Dear Thyroid

Dear Thyroid,

I'm just going to keep this short and sweet.  Today marks one year since you left me, so I've had some time to reflect on things. While there are some things I miss about you (clarity of thought, waking up refreshed, not relying on a daily medication to do your job), I have come to the realization that I don't actually miss you. You were making me sick, but in such a sneaky, ninja-like way that I never even realized it until you were already gone. Therefore, I am glad you were evicted. 

And although I don't miss you, I do have you to thank for a couple of things.  First of all, your absence helped me to see just how strong I can be during difficult situations. Thank you for that. I would also like to express my gratitude for causing me to truly appreciate this life I get to live. My days may not always be perfect or happy, but I am at least able to find one moment in each day that I'm thankful for getting the opportunity to experience.

I'm just going to leave you with this thought...

#sorrynotsorry

Sincerely,
Alysia 

PS - I've been wondering: Where do diseased thyroids like you actually go once they leave??? Hmmmmmmm...maybe we'll save that discussion for another post.

That Sick Feeling...

Almost one year ago - August 28, 2015 to be exact -  I got the phone call that my biopsy results were abnormal.  That is a day I will never forget. The sick feeling in the pit of my stomach and the strength of the emotions I felt that day are indescribable. 

Recently, that sick feeling has begun to creep back into my life again. And it wasn't until a conversation with some close friends at the lake last week that I realized I haven't shared this update publicly yet.  I'm hopeful that writing about this today will help calm some of my anxieties and bring me a little bit of peace. 

In late June, my labs didn't come back with the results we would have liked to see. My TSH was up to 1.77 from 0.18 back in March and Tg (Thyroglobulin) rose from undetectable to 1.8, which is the most concerning piece of the puzzle. The thyroglobulin test is also known as the tumor marker because it measures the amount of active thyroid tissue in my body. Theoretically, I shouldn't have any thyroid tissue left due to the RAI treatment I had last November.  When the Tg levels rise after RAI, it can indicate that the cancer is returning (cue the sick feeling). 

In the spring, my doctor reduced my Levothyroxine dosage back down to 88 mcg from 100 because I was having frequent and strong palpitations on the higher dose.  We are hoping that this change is the cause of my numbers being off.  It's like a chain reaction.  The medicine isn't high enough to suppress the TSH, so it stimulates the thyroid tissue (both cancerous and non-cancerous), thus the Tg goes up. Since my June appointment, I have been back on the 100 mcg dosage in the hopes that my levels will return to normal here in a few weeks.  He also put me on a beta blocker to reduce the side effects of the heart palpitations. 

As I am now approaching the one year anniversary of receiving that phone call, I can't shake the thought of how significant this next set of labs (planned for the last week of August) will be.  I am hopeful that August 28, 2016 will be a much more joyful one than last year's.  I would appreciate your positive thoughts, prayers, and good vibes over the next few weeks as I brace myself for the results.

Time for a Checkup

This week was another round of labs and doctor visits for me, which also meant another round of bruises left behind from the needles. I seriously bruise like a peach! I'm okay with these little remnants of my time in the lab though, because I know how important the results are to my health. Yesterday was my meeting with Dr. Thomas. The first thing we discussed was my TSH, which determines whether or not my current dosage of my thyroid medication is working properly.  Because I was diagnosed as Stage I with a lower risk of recurrence, my results this time around of 0.4 was a great number. Patients who are not free of disease or who have a higher chance of the cancer returning usually need to be suppressed to a lower level than that.  He is also hesitant to try and suppress my levels any more because of the heart palpitations I have been having. So, I'll keep on truckin' at 100 mcg!

Another very important test that they did was on my thyroglobulin (try saying that 3 times fast), otherwise known as the tumor marker. The results on this one help us to see if there might be any cancer trying to return. Ideally, the thyroglobulin levels should be as low as possible (close to zero) because I should have no cancerous cells left. This time around, mine was less than 0.1, or barely detectable. As my doctor monitors me over time, those levels should remain constant. If there is an increase, that is a signal that the cancer is recurring.  

While my physical health has been pretty great lately, I have noticed some new patterns in my moods and in the way I handle stress.  I have noticed an increase in feelings of anxiety and my emotions have been on a bit of a roller coaster lately. I talked with Dr. Thomas about these symptoms to try and get to the bottom of what is going on. There are a few things that might be happening. One possibility is my medication still trying to regulate all of the hormones and balance everything out. Another is just more stress than usual combined with the fact that it's winter. Or, it could be that (even though I may not voice it out loud) there is still a fear in the back of my mind about my cancer and the potential of it returning. He said that this last one is fairly common within the first year or two of a diagnosis too. All of this is really good to know because I was starting to feel a little crazy.

What I'm learning through this process is that, for the most part, I just go about my daily life and don't give cancer a second thought. Everything is normal. I feel generally healthy and happy. Life goes on. And then there are weeks like this one that lead up to those lab results. Weeks when I let the fear and worry about my health get the best of my emotions and I just can't deal with it all. If you're around me during those days and I start to act unlike my normal self, would you do me a favor? Just smile and tell me everything is going to be fine.

A Weighty Subject

Okay, here's the deal. I'm thin. I've always been thin and I am constantly reminded by people around me about my body size. Aside from the genetic factor, the main contributor to my twig arms and legs used to be my overactive thyroid.  My metabolism was kicked into high gear for who knows how long. Once my thyroid was removed, one of my fears was that its absence would cause me to gain weight. While I didn't gain a substantial amount of weight like other thyroid cancer patients I had read about, I did gain some.  This is not uncommon for patients who have undergone a thyroidectomy, especially those who have a difficult time getting their medication regulated.  Not to mention so many patients who are completely taken off their medication for weeks at a time before their treatments and scans. Talk about a roller coaster ride!

After my diagnosis, I decided that as soon as my recovery and treatments were done, I wanted to try and find ways to be a much healthier version of me. I wanted to take control of myself and my body back because I felt so out of control for so many months.  When a co-worker offered the chance to sign up for a weight loss challenge, I saw it as my inspiration to try and reach my goal to be more conscious about my health. And you know what? I'm glad I signed up. Did people question my intentions for joining the challenge? Yep! Have I had to dodge comments about my weight? You betcha! Am I going to win the challenge?  Not a snowball's chance in a CAT scanner (ahem - Sheldon).  But for me, that's not the point at all. In fact, I don't WANT to win. My $10 entry fee was a total donation to whomever the amazingly dedicated person is that loses the most weight. I wanted to shed the pounds that I gained after my thyroid was removed...and I'm proud to say that I did! I am slowly working my way back to being stronger and healthier, and that's all I really care about.

Let's all just stop and think about this for a minute: How many of us would ever consider telling a woman how fat she is or that she should really work out more? So, why is there a double standard here? I hear comments all the time about how skinny I am or how I don't need to work out because I don't have any weight to lose. This makes me feel incredibly awkward and guilty for wanting to do something that makes me feel good about myself. 

None of us want to feel judged about our bodies, regardless of what size we happen to be. Can I get all hands in now as we agree that we will shower each other with encouraging phrases like, "Wow! You look so great today!" or "Diggin' the new scarf! It really complements your eyes" or "I hope you are feeling as good as you look today!" Who knows? Maybe it will help us all feel a little better about ourselves!

Kid President Is My Hero

It's Thanksgiving Day and I definitely have a lot to be thankful for this year.  I had my follow up appointment with Dr. Thomas yesterday, and the results from my scan were even better than expected!  When they called with my results last week, all I knew was that there wasn't any evidence that the cancer had spread outside of my neck area.  In yesterday's appointment, the doctor said that they actually didn't even see any activity in my neck...which was pretty shocking to all of us!  Because of such great scan results and the fact that my bloodwork was also looking really good, I won't have to go in for another round of scans for a year.  I will have more labs done next month to see if we need to make any adjustments to my medication, but everything is really positive right now.  And just in time for the holidays!!

Kid President is pretty much my favorite.  I love his positive energy and his sense of humor. I love the fact that I can show his videos to my children and my students without hesitation. Last week, he came out with a new video about thankfulness that has really encouraged me to stop and think about what I'm thankful for - no matter how big or small those things may be.  You know...sometimes you just need to be thankful for pants.

I decided to narrow mine down to my Top 10 List today so I can spend as much time focusing on food and family as possible:

1. Belly laughs.  The kind that can cause tears of laughter.
2. Slipper socks in the winter time. Because I hate having cold feet!
3. Yellow bag Lays and Peanut Butter M&Ms.  If I have to explain this one to you, then we can no longer be friends.
4. Baby cheeks.  The bigger, the better!
5. Coffee.  Because...coffee.
6. Music. All of the music.
7. Impromptu dance parties.  These really are the best and if you've never participated in one, you should try it today.  For realllllllzzzzzzzz.
8. Siri.  Because it's really fun to ask her stupid questions just to see how annoyed she'll get.
9. Friends. I really feel like you can never have too many.  I feel truly fortunate and grateful for every friendship I have made.  I have the most amazing people in my life.
10. Curiosity.  It's what makes us smarter.  I especially love the curiosity of children.  

There are dozens of other things I could add to this list, and maybe I will next year.  Today, I challenge each of you to think of the things you're thankful for.  Feel free to comment below. I love hearing from all of you!  

Until next time, I hope each of you have a wonderful Thanksgiving filled with food, family, and FUN!

XOXO

A Fading Scar and a Blossoming Friendship

There have been lots of things about the past week that have been difficult.  One of the hardest is being separated from my kids.  At this point, it is safe for me to be in contact with other adults (hooray!)...but still not children (boooooooo!) since their little thyroids are so active in helping them grow.  Any radiation they might receive from my treatment could be damaging to their growth.  I returned home yesterday since I am able to sleep in my own bed now, which is great because I can actually SEE my kids (from a safe distance, of course).  But, it has actually been much more emotional for me than I thought it would be.  I can't hug them yet, or kiss their little cheeks, or pick them up when they fall, or snuggle with them on the couch.  It's just so hard. I can't wait until I'm able to do all of those things later this week!!

One piece of good news is that I had my final visit with my surgeon yesterday and he thinks my scar is healing nicely.  I think so, too.

I still have numbness from the top of my scar to my chin, which will hopefully return to normal within the next year.  But, if not...there's really not much anyone can do about it at this point anyway.  I guess that's a small price to pay compared to having a tumor. 

One thing that makes me super cool right now is that I get to carry around this card...

You know...In case I get pulled over for emitting radiation!!  Don't be jealous.

While this week has obviously had its share of hurdles, there has been one bright, sunny spot. I have made a couple of new friends who are fellow travelers on this long, strange thyca trip. I am so truly thankful to be able to connect with other women who can identify with exactly what I'm going through right now.  One friend, I met in person on Saturday since both of us were "glowing" with radioactivity.  Her name is Lindsay, and although we forgot to take a selfie after our relaxing walk together, we decided that if people ask about our scars whenever we're together, we are going to share the story of our nasty gang fight.  Our Bitmojis speak for themselves.

I have also connected via text message with another girl named Laura.  The three of us are planning to meet for breakfast this Saturday, so I am very excited about that and can't wait to meet Laura in person, too!  

I'm Radioactive!

This has been a very important week in my treatment.  This part of the process is called Radioactive Iodine (or RAI) Ablation.  This treatment is specific to thyroid cancer patients because of the thyroid's unique ability to absorb iodine.  Basically, the idea is for the radioactive iodine to seek out and destroy any remaining thyroid cells left in my body, which should ablate those nasty cancer cells too.  I got my dosage of RAI yesterday, so I have spent the past 24 hours or so picturing this happening inside my body:



Extreme?  Perhaps.  But I've had a lot of time on my hands to think about this stuff in the past few days.  Here's a timeline of my week:

Monday:

I was admitted to the hospital for my first Thyrogen injection.  Yep.  They admitted me (bracelet and all) to give me a shot in my hip.  The purpose of this injection is to enhance the uptake of the RAI without having to take me off my daily thyroid medication.  I am SO thankful I was able to take this route because I definitely want to avoid being taken off my Levothyroxine.  I was at the hospital for approximately an hour on this day, which seems like a long time just to get a shot.  But they had to go through the whole list of questions they ask when you're admitted to the hospital, plus I had to wait there for at least 20 minutes after my shot to make sure I wouldn't have any reactions to the Thyrogen.  Overall, it was no big deal at all.  

Tuesday:
Back to the hospital for Thyrogen injection numero dos.  This time, I walked right in and right back out.  I was feeling the effects of the injection though.  They made me extremely tired, and I also experienced headaches and some nausea.  In the grand scheme of things, I'd much rather have that feeling for a day or two than several weeks of fatigue.  

Wednesday:
D-Day.  Time to head back to the hospital and get all sorts of radioactive.  The morning started with a trip to the lab to test my TSH (thyroid stimulating hormone) levels to see if the Thyrogen injections did their job. The goal was to elevate my TSH levels as much as possible to help stimulate any remaining thyroid tissue to take up the radioactive iodine.  The normal TSH range is 0.358 - 3.740 uIU/ml (whatever that stands for), and mine was 155.  So, I'd say I was pretty elevated!!  Pair that with my low-iodine diet, and those little cells should be HUNGRY for that iodine.  I feel ya, little cells.  I am, too.  No, seriously...I'm having dreams about cheeseburgers and milkshakes.

After the lab fun, it was up to the 2nd floor to Nuclear Medicine.  Sounds scary, huh?  I always feel like there should be some deep, spooky voice bellowing that out from the dark of night. Maybe with a sinister "muah-ha-ha-ha-ha" afterwards.  So, off I went to the magical...er...depressing waiting room in Nuclear Medicine, or Nuke Med as my new pals at the hospital call it.  I figure I can use that lingo now, too since I'm pretty much a regular there these days.  This was the darkest, quietest, loneliest place on Earth where I spent about an hour, although it felt like I might die of loneliness and starvation there.  Did I mention that I had to fast for this?  So, there's that.  Here's my view as I sat there (sing it with me, now) -  Allllllll byyyyyyyyyyy myyyyyseeeeeeeeeeeellllllf.

All of that alone time did give me a chance to peruse the paperwork the Nuke Med doctor had asked me to sign during our very brief and very awkward consultation just a few minutes before. Here is the list of my Dos and Don'ts I will be following for about the next week or so. I'm learning that it seems to be a different list of instructions for each patient and each doctor, but I will be playing it safe and following my rules, and maybe even taking extra precautions for a while.

I was scheduled to get my RAI dose at 10:00, but I wasn't able to take it until the lab results came back.  I guess the main thing they needed to confirm was that I wasn't pregnant.  Makes sense - We don't need no radioactive babies roaming around.  At around 11:00, the nurse called me back and said, "Congratulations! You're not pregnant and you get to ingest this radioactive substance into your body!!"  Or something like that.  

She took me to a room that had one of these signs on the door, which was a little unnerving: 

The room was more like a closet, really.  And the rest, my friends, is pretty anticlimactic.  She opened up a container that looked like this...

...and took out a little plastic tube containing the 100 mCi pill I would need to swallow.  She handed me a bottle of water as well as the plastic tube and down the hatch it went!  Then she told me to head on out and follow the instructions the doctor gave me.  And that was it.

I felt weird walking near other non-radioactive people in the hospital. I felt kind of like I was in a game of Frogger.  People would walk toward me and I would step to the side to avoid any direct contact.  I felt like I should be wearing a radioactive sign around my neck to warn people to stay away! It also took a while to find an elevator that wasn't absolutely packed with people.

After I safely exited the hospital, I got in my car and drove myself to my home-away-from-home for the next several days.  My mom and dad's house!  Waiting for me when I arrived were some yummy low-iodine snacks, a beautiful vase of flowers, a coloring book for when I need something different to do, and a warm Snuggie to snuggle up in.  

I can't say that I feel any different after getting my RAI.  I felt a lot of warmth coming from my stomach area for a little bit yesterday, but nothing dramatic is happening.  I just hope that the RAI is doing its job and that this part can be behind me.  Here's a glimpse at what I've been up to so far in the past 24 hours:

Warm snuggie time

Beautiful flowers

Halfway through this book

A Chef Mary low-iodine specialty

Sometimes it's just fun to color!