Julie SchramkeOne tiny, purple pill accompanies my daily vitamin. A faint silver scar stares back at me from the mirror. These companions follow me day to day, an integral part of my existence. Normally, I never pause to consider how the neckline of my blouse reveals a crescent shaped scar, but today is different.
It’s my birthday. I lean closer to the mirror. My jaw line has sagged overnight. At least, I don’t remember it looking like THAT yesterday. I gently pull the offending skin towards my ears holding it tight until the results please me. I sigh releasing my hold. Then I notice the scar.
The scar is camouflaged as a wrinkle at the base of my neck. Easily discernable to anyone caring to look, it has the shape of a Mona Lisa smile. Like Mona, the scar offers no explanations yet promises hidden wisdom.
My relationship with the scar began seventeen years ago when I gained twenty pounds in one year! I complained to mom that I wasn’t eating differently. Why had I gained so much weight? Mom suggested a thyroid test. She said thyroid problems could be hereditary and she’d recently been diagnosed with a deficiency.
The thyroid is a small gland at the base of the neck. Shaped like a butterfly, it regulates cell energy and organs in the body. An under active thyroid causes the body to run in slow motion. Some symptoms may include fatigue, feeling cold, weakened memory, depression, and weight gain.
My doctor gave me a blood test for thyroid stimulating hormone (TSH). Results came back within a normal range. He said my twenty-pound weight gain resulted from my job, my age, and lack of exercise. Disappointed, I resolved to eat healthier and move more.
That year, my body stayed the same, but my job changed and with it my health insurance. I made an appointment with a new doctor, again complaining about the twenty pounds. At this point, I felt rather defeated. I complained half-heartedly expecting the same explanation. Imagine my surprise when this doctor asked probing questions examining me more closely; close enough to observe a lump. About the size of a walnut, it sat just above my collarbone.
Once he pointed it out, I don’t know how I could ever have missed it. Similar to an Adam’s apple, the lump or nodule was right in front of me all the time. How did I miss it growing insidiously larger each day?
My doctor explained many people develop thyroid nodules by the time they’re fifty and the majority are not cancerous (benign). He recommended fine needle biopsy to see if my nodule could be cancerous. In this test a tissue sample is extracted using a very small needle and examined under a microscope to see if cells appear to be cancerous.
TSH levels are usually normal when a nodule is present and normal TSH levels do not differentiate cancerous from benign nodules. So much for the first doctor’s diagnosis of the twenty-pound mystery. Always get a second opinion.
Results of the fine needle biopsy were suspicious and surgery was recommended to remove part or all of my thyroid gland. Surgery took place at a teaching hospital and fresh-faced interns stopped by to examine the protruding nodule. They asked if I minded. I was glad to help them learn what to look for in future patients.
The surgeon informed me surgery could result in changing my voice by adding a wispy, breathless quality. I consoled myself with thoughts of Marilyn Monroe. Finally, it was time for surgery. I counted backwards from one hundred and didn’t get very far. The next thing I knew, my husband’s voice floated through a cloud. I heard him say, “It was cancerous.”
Even in my haze, I could hear the tremor in his voice. Later I learned, there are four types of thyroid cancer: Papillary, Follicular, Medullary, and Anaplastic. I had Papillary which is the most common and curable type of cancer a person can get. My entire thyroid gland was removed and I felt lucky not to need radioactive iodine treatments. I did have a souvenir, however.
Initially, the scar reminded me of Frankenstein. a scarf to covered the stitches and redness that gave the impression my neck was sewn onto my shoulders. This would soon fade leaving a Mona Lisa scar and a heart filled with gratitude.
There are other reminders in my life. My TSH level is checked annually and when I donate blood, I explain about the cancer. They always ask if there’s been any recurrence. My answer is “not yet, thank God.” Side-effects? Well, I’ve learned to watch my body more closely for changes, but my voice is only breathless after kissing my husband.