The country had already been in lockdown for a couple of months when I tweeted my plea on May 6 that we don’t become “Zoombies” (David Steensma’s term). At the time, I was trying to include a graphic with every Tweet. So, I showed myself with an icebag on my eyes, in my comfy robe, enduring yet another Zoom meeting.
I have been trying to take care of myself. Early in the pandemic, it was a treat to binge-watch shows and movies I’d missed, although it wasn’t all bliss because I developed swollen itchy eyes and forearms which I self-diagnosed as a contact dermatitis and treated with topical steroids. I had settled into a rhythm: stay safe, work from home, and shelter with my husband and two sons trapped with me. The kids are the perfect quarantine ages of 15 and 20 — independent in self-care and online classes, but not old enough to live away from me. Life has been very busy, but good, and I kept doing my intensive hourlong exercise tape every weekend, just like I always did before COVID.
So, when I started getting some intermittent bilateral ankle swelling in early June, I self-diagnosed as status post-salty meals and venous compression from intense Zoom days. Prescription: Turn off the videocam and do squats and stretches. Then, I couldn’t get all the way through the exercise tape without a break. Prescription: increase exercise frequency. Despite these measures, I developed progressively more pitting edema, dyspnea on exertion, and tachycardia. The symptoms came on slowly but eventually it was clear that I needed a medical evaluation. I made an appointment with my primary care nurse practitioner, then moved the appointment earlier when I developed a tremor. She was shocked I had waited so long to seek evaluation.
It turns out I have hyperthyroidism from Grave’s disease. The itchy eyes and rash probably were the onset. Thankfully, my care is being managed by an endocrinologist and not a cardiologist, pulmonologist or oncologist. Being a patient reminds me what I’ve always believed: It’s important for physicians to be on the other side of the doctor-patient relationship sometimes. You get to experience what our patients have to deal with: the phone trees, the next new appointment in a month, the 45-minute line for a blood draw, the waiting for the test results and diagnosis. I am also reminded how reassuring it is to get a true expert opinion and treatment plan, and the importance of rapid online access to your test results. Oh, it is also critical to get a fully treatable diagnosis. Many of our patients don’t get to hear that.
Looking back, I do think I would have sought evaluation earlier if things were “normal” and I couldn’t blame new symptoms on COVID-19–related changes to my schedule. Please don’t make the same mistake I did. If something is wrong, get it checked out. Don’t self-diagnose or put off routine care. Maybe COVID-19 stress brought out the anti-thyroid stimulating hormone receptor autoantibodies that cause Grave’s disease. I will take this as my warning to slow down and really take better care of myself. I hope you are able to do the same.
