I remember as a teenager, I'd often felt off kilter. I was too skinny. My hair never seemed to grow, and neither did my nails. I had dull skin, circles under my eyes, and I always seemed to be sick with one ailment or another. But It wasn't until my freshman year of college that I began to realize that something was seriously wrong. After moving to New York to attend college I became increasingly fatigued. While many people attributed my thinness to my extremely petite stature, my weight would yo-yo as much as 10 pounds in any given month. Even when I exercised or changed my diet, it didn't seem to affect the weight gain or loss. No matter what beauty products I used, my hair and complexion remained dull. I felt sluggish, I couldn't concentrate, I was moody. In short, I was miserable.
Like any teenager, I complained about the way I was feeling, but every symptom was dismissed as either isolated or insignificant. Doctors, and my parents, said that poor diet explained weight fluctuations (I was rebelling against the strict "no McDonalds" rule in my household), my overwhelming tiredness was due to feeling homesick, and my crankiness was hormonal and simply reaffirmed that I was a young woman. Again and again, I was told that everything was fine and that I would eventually outgrow whatever I imagined to be ailing me.
Exhausted and increasingly depressed by the feeling that something wasn't quite right, I found it hard to focus on my studies. I started to oversleep and sometimes missed classes entirely. I was so tired I couldn't concentrate in class, let alone keep track of assignments or due dates. My whole body felt achy. But I didn't know what steps were necessary to find out what was wrong. I felt that my age, or lack there of, became one of the barometers by which doctors decided whether they would take my complaints seriously. In my allotted 15-minute appointment time, I struggled to convey all the symptoms that had been plaguing me. The doctors would usually take blood and inform me that the lab work didn't turn up anything remarkable.
It took several doctors and nearly three years before I got the right diagnosis at 23: I had cancer. A small node had been discovered on my thyroid earlier that I was assured was benign; it turned out not to be. The day my biopsy came back positive for thyroid cancer I felt a mix of emotions, but, strangely, I didn't feel afraid. All my concerns and complaints were suddenly validated. I could tell all the naysayers that I really was sick after all.
Still, though this form of the disease has excellent survival rates, I wasn't completely numb to the idea that I actually had cancer. I was just trying to look forward to enjoying my future without thinking too hard about the treatments that lay just ahead of me. Ironically, more than the surgery or the radiation treatment I would endure, what I would struggle with the most was the transition back to living a normal life.
The surgery to remove my cancerous thyroid was described to me as a simple procedure. I had one of the top surgeons at New York University Medical Center perform my surgery, and I have to say his excellent work has helped me recover faster that anyone assumed I would have. Once in surgery however, he had to remove more than he had originally anticipated. The tumor had metastasized to my right lymph nodes. The surgeon knew that from a previous CAT scan, but what wasn't known was how much the tumor had affected my parathyroid glands. (The parathyroid glands are four small glandular structures located in extremely close proximity to the thyroid that are responsible for regulating the body's calcium levels.)
Had doctors caught my cancer sooner, they would have probably performed a less invasive surgery, perhaps even saving some of my parathyroid glands. Instead, my thyroid was fully removed along with all of the lymph nodes on either side of my neck in an effort to preemptively stop any possibly recurrence of cancer. My journey to full recovery was extremely challenging. While I had support groups I could attend, I never really felt like anyone understood what is was like as a young adult dealing with cancer. Unable to fully communicate to my friends how I was feeling also made my experience with cancer isolating. By the time I was 24, I was battling with insurance companies over why they wouldn't pay for follow-up PET or CAT scans, discovering the caveats in post-hospital coverage for physical therapy and learning to schedule what seemed like endless medications for the day. Meanwhile, my friends were usually recovering from endless nights of partying.
Radiation was a physically and emotionally exhausting experience. For about a month after surgery, doctors put me on a strict iodine-free diet in an effort to starve all the cancerous thyroid cells remaining in my body of their main energy source. This meant no salt and no seafood, among other restrictions.
While it may be easy to pity myself for having gone through such a tumultuous experience at such a young age, I try to focus on the upside: I am alive and the cancer has not reappeared. And I have found that, since this experience, I am better able to distinguish between the things that really matter in life and all the stuff that just clutters it up. The healthy human body is amazing. Every structure works together within us seamlessly to perpetuate and maintain life, while we sit back and simply exist. Cancer is a really tough, really scary hurdle to jump. It changes you, and in many ways it challenges you, but it can also make you wiser than you ever thought you would be. A huge part of what I have learned during this experience is the importance of education, diligence and persistence--of being a proactive patient.
I was surprised to discover that a thyroid exam, a very simple blood test that can be done during an annual physical, has to be ordered separately by a doctor because it is not considered to be part of a typical annual test. This is remarkable considering that this year alone 33,550 men and women will be diagnosed with thyroid cancer, according to the North American Association of Central Cancer Registries (NAACCR)--most of them women. (Women run up to seven times the risk of developing a thyroid disorder than men do, especially during periods of hormonal change like puberty, pregnancy and menopause.)
If you are ill and feel there is something wrong, see a doctor. If the doctor sweeps your complaints under a rug, go see another one. See as many doctors as it takes until you get an answer. Research your symptoms, know your risks and ask questions. Make sure that you know what you are being tested for and that thorough tests are performed at your annual physicals. If insurance is an issue, investigate what your alternatives are. But most importantly, don't dismiss your symptoms or wait to "outgrow" whatever is bothering you. If I had, I might not be writing this today.