"...whether you're a brother, or whether you're a mother, you're stayin' alive, stayin' alive, feel the city breaking and everybody shaking, and we're stayin' alive, stayin' alive. ...got the wings of heaven on my shoes, i'm a dancing man and i just can't lose. ...life going nowhere, somebody help me, ...yeah, i'm stayin' alive, stayin' alive. " stayin' alive by the bee gees

it seems that i have a wee bit of a problem. i still  have thyroglobulin antibodies. i would not have known this, but i requested a copy of my last blood work for my records- remember that i am always telling people to do this? get copies of your tests and labs and put them in a folder so that you will know what your "numbers" are and can make intelligent, knowledgeable decisions. my doctor did not go over this with me when i was in her office last time. she went over my other  test results- no thyroblobulin, and nothing showing on the ultrasound..... now, here is the tricky part of the report- the one i just happened to see when i looked over the results.

some people( i just have to be different, i guess) have thyroglobulin antibodies. these attack, or work against, the thyroglobulin in our bodies. sounds good? no, not really- if you are a thyroid cancer patient and your doctor is measuring the thyroglobulin in your blood stream to determine if you have recurrent disease. if you have thyroglobulin antibodies like i do, and they have not gone away( some people have them at first, then they go away, to wherever, after the surgery/ I-131. ) then you could get a FALSE NEGATIVE report. in other words, you could be celebrating good news a little too early.

according to new research reported by thyca, " an ultrasound should be one of the first tests in monitoring a patient for recurrence, especially in patients where thyroglobulin antibodies are an issue". of course you probably remember that i said that my doctor always does an ultrasound at my "testing time" along with the blood work. thyca recommends that the device needs to be a POWER DOPPLER AND COLOR DOPPLER in order for the entire spectrum to be seen properly. doppler ultrasound detects the movement of blood around tumors. increased blood flow can be a strong marker for a tumor. not only that, but the scanning procedure should " take at least 45 minutes in order to be thorough". and it gets even better: " the average ultasonography technician may be very good on other ultrasounds, but requires special training for thyroid examination."

jeez. my ultrasound took no more than five minutes. and i am pretty sure that it was not a power/color doppler. i am not sure how much training the technician has, but i am fairly certain  that the ultrasounds i have been having over the past two years have been, basically, worthless. now what? i know that papillary thyroid cancer, even" stage three, and intermediate risk"- which was what mine is/was has a pretty good survival rate. unfortunately, it also has a rather high recurrence rate- which is about 30%. i also found out from thyca that there should be " lifelong surveillance". EXCUSE ME, but with all the stress that comes along with testing, i need to know that at least the tests are accurate. i have no problems with the blood work part, but i am now going to try to locate a facility that uses the power/color doppler. i am not sure how i will do this, but i am going to start looking now. my next test is not until september, but honestly, i need to have this done pretty soon- and with the correct equipment.

i would like to have this test done in the winston-salem, charlotte, raleigh-durham-chapel hill area, but if need be, i could go outside of north carolina. if anyone out there knows of a place where i might get the power/color doppler done, please shoot me an email. i would really appreciate it. i probably do not need to say this at this point, but everyone out there, please keep copies of your tests and blood work. be your own patient advocate, and best health and best wishes to everyone.

"....sometimes the lights all shining on me. other times, i can barely see. lately it occurs to me, what a long, strange trip it's been. " Trucking, by the grateful dead

"testing time " puts me in a strange mood. i will admit it. so, here is the good news: no goblins in my neck and no thyroglobulin in my bloodstream. when my endocrinologist told me this, she looked at me and said, now why are we doing this every six months? ( here is the bad news). after a very pregnant pause, during which time i was holding my breath- so long that i think i could dive for pearls now, she said, oh i see! don't you just hate it when your doctor is reading the information on your chart and she/he gives you THAT LOOK. and by that look i mean that she is surprised that you are still  sitting there before her.

you see, i had one bad test right after my huge treatment dose of I-131. i had thyroglobulins out the wazoo in my bloodstream. little darth vaders if you will, going after other parts of my body that were just minding their own business. i found out  about this from the nurse. now everyone knows that only the doctor gives you bad news. but on this day, and yes i was at work, the nurse called to give me my results. in her defense, she did not have any idea of  the size atom bomb she was dropping on me. i was of course, upset, and left work early that day. my daughter asked me why don't they do something? can't they give you more of the I-131?   ( what a pleasant thought!). when i got my treatment dose, the radiologist told me that my dose was so large ( 155 milicuries) that they could not administer more of the I-131, even if they wanted to, for at least six months.

when i went for my results this time, my doctor told me that she had no idea what had  happened to me. to have one bad test, and then three good ones is unusual i guess. she told me that she only  has one other patient who has done the same thing that i have done-had  a bad test, and then for seemingly no reason, gone into remission. she told me that she could not begin to say that i am " cured",though, and i have to continue on with the every six months ultrasound, bloodwork, etc, i have mixed feelings about this. while i get majorly stressed out about the testing, i think that i would worry more, considering that one bad test, if my doctor did not do the testing every six months. i have not explored treatment options if i were to have another bad test. i  assume that it would mean another dose of the I-131, and perhaps radiation if it had reoccurred in my neck area.

but for now, life is good. i am going back to zumba this week( boy do i need it!) whether my knee is up to it or not. i just have to make it lower impact, i,e. not try so hard to keep up with the 20 year olds in the class. yep, i am going to wipe the dust off of the gold coins on my belly scarf, dig my exercise tee shirt out of the wash, and pray that my exercise pants still fit! i am truly thankful that i received good news, and i plan to make the best of it. i will be just fine, that is, until september.............

" you go back, jack, do it again, wheels turning 'round and ' round, you go back, jack, do it again. " steeley dan

tomorrow it is time for my six month cancer check up. my husband and i are driving down to raleigh and i have an appointment for blood work, and also an ultrasound of my neck. the ultrasound will check for goblins( aka, growths that should not be there- perhaps caused by rogue thyroid cancer cells). the blood work will be checking for thyroglobulin and thyroglobulin antibodies- two markers for thyroid cancer cells, also rogue, that may be causing mayhem somewhere else in my body. my reveal show is next week, when i have an appointment with my doctor. she will go over my results, and hopefully all we will do is schedule the repeat  tests six months from now- which will be in september.

i have ambivalent feelings about these six months check ups. of course, i am thankful that my endocrinologist keeps a close eye on things. i asked her one time if five years was a good " everything is o.k." marker. she said, " well, actually, i just had a patient come back who has had a recurrence after seven years. " bummer.  this may, i will have been in remission for three years. i guess i have a while to go before i can assume that everything is o.k. every time i have these tests, i have days of self reflection, sadness, joy, and yes, sometimes, anger. i have never asked " why me?", because in my line of work i have seen so many good people dealing with health issues much worse than i have. i guess my " anger" comes from the realization that i may not be around to see all of my grandchildren, or  enjoy time with my husband, or  support my children. i am thankful for every day that i have with them, and hopefully i will have a lot more time to be with them.

next week, after my doctor's appointment, i will blog and let everyone know how things went. until then, happy st. patricks day, and bring on spring!

TED- no, i am not talking about a little teddy bear who presented at the oscars this year, and has a penchant for being naughty, i am going to try to discuss THYROID EYE DISEASE, aka, TED

in researching this subject, i found out that i really do not know that much  about TED. nor, it seems, does the medical community. TED can be present- and it is  most often diagnosed in hyperthyroid disease, namely, graves disease. it can cause extension of the eyeballs- a classic symptom. it is an autoimmune disease, that sometimes hangs out with another autoimmune disease- hashimoto's disease. hashimoto's disease is a hypothyroid condition. so, i will tell you what i have found about about TED, but i will encourage anyone experiencing eye difficulties of any sort, to please see a physician. while your doctor is the only one who can make the diagnosis, you- as always, and in all medical conditions- have the final say in your treatment.

some symptoms of TED include: dryness, a gritty feeling in the eye- you know, like you have sand or something in there, excessive watering of the eye, pain upon looking up or sideways, bulging of the eyeball, double or blurred vision, redness, irritation, sensitivity to light or wind, just to name a few. of course, some of these symptoms may be misdiagnosed as" pink eye" ( a bacterial infection)  or allergies. so how do we know?

some patients have reported that they have more TED symptoms when their thyroid hormone is too low. others may need to reduce their thyroid level dose- those with graves disease, perhaps. a visit to an ophthalmologist ( eye doctor) may be in order to obtain a diagnosis. it is good to have your thyroid level checked, as well as a thyroid-stimulating antibody test. obviously, you need to choose a physician wisely. someone with experience in  treating TED. there are other, more costly tests- CT  or MRI tests for example.

treatment depends on the stage or severity of TED. steroids are an option, but to be honest, i am not a big fan of steroids. personally, i think that steroids have multiple side effects and there is a chance that when a patient stops taking the steroid for TED symptoms, they may become worse. of course, as with ANY medication, you have to weigh the benefits versus side effects before deciding on a course of treatment. simple treatments include artificial tear drops and/or a lubricating ointment.

when i was researching this topic, i was frustrated in how little is known about this disorder. if you are a thyroid cancer patient , like me, and have received RAI as part of your treatment, then constant eye watering may be a side effect of the RAI and not necessarily TED. this constant watering may be caused by the RAI blocking a tear duct. if this is the case, a physician can possibly un-block the tear duct, and that may take care of the constant watering.

here are three more things to note: 1) TED can get better on it's own. 2) smokers are way more prone to TED than non-smokers and 3) there is a website which is supported by the Thyroid Eye Disease Association. i suggest that anyone with concerns, or who feels that they need more info on this subject check it out. the TED association goes deeper into the details of treatment, symptoms, etc, and would offer more support for those suffering from TED.

WHAT ARE THOSE PESKY LITTLE PARATHYROIDS, AND WHAT THE HECK DO THEY DO?

i like to joke around a little and say that two of my parathyroids left me  and moved to Paraguay!  ( i guess that is easier than the truth- that two of my parathyroids were cancerous and had to be removed). it was then and only then- you know the saying, you only miss something when it is gone- that i really started to think about our parathyroids. what  are they, what do they do, and why are they soooooo important?

well, they live near our thyroid gland- hence the name parathyroids. a fun fact, if you are a science nerd like me, is that most people have four of these, but some people have three, or even up to six! it would be sort of hard on the little guy, but you actually can get by pretty well with just one parathyroid gland. you do need at least one, as i said. if you happen to think being hypothyroid is difficult, being hypoparathyroid  seems ( to me, anyway) to be worse. the symptoms of hypoparathyroidism are as follows: muscle cramps/spasms,numbness or tingling in the hands or feet, tingling of the lips and in worst case scenarios, seizures. uh, no, thank you. 

our parathyroids are small glands near our thyroid glands. they look a little like a lymph  node,  and they produce  a hormone called( and brilliantly, i might add) parathyroid hormone, or PTH. our parathyroids  do NOT make  thyroid hormone, but the PTH they produce  regulates the calcium in our bodies. the PTH also increases the activation of vitamin d in our bodies. i could get more involved here, but i think you get the idea. as long as we can hang onto one parathyroid gland, life is good. if there is cancer present in all of the parathyroids, or you unfortunately get a surgeon who is not skilled in saving the little guys,  then hypoparathyroidism occurs. hypoparathyroidism can be treated of course, with mega doses of calcium and a drug called calcitriol, which helps with the absorption of calcium. needless to say, people who have hypoparathyroidism need to have their calcium levels checked regularly. there is also a more sensitive test for measuring calcium -it is called an ionized calcium level, which is usually reserved for those people dealing with hypoparathyroidism. 

well, now, kind of makes you appreciate those parathyroid glands. who knew, right? after my surgery, my surgeon was afraid that the blood supply had been cut off to my remaining two parathyroid glands. i was given large doses of IV calcium in the hospital, as well as calcitrol, and 12,000mg, yes, i said 12,000mg, of calcium per day. he prescribed this for one month, and then checked my calcium level. so far, my two remaining parathyroids are working pretty hard. my calcium level runs a little low, but is not in the hypo range. an interesting side note- when i asked my surgeon where he put my parathyroid glands since my butterfly had flown away, he said that he " just threw them back in there". i never got the answer to my question, but i would imagine that they are attached to some friendly " vessel". interestingly enough, sometimes the surgeon will put them in a patients forearm. i am not sure why this would be a good idea, but it would provide easier access i guess. regardless of where they are placed or " thrown back into" they need a good blood supply to pick up the PTH and get on with the business of regulating  calcium levels  in our bodies. 

Note: i published this blog back in 2013, but wanted to republish it now. i am going to discuss vitamin d levels, and this is a part of that subject. 

"low vitamin d levels and the hypothyroid connection". here is my disclaimer: no scientists were harmed in the writing of this blog. the opinions expressed are solely those of the author. ( hint: me)

 for some time now, i have been fascinated by the connection between low vitamin d levels, and hypothyroid disease- especially thyroid cancer. i have experienced low vitamin d  myself, and have known countless patients who have low vitamin d levels and also have hypothyroid disease or thyroid cancer.

just to review, vitamin d is so important for the body because it  aids in the absorption of calcium and phosphorous, which is important for strong bones. since this vitamin seems to be the " it" vitamin right now, research is being conducted on the importance/ roles  of vitamin d in our body. new studies on the benefits of  good vitamin d levels and the effects on  our bodies seem to be coming out every day.  an  adequate level  of vitamin d is  important for strong bones, and may be helpful in reducing high blood pressure, and  protecting us from some cancers- especially autoimmune ones( hint: thyroid). vitamin d is also thought to help prevent colon cancer, breast cancer, and one study finds that some patients with blood cancers have much improved survival rates with optimal levels of vitamin d. ( this study was cited by the mayo clinic website, if you want additional information on this).

what is an optimal level of vitamin d? it gets tricky here. doctors differ on what they think  is the optimal range, and of course testing from lab to lab varies. i will quote an article from the mayo clinic website which states that " in routine health check ups, between one- fourth and one-half of patients seen have vitamin d levels below the optimal range". i will now just throw out the range that my lab uses: from 30 to 80 ng/ml is the optimal range. my doctor feels that thyroid cancer patients should have a value of at least 60ng/ml. a level   over 80ng/ml may cause some kidney problems, so one needs to stay in the correct range. taking the correct dose of vitamin d  and having the vitamin d level checked is very important. the over the counter supplements come in doses up to 5,000 units. the prescription dose, and the dose i am currently on, is 50,000 units. this is taken once or twice a week, depending on the patient's level  and what the physician feels is appropriate therapy.

several years ago, when i was sick, and before the doctors knew what was wrong with me, my doctor checked my vitamin d level. it was less than 10ng/ml. that is obviously very  low, and probably was a first indicator( i think) that i might have cancer. i want to personally encourage all those patients with thyroid disease, especially thyroid cancer, to please get your vitamin d level checked, if you have not done so already.

it is also important to get adequate sunlight so that vitamin d can be activated in our bodies. i read somewhere that as little as 15 minutes a day is probably sufficient. today, we all rush to work before daylight and get home after dark. it is especially hard to get any sunlight exposure in winter. and the wide use of sunscreen makes it difficult for our bodies to get the sunlight that we need to convert vitamin d to its active form. i feel that, especially since i have also  had skin cancer, sunscreen is an essential part of good health care. so please do not stop using sunscreen!

another part of the calcium/vitamin d connection is our parathyroids. i really get excited talking about the parathyroids! this will be an entire blog- for next time. i also want to talk about a side effect of the I-131-which is  constant eye watering. this is something that i have just discovered, and in a related topic, there is TED, or thyroid eye disease. this is present in both hypo and hyper thyroid disorders. and how do you know, if you have had thyroid cancer and the I-131 treatment , if you have eye watering from the I-131 or you have TED? maybe by presenting the facts that are known about each, it will make things look a little clearer( no pun intended; well, maybe just a little).

Am i glowing? or is that just the radioactive iodine i have just had?

to quote my wonderful endocrinologist, " even the most accomplished surgeon can not possibly get all of the thyroid cancer cells." i do think that my endocrinologist is wonderful- i was not being sarcastic , but my surgeon( and his very large ego)  was not so happy to hear that he may have missed some of the bad guys.  so, after my cancer surgery, i had the option of having the radioactive I -131 treatment( to me it sounds like chemo- and that is what i usually call it) or not. it was a no-brainer for me. my tumors had " exploded " into my lymphatic system, to quote the radiologist, so there was no doubt in my mind that  some of those nasty little thyroid cancer cells were lurking around in my body, ready to cause mayhem and possibly start some thyroid cancer tumors elsewhere in my body. yuck.

to give a little bit of an explanation why use the I-131, to date, thyroid cancer can not be treated with traditional chemotherapy. although i believe that a new drug has been approved by the FDA to treat a certain type of thyroid cancer.( i do not have all of the information about this drug, but i can research it and get back to anyone who might be interested.) . but the norm for treating thyroid cancer after surgery is still to use the I-131. thyroid cells, cancer or otherwise, love, love, love iodine. our TSH stimulates the thyroid cells to gobble up iodine. so, if our thyroid is gone we should not have any thyroid cells left to munch down on the  iodine. after our thyroid surgery, the doctor will do a radioactive scan- using a small dose of radioactive iodine - that will show any thyroid cancer cells that have been left behind after the mother ship took off. to quote my radiologist again, my scan " lit up like a christmas tree." i decided that no matter what side effects that i might have, i would go ahead with the I-131 treatment.

to prepare for the treatment, i had to be on the low-iodine diet. we want those thyroid cancer cells to be very, very hungry when they do come across the radioactive iodine. my doctor recommended, and i agreed, that i get the thyrogen injections instead of being off of my medication for several weeks.i had to work, and i know that zombies are very popular now, but who wants a zombie to fill their prescription?  the thyrogen injection, or being off of the thyroid hormone replacement drug, will cause a pretty large  increase in TSH. TSH hormone encourages thyroid cells to eat (sort of like how your mother does ).

so i get my radioactive I- 131 dose after my two thyrogen injections ( one day apart). the technician that administered the dose looked like she was  embarking from a mission to the moon. the innocent looking capsule was in a glass vial inside a lead lined box. she handed a heavily gloved hand out to me and i took the capsule and swallowed. my mouth was sort of dry, so it took a lot of water. i had an hour to get home- that was when i would officially be radioactive. the radiologist told me not to go outside for three days. i said, " if i do, will the birds fall out of the trees or something?".

90 minutes or so after my I-131 dose, i felt very nauseous. i did not toss my cookies, but i sure almost did. i drank some cola ( my mom's cure for everything) and took a nap. i felt sort of funny- but i am not sure if i was just anxious about the treatment. i did have quite a bit of hair loss- but this could have  come from the removal of my thyroid and not just the I-131. the side effect that i am still dealing with, though it is not as severe as it was at first, is salivary stones . the I-131 gets into the paratid salivary glands and solidifies making " stones". it happened to get my attention for the first time when i was at work. my jaw/face swelled up and was hot to the touch. needless to say, it was painful. i have found that drinking lots of sour lemonade works just about better than anything. the sourness stimulates the salivary glands to get those stones moving. you can also use warm compresses, and taking ibuprofen may help with the pain/inflammation.

am i sorry i took the I-131? heck no. my hair grew back- mostly, though i still deal with a little more hair loss than the "average" person. the salivary stone issue has been bothersome, but if taking the I-131 has meant that i will be cancer free, as i have been for the past two and a half years, then it was worth it. everyone must make up his/her minds on this issue. RESEARCH, RESEARCH, RESEARCH!!! talk to your doctor and other health care providers, then make the best decision for you.

one thing though. i do NOT  like to hear- and it is up there with " thyroid cancer is the best cancer to have" issue, that the I-131 is not without side effects. as i said, it is thyroid "chemo" to me. no, it is not as bad as traditional chemo as far as side effects go. but it is not without side effects, and i do not like to hear doctors or other health care providers trivialize this treatment. to those of you who may be undergoing this treatment now, i wish you the best of luck.

for my next blog, i will stay on the thyroid symptom train, but it will be a surprise. i,e., i have not decided on a topic yet! but it will be forthcoming this week.

depression and hair loss-- uh, no thanks.

entire books have been written, and will be written, on the subject of depression. i think that everyone has some idea what depression is, thanks to the media. " depression hurts, blaa, blaa, can help" for one example. it basically boils down to our thyroid glands, when we suffer from depression related to  hypothyroidism,not being  able to supply the hormone necessary to help our other organs function properly. as a pharmacist, i see so many people on antidepressants. i know that these medications can really help in some cases. but, i would love to see doctors take the time to find out if the depression is caused by a brain  chemical imbalance, a hypothyroid condition, diabetes or other autoimmune disorders, a life event ( death of a spouse,etc) before antidepressants are prescribed. i will give you an example. i know a young woman who was suffering from depression and was immediately prescribed antidepressants. she improved somewhat, but was still having depression along with other symptoms that would indicate a thyroid disorder. she was finally tested for thyroid disorder, and BINGO, they discovered that she was hypothyroid. she was then prescribed thyroid hormone replacement, and is doing much better. it makes more sense to me, and is better therapy, to determine what factors are causing the depression and then use that information to determine treatment.

antidepressants can be a good option, of course, but so can talk therapy, exercise, and of course, just getting a diagnosis of hypothyroid disease, if that is the case,  and receiving treatment for that . we live in an " instant gratification" society. we want results, and we want them now. i understand that the patient wants to feel better right away . but i would like to see more investigation and more communication between the patient and health care providers before antidepressants are prescribed.  it is important to get this symptom of hypothyroidism under control because it has such an effect on the quality of our life. this is how things would work in my perception of an ideal world:  if you are depressed- and suffer on a fairly regular basis, get tested for hypothyroid disease. if you are hypothyroid, your doctor would prescribe a thyroid  hormone replacement drug for you. then use talk therapy and exercise and see if that helps. if you still do not have the quality of life that you desire, the doctor would try an antidepressant drug.

on the subject of hair loss, it also results from the changes in our metabolism due to decreased thyroid hormone. you only need to look at any women's magazine these days to realize how important good hair is! i would like to be able to tell everyone that there is a magic pill out there for hair replacement. there is not, i am afraid. being on the correct thyroid replacement dose helps of course. multivitamins may help somewhat- especially the b vitamins, but it not guaranteed. what may help a little is  to use a gentle, organic if possible, shampoo and conditioner. and of course, try not to overuse the flat iron or curling iron. these can be hard on our hair and we need to take care of the hair that we have! i had quite a bit of hair loss after the I-131 treatment  and my thyroid removal  surgery. but i am thankful that i did not lose all of my hair like some women do  who have "traditional" chemo after, say, breast cancer. one benefit of my job, i guess you could say, is that i always- every day- see people who have more serious issues to deal with than i do. that being as it may, i think that next time i will discuss the side effects, benefits,etc, of the I-131 treatment. it is a form of " chemo" and it is certainly not a walk in the park, as some doctors would like for us to believe.

" all aboard!!" here are two more symptoms of hypothyroid disease ( and hopefully some ideas to make living with them just a little easier)

today i am going to talk about the two "C's". one of which nobody likes to mention in polite company. and i am talking about CONSTIPATION . there, i said it. as a pharmacist i get asked about this problem every day. unfortunately, now i have some personal experience with this difficult hypothyroid issue. not everyone who suffers with constipation is hypothyroid of course, but i would bet that everyone with hypothyroid disease has struggled with constipation if not routinely, then from time to time.

when asked by a patient about what to do, i always take the natural approach. if a person gets "addicted" to a harsh laxative then that can lead to other problems- electrolyte imbalance, absorption issues, and well, heck, you have to go out and buy the laxative on a pretty regular basis. first, i  recommend some lifestyle changes, i guess you could say. make sure you are getting enough exercise- walking is great, and make sure that you are drinking enough water. fiber is important, of course, and a fiber supplement can be a good idea, but eating enough fruits and veggies is best. remember that red meat is constipating, and i am not talking about giving up red meat, just try to replace some meals with chicken or fish. red meat tends to take longer to digest and will remain in one's digestive tract for a lot longer than most other foods, thereby slowing things down. probiotics are great- i do not like the texture of yogurt, so i take a probiotic supplement. there are several good ones, but i have found that different ones work better for different people so one just has to try and see what works best for them.

this issue  takes some time to come to terms with- it is not an overnight fix . everyone lives a hectic lifestyle, and our schedules vary from day to day. i have found that organic, unfiltered ( has some apple puree in it) apple juice works well, prunes work well for some people. if worst comes to worst, and i am pressed to recommend something over-the-counter, i usually recommend a fiber supplement- powder, not pills( they can cause more problems), or a product like miralax. this is not a stimulant laxative, it is more like a fiber product, and can be taken for a period of time.i have to say here that if you have tried all of the above with no success , or have " bleeding issues" please see your physician.

now, on to the next " C". coldness. an under active thyroid means that our metabolism is too low, as we all surely know, and our bodies can not generate enough heat to keep us warm. sometimes i feel like i work at the north pole. i am the only hypothyroid person there- the others being either pregnant, pre-menopausal, or menopausal, or men. the air conditioning is on all year long and i freeze to death! i wear insulated silk cammies  under my blouses- layering is best, and i always have a sweater on under my lab coat. i have found,though, that at night i am the coldest. i know that my thyroid medication level is down, and my body is struggling to provide warmth. one simple tip that does help me at night, is wearing socks to bed. my husband likes a cool bedroom, so we turn the heat down at night. i have several blankets,etc, on the bed. i guess you could say that it is the concept of layering again.

i hope that i have provided some useful information and tips about the two "C's". i know that the topics have been discussed and then some, but sometimes it is good to review. next stop on our thyroid train ride will be depression and hair loss. see you then......

since you have a ticket for the hypothyroid train.....

ever feel like you have a ticket for the hypothyroid train? and that it is a runaway train, with no stops in sight? there are some inevitable symptoms of hypothyroid disease, and i think these are more pronounced with patients who have had total thyroidectomy ( cancer, graves, goiters,etc). i thought that i would cover some of  the most common, and heck, why not, some uncommon symptoms of hypothyroid disease- with an emphasis on those of us who are missing our butterfly.

i guess that my number one symptom, or complaint, is the persistent tiredness. now, i know that most people, especially this time of the year are tired- all the holiday festivities, and chores, but for those of us with a thyroid problem, it just seems like  too much to deal with  sometimes. of course, the best solution would be " get more sleep". sounds easy enough, but tell that to a mother with young children, or a not so young mother( ahem, me) who is taking care of her beloved grandson for the weekend. i try my best to stay away from caffeine- i have one cup of tea with caffeine in the morning to get my engine running, and the rest of the day i just drink decaffeinated tea. i think that too much caffeine will  cause the inevitable crash at some point. also, for those of us with blood pressure or heart issues, it can increase our blood pressure, or cause some heart palpitations. if i hear one more rave about how great raspberry ketones, or green tea extract is for weight loss or energy, i think that i will scream! these products are useless. raspberry ketones have been around for a long time, and the reason that the public has not heard of them is because one would have to eat about a wheel barrow load to get the desired weight loss effect. also, green tea extract is caffeine- a powerful stimulant, and this can cause the above mentioned side effects.

so, if you can not get more sleep at night, perhaps you can get in a short " power nap" during the day. this is not possible for me unless i am not working, as i am sure is the case for most people. actually, exercise is a great energy booster. i will admit that i sometimes want to back out of zumba class because i feel too tired to be there. luckily, my husband always encourages me to go. i find that once i get started, i get my second wind, so to speak, and i feel more energized for a day or so afterwards. now, if you do not enjoy zumba( or beautiful, sparkly, belly scarves) a brisk walk should do it. find your joy- find out what exercise you can do that is fun and does not seem like a chore. if you dread being there, going to exercise class, or whatever, you are not going to do it, period. that is" all i got" on this issue. if someone has other ideas, please let me know.

another important issue for hypos, is dry skin. and i am not talking about just a little dryness, think the Sahara desert. the best solution is to drink plenty of water- works from the inside out. besides, water is so good for many other reasons. i take two large water canteens( i just love ll bean) with me to work every day. i drink one before lunch, and one after. i think that this has really helped my skin. of course, it is also important to slather on plenty of a good body lotion- i like organic ones- less icky stuff to be exposed to- right after your bath or shower. slightly damp skin will just soak it up. reapply lotion to hands after washing, and to exposed face and skin after being outside in the cold and wind. do not forget your lips! i keep several tubes of lip balm with me- my pocketbook, beside the bed,etc, so that i can apply several times a day.

o.k. these are just two symptoms of hypothyroid disease. i will go over two or three more next time.i sincerely hope that these ideas will be helpful. i know they are simple ideas, and have surely been discussed before, but maybe it is a good idea to review them when one has a one way ticket on the hypothyroid train.

who's got a beard that's long and white? santa's got a beard that's long and white. who comes around on a special night? santa comes around on a special night. special night, beard that's white. must be santa, must be santa, must be santa, santa claus. ....reindeer sleigh, come our way, ho ho ho, cherry nose, cap on head, suit that's red, special night, beard that's white. ....dasher, dancer, prancer, vixen, comet, cupid donner, blitzen, must be santa, santa claus " i like the version that bob dylan does on his Christmas album, Christmas in the heart

i guess  you can tell that i have a little grandson in my family now! i get to sing fun songs( well, play them anyway),visit  the toy section( not that i did not sneak a peek before i had a grandchild) and generally share the christmas magic through the eyes of a child again. with all of the unspeakable tragedy that has come about lately, it is a reminder that life is indeed precious, and we should appreciate each and every day. the most important take away from having had  cancer is that i realize this fact, and have tried my best to incorporate it into my every day living. not that i am perfect by any means. i still let little stuff, usually at work, bother me more than it should. i rush around and do not always take the time to notice the good, little stuff that is all around us. i also worry too much about, well, everything. i think that i am stuck with the worrying thing, but i am making some progress on realizing what is really important, and appreciating the beauty around us.

on several blogs i have noticed that the authors give tips for " avoiding those holiday pounds". well, guess what? you will not read about that here! enjoy the good food- all things in moderation of course. it is a gift to be able to cook something special for your loved ones during the holidays. when i see my family really enjoying a special meal or dish that i have prepared for them, well, it makes my heart sing. the way i see it, we can all go back to healthy eating when we make our new year's resolutions. now, do you not feel better? so the advice here, is have that slice of pecan pie, or whatever, and enjoy it to the fullest! probably best to stop with one piece,though, but do not deny yourself one of life's simple pleasures.

i want to thank everyone who has been reading my blog this year and wish you all merry christmas/happy chanukah or whatever holiday(s) that you celebrate. i wish everyone much happiness during the holidays,  and if i could give everyone one gift, i would give you  the gift of time. that is one thing that we all need more of, isn't it? i will try to write more blogs this year that are interesting and helpful to cancer patients at all stages in our journey. when i was first diagnosed, ideas for  blogs just came pouring out. and i had so much to talk about- diagnosis, treatment, etc. now, i am sort of at a turning point in my journey( i prefer this over the word " disease") i still have the every six months testing to deal with, but in a way i feel like, o..k. what now? the doctors have fixed my boat up, done what they could, and set me back upon the water again. my life has changed in many ways, as i have said. most of them good. i am a two year cancer survivor, but i still think about having cancer every day. i try my best to be motivated and positive, and i am fortunate that i get to counsel patients at work on having hypothyroid disease, and yes, sometimes, thyroid cancer. i feel like i am making a difference- a small one, but a difference none the less.

i received an email from an organization that i think might be helpful to other cancer patients. it offers support through homemade( and beautiful) cards. the website address is: http://www.cardcareconnection.com. i think that sending  a beautifully hand made card is a nice way to show support for a cancer patient. my daughter's students ( she teaches ninth grade english, bless her!)  all made me  cards before i had my surgery. i just can not say how much those have meant to me. so, check it out and enjoy.

How is everyone holding up?

this is such a hectic time of year! exciting, fun, reflective,but hectic. i started early on my Christmas " chores" this year, for once. but i still find myself worrying that i am getting behind on my schedule. this is an " every other" year for me. my husband and i have grown children- and one grandchild, of course, and we have to share their presence on holidays. we did not get to see them on thanksgiving this year, but Christmas is at our house! i am getting so excited about having everyone here at our house for the holidays. there is a lot of work- outside and inside that needs to be done before then, but my husband and i really enjoy getting everyone together. our grandson has been the "glue" that has kept our family  together after my dad passed away last year. it was a blessed event after our family tragedy.

depression is a serious result, or symptom of thyroid disease. this is sometimes magnified during the holidays. i miss my mom and dad so much, and i think about all of the happy times that we had together during holiday celebrations. sometimes people are embarrassed to admit that they are depressed. it is a medical condition, and as i mentioned, a symptom of untreated, or under- treated hypothyroidism. there is not any reason to be embarrassed to ask for help with this issue. talk therapy, exercise, a correct dose of thyroid medication can all help. if this fails, then anti-depressants can be helpful. think of it as having high blood pressure, or diabetes. it is a health condition that needs to be addressed and treated. i think that for the most part, people are understanding this and do seek treatment as they would for any other health related issue.

i can not stress enough how important getting enough sleep is! adequate sleep helps our immune system ( very important this time of the year!) and decreases the levels of cortisone in our bodies. increased cortisone can lead to a multitude of problems, ultimately leading to stress on our immune systems and perhaps making us vulnerable to disease. this news is flooding the magazines now, but i think that it is important. if we can do this one simple thing to improve our health, why not?

i started early this year, as i said, and it has made for a less stressful time for me. ( notice i did not say stress free). when i get too wound up, i think about what this time of year really means to me. family time, helping others less fortunate, and yes, taking care of myself so that i can care for my family. if i had one wish for everyone i would wish for more sleep for you, and a less stressful, but joyful holiday season. getting chores done is necessary, and can be fun, but take time for yourself. a bubble bath, reading a book, yes, even taking a zumba class should be on the top of your " to do" list. maybe i will see you there.

"Grandma got run over by a reindeer. walking home from our house, Christmas eve. you can say there's no such thing as santa, but as for me and grandpa, we believe. she'd been drinking too much eggnog, and we'd begged her not to go. but she forgot her medication, so she staggered out the door into the snow........now the goose is on the table, and the pudding made of fig. and a blue and silver candle , that would just have matched the hair in grandma's wig." Grandma got run over by a reindeer, by elmo and patsy

after you have thyroid cancer, and lose your butterfly, your body goes into full blown  hypothyroidism. before i found out that i had thyroid cancer, and before my surgery, i had some of the classic hypothyroid symptoms, but not all. now, i find that i have every single one of them. so, along with dealing with the challenges of have had( hopefully) cancer- both physical and mental changes, i find that my body is on turbo-hypothyroid mode. this has presented challenges for me- i am still trying to adjust to  and deal with some of the changes. 

since i am now a proud, first time grandmother, i feel that i can use the lyrics of this humorous holiday song to illustrate some of my problems.i honestly think that it the grandmother in this song had thyroid disease- maybe she was distracted ( another symptom) and that is why the reindeer got her.

first example: the title, or "grandma got run over by a reindeer". i feel like that reindeer ran over me,too. i get so tired, well sometimes, beyond tired. i know this is a busy time of the year- so many things to do, even if they are fun things. but these holiday errands or chores( hate to use that word) are just added onto work duties, house cleaning,etc, and all the other things that we all have to do everyday. i have been trying to go to bed earlier, but i find that this time of year i tell myself, well, i will do  just one more thing before bed...... and of course i end up getting less sleep.being tired is probably the number one hypothyroid "problem" for me.

next, she'd been drinking too much eggnog. well, i do like to have a glass of organic wine now and again. but i read in one of my thyroid books, that the "hypothyroid liver", to quote the author, metabolizes alcohol in a different way than a normal person's liver does. guess i will have to pass on the eggnog this year.

"she forgot her medication". oh the horrors of that! that is truly a disastrous event for me, or any other hypothyroid patient. i forgot my thyroid supplement the other day, and i just had to drag myself through work. amazing how much thyroid patients depend on that one little tablet in the morning to get us through the day! and of course, it must be taken on an empty stomach, first thing in the morning, to get the full effect. i had that fuzzy( but not warm) feeling the day i forgot to make my medication.

about hair loss ( grandma's wig). i lost quite a bit of hair, actually, after my surgery and I-131 treatment. it has mostly grown back in, but some days i feel that i could use a wig! the texture seems to have changed also. this is an important issue! you only have to glance at the magazines in the store to realize how much hair matters to women( and i secretly think to men,too. even if they are not going to admit it) 

so grandma had an untreated thyroid problem, and as a result, got run over by a reindeer. hopefully this grandma can make it through the holidays without incident. and by the way, i have ALWAYS believed in santa. 

" i have climbed the highest mountains, i have run through the fields, only to be with you, only to be with you.,,,,but i still haven't found what i'm looking for. i still haven't found what i am looking for. " i haven't found what i am looking for, by U2

i STILL did not get to see the wizard, but i did get good news yesterday! my diagnostic mammograms on both sides were unchanged, no monsters present, i guess, so i get to go back to yearly, not bi-yearly mammograms! yippee!!! perhaps someone thought that thyroid and skin cancer were enough for me to have to deal with. i really was not worried about the results of the test,though. i was just afraid that things would snowball, and i would be having a biopsy,etc. like i said, i am sick, sick, sick of testing and would like to take a break from it for a while. my next thyroid ultrasound/blood work tests are in march- i will deal with those at that time.

i talked to a friend of mine the other day. she had breast cancer and i asked her how she was doing. she said that she was doing great, feeling great and for the first time in eight years she actually did not spend a part of every day thinking about having or having had, cancer. wow, that is my goal! i am not there yet, being a two year cancer survivor. i was looking forward to the  "the five year" all is clear, shout hooray, mark, but my endocrinologist spoiled it for me. when i asked her if the five year mark was the end of worry, so to speak, she said no, that  unfortunately she had a patient who had a recurrence after seven years. darn. this lady has to repeat the I-131 and add on a little radiation. i have not had the heart- even if she could/would tell me- how this patient is doing. my endocrinologist told me( she knows what a worry wart i am) that if my cancer does come back not to worry- " we will get it".

i started using my imagination and tried to figure out how they would "get it". perhaps a trap? what bait would they use? perhaps they could offer up my last two parathyroids- sorry, boys, someone has to do it. they took out eleven lymph nodes,too. i am still getting some salivary stones two years after my I-131 treatment. they cleared up for a while, but THEY'RE BACK! of course, i have to remind myself that the painful lumps in my jaw area are  just that-   salivary stones- and not the nasty thyroid cancer  cells invading my lymph nodes. i would feel more comfortable about my blood work  if i did not have thyroglobulin antibiodies. this condition is very confusing to me. i have read and re-read the section in " my favorite" thyroid cancer book by sara rosenthal. i even asked my endocrinologist about it. ( i actually pointed out the section in the book during my last visit with my endo) . my endo said, well, it says here your body makes the thyroglobulin antibiodies. o.k. i get that part- but where? why? is there a better blood test available for those lucky people like me who mysteriously manufacture those antibiodies? bless my endocrinologist. i know that i am a pain in the butt.

so i am not" one with my body" again. i do spend some part of most days thinking about my cancer. there, i admitted it. but i have so many great things going on in my life now. i have a wonderful family- including the cutest grandson on the planet- and there is my faith, of course, and last, but not least, Zumba! yes, that exercise class keeps me from totally losing it. i enjoy my work, most of the time, and i have some great friends. until the time i can truly say i am rid of, done with, over that, had enough of , etc, cancer , i will live my best life. whoops, sorry oprah. i think that you said that first.

"....go with the funk, it is said. that if you can't groove to this, you probably are dead. so wave your hands in the air, bust a few moves, fun your fingers through your hair. that is it for a winner, dance to this and you're going to get thinner. move, slide your rump, just for a minute, lets all do the bump, bump, bump. break it down! stop. hammer time!! you can't touch this! " can't touch this, by mc hammer

boy, just typing these lyrics is not nearly as fun as listening/ dancing to the song! it is not a zumba song, that i know of, but it would be a really good one! zumba has indeed made me thinner- or at least toned me up. i have noticed that is the case for many others in my class. it is so much fun, we hardly know that we are exercising. of course, i get so red in the face- no matter what i happen to do. i look like i have just completed the boston marathon or something. i used to be so embarrassed about this, but there is nothing that i can do about it- to prevent it from happening,etc. ( it is the red hair/freckles thing). there is a woman in my husband's spin class who does the same thing, so at least i have company.

next week i get to go to the imaging center for a double diagnostic mammogram. i am not sure why the radiologist is picking on me..... six months ago, i had a diagnostic mammogram on one side, and at that time he told the nurse to tell me that i would be having it done on both sides in six months. is it because i had cancer? is it because( some people believe this, some do not) i had a rather large dose of the I-131? and that may cause  me to  have a slightly  higher chance of having  breast cancer? i have questions to ask, and i believe that i am somewhat better informed this time. i wish that " the wizard" would come out from behind his curtain( he communicates with me via the nurse) and talk to me! perhaps i can smuggle toto in there to help me. he may in fact be the same " wizard" that administered my dose of I-131 two years ago.( well, he calculated the dose and had his space suit clad assistant bring it to me )  i decided not to go for the " deer in the headlights" look this time. i have questions, and by golly, if i have to pull back the curtain myself, i intend to get some answers!

you might be asking yourself why this song popped into my brain. i have decided that no matter what the doctors do to me- biopsies, surgery, I-131, ultrasounds, blood work, mammograms,etc, THEY CAN'T TOUCH ME. of course, they physically touch me, but " myself" inside belongs to me and me only. i am still the same person no matter what. i appreciate that the doctors are trying to take care of me, and i realize the importance of testing, but i am pretty sick of it.

so next week, while the wizard is hiding away in the next room, and the technician has me clamped down to the machine, i am going to be humming " can't touch this". if i get bad news i will deal with it. if i get good news, well..... i will go shopping of course. maybe i will go shopping anyway. then on to zumba class. maybe i will suggest this song to the instructor.