Tuesday, 20 June 2017

The Best Laid Plans in Pregnancy...

Pregnancy is a great time of change - physical, emotional, practical - and a certain degree of planning  is generally required in order to help prepare for the life-altering arrival of a little one. Making lists and ticking tasks off as you complete them can help you feel more in control of what is largely an unknown situation, and putting practicalities in place certainly helps to settle the soul ahead of the anticipated major life event.

Some people are extremely detailed with their planning, leaving little or nothing to chance, whilst others prefer to plot out the main points but leave the finer elements flexible. I am in the latter camp; whilst I like to have the fundamental factors clear in my mind and on paper, I don't want to get bogged down in the minutiae as I think many of the smaller details are subject to change beyond our control anyway.

And, as is often the case in life, even the best laid plans can go completely to pot in a split second. Sometimes, if you have invested effort and consideration into putting a painstaking plan in place, you can end up more disappointed or traumatised when it goes tits-up all of a sudden than if you had allowed for some flexibility.

That said, even with a 'go-with-the-flow' attitude, we all imagine the way we expect events will unfold in our heads and any disruption to or deviation from that can be a source of distress.

This is the boat in which I currently find myself, on several counts.

Firstly, my husband and I specifically decided to come to London for the final 2 months of my pregnancy to escape the oppressive desert heat of Dubai, so that I would be comfortable in more temperate weather and able to take nice long walks in the park and by the river every day, staying active right up until labour. As it happens, we find ourselves in the midst of the hottest June the UK has experienced on record for the past 25+ years, with London and the South East bearing the brunt of the heatwave. At 34 weeks and 4 days pregnant, this 30 Celsius (feels like 40) London heat is melting me. I can't go anywhere comfortably. I can't even sit in my own home comfortably. My hands and feet are throbbing, and I'm frequently found sitting with my feet in a bucket of ice cold water. Thank goodness my husband is a fussy sleeper and can't nod off without air conditioning - whatever the weather - so we had already purchased a portable unit for the bedroom on our first day. Otherwise there is no way I would've been getting any sleep during this hot spot either.

So that's the first well-intentioned plan which has gone well and truly out of the window.

Next up is the matter of our private health insurance, which conveniently expired at the end of May. We knew this would happen, of course, and had planned to renew it immediately - which shouldn't have been an issue at all - but it has become one. The insurance is issued as part of a 'corporate package' to all employees (and their families) of the company my husband is employed by. This is standard; in fact it is a legal requirement for private companies in the UAE to provide private healthcare to their employees. It's a wonderful benefit and I'm not complaining at all, but unfortunately the company has been slow to activate the renewal of the corporate package, thus leaving us all without valid health insurance cover until now. We're not entirely sure what the hold-up is from the company's side, and even though my husband has attempted to renew my insurance as an individual off his own back, apparently it is not possible.

Cue the private Maternity wing at which I am due to deliver next month, suddenly demanding payment in full for the care package THIS WEEK! Great. Luckily we are fortunate enough to be in a position whereby we CAN self-pay the full amount if necessary and then later claim it back from the insurance company once our policy is renewed, but many others wouldn't necessarily have that option to fall back on. Either way, it is an expense we hadn't planned to pay out of our own pockets at this precise moment. But needs must.

Nothing, however, could have prepared us for the complete capitulation of the best laid plans, as an entirely unexpected piece of news came through at the start of this week. A curveball hurled from so far left-field that it has knocked me out of the park.

On Sunday, my husband received an official call-up to the 1-year national military service, due to report for duty on 1st August. My due date is 29th July. He immediately had to fly back to Dubai on getting the call-up, in order to enlist and go through all the medical assessments and psychological evaluations prior to the start of service date. This is the first time they have initiated military service call-ups for August; usually new recruits are taken on in January.

It will mean an initial 45-day cold turkey period with absolutely NO communication whatsoever. No phones, no emails, not even pigeon post. Nothing. The prospect of facing 45 days without talking to my beloved husband - my best friend, my soulmate, my world - either when I have just delivered our first baby, or even when I am delivering our first baby, if he arrives late, fills me with absolute dread and horror. Following the 45-day radio silence, there will be a further 4 months of being locked up at the military camp and sometimes being allowed out at weekends. Then a further 8 months of daily commutes to the military base.

My emotions and hormones had been so wonderfully stable since we came to London; every day was a happy day and a tear couldn't have been further away from my eyes, but since getting this news on Sunday I've been an oversensitive bag of weeping. As I mentioned in a previous post, we knew my husband would be in a training camp somewhere in Central Europe from mid-July for just under a month, but that he would be allowed to leave and come straight to me in London once I went into labour. Now that is not the case. There are no exceptions made to the 45-day lockdown. There are no delays to the start of service date.

What should be the most exciting and love-filled time of our lives has now been turned upside down into one of the most unsettling. I can't really get my head around what is to come and how I will handle it at the moment; it's still such a fresh shake-up to our 'best laid plans' and my husband having to hop on a plane and fly away last night was not something I had ever anticipated, let alone the rest of it. I know he has to respond to the call of duty and I'm very proud of him and what he will be doing, but for our fledgeling little family, the timing literally could not be any worse.

So, as is the theme of this (long, rambling, sometimes ranty and overemotional - my apologies!) blog post; you can plan for what you THINK is every eventuality, you can prepare for multiple scenarios, but in the end there is always a possibility that something could flash like a bolt from the blue and your only option is to react on the spot and deal with it as it happens. I suppose it will at least serve as good training for the unpredictability of life with a new baby.

Wednesday, 31 May 2017

A 7-hour flight with a 30-week bump

We leave as two, and will return as three...!

I've been MIA from posting lately as I've been busy getting settled into London life for the final stretch of my pregnancy... But despite the delay, I thought it would be worth writing about my experience of travelling whilst heavily pregnant, as it may be helpful or interesting for some of you.

So, we flew from Dubai to London exactly 10 days ago, when I was 30+1. In the days leading up to our departure I had my final appointment at Medcare Women & Children's Hospital with my OB-GYN, during which I passed the dreaded GTT (glucose tolerance) test with flying colours, and the doctor issued me with a 'Fit to Fly' certificate to present when asked by the airline during my impending travels. It's generally required by all airlines from 26 weeks of pregnancy onwards, but you may even be asked to show it earlier than that depending on how pregnant you actually look.

My doctor also prescribed me an Innohep injection to be taken just before flying; it's used as a 24hr blood thinner to prevent the risk of DVT (deep vein thrombosis) and is recommended before  any flight of over 4hrs in the later stages of pregnancy. Mine was administered at the hospital by a nurse into my thigh at 11pm, before a 5am flight the next morning. I didn't feel any effects of it and it's apparently a very normal injection with minimal risk of any side effects, so I was more than comfortable to take it.

The prospect of a 7hr flight from Dubai to London rarely fills anyone with joy, but factor in being really quite pregnant and also having booked a connecting flight via Doha rather than travelling direct, and it is safe to say I was rather looking forward to the whole transit part being over. I made sure to wear my most comfortable Topshop maternity leggings, a big baggy sweater, and my absolute favourite shoes to wear during pregnancy: Yeezys. I know they're overhyped and overpriced but there is really nothing more heavenly for those swollen pregnant feet.

Checking in at the Qatar Airways desk in Dubai International Airport was a breeze - even with our total of 100kg luggage between my husband and I - and nobody even seemed to notice I was preganant. The flight to Doha was a short and sweet 1 hour in First Class, but once we arrived in Doha the fun and games began. A shepherd from the airport was waiting for us as soon as we stepped off the plane, and proceeded to hurry us to the other side of the terminal - without a buggy - as he said our connecting flight was waiting for us. He also didn't notice I was pregnant and was rushing ahead whilst I struggled to keep up. We finally reached the boarding gate with much huffing and puffing on my part, and the shepherd informed us that there may not be time to transfer our baggage from the first plane to the second as the transit time was so short. Great.

We raced through the gate, believing that we were the only two holding up the entire flight, only to find that takeoff was to be delayed by at least an hour for a totally unrelated reason. So we rushed for nothing, and I sacrificed a bathroom trip for nothing. We sat in the holding pen at the gate with all other passengers for over an hour, with no access to any bathrooms - the worst prospect to face when you have a 1.5kg baby nestling against your bladder!

Eventually we boarded and yet again nobody from the airline appeared to even notice I was pregnant - so my Fit to Fly certificate went totally unused. As soon as we reached cruising altitude I reclined my seat to the flat position and proceeded to sleep for 5 of the 7 hours in the sky. I also made sure to stay hydrated and drink plenty of water throughout the flight, plus I requested ice cold towels a few times to soothe my feet, which are tending to overheat at any altitude these days.

Upon landing at Heathrow things were nice and smooth - both of us breezed through border control and our baggage - which thankfully had had enough time to be loaded onto the plane during the delay - was the first to roll off the carousel. Excited to be home in London and to see my mother, my energy levels were good for the remainder of the day, but when it came to bedtime I was absolutely exhausted from the exertions of the trip and spent much of the night and the next morning virtually comatose.

Overall it wasn't a bad experience at all taking a long haul flight at 30 weeks pregnant, although a direct flight would've been more convenient in general. I didn't suffer any aches or pains or new symptoms as a result of flying, but of course I was fortunate enough to be flying First and Business class so I had plenty of space to get comfortable, and I think an Economy seat would be far more difficult to deal with during pregnancy. So if, like me, you must fly in your third trimester, it's definitely worth it to book as high a class as your budget can stretch to (or do some great hustling work to get an upgrade!) for the sake of your baby and your body. 

Monday, 15 May 2017

Why I'm going to 'eat' my placenta

No... Not fresh out of the womb with a knife and fork, or spread liberally over a few slices of toast... Don't panic, and get those common 'eww'-inducing misconceptions out of your mind! For placenta encapsulation is the way forward, and there's absolutely nothing gross about it at all.

You've probably seen sensationalised headlines in various newspapers and celebrity magazines recently about the likes of Rochelle Humes, Coleen Rooney, Tanya Bardsley, Alex Gerrard and Amy Childs 'eating their placenta' after giving birth, which at first glance you might think was a little bit weird. But these ladies, and many more, have in fact turned to the practice of placenta encapsulation by the Liverpool-based, female-owned and -run business called Placenta Plus.

Danielle Kinney started her business after experiencing the benefits of placenta encapsulation first-hand. Having suffered from crippling post-natal depression after her first baby, Danielle heard about the advantages of placenta encapsulation and tried it with her subsequent pregnancy. Her experience was so drastically different from the previous one, and so overwhelmingly positive, that she pursued a path to make placenta encapsulation accessible to many more women in the UK.

In case you hadn't gathered from the term 'placenta encapsulation', the process literally involves the placenta being steamed, dehydrated, ground, and placed into pills or capsules, which you can then take daily as you would any multivitamin or health supplement until your yield runs out. Danielle at Placenta Plus offers two methods of placenta encapsulation: Traditional Chinese method, which involves steaming before the dehydration process and is thought to have a more calming and rebalancing effect, or the Raw Dehydrated method, which skips the steaming stage and is recommended as the more energising of the two methods.

So why exactly have I decided to do it? Well...

The benefits of placenta encapsulation include:

  • Increased energy levels
  • Reduced post-birth bleeding
  • Faster reduction of uterus size post-birth
  • Reduced risk of post-natal depression and post-natal thyroiditis
  • Reduced likelihood of suffering from a post-natal 'hormonal crash' - hormones are rebalanced much quicker
  • Enriched and more plentiful supply of breastmilk
  • Reduced amount of time to return to pre-baby weight due to boosted metabolism
Your placenta is a tailor-made source of nutrients, hormones, naturally occurring chemicals, iron and protein, created specifically by your own body to nourish your growing baby during the gestation period. Therefore, consuming an encapsulated version of your placenta and all the nutrients it contains is like taking a multivitamin supplement which was designed exclusively for you. The majority of mammals (including herbivores) eat their placenta after giving birth, proving that this is a beneficial practice in nature throughout the animal kingdom. 

The placenta is rich in nutrients and hormones such as:

- THYROXINE: a major key for all thyroid patients like me, especially after suffering a sudden increase in TSH levels during pregnancy. Natural thyroxine from the placenta will assist with rebalancing TSH, improving thyroid function, boosting metabolism to assist with shifting the baby weight quickly, and staving off the risk of post-natal thyroiditis (which is often misdiagnosed as post-natal depression)

- ESTROGEN, PROGESTERONE & PROLACTIN: Female hormones which contribute to stabilising post-natal moods, boosting lactation, regulating post-natal uterine cramping, decreasing depression and normalising libido

- THYROID STIMULATING HORMONE (TSH): essential for regulating and restoring thyroid function, boosting energy levels and supporting recovery from stressful or traumatic events

- OXYTOCIN: known as the 'love hormone', this stimulates bonding between mother and baby, therefore reducing the likelihood of postnatal depression. It also counteracts the production of the stress hormone cortisol, and enhances the breastfeeding let-down reflex

- CORTICOTROPIN RELEASING HORMONE (CRH): increased levels of CRH are vital to fighting off the risk of suffering from post-natal depression

- CORTISONE: reduces inflammation and swelling, and promotes healing after childbirth

- INTERFERON: triggers the immune system to fight infections - remember, your immune system is massively subdued during pregnancy

- PROSTAGLANDINS: an anti-inflammatory which helps to regulate uterus contractions and shrink it back to pre-pregnancy size

- IRON: replenishes maternal iron supplies to combat the common onset of post-natal anaemia, whilst also increasing energy and reducing depression

- HAEMOGLOBIN: oxygen-carrying molecule essential to increasing energy levels

- CYTOKINES: trigger cell metabolism healing and replace damaged cells and tissues

- VITAMIN B6: aids in the production of antibodies

- VITAMIN E: rich in healing properties for damaged skin cells

- IMMUNOGLOBULIN G: antibodies to support the reinstatement of the immune system

- HUMAN PLACENTAL LACTOGEN (HPL): boosts lactation as well as regulating maternal glucose, protein and fat levels

So, for the privilege of receiving all the evident benefits above, I have booked in and paid for a £200 package from Placenta Plus to encapsulate my entire placenta, which can yield anything between 90-250 capsules depending on its size. That's almost a year's supply of custom-made multivitamins designed just for me. There are also packages available including pills and body cream, but for me I feel the pills will be of most benefit so I preferred to maximise the number of those I will receive.

The whole Placenta Plus procedure includes Danielle sending a licensed medical courier to collect the placenta from wherever you give birth in mainland UK, and delivering the beautifully-packaged pills along with a dried umbilical cord keepsake (sweetly twisted into the word 'love' - a bit better than the grotty old cord clip my mum has saved from my birth back in the 90s!) between 24-48hrs after you give birth. An exceptional service, and I can't wait to try it out. I will definitely be posting more about my experience once I've had the benefit of trying the pills myself.

For more information about Placenta Plus or to book in for your own placenta encapsulation (available in England, Wales & Scotland only), visit their website - www. placentaplus.co.uk 

Wednesday, 10 May 2017

The awkward moment when you enter your Third Trimester but haven't bought any baby things yet

Officially the first (and only) baby-related item we own... Oh, and baby!

So, I officially entered the third trimester of pregnancy this week, which means we are now on the home stretch! Part of me feels like I've already been pregnant forever and the days are passing really slowly, but another part is suddenly startled by how time appears to be speeding up as we hurtle towards one of the single most life-changing events we will ever experience.

I joined the 'Mumsnet July 2017 Births' group a little while ago, and have been following and contributing to the thread with great interest ever since; learning a lot and sharing experiences with a diverse group of fellow mamas-to-be. It has been particularly interesting for me to compare my experience of prenatal care in Dubai with the other group members' UK experiences, with some of the biggest differences including the fact that I appear to have a great deal more ultrasound scans than anyone is getting in England, as well as the fact that the whooping cough vaccine is not offered in the UAE whereas it is standard on the NHS, and here in Dubai the GTT (glucose tolerance test for gestational diabetes) is standard for all expectant mothers, but in England it seems to only be offered to those who are considered at a high risk.

I really enjoy my interactions with the other July-due mothers - a group which also includes my expectant cousin! - and we often reassure each other by comparing notes on mutually-endured pregnancy symptoms and indulging in general baby-on-the-way chit chat. However, over recent weeks, reading the thread has started to give me mild anxiety.

I think I am quite literally the most utterly unprepared pregnant woman in the entire group.

It started dawning on me when I realised I was able to contribute less and less to the more prevalent discussions on the thread. Clearly I was the black sheep; the odd-one-out. Everyone else has moved on to sharing photos of their fully-decorated, fully-equipped nursery rooms. Talking about which brand of non-bio detergent they've already used to pre-wash their entire 0-3 months AND 3-6 months collections of babygrows. Reviewing the different baby-carrying systems they've trialled and tested out at their local sling libraries. Suggesting clever storage solutions for the multipacks of nappies they've already purchased. Writing up their lists of what they've already packed in their hospital bags.

I honestly have NO common ground on which to join in with the discussion anymore. I CANNOT relate. At all!!

I don't even know where we will be living when we come back to Dubai at the end of August; let alone how baby's room will be furnished or decorated. I didn't even know you were supposed to pre-wash all baby clothes before they wear them, and, suffice to say, to date we have not purchased a single item of baby clothing. I didn't have a clue that such a thing as a 'sling library' even existed. Clearly I haven't started to stock up on nappies yet - disposable or reusable (and that's a whole other story...). And as for packing my hospital bag...? I DON'T EVEN HAVE A HOSPITAL BAG YET!

We physically do not own a single baby-related item. Not one single thing.

Trying to reassure myself that I wasn't way behind or being too lax in my approach, I convinced myself that all the mothers-to-be in the July group are just superhumanly organised, overly keen, overly cautious, overly prepared, and/or verging on OCD.

But then...not one, not two, but THREE babies were born to mothers in our July-due group. In the same week. In May!!! Thankfully they are all healthy and doing well, despite arriving so early, but it really hammered home to me that all the other women in the group who already have everything ready and set up are in fact not being overzealous with their preparations. They are simply being practical.

Ok, my circumstances are a little different, in that I'm currently in Dubai and will be travelling to London in less than two weeks, due to give birth there in July. So really it doesn't make sense to do any baby-related shopping until we get to London. Inspired by the massively organised mothers-to-be of Mumsnet, I have at least started curating shopping lists of items we'll need to get as soon as we arrive in the UK on the Mothercare and John Lewis apps. But I still can't help feeling a bit naive for the way I've just made the sweeping assumption that I'll carry baby to full term and therefore still have plenty of time between now and then to get everything sorted.

To be fair, I've taken care of the 'big stuff'; the hospital booking for the birth, the placenta encapsulation booking (more on that in a post soon), plus overseeing (from overseas) the renovations of a number of rooms at my mother's home in London, ready to accommodate us all over the summer. But in terms of physical, material, baby-specific items... Nothing whatsoever has been done in that department.

Yesterday, after having another 4D scan to see baby delightfully wiggling around, yawning, smiling and touching his face, the sonographer gifted us a tiny weeny pair of socks along with our CD of images from the scan. So, finally, we do actually own ONE thing for the baby, although we didn't purchase it ourselves! There's still a long way to go towards being ready, but at least it's one small, baby-sized footstep in the right direction...

Saturday, 6 May 2017

Despicable Trumpcare bill punishes thyroid patients & pregnancy

I'm not usually one to get on my political soapbox in public, particularly when I am neither a citizen nor a resident of the concerned country, but many of my readers are from the USA and most of my 'thyroid network' of friends and fellow thyca-fighters are Americans. So here I am, sharing my outrage on your behalf.

The first 100+ days of Trump in office have been a horror show to say the least, and from an overseas perspective we have watched the numerous scandals and sickening decision-making unfold with our jaws on the floor.

The latest in a series of disturbing events is the passing of the AHCA (American Health Care Act) - otherwise known as 'Trumpcare' - by the House two days ago, in an attempt to repeal the current ACA (Affordable Care Act) referred to as 'Obamacare'. I realise that I am commenting from the outside, as someone who has no experience of American healthcare whatsoever, and I realise that there were also valid criticisms of Obamacare and that it had its imperfections. But this Trumpcare bill is just so, so much worse.

It has been brought to my attention by reading the posts of several influential and inspirational American ladies I follow across various social media platforms - including Aisha Thalia and Shelah Marie - that the new Trumpcare bill appears to be a major attack on women. Stunned by what I was reading, I investigated further, and researched the list of all illnesses, conditions and circumstances which will now disqualify people from receiving healthcare coverage - either as subsidised packages through Medicaid, which provides reduced price healthcare and financial support for 74 million poor, disabled and elderly Americans - or even for citizens who are attempting to purchase health insurance at the full premium. The bill will enable health insurance companies to deny these people coverage, or significantly raise their premiums to an unfeasible level.

The vast majority of the newly-considered disqualifying 'pre-existing conditions' are suffered specifically (or almost exclusively) by women. Breast Cancer, Cervical Cancer, Hysterectomy, Osteoporosis, Sexual Assault, C-Section, Pregnancy, and Thyroid Issues are all considered reasons to disqualify patients from being able to obtain health insurance in the new bill. If that is not gender discrimination, I don't know what is.

As someone who is fortunate enough to be British and have grown up with the NHS (National Health Service), providing free healthcare for all under all circumstances, and now as someone who has fully comprehensive Gold Standard private health insurance in the UAE, for which we pay around 8000 AED (£1678 / $2178) annually to get a remarkable level and standard of coverage, my heart really hurts for the estimated 24 million Americans who will be disqualified for health insurance due to this bill. If I was in the USA and subjected to this legislation, my healthcare would be denied on several counts. If I wasn't able to avail of this private health insurance coverage in the UAE - or free NHS healthcare in the UK - my treatment bills for my thyroid surgery and subsequent issues, followed by my pregnancy, would have easily topped 200,000 AED (£42,000 / $55,000) over the past two years. That is simply not a fair or sustainable amount for the regular working class citizen to shell out for the human right of healthcare.

I sincerely hope and pray that this barbaric Trumpcare bill doesn't make it through the Senate and that enough sensible politicians will stand up for the rights of those who are suffering in order to oppose its passing. My thoughts are with all my friends and readers from the States, who are dealing with similar medical conditions to me, but could soon be dealing with vastly different healthcare privileges and financial issues. Nobody deserves to be punished for being a survivor, and women certainly don't deserve to be discriminated against for going through the physical struggles we are susceptible to due to what we were put on this earth to do.

Thursday, 27 April 2017

The Struggle is Real

I just realised that I haven't written a new post in 10 days. 10 whole days! When I started writing Butterfly Free in February, I was so energised, so full of ideas... pre-planning topics to write about weeks in advance... But in recent days that motivation suddenly trailed off.

I recognised this feeling. It had happened to me before, in the aftermath of my thyroid surgery. All my excitement and brainstorming and effort I would routinely throw into my work projects suddenly evaporated overnight. I became disillusioned, dejected, and utterly demotivated, and I had no idea why. I couldn't focus. If I had an idea or thought, it would quickly disappear, or my enthusiasm for it would wane in mere moments, or I just wouldn't have the energy to follow it up. My work duties began to feel like chores for the first time. My creativity was gone.

It was not until the discovery and treatment of my severe Vitamin D and Ferritin deficiencies that I started to get my sparkle back, and then I realised that my apathy towards my work had come as a direct result of those deficiencies and a debilitated thyroid function.

This time round, I have been able to identify that apathetic symptom far quicker. At my most recent checkup with the OB-GYN last week, I insisted that she run some more thyroid blood tests despite it being outside the scope of health insurance coverage. I knew something was out of balance; I knew there must be a physiological reason for my sudden lack of lustre. Sure enough, the hospital called the next day with my results - my TSH has jumped from 2.4 to 3.9 in one month. I immediately doubled my dosage of Euthyrox to try and quickly get it back down below the recommended range of 3 during the second and third trimesters of pregnancy.

Some days I haven't wanted to leave home at all. Other days, a simple trip to the supermarket has been a struggle. A dinner out at a lovely restaurant with my husband left me feeling utterly drained. I kept pushing myself to attend my prenatal Pilates classes, but I didn't feel enthusiastic in the slightest at the idea of doing something physically taxing.

My emotions have been all over the place, too. I know pregnancy hormones wreak havoc with a woman's emotional state, but I'm someone who has always been quite reserved with her emotions. I never suffered from PMS or any other sort of hormonal oversensitivity, but recently I've been out of control (by my standards). I've gone from someone who cried maybe once or twice a year maximum - my husband had only previously seen me shed a few happy tears when he asked me to marry him - to someone who starts welling up at the slightest little thing on a daily basis. I got tearful during the opening sequence of the new 'Boss Baby' movie at the cinema the other day, for goodness sake!

Some days I barely recognise myself for how outwardly sensitive and emotional I've become. My insecurities, worries and fears have all been royally shining through, too. I don't know how my poor husband has been able to handle his previously placid wife turn into a drama queen, but I'm grateful that he has been very understanding and reassuring throughout.

As my newly-upped dosage of synthetic thyroid hormone starts to take effect, I am feeling the grey cloud lift from over my head. My motivation is coming back, my focus is clearer, and I have more energy to go out, to work out, and to simply get out of bed before the afternoon. I can't promise that the tears will dry up anytime soon though - that seems to be a direct knock-on effect of pregnancy!

So, I have written this post because I finally felt enough drive to actually open my laptop and start tapping away at the keyboard again, and because I wanted to be honest with you. On social media we tend to see the highlights of people's lives; they only want to share the shiny, glossy side, which is understandable, but also leads us to set unrealistic expectations for ourselves. Sometimes it's ok not to be ok. It's normal to go through a down or demotivated spell. What's important is to seek the right help to pull yourself out of it. The struggle is real, but the struggle doesn't have to last forever.

Monday, 17 April 2017

The Delicate Matter of Deciding Where to Give Birth

Choosing where to bring your child into the world is a big decision at the best of times, but when you and your other half are from two different countries it becomes an entirely greater challenge. Not only do you have to consider hospital birth vs home birth - and then, if you go with hospital birth, which hospital - but also the rather major factor of which country to deliver your baby in.

I was born at a now-closed hospital in London, a mere stone's throw away from the home in which I lived with my mother for 21 years before making my move to Dubai. My mother still lives in the same house, and my grandparents live an hour and a half outside of London. My husband was born and has lived his entire 25+ years in the UAE, where his mother, two brothers and three sisters also live, as well as it being where we met, got married, and have set up home together.

Here are some of the main factors we considered when weighing up our options as to whether I should give birth in the UK or UAE:

Quite clearly my husband has a far bigger family than me, so in logical terms, it would appear more reasonable to fly my 3 immediate family members to the UAE for the birth rather than booking an entire jet to transport my in-laws to the UK (slight exaggeration for comedic purposes!). My family wouldn't need visas to fly to the UAE and could stay for up to a month visa-free, whereas my in-laws would be required to fill out the online visa waiver applications a minimum of 48 hours before departure to the UK, which would mean a last-minute flight booking if I suddenly went into labour early would be entirely out of the question.

In practical terms, though, it is not quite so straight forward. My grandparents are both of a fine vintage, but a long flight to Dubai in the peak of summer would certainly not be ideal conditions for them. And, it being my first baby, of course I am absolutely adamant that I have my mother with me not only for the birth, but also for as much time as possible afterwards to help me adapt to motherhood. She works and has responsibilities in the UK, so to ask her to drop everything and come to the UAE for a month or more just isn't fair or feasible.

Then there's the thought of offending one side of the family or another, depending on which country we settle on deciding to deliver in. However, as with all things relating to such a major life event, I don't believe one should agonise over offending others when the best interests of the mother and baby are the main priority in such a situation.

Naturally this is a huge consideration, as the welfare of baby and mother are paramount. Luckily enough for us, the standard of healthcare both in the UK and UAE are exceptional - which is great - but doesn't really help in making the decision any easier! I am also fortunate enough to have private medical insurance (an essential for all UAE-based expats) and my policy will fully cover the costs of private maternity care both in the UAE and overseas, including the UK. So I'm thankful that I don't need to factor cost of care into the equation either, but once again, it doesn't assist with narrowing down my options from two to one.

This is a more documentation-based consideration to keep in mind for couples of different nationalities who are expecting a baby together. In our case, again, it doesn't really make a big difference in helping us to hone in on a choice, though, because with a British mother, our baby will be entitled to British citizenship regardless of where he's born, and with an Emirati father, he is also entitled to Emirati citizenship regardless of where he's born (though, as per UAE/GCC rules, he will not be able to hold dual citizenship - more on that in a future blog post). 

It may seem strange to some of you that this is a major contributing factor in making our decision, but anyone who has lived through a hot Middle Eastern summer will understand. It's only mid-April and temperatures are already reaching the mid-30 Celsius range here in Dubai at the moment, and quite frankly I'm already overwhelmed by it in my current pregnant state. Yes, it's easy to avoid the heat here if you want to - everything is air conditioned to Arctic proportions and driving everywhere is the norm - but I actually want to be as active and outdoors-y as possible both in the late stages of my pregnancy and after giving birth. 

I love the idea of walking (or, more accurately, probably waddling before my due date) in the park and along the River Thames pathway next to my home in London every day... The moderate exercise and fresh air will do me the world of good leading up to going into labour, and will also be blissful to experience with my newborn baby in his pram as I try to start walking off the baby weight. I think I would lose my mind if I was trapped indoors with my baby due to scorching heat for months on end. So this is one big plus point for a UK birth.

This turned out to be the crucial, all-deciding factor for us. My husband's work is 'seasonal', and the summertime is the only period in which he gets a decent stint of time off. Since we've been static in the UAE for the best part of the year (ok, ok, I know we went to London for 3 days and The Maldives for 4...but those were quick trips and not during his 'major' holiday time), it is important particularly for my husband to have a change of scene during the off-season. He fell in love with London since visiting with me for the first time in his life last summer, and he's very excited about spending a month or so there this summer. It's also a great place to use as a base and then travel for quick getaways to nearby European destinations. 

My due date is, obviously, in summertime. Mr Butterfly's duties will take a break at the end of May, so it makes sense for us to travel to London then - escaping the heat, getting a change of scene, having my mother on-hand to assist as I get closer and closer to delivering - and we can even try to get some extra mini-babymoon trips in to nearby places like Paris. The sticking point is the fact that my husband will have to resume his duties in mid-July, and Baby Butterfly is not due until the end of the month. However, for probably the first month back on duty, my husband will be based somewhere in Europe with his colleagues, so it would be much faster for him to get a couple of days' leave and hop on a plane from a European destination to London at my first signs of labour than it would be for him to head all the way back to Dubai if I was giving birth there. Plus, since he won't be able to stay with me for long after the birth, it's better for me to be at home in London with baby and my mother.

So, whilst there were good arguments for both places, all in all, the factors were weighted in favour of me delivering our little bundle of joy in London, and we all unanimously agreed on that decision. I honestly couldn't be happier with our choice and am so excited to bring our baby into the world in the place where I was born and raised, and most importantly surrounded by love.

Tuesday, 11 April 2017

Mamas I Admire, #1: My Mummy

As my pregnancy progresses, I find myself contemplating more and more the type of mother I wish to become, and reflecting on the many mothers who have helped to shape my views and ideas about motherhood. Through a series of 'Mamas I Admire' posts, I will showcase some of the most magnificent mothers I know, who inspire me and others around them and whom I hope to emulate in some way or another as I embark upon my journey of motherhood.

There is only one place to get started on this series of posts, and that, of course, is with my own mother. Helen, Mama, Mummy, Maja... She goes by many names, but funnily enough, I never call her 'mum'. It just doesn't seem enough of a word to do her justice. She deserves more syllables; more breath dedicated to calling her.

My Mama is undoubtedly one of the strongest human beings I have ever come across in my life, and the extent of her strength is becoming even more apparent to me now as I go through my own pregnancy. Just consider the fact that she was horribly deserted by her long-term partner in the early stages of carrying me, and that she continued to work full-time in her hectic TV producing job right up until the very day I was born (I arrived early - surpriiiise!), and then proceeded to raise me entirely as a single mother with absolutely zero input or support on the paternity front... I cannot even begin to imagine the amount of fear she must have felt at bringing this new life into the world on her own, and the amount of sacrifices she made in order to raise me in a way whereby I never even felt anything was missing as I grew up.

She showered me with unconditional love, affection and support right from my very earliest memories, and still does to this day. I never wanted for anything. She juggled her career with always dropping me off and picking me up from school, and always cooking and eating our meals together. I never had a nanny or au pair, and rarely even a babysitter. I never felt I was lacking in love due to only having one parent. She surrounded me with positive male role models from a young age, to look up to in the absence of my father, and she made me believe I was special and capable of anything.

The bond between a single mother and her only child is truly unbreakable and insurmountable by distance, as we have learnt since I moved overseas 5 years ago. Sometimes I feel guilty about moving so far away and leaving her alone, and of course I miss her immensely on a daily basis, but she never doubted my ability to thrive and succeed on my own two feet, in a new country, amidst a different culture. In fact, she encouraged me to pursue my dreams wherever they may lead me, and thanks to her guidance and love as my mother, she is the one who provided me with the foundations upon which to grow, to become independent, and to spread my wings and fly.

I could fill the pages of a rather lengthy book recounting stories of my Mama's love, strength and support, her struggles and sacrifices to give me the best possible childhood and to raise me into becoming the woman that I am today. Perhaps I will write a book about it one day, because some of the things we went through and some of the trials and tribulations we overcame are really quite extraordinary. But for now, I shall simply end this blog post by saying how words are not enough to express the gratitude I feel towards my Mama, and if I can be even half the mother to my baby that she has been to me, I will be considered a great mothering success.

Thursday, 6 April 2017

The Benefits of a Babymoon

The obligatory 'babymoon bump' shot!
As you may have seen if you follow me on Instagram, my husband and I were recently lucky enough to get 5 days off amidst his busy schedule, which we used to travel for a dream getaway to Furaveri Island Resort & Spa in the Maldives.
I suppose we can call it our 'babymoon', as it will most likely be the last chance we get to have an actual holiday together before the little one arrives and turns our world upside down. Babymooning seems to be all the rage these days - though I must admit it wasn't a term I was familiar with until very recently - and I would highly recommend heading off on one to any parents-to-be, if you get the chance. Here are just some of the reasons why it's so worth it...

Spending quality time together as a couple

Now, my husband and I are lucky in that we spend plenty of quality time together most days, but the chances to actually travel together are few and far between. There's nothing like exploring and discovering a new place with the one you love, particularly if you choose a romantic destination for your babymoon - for instance, a paradise island in the Maldives, like we did. With a baby on the way, we realise that our priorities will be changing in the coming months as much of our time will be taken up with raising this tiny human we've created together, so a babymoon offers an opportunity to devote some special days of undivided love and attention to one another, before becoming a trio.

We told the hotel staff it was our babymoon and they threw in some extra romantic treats during our stay

Makes a change from the daily routine

I don't know about you, but my daily routine since getting pregnant has been rather restricted and repetitive...  In fact, I behave somewhat like a newborn: eat, sleep, bath, repeat! Not that I'm complaining - I need all the rest and chill-out days I can get - but to have a change of scene for a little while was definitely uplifting for both my husband and me, and the excitement of travelling boosted my energy levels.

Candlelit dinner by the beach and breakfast at our beach pool villa definitely made a change to the normal routine

Spontaneous getaways won't be so easy to come by in future

Although in our case we are lucky that we will always have family on hand to take care of our little one if we ever wanted a few days away by ourselves after he arrives, it still won't be the same as just being able to pack our bags and jump on a plane to anywhere in the world. Logistically, there will be more to think about after becoming responsible parents, and I'm sure I would also suffer from separation anxiety and probably wouldn't want to be away from my baby anyway! For many people, I know childcare will be a major issue in the future planning of any mum-and-dad-only trips, so the babymoon represents the last chance to travel with no strings attached.

Great opportunity for making (and documenting) 'bump' memories

The obligatory babymoon bump pictures just HAVE to be taken! The first pregnancy will be such a special phase in life to look back on, and having beautiful photos of you and your bump glowing on holiday will be treasured mementos to keep forever, and to show to the little one when they're not so little... Imagine telling your child "You went to the Maldives when you were in my tummy!" - that's a nice 'first travel experience' to share with them in future.

We thoroughly enjoyed our babymoon and definitely made the most of it - beaching, snorkelling, lounging by the pool, going out for fishing trips and yacht cruises, spa treatments, eating yummy food - but even if you can't manage a trip to somewhere tropical, even a local getaway for a couple of nights to a spa hotel or a city you haven't visited together before would be well worth it. Pregnancy can be physically and mentally draining, not only for us ladies but also for our partners too, and a little change of scene can provide a welcome break for both amidst all the exciting (but often exhausting) baby preparations. 

Sunday, 2 April 2017

What NOT to say to a thyroid sufferer

If you are dealing with any kind of thyroid condition, I am almost certain you've heard at least one of the things I'm about to list... On top of the symptoms we largely suffer from in silence, one of the most difficult elements to face is a lack of understanding or empathy for our plight. So, without further ado, here's what NOT to say to a thyroid sufferer...

"But you look fine."
Now let me tell you. Just because we look fine on the outside, doesn't mean we aren't struggling on the inside. Some people actually refuse to believe that anything is wrong with us simply because we aren't displaying physical signs of sickness. Be sensitive to this fact and don't question us when we say we are not feeling well!

"Get some more sleep then."
Ah, this gem. One of the prime symptoms of thyroid conditions is severe fatigue and exhaustion, however, we also tend to struggle with falling asleep at night. Getting more sleep is not always an option (if it was, believe me we would...you don't need to tell us). Anyway, thyroid fatigue can't always be combatted by a lot of sleep either - even if we get plenty of regular sleep and rest, we will probably still feel drained. It's just a fact of that thyroid life unfortunately.

"Your TSH is within normal range."
A special one for the doctors. If we are coming to your office and complaining of worsening symptoms or difficulty functioning, please please please don't just throw our 'normal' TSH level in our faces and say there's nothing wrong. We are suffering and asking for relief. Test us for other relevant factors - Vitamin D, Ferritin, check our thyroid antibodies... TSH may be within 'normal' range but is it 'optimal'? There is so much more to a healthy thyroid function than just TSH being within range.

"Thyroid cancer is a good cancer to get!"
Wait what...? You may be shocked and in disbelief that anyone would actually say or think this, but trust me it's a regular comment we receive. Let's just get this straight: THERE IS NO SUCH THING AS A 'GOOD' CANCER! Yes, it's true that thyroid cancer has one of the best prognoses, but it's still cancer. Everybody hates cancer. And nobody wants to be told they have cancer.

"Just eat less and work out more." 
I'm lucky not to have suffered with this because weight gain has not been a side effect of my condition for me, but for many of us it is. The thyroid controls our metabolism, and in many hypothyroid patients, their metabolic rate slows considerably due to poor thyroid function, thus making it almost impossible to lose weight regardless of how well they eat or how much exercise they do. Oh, and don't forget we are almost always tired. So working out is more of a challenge than it normally would be.

"But they removed it, so you're better now." 
I got this a lot after my surgery. Ok, so the nodule/tumour/cancerous cells are gone - BUT SO IS THE THYROID GLAND! In case you hadn't noticed, we actually need it to function properly... and no medication can completely replace the abilities of an essential gland, which is formed in every human by the time they reach their second trimester in the womb. Getting rid of the danger zone via surgery is vitally important, yes, but it is also just the beginning of coping with a lifelong condition.

"Let's meet for breakfast at 9am on Saturday."
A light-hearted one to finish on, but this is just all kinds of wrong... Number one, weekends are our chance to get a much-needed lie-in. Number two,  we can't eat anything or drink coffee for at least an hour after taking our thyroid medication. So if we're meeting you for breakfast at 9am, that means we need to at least take our tablet by 8am...at a weekend. That's cruel. Let's just settle for brunch please!!

Thursday, 30 March 2017

Baby Joy: Sharing the News

Much is made of breaking the news of your impending bundle of joy these days... From social media pregnancy announcements and gender reveals to the increasingly popular 'baby shower', people are becoming ever so creative (and elaborate) in publicising the fact that they have a bun in the oven.

Perhaps our 'pregnancy announcement' could also be considered quite elaborate, bearing in mind the fact that it involved international flights and a large element of surprise, but it was also extremely intimate. I don't have anything against people who choose to make a large public display of their news, but for us the most important thing was to tell our nearest and dearest in the most personal way possible.

Giving it the personal touch is all the more difficult when you live an 8-hour flight away from your family. My husband's side live in the same country as us, and we see them roughly once a fortnight, so it wasn't an issue telling them face-to-face. But the distance and time to reach my mother and grandparents back in the UK - paired with the fact that my husband doesn't have a 'regular' job whereby he gets weekends off or can request annual leave at any point - proved to be quite an obstacle.

Our first window of opportunity to travel appeared to be presenting itself in late December, just before New Year - still in the very early days of my pregnancy. But, due to the changeable nature of my husband's work schedule, the possibility was taken away from us at the last minute. Cue much disappointment on my behalf; all I wanted to do was share our happiness with my close family, and be able to keep them updated and involve them in the journey.

The next chance - in mid-February - was touch-and-go as to whether my husband would get the approval to travel for 3 days from his work or not. In fact, we only got the green light very late on the Friday night, and were hopping on a plane in the early hours of Saturday morning. My family were none the wiser and thought we were at home in Dubai as usual.

So, surprise number one was simply us being in the UK - our first visit back to my homeland since getting married. It went down a treat. But nobody was expecting surprise number two.

The day before flying to the UK I had been for my 18-week scan, during which we were hopeful of finding out the baby's sex to add to our little reveal. Unfortunately, though, baby was proving uncooperative at that point, shyly keeping his or her legs firmly crossed for the entirety of the scan, so we didn't have a clue! Our initial idea for revealing our pregnancy news to my family had been to gift-box a little pair of either pink or blue socks for them to unwrap, but since we still didn't know which colour would be appropriate, we moved on to Plan B.

Plan B was to frame the most recent scan picture - one for my mother and one for my grandparents - wrap the frames up, and sit the three of them down to open them at the same time. So this is exactly what we did. With my husband at the ready to film their reactions, we sat and impatiently watched them sloooowly unwrap (plenty of "but I don't want to rip the paper!" exclamations as we urged them to hurry up...!) the surprise. Both parties had assumed from the feeling of the packages that they were framed photos from our wedding.

Having delicately torn through the paper and slid the frames out, my mother knew instantly what the image depicted, and immediately reacted with tears of joy. My grandparents, on the other hand, were a little bit delayed with their reaction. We had completely failed to account for the fact that my grandmother - who gave birth in the late 50s and early 60s - had never had ultrasound scans for her own babies, meanwhile my grandfather, being a true Merchant Navy Captain, had initially mistaken it for a radar picture of a storm!!!

It was only a few seconds later, after my mother regained her composure enough to say "Congratulations!" that the realisation suddenly dawned on the faces of both grandparents; all expertly captured on camera by my husband. There were tears of joy and celebratory hugs all round.

Grandpa the Navy Captain celebrating his future half-British, half-Emirati great grandchild with a lapel pin

So whilst it may seem a little extreme that we made a 16-hour round trip just to break the news to my family face-to-face, it truly was one of those unforgettable, money-can't-buy moments, and it was worth every Dirham of the flight tickets, every minute of exhaustion due to the intense travelling, and every ounce of restraint to hide the news during our regular telephone communication for several months before. I can't wait to show the video to our little one in years to come, and show him just how excited we all were for him to arrive. 

Monday, 27 March 2017

Being Butterfly-Free and a Mama-to-Be

As you may have gleaned from previous posts, I have a small human growing in my (as yet only slightly expanding) belly. The little human is currently at 22 weeks of gestation, weighing in at a healthy 390grams and with all measurements as expected. And, judging from the most recent 4D scan images, he is shaping up to be quite the mini-me of his father (yaay!)

If I'm being very honest, I didn't expect to get pregnant quite as quickly as I did, given my previous (misdiagnosis) of polycystic ovaries, coupled with my thyroid condition. I wasn't necessarily worried that I might struggle with fertility - in fact, that precise thought had never crossed my mind - however, I just assumed it wouldn't happen immediately. But it did! And for that we are extremely thankful and blessed.

When the OB-GYN confirmed my pregnancy at 6 weeks and 5 days, she immediately ordered a full panel of thyroid blood tests; something which is NOT standard procedure for all expectant mothers, but further to my research on the topic, I truly believe should be.

My partial right thyroid lobe, which had been magnificently maintaining my TSH at a steady 1.8 prior to pregnancy, had instantly shot up to 4.6 since getting pregnant. This (along with the standard first trimester tiredness) explained why I had been struggling to get out of bed most mornings in recent weeks; something my husband had kindly encouraged me to indulge in since I had just become free of the pressures of a full time job.

It is entirely normal for TSH levels to increase in pregnant women, particularly in those who have a pre-existing thyroid condition, but also in those who don't (or are unaware that they do). Pregnancy typically requires an additional 25-30% of thyroid hormone, and for those who are struggling to produce or regulate a normal amount by themselves, it will become even harder during pregnancy. As I have found out, it is absolutely crucial for the healthy development of the foetus for the mother to keep her TSH level below 2.5 during the first trimester of pregnancy, followed by keeping it under 3 for the remaining trimesters and breastfeeding postpartum. This is why I find it astonishing that a TSH check is not mandatory for all newly-expectant mothers.

Acting swiftly to counter my rapidly rising TSH, my doctor immediately prescribed me a 25mg daily dosage of Euthyrox. It's a very low dosage, but considering my partial thyroid's remarkable strength to return to regulating itself after my surgery, she was confident that it would be enough. And she was right. My TSH soon dropped to 2.4 - within healthy range for pregnancy. She is also hopeful that, with close monitoring, I will be able to be weaned off the thyroid medication after giving birth and go back to living a tablet-free life again. So, going onto Euthyrox/thyroxine/levothyroxine is not always an irreversible lifelong decision.

The correct supplements can make a world of difference

During the first trimester the foetus relies entirely on the mother's thyroid function, hence why the recommended TSH level is lower during those formative first three months as the T4 crosses the placenta. By the second and third trimester the developing foetus has its own thyroid, which begins to function and regulate by itself, but it is still important for the mother to keep her TSH below 3 and thyroid antibodies as low as possible.

Hypothyroidism can be a root cause of infertility, but is often overlooked as a possible diagnosis in women who are struggling to conceive, whilst during pregnancy (or at the exact time of conception), maternal hypothyroidism can greatly increase the risk of miscarriage, stunted growth, reduced brain development and has even been linked to a heightened chance of autism and Down's Syndrome.

As soon as I found out I was pregnant, I took it upon myself to research the best foods to eat and supplements to take to support the healthy development of my baby, in addition to following my (highly capable) doctor's orders. Once again, Google has been my best friend, and I came across a fantastic online docuseries called The Thyroid Secret by Dr. Isabella Wentz. The 9-part docuseries shed light on many myths and misconceptions related to thyroid function and illnesses, and Episode 7 - 'Motherhood Interrupted' - was particularly fascinating for me.

For some, the role of motherhood begins before even conceiving, as they plan ahead and prepare their bodies for the best chance of fertility. For others, like me, motherhood started as soon as I got that positive test, and with it came the immediate responsibility to take care of my health to my best abilities in order to provide the optimum conditions for my foetus to develop. Sometimes it's daunting, particularly when you know you have a condition that may compromise the health of your baby, but keeping informed of the latest research and following the recommended guidelines is an important first step towards giving your baby the best possible start in life.

Monday, 20 March 2017

The Doctor is not always right

If only we could all have access to Dr. House & his diagnostic team...!

A recurring theme I often read in comments posted online by thyroid patients is that, when their lab results come back showing TSH within a 'normal' range, the doctor makes a sweeping statement to declare them 'fine.' The numbers on a piece of paper apparently overrule the symptoms we are oh-so-strongly feeling.

I, too, have been on the receiving end of this - rather lazy and quite frankly dismissive - 'but your TSH is normal so you are fine' diagnosis. I knew I was not fine at all. What I wished I could do was invite that particular doctor to try living with my symptoms for a week, and then tell me I was 'fine'.

After my post-op care had been completed and my scar was healing up nicely, I was handed over from the mightily capable hands of my surgeon, whom I trusted implicitly, to the hospital's in-house endocrinologist. Supposedly an expert in thyroid conditions.

From my very first referred appointment I felt uneasy with him, and I got the impression that the thyroid was probably his least specialised element of the endocrine system - perhaps understandable when living and working in a country with one of the highest rates of diabetes in the world. In my head I was questioning the logic he used at explaining away my symptoms; ok, I know I'm not anywhere near being a doctor and he has studied and practised for a very long time, but I have also done my due diligence into thyroid conditions and I'm not entirely clueless. But, it was still early days after my surgery, and I was willing to go along with his suggested course of action in the beginning, which was absolutely nothing. No medication. No treatment. No further testing.

Having thrown myself back into work, I tried to carry on as normal, but as the weeks passed I just knew I wasn't able to function as I previously had been. I was exhausted. ALL. THE. TIME. My motivation was zero. Even my appetite had waned immensely and my weight was dropping (not something you would expect in someone who should be hypothyroid).

I went back to the endocrinologist. Again, he told me my TSH was normal. I complained of having slightly dry skin compared to usual, and that my body hair - which had been banished months before through a successful course of laser hair removal - was growing back. He took these mentioned symptoms, without any further testing, and diagnosed me with PCOS (polycystic ovaries).

My gut instinct was that he was wrong.

I grappled with it in my head for a few days and did some more online research, before deciding to book an appointment with the very first General Practitioner I had seen at the start of my thyroid journey; the one who had discovered my nodule in the first place. He disagreed with the PCOS diagnosis immediately.

This was the first time anyone had even thought to test my Ferritin and Vitamin D levels, which, in fact, work hand-in-hand with thyroid function. The GP called me back later the very same day with the blood test results, saying he had to inform me immediately. "I think we need to enter you into the Guinness Book of World Records - this is the lowest Vitamin D reading I've ever seen in a living person," he said. Anything under 30 is considered a deficiency. 50-70 is normal. 70-100 optimal.

My Vitamin D level was 1.4.

Similarly, Ferritin - which should ideally be above 70 - was just 12.

These two simple blood tests produced two clear results and simple explanations to my symptoms. Thankfully, they also have simple treatments. Three lots of 300,000iu intramuscular Vitamin D injections were prescribed over the course of the next calendar year, as well as supplementing with a daily tablet of 10,000iu and weekly tablet of 50,000iu. An iron supplement helped to regulate the Ferritin. Within a matter of a month or so I could feel my energy levels returning to something close to recognisable, my motivation was up, and I was getting my sparkle back.

The point I want to make is simple, but not something I would necessarily have realised before going through this experience. And that is, the Doctor is NOT always right.

You have every right to research about your own condition and symptoms, and every right to challenge your doctor on what he or she is prescribing or suggesting. You also have every right to seek a second, third, fourth - as many additional medical opinions as you like. Until you find a diagnosis and treatment that you trust, you feel comfortable with, and you feel the benefit of.

I used to be shy about questioning anyone's authority or qualification, but not anymore. You are the only one living in your own body, and experiencing your own symptoms. You know when something is not right. Listen to your body - I have found that mine always has a way of showing me when it needs attention, and it should never be ignored.

Tuesday, 7 March 2017

Why I didn't want my thyroidectomy scar photoshopped out of my wedding photos

My thyroidectomy scar was something I struggled with in the beginning. Even before I went under the knife, it was that somewhat superficial element of the surgery that I chose to focus my fears on the most; endlessly Googling photos of post-op scars and becoming preoccupied with how it would change my appearance, particularly in the eyes of others. Deep down I knew that it didn't really matter, but perhaps it was easier to channel my worries into something 'skin-deep' rather than to fully face the magnitude of my sudden diagnosis and the real risks of surgery.

Outwardly, I started off by making a joke out of my scar immediately after the surgery. As my operation happened around the time of Eid al Adha - the Muslim celebration otherwise known as 'the feast of sacrifice' - it set me up well to humorously dismiss it as "an Eid sacrifice gone wrong - they mistook me for a goat!"

My first outing after surgery - bandages and all

Once the laughs had worn off, and the bandages came off, I was pleased to see just how neat my surgeon had managed to make the incision - as he had promised me. The placement was perfectly on the collarbone, so that over time it would fade and just appear as a normal shadow at the base of my neck. Like clockwork, I applied BioOil thrice daily to the area, with the promise that it would aid the healing and fading process. (To this day, I still apply BioOil to my scar once a day).

When the bandages came off...

I had thought of wearing scarves to cover up the unsightly area as it began to heal - still bloodied and a bit swollen - but the friction of any fabric rubbing against it was painful so I had to leave it uncovered. As I already established in a previous post, I was back to work and back to normal life immediately after having the dressing removed, and thus this left my wound open to the attention of everyone I came across as I went about my days.

I'm not sure if it's cultural, as I feel this probably wouldn't have happened (or at least not nearly as much) had I been in the UK, but I started to get a procession of random strangers coming up to me in the mall, the supermarket, in the queue at Starbucks, to pass comment on my scar.

"Excuse me, there's something on your neck," one guy said to me in Arabic, waving his hand in a neck-slitting motion. As if I didn't know!
"Oh my gosh ma'am, what happened to you?!?!?!" was the usual response from most shop assistants.
"When will it go away? Why aren't you covering it?"
"You know you can do laser to remove that thing right?!"

It quickly became tiresome having complete strangers trying to pry into what I believed was my very personal business. As soon as it became comfortable to do so, I started wearing light, silk scarves - and then, as the UAE winter set in, polo neck sweaters - merely to avoid the constant questioning.

The scrutiny actually made me very defensive of my scar. How dare they suggest that I should do laser to get rid of it?! This is my battle scar. It's a constant physical reminder of what I went through and what I overcame. It's a sign of my strength. It was at this point that I realised I had become really attached to it, and proud of it. I liked my scar.

6 months after surgery

Of course, there were days when my scarf slipped and the prying eyes pounced once again. I was out at a sporting event for work in December - three months after the surgery - and one man who worked vaguely in the same field as me launched into a lecture about it, in front of other colleagues.

"You will never get married now that you are damaged, especially not to a man from this society. You should have got married before you did the surgery. Now you have no hope - this thing on your neck, it removed your beauty. The people who get sick, it's their own fault. It's because they didn't pray enough. No man wants a woman who got sick because she didn't pray enough."

I was dumbstruck. I didn't even want to dignify him with a response. I just went to my car and cried.

But oh how wrong he was.

Soon I was to meet a man who would change my life forever. A man who helped me to heal from within, without even realising it. A man who, from the very first day we met, appreciated my scar.

He approached it in a curious, yet sensitive way. "Can I ask you something," he said, with a quizzical look on his face. I could see where his eyeline was; I knew what was coming. "What happened?"

I told him the story, and he recalled seeing me from a distance for months before, always wearing scarves. "Don't hide it anymore," he said. "Don't cover it up. I like it. It's nice. It's unique."

A few months into our relationship, he returned from a work trip and was eager to meet to give me something. It was a beautiful necklace he had brought back from his travels; small, simple, delicate, and falling just below the line of my scar. "I want you to have this and wear it every day. It should remind you of your beauty, and take the negative attention away from the evil eyes looking down upon your scar."

The day my (now-) husband gave me the necklace

As the scar got lighter and the attention got less, with the pretty necklace of protection around my neck, the love got deeper. He asked me to marry him. I said yes.

Your wedding is naturally one of the most special and memorable days in your lifetime, and a wonderful way to preserve and share these memories for years to come is through the wedding photography. I wore a white dress and the beautiful white gold and diamond set given to me for the occasion by my new in-laws, as is tradition, and it was the first time I had removed the little necklace since my husband gave it to me, to make way for a much bigger one (still sitting below my scar, though). The makeup artist had instinctively started to slap industrial-strength foundation onto my neck to try and cover up the scar, but I told her not to. She removed it and left it natural.

With the wedding album and photos promised to be delivered by the studio a month after our ceremony, we waited in eager anticipation of receiving the captured mementos of the event. But imagine my dismay when I opened the photos to see that an important element of my being was missing: my scar had been photoshopped out!

What? No scar?!

Now, I know these Arabic-style wedding albums always go heavy on the airbrushing (they also practically changed the race of my husband...), but there was absolutely no hint, no trace of my scar in any of the photos whatsoever. The pictures were not an accurate representation of myself. And, more importantly, my scar is not considered a 'blemish' I would want to eradicate via airbrush. We sent our feedback to the photo studio and instructed them to revise their overzealous editing.

So, as you can see, although it took some time (and some thick skin) to accept and appreciate my thyroidectomy scar, it is now something I am truly proud to wear round my neck as a medal of honour. Ladies, wear your scars with pride, and never let anyone suggest you would be better off without it.

My scar now, 18 months old

Sunday, 5 March 2017

The Worst Thing I did after Thyroid Surgery

A bit of a dramatic title, perhaps, but it is completely and utterly true, and I hope this can serve as, at least, a little food for thought for anyone reading my posts prior to having their own thyroidectomy.

So, what was the worst thing I did after my thyroid surgery?

I went back to work too soon.

The timing of my diagnosis couldn't have come at a more inconvenient moment for me professionally. I was working in sports media, which is a fast-paced, 24/7-type of environment to operate in, and my situation unfolded right at the beginning of the new season. Peak time in terms of workload and hecticness.

In fact, the day after my Fine Needle Aspiration (FNA) biopsy, I had to drive 120km to another city and cover the curtain-opening Super Cup Final - the kick-off event of the annual sporting calendar. I was not only a 'media person' at this sort of big event, though; I was also part of the organising committee, so on such days it was crucial to be there from dusk till dawn and be fully active and operational. Not to mention it was all outdoors, in the searing summer heat of the Gulf.

It was partly a blessing to be so busy in the lead up to my surgery, though, as it kept me distracted and didn't allow me much time to wallow in worry or despair. I just kept going. What I should not have done, though, is continue at that same hurtling pace after the surgical procedure.

Recently I - at last - got around to reading Lady Karren Brady's excellent book, entitled 'Strong Woman', and I was particularly able to relate to her anecdotes surrounding her surgery to remove a brain aneurysm. She describes the feeling of pressure to return to her roles and responsibilities almost immediately, as well as a sense of guilt and even uneasiness at the thought of having people 'fawn' over her as though she was no longer capable of carrying on 'business as usual'. Though not in anywhere near such a high-profile or high-powered position as her, I felt the same.

It didn't sit comfortably with me to be labelled as 'sick', and therefore I was keen to show quickly after my surgery that I wasn't. Some staff members in my office cried upon hearing the news of my diagnosis, which I found baffling. I wasn't used to being cried over and I certainly wasn't seeking sympathy, nor was I any less capable than I ever had been.

Another reason why I was so desperate to prove my capability to continue as normal was that I was under scrutiny and pressure at work, from the new boss. A dictatorial type who earned his title based on connections rather than merit; to my face I was told I would be supported throughout my ordeal, but behind my back I found out that emails were sent to Human Resources instructing them to strictly monitor my attendance and deduct salary if I went over the company policy allowance of sick days. I didn't want to lose my job, nor could I afford to.

It was due to these points that I was on my work phone and writing press releases from my hospital bed. I did receive a one-week sick leave certificate from my surgeon, meaning I could at least avoid going to the office for seven days after the surgery, but I was still constantly on call, and even those seven days were scrutinised by my company's 'medical committee' as to their legitimacy.

As a result of trying too hard to prove to myself and everyone around me that I was absolutely fine, I put my own health and recovery at risk. I didn't allow my body - or my mind - time to HEAL. I didn't even give myself time to process what had happened. Being told you have cancer at the age of 24 is not something you can just shrug your shoulders about, even if you try to act like it is. Any type of general anaesthesia and major surgery has major physical and mental impacts. I just tried to cover it up.

But, as with everything in life, it caught up with me. And it didn't actually take that long to do so. Everyone who's had thyroid surgery knows the struggle to recalibrate your body afterwards; trying to deal with the lack of thyroid function, trying to find the right dosage of thyroid hormone replacement medication, or - as in my case - simply trying to operate as a human being with just 20% of a thyroid left and no medical supplementation... It's draining. It's exhausting. But it's also invisible to others. We look fine, so everyone thinks we are fine.

Around 2 months after my surgery my energy levels dipped to their lowest ebb. There were days when I couldn't get out of bed until 3pm, and other days I couldn't get out of bed at all. I kept having to drag myself to hospital and try to convince my doctor to write me another sick leave certificate, but in the end I also just accepted sometimes being docked a few days' pay. I always still did my work from home, but not being physically present in the office was affecting my standing within the company.

In the end I just had to accept the fact that I needed to listen more to my body. I needed to allow myself to be 'lazy' some days. The more rest I allowed myself to catch up on, the better my partial thyroid began to repair itself and function. It came down to priorities, and really there could be no debate that my health was paramount.

The truth is that you never completely recover and heal from thyroid surgery. The scar fades, the optimal dosage of medication is eventually found, your coping mechanism becomes refined. But if you don't give your body or your mind a chance to recuperate from what you've been through from the very beginning, you will only be hampering yourself on the pathway to better health.