it on. Oh, and remind me to repeat in ten years the fantastic conversation we had about why there are no female kickers in football. There’s no physical disadvantage, unlike in every other position in the game, but it’s still not at all open to women. Court cases have gotten some women onto college teams, but they had a rough time. Brave women, all of them!

Two: I’m going to run around with my kids and throw a ball with accuracy and force. I practice with our dog, although I often use a “ball chucker” so my arm doesn’t feel like it’s going to fall off. Catching a ball might take a little more work. For some reason I’ve always been able to throw any kind of ball, even a football, pretty well, but I now psych myself out of catching things. I will not giggle and run away, though. I will at least try and catch the stupid thing. Hey, it may just show them that you can enjoy doing things even if you’re not good at them! Just don’t blame me for demanding a good game of Scrabble sometimes just to prove I can dominate at something.

My brother-in-law and my husband are both totally awesome about answering my questions when we’re watching a game. And they both watcheverything. World Cup time is particularly awesome. Women’s World Cup games get air time, too. I have awesome memories of watching the NBA finals when the Lakers were great in the late 1990s. My sister and her then boyfriend (now husband) live in Los Angeles. I spent time there every summer as a kid. (She’s eleven years older than I am.) I watched the games with my sister, future brother-in-law and his friends. No one minded answering my questions during commercial breaks, and it was the first time I understood what was happening. It was really cool to hang out with grown-ups, and it was really cool to see my sister enjoying the game as much as ay of the guys. I still feel like an outsider in this weird world of sports, but a game is a game. Like I said, I have always been competitive.

Do you have other ideas about what I can do to show the kids in my life that women belong in sports, too? I can’t change the fact that mens’ professional sports get a lot more attention. But I can make being active a natural part of our family’s life. I can have a sense of humor about the fact that my strengths lie in my intellectual, rather than physical pursuits, without just giving up at everything physical. What else can I do, having spent most of my time reading? Please, more ideas! Oh, and do the commercials that air during sporting events push back against the image of seeing Mom and Dad watching the game? I worry about that. They’re just so awful.

As a matter of fact, please “dislike” this on YouTube. It makes me red-in-the-face angry every time I see it! Why would any reasonable woman demand that “her” man stop doing something he enjoys just because women are not supposed to like it, too? This is just bull crap in so many ways. And this is what I want to fight against just by showing the kids in my life that I can cheer for an awesome catch or recognize an awesome play.

McDonald’s: Sundays Are For Watching Football?

Save Girlhood! and How I Learned to Accept TV

Two events coincided at an interesting moment yesterday. One: my husband’s dream came true, and Direct TV hooked up the satellite dish that brings him a ridiculous amount of NFL and college football. We haven’t had anything except the XBox hooked up to our TV as long as we’ve lived together, so he’s pretty darn excited. I, honestly, am more excited than I expected. What I didn’t realize was that we were signed up for a two-year contract. Whatever. I now have access to BBC America, and this Anglophile is one happy camper.

TV with DVR

Evil Media? Not if used properly! And it's pretty cool looking, you have to admit!

So last night, while my husband watched football, I participated in a discussion called Save Girlhood on Twitter. (This blogger is officially media savvy. Well, I’m getting there!) What do we want to save girlhood from, you ask? Why, sexualization, of course. The kind we see in, well, the ads that air during NFL games. But for those of you who are new to this debate, I’ll let this fantastic lady fill you in:

@nancy_newmoon sexuality is the inner person, as the subject and proactive. sexualization is others projecting on you as passive object.

(Nancy Gruver is an “Expert on girls, author: How to Say It To Girls, Founder: & ad-free @NewMoonGirls Safe Social Network & Magazine for age 8+” – from her Twitter profile. I have loved New Moon since I was small.)

Read this blog, in its entirety, or, if you don’t have time, this post on Lingerie for Little Girls (not a joke) will fill you in on what exactly we’re up against. What does TV have to do with it? Well, I want to have a kid, right? And this isn’t just about girls. It’s also about the messages we send boys about girls. So whether I have a boy, a girl or both, this matters. Here are some highlights from last night’s conversation about the media and its role in the sexualization of girls:

@PigtailPals Q3: Do you limit toys/music/media for your daughter with concern to sexualization?

@DrRobyn: Q3: I’m a fan of actually taking the media, toys, etc and showing #girls the problems. discussing them.

@DrBeckerSchutte: when we teach our girls to be critical of media, we give them tools to push back against peer pressure.

@MauveDinosaur If their peers and media is all they have, that’s all they see.

@KnowldgeLinking: Want another shocker? 29% of kids age 2-3 have TV in their bedrooms. 43% of kids age 4-6 do

@DCalifornia: I think TV is a wonderful conversation starter. Good or bad, talk about it, discuss it, point out why it is or isn’t ok

@TheMomarchy Watching TV w kids is one of the best strategies. Called “co-viewing” in research.

I have never been sure what I think about kids and TV. Obviously, TV is not a babysitter. Unsupervised TV is not an option. A DVR will allow us to remove the commercials. [FYI: Kids can’t tell the difference between the program and the commercials! They don’t have that necessary “this is an ad, and advertisers lie to me” automatic response!] For most of my childhood, we watched movies but didn’t have channels via cable or satellite. I think that this was probably for financial reasons. I’m thinking maybe having TV in our house isn’t such a bad idea, with limits and not in the bedroom and, for many years, watching with the kids. I reserve the right to change my mind at any time. Well, I reserve the right to ask that we do not renew the contract. But even if we decide not to pay for this after we have a kid (and let’s face it–there are lots of things we won’t be able to pay for after we have a kid), our children will encounter the crap that’s on TV, and the good stuff too, somewhere. It’s just so accessible. And that’s now–I am going to have to know a lot about what is out there if I want to have a conversation with my child when she or he is ten years old. In 11+ years, it’s just going to be easier to get access to anything we try to ban.

I don’t want to ban media; I want to talk about it and teach our kids to make healthy choices. And the more Nathan and I talk about parenting, the more we agree that all we can do is try to raise healthy, compassionate, self-respecting children who make (mostly) good choices. Our shared goal is to model those choices for our kids. What we choose to watch on TV? Role modeling opportunity! Showing our kids that men and women like sports? Awesome! Talking about why that commercial we just saw during The Game is Bad Media? Teachable moment. Ok, so that’s not going down as easy… maybe too many teachable moments in that scenario. But we’ll figure this out as we go. With help from a seriously awesome support group, if the parents and friends of girls I met last night are any indication!

“BPA is illegal now, isn’t it?” NOPE.

From Healthy Child, Healthy World and AP:

“Better labeling news comes to us from Washington state, where a new law went into effect this week that forces manufacturers of toys, cosmetics, jewelry and baby products to report to the state if their products contain hazardous chemicals such as formaldehyde, bisphenol A and phthalates, according to the Associated Press.

P.S. On the BPA front, California is well on its way to passing a law banning the substance from baby bottles, sippy cups, infant formula and baby food.”

Know what that means?

  1. California has NOT YET banned bisphenol A from baby bottles, sippy cups, infant formula and baby food. (Please tell me that means formula and baby food containers!)
  2. In Washington state, you can use “formaldehyde, bisphenol A and phthalates” in baby products. You just have to LABEL it, now.
Let’s start with BPA. I talked about it in an earlier post, but let’s look at why parents should definitely pay attention and the rest of us should feel concern. I even found a nice little picture for you! The National Toxicology Program has a handy website with no alarmist rhetoric (this blog is TAME, people, compared to what else is out there) devoted to educating us, the public, about BPA and how to avoid it, if we want to.

Concerns about BPA are on the left. The level of concern is in handy stoplight color. This is the most conservative statement about concerns surrounding BPA, from the National Toxicology Program.

In case that’s hard to read, there is “some concern” (that’s orange, or yellow-turning-to-red: consider stopping!) for “Developmental toxicity for fetuses, infants, and children (effects on the brain, behavior, and prostate gland).” How? Well, it’s an “endocrine disruptor.” Which means that it messes with hormones (endocrine system). And here’s another tip from the NTP–if you’re concerned, avoid plastics with the recycle codes 3 and 7. The ones that look like this:

See the 7? Recycle it now. See a 3 in there? Recycle it. Just don't risk it.

These charming folks would like to assure you that your BPA intake is very low, and that there is therefore, no need to worry. Not true. As Annie Murphy Paul writes, in her book Origins, in this case, traditional views are not helpful, because with endocrine disruptors, “the dose does not make the poison.” In fact, a tiny amount might be more dangerous than a large amount. According to Paul, a tiny amount of an endocrine disruptor fails to trip immune system “alarms”–it looks a lot like a natural hormone. If you drank it, undiluted, I’m not sure what would happen, but your body would definitely say “That’s a foreign substance!” and fight it. But we’ve known for awhile now that endocrine disruptors are more dangerous in smaller amounts because they sneak past those alarms and make it straight into breast tissue, umbilical cord tissue, and other scary places.

And just in case you thought you were safe because you use a stainless-steel water bottle and avoid plastic dishes, there’s one more dirty little BPA secret: it’s in your soup can. I have signed two petitions trying to get Campbell’s to stop putting it in their cans; they refused to respond to either. And guess what’s got the highest concentration? Chicken soup. That’s right, the stuff with the character-themed noodles marketed directly to children. Also, ravioli and BABY FORMULA. Okay, enough yelling. But seriously, if you don’t believe me, read this from the Environmental Working Group.

So if you’re one of the people who told me, after my earlier post, that it’s okay to relax, BPA has been banned, this one’s for you. It has not even been banned from baby bottles in all states. True, far fewer baby bottles have BPA in them, but chicken soup and infant formula cans still have it.

Send a letter to your senator. Ask that our kids be protected from BPA. The smart people at, “where moms and people go to change our world,” have already written a great letter for you. All you need to do is sign it.

Go Team!

Traditional shrimp curry as prepared in Benagl...

If you haven't tried shrimp curry, you are missing out. And yes, I thank God and Nathan daily for my husband's culinary skills, which include Indian food that is better than takeout.

I have “met” with Jan The Amazing Nutritionist twice now, and after both Skype video chats, the flood of hope and relief I have felt has brought tears to my eyes. These emotions come after I begin to absorb the wealth of new information each conversation affords. While a visit to a doctor, even a good doctor, finds me struggling to get a word in, visiting with Jan means answering questions about every aspect of my life, not just about her area of specialization. I have lost count of how many darn times rushed to stop a doctor with a hand on the door handle, saying “Wait! I think this other piece matters!” only to see Doc turn around, sit down again, and reconsider a medication or other piece of advice. Even the neurologist I raved about had no idea which questions to ask. The visit went well because she listened to me, but I have had to learn to make them stop and listen to my speeches about how migraines are connected to anxiety which is connected to you name it. Jan asks me questions and then tells me why she’s asking. Best example? She asked a bunch of questions about Frova, my new migraine medication. I figured she just wanted to know what else I was putting in my body in addition to the foods I reported in my food diary entries.

I felt discouraged this morning, when I woke up with pain all through the right side of my upper body, from my shoulder blades to my eyeball and realized I was going to have to take Frova if I wanted to make it to babysit this afternoon. Then came the beta blocker. Then, I forgot to take my anti-anxiety meds until 11:30 am, and only remembered because I suddenly thought “Why in the hell do I feel so jumpy?” So I added a Xanax to the mix, to make sure that I’d get dressed and leave in time to make it to my 1:00 pm gig at the big house down the block. A baby just felt so far away as I swallowed that handful of blue, red and gray pills, all with warnings on their bottles against consumption during pregnancy.

But then, I read this in an email from Jan:

“Frova is a serotonin receptor agonist. It mimics serotonin production. This is the feel good, calming neurotransmitter. Tryptophan is the precursor to serotonin.
 Have a look at the foods high in tryptophan..  shrimp is #1!!!!!
That link revealed this list of “events” that indicate a need for foods high in tryptophan:
  • Depression
  • Anxiety
  • Irritability
  • Impatience
  • Impulsiveness
  • Inability to concentrate
  • Weight gain or unexplained weight loss
  • Slow growth in children
  • Overeating and/or carbohydrate cravings
  • Poor dream recall
  • Insomnia
Yes, Yes, Yes, Yes, No, Yes, No, No, Yes?, No, No. That’s fully HALF of things I most definitely need help with. And FOOD can help! Because the chemicals in my brain are also in food… which makes total and complete sense. “Hey!” I thought, “I eat lots of shrimp! Shrimp is great!” (Nathan makes the best sauce you’ve ever tasted.) But we had just talked about how I’m not eating enough of any of the animal proteins in eggs, cheese, grass-fed beef, organic chicken and other obvious foods. I am eating more shrimp. Connection? Who cares! Let’s pile on the shrimp and see what happens!

Some of these are on the high-in-mercury or over-fished categories, but lots are in the Wonderland-style "Eat Me!" category even for pregnant ladies. (PS Jan says "shrimp is #1!!!" in her email because it was high on our co-created list of foods to eat more of on a budget.)

Here’s what just makes me insane: not one of the many, many doctors I have asked about migraines and triptans has ever explained to me what they actually do. I have asked. They have been vague. Discouraged and already having taken twice as long as I’m “supposed” to take in the doctor’s office, I give up. Time and again, I give up trying to get doctors to explain to me what exactly these chemicals are doing. I have mutely accepted “help with the pain” and “help keep blood vessels open,” too exhausted to repeat “But HOW?!” I’m smart. I’m well-educated. I even understand a good amount of medical jargon. Hit me. I can take it. But they refuse. The notable exception is my neurologist, but I see him four times a year, and we usually have a whole lot else to talk about. I am now encouraged to email him to ask more questions, though, because he’s just such a nice guy and so good at explaining stuff.
My therapist is right (shocker!)–I feel less anxious when I learn more. The more information I have, the more empowered I feel and the less anxiety I experience. Right now, I am pretty excited about that huge bag of frozen shrimp Nathan found on sale. (I never get sick of it.) As Jan pointed out, preparing for pregnancy by eating more and more often. She tells me that I’m already eating lots of the foods she recommends during pregnancy. And, one of my favorite quotes from her is this one: “You need tons of this stuff when you’re building a human fetus, but you need them to rebuild your own cells, too!”
Maybe the Xanax has kicked in. Maybe I’m excited about my ability to do more every day to help me fill my brain with the happy chemicals the pills are currently helping me produce/use effectively. Information is power.

Apprehensive, Excited and Back in Therapy: Good-bye August

My therapist has returned, ladies and gentlemen! And I am so glad. She was in Vermont, but came back before Irene. As I gushed about how much I LOVE the babies I’ll be caring for this fall in my attempt to earn a living, she said, “It sounds like you’re ready to have your own.” Well, that was really good to hear! But I have to get off of these meds before I can justify trying to get pregnant. Tomorrow, I’m heading to NYC to meet with my psychiatrist (a different person, one with an M.D./Ph.D. and a prescription pad) to discussing shaving a little bit more off of my daily dose of Klonopin.

I am excited about the idea of going off the anti-anxiety medication Klonopin and, after that, my SNRI, Effexor, because after I stop taking those pills, we can start trying to get pregnant. We will have that option. I am apprehensive about even just this next step because, as I have said before, I can feel the Klonopin kick in, calm me down and help me start my day. I want this so badly it hurts. I hate that the pharmacist knows our faces. I wish that this process simply involved throwing all the dangerous pills away and not looking back. I sometimes wonder if I am somehow missing whatever basic information other humans have that allows them to get through a day without feeling panicky. They must know something I don’t know! I’m told that this is not true. That there is no key. It’s just hard. And that sucks.

Why doesn't this freak you out, too? Seriously! Grocery stores are crazy places!

You know what else was hard? August. And August did not suck, at least not every day. I took my “as needed” Xanax a few more times than I do when I’m in regular therapy. I did a lot of talking to Nathan about why I felt scared of [insert mundane, not dangerous object or activity]. I also went out to dinner with people I hardly know (a really big deal for me) and had a good time. I left a job I loved (my summer gig at the child care center) and then went out and got a new job. Two jobs. I went to the doctor. Two different doctors, in two different locations. I went grocery shopping by myself, voluntarily. I do not go to grocery stores alone, people! This morning, I took public transportation to work and home from work and did not panic. The mere thought of getting on a train used to trigger hyperventilation and lead to many skipped classes. And I like trains. Today, I took the bus. And I hate the bus. I haven’t had a migraine in ten whole days [and I am now knocking on wood].

In sum, I did it. I got through August. Not only did I get through it, but I kicked butt. I was happy–am happy. I am also quite proud of myself. September is going to bring new adjustments at work and in my medication. I am scared. I don’t want to take the bus. I don’t want to feel more anxiety. I don’t want to deal with Nathan being gone a lot, as school starts up again. But you know what I have to say to you, September?

BRING IT ON. I can take it. I am one tough lady.

See? Happy! And yes, that is the chubbiest baby you have ever seen.

Migraine update: Neurologists are Amazing

I saw a new neurologist this morning, just two days after getting a referral. I was so impressed with the way she made time to answer my 800000000 questions, even looking up whatever she didn’t know off the top of her head. She also took my desire to get pregnant next year seriously! She told me that while I should avoid triptans (the class of meds that includes Imitrex and is usually used to treat the headache once it has started) I can use them for now; she’s even letting me try a new one, since Imitrex almost never works anymore. She also heard my request for a preventative medication that either won’t be a nightmare to get off or that I can safely take while pregnant. I have a new beta blocker, a drug that blocks adrenaline receptors, lowering blood pressure and therefore the pressure in my scalp if my blood vessels constrict during a headache. I was taking one, but it wasn’t helping. And as I said, this new one might be ok during pregnancy. We’ll talk about tfat when the time comes. I’m just glad she didn’t try to convince me to add medications–she simply believed me when I said “these don’t help” and replaced those. I even get to come back in a month or earlier (a really short period of time for a neurologist) and check in. Also, just on case you were concerned, I did pass the physical neurological exam. Which means I can stand still with eyes closed without falling over, among other things. Hope! Thank goodness for good doctors.

Later the same day…

I picked up my prescriptions, and found out the “yikes” way that Flova, my new triptan, is not available in a generic yet. So that’s expensive. But this new beta blocker is really cheap, so if it works, it’ll all balance out. Anyway, what I really wanted to mention was that the neurologist recommended some really affordable supplements to add to my ever-growing list of daily pills. So if you have migraines, you might want to ask your doctor about these two: Riboflavin (vitamin B2) and CoQ-10 (Coenzyme Q-10). Both work to prevent migraines from happening in the first place by improving “energy metabolism. Read about one riboflavin study here and a CoQ-10 study here.

In looking for research about these supplements, I also found a fantastic blog called The Migraine Chronicles that I highly recommend.

Migraine Update

I thought that this list might be helpful. These are the things I now know cause migraines, after keeping a headache diary for the past couple of months:

  • Hunger. If I don’t eat, I get a headache. I have to stop what I’m doing and eat, no matter how busy things get.
  • Caffeine. One, maybe two cups of coffee a day, only in the morning or very early afternoon, and I’m fine. If I use it as a cure, it triggers a “rebound” headache.
  • Sugar. Sodas, in particular. If I have something like this on an empty stomach, it’s a pretty good bet. Usually only in combination with another factor.
  • Disrupted sleep pattern. It could be a too-long nap in the middle of the day (woohoo for under-employment) or staying up too late. Sleeping too much or too little. Regular sleep is the best medicine for my headaches since pain killers.
  • Hormone shifts. Artificial hormones, as my other migraine post explains in detail, like the ones in The Pill. Natural estrogen spikes will do it, too, but less aggressively.
That’s my list. I’m slowly bringing back the foods that supposedly trigger migraines, because in my experience, they really don’t. They do for some, but not for me. It seems so simple, doesn’t it? Unfortunately, I’m the kind of person who will fail to realize she hasn’t eaten until it’s been 12 hours. I’m working on it, but I tend to put whatever I’m doing for someone else ahead of what I need. And that’s a bad lesson to learn–taking care of myself is not less important or self-centered. But it can often seem that way. (I know, I know, just wait until I’m a mom–gotta work on this now!)
All-time best description of migraine symptoms, in French:

"J'ai envie de vomir" = "I want to vomit"

Found here.