Tidbits: On self-management

This past year, I was diagnosed with an autoimmune disease after an abnormal thyroid result showed up during a fertility workup. In this disease, Hashimoto’s Thyroiditis, the immune system attacks the thyroid gland and hinders the production of critical thyroid hormones. (Interesting: it was infertility that prompted a doctor to test me for autoimmunity, not, for example, the years that I went into the doctor complaining of deep fatigue, a common symptom of the disease. This, despite the fact that Hashimoto’s is the most common form of autoimmunity and is estimated to affect one in eight women at some point in their lives).

Aaaanyways. While my endocrinologist has assured me there is “absolutely nothing” I can do to reverse this process in my body, a growing body of evidence and endless anecdotes (like these) suggest that dietary changes can have a big effect on slowing or reversing the course of the disease (I will be discussing this in much more depth in future posts). I am grateful that there are actions I can take to shore up or reverse Hashimoto’s, which for me include cutting out gluten, dairy, sugar, processed foods, most grains, and a smattering of other foods. At the same time, with this type of major dietary change, life can easily become a full-time self-management project where significant portion of the day is spent on food purchase and preparation, taking supplements, and doing nasal cleansing or whatever, and the rest of the time is clouded with planning and strategizing and perfecting and obsessing. This is a familiar experience for many who are trying to manage a chronic illness, and in particular those who have any of the under-researched and therefore “mysterious” diseases that largely affect women (e.g. fibromyalgia, vulvodynia, chronic fatigue syndrome, multiple chemical sensitivity, all kinds of gut stuff, and a large number of autoimmune diseases).

Enacting this kind of lifestyle change is not just logistically difficult, but forces a reckoning with one’s identity: I am now the the type of person who cannot eat most food. I am an un-chill type of person at parties or on family vacations. I have joined the ranks of the constantly-vigilent-about-food; you know these people, maybe you are one. Furthermore, and particularly with autoimmunity, coming to terms with the disease is almost inevitably intertwined with self-blame—I am attacking myself after all. This must be happening, my mind reflexively concludes, as a result of something I did wrong: I lived in that old moldy apartment too long, worked too hard, ate too many candy bars. Therefore, I must rectify the issues with corrective actions: eating organic and spending more time outdoors and getting enough sleep. If only I find the right combination of things and do them with enough diligence, I can curb my attack on myself.