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.
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 (book): Living Well With Hypothyroidism by Mary J. Shomon http://www.thyroid-info.com/book.htm
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.
Thanks for gathering the energy to teach/preach it, Terri! A colleague had thryoid cancer diagnosed last year at her annual physical. Makes me think of my current doctor--the one who clearly does not like to touch people. I should get a different doctor, but who has the energy? And, really, having ready access to a doctor is a privelege, just think about the women in a refugee camp.
ReplyDeleteSue, thank you for the message. So sorry for your colleague. The way my doctor described it is that there will be more and more thyroid cancer diagnosis because the technology has evolved. Since its a slow moving cancer, in the good old days, you could have it for years, even die of natural causes, and not know of your thyroid cancer. Only the unfortunate few individuals whose TC metastasized did. Then, apparently, its pretty horrible. When you summon up the energy, I recommend switching to PA or LNP for general exams. Love to you and your beautiful family. Terri
DeleteTerri, I'm so sorry that you have been struggling with this. My mother had a very similar journey (at least at the beginning). She kept her uneasy feelings about a lump in her neck from me until after my wedding. Then she described a small, rubbery mass that needed to be excised from her neck. When the surgeon removed the mass, which was benign, he found cancer behind it on her thyroid gland and entwining her vocal cords. I remember arriving at the hospital with a fistful of pink tulips and a whimsical card that I threw away minutes later. The surgeon met with me, my father and my sisters and told us that he had removed my mother's thyroid gland and had scraped her vocal cords which may result in a permanent change in her voice. I remember feeling a cold dread befall me. I asked if she would be able to speak? "Yes, but the vocal cords were traumatized and they need time to heal," replied the surgeon. I selfishly wondered if I would never hear my mother's familiar, sweet,and comforting voice again. Later, my mother told me she was relieved to learn there was an organic cause for her emotional and physical symptoms. Her surgery and follow up chemotherapy was successful. Throughout this process, she showed a brave face and downplayed the anxiety that she felt. (You and she must be cut from similar cloth.) But her voice was raspy in the morning or if she had not spoken recently, she was self-conscious about her scar and she always feared that the sneaky beast would return. I remember parroting that same phrase you wrote about to my friends when I explained the event, "If you have to have cancer, it's the best one to have..." I thought if I repeated that statement enough times that I would come to believe it. I share this with you as a predicate to telling you that I am glad you are talking to people. I understand some of the uncertainty and apprehension you must be feeling. I will pray for you. Please know that I am a willing ear ,if you ever need another one, and thanks to my life path and my boxing classes, I have strong shoulders if you ever need to lean. Love, Pat A
ReplyDeletePat A, thank you for your story and message of support. How is your mother? How long ago did this happen? Love to you and your family. Terri
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