This picture helps tell the story. This is September 28, 2003. It shows an enlarged thyroid--the swelling is clear on the outside. However, if you compare the thyroid size in this image with the one a year later (an earlier posting in this blog--just scroll down) you can see that it did grow significantly. A key point is that the thyroid must have been enlarging before this image--perhaps a year or two earlier.
This was Madison's birthday.