Saturday, July 2, 2011


Good morning,

It's a gorgeous long weekend here in Seattle! We've already been taking advantage of it with great friends and a BBQ and wine on our balcony last night. There is an air of festivity here in Seattle; I think everyone is so excited to finally have a summer on the horizon.

Yesterday afternoon I had an appointment with Dr. Failor, my endocrinologist at the Cancer Care Alliance. I was so nervous going into the appointment, dreading more bad news, but really there was not any news. It was more of an appointment to establish care, as I'd never met him before, and review our plan, since he will be managing my care from here on out. He reviewed my bloodwork and our goals. My thyroid stimulating hormone (TSH) levels should be at 0.01 and my thyroglobulin (Tg) should be 0 (or <0.02, which is the lowest the test can read).

Thyroid stimulating hormone is produced by the pituitary and does exactly what it sounds like. In a normal person it should be around 0.5-2.5, although those numbers vary a lot depending on whom you talk to. Some say a level of 5 is normal, while a nurse practitioner I worked with before aimed to have every patient at 1.0. Because this value is the hormone that stimulates the thyroid, and not the actual thyroid levels, it is inversely proportional to the thyroid levels. For example, if your TSH is 7, you are considered hypothyroid (and experiencing the beginning of all the fun symptoms I just had. My TSH was 58 when last checked). If it is 0.2, you are considered hyperthyroid. The goal for my treatment is to keep my TSH at 0.1. Although it is considered hyperthyroid, it is done to suppress the thyroid stimulating hormone - we don't want it stimulating any thyroid cancer cells!

So this summer will involve a lot of lab work to determine if my TSH is at the appropriate level and adjusting of my levothyroxine dose. We'll also be monitoring my Tg level, hoping that post-RAI it comes down, showing that the ablation was effective at destroying those evil cancer cells. And as planned, I'll have my ultrasound in September. This means my next doctors appointment isn't until September 19! Blood draws are easy because I can have them done right in the office I work at, and my medication dose can be adjusted over the phone. I'm excited that when I look at my calendar for the upcoming months, the only appointments I see are for pedicures and massages :) Just kidding, I'll still be seeing my naturopath, but she only gives me good news and has a much more flexible schedule so I don't have to take more time off work.

Happy 4th everyone! Please consider not blasting off firecrackers - they terrify animals, including my Z dog. Wishing you all lots of sunshine.



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