Thyroid Cancer Awareness

I have decided that thyroid cancer needs some awareness. Since September is Thyroid Cancer Awareness Month, I thought I should write a little about it.

Most people know all about breast self exams, mammograms, pap smears, prostate exams, colonoscopies, and more. We know that there are preventative things that doctors can do to try and find cancer in it’s early stages.

Do you know about a neck self check? Do you know to ask your doctor to check your neck?

http://www.thyroidcancercanada.org/userfiles/files/Thyroid_Neck_Check.pdf

This is the best, most well explained info I have found on how to do a neck self check. Also, when you go in for a regular well check, or a well woman’s check, your doctor should be feeling your neck, telling you to turn your head and swallow, and feeling your neck for any nodules or inflammation of your thyroid.

There are plenty of things you can do to help prevent cancer as well. None of them are sure fire, of course. But there are things you can do. http://www.mayoclinic.com/health/cancer-prevention/CA00024

The number one thing I would say to any patient is this: if you feel like something is wrong with you, don’t give up trying to figure out what it is. I went in to my doctors for 3-5 years before my diagnosis with complaints. They were varied complaints that honestly could have been many things. I had strange menstrual issues, I was exhausted all the time, I had skin infections, I wasn’t healing like I used to if I got some sore or cut, I was bruising, I wasn’t sleeping well, I felt my hormones were off, I was gaining weight, I was generally not feeling like myself, I was heat sensitive. Several times, and during my pregnancy too, we thought it might be thyroid related. My blood results always came back normal. I believe if we had done more than a simple TSH (done a free T3 and free T4 test) we may have had a better idea that the thyroid was off, but I don’t know for sure because I didn’t even know to ask that. When I had a lump the size of a ping pong on my neck during my pregnancy I talked to 3 different doctors a total of 7 times about it. Finally in the 8th month of pregnancy my allergist decided to ultrasound it. But I went into early labor and we had to reschedule for the week after my son was born. If I hadn’t pushed and asked and asked and asked, we would have never found it. Yes, it was frustrating for doctor after doctor to tell me I was fine and I just needed to loose weight, eat better, sleep less, work less, sleep more, eat less, exercise more…. over and over again. But eventually we found the problem. If we had been able to catch it earlier it would have been easier on me for sure. But my thyroid never had any nodules, the cancer that was in it was very small, it had just spread a really long way. (you can read more about my cancer journey here: https://fishjello.wordpress.com/2012/04/23/did-they-have-to-take-out-your-heart/)

Doctors believe that the recent rise in thyroid cancer can partly be blamed on radiation. We have much more radiation in our environment than we did 200 years ago. We have all sorts of electronics, cell phones, airplanes (an airplane ride apparently has a lot of radiation), microwaves, x rays and metal detectors, and more diagnostic radiology than we have ever seen before.

Let’s talk about diagnostic radiology for a minute. These are things like x-rays, mammograms, CT scans, PET scans, medical radiology like people get for cancer, and more. I have learned that my thyroid cancer most likely came from a set of CT scans I had when I was very sick with an abcess in my belly following a gall bladder surgery. I had 12-15 CT scans in one month (the insurance and hospital have differing records on how many I had.) The doctors were trying to save my life. And they did. But that is a whole lot of radiation. A nuclear physicist figured it out for me that it was approximately 65 years of background radiation. (that is how they measure it – they compare it to normal back ground radiation and how long it would take you to accumulate that much radiation.) I have also had many many dental x-rays, many x-rays, and many other CT scans for things like kidney stones and migraines besides those 12-15.

I have also learned that sometimes you have to stand up for yourself in your own health care. The first thing you can do to help diminish the effects of this type of radiation exposure is to ask for a thyroid shield when you are getting a test done. Some tests don’t have thyroid shields, some tests can’t use a thyroid shield (for example, if it’s an x-ray of your neck you can’t use one because it will interfere with the picture). I have started ALWAYS asking for a thyroid shield. If they can’t use one, or there isn’t one for that machine, the tech is experienced enough to tell you, and to get you one if there is one. I have run across plenty of techs that don’t use them on a regular basis, so I always ask. I especially ask for my son. He was getting an x-ray of a broken foot done. When I asked the tech to put a thyroid shield on him the tech lectured me about how the dose is very low and the beam would be far away from his neck. I said very politely that I had gone through 3 years of hell because of thyroid cancer and to please get my son a thyroid shield and not lecture me. Then he took an x-ray of my son’s foot – with my son sitting up, leaning forward to get the proper angle, and the machine directly over his head. I am not saying the tech didn’t know his business, but his neck wasn’t as far away from the beam as he initially indicated.

Do not be afraid to ask questions and do not be afraid to stand up for yourself or your family. Another thing I think people need to be educated about when it comes to diagnostic tests is to ask whether something is necessary or not. Is this CT of my head really necessary? What are we looking for? Does this test give us more information as to what my condition is, or is it just precautionary? Will your course of treatment be affected by the outcome of this test? For example – you are having sudden onset of migraines that are so severe they are impacting your life. You have never had migraines before and you are missing work and personal activities because of it. A CT scan might be prescribed by your doctor to see if there is something physically causing your migraines, and it might be important in ruling out things like tumors. I would probably get one if my doctor suggested it. On the other hand, a friend who is pregnant and has thyroid cancer just recently broke 2 fingers. The doctor wanted to do an x-ray to see whether they were actually broken. She asked what it would change. Would it change the course of treatment? Would it change what they did to make her better? The answer was no. Whether it was broken or sprained, they would splint it and have her apply ice and use other comfort remedies. She decided not to get an x-ray. It is just a little bit of radiation – but to an unborn baby it is more, and to a cancer patient trying to limit her exposure to radiation, it is worth asking and thinking about. I always have frank conversations with my doctors. Does this kidney stone feel different than the others? Are we worried about an infection or blockage with it? Why do we really need this CT scan.

Be your own advocate. Be an advocate for your family. Ask questions. The most dangerous thing a patient can do is blindly follow their doctor’s advice without knowing what their condition is, what it means, what needs to be done for it, and why your doctor is suggesting the plan they are suggesting. Educate yourself on what the tests mean, what the “normal” course of treatment is for any ailment you have. Educate yourself on the things that you should be doing at home to help. For example, a nurse told me that after surgery eating a very high protein diet can help speed healing. Very high carbs and fats can slow healing. There are things you can do at home to help your healing if you ask or read about it. Yes, your doctor went to school so they know more about most medical things than you do. But that doesn’t mean they know everything. It also doesn’t mean you should blindly follow them. Be a partner in your care. Don’t “google self diagnose”. Do figure out what questions you have and ask them. Write them down and ask them.

Check your neck. Ask for a thyroid shield. If you don’t feel well, keep trying to get to the bottom of it. If you get cancer, fight like hell. Thank your family or friends for all they do to help (thank you family and friends.) And most importantly, spread the word to others. Cancer of any kind is most easily treated if caught early, so get ALL of your preventative tests done.

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