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A 30-year-old enby presents to her physician due to new onset dry skin, broken fingernails, and some weight gain. Past medical history is significant for asthma, atypical depression, and anxiety. She experienced her first seizure episode with some psychotic features 4 months ago, for which she received valium and supportive care. She was recently started on lamotrigine and has been taking prozac and wellbutrin for the past 4 years, with a step down from 300mg to 150mg for the latter, immediately following seizures. She takes clonazepam a few times a week and reports more fatigue than usual since decreasing her wellbutrin dose. At the time of her seizure episodes in May, CBC showed electrolyte abnormalities. Additional laboratory studies show:

May: TSH: 13.2 (nl 0.3-4.2) Free T4: 1.16 (nl 0.9-1.7)

September: TSH: 15.8 Free T4: 0.88 Free T3: 3.4 (nl 2-4.4) Anti-thyroid peroxidase: 550 (nl <34)

What is the most likely diagnosis?

A) schizoaffective disorder B) adjustment disorder C) hypothyroidism D) hyperthyroidism E) mood disorder with psychotic features F) sick thyroid syndrome

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i definitely have hypothyroidism, and it's probably an autoimmune disease called hashimoto's, which is the most common form of hypothyroidism in the US (if i remember correctly)! caught it before my T4 went significantly lower, but i'm still feeling it. it's kind of validating.

i got my blood drawn yesterday after emailing my primary care doc and psychiatrist over the weekend, and lab results came in last night when ben and i had just started rewatching battlestar galactica. i'll go to school to pick up the thyroid replacement meds today or tomorrow.

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this morning, i also found out that my firstborn cat baby, my son since the 8th grade, is being put down tomorrow. his name is marlowe. he lives in texas, although i took him to RI with me for my senior year in college, and he demands ice cubes in his water bowl. parents didn't let me take him to st. louis, and i haven't seen him since i went back to get my wisdom teeth removed in 2017. i've already missed him a lot over the years, and i know i'll always be connected to himb. i feel better after being around ben when i got the news, and talking to friends after. i'll get to facetime with marlowe tonight and hope he can get something out of the sound of my voice. bff stephanie is going to be there with me to see him. i hope he can meet sophie sometime.

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also, we get the keys to our new apartment in FOUR DAYS. right now, i feel like taking stock and packing my first load of stuff to move over, probably lots of winter clothes. my roommate moved out yesterday, and i have a lot of empty space to use. dissertation stuff is going okay. i think i have room to take a deep breath.

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i'm just realizing been TEN YEARS since i first came to this school for one of the summer research programs i did as an undergrad. asd;fladfslkj

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life update: wellbutrin (aka bupropion) will lower your seizure threshold, all right!

🎶 'cause karma is my boyfriend! karma is a god, karma is the breeze in my hair on the weekend karma's a relaxing thought ...

What is karma?

according to ideapod.com, "Karma is a Sanskrit word meaning 'action.' It refers to a cycle of cause-and-effect that is an important concept in many Eastern Religions, particularly Hinduism and Buddhism. ... it means that the steps of your life, your spiritual development, and your personality are directly molded by your thoughts and actions. Present you affects future you." i hope i'm not too far off, but this lil article does remind me of the way that i think my friend with the relevant knowledge explained it to me sometime in the past decade. unsurprisingly, the song "Karma" might simplify this a little; but even if it doesn't really, 100% accurately represent what karma is, spiritually, it's my favorite Taylor Swift song of the moment. arguably the best on Midnights.

spider boy, king of thieves weave your little webs of opacity my panties* made your crown. trick me once, trick me twice don't you know that cash ain't the only price? it's coming back, around.

*it's actually "pennies," but -- excuse me? 👑 listen to this song and try to tell me you don't hear "panties." or just try to tell me it doesn't make the better lyric. try to tell me that it doesn't fit Taylor's chest voice. try to ignore the harmonies in, "i keep my side of the street clee-ean. you wouldn't know what i mean." tell me this isn't one of the best songs to cat-walk in the airport to. try to keep it out of my karaoke-ing mouth this summer. i dare you.

speaking of airports and causes and effects and summer -- eek! i was supposed to visit Ireland and the UK this past week (only Northern Ireland is part of the UK, fun fact!?). my boyfriend (my actual one, Ben, not the concept) was taking me overseas for his college roommate's wedding. it was going to be very cute! and maybe even nudged me to think more seriously about marriage -- an institution i've resisted since growing up with its politicization, a thing that could maybe actually be practical if i wasn't so worried about the aesthetics of my own fucking personal life being twisted into talking points for the right. fuck them, fuck JK Rowling, fuck bisexual erasure, fuck transphobia, fuck off.

if this sounds disorganized, it's because it is! it's because i want to convey something about the state that my brain apparently reached for me to have my first seizure on thurs, may 11, DURING A LAYOVER IN VIRGINIA, HOORAY!

sorry, the rest of this post might be upsetting for various reasons. content warning for:

expanding on aforementioned seizure & another the next day

psychosis

medical bills from the ER(s) lol

babbling — this isn't really a warning as much as it is a qualification: since i do have some (small) degree of control over who can find me on instagram, and this is likely too long to go viral organically — if you're reading this, it’s prob because i posted it or sent it to you, or it was shared by someone whom i trust with the decision to share. something happened to me last week, and, if this tumblr blog is going to be what i wanted it to be when i wrote my inaugural post in january, it's the place for me to explain what happened from my perspective. i want the people in my life to know. i also, just, can't imagine calling people up just to be like... "hey i had a medical emergency but i'm okay." idk, i want to have my whole-ass say on it. you gotta read the taylor swift lyrics first.

all right, so, right before we left for the airport, i had a meeting with my dissertation advisor about the chapter i've been struggling with for the whole school year. i was so anxious i hadn't slept the night before, even after staying up all of monday night, too, revising the most recent draft. i also smoke a lot of weed, but it couldn't help me sleep this time. instead -- and i say this with some degree of expertise/professionalism -- i must have had something like a psychotic break. i had sent my advisor about twice as many pages as he was expecting, and i literally could not believe it when he told me that what he'd read so far sounded good. i told him i felt like a delusion of grandeur was coming true. and, after that, there was a moment where i literally thought he was reading my mind or speaking to me in code or something. it was weird. i was weird.

for the rest of my waking hours, until my first seizure, i thought i'd unlocked some secret of the universe. overwhelmed by the body language of hundreds of traveling strangers around us, i seriously thought i could read people's minds, too, or at least Ben's. normal airport stuff happened, our flight kept getting pushed back, waiting was miserable; in addition to convincing myself i was reading Ben's mind, i concluded that the only logical explanation for everything was that the internet must be down, like, universally, and/or everyone's collective consciousness was going through something like Opposite Day. ... again, i was weird. but, at this point, it seemed like i just badly needed some sleep. i also kept randomly singing the chorus to “anti-hero.”

sweet like honey, karma is a cat purring in my lap, 'cause it loves me

our flight got pushed back so late that our airline put us up in a "quality inn" for thursday night. my grand mal happened during the lyft ride there, which royally freaked out our driver and pushed Ben over a mental cliff from "my girlfriend's acting weird" to "my girlfriend might die." after sleeping through a $4000 ER visit that i don't remember, that my family and i have to figure out how to pay $2000 for lol, i passed all the psych tests to be discharged. we had a short connecting flight just for me to have the same delusions and another seizure during our layover in new jersey, right around the time our Ireland flight was finally canceled. don't ask me how much the second ER visit was because i don't know yet! friday night, i slept in a hospital bed in a hallway, before i remember getting some scrubs and an actual room for the rest of the weekend. no pillow, though -- just two sheets. i was pretty confused and upset after the first couple times i woke up there and still couldn't pass the psych checks until sunday. but obviously i eventually did, Ben came to get me, and we finally flew home monday.

it's actually kind of funny. it's okay, my home doctor laughed at me, too, when i saw her on wednesday; i am a clinical vignette. like, classic psych case. girl with depression and anxiety misses too much sleep, smokes too much weed, has seizure risk factors, and seizes. (i also wasn’t eating enough, surprise). among other things, i'm on prozac and wellbutrin but am better about the latter, because i associate the former with heartburn, and i get the impression that i can actually feel when the latter works. doc and i decided to halve my wellbutrin dose, at least until i see my therapist and psychiatrist on tuesday, and i'm on a THC/tolerance break. i'm tired from over/writing this, but that's what happened!

karma is the thunder rattling your ground karma's on your scent like a bounty hunter karma's gonna track you down, step by step from town to town. sweet like justice, karma is a queen...

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"she's sneaky and smoked out, it's starting to show..."

summer 2017, i found out i got doxxed, and i deleted my 7-year-old blog in a panic. i copied the ten-ish most recent entries from my password-protected section into a word doc and said goodbye. i shouldn't have had to (no one should).

i was a vibrant, self-actualizing 24-year-old -- just two years out of the closet, two years into my grad program, two years in community with radical organizers. that very same day, i got my first frames in a long, uninterrupted line of dainty eyewear. i'd gone from "the bisexual haircut" to a swooping pixie just months prior. i had transitioned from visitor to actual student in my philosophy department, after leaving my medical school class in 2016. i grew a crush on hank green and more than one of the senior students. i had my first shot at ethical non-monogamy.

i had been a witness in a failed sexual assault investigation that drove my friend and roommate of the time out of our med school cohort, and my friends and i were drafting our own impact statements for a second, impending investigation by the federal title IX office. my letter included that i'd been groped in fall 2015 and derided by classmates the entire school year.

as her case concluded, at least at the university level, my roommate was moving out (to continue her training, fully funded at a peer institution), and i was moving way, way closer to my activist friends in a different part of the city. my rent basically halved. i could walk to political meetings and the bars afterward. i was happy to fill my instagram with queer theory and flowers while supporting the hangouts that'd later fall to COVID. i fell in love and started the never-ending ✨process✨ of wrangling my jealousy. cats died, experiments ended, i finished coursework, i cut off my parents, i fell in love again, and cats were adopted.

i missed the friends i'd trauma-bonded with and moved away from, but the gap was filled with organic intentions, and we grew a space of chosen family. they come over and love me, and we drink sparkles.

my closest comrade became like my gay mom, then like my sister as i grew up a bit. we're all trying as hard as we can. i worry i'm not there for her enough. i'm reconnected with my bio sister, but i don't think i make much time for keeping in touch. i overthink everything. there are people i think about almost every day who i haven't had a substantive conversation with in years, but/and the way everything has played out is okay.

i think i'm coming back to tumblr partially as a way of telling people, i care about you, i want you to know what's going on in my life, even when i'm irrationally anxious about taking up time with a one-on-one.

i also wanna show off build confidence as a writer before i'm supposed to birth my dissertation late this year. then, i'll meander back to medical school and finish it. i'm pretty sure i'm going to be a child and adolescent psychiatrist. i'm currently recovering from a cold that has taken me out for days and munching some fancy biscotti from a sweet in-law. i have dinky hobbies that i love, it's 2023, and i just turned 30. 💫

[this part of the post was supposed to be the youtube video for RAC's "Never Let You Go" cover, ft Hilary Duff (wow, nostalgia!) and Matthew Koma (who I don't know, but sounds great with my childhood idol); i posted this jan 11, 2023 and by may, the vid is down lol. something something about how quickly the internet deteriorates. now, the lyrics below just link to the spotify URL.]

...but even if i changed, what's wrong with it?