Some of you know that I've got a malfunctioning thyroid gland. This was discovered when I went to a family practitioner in May of this year complaining of excessive tiredness. The doctor ordered some blood tests and, by nothing short of a miracle, eyed a slight bump on my neck when I was chatting with her at the end of the appointment. She ordered an ultrasound of the lump, which confirmed that it was attached to my thyroid. The blood tests showed low TSH, which indicates a hyperthyroid condition. Follow-up blood tests showed that my thyroid hormones were within a normal range. The doctor said I still have hyperthyroidism. She referred me to the Internal Medicine Department.
In going to my appointment at Internal Medicine in June, I expected a quick fix: some medication to correct my thyroid hormone levels, (which would perhaps shrink the nodule?), and I hoped to be feeling better before our summer trip to the states so I could fully enjoy myself. But one of the first things the doctor told me is that it was going to take a while longer to figure out what the problem is. My blood work had some difficult-to-diagnose results. It showed a couple of antibodies which can indicate Grave's Disease, the most common form of hyperthyroidism, but more tests would be necessary to get a diagnosis. He referred me to the Nuclear Medicine department for two tests--a radioactive iodine uptake and scan--which would require me to go on a low-iodine diet for 3 weeks, and, once I took the dose of radioactive iodine, I would not be able to breastfeed anymore. The tests were postponed until after our summer vacation to the states, when a restricted diet would be more feasible, and when Nicole would be more ready to be weaned.
So, I went on our summer trip and struggled with more tiredness than usual, and opted out of some activities, but jumped in and participated in others, such as a quick side trip to Niagara Falls and Palmyra, New York. I was glad I went and, as a whole, I enjoyed the summer.
Soon after we got back to Okinawa, I scheduled my radioactive iodine tests and began my diet. They had emailed me a cookbook of low-iodine recipes, which was a huge help. On this diet I had to avoid iodized salt (and thus, almost all packaged foods), tap water, most dairy products, soy products, and seafood. I was allowed a cup of milk per day and occasionally an egg in a recipe. I made my own bread and peanut butter and used fresh ingredients for most of what I ate. The first six days were pretty hard because I had to make such a big change in my diet and didn't feel well. But soon I felt better, and Paul helped a lot by preparing good food and selecting doable recipes. He even made me some homemade ketchup, which was useful for a couple of the recipes, since we don't have unsalted ketchup at our grocery store on base.
I was concerned about weaning Nicole because she had thus far rejected bottles. Actually, she was rejecting both formula and whole milk, not the bottle. She's doing a little better now. I mix chocolate syrup with her milk, and I'm slowly decreasing the amount of chocolate syrup I add.
I cried when I nursed Nicole for the last time before going in for my tests on Sept. 13. I had never been forced to quit breastfeeding. In fact, my other babies had always self-weaned by their first birthdays once my milk supply had diminished. Nicole was two weeks shy of turning 1, but I was still sad to do it this way, especially since I couldn't yet enjoy snuggling with her with a bottle, because she always pushed it away.
I asked a lot of questions of the technician doing the tests. Her name was HM1 Gibbs. I don't know what that title means, but remember this is a military hospital. I also had talked with her on the phone several times with questions about the diet, breastfeeding, etc. She seemed very good at what she did, but she told me my questions had helped her learn more about her job rather than just going through the motions. She even told me that because of my questions, she did some research and then convinced her superior to shorten the low-iodine diet to two weeks rather than three! So I'm the last person that had to do the diet for three weeks! But it's satisfying that I indirectly affected those who would have to do this diet at this hospital in the future. That's 4-5 people per month, she said. I wasn't too discouraged about having to do the test for an extra week since the last week wasn't too hard.
HM1 Gibbs told me as much as she could about my results. She told me that (1) the amount of the radioactive iodine my thyroid absorbed was way above the normal range (which, when I Googled that, I learned
could confirm the diagnosis of Grave's Disease), and that (2) the nodule on my thyroid was cold; it did not absorb the radioactive iodine. I think that means it doesn't produce extra thyroid hormones.
I was very curious about hot and cold nodules, so of course I Googled that, too. I read that if it were hot, the next step would be either surgery (total or partial removal of the thyroid) or partial destruction of the thyroid using a much higher dose of radioactive iodine. I wanted neither! But for a cold nodule, the website indicated that the next step is fine needle aspiration of the nodule to check for cancer, and if it's benign--which is probably is--they can probably leave it there in my neck. But anyway, I'm just guessing. You never know about these websites. Plus there may be more interpretation of my tests which will provide more information about my treatment.
It seems to me that there are two aspects to my treatment: the hyperthyroidism and the thyroid nodule. How will they treat the hyperthyroidism? I'm having to be patient. In any case, I have confidence that they can fix me. I'm looking forward to feeling better, and to adding a couple more wakeful hours to my day.
I will meet with my internist on Sept. 29 to find out more. I'm excited! (Yes, that is the best word I can come up with. I'm truly looking forward to finding out what's next.)
