Lilian's Story

In 1953, Lilian had just given birth to her first son and was working as a nurse. When she started to lose weight, she assumed it was because she was busy trying to manage a career and family. She did not think anything was wrong until she returned from a vacation. A fellow nurse picked her up at the airport and commented on her appearance.

She took one look at me and said, "You need to go to the doctor." I had lost weight, and my eyes were bulging. Looking back on it, I had all the symptoms. My throat was quite prominent, my pulse was very rapid, my hands were shaky, and I was very nervous. I ached constantly. I weighed about ninety-two pounds, but I was eating a lot. I should have put two and two together, but I didn't. I was just too busy.

I realized that I probably had Graves' disease, so I went to a surgeon I knew. In those days, you went to surgery for Graves' disease. He did the surgery right away. I was in the hospital about a week. I did fine; the surgery went very well. I didn't have to take any [thyroid] medication at all; he left a very small amount of thyroid. I started gaining weight-back to where I had been before surgery. Gradually the symptoms went away; it wasn't overnight. I was just fine afterwards.

Forty-seven years later, Lilian went to see an internist for a complete physical.

My children had been real worried; they kept after me to go to the doctor. Because my hands were shaking, my daughter thought I had Parkinson's disease.

I knew something was wrong. I wasn't real sure, but I thought it was my thyroid. I had all the symptoms again. Right away [the internist] noticed how I looked. My eyes were just beginning to be prominent; my hands were shaky. I was eating like crazy but losing weight. I lost about twelve pounds; I went down to ninety-four pounds.

[My internist] made the appointment for me with [an endocrinologist]. [The endocrinologist] did all the blood work, thyroid tests, ultrasound, and uptake.

The results of Lilian's diagnostic tests confirmed that she was hyperthyroid again-her thyroid gland, including her pyramidal lobe, had grown back during the forty-seven years since her thyroidectomy. Her endocrinologist recommended that she take radioactive iodine.

He explained all the options to me and gave me [a book] to read. I had no hesitation; I followed his recommendation. I went to his office, and he gave me a capsule. When they brought it in, it was in a concrete canister. [The nurse] dropped it directly in my mouth. I thought I was going to glow in the dark! I didn't have any side effects from that at all. I didn't have to take any special precautions.

I'd say it took about six weeks to stop shaking and for my goiter to start going down. I started to gain weight. It was just a few pounds at first, but now I'm up to 114 pounds, and I'm five feet tall! I'm going to have to buy an all new wardrobe. I wore a size six to eight for a while. Now I can't get into them. I'm an eight in some things; it just depends on how it's made.

[My endocrinologist] put me on [levothyroxine] about a month after [the radioactive iodine]. It was a small dose. Then I didn't have to go back for three months. It was during that time when I gained the weight. I'm still hungry like I was before I was diagnosed. My appetite hasn't changed, so I'm gaining weight.

The doctor suggested that I take up jogging, but I broke my leg three years ago, and they removed two inches out of my femur. I'm not in any pain; I just don't walk as well. I'm inclined to limp a little bit. I'm cutting down on what I eat. I just need to cut down on the calories I'm taking in. I don't want to get to the point I'm uncomfortable with my weight.

Lilian's experience demonstrates one complication of surgery for Graves' hyperthyroidism-recurrence. Since Lilian was still hypo­thyroid at her last check-up, her endocrinologist increased her levothy­roxine dosage. She is expected to do well, without any more recurrences of her hyperthyroidism..