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Thursday, July 23, 2015

The Trouble with Thyroids

I was first diagnosed with hypothyroidism in April or May of 2009. I mentioned my struggles with the meds on a few posts back then but as a recap here's how it went...

In early 2009 I was on fire. I had finally lost the baby weight from baby #2 and I had just started to build up mileage with my running. I worked with a personal trainer at our rec center and really had a well balanced workout routine between cardio and strength training. When I went to my annual physical the doctor noticed a slightly enlarged thyroid when he examined my neck. The blood tests also showed that my TSH level was too high and my T4 numbers were too low (I believe he also ran T3 numbers which not all doctors do).

I previously had a couple of weird thyroid level numbers but nothing that other doctors felt the need to examine further. I really think baby #2 was what swung things really into action as I felt like I went hyper-thyroid for a while before dropping down low. Thinking back att the time of my examination in April/May of 2009 I had some symptoms of being hypo but nothing that I was too worried about or really noticed - I thought the tiredness was just a normal part of having two kids under the age of 4 and working full time. I didn't even think about anything being related to my thyroid.

So after my exam my Doctor put me on synthyroid and it ruined my life. Not kidding.  I don't know if he gave me too high of a dose or what but it was like trying to keep running in molasses. My digestive system got all screwed up and I remember having such low levels of energy that I got exhausted just walking around my house. My exercise took a nose dive.

After a couple months of this I demanded to be taken off of meds and to re-examine my levels at a later date.

I forget how long I was off meds but my levels continued to get worse so he put me back on meds but on Armour Thyroid instead. I did much better with that med (when I remembered to take it) and we plodded along. I would have bad thyroid days - as I like to call them now - when my energy was lower than a slug's but sometimes I would swing a little hyper too. I also had him do the Hashimoto's test at some point in that first year or so and I did have the antibodies that indicated that my hypothyroidism was related to that.

During this time I struggled much more with my weight as well. I'm not one to blame all my weight gain on a bad thyroid because I've had plenty of bad diet decisions and lack of exercise. But I do find that I have to work harder to lose weight because of my metabolism being affected by my thyroid issues.

Fast forward to fall 2012. I had my annual physical again and my doctor noticed some nodules and sent me to have an ultrasound on my neck. I didn't expect anything to come of this as I usually have these diagnostic tests and they find nothing. Well, this time I was wrong - I had a huge nodule on my right side. Now not only did I have Hashimoto's Hypothyroidism; I also had a multi-nodular goiter. So my PCP sent me on to a endocrinologist. That guy's office turned out to be the worst and it was going to take forever to get an appointment for a biopsy so I ended up getting a different referral to a surgeon. She was wonderful and I got to experience a fine-needle aspiration (FNA) biopsy at the tender age of 34.

Normal thyroid versus multi-nodular goiter
Just the word biopsy is scary enough. And having a long-ass needle stuck in your neck several times is not as fun as it sounds. Turns out the results were inconclusive. That's an exciting way to spend your holidays (as this happened right before Christmas that year) - I didn't know if I had thyroid cancer or not.

So, yay me, I was lucky enough to get a second biopsy (more fun needles stuck in my neck). This time they sent the results to get a DNA reading (which I almost had to pay $4000 for but thankfully my insurance finally got up to speed). Those results were that the nodule was benign - phew! But I had to keep an eye on it by getting a new ultrasound every 6 months.

I've done the 6 month checkups since then and with each ultrasound the nodules multiply and grow (my largest one, the one they biopsied, went from 2.8 cm to 3.3 cm). It's to the point now where I can feel them in my neck and the width of my neck is noticeably larger. I occasionally will even have trouble with swallowing. At this last Dr. appointment I asked him how much longer we were going to do nothing about it (or perhaps I phrased it less tacky) and he said for me to visit with the surgeon again and to see what she said.

I just had my appointment with her again today and after doing another ultrasound she said, "yep it's time for a total thyroidectomy." She said having the nodules grow and multiply increased my odds that one day I might get thyroid cancer (which to phrase it simply, it really isn't a bad cancer to have if you have the more common form of it - they take the thyroid out and give you a radiation type iodine pill and you just make sure it hasn't gone to your lymph nodes).

Long term results of a thyroidectomy are that I don't have to worry about thyroid cancer but I will have to continue to take thyroid meds for the rest of my life. Since I was already on the "thyroid meds for life" path this isn't that much of a change. The surgery itself will require a two week recovery so as I said in an earlier post it will put me on the sidelines for a bit. Since we aren't in any kind of emergency situation I've planned for it to be in December - due to my work schedule and the ease of taking time off. Also, this works with my current weight loss goals because I should be pretty close to goal by that time.

While I'm not thrilled with the idea of surgery I will be happy to have this particular chapter done with in my life. I was pissed when I first got the diagnosis of hypothyroidism. I resented having to take a pill and having a "disease".  I've since become reconciled to all of that because what can you do? But I'm ready to have the stupid thing out if it's just going to keep causing me issues.

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