Five-year-old Jason was crankier than usual. Everything seemed to bug him — even things he previously loved, as well as sleeping and eating. Suddenly, he had trouble falling asleep and when he finally did, he couldn’t stay asleep. Foods he previously loved made him feel sick or he was starving so much, he couldn’t get enough food. He seemed more hyperactive, swinging his leg back and forth constantly, talking very fast, and was feeling hotter than usual, often sweating when it was cold out.
The pediatrician said he was simply having a growth spurt, or “just being a regular active boy.” Jason’s mom, Lindsey Moynihan, knew there was something else going on, but trusted her doctor. However, when Jason grew more restless and irritable, she sought out a second opinion from another pediatrician a few weeks later, and was given a clean bill of health once more.
“I was infuriated, because I knew Jason was just not himself,” she says.
A few days later, Lindsey noticed an ever-so-slight bump on Jason’s neck, and when she felt it, she instantly felt cold to her bones, not knowing what it was, but knowing that it shouldn’t be there.
At an Urgent Care facility, the doctor in charge ordered an immediate ultrasound of Jason’s neck, which showed a very large nodule directly on his thyroid gland, and bloodwork. Lindsey was directed to an endocrinologist who did more bloodwork, which showed that Jason was hyperthyroid, meaning that he was producing too much thyroid hormone, which was causing his anxiety, rapid heart rate, mood swings, and more.
The endocrinologist discussed the possibility that a nodule of this size could also be malignant. The American Society of Clinical Oncology reports that “thyroid cancer is the most common cancer in women 20 to 34. About two percent of cases occur in children and teens. The incidence rates of thyroid cancer in both women and men have been increasing in recent years, at a rate of about five percent more a year.”
“To learn that Jason had a thyroid problem was bad enough, but to consider that it might be stemming from cancer was devastating,” says Lindsey.
Lindsey was then referred to a thyroid surgeon and a biopsy was performed in the surgeon’s office in the form of fine needle aspiration. The American Association of Clinical Endocrinologists recommends that fine needle aspirations should be considered for nodules larger than 10 millimeters in diameter. Jason’s nodule was more than three centimeters. After three agonizing days, Lindsey got the phone call that the nodule was benign. She was “extremely relieved and thankful,” however, Jason still suffered with the hyperthyroidism.
The thyroid is a vital organ and responsible for every system in the body, so hyperthyroidism causes every body system to work in overdrive. Jason’s heart rate was 130 at rest and his metabolism was so sped up that he was losing weight despite eating more. Graves’ Disease, an autoimmune disease, can cause hyperthyroidism, but Jason’s blood test showed he did not have this, so the next step was a radioactive thyroid uptake scan. This requires the patient to ingest a radioactive pill and then have a scan done to see how the thyroid is working.
Lindsey was not thrilled with the idea of her son having to ingest a radioactive pill, but she was assured that the amount in the pill was a safe level, and it was crucial to finding out where the hyperthyroidism was coming from.
This thyroid uptake scan showed that Jason had a toxic nodule, a solitary nodule that was producing extra thyroid hormone. There are two options when faced with a toxic nodule: radioactive iodine treatment or surgery. Children are not candidates for radioactive iodine treatment (and many adults opt out of this as well as it contains a massive amount of radioactive iodine and necessitates isolation for three to seven days). Anti-thyroid medication may also be given to help alleviate hyperthyroid symptoms initially, but it will not be a permanent solution. Surgery was the recommended choice.
“The surgeon explained that toxic nodules do not go away on their own, and surgery is often inevitable, and it’s a long-term solution. I was so on the fence about it, but when I heard this, I knew it had to be done.”
A month later, Jason underwent a partial thyroidectomy. His hyperthyroidism resolved almost immediately and the surgery discovered that the nodule had been pressing on his trachea, another reason why removal was the best option. Lindsey feels relieved now that the six-month ordeal is over, and happy that she did not take “no” for an answer when her son first became sick.
“Jason did wonderful with the surgery, and says he can even breathe better now,” says Lindsey. “I am so glad it is all over, and also glad that I discovered the lump before his condition worsened.”
Danielle Sullivan is a writer living in New York City. Follow her on Instagram @Deewrite.
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