Thursday, August 04, 2011

The Cortisol Test

What follows may be a little gross, so I'll be fairly clinical about it. As I talked about the other day, I've been dealing with extended periods of fatigue. The only way to detect whether my body is producing excessive or insufficient amounts of Cortisol is to track bodily function for 24 hours solid. This test shows how primitive modern medicine can be, since I'm being asked to provide a full day's urine sample, as well as to refrigerate said sample in between. I have another specialist's appointment mid-day, so taking everything with me is going to be a chore. But since it's at a hospital, I doubt it'll be anything they can't accommodate.

I can't pour the recently urine into the container itself, as it contains boric acid. Getting that on myself would not be good. Still, having just started the process, I see how cumbersome it really is and will be from start to finish. The total collected sample is in the form of an orange plastic jug that I must also refrigerate whenever possible. Cortisol levels change frequently throughout the day, and the issue here is whether or not the trajectory is normal or abnormal. I would opt for abnormal. And if I had to point a finger at any culprit, it would probably be the thyroid gland, which already showed evidence of abnormality during an ultrasound a few months back.

What is being tested here is whether I have Cushing's Syndrome, an adrenal tumor, or excessive production of a pituitary-secreted hormone called ACTH. A tumor could be involved there, too. At this stage in the game, I am far less likely to entertain the worst case scenario. If I had to self-diagnose, I'd believe that there's something about my adrenal gland that is causing it to overproduce or underproduce cortisol. When I had the MRI of the pituitary gland performed in November, the odds were more likely that it might be something serious. The doctor who provided the order was extremely concerned that I might have cancer, which is why I flipped out the way that I did. This is not the case here.

It's also possible that two drugs I take to treat bipolar, Seroquel and Lithium, are either the cause or are making an existing condition much worse. I suspect there may be a correlation between Lithium and mild outbreaks of Psoriasis. Within the last three months, I have discovered two places on my chin that become red and a little scaly. I apply a steroid gel prescribed for that purpose and within two days it is fully healed. Again, the complexities of the human body means that sometimes drugs used to treat existing conditions provide unwanted and unforeseen side effects. Someday they might be able to develop treatments that didn't create other problems and I embrace the future for this reason.

It's very strange. Seemingly the moment I turned 30, everything went wrong. But as I think back, I know that some of these problems had been evident since my mid-Twenties. They just weren't severe enough to be detected by lab tests or even doctor's intuition. It is unfortunate that things have to blow up before they can be properly treated. This was also true with depression for me when I was 15. My first diagnosis was Attention Deficit Disorder. It took severe outbreaks of debilitating depression before the proper combination of medication was ever even attempted. And even then, it took close to a decade before the right cocktail was ever established. I try not to think about how much I must rely daily on expensive, complicated substances produced in a lab to simply be able to function.

But once again I turn to my faith. By myself, nothing I have accomplished recently would have been possible. Scripture is full of stories, stories of people with disabilities and limitations who God uses to perform great good. I think were I not so handicapped, I might miss that completely or ascribe my success to the wrong source. I know that this is not the end of greater spiritual growth or growth in more secular spaces. Earlier in life, I didn't understand the concept. It seemed like group deception, but when God reveals himself to you, believe me, you listen.


I guess I could be pretty angry about what happened to me, but it's hard to stay mad when there's so much beauty in the world. Sometimes I feel like I'm seeing it all at once, and it's too much. My heart fills up like a balloon that's about to burst. And then I remember to relax, and stop trying to hold on to it. And then it flows through me like rain. And I can't feel anything but gratitude for every single moment of my silly little life. You have no idea what I'm talking about, I'm sure. But don't worry, you will someday.

-American Beauty

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