Thyroid Blues

Herein the author discusses medical stuff. Feel free to pass this by, with a clean conscience. There will be no quiz later.

I’ve been debating, internally, whether or not to post this for quite a while. I’m a latecomer to social media, and still have mild conniptions over sharing certain types of information. On the other hand, this amounts to a medical excuse for laziness, which is kinda cool. And there’s always the chance that someone out there will read this and recognize something and go see their gland wallah and get fixed up. It’s probably about the same chance as that this ticket with random numbers on it will turn into a check for a few million bucks, but what the heck.

So the short version is that I recently had my thyroid yoinked, which is having some interesting side effects, one of which is to give me new perspective on my life for the past twenty-odd years. The bad news is that I am really tired these days, tired beyond all normal definition of the word (and I’m someone who used to stay awake for days at a time for fun, so I’m well acquainted with normal and abnormal definitions of “tired”). The good news is that maybe what I thought was my brain malfunctioning was just this damnable gland. Onward to the long version:

I moved to Iowa about a year and a half ago, and for the first time in years had access to health care (a subject for another post). One of the many complaints I brought to my doctor was this lump on the side of my neck. I’d visited my parents’ doctor in Pennsylvania once, and had asked him about it, and he said it was a harmless lipoma, a fatty tumor that could only cause problems if it grew too large, so I could ignore it until then. So I was somewhat surprised to ask the doctor here about it, intending to find out whether my insurance would cover its removal, and have her tell me, “That’s your thyroid, and that is not good.”

Compressing things from there (they were interesting, in a not-so-great way, at the time, but would become tedious here): I went to see an excellent endocrinologist, and she told me that it was the largest thyroid she’d ever seen, so I’d better get a biopsy. I got the biopsy, and they said maybe it was cancer and maybe not, so I’d better have it out. I talked to an excellent otolaryngologist who specialized in thyroid removal, and he said it was the largest thyroid he’d ever seen, and kindly took it out of me. (The surgical team visited me as I was recovering, in order to tell me en masse  that it was the largest thyroid they’d ever seen. Have you noticed a trend?) Oh, and it was cancer, natch.

So now comes the fun part. The thyroid is one of the more important cogs in the body’s automation, what my endocrinologist calls the thermostat. Simplified, it regulates your metabolism. It determines how much energy you have for running around, climbing trees, chasing butterflies, going to work, being productive, doing anything with your day other than pulling the covers over your head and occasionally whimpering. Through attempting to dial in the dosage of synthetic thyroid hormones, I’ve been experiencing a range of energy levels, a process which has been most enlightening.

I’ve been struggling for many years with what I thought must be depression, or dysthymia (which, for those who haven’t encountered it, is more-or-less chronic depression minus the active desire to end one’s life). My ability to get things done, to get life done, had been diminishing. I had increasing trouble dragging myself through my daily activities. I had no energy. Lack of energy doesn’t sound all that dire, until you’ve experienced its near-complete absence. Lack of energy led me to give up on all of the activities that made life at all enjoyable, even writing, even, in the past year or two, reading. As a result, I developed a distinct happiness deficiency. Yet I was still capable of feeling happy, for brief periods, which was rather confusing given my self-diagnosed depression. I could laugh; I could even feel joy. And then I ran out of energy afterward and couldn’t feel much of anything.

Which is exactly how it felt when I only had the minimum dose of replacement thyroid hormone, only even worse. Given a short-acting hormone pill with which to fine-tune things a bit, I was able to experiment, and by choosing (with doctor’s approval) how many of the pills to take, I can replicate various stages of my “depression.” And when I take a bit extra, I feel, briefly, the way I did in my youth: energetic, un-tired, able to work. I even had insomnia last night! I know that’s an odd thing to be pleased about, but I was a chronic insomniac for much of my life, until in recent years it went the other way, and I was all but narcoleptic. It was nice to be unintentionally conscious in the wee smalls again.

Which isn’t to say that it’s all sunshine and roses when I take a pill, of course. But I have some hope that the faulty wiring was in my endocrine system more than my brain, with of course an attendant dose of reasonable melancholy. And that’s why I’ve bothered writing all of this out. I know, from talking to my endocrinologist, from talking to a nurse with a similar history, that this is more common than most people suspect. I also remember a TED talk in which someone spoke of the opposite of depression being energy, not happiness. I begin to suspect that, when that is true, there may be some endocrine involvement. So get mental health assistance for depression (yes, absolutely, definitely, obviously), but also schedule a chat with your local thyroid fixer-upper.

Just be aware that you probably won’t be as lucky as I am. You probably won’t have the largest thyroid growth anyone has ever seen, with the rarest form of cancer in it, and the added fun of dealing with hormone pills made for people half your size. Chances are it’ll be the mundane, common sort of trouble, you take a pill in the mornings and feel better. But hey, we can’t all be special.


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