i am supposed to have my thyroid cancer check up every six months, and i usually do- that is until this year. because i was diagnosed with breast cancer this year, and was " involved" with that, i missed my check up in april of this year. the fact that i did miss that check up, added to the fact that i had a second primary cancer, caused me to be very apprehensive about this check up. i had the blood work ( six tubes out of the back of my hand- but that is another story) done last week. yesterday , i had my ultrasound done first. i was a little anxious during the test because the ultrasound technician kept going over one area again and again. it brought back memories of my first ultrasound, when my thyroid nodules were discovered. keeping the mood light, you might say, i asked the technician if she was seeing any " goblins" in there. appropriate for this time of year, i thought. she said everything looked fine. i guess she was just being thorough.
next up was a bone density test. the reason for this is that keeping the TSH essentially zero so as to hopefully prevent thyroid cancer recurrence , and the fact that i am now taking an estrogen blocking drug to help prevent any breast cancer recurrence puts me at a higher risk of having osteoporosis. i have some bone loss in the " neck" area of one of my hips. it is not enough to warrant treatment, but unfortunately it is in an area that is prone to hip breakage. that said, i am not overly concerned about it. i am taking a high dose of prescription vitamin d, and my levels were good there. for some unknown reason, my calcium level was 9.3. it has never, ever been that high! i usually am in the 8 to 8.30 range. i am not taking a calcium supplement, but am trying( obviously doing a good job) to get calcium from foods. the reason that i am trying to get it through foods, is that when i was taking an oral supplement i got a kidney stone! natural (from foods) sources are best- and it does not have to be entirely dairy products. kale, for example, has more calcium than a container of milk. kale also has two times the vitamin c found in a medium sized orange, and has a healthy dose of omega 3 fatty acids, which is essential for brain health( heaven knows i need that!). one caution about kale: it is one of the worst foods for containing pesticides. if you decide to eat lots of kale, it would be best to go organic in this purchase.
the last part of my check up was a visit, or the big reveal, with my endocrinologist. i can not say enough good things about my doctor! she is compassionate, willing to discuss my treatment, compromise when necessary and she listens to me! she does not rush me out the door. she decided to reduce the dose of my levoxyl for three reasons: one, i have lost weight due to the chemotherapy, and thyroid hormone dosing is partly weight based. two, a TSH approaching zero can cause osteoporosis, as i had mentioned earlier. and three, a very low, or near zero, TSH can sometimes cause heart arrhythmia's. since it has been five years since my thyroid cancer with no recurrence, we both agreed to try a smaller dose and see how that goes. i am a bit nervous, i will admit, but i understand the reasons for reducing the dose. i am just hoping that this will not allow my thyroid cancer to return. with thyroid cancer, unlike some other cancers, a patient can have a recurrence at any time. there is no set time line for being cancer free with thyroid cancer, you have to be tested for the rest of your life and your dosage has to be finely tuned . if your thyroid hormone dosage is too low, there is a chance for recurrence, but if it is too high, you have a risk of some serious side effects. it is a slippery slope, you might say, but no thyroid hormone supplement- be it naturally or chemically sourced can compare with having an actual functioning thyroid gland. feeling well without a thyroid is not easy, as i am sure that anyone who is missing one will agree.
so, i have made my appointments for my next big check up- which will be in april of next year. some of my blood work values are still not straightened out from having had the chemotherapy. but they are improving, and i expect that the next time i have blood work done, everything hopefully will be back to normal. i am trying to rest, eat well and exercise. i have my last surgery for breast reconstruction next month. and my husband and i are going to go to the beach, which is something that i have wanted to do ever since i got the breast cancer diagnosis. i know that this is a thyroid cancer blog, but there is a link with my thyroid cancer and this second primary cancer. not all is known about the link at this time, but i am hoping that with continued research in both thyroid and breast cancer that perhaps in the near future we will have more information about the prevention of both of these cancers.
