Catching Up

I'm pleased to list links to my most recent blog posts on Living Lutheran:

• Waiting and Wrestling

• The Grace of Wild

• The Delicate Power of Protein

Yours truly, in gratitude.

Hypothyroid 007

Warning: this blog post is about thyroid health. Thus, if you are bored by reading about the thyroid or health, do yourself a favor and skip this. I would not have read such a post six days ago. However, if you are one of the 300 million people or so worldwide experiencing thyroid dysfunction (over half are presumed to be unaware) and/or the 60,000 people in USA diagnosed annually with thyroid cancer, maybe this post will help.

Last week my mental health therapist asked me a bunch of questions, trying to discover the root of my depression. Age (52). Occupation (sitting). Sleeping (need more). Eating (pretty decent). Exercise (actually quite a bit). Drinking (probably too much). Thinking (pile of scissors in the brain). Etcetera. I mention “my therapist” nonchalantly, as if we’ve been together forever. Actually, it was my first time with her, second therapist this year, third therapist in the past half dozen years. I have a hard time keeping appointments (having missed a salon and dental appointment earlier this month), thus the change in therapists. It’s not that I haven’t liked previous practitioners, it’s that I can’t keep up my end of the deal, which is: showing up.

This time Bob agreed to go with me. After an entire hour of three-way therapeutic chat the one question that stuck with me was this: Have you explored your thyroid, aka lack of it, as a source of your depression? My answer: No.

Hypothyroid Barbie wants answers.

(This picture is intended to be funny, in case 

the humor is not apparent. And I must give credit 

to the artist who created this photo, Claire Anderson. 

She created a whole set of dystopic Barbie pics, 

which we won at a church auction. More and more, 

I think they give a good visual of hypothyroidism. 

Thanks, Claire, for giving a 3D look to an invisible 

glandular dysfunction.)

The bigger question is, I now realize, have I thought of my absentee thyroid at all? Other than the annual check up with Dr. Endocrinologist, no. Other than Dr. E  telling me “everything’s normal,” no. Other than the daily thyroid replacement pill, no. Other than my biennual trip to the nuclear medicine department, no. 

No. No. No. I rarely think of the void that was my thyroid.

Hense, the 007. It’s time to do some detective work, as per suggestion of my therapist. I’m starting with the year 2007, when my thyroid was surgically removed due to thyroid cancer. I like to call it the year they slit my throat because I consider it a rare opportunity to claim badass status, with apologies to my mother. Seriously, the year 2007 was big for me, Bob, and the kids. My thyroid cancer was tucked in-between a bunch of other momentous turning points such as Bob’s liver failure, the immense outpouring of love around Bob’s liver failure, Bob’s unemployment (lack of call, as they say in the Lutheran world), Bob’s call (employment as they say in the bill-paying world), Bob’s open heart surgery (which the kids and I transformed into a week long family vacation), our move from St. Paul to Des Moines where we seemed to have stumbled into the best post-seminary situation you could ask for, and everything entailed in a move – buying a house, finding schools, getting kids into said schools, relocating office, etc. 

In the year 2007 I was granted three medical leaves from my job, 1.) liver, 2.) thyroid, and 3.) heart, telecommuting/traveling to the home office in Baltimore in-between healthcare procedures and the move. I felt (and still do) that we had little right to complain because we had excellent insurance and an ongoing salary through my job. It was through much generosity, on many levels, that by the end of that year we had not only survived, but thrived. Why would I focus on my missing thyroid?

The kindness of others gives perspective. I should just stop there and be grateful. But me being me, I have a self-sabotaging habit of comparing myself to a mother in a refugee camp. Any mother in any refugee camp. When I gave birth, as horrible as it was, I imagined giving birth in a refugee camp which was surely worse. When I am exhausted with home and work, I imagine a mother in a refugee camp with no food for her children. Worse. No matter what is happening to me/us, I imagine the same thing happening to another mother in a refugee camp. It's always worse. It’s my version of clinging to the Midwestern ethos of “things could always be worse.” But clichés always point to truths, right?

All that to try to explain why I haven't thought much about my health.

Back in 2007, my thyroid cancer was diagnosed by a physician assistant (I prefer PAs or licensed nurse practitioners over MDs for primary doc) during a routine exam in early May. With her bare hands, she felt a lump in my throat and ordered a biopsy, which tested positive. (Positive means bad, if I have that right.) Everyone thought it was a mind-body thing, the way my thyroid cancer seemed to present immediately following Bob’s long liver illness. Anyway, long story short, my thyroid process all went very fast. Diagnosis, surgery, and done all within the month of May. Besides developing an unreasonable love for my surgeon (normal, according to my friend, a licensed psychotherapist), everything went smoothly. Compared to acute liver failure, it seemed extremely simple, I thought. Even Bob’s open heart surgery felt like such a relief, so procedural. After my surgery, they sent me and my lifetime prescription of thyroid replacement off to live happily ever after. 

 “If you gotta have cancer, thyroid cancer is the one to have,” I would joke.

 “It’s the easy cancer,” I would say.

“It’s not like breast cancer or brain cancer,” I would minimize.

“What do women in refugee camps with thyroid cancer do?” I would wonder.

I was the lucky one, and I still believe that.

Mostly, besides the daily pill, I forgot about the thyroid cancer. Dr. E, however, reminds me in my annual check ups that it could return. It’s serious, she says. I can’t skip my appointments, she warns. The thousand dollar nuclear medicine scans are essential, she tells me.

But now, five, six, seven years later, when I tell Dr. E I don’t feel well, she’s the one who minimizes. When I bring it up, during my annual my 20-minute appointment, she tells me there’s nothing she can do. It’s my age. It’s normal. It’s not my thyroid level. Blood labs show everything’s fine. 

However, since Monday (five days ago), when my latest therapist asked about my thyroid and depression, I’ve been researching. And I’m thoroughly embarrassed about little I know about my own health, especially now as it moves in such a downward trajectory. First and foremost, I did not know that a removal of the thyroid makes one “hypothyroid” by definition.

Hypothyriod = low functioning.

Hyperthyroid = manic functioning

(my paraphrase)

My research says that getting a diagnoses for hypothyroidism is very difficult (often passed off as crazy lady syndrome, etc.). That’s one hurdle I don’t have to jump, but if you do, I offer my support, and encouragement to try different doctors and approaches. Post diagnosis, the next hurdle is the finding the right treatment, which apparently is not a one size fits all (she said seven years into it).

 I am hypothyroid and so what? In the unbelievably long list of 300 symptoms of hypothyroidism, I have too many to bore y’all with. Since 2007, they have become progressively worse. I realize that if I want to stay married, stay employed, stay sane, stay human, stay out of bed, I need to turn the curve toward health. But if Dr. E says everything’s normal, what do I do? Step one:  Find a new doctor. My research suggests many ways to shop around for a thyroid doctor. I started with this method:

1.     Call a compound pharmacy and ask for a list of doctors who prescribe compound thyroid replacements.

2.     I’d never heard of a compound pharmacy so had to look it up. Basically, it’s a specialty pharmacy whereby prescriptions are uniquely created for individual needs, as opposed to mass production.

3.     I found a compound pharmacy in my neighborhood, called it, and easily got three names and telephone numbers of local thyroid healthcare providers.

4.     I called first name (a nurse practitioner) and made an appointment for Monday. She’s on my insurance. I’m hoping for a good fit, a new pill, and a quick fix. (Fa la la la, la la, la, la.)

Face palm. While I have written hundreds of pages, a zillion blog posts, an MFA manuscript, and many elaborate descriptions about the mysteries of liver function, I know nothing about the thyroid, especially my own. The only thing I know is that more and more I feel like Hypothyroid Barbie (see pic). I am astounded at the extent of what I don’t know, including this partial listing:

·      Exactly the purpose of a thyroid.

·      - What specific type of thyroid cancer I had. (How can anyone not know what kind of cancer they had/have?)

·      - What blood panel was ordered to determine if my synthroid is working.

·      - What my doctor considers normal range in the labs (apparently this is a moving target).

·      - What I consider normal.

·      - Why my doctor has not suggested any sort of alternative or complementary treatment.

·     -  What would lead me to not ask these questions when I’ve had no thyroid since 2007.

A partial answer to my ignorance is this: I’ve got other things to do. I’d rather not focus on my stupid neck. Women in refugee camps have it much worse.

Yet, my twisted sense of self-martyrdom is not helping, plus I’m sharing the misery with my family. Super not fair. However since last Monday, I’ve discovered a ton of resources. I wish I’d have searched sooner, but there’s that saying: “The teacher shows up when the student is ready.” The student is ready.

Here is a list of resources that I’ve started with, and if you’re wondering about your own thyroid health, maybe they’ll help you too:

R Hypothyroid info (blog): Http://www.HypothyroidMom.com

R Hypothyroid info (book): Living Well With Hypothyroidism by Mary J. Shomon  http://www.thyroid-info.com/book.htm

R Thyroid Cancer Support: http://www.thyca.org

There are many more resources, I just haven't gotten that far yet. Thank you for checking out my blog. Warm wishes for the new year.

Yours truly.