One of the first questions I always ask new patients is "when did you feel your healthiest?" Was it last year? Age 15? Mid 20's? Is it now? The question forces them into their memory data bank to pull an experience of health that they can viscerally feel and it gives us something to aim for in treatment.
When I ask myself that question, it's a hard one to answer. I don't remember being healthy. Ever.
I know. Not a resounding testimonial for the work that I do. But health has eluded me from the moment I arrived on planet Earth. Raging colic as a new born. Legendary allergies as a toddler. I would always get those weird viruses or bacteria that my doctors had only read about in medical journals. I had clubbed feet - so there were braces, podiatrists, shoe inserts, physical therapy, casts, and specialist MDs. The middle school years didn't bring relief - they brought a whole different set of problems. I started having fatigue and joint pain that was crippling. Lyme's was suspected, but this was the late-80's and no one really knew for sure. When I started menstruating, the pain would leave me blacked out on the bathroom floor.
But when you don't know any differently, you simply work it out.
We were at the lower end of middle class, so as soon as I was of legal working age in high-school, I got a job. Any luxury items that I wanted (i.e. anything other than a roof over my head or food), I was expected to pick up the tab for. By my junior year, I was waiting tables close to 40 hours a week, attending high-school, and on the varsity slalom ski team. I learned to keep myself busy as a means of escape which distracted me from the over riding sense of fatigue that was always present. I also had an anomalous weight gain, achey muscles, tired joints, and an ever present sense of depression. Being busy also allowed me to avoid home and the chaotic environment that was happening due to my parent’s marriage imploding in slow motion. I was tired of being sick. I was tired of being tired. So my coping strategy was to work through it and be "busy" to the point of numbing myself out so I could collapse into an exhaustion so severe I didn't feel anything.
I got accepted to a college five states over and had all kinds of mixed emotions about going. One of the pre-reqs to attending was a physical - administriva that didn't really mean anything to me at the time. Given that this was 1995, I don't remember the details of the appointment or even what my doctor looked like. However, about a week later I came home to a panicked voice mail containing words such as "thyroid", "dangerous results", and "life long medication". The GP sent a prescription to the pharmacy and I picked up my very first bottle of Synthorid at 18 years old.
I didn't understand why I needed medication, so it was just another thing to ignore.
I put the meds in my suitcase and promptly forgot all about them. The college years brought new challenges including penicillin resistant strep combined with Epstein Barr and back pain that was so extreme it landed me in bed for 5 days on pain killers. I had kidney stones that required surgery, a 40 pound weight gain, and a parental divorce which the judge declared to be the worst he'd seen in 20 years on the bench.
There were multiple reasons for the decision, but I decided to do a semester abroad in Japan. My maternal grandparents had met there after WWII and one of my best friends in high school was Japanese. I also needed to do field research for my anthropology degree. In hindsight, I can see that it was also an escape strategy. Five states didn't feel far enough from so home, but maybe a continent and an ocean would. I moved to Kyoto to study for a semester and then renewed my visa to travel and teach English for another 3 months.
I returned to the US to finish my undergraduate degree and landed a job with the Japanese Education Teaching Programme (J.E.T.). It was a program through the Japanese Ministry of Education that placed young native English speaking graduates in the Japanese public schools alongside Japanese teachers of English. The caveat to the job was that I didn’t get to decide where in Japan I would go - the ministry did. I was placed in a village three hours west of Tokyo in a little village called Ojima-machi that’s known for its strong winds and strong women. I joined a community of fourteen thousand Japanese farmers and few car manufacturing plants. It was terrifying and perfect.
While abroad, fate happened.
My days consisted of teaching English at the town’s junior high school, moonlighting as an English teacher at a local Subaru plant, and spending time as a "cultural ambassador". Part of my job as an informal ambassador include drinking copious amounts of sake, karaoke, tea ceremony classes, deep dives of local history, cherry blossom viewing, taiko drumming, wood block printing, and snowboarding. I dove in head first to any adventure that came my way. Many of the locals at first called me "gaijin sensei" (foreigner teacher); however, my nickname eventually graduated to "Ojima musume" - Ojima’s daughter. The village embraced me as deeply as I embraced them.
True to form, my body decided to throw a wrench into the works. I'd only been there a few months before my face decided to freeze up, leaving me looking like a stroke victim due to a random case of Bell's palsy. No matter how far you go, your troubles are still with you.
This all happened as the internet was in its infancy - 1999. So there was no googling the answer, or ordering a book from Amazon, or stumbling upon a life changing blog post. If you wanted an answer, you had to source it by hunting down people who could give it to you. And I had to do it in Japanese.
At age 22, I started to explore what "healthy" even meant since I didn’t have a frame of reference. I was eating a strictly Japanese diet, I was up early and physically active. I switched from skiing to snowboarding and found a new passion for a different kind of movement. But I wasn't losing weight and would regularly fall asleep in meetings due to bone level fatigue. I was always sad in a weird way that I couldn't define because nothing was necessarily wrong. I never defined myself as being “sick” because I had normalized all my symptoms. I assumed that everyone struggled silently in their own way, so there was no point even talking about my health history or what was going on with me.
In the middle of snowboarding season, the friend who had introduced me to the sport pulled his hamstring. Instead of being the season ender I had assumed, he was back up riding a few weeks later.
My question was, "how". His answer was, "acupuncture."
I didn't even know enough about it to have a stereotype of what acupuncture was - it just seemed like weird voodoo. I couldn't wrap my head around it. So my friend scheduled an appointment for me and we drove out for my first session. I didn't really have anything I was "coming for" - I was there because I had decided to embrace everything Japanese and this was simply another adventure. Kuribara-sensei, the practitioner, looked to be about 25 years old - I later discovered he was in his mid-50's. He had an insatiable curiosity, a penchant for bad Japanese puns, and gentleness that I'd never encountered before or since. I could immediately see why my friend liked him.
The acupuncture clinic only had two treatment tables divided by a curtain and the whole office was really just an extension of the front of Kuribara's house. After our appointments, we would have dinner with Kuribara and his wife that often lasted deep into the night. He tried to explain my thyroid situation via Chinese medicine, but I didn't understand medical Japanese and the little dictionary I had didn't either. But he imparted how important it was that, regardless of anything else, I tackle it head on.
I wasn't really sure what I was suppose to be physically feeling, but I knew I liked hanging out with the acupuncturist and just took it on as part of my overall experience abroad to go to acupuncture as regularly as I could.
The strangest thing happened. My menstrual cramps disappeared, my fatigue started to dissipate, my weight started to creep down, and my back quit hurting.
It was the first time I started to understand what people meant when they said they felt good. Could this be health? I had a full year, the first in my life, where my body was coasting without getting sick. It was a god damned miracle. I had plenty of stress, plenty of booze, plenty of travel - but I was doing OK. I didn't really know what to do with myself. By then I had been living Ojima for 2 years and it was time to come home.
I left Japan in June 2001 and moved to New York City that October.
Yep - I moved to NYC less than a month after 9/11. And yep - there was a boy involved. The rational side of my brain screamed “don’t do it”, in part because I had $250 to my name and I suspected the economy was about to tank. But my heart felt like it would be home. So I took a chance, sent my stuff C.O.D. to the boy and jumped on a discounted flight to NY.
By January of 2002, I had landed a job with a Japanese tea company and started working at their store on Madison Avenue. Seemed serendipitous and right at the time. I slowly started climbing up the corporate ladder one rung at a time; however, when I hit the glass ceiling, I hit it so hard it knocked me out. During my time with the company, my health went into a headlong nose dive and any headway I had made in Japan disappeared. I started getting weird rashes, my joints started to become visibly inflamed, there was a fatigue that would start in my marrow and leak into every fiber of my being. I couldn’t think straight, I would burst into tears randomly - leaving me with a sense of wondering if I was losing my mind.
I was talking with one of my colleagues about what was going on and she told me to see her endocrinologist because she saw herself in my story. I made an appointment and midway through our conversation, he casually sonogramed my throat. My thyroid appeared in all her glory on the large television screen in front of me and looked like crystalized stained glass.
“Classic Hashimoto’s” he said. “Hashi-wuuutttt?” I replied.
I burst into hysteric sobs of joy. I finally had a name for what was happening to me. I didn't know what it meant - but when we name things, we own them. I was finally ready to own what was happening to my body. I left the appointment with an updated Synthroid prescription, a referral for a nutritionist, and feeling empowered for the first time since returning to the US. I wish I could say that everything magically took a turn for the better - that life has been red roses and rosé wine since. Nope. Double nope. That’s when shit got hard.
Synthroid didn’t resolve my symptoms. The eventual addition of cytomel (synthetic T3) brought on fibromyalgia. The nutritionist looked at my food journal and told me I was lying. Based on what I was eating, I should be at least 40 pounds lighter (My reply? “No shit buddy. That’s why I’m here.”) My rashes got so weird the dermatologist was calling her colleagues into the room for help. I started having migraines.
So I did what worked once before - I found an acupuncturist. Because my body already knew how to manage the needles, within two treatments my symptoms started to recede. I didn't know why it worked. All I knew was that I wanted to feel better and this was an avenue that made sense to me.
It took another couple of years of getting my resources lined up, but I decided to go to Chinese medicine school as a means to figuring out my health and owning my journey.
Admittedly, I didn’t really know what I was getting into at the time. I just knew that I needed something outside of conventional medicine that would explain what was going on with my body. The first day of school felt like Hogwarts - so I made the false assumption that it would be all rainbows and intuition. Wrong again. It was four years, full time, of the hardest learning and studying that I’ve ever done. I thought, “if my health doesn’t kill me, school will.” But I loved the knowledge, the challenge of discovery, and I knew while still in school that some day I’d want to teach the medicine to steward the secrets of the universe into the 21st century.
I graduated in 2009 and immediately jumped into private practice. I had done rotations at St Vincent’s Cancer Center, HIV Center, and the Manhattan VA - where I quickly learned that institutional medicine was not where I wanted to be. I wanted to be one-on-one with patients in a small setting where we had time to brainstorm, research, discover, and co-create a path to wellness. I wanted to provide them with all the things that I had been missing in my own journey. I wanted to listen to them. I wanted to hear what their unique experience of being human was like and how we could bring that experience from black and white into 3D technicolor.
My patients are my teachers, my inspiration, and my heart. They are the reason I get out of bed in the morning. Their stories move me to tears and push me to not only do right by them, but make me a better person. Being human is hard. Our bodies and minds, which are designed to provide an experience for our spirit, come with so many issues. But watching my patients navigate, overcome, and conquer their issues heals my own my broken humanness. I can’t imagine a better job.
It’s been a long ride and I’m by no means cured. My Hashimoto’s has stabilized where I hover at the borderline of auto-immune.
Which I’m fine with because my Hashimoto’s has become a beloved friend. It’s forced me to look for solutions in unexpected places. It’s taught me to forgive my body. The diagnosis of auto-immune initially felt like a gross betrayal but in reality is my body trying to protect me because she loves me more than I’ve loved her. Hashi’s has helped me make connections between catalyst events in my life and taught me emotional literacy that had escaped me until recently. I now pick battles that I can win instead of going into every fight with a vengeance. I’ve learned to ask for help and allow people to contribute to me rather than taking on the world solo. Compassion is often a knee jerk reaction rather than something I struggle to find. My Hashi’s is a tool that I have nothing but gratitude for.
I'm still gluten free and curvy in places I struggle to love. Nature-throid is part of my morning routine and I’m taking low dose naltrexone as an experiment to see how it shifts my antibodies. In the summer of 2018, I had a set-back. While opening my new 12 room wellness center / healer’s collective in Manhattan, running my private practice, teaching at Pacific College, and supervising in the college clinic - I overtaxed my system. The Lyme’s disease that had been hiding in my system since childhood came back with a vengeance (confirmed this time) and the Epstein Barr Virus decided to make a reappearance. I crashed in epic proportions. As harrowing as it was to get back on my feet, it was an awesome reminder that health is dynamic, not static. It’s a fickle friend that needs be tended to on a daily basis. Acupuncture will always be a cornerstone to keeping my immune system purring while yoga and meditation help me decompress so that I can show up where it counts. And I now make these things a priority because they work for me. I say “no” to things as a means of creating space to say “yes” to things that matter. However, none of these things feel burdensome - they feel like steps moving me towards the best version of myself.