October 2007--First signs

I woke up in the morning unable to breathe. My throat was sore, and laying back flat in my bed, it felt like my throat had collapsed. My throat did not hurt too much and I have had a few sore throats over the past ten years, but something was different this time. Had my throat collapsed? Did I eat something that caused my throat to swell? I could not even swallow.

I went into the bathroom and stared at myself in the mirror. Suddenly, I could breath again. What happened? Why could I breath when standing but not while laying down?

One year earlier, I had moved to the small mountain town of Jasper, Georgia, about 60 miles north of metro Atlanta. I had visited my Atlanta internist, Dr. James Capo, about three months earlier for something else. This time, because of the pain and my trouble breathing laying down, I thought I would visit a local Jasper doctor to check out my sore throat. I wanted to be able to sleep better that night.

The appointment at the doctor's office was about 10 minutes from my home. Like most modern physician offices, a physician's assistant did a lot of the work. The assistant came in and listened to me complain about not being able to breathe, hoarseness and a sore throat. She stuck a tongue depressor in my mouth, and said that I had a minor irritation and prescribed an antibiotic. She was somewhat concerned that I had trouble breathing and she sat back, looked at my face and neck and said "You know you have a goiter and you should check it out". Now, being a biology major 25 years ago in college, I remembered the term "goiter", and I remember it being an "enlargement" but an enlargement of what?

I went home, looked at my neck and at this "goiter". Nothing looked different on the outside from what I normally see. I looked the way I did several years ago, except for a few more gray hairs. I did see an enlargement, a swelling around my Adam's apple. Was this the goiter? It had been there for a number of years. Pretty obvious. But nothing to worry about, right? Dr. Capo doctor never said anything about it, so why worry? Being 48, I thought this was just something that happened with age, as I put on a few extra pounds over the years. I kept in shape, but at 180 pounds, I was about 1o pounds more than I felt I should be.

Next step--go to the Internet and look up "goiter".

Goiter: An enlargement of the butterfly shaped thyroid gland, at the base of the neck, under the Adam's apple. The enlargement can be benign or malignant--cancer. Uh oh. Warning sign.