Montreal

Point of View: At 23, I had my cancerous thyroid removed. My family doctor thought I was depressed

A cancerous thyroid gave Alexa Everett the scare of her life when she was 23. In this point of view piece, she describes the ordeal, and what she knows now about the signs and symptoms.

'I felt intimidated, like I was bothering her with my questions,' Alexa Everett said

Alexa Everett, 25, still has a faint scar on her neck from the removal of her thyroid 2 years ago. It was a doctor at a walk-in clinic who ordered tests that showed Everett had thyroid cancer. (Elysha Enos/CBC)

The rhythmic ringing of my smartphone interrupted my true crime podcast. On the other end of the line, my surgeon broke the news.

"It's not looking good. We got the results back — it's cancer."

About a month later, my cancerous thyroid was removed. 

The surgery left me with a long list of health issues and a permanent scar across my neck, the width of my mouth.

Two years earlier, as I was working through my bachelor's degree in journalism and communications, I had begun feeling exhausted, depressed and anxious. I started gaining weight, too. 

Even though I was just 21, I assumed this was the beginning of the natural downturn of my health that could be expected with age. 

I spoke with my doctor, and she prescribed antidepressants. 

Around that time, I remember a friend photographing me and noticing my neck. 

"It looks so poofy!" she said. 

My family history of thyroid issues, combined with my symptoms — and my friend's remark — led me to wonder if this age-related downturn was actually a problem with my thyroid gland.

The thyroid regulates the body's temperature, mood, weight and energy level. 

But when I took all this to my doctor, she brushed me off. 

I felt intimidated, like I was bothering her with my questions. So I dropped it. 

With my symptoms worsening and my worries dismissed during subsequent visits, I decided to take my health into my own hands and find a new doctor. 

Everett had her thyroid removed within a few weeks of being diagnosed with thyroid cancer the summer she turned 23. (Submitted by Alexa Everett)

The next time I went to a walk-in clinic, I asked the physician who saw me if she would take me on as her patient.

She examined my neck and ordered a blood test and a biopsy of my thyroid gland.

The blood test showed that my thyroid was underactive — something known as hypothyroidism — and it was sabotaging my well-being.

Depression, fatigue, weight gain and memory fog are all symptoms of hypothyroidism.

Other people may have an overactive thyroid, a condition called hyperthyroidism. Symptoms include excessive sweating, heart palpitations, anxiety and weight loss. 

While the blood tests confirmed my thyroid was underactive, it was the biopsy that detected cancer.

According to a 2014 publication by the Canadian Public Health Agency, thyroid cancer is increasing more rapidly than any other cancer in Canada. 

In the last decade, the number of cases has gone up 144 per cent, and women are three times more likely to get it than men.

No longer 'one size fits all'

The surgeon who removed my thyroid, Dr. Richard Payne at Montreal's Jewish General Hospital, is known for his innovative techniques.

"In the past, a one-size-fits-all approach was taken with respect to thyroid cancer surgeries," says Payne.

It used to be that every patient had their entire thyroid removed, then received radiation. Now, Payne says, surgery is personalized. 

In my case, even though my entire thyroid was removed, I didn't have to endure radiation.

Everett has spent 2 years figuring out how to regain her health with the right combination of medication and lifestyle habits. (Submitted by Alexa Everett)

But why is there such an uptick in thyroid cancer cases?  

"Patients are having more imaging like ultrasounds or MRIs done, so a lot of cases are first detected incidentally," says Payne.

One in 10 Canadians suffer from a thyroid condition, according to the Thyroid Foundation of Canada. 

But, thyroid specialists say there aren't any preventative measures.

"We can do some tests to see if a patient is more at risk of developing an issue, but it's not like diabetes — you can't prevent it with your lifestyle," says Dr. Waheed Rehman, an endocrinologist at the Lakeshore Hospital.

Figuring out my new normal

I underwent surgery to remove my cancerous thyroid the summer I turned 23.

The surgery went smoothly, but I didn't feel any better.  

I was prescribed a pill to imitate my thyroid hormones, but it didn't seem to be working. 

After months of dose adjustments, frustrated sessions of crying and many, many hours of sleep, I found the right combination and strength of medication.

With more energy, I began seeing a nutritionist, working out and sleeping less than 15 hours a day — a goal I never expected I would need to set for myself.

Now, more than two years later, I am starting to feel like myself again.

Every three months I have to meet with my endocrinologist to ensure that my synthetic thyroid dose is optimal. I get blood work done several times a year and an ultrasound twice a year.

In the future, should I again experience symptoms like weight gain, extreme fatigue and memory fog, I will need to have my dosage readjusted to find the right balance. 

Since my surgery, I've crossed paths with strangers bearing the same scar, who don't feel so unfamiliar. 

I recently bought a jacket and was served by a middle-aged woman who exclaimed: "Hey! You've had your thyroid removed, too!"

I noticed the small slit running horizontally across her neck. 

"We're matching!" I said. 

As I walked away from my new friend with my purchase, my eyes darted to the throats of nearby shoppers, looking for more people like us. 

How many others are walking around with this tell-tale scar?

About the Author

Alexa Everett is a multimedia journalist based in Montreal. She has written for the Montreal Gazette and Ricochet Media. She co-produced and co-hosted MAtv's RTDNA-nominated series 514 Undiscovered.

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