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I am so lucky that I listened
Tag: help
Gaggy and Googley-eyed…or…the joys of hyperthyroidism
For a long time now since my chemotherapy ended, I have endured the effects of hypothyroidism because my poor thyroid was chemically destroyed with little hope of its recovery. The thinning hair, the dry skin, the ridiculous fatigue and the inability to lose weight have become a part of my daily routine, despite constant medication dose adjustments, doctor’s appointments, etc. Don’t get me wrong. I am extremely grateful that my liver and kidneys recovered. I can’t live without them, but this thyroid stuff is still a bummer.
Well, just when I’d settled in with those symptoms, my thyroid decided to take a turn and launch me in the opposite direction…..hyperthyroidism. Let’s talk about how it is different.
Hyperthyroidism can result from four main causes. The first is inflammation/thyroiditis of the gland due to viral infection, medication side effects, or pregnancy. The second is Grave’s disease. The third is taking too much thyroid medication. The fourth ( although very rare) ifsfrom non-cancerous growths of the thyroid or pituitary gland.
Here are the symptoms. There are so many, let’s break them down into categories.
Whole body- excess sweating, hunger, fatigue, heat intolerance, restlessness, weight loss, diarrhea, warm skin, weakness, tremor
Mood- mood swing, nervousness, panic attacks
Heart- abnormal rhythm, palpitations, tachycardia
Sleep- insomnia or difficulty falling asleep
Menstrual- irregular periods or periods that are very short and light
Behavioral- hyperactivity and irritability
Eyes- puffy eyes or protruding eyes
It all sounds fabulous doesn’t it? Nope! I was looking up risk factors for hyperthyroidism. The most common ones are family history of thyroid disease, pregnancy, chronic illness like pernicious anemia and adrenal insufficiency. I haven’t really seen my reason in many resources: the chemo destruction of the thyroid, but I can tell ya, it exists and is very difficult to treat.
All of these symptoms sound pretty annoying but not life- threatening, right? Wrong! Hyperthyroidism needs to be treated! If you have any of these symptoms, you need to see your doctor. Let’s look at what happens if hyperthyroidism goes untreated.
It can lead to weak, brittle bones and osteoporosis. Our bone strength depends on the amount of calcium and other minerals in them and too much thyroid hormone vastly decreases our calcium absorption.
Thyroid eye disease can develop. This affects the muscles and tissues around the eyes leading to bulging eyes, gritty sensation, pressure and pain in the eyes, retracted eyelids, red eyes, light sensitivity and even double vision. These untreated problems could even lead to loss of vision.
It can lead to a dermopathy that causes the skin to change color and swell. The swelling is often so significant that the skin on the shins and feet literally shins to the eye.
The most dangerous potential complication of untreated hyperthyroidism is a thyrotoxic crisis or thyroid storm. This requires immediate emergency care. Symptoms can include fever, tachycardia, nausea, vommitting, diarrhea, dehydration, and even delirium.
The first step in getting diagnosed is to go to the doctor. Get a thorough history and physical exam. The doctor will look for signs like tremor, overactive reflexes, moist skin, rapid pulse, eye changes, etc. They will examine your thyroid. labs will be ordered like T4,T3 and TSH(thyroid stimulating hormone). Make sure you are fasting when you get these tests. Also make sure you are not taking any b vitamins like biotin for at least 3 to 5 days before. If your tests are positive, you will probably get a thyroid usn.. If there are nodules, you will probably have to have a radioiodine scan.
How do you treat hyperthyroidism? Anti thyroid medicines are one option. They prevent the thyroid from making too many hormones. They usually take several weeks to work. Beta blockers are a symptom treatment option because they can bring down the rapid heart rate and tremors. They don’t do anything to the thyroid hormone levels though. Radioiodine therapy is an option. This makes the gland shrink and usually makes it underactive. This can lead tro hypothyroidism, which also needs to be treated. The most drastic option is removal of all or part of the thyroid. This is reserved as a last resort if meds , iodine etc are not an option or did not work. There are risk to this surgery which include,but are not limited to damage to the vocal cords and the parathyroid glands.
The bottom line is that hyperthyroidism needs to be taken seriously because serious complications can occur. So, if you have any of those symptoms, please seek a doctor’s care right away.
Dr. Katz
December 12th is coming and I’m freakin out!
Dec 12th…..Dec 12th 2020. It’s where it all started. The morning I woke up feeling like I was choking with a voice yelling inside my head to get up and look in the mirror. Whether it was my own gut instinct or my late father I will never now. That morning changed my life. I did get up. I did look into the mirror. I saw the lump on my neck and off I went. It was the beginning of a battle of fear, frustration, and anxiety as made my first steps toward my cancer revealing itself and everything that followed.
Well, that was almost two years ago. I thought I was getting better at letting it go. I really did but nope, here we are. It’s less than a month away and suddenly the panic attacks, the anxiety out of nowhere, the wondering about every little symptom is all back. It is PTSD at its best/worst. I can’t really believe how long it took me to figure it out. I guess I had to waste time beating myself up for having anxiety first. We all do. Then it hit me! Of course. The anniversary of one of the most traumatic times in my life is coming up! What normal brain can completely let that go? That trauma gets stored and buried, with significant effort from me. But, even I can’t hold it back all the time. Lord knows I try.
So, what do I do? I can’t keep fighting to suppress it. That will only keep me prisoner to it longer. I have to acknowledge it! I have to embrace that it is real and that it happened and that it affected me in ways that I still don’t fully process. I have to actualize my own feelings about it. The only way to be free is to go forward through it when the feelings flood me. The only power I have is the power to see it for what it is and decide how I want to proceed. The choice of direction is actually completely up to me. I could allow a day( or two or three) to break down and crumble. I could stop functioning. Or, I could move forward and use the experience for good. They say that the final stage of healing occurs when you are able to use what happened to you to help others. That is what I have chosen and continue to chose. I have written my books. I am giving my talks. I am helping other cancer patients. I help other people “get their mind right” for the battle ahead. I share knowledge every day to help give people some sense of control as to what is happening to them. These are the battles I chose to fight every day. These are the battles I want to win. I realize that my past trauma is still with me. I cannot change that, but I can chose to change what I do with it.
Dr. Katz
So, I kind of broke up an almost fight at Kroger today
Hey everyone! Long time no write. LIfe has been a crazy series up downs…and downs…lately and my time and mind have been elsewhere out of necessity. But today, something happened that I think is worth sharing so here goes.
I was in line at Kroger today and I slid in right behind this very frustrated guy who was about to have a verbal duke out with the poor blameless cashier, who appeared to already be having a very difficult day. I observed quietly for a second, and then I felt compelled to intervene. I realize that this is a risky move, especially nowadays but I went for it anyway. I was going to bring some peace to Kroger dang it. I said, ” You know, I think we have all forgotten how to be kind. We have all gotten so frustrated with other stuff and other people that we forget how to be nice to others. ” This stunned them into angry silence for a minute. I boldly went on. “When I had my cancer this year and then my husband had emergency heart surgery soon after I was done with chemo, I realized that there are some battles I just don’t need to fight anymore. I just feel lucky to be above ground. Everything after that is just gravy.” Both men got even quieter and just stared at me. I wasn’t really sure what was going to happen. Then, the fighting man asked if he could help me get the stuff from under my cart. I said, “Absolutely! Thanks!” He did. Then he turned to the cashier and said thanks and then went on his way. The cashier thanked me and I noted out of the corner of my eye that everyone was smiling and nodding. I have to admit. That felt really good. I had brought peace to Kroger that day.
You have to ask yourself, why are we all so frustrated? Actually, that is a fairly easy question to answer. Look at all the colossal shit that has happened in all of our worlds lately. We’ve got the ongoing pandemic (depending on which blend of fact and fiction you subscribe to. I am just going to leave that one alone.) We have unemployment issues. We all know someone that has gone through incredible health issues. We have all had ridiculous amounts of financial strain. The list keeps going. It requires no stretch of the imagination to suppose why we are all on edge. The real question to answer now is how are we going to stop it? Are we going to be able to act like logical, sensitive, compassionate humans again once things get better? Or are we so entrenched in the cycle of negativity that we have forgotten how to recognize when things are good? I can understand the negative reactions to negative environments and things that we cannot control. But, I am suggesting that we start trying to remember how to act like civilized rational beings again regardless. Take it slowly at first, deciding to be content with or grateful for some tiny little thing: a single decision that goes your way. Then, go from there. I am just afraid that if we don’t start at least trying now, we won’t be able to do it later. Then, we will have a much bigger problem.
Dr. Katz
I Forgot
forgot what I was looking for
forgot who was looking for
a source of inner strength?
Secret cave of wonders?
a power source?
something I was missing?
Hold on a sec.
it’s getting a little clearer.
I don’t need anything else.
I don’t need anyone to do this for me.
I need to stop wasting time
Stop searching unnecessarily
I have what it take
I can do this.
Suckin the Life Outta Ya
Man this cancer thing is already kind of ridiculous, and I haven’t even started treatment. From the moment I found out, I firmly positioned myself in full bad-ass stance, made long term grandiose plans and capriciously swore that nothing would hold me down or stop me from caring for other people and patients. I was cocky. I was confident. I thought that it would help me beat this thing.
So, that was like….so last two weeks. Now let me tell you about what I actually should have done or learned…lol When I first learned that I had cancer, I had people telling me everything from reminding me how I need to slow down to I could work full time with this no problem with no pauses! Well of course I gravitated toward the full throttle advice! Who wouldn’t? I didn’t cancel patients right away. I started writing my book. I started a new podcast. I recruited my army, once I finally let the cat out of the bag. I cried for about two seconds and then I was ready to go! I was not done yet! Screw you cancer! You’re not the boss of me! Sound familiar? Anyone else been there? It doesn’t last too long does it?
Here is what I should have realized and learned. The first thing to realize when you are told you have cancer is that it has been around a lot longer than you thought. You need to add a couple of years in some cases to the time of diagnosis. Whaaat?! A couple of years?! That sucker has been sneaking around in my body for a couple of years? What the hell?! What that means is by the time you are diagnosed, it has been around long enough to give you symptoms. This means that the path from feeling normal to shitty has been significantly shortened before you even get the chance to process the fact that you have cancer in the first place. How rude!
Second, I should have realized that now is the time to plan carefully, anticipate and CONSERVE energy, not burn it all up before you even start. This is the time to try to be realistic, without guilt, about what you will be able to do and not do. This is my biggest challenge. Instead of just relaxing, I spend way too much time feeling guilty on what I am missing out on and who I am letting down. I am fixated on the fact that I am dropping the ball. Ugh! I went from feeling good to crappy in about a week. Now I walk across the room or just sit and promptly get short of breath, depending on the day. I have fatigue that is so intense that it literally comes out of no where and sucks the life out of you to the point that even breathing seems like too much effort. I am told that this is common with lymphoma since it is a condition that has a lot more inflammation associated with it. Therefore, your body requires a ton of excess energy and calories to try to fight it off. It makes sense I guess. My point is, that I waste time when I feel good trying to accomplish a million things until the next time I don’t feel good. I am not good at resting. How will this benefit me? It won’t. It will only make it tougher and take me longer to get better.
Last but not least, I should have realized that I have to let people help me! They are doing it because they want to, not because I am making them. I need to stop trying to do everything myself. I need to stop confusing accepting help with some weird acknowledgement of failure or weakness. What is my problem? I still don’t know…lol All I can promise is that I will work on it, because I intend to see this thing all the way through. Wish me luck!
Dr. Katz
Isn’t it strange that it’s ok that I’m human now, but it wasn’t ok before?
Traditionally, it seems that most patients do not view their physicians as actual, potentially flawed human beings. It’s just too uncomfortable a concept. If patients viewed their doctors as humans, that would mean that they would have to acknowledge the fact that they can make mistakes, have emotions, have physical ailments, and emergencies as well. To most patients, that is an untenable thought. Their doctors need to be superhuman, infallible, and infinitely available at a moment’s notice. This kind of thinking allows patients to engage in demanding, unreasonable, and entitled behavior at times and puts a significant burden on the doctor patient relationship.
Interestingly, this seems to have turned around somewhat now in the time of COVID. Now it seems like patients are attaching themselves more to doctors who are showing their human side. The videos I post of myself at home in regular clothes or talking about how I finally figured out how to do my nails by myself get tons of views. Patients are listening with baited breath to see how I might be struggling with all of these changes. It’s as if listening to me is giving them tacit consent that it’s ok not to be ok right now. I feel like giving them a glimpse into me as a person is actually helpful right now. I can potentially help guide them through the proverbial tunnel to the other side of this thing. I get excited when I post my Facebook live daily video in the morning and all those people tune in. Knowing that I am able to reach all those people in a positive way helps me too. Personally I am loving it. If I can be myself with patients and still help them at the same time, I am all in! I would prefer to be that way all the time, within reason of course. I still stand by what I have said in previous blogs. Patients who are suffering or have just been given a terrible diagnosis do not necessarily care how I am feeling at the moment. Common sense still has to reign supreme here. I guess what I am really saying is that I hope the compassion doesn’t die out when the pandemic does. Have a great day everybody!
Dr. Katz