Finally Reading the Sourcebook

Yesterday, after eighteen years as the wife of a cancer survivor, I finally started reading The Thyroid Sourcebook by M. Sara Rosenthal, Ph.D.  The first edition of this book (now it its fifth edition) was published in 1993, the year King Richard was diagnosed with medullary carcinoma of the thyroid, a dangerous, often hereditary, type of cancer that does not respond to radioactive iodine or radiation therapy.  So why now?  Why read the premier book on thyroid treatment after all these years?  Well, for one, I wanted to make sure I had the latest information on follow-up care for my husband and, two, I wanted to offer the book to the family of a newly engaged young couple at church (the bride has been diagnosed with thyroid disease) and I couldn't do that in good conscience without first reading the volume.

Living with a thyroid patient is no picnic.  Every day means dealing with some manifestation of two issues:  the reality of a physiology with a compromised organ (or, in my husband's case, no organ) and the reality of a medication that has side effects.  Most days, I am uncertain which is going to show up, biochemically speaking, but whichever issue makes an appearance, I try to cope with grace.  Note the symptoms of each issue;  those in bold are the ones I have had to deal with over the years.

Hypothyroidism	Synthroid® Side Effects
Fatigue	Rapid or irregular heartbeat
Sluggishness	Chest pain, breathing issues
Increased sensitivity to cold	Muscle weakness
Pale, dry skin	Nervousness
Puffy face	Irritability
Hoarse voice	Sleeplessness
Elevated blood cholesterol level	Tremors
Unexplained weight gain	Change in appetite
Muscle aches, tenderness, stiffness	Weight loss
Pain, stiffness, joint swelling	Vomiting
Muscle weakness	Frequent bowel movements
Brittle fingernails & hair	Excessive sweating
Depression	Heat intolerance
Forgetfulness, slow thinking	Fever
	Impaired fertility
	Decreased bone density
	Other unusual medical events

Most, if not all, of these symptoms are relatively mild or nonexistent for my husband these days, either that or I have become so inured to them after eighteen years that they only seem mild to me now.  It wasn't always like that.  The first few months after surgery were a very different story, as our first endocrinologist tried to settle on an optimal Synthroid® dosage for King Richard.  She eventually had him taking 325 mcg of levothyroxine daily, an amount we later discovered was so high that, most of the time, my poor husband walked around in a state of profound hyperthyroidism as his doctor attempted to force his TSH (thyroid stimulating hormone) level to register zero on a bloodwork run.  Such was the accepted therapy for medullary thyroid cancer at that time, thinking that suppression of TSH would prevent recurrence.  At least that is what we were told back in the early 1990's.  Thankfully, my husband and I eventually found our way to an excellent specialist who adjusted his Synthroid® dose down to a more normal level (~175 mcg), not in the stratosphere.

So why do I want this young couple to be armed with the information in this book?  Quite simply:  divorce.  Over the years, King Richard and I have encountered a number of couples that have dealt with some kind of thyroid disease, be it thyroid cancer, Graves disease, or hypothyroidism.  To date, of the couples we know in our locale that have had to deal with thyroid cancer, ours is the only marriage still intact.  I do not say that to brag, nor do I say it lightly.  As I said before, living with a thyroid patient is no picnic.  Ending up with a thyroid patient after several years of marriage is one thing.  Taking on a thyroid patient as a "young couple in love" and having little or no knowledge of what you are getting into could be disastrous;  at the very least, it could lead to years of emotional damage.

So...I will offer the book to them when I am finished with it.  Hopefully, they will find it helpful and will graciously listen to an elder who has walked the path before them.  If not, then I will continue to make myself available to them for advice and counsel should they ever have the need or the desire to ask for it.