Radioactive iodine

A Daughter’s Efforts To Preserve Her Physician Father’s Extraordinary Legacy

By Barbara Hertz

In 1936, clinical research into the potential of nuclear medicine–a medical specialty involving the application of radioactive substances in the diagnosis and treatment of disease–was in its infancy. That year, endocrinologist Dr. Saul Hertz attended a lecture in which Massachusetts Institute of Technology president Dr. Karl Compton urged physicians to seek out applications of physics in medicine and biology. Intrigued and inspired by Dr. Compton’s call to action, Dr. Hertz posed a simple question to Dr. Compton: “Could iodine be made artificially radioactive?”

Thus the seeds were planted for research that culminated in one of the most profound and enduring of medical discoveries: the successful use of radioiodine in the treatment of Graves’ disease (hyperthyroidism) and as the first targeted cure for cancer, specifically thyroid cancer (because the thyroid absorbs iodine, the radioactivity is also absorbed, destroying the cancer cells while leaving all other cells in the body unharmed).

There’s no doubt that Dr. Hertz’s revolutionary work not only changed the treatment of thyroid disease forever and saved countess lives worldwide, but also paved the way for significant advancements in the nuclear medicine field. Sadly, Dr. Hertz died of a heart attack in 1950 at the age of 45. Here his youngest daughter, Barbara, shares her memories of her father, how she became aware of his historic achievements and what she is doing to preserve his extraordinary legacy.

What are your early memories of your dad?

The first memory I have of my dad is from a picture that hung on my bedroom wall. He had died suddenly of a heart attack when I was three. In the photo, he looked elegant in formal tails and happy next to my beautiful mom in her rented wedding gown. They stood by the fireplace in our Grove Street home in Brookline, a suburb of Boston. As a youngster, I would not have recognized the Phi Beta Kappa Key he wore that day. It was not until much later that I learned of its significance as well as his important contribution to medicine. I grew up hearing my dad had discovered radioactive iodine (RAI) as a treatment for a disease, but had little information beyond that.


Dr. Saul Hertz.

How did you come to learn about his contribution to medicine?

While cleaning out my childhood home I discovered boxes and boxes of my dad's papers that were safely stored in the attic. My mother had thrown out very little in the nearly 60 years she had lived there. What a treasure of correspondence, original journal drafts, newspaper articles and, to my amazement, the data charts of the very first series of patients treated with radioactive iodine!

Over time, and with the help of medical historians, archivists and prominent thyroid specialists, the story unfolded. I found the letter that MIT's President Compton sent responding to my dad's spontaneously asked seminal question posed in November of 1936. I came to appreciate that my father was the first and foremost person to develop the clinical data demonstrating the tracer qualities of RAI and its use in the treatment of thyroid diseases. I later came to understand the RAI is the first targeted cancer therapy and that it represents the gold standard, even today. The materials revealed his commitment to teaching, research and practice. He clearly envisioned an integration of the sciences and that a targeted approach to cancer treatment would go beyond thyroid cancer.

What have you done to share his work?

To begin with, the American Thyroid Association (ATA), as part of its 74th annual meeting in 2002, held a "Saul Hertz Meets the Professor Luncheon.” I wrote a short article for the ATA's newsletter highlighting my dad's background and pioneering work. I also attended the meeting and was able to meet many of the ATA leaders and members.

The next year marked the Endocrine Society's 85th Meeting in Philadelphia. I worked closely with Dr. Adolph Friedman, who had visited my dad in the 1940s in Boston during the early years of his research and was the first Washington, D.C. physician to use radioactive iodine. He headed the Endocrine Society's history project and had developed a presentation featuring my father’s patient data charts that was displayed on the exhibit floor at the meeting.

My mission became clear that my dad's story could and should be shared.

The next significant step was his induction in the National Museum of American Jewish History. He is currently featured in the museum’s multimedia "Only in America" Gallery.

The staff at Harvard Medical School Countway Library of Medicine has offered suggestions, contacts and support. This relationship led me to endocrinologist Dr. Lewis Braverman, then-editor of Endocrine Practice, the peer-reviewed journal for the American Association of Clinical Endocrinologists. He encouraged me to work with his staff in developing an historical vignette for the magazine, which was published in July 2010. His fatherin law had been at The Beth Israel Hospital (now Beth Israel Deaconess Medical Center) when my dad was on staff there after World War II. The article reached Dr. Alvin Urles, who had been a young fellow under my dad's direction at Beth Israel. He contacted me when he
was 89 years of age and related many medical details about my father’s work.

2012 was a benchmark year in Boston. It marked MIT's 150th year, Massachusetts General Hospital’s 200th year and 75 years since my father’s encounter with President Compton, which ultimately led to the building of MIT's cyclotron and the radioactive iodine research. An author who was writing the history of Massachusetts General Hospital came to Connecticut to talk with me. He was particularly interested in my dad's work and explained that he had been one of two practicing Jewish doctors at Massachusetts General in the 1930s. I later came to learn that when my dad arrived at MGH in 1931 that he was a Dalton Scholar in that Jewish doctors were not allowed on the staff at that time. There were quotas for Jewish students at Harvard Medical School when he graduated in 1929.

While attending the opening of MIT's 150th anniversary museum exhibit, I was introduced to then-MIT President Susan Hockfield. She immediately recognized my dad's work and spoke about his profound contribution to medicine and science. I then was invited to MIT’s 150th symposia, "Conquering Cancer through the Convergence of Science and Engineering,” held in March 2012 where American geneticist, molecular biologist and Nobel Prize winner Phillip Sharp poke of dad’s work as MIT's first cancer treatment.

Harvard Medical School honored my dad and the 75 years since his RAI research began at Vanderbilt Hall, the very place where MIT's Dr. Compton had spoken. Significant correspondence, newspaper articles, two Journal of the American Medical Association articles that announced the effectiveness of the RAI treatment in hyperthyroid patients, photographs and more were displayed. Harvard Vanguard Medical Associates endocrine division chief and immediate past president of the American College of Endocrinology Dr. Jeffrey Garber and Dr. Braverman highlighted the history and my dad's legacy, with Dr. Braveman stating," We owe Saul Hertz a debt of gratitude."

This motivated me to consider how to pay that debt, and I began pursuing avenues to share my father’s story. My local newspaper, the Greenwich Time, had a frontpage story featuring my dad’s story on Father's Day. Additionally, National Public Radio broadcast a Father's Day tribute on its local Connecticut station. And the Society of Nuclear Medicine and Molecular Imaging (SNMMI) exhibited at its annual conference this past June the materials presented at the Harvard Medical School 2012 reception. These efforts, while significant, have led to my desire to further acknowledge my father’s work with the establishment of a yearly award in honor of my father’s accomplishments.

Why did you contact the American Association of Clinical Endocrinologists to honor Saul Hertz?

This Theodore Roosevelt quote made me think of all the members and support staff who are "...actually in the arena” for more than 70 years, along with countless future generations, who have carried or are carrying my dad's dream forward:

“It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.” --Theodore Roosevelt

To pay tribute to the hope, courage and determination of Saul Hertz and other medical pioneers, Ms. Hertz has established the "Dare Bravely" Award.

Award can be sent to:

Donald C. Jones
Chief Executive Officer
American College of Endocrinology
245 Riverside Avenue - Suite 200
Jacksonville, FL 32202

Iodine and the Thyroid: The Connection You Should Know About

By J . Woody Sistrunk, MD, FACE, ECNU

To many, iodine (EYE-eh-dine) is simply element #53 on the periodic table you learned about in high school chemistry class or an antiseptic used to disinfect a nasty case of road rash after a bicycling mishap. In fact, iodine is the most essential ingredient needed to make T3 (triiodothyronine) and T4 (thyroxine), two thyroid hormones that affect virtually every cell in the body and are essential in regulating metabolism. Your thyroid concentrates the iodine and uses it to make thyroid hormone much like the Ford Motor Company uses steel to make cars. Without iodine, the production of thyroid hormone simply does not happen, thus throwing the body’s function into a tailspin.

Iodine was identified in the year 1811, when French chemist Bernard Courtois discovered it accidentally while mixing burnt seaweed (kelp) with sulfuric acid to create potassium nitrate, a vital component used in gunpowder. Soon thereafter, Swiss physician and researcher Jean Francois Coindet found that iodine could reduce goiters (enlargement of the thyroid gland) and began treatment of the condition with iodine. And the rest is history? Well, not quite.

Iodine Deficiency ...how common is it?

Iodine is present naturally in seawater and in soil. But a stable source of the element does not exist in many parts of the world. And since the body cannot make the substance, iodine must come from an outside source. Consequently,
control of iodine deficiency disorders is an integral part of most national nutrition strategies. In the United States, salt producers cooperated with public health authorities in the 1920s and added iodine to cooking salt to correct the then-present epidemic of goiter (salt was used as the carrier because it was an easy, spoil-free method of getting iodine into the food chain). So, if you live in the United States, the chance of having simple goiter from iodine deficiency is rare. Most thyroid enlargement in the United States these days is a result of thyroid nodules (multinodular goiter) or other autoimmune thyroid disease such as Graves’ disease or Hashimoto’s thyroiditis.

Still, the population in many parts of the world where there is little iodine in the diet (remote mountainous areas, semi-arid equatorial climates and certain parts of Europe) continue to be at risk for iodine deficiency, which affects about two billion people worldwide.

Pregnant women are particularly at risk for the condition. This is a result of increased thyroid hormone production during pregnancy , which a fetus needs in vitro (inside the womb) to reach optimal development. Thus, the body requires more iodine than what would typically be considered a baseline amount of iodine. And because expectant mothers typically experience increased excretion of iodine through the kidneys – a normal part of any pregnancy – the need for iodine intake is enhanced further. Iodine deficiency during pregnancy may result in cretinism (mental retardation in children), deafness, autism, and delayed brain development and is the leading cause of preventable mental retardation.

As the body’s iodine levels fall, hypothyroidism may develop, since iodine is essential for making thyroid hormone. While this is uncommon in the United States, iodine deficiency is the most common cause of hypothyroidism worldwide.

Daily Dose Guidelines

Although most table salt available today is fortified with iodine as part of the manufacturing and refining process, because we are an on-the-go society that often partakes in processed and so-called “fast” foods – almost none of which contain iodized salt – concern about continued iodine deficiency has been raised by groups such as The Salt Institute and the International Council for the Control of Iodine Deficiency Disorders (ICCIDD).

The current Institute of Medicine Guideline for iodine for men and women is 150 micrograms (mcg) per day. Most multi-vitamins contain this amount of iodine. For pregnant women, 220 micrograms/day is recommended. For women who are breast feeding, 290 micrograms of iodine is recommended. Surprisingly, many prenatal vitamins contain no iodine. So, if you are considering pregnancy or are pregnant, check your prenatal multivitamin’s contents to make sure you are
getting the iodine you and your developing fetus will need for a healthy pregnancy and baby.

Your Health and Iodine Excess

Although iodine is essential to life, taking too much iodine can cause problems. This is especially true in those individuals who already have thyroid conditions.

Exceeding the recommended daily dose of iodine can cause symptoms such as pain in your mouth or throat or a metallic taste in your mouth, nausea and vomiting, diarrhea and difficulty urinating. More severe symptoms of iodine poisoning can include life-threatening conditions such as seizures, delirium, breathing difficulties, fever, shock and severe confusion. But the amount of iodine for this to occur is quite high -- a consistent intake of over 2,000 micrograms of iodine daily.

When iodine-rich seafood or seaweed is a large part of the diet, the thyroid might become overactive because excess iodine can promote extra thyroid hormone production. The thyroid counteracts this action through a very specific mechanism present in the body known as the Wolff Chaikoff effect. Once a threshold of iodine is reached in the body, a decrease in the output of thyroid hormone occurs. This effect lasts just over one week, after which the body will then resume the production of thyroid hormone.

Dietary iodine is rarely a source of iodine excess . Most iodine excess is either from the abnormal heart rhythm prescription medication amiodarone or from the use of iodinated contrast dye, a form of intravenous, iodinecontaining radiographic dye used for x-ray studies. When exposure to these substances is ongoing, the body continues the production of thyroid hormone.This is called “escape from the Wolff-Chaikoff effect.”

There are special circumstances in which avoiding excessive iodine intake is essential.

When therapy with radioactive iodine is planned either for hyperthyroidism or thyroid cancer, avoidance of regular iodine is of critical importance as the body does not discriminate in the forms of iodine that it takes in. By not following a low iodine diet prior to radioactive iodine therapy or testing for thyroid cancer, the radioactive iodine may not reach the cells to be destroyed.

Also, if someone has become hypothyroid either by disease, surgery, or other forms of therapy and is on thyroid hormone replacement, additional iodine will not help and may interfere with the way any remaining thyroid tissue works.

Radioactive Iodine

Since the 1940s, the radioactive isotope Iodine-131 has revolutionized the evaluation and treatment of thyroid disorders. The once-fatal illness of Graves’ disease (hyperthyroidism) can almost always be treated with a single capsule of radioactive iodine. The thyroid takes up the radioactive iodine, just as it would normal iodine, and the radioactivity in the iodine destroys most or all of the tissue in your thyroid gland, but does no harm any other parts of your body. Radioactive iodine is also useful in destroying both normal and malignant tissue in thyroid cancer following thyroid surgery. Although these therapies are approaching 70 years since their widespread use in clinical medicine, they remain the standard of therapy for both hyperthyroidism and thyroid cancer.

If you are allergic to iodine and are scheduled for thyroid testing that uses radioactive iodine, make certain you clarify with your physician the nature of your allergy. For example, a reaction to shellfish does not equate to an allergy to iodine, nor does a prior reaction to a large dose of intravenous contrast exclude the use of radioactive iodine for diagnostic or therapeutic purposes. A usual dose of radioactive iodine contains roughly the same amount of iodine as a piece of bread. With this, an allergic reaction to radioactive iodine is very rare.

Conclusion

Due to its important role in thyroid function, as well as fetal and infant development, iodine is critical for proper health at all life stages. Thus, adequate iodine intake remains of paramount importance in prevention of thyroid disease. The history of understanding the importance of iodine is the history of understanding many thyroid diseases. To better appreciate how this simple element has been entwined in the management and treatment of thyroid disease throughout time, you can view the complete American Thyroid Association (ATA) Thyroid Timeline at: http://thyroid.org/ events/thyroid-cancer-tumor-history/. For additional information on thyroid diseases, their diagnosis and treatment, visit the American Association of Clinical Endocrinologists’ (AACE) thyroid website at: http://thyroidawareness.com.

J. Woody Sistrunk, MD is an endocrinologist in Jackson, Mississippi. His practice, Jackson Thyroid & Endocrine Clinic, is a full-service thyroid clinic offering an on-site CLIA-certified lab, thyroid ultrasound/FNA biopsy, thyroid cytology and thyroid nuclear medicine. He currently serves as the chair of the American College of Endocrinology’s Endocrine Certification in Neck Ultrasound (ECNU) Certification Committee. He is also a charter member and current president of the Academy of Clinical Thyroidologists. He has a strong interest in the history of thyroidology and is the Chair of the American Thyroid Association’s History and Archives Committee.

Back on Track: 3 Time Olympic Gold Medalist Gail Devers' Story

Back on Track

3 Time Olympic Gold Medalist Gail Devers' Story

By Bryan Campbell

Blink and you just might miss the fastest woman in the world. But you’ll never forget her champion’s smile, and her signature fingernails.

Gail Devers became a household name during the Barcelona Olympics of 1992. The young American sprinter raced into our hearts with one of the greatest finishes in Olympic history—a photo finish in the 100-meter sprint finals. Five women finished within 0.06 seconds of each other. Gail won the gold medal and the title “Fastest Woman in the World.”

People around the world instantly recognized her for her huge smile and her even bigger fingernails.

But just two years before that race, it seemed like Gail’s racing days were over.

Gail Devers was a rising star in the track and field community. After a successful college career, she set her sights on the 1988 Seoul Olympics. But as she prepared for the games, she noticed that something wasn’t right with her body. She often felt run-down, like she had been “running in neutral” all day long.

She experienced other problems, too. She was losing weight fast.

“At first, I thought this was cute, but after a while, it went beyond being cute,” says Devers.

She competed in the 1988 Olympics but did not win a medal. After the games, her health continued to get worse. At one point, she thought about giving up racing altogether.

“I went to several doctors, and none of them could tell me what was wrong,” says Devers. “At some point it stopped being about competing, and it started being about getting my life back.”

Finally, after three years of unanswered questions, Gail got a simple test called a TSH. The test checks the function of the thyroid. As it turns out, she had a condition called Graves’ disease.

Graves’ disease is a form of overactive thyroid disease. It is an autoimmune disorder, which means that the body’s immune system is actually attacking the thyroid, prompting it to produce more thyroid hormone than is normal.

Thyroid hormone acts as a kind of regulator for metabolism. If your body doesn’t have enough thyroid hormone, you can feel sluggish and weak. In Gail’s case, with too much thyroid hormone in her system, her body was running on overdrive all the time.

She received radioiodine [RAY-dee-o-EYE-uh-dine] treatment, which slowed down her thyroid. Because her thyroid now cannot make enough thyroid hormone, she is on a daily thyroid hormone replacement regimen. She takes one pill every day to keep her thyroid levels in check. And she makes sure to see her endocrinologist [en-doh-kri-NAH-low-jist] every six months to make sure that her levels are good.

The treatment got Gail back in the race.

“It was like I got my life back,” says Devers. “I was back to battling my opponents, not my own body.”

And with careful monitoring from her doctor, she started training again. And less than two years later, she was standing on the podium, accepting her first gold medal.

Yes, first.

Four years later, at the Olympic Games in Atlanta, she took home not one, but two more gold medals, one for the 100 meter sprint, and one for the 4×100 meter relay. Again, Gail was a household name. Those fingernails became known around the world!

But just what was it that led the fastest woman in the world to grow those fingernails? The answer provides a key to understanding her personal struggle.

“I grow my fingernails for three years, because that’s how long I went undiagnosed,” says Devers. “Every three years I cut them and start growing them again.”

Gail’s signature fingernails are a message to people everywhere that they don’t have to live with a thyroid disorder. If you are feeling sluggish or run down, if you are experiencing weight gain or weight loss that you can’t explain, or if you are feeling any of the other symptoms of thyroid dysfunction, then you should think about getting your thyroid checked.

Today, Gail is running a new race. She’s no longer competing in track competitions. But she is still chasing young ladies around. Today, Gail is living in Atlanta, site of her 1996 Olympic victories, with her husband and two young daughters.

“I haven’t slowed down at all.”

And that’s the message that Gail still takes with her wherever she goes. She’s passionate about making sure people understand the signs and symptoms of thyroid disease, and that they understand proper treatment.

“I get my thyroid hormone levels checked every six months, and I make sure my levels are right,” says Devers. “I don’t plan on slowing down again for a long time.”

To hear more from Gail Devers about the importance of thyroid health, Click Here

Have Faith: Actress Faith Ford’s Struggle with Graves' Disease

Have Faith: Actress Faith Ford’s Struggle with Graves' Disease

By Bryan Campbell

It’s Christmas time. A childhood dream is coming true for the girl from Pineville, Louisiana. As she gets ready to tape an episode of a hit new television comedy, she starts to feel hot and jittery. “Just nerves” is what people tell her. But then she realizes she is having trouble remembering her lines. It gets so bad that someone calls the paramedics.

“An anxiety attack,” they say. The young actress is given a glass of milk and a peanut butter sandwich. She knows that something isn’t right. Somehow, she pulls everything together to give her performance. But once the taping is over, the star of the show, Candice Bergen, gives her simple, and ultimately life-saving advice.

“You need to see your doctor.”

In the fall of 1988, actress Faith Ford should have been on top of the world. The 24-year-old former model had just landed a leading role on the hit comedy Murphy Brown. Playing the loveable journalist, Corky Sherwood, she was an overnight star across the United States. But while she was experiencing virtually overnight success, she was struggling with more subtle changes in her body.

“I was losing weight, even though I was eating enough food for two full grown men,” said Ford. While many might think that is a good thing, she knew something wasn’t right in her body. Despite being an avid exerciser, she often found herself very weak. Often, she would find herself incredibly hot, despite being in relatively cool rooms. “I wanted to dip my hands in ice water just to cool down,” Ford recalled. To make things worse, she often felt that she had sand in her eyes.

Ford tells of a bonding experience where Candice Bergen invited the cast of Murphy Brown on a ski trip. But every time that Ford would fall down, she struggled to gather the strength to stand up again. Later, after the misdiagnosed panic attack episode happened on the set of Murphy Brown, Ford knew she needed to take the advice of her co-star and go see a doctor. But because her symptoms were somewhat vague, the doctor had a hard time making a diagnosis.

“I stayed with my doctor for more than two hours,” said Ford. “Finally, he had an ‘A-ha’ moment and asked me to take a glass of water and swallow.” That’s when the doctor noticed a lump at the bottom of Ford’s throat. It looked like a bulging muscle. Ford had seen it, but assumed it was the result of her workout routine. The doctor knew that it was a malfunctioning thyroid.

Ford had a condition called Graves’ disease. This condition is marked by an overactive thyroid. The thyroid gland produces the hormone which regulates the metabolism in the body. In Ford’s case, too much of this thyroid hormone was responsible for the symptoms she was experiencing.

Happy to finally have a diagnosis, Ford was ready to deal with the problem. Her doctor prescribed a medication to regulate her thyroid hormone levels. She took the medication as prescribed and thought that her thyroid problems were behind her.

Fast forward to six years later, Ford started to notice that, again, she wasn’t feeling right. This time, she recognized the symptoms right away and went right back to her doctor. She received the same treatment as before, but this time it didn’t work.

Her doctor informed her that in order to maintain a normal thyroid hormone level, she would have to lose her malfunctioning thyroid. This left her with two options: remove the thyroid surgically, or kill the thyroid using radioactive iodine (RAI) treatment.

By this time, Ford was very thyroid smart. She had learned that her mother has an underactive thyroid, and that thyroid conditions are hereditary and highly common in families. Her mother advised her against having her thyroid surgically removed. Add to that the fact that surgery would take her away from work for about three weeks in the middle of the season, and Ford’s decision was easy. She opted for the RAI treatment.

Once her diseased thyroid had been destroyed, Ford’s doctor needed to replace the thyroid hormone her body should have been producing normally. She was placed on a synthetic thyroid hormone replacement therapy. Simply put, she started taking one pill, every day, to replace the thyroid hormone her body could no longer make. That was more than 16 years ago. And every day since, Ford takes her medication religiously.

“I take it at the exact same time, every day, first thing in the morning,” said Ford. “I take it on an empty stomach and I never skip a day.”

Ford has enjoyed a long and successful career in acting, including Murphy Brown and Hope and Faith, and will next be seen in the upcoming Disney feature film Prom, scheduled for release on April 29th. Recently she ventured into the producing business. She just produced and starred in a feature film entitled Escapee that will be released later in 2011. She’s working with her husband to run a full production company in her home state of Louisiana while helping to invigorate the growing film industry in the state.

In addition to acting and producing, Ford has hosted two seasons of a lifestyle web series for MSN and Kraft called “Mind Body Balance” (www.mindbodybalance.com). On the series, Ford interviews experts and gives tips about how to simplify life in all areas, particularly when it comes to cooking, exercising and organization. Ford enjoys cooking and is the author of the cookbook Cooking With Faith, which features some traditional Southern recipes along with some healthier, updated versions of Southern favorites.

How does she manage to keep up the energy to juggle all of these tasks at once?

“Because I feel better today than I did in my 20s,” said Ford. “Once my thyroid was in balance, it gave me my life back.”

And she has one simple piece of advice for you.

“If you aren’t feeling like yourself… if you just feel like something is different and you aren’t sure what it is or why… it might be your thyroid. So do what I did. Talk to your doctor.”

Have Faith: Actress Faith Ford’s Struggle with Graves' Disease

Have Faith: Actress Faith Ford’s Struggle with Graves' Disease

By Bryan Campbell

It’s Christmas time. A childhood dream is coming true for the girl from Pineville, Louisiana. As she gets ready to tape an episode of a hit new television comedy, she starts to feel hot and jittery. “Just nerves” is what people tell her. But then she realizes she is having trouble remembering her lines. It gets so bad that someone calls the paramedics.

Life, Interrupted...

Life, Interrupted...

The year is 1994, and Carmen Kenrich is living the dream.

The 20-something newlywed and her husband Walter “Chip” Kenrich had recently relocated from Washington, D.C. to Boston to be closer to her Long Island-based parents, making the move shortly after an “investigative weekend” visit to the city and interview produced a plum job offer.

Carmen and Chip were busy getting reacquainted with college friends also residing in the area, and she was settling happily into her new position as a health care administrator in charge of surgical specialties with Harvard Community Health Plan when – during a routine workday – Carmen made a discovery that would forever alter her life.

“I’m of Spanish heritage and talk a lot with my hands, and I was in a room with colleagues, talking, talking, talking, when I put my hand to my neck and thought, ‘Well, that’s a big lump on my right side.’ And my knee-jerk reaction was that I had something wrong with my thyroid.”

Previously an emergency medical technician who had also studied to be a physician’s assistant, Carmen immediately booked an appointment with her primary care physician, who initially was skeptical about Carmen’s self-diagnosis, but upon examination confirmed that she had a thyroid nodule (a solid or fluid-filled growth that forms a lump in the thyroid gland). Subsequent blood tests, ultrasound, nuclear scans (with radioactive iodine) and a biopsy with a fine (thin) needle then led to a diagnosis of thyroid cancer.

“It was my first time hearing the diagnosis, and it was literally one of those moments of pure shock,” Carmen recalls. “When you hear the ‘c’ word in those circumstances, it’s so associated with death, and back then there was no internet to look up things, no support organizations at the time that I could call, so I felt incredibly isolated.

“To tell friends or even parents that I had cancer, even though I’m a people person, it was hard to explain and was difficult because I was so young,” she adds. “Plus, I’m a person in my 20s, my friends are partying or just getting married, so it felt like isolation at the highest level for a while there.”

One of Carmen’s saving graces was Dr. Gordon Vineyard, who performed her thyroidectomy, the surgical removal of all or part of the thyroid gland. “Not only was he an accomplished surgeon who was technically superior, but he was also very compassionate and had an excellent bedside manner,” Carmen notes.

Following the surgical procedure, a post-surgery overnight hospital stay and a two-month recuperative period, she was admitted to Beth Israel Hospital (now Beth Israel Deaconess Medical Center) to undergo radioactive iodine treatment, a procedure in which the patient takes liquid or tablets that contain radioactive iodine. The iodine goes directly to the remaining thyroid tissue, where it is absorbed by the tissue and destroys any remaining thyroid cells in the body. Any excess radioactive iodine not collected by the thyroid cells is eliminated from the body in a few days through urine.

“That was the most interesting experience because I was in a room alone, totally secluded and I couldn’t have visitors,” Carmen recalls. (Editor’s Note: At present, most patients are not hospitalized for radioactive iodine therapy).

Enter saving grace number two: Dr. Jeffrey Garber.

An endocrinologist who had met with Carmen prior to her radioactive iodine treatment, Dr. Garber took over Carmen’s ongoing post-surgery care, prescribing thyroid replacement hormone drugs, testing her levels and adjusting her medication periodically as needed to ensure optimal results. Beyond monitoring and managing her thyroid condition, his diligence and skills were critical in helping the Kenrichs have a family, Carmen believes.

“We weren’t able to conceive and I had an unexplained diagnosis of why we couldn’t have kids, so I always wondered if it was the thyroid. And I went through a lot of IVF (in vitro fertilization) and a lot of hormone therapy, so we worked very closely together on what I was going through, including him looking very closely at all of the treatments,” Carmen notes. “There were so many medication adjustments with all of the P treatments, but he’s a stickler for detail, as they have to be in his specialty, to determine the proper dosage of my medicine.”

The proof, as they say, is in the pudding: today Carmen is proud mom to 11-year-old daughter Taylor and eightyear-old son Trace, both conceived via IVF. “My third (seven-year-old daughter Tatum, who was conceived naturally), as I said to Dr. Garber, was my miracle baby,” Carmen says. “A gift from God who said, ‘Here you go, you’ve gone through a lot, so here’s your gift.’”

Cancer-free for 18 years, Carmen is quick to count her many blessings.

These days she is employed by a healthcare leadership search firm as an executive recruiter, spending most days engaged in conversation with physicians under consideration for chief medical officer placements. She has given back to the community, serving as chair of The Wellness Community of Greater Boston, a support organization that provides free services to cancer patients and their families, and as chairperson of the Winchester Republican Town Committee.

But ultimately, it’s time with family that she most cherishes. “I’m a summer person, so what I enjoy most is being on the beach, hanging out with my husband and with the kids on Long Island or East Hampton,” she says.

“When you face a cancer diagnosis at such a young age, then face the challenge that you can’t have kids, then you’re blessed with three healthy children, all you can say is ‘I’m the luckiest person on this Earth. Because look what I have. Look what I have now.’”

Living the dream, indeed.

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