Thursday, 31 July 2014

Graves Disease

I have had Graves’ Disease since I was 7 and would like to help explain what it is to those who want more info or know of a friend or family member or even yourself suffering with this disease. 

Graves’ Disease
was discovered in the mid-19th century and named after Robert J. Graves (1796–1853), the Irish physician who first identified it. 

What is Graves’ Disease?

Graves’s Disease is an autoimmune disease. An autoimmune disease develops when your immune system, which defends your body against disease, decides your healthy cells are foreign. As a result, your immune system attacks healthy body cells. In this case, your thyroid would be under attack.

What is the thyroid? 

The Thyroid is a butterfly-shaped gland that sits against and around the larynx and trachea. The thyroid gland controls how quickly the body uses energy, makes proteins, and controls how sensitive the body is to other hormones.

How does the Thyroid work? 

The Thyroid gland produces thyroid hormones, the main ones being triiodothyronine (T3) and thyroxine (T4). These hormones regulate the growth and rate of function of many other systems in the body (metabolism). T3 and T4 are made from iodine and tyrosine. The thyroid also produces calcitonin, which plays a role in calcium homeostasis.
The hypothalamus produces thyrotropin-releasing hormone (TRH) which makes the anterior pituitary gland produce thyroid-stimulating hormone (TSH) which causes the thyroid to produce T3 and T4 among others. TSH production is suppressed when the T4 levels are high. The TSH production itself is modulated by thyrotropin-releasing hormone (TRH), which is produced by the hypothalamus.  

What Malfunctions in someone with Graves' Disease? 

In someone with Graves' Disease, the thyroid over produces thyroid hormones (T3 and T4) as a reaction to being attacked by the autoimmune cells in the body. This causes an unnatural disruption of the negative feedback system shown above. 

What Treatment is there for someone with Graves' Disease? 

Correcting the high thyroid hormone levels can be achieved with antithyroid medications that block the synthesis of thyroid hormones, thyroidectomy where the thyroid can be wholly removed by means of surgery or by treatment with radioactive iodine (RAI). These days RAI is the most common treatment for Graves' Disease. 

What is RAI? 

RAI or radioactive iodine is a treatment most commonly used to treat Graves' Disease and other hyperthyroid conditions. Iodide is a main component of thyroid hormone so a large portion accumulates in the thyroid and, in a person with an over active thyroid, an even higher amount is accumulated. Radioiodide is administered orally by pill or liquid. A measured dose is given according to measurements made beforehand and it irradiates the thyroid cells that remove the iodide from the bloodstream. This concentrates the radiation in the thyroid which suppresses the thyroid cellular function. 

What are symptoms of Graves Disease?

Common signs and symptoms of Graves' disease include:

  • Anxiety and irritability
  • A fine tremor of your hands or fingers
  • Heat sensitivity and an increase in perspiration or warm, moist skin
  • Weight loss, despite normal eating habits
  • Enlargement of your thyroid gland (goiter)
  • Change in menstrual cycles
  • Erectile dysfunction or reduced libido
  • Frequent bowel movements
  • Bulging eyes (Graves' ophthalmopathy) (TED)
  • Thick, red skin usually on the shins or tops of the feet (Graves' dermopathy)
  • Rapid or irregular heartbeat (palpitations)

What is TED?

About 30 percent of people with Graves' disease show some signs and symptoms of a condition known as Graves' ophthalmopathy (or Thyroid Eye Disease (TED)). In Graves' ophthalmopathy, inflammation and other immune system events affect muscles and other tissues around your eyes. The resulting signs and symptoms may include:

  • Bulging eyes (exophthalmos)
  • Gritty sensation in the eyes
  • Pressure or pain in the eyes
  • Puffy or retracted eyelids
  • Reddened or inflamed eyes
  • Light sensitivity
  • Double vision
  • Vision loss

What happens after RAI?

Most people become hypothyroid after treatment with RAI. This is because the thyroid cells have been sufficiently irradiated rendering your thyroid unable to produce sufficient thyroid hormone. The reason for this is because treatment for hypothyroidism is easier than treatment for hyperthyroidism. This consists of regular blood tests and hormone replacement therapy which involves taking pills every day for the rest of your life. 

What happens after that?

You then have to have more blood tests and start gaining weight and then you modify your diet and exercise more and it doesn't help. So you go for more blood tests and you suffer from depression and then you do some research online and print out a booklet of research you've done online to take to your endocrinologist who then doesn't bother looking at all the reading you've brought him but agrees to prescribe you T3 with the T4 you've been taking for an eternity and suddenly your bad skin clears up and you stop the antidepressants and you feel so much better yet you still can't seem to knock any of the 20kgs you've put on over a span of 3 years but you feel more positive because it has plateaued for the past 2 years. When your levels are not optimal and you experience the normal stresses of life it can become overwhelming as fatigue can play a huge part and result in you feeling rather useless. 

Most websites discuss what happens to you immediately after RAI and how you will become hypothyroid but there isn't much in the form of support for patients after that. Most websites and doctors seem to have this idea of a happily ever after by taking a pill a day everything will be back to normal and you will never have to do a thing again. In reality you still have an autoimmune disease and you can still show signs and symptoms of that disease as well as another condition you've "swapped out for" as you have treated a symptom and not the cause which is an autoimmune disease. You can experience symptoms related to Graves in the autoimmune side of things as well as new symptoms of being hypothyroid. The constant testing and tweaking of your meds until you reach the perfect dose. 

Unfortunately your body changes as time goes on and the perfect dose years ago is not so now. Your dietary requirements change and you have a huge amount of adjustments to make. There are so many different facets to this disease and the effects it has on your body and even your emotions. You cannot look at your body as a sum of parts as each part influences another in some way. Stress affects you in a major way and then you get TED and have to have these really scary surgeries where they hack away at the inside of your face to make more space for your eyeballs. It's stressful to have surgery and to not be able to see for months because you're squint inbetween ops. You're told to re-evaluate your life and practise calming techniques but life happens and you hate your job and people die and you crash your car and you get dumped and it's very difficult to avoid stress altogether unless you're highly medicated where you have no concept of reality or you run away to a secluded cabin in alaska with no communication with the outer world but even then, you may see a bear and that would get me pretty stressed. 

I hope this page has been informative and given you a little more understanding into this disease for yourself or your loved one and to know that I have only touched on the tip of what it is to experience this condition. There is so much to consider when trying to be your best and can become quite overwhelming when things aren't working optimally. If you are going through any of this, remember to take it easy on yourself and you don't have to be perfect, you only have to be good enough. It's a scary thing to go through and you won't receive the support you'd want from family and friends because they can't begin to understand what this is all about and you can't blame them. All you can do is try and at least not overdo it on anything if you can help it. Take care of yourself, exercise regularly, eat nourishing food, drink plenty of water and be kind to yourself because you're going to be with yourself for the rest of your life. 


Tuesday, 29 July 2014

How to be more successful

1.  Measure yourself

The best way to know that you’re improving is by being able to measure it.

2.  Break down into smaller parts

When you break your goals down into their smaller parts, they become more easily achievable. 

3.  Start with a small habit

Basically here, the theory goes, do something easy to start off with. If your main goal is to floss everyday then start by flossing one tooth every day and work your way up. It’s all about habit formation and if it’s easy to do you’ll be more likely to stick to it until it becomes a habit.

4.  Make it so easy you can’t say no

Again with the previous point, start off with something simple so you won’t make excuses. If it’s easy, there’s no reason why you shouldn’t do it then and there.   

5.  Start small and gradually improve

Initially start with the easy task but as you find it easier to do without thinking, add to it so you start working toward your goal.

6.  When you slip get back on track quickly

The faster you get back on track the less momentum you will lose. The longer you avoid the new habit the harder it’ll be to get back into the habit and you may even have to start from scratch again. Don’t see a set back as a complete failure, merely a slip up and an opportunity for you to learn from it. 

7.  See how and why you lose control

When you slip up, look at what caused it. Try figure out why or how so you can adjust your routine or come up with contingencies to avoid a slip up in future. 

8.  Be patient and stick to a pace you can sustain

Don’t overdo it or you will feel overwhelmed. Keep it easy enough that you barely have to think about it and increase gradually. If it feels like a chore, it’ll become a chore and soon you will slip up more and more because you’re making it difficult to form a habit. 

9.  Begin each day with a ritual

Rituals set yourself up for completing your habit. If you put your gym clothes on when you get home from work, you’re more likely to continue on to the gym to work out. Putting on your bike helmet sets you up to go for a cycle. Rituals provide a mindless way to initiate your behaviour. When you master the ability to mindlessly initiate the tasks that are important to you, it's not necessary to rely on motivation and willpower to make them happen.

10. Motivation comes after starting a new behaviour not before

Once you’ve started something, you’re more likely to follow through to completion and feel good about it so you can say, retrospectively, that you felt motivated to do the task but only after initiating that behaviour. 


11. Procrastination: The 2 Minute Rule

To avoid procrastination, follow the 2 minute rule. If it takes less than 2 minutes to complete, then do it immediately. To start a new habit, initially the action should take less than 2 minutes. This way you can apply the rule to it and do it without procrastination.

12. Objects in motion tend to stay in motion

Once you've gotten started, the habit is easier to follow through with. It’s always hardest getting to the gym but once you’re there it’s fairly easy to follow through with your workout. It’s hardest getting yourself to the bathroom but once you’re there with the floss in hand, the rest is relatively easy.

I successfully stopped biting my fingernails for about 6 weeks relatively easily using the methods described above. My only downfall was not following point 6 and I gave up on myself when I slipped up and bit my nails. I didn’t stop and evaluate what was causing me to bite my nails and to come up with a strategy to avoid it in the future, instead I gave up having decided I had failed in my attempt to break a bad habit. I would like to try this method to stop biting my fingernails again as well as using it to start new healthier habits for myself.  

The ideas in this post come from

9 Ways To Be A Better Person

I realised again that I’m falling into the trap of self-involvement and my own little whirlwind of drama and I know now that there is only one way in a drama whirlwind and that is down. I need to get myself out of this negative headspace and remember that I love myself and value myself enough to stop the negative spiralling. One way I find helpful is to set myself a bunch of goals that help better me as a person. I feel good about myself for achieving my goals and it gives me a great self-confidence boost. It also helps me to focus on where I want to be and help me steer myself away from the kind of person I no longer want to be.

I decided to do a bit of online reading and found a few self-help remedies here and thought I’d look through them and see how they worked for me.

According to, here are 9 ways to be a better person through self-development:

I took their points but added my own comments on each:

1.   Be Willing To Change

In this sense, they’re a little vague about being open to change. See if, like me, you want to become a better person then it involves change. You need to open yourself up to the fact that you may have habits or rituals or ways of thinking that may have served you in the past but are now detrimental to your growth and are outdated and no longer serve you but, rather, hold you back.

2.  Stop Making Excuses

This one is about taking responsibility for your actions. There comes a time in your life when you can no longer blame anyone for the way your life has turned out, unless you’ve been handcuffed in a basement since you were five, then well you have my permission to blame away.

On the other hand, if you have been an independent, adult who has the ability to think for yourself and make your own choices, then you only have yourself to blame if anything doesn’t turn out exactly as you’d hoped. Now this is a double-edged sword, do take responsibility for your life but don’t let it become an excuse for a pity party. Taking responsibility helps you avoid dragging out anything that went wrong and helps you to move on quickly and to see why you messed up and to make positive changes to avoid the same mistakes in future.

3.  Stop Being Angry

Now this is a real toughie for me. I am an angry person and I fly off the rails at almost anything these days. I’m still trying to figure out if it’s an issue of self-control, my hormones (making excuses?) or a bunch of unresolved issues I need to make peace with. I am not only angry, I’m teary, I’m depressed, I’m ecstatic, I’m worried, I’m an emotional mess but anger is something I have struggled with a lot in the past too so it’s definitely something worth tackling to help my life be a little less emotional and highly strung. I know this is going to take some patience and good harsh look at myself and my short comings and then some more patience.

4.  Be A Role Model

I honestly don’t have enough confidence in myself to be someone’s role model. I do get what they are getting at here though. The thinking behind this idea is that if you know someone is watching you, you tend to adjust your behaviour in a favourable way to avoid negatively influencing the person watching you. I feel like I still have a long way to go and to put the pressure of being someone else’s hero is setting myself up for failure. Instead, I have an idea. I shall try be my own role model. If I keep reminding myself I can see myself from both perspectives. That way I can get an introspective look at whether I’m on the right track or not. If I’m proud to be me to my past self then I’m on the right track. I do have glimpses of whether I feel like I’ve achieved something considerable or not and this just gives it a name and is a reminder keep checking.

5.  Forgive Someone

Again, this is one of those difficult ones. This point also goes back to previous points too. Forgiving myself is the biggest task to tackle. That is an ongoing process and takes a lot of introspection. I need to stop being my biggest critic and start being my biggest fan.

Forgiveness does not necessarily mean you condone someone’s behaviour, it only frees yourself from the pain of the anger you hold on to because of it. When you forgive someone you stop giving them your power by focusing your energy on them, instead you free yourself up to focus your energy on more productive things and on ways that make you happier and stronger. It is good to set boundaries and if people choose not to respect them, you can choose not to be around them.

Self-forgiveness in the same way stops you from constantly beating yourself up about things you’ve done or said in the past that have lead you to where you are now. I hold very high standards for myself that I almost always never live up to so it gives great fuel to my self-loathing fire. I need to re-evaluate my almost perfection standards and realise I am only human and can only achieve so much.

6.  Listen To People

This one I do often and find it is very interesting. It’s amazing the things people will tell you when you let them talk. Also I find it almost therapeutic for the people talking to get it all out. I guess we all live such busy lives that nobody actually sits and listens to us anymore. We’ve all become so busy that we can’t make time for friends. It’s been happening a lot to me lately I’ve noticed. I find people just start talking AT me rather than to me and it’s almost like I know instinctively to sit and listen to what they have to say. I don’t necessarily need to take it on or even take it in if I choose but just the fact that I’m there and listening, seems to make people feel a whole lot better for it.

7.  Be Honest

I often find myself in a white lie. I guess it’s my high standards I set for myself coming back to haunt me again. I feel like I haven’t done well enough so need to lie about it to other people as if they hold the same high standards for me as I do. There are also parts of myself I’d rather not share with people so I lie about them. A lot of the time I don’t even lie but omission is a form of lying too. I can say that I have also told some big lies too in order to avoid getting in trouble with loved ones. It’s easier to pretend like nothing’s wrong when you’re trying to figure things out than to have everybody’s opinion or input into your already muddled mind.

8. Do Something You Don’t Want To

This is a good way to find out what you’re made of. It also broadens your horizons and helps you figure out what you really do like and dislike. It helps challenge your idea of things versus what you actually think about them. Take food for example. The more food you try, the more food you start to enjoy. You pick up on more subtle textures and flavours and start to appreciate more. I used to hate avocado and thought it tasted like snot but now a little lemon juice, loads of salt and pepper makes for a creamy, refreshing, delicious topping on toast. If you don’t challenge your old ideas about everything, you’ll never realise you’ve changed or at least your tastes have. Perhaps they haven’t but you’ll never know unless you try something new.

9.  Surprise Someone Special

Surprises for me are always good in theory but I find extremely difficult to execute. Either I plan badly and fail to get the surprise in time, i.e. special prices for things expire or people’s birthday’s happen before I get myself organised. Or I faff so much with minor details I ruin the surprise. Doing nice things for people for me tend to be a case of the mind is willing but the body is weak (or lazy in my case). This is just me making excuses but yes it’s a good idea and something I should try to do more of to show those I love how much they mean to me.

I'm a big fan of making lists and I think it’s about time I set myself some goals and see how I do with those. They give me something to strive for and a measurable achievement that I can feel proud of. Of course, it’s a process and will take time.