Getting to the core

Since the last couple of nights, the hamstring muscles of my right leg have been feeling tight enough to cause discomfort, due to which I’ve been having trouble getting to sleep. This bothers me on many levels, but especially because our bodies NEED sleep for repair and restoration every night. A little search online led me to find out that hamstrings tend to tighten when they are trying to protect your back. So why did my back need protection? Well, it’s because I have been experiencing pain for months, and I’ve been doing yoga to help with that…only it hasn’t really been working. I’ve also noticed other pains cropping up, in my heels and my knees. Last night I finally understood what the problem actually was though, and the clue lay in the feeling of weakness I have also lately been experiencing in my middle body as I toss and turn at night. A little voice inside me whispered…it’s not about your back or your knees or your feet my child……it’s about your core.

This little voice was all I needed to hear to guide me to seek out a very short 10 minute core yoga routine that would target the abs, and as I practiced I came to realize how much I’ve been neglecting them. Or perhaps it’s the 50’s telling me to wake up and get busy doing some real work.

It’s very easy to overlook one’s core muscles apparently, and I can’t believe I am guilty of this, knowing all I know, having heard countless instructors talk about strengthening your core to strengthen your back. And yet, I’ve never really delved into the actual anatomy of my core muscles, what they are, how many there are, and what function they each perform to keep my entire trunk working properly. Another little search provided me with all of this crucial info.

I also realize that I’ve been using my back to lift heavy things instead of my core muscles, so it’s been a loop of misuse. it’s one thing to have information stored away in your brain and quite a different thing to begin to grasp just how connected everything is. Feet, knees, hamstrings, glutes, spine, core, all working in glorious cohesion, and one weak link affects all the others. The thing to pinpoint is…what is that weakest link? Hint: It’s not where the pain manifests …

So here’s to committing myself to a much more intentional, aware and targeted daily workout routine for a month and see what difference that makes, not only to my overall strength, but also my nightly sleep. Quite excited about this! It’s time to stop scrolling fitness reels and mindlessly consuming content on Instagram and consciously put into practice all the wisdom I glean now instead of saving posts to look at later. I never visit later.

In other news, I acknowledged the loss of two very old trees I used to know, one a majestic gulmohar I used to climb and hang out in between the ages of 8 and 12. This tree died a very tragic death, apparently due to an underground gas leak that killed many trees in the entire neighbourhood. The other was a very tall and old jamun, diagonally across the’ gulmohar, which harboured a lot of birds and dropped a lot of fruit on the road below. Heaven help your car if it was parked underneath. The people who lived in the house behind this tree had it chopped down a couple of years ago, but for some reason I registered the absence of it yesterday when I happened to park my car in that corner after a long time. Without the protective foliage of both these old trees, the street outside my old home felt hot and inhospitable in the mid morning sun, as if a deeply familiar place had become a stranger. It used to be really beautiful once, with the vermilion flowers of the gulmohar and the cool shade of the jamun.

Eldest Sis said that when the neighbours chopped down that tree, they found a hollow in it filled with socks. The socks had all been stolen from the clothesline in her balcony and deposited in the tree hollow by crows. What a cute thought 😊

Jimmy has not returned. My ambivalence has given way to a deep grief that we may actually never see him again. It’s strange sometimes to realize how alone we are in feeling our feels. A few evenings ago I actually socialized and those who know me well asked how my cats were doing. I mentioned Fuzzy’s death and the loss of Jimmy but talking about it fell short of the depth of sadness felt, and my voice trailed off when I realized these things can’t really be conveyed…and I make peace with this. It boils down to this: Jimmy was love, and his presence in and around our home had a value that only those who loved him could feel, and this feeling is precious to me and the only other person privy to this very visceral knowledge is Amu, for which I am very grateful. Huz shares the sadness too in his own way. Together we will keep our love-flame lit, that eternal one that binds us all.

The great reset

It’s a peaceful time of year, it being Ramadan, and Amu and I are surprising ourselves with a willingness to fast which heretofore did not exist. Methinks this willingness has a lot to do with a dawning understanding that it is not a punishment after all, but a gift we have the ability to give our bodies. To be fair to myself, if I had known the science before, my spirituality might have kicked in sooner.

Somehow, miraculously, my migraines aren’t getting triggered this year, and I wonder how much of this has to do with setting true intentions and keeping a very positive mindset. I don’t know man. I had to figure out the best time to take my hormone pill (optimally an hour before eating anything, once every 24 hours) so I set my alarm for 3:30, I pop a pill with a glug of water, go back to sleep for another half an hour, then get up and organize sehri, which has been strangely fun, maybe because I have such companionable company, and a lot because of the greater focus on mindful nutrition. I don’t know what it is, but we’re halfway through the month, and we’re still at it, not giving up. Clearly, there has been a Great Shift.

Of course it helps that iftar is reeeaaalllyy something to look forward to, and I spend a large portion of my afternoons thinking about and preparing lovely simple meals. Most people would probably be greatly disappointed at the lack of pakoras and samosas on my table though. Early on, I decided fried things didn’t quite see eye-to-eye with my gut biome, appetizing though they were, as the cheese balls I happily gobbled on the first evening ultimately made me quite nauseous the rest of the night.

I surprise myself by beginning to see why people are so sad to reach the end of the month. I’m weirdly enjoying this upheaval of my entire day-to-day, sleeping away the mornings, awake most of the night. It all feels quite special, no stress about anything at all, and no obligation to be performative. It’s an inward time of feeling, and healing. I continue fetching-water-chopping-wood, delighting in the sunny blooms of the loofah vines.

At the beginning of the month, Sis #1 happened to get her legs x-rayed, to find that her bones were totally out of alignment. We had all been witness to her increasingly unsteady gait after a couple of knee dislocations, for years we watched her walk like a wobbling duck, but none of us thought of taking her hand and marching her to a good chiropracter, simply took her word for it when she insisted she just needed to lose some weight. These x-rays have proved to be a wake up call, prompting her to finally give herself some love, some rest, some intensive treatment. I’m putting my faith in her body’s ability to re-align itself, so that she doesn’t need both her knees immediately replaced as per the doctor’s advice.

Sis #2 had a wake up call with her teeth and gums, which were in desperate need of help. But there is a tendency in many of us to put things off till push comes to shove, heaven knows I’m ignoring my lower back as we speak. Who the hell knows what’s going on there? In her case, it was shaky teeth and a very painful mouth which finally compelled her to go see a dentist who diagnosed her with gingivitis, something if left untreated can cause serious permanent damage, so it’s very good that she is now looking after herself more.

Meanwhile, Minnie injured her mouth while chewing a bone and before things went from bad to worse we took her to the vet where she received a few shots and was very much better the very next day. Jimmy Choo has a spasming urethra and not crystals blocking his passage as we had first thought, but he needs some ALP to relax his muscles so that he can urinate easily. It is not easy to medicate this particular cat. All three cats have fleas, and the price of the only effective flea spray in the market, already expensive to begin with, has tripled, like most imported goods. We still have to buy it of course, as there is no local alternative.

The baby sparrow fell out of the nest and died a few days later, something we realized when the sparrow-couple abandoned the nest. The balcony fell quiet, until another sparrow couple took up residence in the other birdhouse, but I’m trying not to get emotionally involved this time.

The friend I felt disconnected from, left the city and I didn’t say goodbye. It is possible we may be estranged. I set some energetic boundaries and she sensed it and stepped back. No explanations asked, none given. And I’m cool with that.

Bolna mana hai

I think I can quite safely declare myself to be in a rather acute state of laryngitis post-thyroidectomy, and must try and completely avoid speaking, whispering, coughing or clearing my throat. That vipassana I had mentioned earlier? It begins now.

My vocal cords have been off since day 1, and I suspect the damage to the recurrent laryngeal nerve due to surgery was further exacerbated by the viral flu I contracted on day 10. It is now day 25, and last night I had to resort to painkillers as I didn’t know how else to deal with the pain and swollen feeling in my throat. This was following a cold cup of passionflower-skullcap herb tea i sipped to self-soothe.

When I google these feelings, I come across alarming words like epiglottitis and laryngitis, and I’m fairly sure I may be experiencing both to some extent. Friends and family message me every day to ask how I’m doing, if I feel better now, and I am quite literally at a loss when it comes to words. I’m still in a transition phase, still in the midst of recovery, and I’m okay, but then there’s the not-so-small matter of the cords. I don’t really know what’s going on inside my throat while Nature does its stitching up work, so all I can do is pay attention, and really effing take care of myself. If this means no visitors or talking on the phone, so be it. I really shouldn’t have to feel guilty about having laryngitis. I do have fingers though, and I can type, not just to write this post but also to communicate with the homies.

The very good news I received yesterday was the result of the blood test I was asked to get done to check my levels of serum thyroglobulin, antibodies, and TSH. There was a slight glitch when the lab sent me the antibodies and TSH result, but not the most definitive thing to rule out radio iodine therapy, which was serum thyroglobulin. We had to go back the next day and ask them if they still had some of my blood sample left, or if I would need to get more blood extracted. Thankfully I didn’t, small joy, as I’m quite tired of having my arm repeatedly jabbed in the same area, we just had to pay some more for the serum test and wait a few more days.

Serum thyroglobulin is a storage form of thyroxin, which is the hormone produced by the thyroid gland, and in a normal healthy adult it should be around 55 ng/ml. Mine came out to be less than 0.20 ng/ml, which I’m guessing indicates that all my storage was almost depleted at the end of three weeks post-thyroidectomy, and nothing was being produced by any remnants of thyroid tissue left in my body. Therefore the need for radio iodine ablation was ruled out by the nuclear physician and he as well as my surgeon said to start taking one tablet of Thyronorm 100mcg.

So this fine morning on day 25, half an hour before my usual breakfast of tea and toast, closely supervised by my sweet Huz, I swallowed my first pill. This little white pill I shall swallow every morning for the rest of my life.

It’s so strange to reflect today on this page that has been turned to start a new chapter. The chapter that started in February 2022, but which actually started sometime in 2017, has come to an end. I should probably do a little ceremony to mark this day, maybe light a candle and burn some incense. Sit in quiet meditation and breathe it in, accept gracefully what is, embrace the new, release the old, hug myself a little.

Maybe there has been no beginning, and no ending.

Maybe it has all been a journey and an adventure and it simply continues.

Maybe my life is about deeply feeling, all the heavinesses, and all the lightnesses.

Maybe life is all about moving to the beat of my own energy, owning it unapologetically, speaking my truths, owning them, loving myself.

Maybe life is all about awareness……that my happiness and peace are all within, recognizing that the subtle nuances in my environment are created by the energy I emit, and not the other way around.

I acknowledge this immense shift and surrender to it, unafraid, making space for ever-increasing love as I move along in this blessed, never-ending transition called Life.

It is all very beautiful, even the horizontal scar on my swollen, tight neck. And I predict it will become even more peaceful than it already is.

Post-thyroid Munira

It is exactly two weeks since my thyroidectomy, and I just finished happily watching the two and only seasons of An Astrological Guide for Broken Hearts. Dil khush kar ditta, as an old crush from my college days would say, every romantic nerve in my body all a-tingle. Well, at least some things are still functioning like pre-thyroidectomy Munira.

Nights haven’t been the best over the last two weeks, firstly because of neck discomfort and an inability to find an optimal position conducive to restful sleep. But for the last couple of days, it’s been an inopportune bout of the flu. There’s something quite nice about the initial onset of a fever though that I can’t quite explain, that halka halka suroor before the headache, the bodyache, and general feeling of malaise set in. The worst though are the little spiky gremlins that show up without fail as I hit the sack, to take up seats in the mucosa of my upper trachea, creating a great longing to cough the most violent cough that could be coughed, and the gremlins get dislodged temporarily only to come back and resettle with fiercer determination. Even a tsp of ginger honey did nothing to soothe, and it was all I could do to maintain a cough-less state of equilibrium so I wouldn’t cause any more damage than had already been done.

I don’t want to dwell on anything regarding the situation I find myself in now, this weird thyroid-less limbo. The post-op biopsy report is a good one in the surgeon’s opinion and he doesn’t seem to think I need radioactive iodine (RAI) ablation. This procedure basically obliterates all remnants of thyroid tissue that may have been missed, thereby reducing the chances of errant thyroid cells making their way into other areas and creating potential problems. We were asked to get an opinion from a nuclear physician too though, just to get some clarity.

According to the nuclear physician, if my nodule had been 1 cm or less I wouldn’t need RAI. On the other hand, if it had been 2 cm or more I would definitely need RAI. Mine was 1.5 cm, which puts me in a gray area.

Being hyper aware of the kind of unpleasant effects RAI has on my salivary glands and heaven knows what other glands, I am extremely squeamish about this hurdle in my path. (Hurdles in the path ARE the path, says someone wise) I remind myself I’ve been through a lot worse by now, and my big girl panties are hitched up so high they’ll give me a wedgie if I pull them any further. One more blood test in about 8 days will determine not only my TSH and thyroglobulin levels, but also the necessity of RAI, therefore I have a little breathing space until ……I don’t know.

What should I expect as to the ways I can fall apart? It all remains to be seen, and I’ll be watching out for signs…

I’d much rather talk about the very palpable outpouring of love I experienced as soon as word got around about what I was going through. Loving, heartfelt messages from friends and family, so much kindness and concern and support from far off ones, the prayers and duas, the food that was cooked by some very unexpected mother hens with love and sent over, the soups and juices my sisters made, the daily check-ins by someone or the other…..all of these made me feel so loved, so like I belonged, that I meant something, and if this kind of love isn’t unconditional, what is? I was even the recipient of a whatsapp prayer chain for the first time ever in my life. I had the strongest feeling that it was the combined energy of the collective that lifted me up and out of harm’s way, that kept me safe and cared for at the most vulnerable moments of my life.

And much though as I reveled in this unfathomable sea of goodwill, a very strange feeling of unworthiness also crept in. What did I do to deserve such love?

I am aware of how good it feels to give, and I am also aware of how good it feels to be received. So now that I was on the receiving end, I had to learn to accept with grace all that I was receiving. I think at some point I began to feel overwhelmed and anxious about how I would ever repay all the kindness with my current energetic limitations.

I decided to let go of these useless burdens and just feel very very grateful instead. Gratitude is such a heart-based response, I figure that if I felt it then everyone felt it too, and that is all that is required. I am grateful too, for all who read my words and come along on the journey and feel my feelings and empathize. You are my tribe, and I love you and value your presence here. Thank you so much.

I just drew my curtain aside to look out the window at the sky and saw such a wondrous cloudscape, with iridescent spots of pink and swirly blue. Dragonflies are flying around everywhere…….how very symbolic.

Off with its head

It is day 12 post-surgery, and my vocal cords have gone into protest mode.

In the weeks before surgery , when I began to glean information about potential risks and complications of thyroidectomies, I half-joked with Amu that I might be forced into lifelong vipassana. The idea felt oddly delightful to me, though I obviously didn’t want my recurrent laryngeal nerve to suffer unnecessary damage at the hands of an unsuitable surgeon.

A friend who underwent a total thyroidectomy last year due to Hashimoto’s reported changes in her voice for some time, but it’s perfectly normal now, so I am not too worried. My ex-next door neighbour was advised to get rid of her entire thyroid upon discovery of multiple nodules in it many years ago after the birth of her first child. Her biggest worry back then was the separation anxiety her little daughter would experience with her surgery and hospitalization.

I consulted a senior and well-respected endocrinologist very soon after my dismal biopsy report, and she referred me to the same surgeon who operated on my friend last year. I took my own sweet time before making an appointment to go meet him though, but followed instructions to get a few baseline blood tests as well as another, more detailed ultrasound very efficiently the next day.

We marveled at the accelerated speed and ease at which things started to unfold once the uncertainty started to give way to action. There must be a reason why I felt such equanimity, and surely, I received my confirmation of angelic help when I happened to glance at the time on my phone while walking towards the ultrasound room from the waiting lounge. It was exactly 11:11 am, and I didn’t care if anyone saw my delighted grin, wishing I could high-five Huz and Amu. All repeating numbers stop me in my tracks and make me quickly come out of my mind and into the now. And in the now, I am well, I am safe and everything will be okay, no matter what.

This spirit connection is such a beautiful source of peace for me, as even when I am all alone, I never feel as if I’m alone. And the gratitude for having this understanding made me feel deeply emotional as I lay with my head tilted in a way to facilitate the movement of the ultrasound transducer over my neck and throat, tears trickling automatically out the sides of my eyes, hidden behind my mask. I was sure my lymph nodes would be perfectly okay, and the ultrasound doctor said it seemed they were!

There is a lot to be said about keeping an open heart while navigating your way through the medical world, finding joy in the positives while releasing anything negative as quickly as possible.

I know I may sound a bit too zen to be credible, but honestly, the peace I am able to access definitely does not preclude the feelings of confusion and anxiety that often assail me at night. I’m just getting a lot better at sitting with discomfort since I know all feelings are temporary…. as of course, is the very nature of Being.

What can I say, I’m in touch with my inner mystic.

Now that I was beginning to make peace with the loss of my thyroid, a new concern reared its head….what about the parathyroids? I definitely couldn’t bear the thought of losing them too. The endocrinologist made light of having to take copious amounts of calcium and vitamin D to make up for my body being unable to regulate them, but this was a huge red flag and even my inner mystic freaked out. I mean, I really didn’t want the system of calcium-release from my bones into my bloodstream to go out of whack. And why would I want the process of calcium-absorption from the food in my intestines to go awry? I love that my kidneys perform the vital function of conserving all my calcium without me even knowing. I took all this awesomeness so much for granted all my life….until now.

After a tentative online exploration of potential candidates for thyroid surgery, I felt more uncertain than ever. How was it possible to decide who would protect my parathyroids and who wouldn’t? It turns out the best indicator of the experience of a good surgeon is, quite simply, volume. I needed someone who did at least 25 thyroid surgeries a year.

The first endocrinologist put me at a little ease by saying he would put his blind trust in anyone recommended by the second endocrinologist. And since my friend had already given me glowing reviews about her experience with the recommended surgeon, it seemed wisest to go see him first.

If meeting the surgeon and discovering that he not only specializes in thyroid surgery but that he performed over three hundred surgeries last year wasn’t enough, the beautiful forest outside his consulting clinic had me sold. It was literally a no-brainer. His manner and presence exuded a patient confidence and after explaining lots of things about thyroid anatomy and physiology, he told us to go home, think about what to do next and get back to him if we chose.

And after three days of thinking, get back to him we surely did. A week was the time-frame I had in mind to prepare myself for surgery, but there were a few things I had to consider…..the monsoons, my menstrual cycle, and Muharram. The irony of having my neck dissected in this holy month wasn’t lost on me.

There were a few other idiotic things on my mind too, like buying new sheets for my bed. I didn’t know what my life would look like post-surgery, it seemed like some kind of looming debilitation that would stop me from living despite all assurances to the contrary.

When we met the surgeon three days later, he proposed to do the operation in two days and after a paralyzing few minutes of staring alternately at Huz and the surgeon, brain going from overdrive to numb, I found myself saying ….okay. Why not? And even though Huz was in favour of sooner rather than later I heard him pipe up with a ‘But what about the bedsheet….?’ I gave him a look and he trailed off.

And so it came to be that we drove the 30 seconds it takes to reach the hospital from my home, early on the 1st of August (armed with our Covid test results and an x-ray) and got me admitted into a nice little private room for a total thyroidectomy at 2 that afternoon.

Fear is a nodule

Today I am grateful for the healing of the warm water in my shower, the freedom of zero expectations, the feeling of well-being brought on by nourishing food that I didn’t cook, and a cat that watches tv with me.

I had many questions to ask the quiet visitor sitting in my throat chakra. Why was it there, for one, and did it have a message for me? If it had been around since 2017, did it just stay the same size since it arose? Why didn’t I notice it? Was its purpose to remind me of something, and if so, why did I ignore it? Why didn’t it give me any trouble for five years? And most importantly, now that I was aware of its existence, did I really need to get rid of it?

I placed my hands around my throat and thyroid and sent it so much love and gratitude. All those years of quiet, faithful service…..it made me weep to think of what I may have done to it. Was it my fault though? Did I behave in ways to create an energetic block there? Did I have a repressed scream bottled up in that nodule, and if I let out that scream, would it melt away? If I were to be my authentic self, unleash my creativity, speak my truths louder, live my life fearlessly, heal my inner wounds…..could I just shrink the nodule into nothingness?

Everyone I spoke to had only this to say: get rid of the damn thing! Don’t wait!! and these words felt harsh to me, I couldn’t quite concur. Why throw the baby out with the bathwater?

I was deathly afraid to get a biopsy. Allowing my neck to be injected with a local anesthetic, then jabbed repeatedly to draw out cells, was frankly the worst thing I could imagine. I just couldn’t bring myself to make that appointment. Instead, I threw myself into yoga, meditation, spirituality books, and researching things like how to make kimchi, wondering if I should incorporate more fermented foods in my diet.

Three months, including Ramadan, Eid, and a cousin’s wedding passed by and I was happily bypassing Huz and his gentle coaxing, making excuse after excuse to not go see a doctor.I wanted to buy myself some time, a little breathing space to sort out the resistance I felt, trying to hold on and protect my thyroid as long as I could perhaps? I really felt I owed it that much, considering it had been around for almost fifty years.But the monsoons arrived and Huz finally put his foot down, nagging me until I reluctantly called the endocrinologist, then accompanied me for the visit, armed with all the questions I had been raising since the first scan and ultrasound.

There’s nothing like health issues and doctor visits to bring you firmly back into the 3D. The friendly endocrinologist (who is a family doctor too) examined my nodule with gentle fingers and said it felt a bit too woody for his liking. It didn’t feel soft, like a benign nodule would. A hard little nodule like this was very suspicious and needed to get an FNAC ‘asap’. He told me not to worry at all, if he had a choice between all the various cancers one could get, he would pick thyroid any day since it was 100% curable. His own wife had had it 20 years ago and lived to tell the tale. Before we left, he apologized for bandying about with the C word so much, his intention was not to alarm me but he really didn’t believe in beating about the bush. I appreciated his candidness, his reassuring manner and sense of humour, walking away feeling grateful for his existence, strangely uplifted by the visit. Something had shifted….

The tight grip I was keeping on my precious gland loosened a little. The words that started to float into my consciousness were, ‘calm acceptance’, and all the angel number synchronicities went into overdrive. A big change was coming my way, but all was well, I was safe and I would be okay, no matter what happened.

That feeling of calm acceptance began to percolate in my cells over the next few days, and I allowed myself to go into observer mode, watching as I dressed for the FNAC appointment, drove to the hospital, parked, walked the maze of corridors of AKUH to get to the lab. When it was my turn, I watched myself being examined by a young doctor who called my nodule a lesion and told us a blind biopsy wasn’t possible in my case. What I would need is an ultrasound-guided one and for that I was directed to a different lab down a different corridor and ultimately requested to come back the next day as they were all booked already for that morning.

For the record, it was a beautiful cloudy day, there was a light drizzle, the sprawling grounds of the hospital were green and beautiful and it was impossible to walk around the premises without sending a heartfelt thanks to all the gardeners and landscapers who worked there.

The C word that comes to mind when I think about myself changing out of my t-shirt into a hospital gown and walking into the lab to lie down for the procedure, is courage. Cor, the Latin word for heart. Did my heart have enough heart, for all these scary new experiences? Perhaps the answer lay in my blood pressure, which stayed quite steady when the technician told me to take a deep breath and stuck the first needle into a spot right above my nodule. The second one didn’t even hurt since the first one had done its job. I cannot deny feeling anxious during the rest of the procedure though, when the hollow needle had to be pumped repeatedly to dislodge enough tissue to suck out four syringes of sample. There was such vulnerability tied up in this whole strength business!

Not for the lily-livered I thought, as I walked out of the lab to join an anxiously waiting Huz in the outside world, anesthesia rapidly wearing off. I think his worry about me had far surpassed mine for myself, yet I couldn’t reassure or give him details about the procedure, as the creeping pain and trauma had to be processed quietly in my own mind/body first.

It took a week for both the pain in my poor brave neck to subside… and the results.

Biopsy results can fall within one of six categories as defined by the Bethesda system for reporting FNA cytopathology results: I (non-diagnostic), II (benign), III (atypia of undetermined significance/follicular lesion of undetermined significance), IV (follicular neoplasm), V (suspicious for malignancy), and VI (malignant).

My little undefined nodule turned out to be a papillary thyroid carcinoma, category VI on the Bethesda scale.