As I write this post, I am alone in my bedroom, sitting on my bed with the door closed to the sounds of the rest of the house. But, I can still hear my baby’s joyful screams and my husband’s dinner preparations as they clatter against the lilting strains of Frank Sinatra crooning in the living room. It’s a completely unremarkable evening, full of the familiar and beloved chaos that is usually found in my house at this time of day…and yet, I am unfathomably sad. These last few days have been some of the hardest of my life, and I am trapped right now in a moment of deep sorrow that I hope will be lifted by writing this post.
I was diagnosed with Graves Disease 8 days ago, and although the prognosis is very good, the diagnosis has brought with it physical and emotional changes that I have yet to come to terms with. About 3-4 months ago, I began to notice a dull ache in my neck that was accompanied by extreme fatigue, palpitations, hot flashes, muscle weakness, and a jittery sensation that made sleeping nearly impossible. I immediately suspected that my thyroid might be acting up, but I didn’t seek medical help right away because I figured I would be seeing my OB/GYN soon and she could order any tests I might need.
Let me explain: my husband and I were just beginning to try for another baby, and since we were extremely blessed with getting pregnant on the first try with our baby girl, I didn’t think I’d have too long to wait before I saw my OB/GYN for a second pregnancy. And when we had a positive pregnancy test in the middle of October on our second month of trying, I felt reassured that I would be getting my thyroid checked soon enough.
But one week later, those happy dreams of a second baby were shattered when I began to have heavy bleeding and cramping. And it became painfully apparent that I had had an early miscarriage. Needless to say, I was not thinking about my thyroid at that time. Instead, my husband and I were mourning the loss of what could have been, and I was distracting myself with applying for a new job.
Fast forward a month, and I tearfully went back to work full-time after spending 7.5 blissful months at home with my baby girl. I barely noticed my sleeplessness, my extreme heat intolerance, my near inability to lift a laundry basket, or my racing heart. My mind was solely focused on thoughts of missing my baby girl while I was away at my new job.
And then Thanksgiving rolled around, which was closely followed by a week-long business trip to Baltimore for work. And, by the time I got back home and felt like I could breathe again from all the craziness of life, I realized that the dull ache in my neck couldn’t be ignored anymore. As I was sitting on my couch the evening after getting home from Baltimore, I absentmindedly touched my neck…and that’s when the big and scary “C” word began to creep into my head. My thyroid was now undeniably swollen and painful. And even more disconcerting was the fact that all the lymph nodes in my neck were suddenly enlarged when they had previously been undetectable.
The very next day after becoming acutely aware of all these frightening transformations in my neck, I made a same-day appointment to see an endocrinologist. I was completely and utterly convinced that I had thyroid cancer as there is a strong history of this condition in my family. Thankfully, the endocrinologist told me straight away that he didn’t think I had cancer. Instead, he said he thought I had a condition called postpartum thyrotoxicosis, which is a form of autoimmune inflammation that causes the thyroid to become overactive following pregnancy.
After a few blood tests and a thyroid ultrasound, I went back to see my endocrinologist. He told me that although my results looked promising for postpartum thyrotoxicosis, he could not rule out a different autoimmune hyperthyroid condition called Graves disease. Furthermore, he told me that my miscarriage in October was almost certainly caused by my overactive thyroid. To differentiate between postpartum thyrotoxicosis and Graves disease, my endocrinologist ordered a radioactive iodine uptake study: if there was no uptake, then I had postpartum thyrotoxicosis and could expect my thyroid to calm down all on its own within 2-3 months. If there was a lot of uptake, then I had Graves disease and would need to either take medication to suppress my thyroid for the rest of my life, or eliminate my thyroid altogether (either by surgical removal or a heavy dose of radioactive iodine to ablate it).
Well, as I’m sure you’ve guessed by now, my scan showed a very high degree of uptake, which is consistent with Graves disease. And this is where things started to get a little dicy for me in terms of my emotional stability. Let’s back up a little bit: in order to have the radioactive iodine uptake scan in the first place, I couldn’t be within 12 feet of my baby girl for 66 hours due to the risk of potential radioactive emission. I also had to pump and dump my breastmilk during that timeframe for the same reason. So during those 66 hours, I watched from afar as other people took care of my baby girl, feeling helpless and lonely.
After waiting 3 long days just to be extra cautious, I finally got to hold my baby girl again, and that feeling of being reunited was more euphoric than anything I’ve ever experienced before. I pressed her tightly to my chest and when she nursed from me, I truly felt as if the emotional bond between us became tangible for an instant. But that instant was destined to be short-lived, and the knowledge that our nursing bond would be severed all too soon hung over my head like a dense fog.
You see, with the diagnosis of Graves disease came the need to begin treatment with an anti-thyroid medication whose safety has not been properly demonstrated during pregnancy or breastfeeding. That’s not to say that thousands of women haven’t had healthy babies while taking this medication; it just means that the theoretical risk is high of passing this medication through the placenta or into breastmilk and potentially causing the baby to become hypothyroid (among other things). My endocrinologist advised me that I should immediately stop breastfeeding in order to protect my baby, and so the decision was clear to me: my baby’s health meant more to me than the enjoyment of continuing to nurse her.
I decided to give myself 3 last glorious days of nursing my baby before beginning my anti-thyroid medication. And each precious moment that I held her to my breast, I was both elated and depressed, feeling torn between living in the moment to soak up every last second of nursing…and worrying about all that the future had to hold when breastfeeding came to its abrupt and premature end.
And before I knew it, my baby was weaned. Nothing about it went according to plan, and yet all of it went exactly as it should have. I had hoped to nurse my baby girl until she was 12 months old, whether that meant 1 feeding a day or 12. And, truth be told, she had naturally weaned herself to about 4-5 feedings a day as her diet had already transitioned to being predominantly solids.
On the dreaded morning of December 26, I nursed my baby for the last time. I knew it would be our final session ahead of time as I couldn’t delay taking my anti-thyroid medication any longer…and there comes a point when you just have to face the music and not put it off anymore. Time seemed to stand still as I gazed down into the eyes of my child. She reached her small fingers up towards my face and caressed my cheek. She stared deeply into my eyes as if she could tell that something was different about this particular feed. We stayed like this for several utterly perfect minutes…then, all on her own, she pulled away. And, just like that, our nursing bond was broken.