The Cancer Elephant Wakes Up -- The Journey, Part 2

The Next Adventure: My Thyroid

After more than a decade of cancer-free mammograms, I truly began to believe that I might never have to face cancer again. This illusion is the hope all cancer survivors have: that we are now cancer-free; that we will never again have to pump poison in our veins, wrestle with dangerous radiation; that we will walk away from our cancer elephant.

The cancer elephant is an analogy that I learned from someone early in my cancer journey:

My teal, pink and blue cancer elephant.

"Sometimes, cancer is like a decorative elephant. It sits on your coffee table: a part of your life, but not a significant one.  You dust it and keep it clean, but otherwise, you don't think about it.

Sometimes, the cancer elephant wakes up, and grows huge, and decides to sit on your chest. The secret is taming the cancer elephant."

My cancer elephant had been relegated to the bookshelf in the basement. I seriously believed that I would never see my cancer elephant again. Hah!

As I got older, I began to develop tooth problems that were persistently painful. For years, I chased a problem with my teeth, first number 30, then 31. I had root canals and had the root canals redone. The pain returned over and over. After years of treatment, I realized I had an allergy to the metal in my crown. Meanwhile, my thyroid received dental x-ray after dental x-ray, all of them unprotected by the most basic of protections: a thyroid collar.

A thyroid collar: make sure
your dentist uses this.

My poor thyroid! It had no protection at all! First there was the onslaught of radiation in the 90s. Now it was exposed time after time to the stray dental x-ray radiation, to my frequent flights -- to all of the radiation of our modern daily life.  It finally succumb to the cells that forgot how to die: I developed thyroid cancer.

I had just begun a new job; this job was awesome. One day, following a cold, I felt a bit of a lump on my throat, and my ENT sent me for an ultrasound. Well, that didn't go well..findings were "hypoechoic, vascularized", suspicious for cancer.  I found myself at a type of doctor I barely knew existed: the endocrinologist. Mine did a sloppy fine needle aspiration. I developed a huge bruise a few days later, and then I got the findings:  Crap! It looks like I have another cancer.

"Oh, but don't worry: if you have to get cancer," the doctor tells me, "this is the kind you want. This is the good cancer."

Really?  Did you just say that to me?

Let's clear this up right now: there is no good cancer. It offends Thycans (thyroid cancer survivors) when you say that; it minimizes their experience, which is far from fun. The reason the idiot doctors say that is because it is very survivable. You may live for decades with untreated cancer.  Most of the survivors will die of something else.  Thyroid cancer has its own special set of issues that change your life forever. The all-too-common medical myth minimizes the changes that each survivor faces (not a complete list): 

• Inadequate medication with some persistent side effects -- medication the patient must take to survive.  Allergies to the meds, weight gain, thinning hair, depression and low, low energy -- symptoms that are all too common amongst us. 
• Exposure to conditions caused by medication: being hypothyroid (too few thyroid hormones, or hyperthyroid (too many.) I was both at various points, and there is at least some evidence that that may have awakened my next cancer.
• Exposure to dangerous radiation, and possibly exposing those you love while you wait out your exposure. The doctors send you home!
• Problems with: voice (some never recover); saliva glands (this is painful); tear ducts; breathing, bad nails. Survivors develop diabetes from the weight gain (and it is impossible to lose weight, so stop judging); cognition and emotion regulation are impacted. 

Thyroid cancer survivors may deal with all sorts of issues -- thyroids affect nearly everything in your body. 

Thyroid surgery was not hard on me.

I quickly learned how inadequate thyroid treatment is: the medications they give you replace only a portion of the things your thyroid used to do, and the standard of care is remarkably insensitive. Thyroid medical science has made few gains in over 50 years. 

I soon had to change endocrinologists. I moved my care to University of Michigan. I had my thyroid removed there. The surgeon (who was brilliant!) performed a thyroidectomy and central neck dissection. She found a few nearby lymph nodes as well. 

The diagnosis:  papillary thyroid cancer, well-differentiated, stage III. (Well-differentiated means they can see the difference between the tumor and the surrounding healthy tissue. It's considered a good thing.) I'd have been stage II if I was younger. My survival stats say I'll die of something else, like most survivors.

I had the minimum efficacious dose of Radioactive Iodine (RAI) in order kill any remaining cells.  I have been on a journey ever since to balance my medications to optimize my well-being.

A word to those who are going through this. Some of us do just fine on the standard medication, called T4 or Synthroid. I was not one of them. I was tired, couldn't think clearly and I was depressed. The doctor added T3, or Cytomel. That allowed me some of my feeling of well-being to return. Others choose desiccated thyroid to replace all of the hormones the thyroid made.  I'd like to try that someday, but for now, I'm ok.

Once again, I returned to my work and minimized my time off. I plunged back in, to ensure that I would not be pigeon-holed into obscurity. In fact, I think I really brought some new ideas and some great work to my company for a few years, and they did reward me well. I loved working with my team. I put my elephant back on the shelf.

Until this year's mammogram.