A registered nurse and a mother of three in Brighton, Colorado, Annie Parrish was 24 years old when she noticed a golf ball-sized lump in her throat.
Her family physician performed a palpation, in which the doctor feels the gland. It was enlarged, so the physician did a thyroid panel, a comprehensive type of bloodwork. The panel revealed Annie’s was hypothyroid, meaning her thyroid-stimulating hormone numbers were too high. She was put on a regimen of Synthroid, because the thyroid was not functioning as it should, leaving her dependent on the medication.
When Annie’s thyroid did not respond properly, doctors performed two fine needle biopsies, which were inconclusive, as was an ultrasound. Annie knew something was wrong, but wanted to keep as much of her thyroid as possible, so she had a partial thyroidectomy done. Doctors removed half of it, but determined that what they removed was cancerous, officially classified as follicular thyroid cancer with a papillary variant. Annie Parrish would have preferred to have half a thyroid instead of none at all, but she didn’t want the cancer to return, so she opted for a full thyroidectomy along with tonsillectomy because her tonsils were abnormally big. The procedure left her with a scar below her neck.
Annie needed two additional surgical procedures, and when they were done, she had to go back on synthroid. This was difficult because it affected her mood mental well being, and each time she took it, she got a headache. She felt “close to normal,” and realized going forward she might never look the same or feel the same, but also realized she was still alive and cancer-free.
It wasn’t until about a year after her procedures that Annie felt she had gotten the upper hand on thyroid cancer. She went in for periodic ultrasounds. The thyroglobin level is an accepted marker that the cancer has come back, and her thyroglobin level showed that she was free of cancer.
Annie Parrish is active in hiking and other outdoor activities. She says she can now physically do everything she could do prior to her diagnosis. However, she is still on synthroid and always will be. Sometimes it leaves her feeling a bit too hyper and affects her ability to sleep, but overall, she is cancer-free and is happy with that, even if its means she has to be synthroid.
By way of advice, Annie Parrish says if anything regarding your health seems abnormal, don’t hesitate, and ask for help. She urges you to be your own advocate, and to never assume that others are going to step up and help if you stay silent.
Additional Resources:
Support Group: Thyroid Cancer Survivors’ Association https://www.thyca.org
TRANSCRIPTION
Bruce Morton: Greetings and welcome to the Cancer Interviews podcast, I am your host, Bruce Morton. Because one’s thyroid affects so many aspects of one’s being, a diagnosis of thyroid cancer can have so many implications. Our guest on this episode is Annie Parrish of Brighton, Colorado, and she survived everything thyroid cancer threw her way. Now we’re going to hear her story. So, here she is, and Annie, welcome to Cancer Interviews.
Annie Parrish: Hi.
BM: Annie, it is our custom to start our interviews the same way, and that is to learn more about your life, exclusive of cancer. So, if you would, tell us where you are from, what you do for work, and when time allows, what you do for fun.
AP: I am from Arvada, Colorado, and now live in Brighton. I am a registered nurse with three wonderful kids, and I am divorced.
BM: And for fun?
AP: I like running, hiking, swimming, very active.
BM: Now we are talking about thyroid cancer. You’re a nurse, so you are in a position most of us aren’t. So, if you would, tell us about where the thyroid is in one’s body and what it affects.
AP: Sure, So, it’s in the middle of your neck. It controls metabolism, muscle and digestive function, bone maintenance and brain function and development.
BM: So, as for you and your cancer journey, when did you notice something was abnormal and needed medical attention?
AP: In 2006, I had tons of energy, I was a nurse, and I noticed that I had a big lump in my throat, totally golf ball size probably, and it didn’t cause a problem in that year, but I went to my family physician. They did a palpation, where they stand behind you and they feel the gland. It was enlarged, obviously. They did bloodwork, they did my thyroid panel, so whenever you have thyroid issues, it’s important to get a panel, so not just the TSH because that is just one test. Those were all normal, but barely, but they said my gland was hypothyroid. When your numbers are up, it’s hypo and when they are low, it’s hyper, because it is an inverse relationship with the pituitary and your brain; but they did those tests, and they wanted me to start on synthroid. I started on synthroid in 2006 when I was 24 years old. Y’know, just being on synthroid is a bad thing because the thyroid is not the way it was before the synthroid regimen, so you become dependent on it. They thought I had thyroiditis, which is just inflammation of the thyroid, and they did that because in their training they are taught that because they first do a trial of synthroid to see if you respond, and I did not. It made me very hype because synthroid is like being on speed. It is very powerful medication. So, I had lots of energy, I lost weight, but it slowed down my gland. It didn’t really prove I had cancer. It wasn’t definitive.
BM: From there, what was the chain of events that led to your diagnosis?
AP: Then I had gotten married, and my husband, and then I had three kids. With each pregnancy, my lump got bigger and bigger, and as a nurse, I am aware that cancer really grows during pregnancy. I have seen plenty of that in my job. So, this lump in 2008 resulted in a choking episode. It was in a restaurant at the party before you get married. I was there with my mom. I legitimately could have died. It was so traumatic because I could not move air at all. I took a drink of tea, and it just came out all over because I was completely obstructed with a piece of steak. Your esophagus is really small, only a couple inches in diameter, but it was completely plugged. I made the universal sign for choking with my hands around my neck. My mom completely went into shock, she did not understand that I was choking. The waiter did the Heimlich on me and dislodged it, but that was kind of a pivotal moment because I think that had been my fourth or fifth incident of choking, but none had been that severe. By now, the lump was almost as big as a softball, but big and noticeable. When I swallowed, you could see it. I called the surgeon’s office with my hospital, and I asked for an evaluation, and I was told I had to begin with my physician. Anyway, I went to my family physician, and they diagnosed it. We did two or three fine needle biopsies. They were all inconclusive. They all came back indeterminate. I had been told by doctors that it’s like finding a needle in a haystack, that you have to get the right aspiration of cells in a test to find it, which they did not. It wasn’t normal because there were abnormal cells. They went on to do ultrasounds and you could see it on an ultrasound. Sometimes with thyroid, any that’s abnormal with the ultrasound obviously gets noticed and recognized and lots of attention from the doctors, but they tend to overtreat certain things. There’s been a lot of consensus in the thyroid community about not treating certain things. They have standards of care so that they don’t remove benign cysts that don’t cause any problem, but they didn’t know I had cancer until I went for surgery in December of 2011. I wanted to keep part of my gland, so I had a partial thyroidectomy. They removed half of it and that came back definitively cancerous, so it was follicular with a papillary variant. Then they did the biopsy and was told that I had to come back, so, I had two surgeries.
BM: Annie, it sounds as though with everything going on, you had a level of awareness that a lay person might not have. Given that, to some degree, were you mentally prepared for your diagnosis?
AP: No, I don’t think you can ever be prepared for that. I knew it was cancer, because what else grows like that during pregnancy? I knew definitively by myself it was cancer, but I didn’t know if I wanted to get my thyroid removed. I had multiple discussions with educated people and a lot of naturopaths who did not want me to get it removed. My aunt, to this day, does believe I should have gotten it out because she feels like I could have cured it using holistic medicine; but I didn’t want to be one of those people, either, that goes without having surgery and having the lump keep growing. It put pressure on my carotid artery, so that is impairing what flows to my brain. That’s one of four branches of blood flow that I need, so I was not prepared for cancer, I don’t think anybody is because when you hear the word cancer, you think you are going to die. It was a huge deal. My aunt came and helped me with the kids. At that point I had two kids. Taking care of two kids and having a full-time job as a nurse, I don’t know what I would have done if she hadn’t come up from Albuquerque to help me because it all I could do to go through it and not freak out, not go into catastrophe mode where you think you’re dying and so nothing matters. That can be very frightening.
BM: Annie, it sounds like you had a number of paths to go on by way of treatment; when you think of the direction you ultimately went on, was that a tough decision?
AP: Yeah. As a nurse, I think long term and I think 30 or 40 years down the road, what will happen because of my actions, so it was really tough to have surgery because there is no going back. With the partial thyroidectomy, I thought I would just leave half, and have half a gland, but with cancer, I don’t want to leave any cancer there to grow. It’s like dandelions when they spread, that’s how it was explained to me and metastasis rate if they don’t get it all, it can come back. So, there was surveillance and every six months or so, I got ultrasounds and they took all of my lymph nodes, so, 12 lymph nodes, and they had a tumor board because of the size of my cancer because it was so big, there were standard protocols, so I did not need chemo, which is was very thankful about, because that would have been so hard to go through and so hard for my family. It’s an ordeal to go through chemo, so I was really thankful for that.
BM: You sound like you were at peace with your care plan, but as we learn from so many guests, it’s so important that you have a good feeling, that you have a high level of trust for your care team. How did you feel about your care team?
AP: I loved them. I had a great surgeon that had an ear, nose and throat specialist so that they didn’t damage my vocal cords. That’s happens a lot where they inadvertently nick the nerve to one’s larynx, so yeah, I was very impressed with the level of expertise with my team and the fact that they consulted me for little things all throughout and I felt like I knew the gameplan from the get-go, and yeah, it’s very important to trust your team, otherwise you second guess, and it would be hard to fight with the care team while you’re fighting cancer.
BM: So, while you were going through the process of treatment, looking back, what would you say is the toughest part?
AP: The recovery. I had a tonsillectomy when I had my thyroidectomy because my tonsils were huge, so they did that altogether; but the recovery, in terms of the metabolism part. I had a great scar below my neck, which nobody could see so I was happy about that, because being young, that’s an issue. I have seen some people with scars that are horrible. The metabolism part was really, really hard because I felt like a train hit me. My TSH (thyroid-stimulating hormone) level was up to 100. Normal TSH is like, zero to ten, but the hypothyroid rate that I had post-op, I had meds, it just takes a long time to get your blood to where you actually feel normal, and then the treatment with the synthroid is the hardest part because the regulation of that is so crucial for just your mental well being and your mood and functioning, like having any energy. I can tell immediately when I take my thyroid med because I get a headache. I was on T3 and T4 for a while and that helped a lot. There is a lot of debate in the medical community as to whether T3 is really important because your body turns T4 into T3. I am into all that because I want to know why, you know, the rationale why we are doing what we are doing, so the T3 really helped. I felt almost normal, but not quite and I have come to the realization that sadly, I may never look like I did or feel like I did, which is okay, because I am still here. It is good to be cancer-free and it is good to not choke on things, but the regulation of the thyroid hormone and the post-op recovery of the metabolism and getting that blood level was the worst part. That, and people not understanding. Thyroid cancer is dismissed as this little gland, but it controls, I have heard people say every single function in your body is determined by your thyroid gland. I don’t know if it is every single function, but it is a very important gland, and I feel it is often dismissed a ‘just a thyroid.’
BM: Annie, you gave me an answer about the toughest part of the treatment, but here is another treatment that I am sure would be unique, not necessarily to you, but unique to people who do what you do. It is your life’s work to give care to others. How difficult is it for roles to be reversed and now you are getting care from somebody else?
AP: Very difficult. To feel vulnerable and to feel like you are not in control of what happens or how things go; I had my uncle tell me it will make you a better nurse, and it did. I was definitely more compassionate and more understanding and more communicative, and too often, we assume people know things, or we don’t explain things like we should in lay terms, so it has made me much more sensitive and empathic, but being a patient was extremely difficult because you are leading so many things, you are doing things and you are in charge, and as a patient, I was not in charge.
BM: You had mentioned your aunt as a source of support. Was there anybody else who came to your aid?
AP: Not really. I didn’t have a lot of support, and it was really difficult because I felt very angry. My dad came to see me in the hospital, but that was it. I thought I was ‘one of those people’ because I have taken care of many people and was really sad that their family didn’t come and see them. They didn’t help out. So, it was just me. My aunt helped immensely. Without her I would have been so depressed because I still had to look forward to going back to work, which was wonderful, but that was really a hard transition, too. I had stitches, so people would ask. The stitches came out right before I went back to work, so it was like a fresh scar. People noticed and I had people ask what happened and I had other nurses that were completely not very nice. That was hard because I expected them to be there for me and to be happy that I was back to work and that I want to be at work, and that wasn’t the reality.
BM: I am sorry to hear that. With the passage of time, did this become less of a problem?
AP: Oh yeah. I mean, it wasn’t a problem. I am not at work to be applauded or any of that, so I didn’t care, but it hurt. I think a lot of problems came for me after my thyroid diagnosis that are completely unrelated to thyroid issues, but it was something that enabled others to pick on me. It’s really unfortunate if I had gotten a different job at a place where people didn’t know me, I think it would have been a lot better for me interms of my profession and my career, just being accepted. I think I am so much of an open book. I talk about things, and I am open with everything, like life, but that’s a problem, especially having cancer and being vulnerable and being open.
BM: Let’s talk about a more pleasant aspect of all this and that is the trajectory you were on because at some point you started to show some signs of improvement, physically speaking. What were the things that tipped you off that you were on a good path?
AP: In 2014, I did the MS-150, which is 150 miles on a bike, so that made me feel like I was making some major progress that I was able to do that, as I had never done anything like that, pre-cancer, so that made me feel really hopeful that I can live a normal life.
BM: Eventually that positive trajectory had to lead to a point in which you felt you had attained survivorship. How exciting was that?
AP: Great, because I had worried for a long time. The whole suppression of your thyroid is a big thing, post-op. So, those first couple months and the next year, the thyroid is supposed to be suppressed; but the whole level of the thyroid, the greater the possibility could proliferate and spread. I think when I hit a year out, I was pretty hopeful that it wasn’t going to come back because generally you would know before that because they do the survey with the ultrasound. They check the thyroglobin level as well, and thryoglobin is one of the key markers that the cancer has come back. I felt really good and really blessed that I had went through this.
BM: Now, if you think about what you could physically do pre-diagnosis and compare it to the here and now, today can you do and what can’t you do?
AP: I can do everything. I feel pretty empowered because my life isn’t over because of this cancer diagnosis. I am the same person. I am just on synthroid. I don’t sleep as well as I would like, so I make sure I have a really good sleep routine, and I have a whole calming ritual before I go to bed, which really helps, but I guess being on synthroid, I guess is like a common thing. I have talked to other people who are on it, and they have the same issues. In terms of what I can and cannot do, I don’t nap. I haven’t napped since 2011, so that’s very unfortunate. If I tried to nap, there is no way I could nap unless I am physically exhausted, then maybe. Overall, the sky’s the limit, I can do whatever I want.
BM: Annie, we are going to bring this to a close and whereas we always start from the same place, we also end on the same note as well. Imagine your speaking one-on-one with someone who has just been diagnosed with thyroid cancer. You might have many things to say, but if there is one piece of advice that stands out above all others, what would it be?
AP: To ask for help. To tell your friends and your neighbors, I’m really going through something and if you could bring by a meal or if you could watch my kids for a night or something like that, that would have helped me immensely, just knowing there are other people that care. I obviously knew people cared, but I would tell the person that had just been diagnosed to be your own advocate and ask for resources. Don’t assume people are going to step up, be that person that asks for help.
BM: Our guest is Annie Parrish of Brighton, Colorado, a mom, a nurse and a survivor of thyroid cancer. Annie, thanks so much for sharing your story, we really appreciate it. I have no doubt this will resonate with somebody at a very pivotal time in their life. It’s information they can use to help them in their cancer journey. So, Annie, once again, thanks so much.
AP: Thank you, Bruce.
SHOW NOTES
TITLE: Annie Parrish, Thyroid Cancer Survivor – Brighton, Colorado, USA
Annie Parrish underwent a procedure resulting in the removal of her thyroid but survived follicular thyroid cancer (with a papillary variant) and has gone on to flourish as a mom and a nurse. This is her story.
Addition Resources:
Thyroid Cancer Survivors’ Association: https://www.thyca.org
Time Stamps:
02:01 Annie noticed a golf ball-sized lump in her throat.
03:10 Went on a Synthroid regimen.
04:47 Lump resulted in choking incident that could have led to death.
07:30 Recalls when cancer was discovered.
12:06 Annie praises her care team.
13:03 Also had tonsils removed when her thyroid was removed.
14:08 Synthroid regimen was the toughest part of her treatment.
16:41 As a nurse, it was difficult to be a patient.
23:12 Annie compares what she could physically do pre-diagnosis to what she can do now.
24:19 Her advice to others diagnosed with thyroid cancer.
KEYWORDS (tags):
thyroid cancer
palpation
cancer interviews
thyroid panel
hypothyroid
hyperthyroid
synthroid
thyroiditis
fine needle biopsy
bruce morton
thyroidectomy
annie parrish
follicular
papillary variant
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