Saturday, February 24, 2007

Testing

Sensei handed out a bunch of test dates this week. This coming Friday Robbie will be testing for his yellow belt at long last! It's taken him about two years to get this far. It's been terribly frustrating. He's known his stuff for ages (or to quote Sensei "It's never been a matter of what's in his head."), but because his brain knows it, he thinks he doesn't need to practice the same things over and over. His taikyokos (beginner katas) took forever for him to do decently, because his head knew them, but his body didn't, and he would stop after every single move to ponder what came next. Once he got beyond that point, he still wasn't ready, because he wasn't taking the need to concentrate seriously and would switch katas in the middle, or suddenly stop and do something completely different.

One advantage to all this time though is that he knows the patterns cold, even if his execution is still a bit sloppy. On Thursday he ran through Taikyoko 2 with three other kids and turned the wrong way on his first turn (a pretty typical Robbie spaceout as far as we could tell). What had the other students watching with their jaws hanging was that he then (with a faintly puzzled look on his face the whole time) proceeded to do the whole thing perfectly only mirrored right to left. In fact he did it better than usual - possibly because he was having to concentrate not to lose his place. When I talked to him afterwards he hadn't realized he was flipped, just that something felt odd. I told Sensei I'd work him at home to make sure it didn't happen during the test, but Sensei felt (as did I) that this was a pretty good demonstration of how well he knows the kata now.

After Robbie (and one of our child yellow belts) test on Friday, K, our resident doctor and the secondmost senior student is testing a couple of weeks later. Then I test two weeks after her (March 30). We're both up for san-kyu which is purple in our dojo. I'm a bit relieved that K is going first. She's been a green since 2005, while I only tested this summer. I know that barring some drastic change in circumstances I'll be testing for brown before she does - with three kids and being a full-time doctor practice time is short for her - but I feel better doing it for brown, when we'll be close in seniority in purple, rather than testing first at this rank. I'm also glad we're getting more people in purple. Our only san-kyu thus far (K's oldest) was, in my opinion, promoted just a touch early - at that point when he knew his stuff, but it wasn't completely secure yet. Adding in all the new stuff for purple has weakened his grasp on the material for green, and it's showing in a new sense of insecurity on the floor. He's quite hyper-aware that he's the senior student; he wants to live up to his rank. I'm hoping that having others of his rank about will let him loosen up a bit and regain his security.

I'm feeling pretty good about where I stand on the material for the test. My katas are solid, including Tsu Yoi Bo (Power Bo), which is the first weapons kata we learn, and I know the language material cold. My only concern on self-defense is the possibility of blanking on ideas, but I'm probably going to choose those about a week before to make as sure as possible that it doesn't happen. I'll have to chose a couple of sets though to make sure of no repeat from the last test. Only one person (other than Sensei) showed up, and my favorite self-defense moves from a bear hug couldn't be used because my "attacker" was about half my size, and couldn't actually wrap his arms around me. I could conceivably use the preset moves that we're learning for black belt - there are nine in all; we've been taught three. Sensei has said they're acceptable choices, but honestly I'm only really comfortable with one thus far. Eh - I'll come up with something. I only have to do three releases, and I know about a dozen. It's more the open-endedness that bothers me.

Thursday, February 22, 2007

ISTEP Results and Related Rambling

We just got back Robbie's results on the ISTEP exams (Indiana State Testing...something or another). It's a state-wide mandatory test that they administer starting in the third grade, so this was his first year. Robbie did really well. We're tickled, his teachers are tickled, he's tickled. Good stuff.

ISTEP comes in two parts, Math and Language. Each part is then broken down into six areas, which are tested separately. The whole process takes a week.

In language he pretty much kicked butt - except for the Writing Applications seciton. Writing Applications gives the kids a writing prompt (The best day of my life was..., or something similar), and they have thirty minutes to write an essay based on the prompt. Anybody who deals with Robbie much knows this is asking for trouble. The kid writes like a house afire on his own ideas, but blanks easily when asked to write about things he's not personally interested in. According to his teacher Robbie wrote nothing for the first 20-25 minutes, until she tapped him on the shoulder and hissed "Robbie! You're going to get a zero!" Whereupon he started scribbling madly. He scored a 79 (state average 69) on the strength of those ten minutes, but it's still a noticeable dip from his other scores, which ranged from 94 to 97. His overall Language score puts him four points below a Pass+, and over 100 points above a passing score. Nothing to sneeze at. Plus (Bonus!), the low essay score bothers him, and he's starting to work a little harder on being able to write to prompts.

Language may have been good, but he blew the roof off the test in Math. His lowest score (Problem Solving) was 92 (state average 57), and he scored 99 in four out of the six sections. Not only a Pass+, but way up at the top of the scale - a full 176 points above a passing score.

Needless to say his parents and grandparents are proud as peacocks about this. Makes me want to take his scores and mail them off to his kindergarten teacher, who kept telling the poor kid how bad he was. She would never believe that he misbehaved in her classroom because he was bored. Not even when we showed her he understood fractions (yes, in kindergarten), or when she gave him a picture book and he wrote in the story because a book with pictures and no words was just wrong. It was all because he was an unmanageable, probably ADHD child that we should go have treated for his problems. Funny how all the problems went away when we pulled him out of kindergarten and never came back. Iincluding the chronic stomach pains that started up about six weeks into school.

Three years later, and in a different school (Hallelujah!), we have teachers who understand that a bright child can be immature, and this mitigates neither his need to be challenged, nor his need to be met at his own level of social maturity. And I have teachers that I can talk to about Robbie being gifted without getting down-the-nose looks, where you can see the thoughts behind them. "Oh another one of those mothers, they all think their child is just so special." Usually followed by a concerted effort to prove to me (and my child) that he really isn't all that.

I could forgive his kindergarten teacher for being snotty to me. I will never forgive her for making Robbie's kindergarten experience so toxic. She's truly the only person I know that I've ever wanted to just slap across the face. I am unbelievably relieved to have Robbie (and Aaron) in a school that doesn't ignore them because they're inconvenient. I can't imagine what this year would have been like if we still lived there. I don't have the skills to give Aaron the extra help he needs (he gets speech and PT help in school), but I would rot in Hell before I would put another child of mine in that kindergarten.

Umm - well that was more of a rant then I intended. Shall we shorten it to - Robbie is finally somewhere where he is blooming, and we couldn't be happier about it.

Saturday, February 17, 2007

No Pointy Things! (At Least For Now)


Finally got in to see the endocrinologist. I had okayed a morning appointment, despite having an early-out day for the kids, because thus far he's always been prompt. I figured I had about twenty minutes leeway.

Sigh. I should have realized that the last minute appointment shift meant I was being wedged in-between existing appointments. I had to call another mother from the exam room and beg her to please pick up my kids - which fortunately she did (Thanks, SB!)

So - the unrinalysis came back negative for Cushing's. The newer, more extensive bloodwork showed some interesting things that can be worked with, though (why is it that every time they draw blood, they take more than they did the last time? This is getting alarming.).

First - IGF-1 is not only normal, but low-normal, GH is still normal. If I have acromegaly, you can't prove it by my bloodwork thus far. Dad is still dubious, but he'll have to be patient.

What they did find was a) high insulin levels and b) thyroid antibodies. When you combine (a) with normal blood-sugar, you get (TaDa!) insulin resistence! aka metabolic disorder. aka, a great way to end up with Type 2 diabetes if you're not damned careful. When you combine (b) with high TSH and low thyroid hormones (well, borderline), you get (TaDa! Again) Hashimoto's Disease! Hashimoto's Disease doesn't get any other names, but really the first one is pretty cool. Hashimoto's Disease means my immune system is attacking my thyroid. They're still not quite sure what's up with the cortisol, or if the adenoma is doing anything at all, but with all the rest of this going on, Dr. Williams wants to deal with these first, and then go back and see what's left afterwards.

The Finer Points:

Insulin resistance means that my cells don't respond as well to insulin as they should. Consequently my pancreas is working overtime, shoving more insulin into the system, trying to keep my blood-sugar under control. Thus far it's doing a superlative job - my blood sugar levels are almost weirdly level under any conditions imaginable. Feed me sugar? - 100. Starve me for a day? 80. Run me around like a mad woman? 85. Diabetics would kill for numbers like mine. Unfortunately the pancreas will eventually poop out from all this extra effort, and that's when you end up with diabetes. Plus heart disease along the way, since one of the other effects of insulin resistance is high cholesterol levels (and really crappy HDL/LDL ratios) combined with high blood pressure - interesting that I've been fighting high cholesterol my entire adult life, despite generally good eating habits. The "best" way to control insulin resistence is with diet and exercise - a low-saturated fat (but moderate/high fat otherwise), low-sugar diet, careful weight control, and good muscle mass go a long way. Except that people with insulin resistance gain weight easily, lose it slowly and only with great effort, and tend to be low-energy and fatigued most of the time, which makes said "best" management pretty damned difficult. I've been put on metformin, which is supposed to increase my body's sensitivity to insulin - which should then make the above mentioned weight loss, dietary changes, and increased exercise much easier to manage. How I'll react to the metformin over time, we will see, but I will say that even one dose seems to have improved my energy levels noticeably (Perky? I don't do perky? What is this?).

Hashimoto's Disease on the other hand, can't be treated with diet and exercise. It's a progressive auto-immune disorder, which means I'm stuck with it for life, unless some clever researcher somewhere has a breakthrough. Right now, my thyroid levels are hovering at the low end of normal, so we're leaving it alone while we deal with the insulin resistance. Eventually, however, I'll need to start taking replacement hormone (thyroxin), and unless that researcher gets on the ball, I'll be taking it forever. Symptoms for Hashimoto's include: weight gain(!), fatigue, depression, physical and mental slowness, cold sensitivity, and any general symptoms for hypothyroidism - plus neck swelling and pain if the thyroid decides to get sensitive about getting eaten (mine hasn't thus far).

I'm noticing this overlap of weight gain and fatigue between these suckers. You mean I haven't just been being a lazy bastard when I don't want to crawl out of bed in the morning? My slow crawl up to 217 pounds wasn't because I lack self-control? This is going to take rearranging my thinking a bit. I've been beating myself up for so long about my own lacks, it could take a while to adjust to the idea that my body betrayed me - I didn't fail it.

Anyway, the game plan at the moment is to treat the insulin resistance for the next few months, then recheck everything and see where we are. I'm scheduled for a repeat MRI to check the adenoma in July, to be followed by another round of blood tests, and a re-evaluation.

Trust me to be weird - I can't just get one unusual thing, let alone one common thing. I've got to get them in batches.

Wednesday, February 14, 2007

Quickie Update

I was waiting until my most recent endocrinology appointment to do an update, but since the office just called and put off the appointment until Friday (lab work not back yet), I'll give the short version here.

The summary of what we have thus far:
MRI showing a 2mm adenoma, low and central in the anterior lobe of the pituitary.
Blood workup #1: Normal GH, borderline cortisol, high TSH (thyroid stimulating hormone)
Blood workup #2: Normal GH, Normal IGF-1, high cortisol, borderline TSH, low thyroid
Blood workup #3 (with cortisol suppresion): Cortisol not suppressed.

Because the suppression test didn't suppress my cortisol levels, we did the more formal test for Cushing's (24-hour urinalysis, whee!), and yet another more generalized blood panel. That's what the lab is slow getting back with. I should get those results on Friday morning when I go in.

Given the low thyroid and high cortisol, I'm suddenly not feeling as guilty about the 40 lbs. I've put on in the last decade. With both of those going on, weight gain is pretty much inevitable. It also explains the great exercise mystery of three years ago - to wit: how could I train for a triathlon for six months and lose a total of three pounds?