February 15, 2006

A couple of weeks ago, my dad sent me this article about placebos. Researchers treated people suffering pain from repetitive stress injuries with either fake pills or fake acupuncture. The fake acupuncture was more effective than the fake pills, but the really interesting thing, I thought, was that both worked pretty well, and in addition to that, many participants in the study also experienced the fake side effects researchers had told them to expect. Some had such dramatic "side effects" that they were unable to complete the study. And the really funny thing was that although my dad didn't know it at the time, I was struggling with plenty of placebo effect issues myself at the time.

Last year, my doctor told me I had a goiter. OK, not like the one in that picture, nobody would even notice mine unless they happened to be feeling my throat, but a goiter nonetheless. A goiter, as I knew from my physiology classes, is an inflamed thyroid gland, and is often associated with hypothyroidism. I also knew from physiology classes that hypothyroidism is a hypochondriac's best friend, because its symptoms are pretty much entirely nonspecific: fatigue, sensitivity cold, memory problems, dry skin, weight gain, etc.

So last year when the doctor found my goiter she asked me, "do you feel tired a lot? Do you have a tendency to gain weight?" I shrugged. "Sure, but doesn't everybody?" She had me go in for a blood test, and it came back "in the normal range." Sometimes people just get goiters for no reason, and I figured I was one of those people.

But all was not completely well. I started having trouble swallowing. I mean, I could eat and everything, but I literally felt like there was a lump in my throat. But that feeling came and went. Some days I didn't notice it at all. Other days it drove me crazy. Was my goiter getting bigger, or was it just bothering me now because I knew it was there? I figured it was probably the latter, but this year, when I went back to the doctor, I mentioned it to her.

"Do you think it's gotten worse?" she asked.

"I don't know! I don't know if it's gotten worse or if I just notice it now because I know it's there!"

"Do you feel tired a lot?" she asked. I almost laughed in her face. Anyway, she brought in another doctor who knew more about thyroid stuff to check me out (this doctor's name was Dr. Rosen which makes me think of Fletch every time I hear it). She felt my throat with her hand, and then she made me swallow mouthfulls of water while she felt my goiter. All the while, both doctors kept reassuring me "Don't worry, this is perfectly normal, lots of people have thyroid problems. It's nothing to worry about!" While I already knew this to be true, the more they kept telling me not to worry, the more I started to wonder if maybe I should worry. Why were they being so emphatic that I not worry? Were they saying this because they thought I would be worried...because there was something to worry about?

After Dr. Rosen finished groping my thyroid, she said that she thought it might be asymmetrical, slightly larger on the right side. She gave me paperwork to go get an ultrasound and another blood test. I was, in fact, a little worried at this point, and not just because of the "don't worry" stuff. I knew that asymmetry was probably a bad sign (like, indicative of a possible tumor) and I figured the ultrasound was to rule a tumor out.

I immediately went from the doctor's office to the imaging place where they do ultrasounds. I walked up to the window and held out my paperwork. "Do you have an appointment?" the woman at the window asked. "No, I didn't know I needed one." She laughed. "Yes, you need an appointment. Call this number," she said, writing down a phone number on a piece of paper. I went to get my blood tests done (I needed no appointment for that) and then called to make an ultrasound appointment. I knew it was a bad sign when they put me on hold for half an hour. I gave up and called back an hour or so later and finally got through that time after only 15 minutes on hold. But I couldn't get an appointment for a month. I'd never had to wait for a medical test in my life, and now the one time I had to get something done to make sure I don't have cancer I have to wait for a month!

But actually, by that point, I wasn't really so worried anymore. I'd done some research online and found that the most common cause of inflamed thyroid is something called Hashimoto's thyroiditis. It's an autoimmune disease (autoimmune disease runs in my family) that typically strikes women (that's me) between the ages of 30 and 50 (yes, hello, right here!). It seemed that I was a textbook case, and you know, I had been feeling pretty tired lately. Originally, I thought maybe it was because I'd been working really hard and maybe Iggy's snoring was keeping me up at night, but maybe it was really Hashimoto's. And I had gained a few pounds. Was that because I hadn't had as much time to run, or was it the Hashimoto's? And my skin and hair did seem dryer than usual. Was I just getting older...or was it Hashimoto's?

To make a long story at least slightly shorter, I had to wait several days to get my test results, and then after I got them, Dr. Rosen made me go do the tests again as well as a couple extra tests, so it took about a week and a half of waiting and wondering before I got my results (during this whole time, I felt very tired all the time. Was it stress, Hashimoto's or my brain reacting to the suggestion that I had Hashimoto's?). But finally I did get my results: my TSH levels were very high (this is the hormone that stimulates the thyroid), but my free thyroid hormone levels were low, and I had elevated levels of anti-thyroid hormones. Which means...I do have Hashimoto's. Which is not exactly great news, but I was awfully relieved to hear it after a week and a half of second-guessing. And basically now I have to take thyroid hormone every day for the rest of my life.

So I started taking the thyroid pills last Thursday, and I immediately started feeling more energetic. Slightly jumpy, even. Except when I looked online, most people seemed to think that it usually takes a few weeks to feel the effects of thyroid hormone replacement. So was I just imagining that I was starting to feel better? I guess it never ends...

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