Reflect

What a difference two small pills make

ST ILLUSTRATION: MANNY FRANCISCO

Getting treated for hypothyroidism has freed me from my recalcitrant glands and unleashed new strengths

As a patient, I have no patience with myself.

The slightest weakness sets off some atavistic cavewoman gene and I respond with snarls and barks to offers of sympathy and coddling. Like an alpha wolf facing down potential challengers, I don a mask of stoicism and growl that all is well.


ST ILLUSTRATION: MANNY FRANCISCO


I'm not sick, I insist, and ooze into the office, a germ-spewing incubator of flu viruses loosely held together in human form. I'm perfectly fine, I wheeze at the concerned, ribs sprained from holding in coughs. This sweat trickling down my face and these red eyes? I'm not ill. It's hay fever.

I have a pain threshold so high that I worked last October with a broken arm, fooling the attending doctor for several days that I had suffered nothing more than a contusion when actually the lower half of my left arm was hanging suspended by a single ligament.

The injury is now thankfully completely healed and with the added bonus of turning my elbow into a reliable weather forecast - swollen with a touch of agony? Feels like thundery showers again.

Having established that I am the opposite of a hypochondriac, I find it ironic that for the past four years, I have been at the mercy of two little white pills which must be ingested daily. Not that I'm ill, you understand.

It's just that my recalcitrant thyroid gland fails to work as efficiently as it should and must be bolstered with a daily dose of the chemical thyroxine. So every morning, an hour before eating, four hours before eating anything involving milk, cheese, calcium or iron, I swallow two pills and a salutary dose of humility.

I am not invulnerable, though I act as though I were. And I can do that thanks to two small pills that changed my life.

The human body is a delicately, perfectly balanced cocktail of chemicals and hormones interacting to allow us to breathe, eat, digest and even think and create. If one tiny part of the system fails to work, the results can be disastrous.

Hypothyroidism, which I have, is characterised by slow metabolism.

It carries the risk of excessive weight gain, low immunity to bugs and viruses and short-circuited temperature controls. This means that, for years, I ballooned into an attractive ball of flesh, contracted flu every second week and had to wrap up like an Eskimo for dinner in a food court where the average customer wore shorts and complained about the heat.

And this continued for at least five years until a family wedding in 2011 threw me into proximity with several relatives from both the maternal and paternal side who were raving about their recent diagnoses of thyroid conditions and what a difference the medication made.

Thanks to a blood test taken soon after and the care of a concerned endocrinologist, within a couple of years, I lost half myself and gained the ability to see my toes; learnt I owned far too many sweaters and woollen scarves for a resident of a tropical country and also began tapping new reserves of manic energy. It confounds old friends whose idea of fun is dinner and a movie, not dinner and a movie and an all-night dance-a-thon followed by a sunrise jog.

It is like waking up after having been asleep all your life and this is the sleep of nightmares, not restful, sweet dreams.

Ask any other members of the secret set of thyroid sufferers (now diagnosed and stable).

We are legion, many of us female and, for years, we may have walked among you without ever letting on how very difficult it was to get up out of bed, to face the day, to goad our own sluggish, tiring minds and frames for the sake of our self-esteem or for the families who depended on us.

I am the least of these warriors. I was diagnosed relatively early compared with women I know who saw children grow into adulthood and carved out inspirational careers in various fields, all while battling decades of illness, anger and depression. Some had pregnancies affected. Some gained reputations as eccentrics because of the emotional and hormonal see-saw they straddled. All have found a new lease on life, thanks to daily medication, and many regret not going for testing earlier.

But why would they have? They gritted their teeth and kept on living with pain and exhaustion rather than admit to themselves and to others that something might actually be wrong with them. Part of the reason would be the understandable fear of confronting the unknown. The other is that our world does not reward the admission of weakness.

In the increasingly competitive times we live in, people are afraid to admit their true age, let alone a chronic illness.

Such illness is a socially fatal flaw, one that dooms the sufferer forever to be identified by an accident of their bodies, rather than their emotional and intellectual strengths. And it is worse, I think, for women, who are judged by more stringent yardsticks and have to prove themselves better than men, not just equal.

Being stoic is one thing, but I have come to realise it is healthier to be honest. Over the last five years, I have heard from so many others who also bear up under a curable but stigmatised condition and who are relieved to be able to talk about it with someone who is guaranteed not to judge.

It might be depression or bipolar disorder, again manageable with the right medication. It might be diabetes. The men and women managing these complaints hide them from most because they do not wish to be pigeonholed by their weaknesses.

Like me, they identify with their strengths.

I am not my recalcitrant glands. I am a writer, a reviewer and a mediocre-but- improving athlete with a life that includes climbing mountains, fighting for justice and one day, hopefully, taking an interstellar flight. So this life also includes regular medical check-ups. We should all have them, to stay as healthy as possible.

Even if - and my doctor said this too at my last check-up - there's nothing really wrong with me. I am absolutely, positively, gloriously well.

akshitan@sph.com.sg

A version of this article appeared in the print edition of The Sunday Times on June 21, 2015, with the headline 'What a difference two small pills make'. Print Edition | Subscribe