Thursday, May 7, 2015

Insidious Anemia

I haven't done much blogging in the past year and a half, haven't done much writing at all, which, believe me, has been painful. Writing has always been my preferred form of self-expression. I wrote my first "story" when I was six.

What has kept me from writing? Life with a toddler. Life, and anemia.

Since my last post of any real substance, in December of 2013 (!), I mentioned the desperate need for a break, the feelings of being exhausted and overwhelmed.  It didn't get any better, really, it just gradually got worse. Two home renovations and travel abroad with a toddler had me questioning my sanity and my decision to have a baby at my age. I felt so tired all the time, me, someone who always used to be high-vitality. I attributed my inability to keep up with my house, play with my child and ferry him around to various activities, and stay awake late enough to spend time with his father to having a baby late in life. My waning vitality was so subtle and insidious that it didn't occur to us it might be anything else. I was in a fog, and my partner was so wrapped up in his very demanding work that he didn't notice anything amiss. I must be too old for this, I thought to myself, many times. My partner, who is nearly a decade younger and finds our son exhausting as well, thought the same thing.

By February 2015 I was starting to think that I was depressed but didn't feel depressed. It was the only reason I could think of why I felt so desperately tired two hours after getting up in the morning. The couch seemed to beckon to me with a siren's call.  In the fog that enveloped me, I didn't really take note of the increasing lightheadedness, my intolerance to cold, the erratic heartbeat, the difficulty catching my breath after any form of exertion, the paleness of my skin and my gums and my eyelids. I was vomiting almost daily due to acid reflux/GERD, and tortured intermittently with IBS-like colon spasms. My name was Misery.

Finally, after experiencing two 5+ hour long IBS episodes in three days, I went to see my doctor. With tears in my eyes, I told her I just couldn't take any more. 10 vials of blood, a CT scan, an endoscopy and a colonoscopy turned up serious anemia (ferritin level of 7), a hiatal hernia, a duodenal ulcer. All the vomiting had caused my lap band to slip very badly. I started iron sucrose infusions and had surgery to repair the hernia and take out the band.

Repairing the hernia and removing the band took care of the GERD. I can drink coffee and orange juice and eat chocolate and tomatoes again! No more waking up at 3am to purge my stomach of the acid that kept me up coughing all night. I'd forgotten what it felt like to wake up feeling renewed.

Three weeks after my first iron infusion (I had 5 in six weeks) I noticed a dramatic difference in my energy level. So did my partner. "I know it is working," he said, "because it is 9pm and you're still awake."

Today, I feel like a whole new person. Or rather, I feel like my old self. I no longer mourn my pre-pregnancy self and question my decision to have a baby at 43.

And my son, he's loving his new mama. He's loving that I have the energy to play with him. I'm less irritable, too. More patient. My New Year's Resolution this year was to try to be a better partner and a better mother. It's taken 5 months to get there, but what a difference in my quality of life, and that of my family.

I've never been anemic before. I didn't know enough about it to connect the dots, and I was so busy, so foggy, I'm not sure I would have connected the dots. But now I know. And I'm passing it on.

If you feel exhausted all the time; if you feel cold when everyone else is fine; if your gums and the insides of your eyelids are pale; if you find yourself feeling lightheaded in the shower or after standing up; if your heart pounds or you feel breathless with simple exertion; if you feel headachy or foggy or dazed or lost -- if even two of these symptoms sound familiar -- you're probably anemic.

A lot of women are mildly anemic, especially women who have had multiple children, have heavy menstrual cycles, or are vegetarian. A lot of women, and indeed the medical establishment, are resigned to mild anemia because taking iron orally can be either hard on the stomach, or constipating (in my case, both).

I've learned that taking iron with a swig of orange juice or similar source of Vitamin C makes it more bioavailable. I've also learned that you shouldn't take iron at the same time as thyroid medication or most antacid medications (wait 3 hours).

I've learned that getting iron by IV is a lot less of a hassle than it used to be, and that it makes a huge difference very quickly. Instead of having to do iron dextrose over a 3 to 4 hour period, they now do iron sucrose (Venofer), which can be done as an IV push over 5 minutes, with or without running a saline drip. I'm usually in and out in 30 minutes. Now, it isn't without some side effects, but it is worth it. I usually get a mild headache, my joints feel achy for a few days, and sometimes my low back aches (kidneys) if I don't drink a lot of water.

I've learned that it takes 4 months to completely replace your red blood cells, so 6 weeks in to the iron replacement, I'm basically 1/3 of the way there. I'll go in a couple of weeks to get my ferritin levels tested, and next week I'll go back to taking my oral iron (325mg once a day instead of 3x a day). Even though I feel like a new person, energy wise, and now that I'm not having the dizzy spells, the breathlessness and the pounding heart, I've still got the pale gums, skin, and eyelids, the low body temp, and the tendency to feel cold when others feel warm. I'm looking forward to the day everything is back to normal.

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