Everything you didn’t want to know about your thyroid (from a thyroid cancer survivor)
When it comes to hypochondria, I fail. Dental appointments go unscheduled, blood test requisitions expire and old glasses stay in rotation well past their usefulness. So when my family doctor found a negligible lump deep in my neck, on my thyroid gland, I thought nothing of it. She booked me in for a thyroid scan and as part of the scan, I was expected to swallow a small amount of radioactive liquid which would help illuminate any abnormalities or lumps (nodules) on my thyroid.
However, the office was plastered with the following sign: If you are breastfeeding please inform the receptionist. The main reason I was able to stick to this appointment in the first place was because I was on maternity leave. So I sheepishly told the receptionist that I was indeed nursing a newborn. “Do you plan to continue breastfeeding after today?” she asked. (I did.) “Then you can’t take this test.”
I walked out annoyed that I’d paid to park at the clinic, but then I started to wonder if maybe I should be concerned? One ultrasound, then a fine-needle-aspiration biopsy later, I was diagnosed with Papillary Thyroid Cancer. The cure rate for Papillary Thyroid Cancer is high. In fact, people call it the “good cancer” (a borderline offensive term, but I get it: people don’t want you to freak out). I wouldn’t need chemotherapy or any radiation, but I would have to have my entire thyroid surgically removed and commit to a lifetime of thyroid replacement meds.
So here is where you start to ask some questions: Where is your thyroid? What does it do? Since January is National Thyroid Awareness Month, and a recent study indicated that one in 10 Canadians suffer from a thyroid condition of some sort, it’s important we all understand the ins and outs of the mysterious thyroid.
The thyroid, a butterfly-shaped gland, lies in the front of your neck just below your Adam’s apple. This “hormone factory” produces two hormones that seep into the blood stream: Thyroxine (T4), which is converted into triidothyrionine (T3) and influences the metabolism of your body cells. The thyroid regulates the speed with which your body works. Too little thyroxine means you have an underactive thyroid (hypothyroid: symptoms are fatigue, feeling cold, weight gain, poor concentration, depression). Too much thyroxine creates an overactive thyroid (hyperthyroid: symptoms include anxiety, heat intolerance, weight loss).
Once my thyroid was removed, I would become “hypothyroid”: My entire body would go out of whack unless I started taking a replacement pill. Synthroid is, by all accounts, a very common drug with thankfully few side effects. So while people will frequently say I’m lucky to have had the “good cancer,” I wasn’t relieved to be going in for surgery. I was deeply troubled by the scar it would leave at my neck, because my skin is brown and prone to pigment changes. And more significantly I hated, and still hate, the idea of being dependent on a pharmaceutical drug for the rest of my life. What if there is an apocalypse and no thyroid pills are to be had?
I will forever be in the care of a specialist (an endocrinologist that ignores my apocalypse scenario) who will use bloodwork to test my TSH levels to hocus pocus a prescription that keeps my hormones moving. Remember, I’m the woman who can’t even make it to a teeth cleaning. I wish I had a med alert bracelet that says: Give her Synthroid.
Following diagnosis, I met with an otolaryngologist—an ear, nose and throat surgeon—to discuss my complete thyroidectomy. When he walked in, he made no eye contact and went straight to his laptop before calling up the wrong file. That was a turnoff. The medical system can get annoying at the best of times; as a patient, you feel you have no control. But I was not in imminent danger of dying from thyroid cancer, so I went online to find the city’s best-rated otolaryngologist. That doctor worked out of Princess Margaret Hospital and when I called his office, the receptionist said he had openings and told me to get referred by my general practitioner.
It took a bit of time to get in for an appointment, but I urge people to seek out good care if you’re not happy with your medical practitioner and you are not in an emergency situation. Ask lots of questions. Don’t settle. Even now I wish I’d asked more questions.
Changing surgeons added an extra three months to my situation, but it was worth it to be at an amazing health care facility like Princess Margaret hospital in Toronto. I was released from hospital a day early and able to speak without any hoarseness almost immediately. While at home for two weeks recovering, I realized that in the previous five years I’d had three surgeries: Two children delivered by caesarean section and now a thyroidectomy. I was exhausted—it all might seem routine and yet it’s not.
The greatest challenge after I returned to work was the pain at my wound. For about six months, I wore either a turtleneck or scarf to protect my vanity, as well as the incision from the sunlight. I will never look at those two items of clothing the same way again.
It’s been three years since my thyroidectomy and I’m not sure I feel the same as I did before. The crush of work and family creates this perfect storm for feelings of crappiness. Is it my lifestyle or is it because I’m relying on pharmaceuticals to regulate the way I feel? I know I’m lucky to have had the good cancer, I still suck at going to the dentist, but writing this post is a reminder that health and vitality is a long term goal that requires time and attention to detail.