Thursday, 30 March 2017

Baby Joy: Sharing the News

Much is made of breaking the news of your impending bundle of joy these days... From social media pregnancy announcements and gender reveals to the increasingly popular 'baby shower', people are becoming ever so creative (and elaborate) in publicising the fact that they have a bun in the oven.

Perhaps our 'pregnancy announcement' could also be considered quite elaborate, bearing in mind the fact that it involved international flights and a large element of surprise, but it was also extremely intimate. I don't have anything against people who choose to make a large public display of their news, but for us the most important thing was to tell our nearest and dearest in the most personal way possible.

Giving it the personal touch is all the more difficult when you live an 8-hour flight away from your family. My husband's side live in the same country as us, and we see them roughly once a fortnight, so it wasn't an issue telling them face-to-face. But the distance and time to reach my mother and grandparents back in the UK - paired with the fact that my husband doesn't have a 'regular' job whereby he gets weekends off or can request annual leave at any point - proved to be quite an obstacle.

Our first window of opportunity to travel appeared to be presenting itself in late December, just before New Year - still in the very early days of my pregnancy. But, due to the changeable nature of my husband's work schedule, the possibility was taken away from us at the last minute. Cue much disappointment on my behalf; all I wanted to do was share our happiness with my close family, and be able to keep them updated and involve them in the journey.

The next chance - in mid-February - was touch-and-go as to whether my husband would get the approval to travel for 3 days from his work or not. In fact, we only got the green light very late on the Friday night, and were hopping on a plane in the early hours of Saturday morning. My family were none the wiser and thought we were at home in Dubai as usual.

So, surprise number one was simply us being in the UK - our first visit back to my homeland since getting married. It went down a treat. But nobody was expecting surprise number two.

The day before flying to the UK I had been for my 18-week scan, during which we were hopeful of finding out the baby's sex to add to our little reveal. Unfortunately, though, baby was proving uncooperative at that point, shyly keeping his or her legs firmly crossed for the entirety of the scan, so we didn't have a clue! Our initial idea for revealing our pregnancy news to my family had been to gift-box a little pair of either pink or blue socks for them to unwrap, but since we still didn't know which colour would be appropriate, we moved on to Plan B.

Plan B was to frame the most recent scan picture - one for my mother and one for my grandparents - wrap the frames up, and sit the three of them down to open them at the same time. So this is exactly what we did. With my husband at the ready to film their reactions, we sat and impatiently watched them sloooowly unwrap (plenty of "but I don't want to rip the paper!" exclamations as we urged them to hurry up...!) the surprise. Both parties had assumed from the feeling of the packages that they were framed photos from our wedding.

Having delicately torn through the paper and slid the frames out, my mother knew instantly what the image depicted, and immediately reacted with tears of joy. My grandparents, on the other hand, were a little bit delayed with their reaction. We had completely failed to account for the fact that my grandmother - who gave birth in the late 50s and early 60s - had never had ultrasound scans for her own babies, meanwhile my grandfather, being a true Merchant Navy Captain, had initially mistaken it for a radar picture of a storm!!!

It was only a few seconds later, after my mother regained her composure enough to say "Congratulations!" that the realisation suddenly dawned on the faces of both grandparents; all expertly captured on camera by my husband. There were tears of joy and celebratory hugs all round.

Grandpa the Navy Captain celebrating his future half-British, half-Emirati great grandchild with a lapel pin

So whilst it may seem a little extreme that we made a 16-hour round trip just to break the news to my family face-to-face, it truly was one of those unforgettable, money-can't-buy moments, and it was worth every Dirham of the flight tickets, every minute of exhaustion due to the intense travelling, and every ounce of restraint to hide the news during our regular telephone communication for several months before. I can't wait to show the video to our little one in years to come, and show him just how excited we all were for him to arrive. 

Monday, 27 March 2017

Being Butterfly-Free and a Mama-to-Be

As you may have gleaned from previous posts, I have a small human growing in my (as yet only slightly expanding) belly. The little human is currently at 22 weeks of gestation, weighing in at a healthy 390grams and with all measurements as expected. And, judging from the most recent 4D scan images, he is shaping up to be quite the mini-me of his father (yaay!)

If I'm being very honest, I didn't expect to get pregnant quite as quickly as I did, given my previous (misdiagnosis) of polycystic ovaries, coupled with my thyroid condition. I wasn't necessarily worried that I might struggle with fertility - in fact, that precise thought had never crossed my mind - however, I just assumed it wouldn't happen immediately. But it did! And for that we are extremely thankful and blessed.

When the OB-GYN confirmed my pregnancy at 6 weeks and 5 days, she immediately ordered a full panel of thyroid blood tests; something which is NOT standard procedure for all expectant mothers, but further to my research on the topic, I truly believe should be.

My partial right thyroid lobe, which had been magnificently maintaining my TSH at a steady 1.8 prior to pregnancy, had instantly shot up to 4.6 since getting pregnant. This (along with the standard first trimester tiredness) explained why I had been struggling to get out of bed most mornings in recent weeks; something my husband had kindly encouraged me to indulge in since I had just become free of the pressures of a full time job.

It is entirely normal for TSH levels to increase in pregnant women, particularly in those who have a pre-existing thyroid condition, but also in those who don't (or are unaware that they do). Pregnancy typically requires an additional 25-30% of thyroid hormone, and for those who are struggling to produce or regulate a normal amount by themselves, it will become even harder during pregnancy. As I have found out, it is absolutely crucial for the healthy development of the foetus for the mother to keep her TSH level below 2.5 during the first trimester of pregnancy, followed by keeping it under 3 for the remaining trimesters and breastfeeding postpartum. This is why I find it astonishing that a TSH check is not mandatory for all newly-expectant mothers.

Acting swiftly to counter my rapidly rising TSH, my doctor immediately prescribed me a 25mg daily dosage of Euthyrox. It's a very low dosage, but considering my partial thyroid's remarkable strength to return to regulating itself after my surgery, she was confident that it would be enough. And she was right. My TSH soon dropped to 2.4 - within healthy range for pregnancy. She is also hopeful that, with close monitoring, I will be able to be weaned off the thyroid medication after giving birth and go back to living a tablet-free life again. So, going onto Euthyrox/thyroxine/levothyroxine is not always an irreversible lifelong decision.

The correct supplements can make a world of difference

During the first trimester the foetus relies entirely on the mother's thyroid function, hence why the recommended TSH level is lower during those formative first three months as the T4 crosses the placenta. By the second and third trimester the developing foetus has its own thyroid, which begins to function and regulate by itself, but it is still important for the mother to keep her TSH below 3 and thyroid antibodies as low as possible.

Hypothyroidism can be a root cause of infertility, but is often overlooked as a possible diagnosis in women who are struggling to conceive, whilst during pregnancy (or at the exact time of conception), maternal hypothyroidism can greatly increase the risk of miscarriage, stunted growth, reduced brain development and has even been linked to a heightened chance of autism and Down's Syndrome.

As soon as I found out I was pregnant, I took it upon myself to research the best foods to eat and supplements to take to support the healthy development of my baby, in addition to following my (highly capable) doctor's orders. Once again, Google has been my best friend, and I came across a fantastic online docuseries called The Thyroid Secret by Dr. Isabella Wentz. The 9-part docuseries shed light on many myths and misconceptions related to thyroid function and illnesses, and Episode 7 - 'Motherhood Interrupted' - was particularly fascinating for me.

For some, the role of motherhood begins before even conceiving, as they plan ahead and prepare their bodies for the best chance of fertility. For others, like me, motherhood started as soon as I got that positive test, and with it came the immediate responsibility to take care of my health to my best abilities in order to provide the optimum conditions for my foetus to develop. Sometimes it's daunting, particularly when you know you have a condition that may compromise the health of your baby, but keeping informed of the latest research and following the recommended guidelines is an important first step towards giving your baby the best possible start in life.

Monday, 20 March 2017

The Doctor is not always right

If only we could all have access to Dr. House & his diagnostic team...!

A recurring theme I often read in comments posted online by thyroid patients is that, when their lab results come back showing TSH within a 'normal' range, the doctor makes a sweeping statement to declare them 'fine.' The numbers on a piece of paper apparently overrule the symptoms we are oh-so-strongly feeling.

I, too, have been on the receiving end of this - rather lazy and quite frankly dismissive - 'but your TSH is normal so you are fine' diagnosis. I knew I was not fine at all. What I wished I could do was invite that particular doctor to try living with my symptoms for a week, and then tell me I was 'fine'.

After my post-op care had been completed and my scar was healing up nicely, I was handed over from the mightily capable hands of my surgeon, whom I trusted implicitly, to the hospital's in-house endocrinologist. Supposedly an expert in thyroid conditions.

From my very first referred appointment I felt uneasy with him, and I got the impression that the thyroid was probably his least specialised element of the endocrine system - perhaps understandable when living and working in a country with one of the highest rates of diabetes in the world. In my head I was questioning the logic he used at explaining away my symptoms; ok, I know I'm not anywhere near being a doctor and he has studied and practised for a very long time, but I have also done my due diligence into thyroid conditions and I'm not entirely clueless. But, it was still early days after my surgery, and I was willing to go along with his suggested course of action in the beginning, which was absolutely nothing. No medication. No treatment. No further testing.

Having thrown myself back into work, I tried to carry on as normal, but as the weeks passed I just knew I wasn't able to function as I previously had been. I was exhausted. ALL. THE. TIME. My motivation was zero. Even my appetite had waned immensely and my weight was dropping (not something you would expect in someone who should be hypothyroid).

I went back to the endocrinologist. Again, he told me my TSH was normal. I complained of having slightly dry skin compared to usual, and that my body hair - which had been banished months before through a successful course of laser hair removal - was growing back. He took these mentioned symptoms, without any further testing, and diagnosed me with PCOS (polycystic ovaries).

My gut instinct was that he was wrong.

I grappled with it in my head for a few days and did some more online research, before deciding to book an appointment with the very first General Practitioner I had seen at the start of my thyroid journey; the one who had discovered my nodule in the first place. He disagreed with the PCOS diagnosis immediately.

This was the first time anyone had even thought to test my Ferritin and Vitamin D levels, which, in fact, work hand-in-hand with thyroid function. The GP called me back later the very same day with the blood test results, saying he had to inform me immediately. "I think we need to enter you into the Guinness Book of World Records - this is the lowest Vitamin D reading I've ever seen in a living person," he said. Anything under 30 is considered a deficiency. 50-70 is normal. 70-100 optimal.

My Vitamin D level was 1.4.

Similarly, Ferritin - which should ideally be above 70 - was just 12.

These two simple blood tests produced two clear results and simple explanations to my symptoms. Thankfully, they also have simple treatments. Three lots of 300,000iu intramuscular Vitamin D injections were prescribed over the course of the next calendar year, as well as supplementing with a daily tablet of 10,000iu and weekly tablet of 50,000iu. An iron supplement helped to regulate the Ferritin. Within a matter of a month or so I could feel my energy levels returning to something close to recognisable, my motivation was up, and I was getting my sparkle back.

The point I want to make is simple, but not something I would necessarily have realised before going through this experience. And that is, the Doctor is NOT always right.

You have every right to research about your own condition and symptoms, and every right to challenge your doctor on what he or she is prescribing or suggesting. You also have every right to seek a second, third, fourth - as many additional medical opinions as you like. Until you find a diagnosis and treatment that you trust, you feel comfortable with, and you feel the benefit of.

I used to be shy about questioning anyone's authority or qualification, but not anymore. You are the only one living in your own body, and experiencing your own symptoms. You know when something is not right. Listen to your body - I have found that mine always has a way of showing me when it needs attention, and it should never be ignored.

Tuesday, 7 March 2017

Why I didn't want my thyroidectomy scar photoshopped out of my wedding photos

My thyroidectomy scar was something I struggled with in the beginning. Even before I went under the knife, it was that somewhat superficial element of the surgery that I chose to focus my fears on the most; endlessly Googling photos of post-op scars and becoming preoccupied with how it would change my appearance, particularly in the eyes of others. Deep down I knew that it didn't really matter, but perhaps it was easier to channel my worries into something 'skin-deep' rather than to fully face the magnitude of my sudden diagnosis and the real risks of surgery.

Outwardly, I started off by making a joke out of my scar immediately after the surgery. As my operation happened around the time of Eid al Adha - the Muslim celebration otherwise known as 'the feast of sacrifice' - it set me up well to humorously dismiss it as "an Eid sacrifice gone wrong - they mistook me for a goat!"

My first outing after surgery - bandages and all

Once the laughs had worn off, and the bandages came off, I was pleased to see just how neat my surgeon had managed to make the incision - as he had promised me. The placement was perfectly on the collarbone, so that over time it would fade and just appear as a normal shadow at the base of my neck. Like clockwork, I applied BioOil thrice daily to the area, with the promise that it would aid the healing and fading process. (To this day, I still apply BioOil to my scar once a day).

When the bandages came off...

I had thought of wearing scarves to cover up the unsightly area as it began to heal - still bloodied and a bit swollen - but the friction of any fabric rubbing against it was painful so I had to leave it uncovered. As I already established in a previous post, I was back to work and back to normal life immediately after having the dressing removed, and thus this left my wound open to the attention of everyone I came across as I went about my days.

I'm not sure if it's cultural, as I feel this probably wouldn't have happened (or at least not nearly as much) had I been in the UK, but I started to get a procession of random strangers coming up to me in the mall, the supermarket, in the queue at Starbucks, to pass comment on my scar.

"Excuse me, there's something on your neck," one guy said to me in Arabic, waving his hand in a neck-slitting motion. As if I didn't know!
"Oh my gosh ma'am, what happened to you?!?!?!" was the usual response from most shop assistants.
"When will it go away? Why aren't you covering it?"
"You know you can do laser to remove that thing right?!"

It quickly became tiresome having complete strangers trying to pry into what I believed was my very personal business. As soon as it became comfortable to do so, I started wearing light, silk scarves - and then, as the UAE winter set in, polo neck sweaters - merely to avoid the constant questioning.

The scrutiny actually made me very defensive of my scar. How dare they suggest that I should do laser to get rid of it?! This is my battle scar. It's a constant physical reminder of what I went through and what I overcame. It's a sign of my strength. It was at this point that I realised I had become really attached to it, and proud of it. I liked my scar.

6 months after surgery

Of course, there were days when my scarf slipped and the prying eyes pounced once again. I was out at a sporting event for work in December - three months after the surgery - and one man who worked vaguely in the same field as me launched into a lecture about it, in front of other colleagues.

"You will never get married now that you are damaged, especially not to a man from this society. You should have got married before you did the surgery. Now you have no hope - this thing on your neck, it removed your beauty. The people who get sick, it's their own fault. It's because they didn't pray enough. No man wants a woman who got sick because she didn't pray enough."

I was dumbstruck. I didn't even want to dignify him with a response. I just went to my car and cried.

But oh how wrong he was.

Soon I was to meet a man who would change my life forever. A man who helped me to heal from within, without even realising it. A man who, from the very first day we met, appreciated my scar.

He approached it in a curious, yet sensitive way. "Can I ask you something," he said, with a quizzical look on his face. I could see where his eyeline was; I knew what was coming. "What happened?"

I told him the story, and he recalled seeing me from a distance for months before, always wearing scarves. "Don't hide it anymore," he said. "Don't cover it up. I like it. It's nice. It's unique."

A few months into our relationship, he returned from a work trip and was eager to meet to give me something. It was a beautiful necklace he had brought back from his travels; small, simple, delicate, and falling just below the line of my scar. "I want you to have this and wear it every day. It should remind you of your beauty, and take the negative attention away from the evil eyes looking down upon your scar."

The day my (now-) husband gave me the necklace

As the scar got lighter and the attention got less, with the pretty necklace of protection around my neck, the love got deeper. He asked me to marry him. I said yes.

Your wedding is naturally one of the most special and memorable days in your lifetime, and a wonderful way to preserve and share these memories for years to come is through the wedding photography. I wore a white dress and the beautiful white gold and diamond set given to me for the occasion by my new in-laws, as is tradition, and it was the first time I had removed the little necklace since my husband gave it to me, to make way for a much bigger one (still sitting below my scar, though). The makeup artist had instinctively started to slap industrial-strength foundation onto my neck to try and cover up the scar, but I told her not to. She removed it and left it natural.

With the wedding album and photos promised to be delivered by the studio a month after our ceremony, we waited in eager anticipation of receiving the captured mementos of the event. But imagine my dismay when I opened the photos to see that an important element of my being was missing: my scar had been photoshopped out!

What? No scar?!

Now, I know these Arabic-style wedding albums always go heavy on the airbrushing (they also practically changed the race of my husband...), but there was absolutely no hint, no trace of my scar in any of the photos whatsoever. The pictures were not an accurate representation of myself. And, more importantly, my scar is not considered a 'blemish' I would want to eradicate via airbrush. We sent our feedback to the photo studio and instructed them to revise their overzealous editing.

So, as you can see, although it took some time (and some thick skin) to accept and appreciate my thyroidectomy scar, it is now something I am truly proud to wear round my neck as a medal of honour. Ladies, wear your scars with pride, and never let anyone suggest you would be better off without it.

My scar now, 18 months old

Sunday, 5 March 2017

The Worst Thing I did after Thyroid Surgery

A bit of a dramatic title, perhaps, but it is completely and utterly true, and I hope this can serve as, at least, a little food for thought for anyone reading my posts prior to having their own thyroidectomy.

So, what was the worst thing I did after my thyroid surgery?

I went back to work too soon.

The timing of my diagnosis couldn't have come at a more inconvenient moment for me professionally. I was working in sports media, which is a fast-paced, 24/7-type of environment to operate in, and my situation unfolded right at the beginning of the new season. Peak time in terms of workload and hecticness.

In fact, the day after my Fine Needle Aspiration (FNA) biopsy, I had to drive 120km to another city and cover the curtain-opening Super Cup Final - the kick-off event of the annual sporting calendar. I was not only a 'media person' at this sort of big event, though; I was also part of the organising committee, so on such days it was crucial to be there from dusk till dawn and be fully active and operational. Not to mention it was all outdoors, in the searing summer heat of the Gulf.

It was partly a blessing to be so busy in the lead up to my surgery, though, as it kept me distracted and didn't allow me much time to wallow in worry or despair. I just kept going. What I should not have done, though, is continue at that same hurtling pace after the surgical procedure.

Recently I - at last - got around to reading Lady Karren Brady's excellent book, entitled 'Strong Woman', and I was particularly able to relate to her anecdotes surrounding her surgery to remove a brain aneurysm. She describes the feeling of pressure to return to her roles and responsibilities almost immediately, as well as a sense of guilt and even uneasiness at the thought of having people 'fawn' over her as though she was no longer capable of carrying on 'business as usual'. Though not in anywhere near such a high-profile or high-powered position as her, I felt the same.

It didn't sit comfortably with me to be labelled as 'sick', and therefore I was keen to show quickly after my surgery that I wasn't. Some staff members in my office cried upon hearing the news of my diagnosis, which I found baffling. I wasn't used to being cried over and I certainly wasn't seeking sympathy, nor was I any less capable than I ever had been.

Another reason why I was so desperate to prove my capability to continue as normal was that I was under scrutiny and pressure at work, from the new boss. A dictatorial type who earned his title based on connections rather than merit; to my face I was told I would be supported throughout my ordeal, but behind my back I found out that emails were sent to Human Resources instructing them to strictly monitor my attendance and deduct salary if I went over the company policy allowance of sick days. I didn't want to lose my job, nor could I afford to.

It was due to these points that I was on my work phone and writing press releases from my hospital bed. I did receive a one-week sick leave certificate from my surgeon, meaning I could at least avoid going to the office for seven days after the surgery, but I was still constantly on call, and even those seven days were scrutinised by my company's 'medical committee' as to their legitimacy.

As a result of trying too hard to prove to myself and everyone around me that I was absolutely fine, I put my own health and recovery at risk. I didn't allow my body - or my mind - time to HEAL. I didn't even give myself time to process what had happened. Being told you have cancer at the age of 24 is not something you can just shrug your shoulders about, even if you try to act like it is. Any type of general anaesthesia and major surgery has major physical and mental impacts. I just tried to cover it up.

But, as with everything in life, it caught up with me. And it didn't actually take that long to do so. Everyone who's had thyroid surgery knows the struggle to recalibrate your body afterwards; trying to deal with the lack of thyroid function, trying to find the right dosage of thyroid hormone replacement medication, or - as in my case - simply trying to operate as a human being with just 20% of a thyroid left and no medical supplementation... It's draining. It's exhausting. But it's also invisible to others. We look fine, so everyone thinks we are fine.

Around 2 months after my surgery my energy levels dipped to their lowest ebb. There were days when I couldn't get out of bed until 3pm, and other days I couldn't get out of bed at all. I kept having to drag myself to hospital and try to convince my doctor to write me another sick leave certificate, but in the end I also just accepted sometimes being docked a few days' pay. I always still did my work from home, but not being physically present in the office was affecting my standing within the company.

In the end I just had to accept the fact that I needed to listen more to my body. I needed to allow myself to be 'lazy' some days. The more rest I allowed myself to catch up on, the better my partial thyroid began to repair itself and function. It came down to priorities, and really there could be no debate that my health was paramount.

The truth is that you never completely recover and heal from thyroid surgery. The scar fades, the optimal dosage of medication is eventually found, your coping mechanism becomes refined. But if you don't give your body or your mind a chance to recuperate from what you've been through from the very beginning, you will only be hampering yourself on the pathway to better health.

Thursday, 2 March 2017

My Thyroid Surgery - Becoming Butterfly Free

Having been diagnosed with a malignant tumour on the left lobe of my thyroid by FNA biopsy, I was swiftly scheduled in for surgery at Medcare Hospital in Dubai on 17th September 2015. Whilst I was, naturally, nervous about the operation, I was also just desperate to get it over and done with, so after waiting impatiently for the necessary insurance approvals it was a relief when the day itself arrived.

True to form, I had done my research about the possible risks attached to the surgery, including the chance of nerve damage permanently affecting the vocal cords, and the chance of damage to the parathyroid glands, which regulates calcium in the body. The neck is a delicate area, after all. However, I was lucky enough to have full confidence in the fact that I was in good hands with my surgeon, Dr. Abdulkader Weiss, who kept telling me not to worry and that he would take care to make the resulting scar as small as possible.

It may seem trivial considering the news I had recently been delivered, and the health scare I was facing, but one of my biggest worries ahead of the surgery was indeed the scar it would leave on my neck. If you Google 'thyroidectomy scar' you will be confronted by a whole range of images, from neat little 4-inch lines to (quite frankly terrifying) thick, full necklace-type scars.

It was during my pre-surgery research that I came across the priceless resource of Talk Thyroid - a community set up by two USA-based sisters suffering from hypothyroidism and Hashimoto's, which is an autoimmune disease that attacks the thyroid - and it was thanks to Talk Thyroid that many of my concerns regarding the appearance of my post-op neck were put to rest. Through Talk Thyroid's Instagram page I connected with a myriad of beautiful, successful, energetic young women who were still glowing and flourishing after their surgeries, which gave me hope for my future.

As Dr. Abdulkader had explained, he wouldn't know whether he would be able to get away with a hemi-thyroidectomy or if he would have to do a total thyroidectomy until he had actually opened me up on the operating table, and even then, if he considered a hemi-thyroidectomy possible, there was also a chance that I may have to return for a second surgery to remove everything pending the lab results on the removed tumour.

Recovering in my hospital bed after nearly 6 hours of surgery

The surgery was a delicate procedure and took just under 6 hours, as Dr. Abdulkader carefully ensured he had removed every last cell of the offending tumour, checking along the way that nothing had spread to my lymph nodes. Thanks to his skill, he was able to leave behind a very small portion of the right lobe of my thyroid, which he hoped would be able to maintain some natural thyroid functionality for me after my recovery.

The drain was the worst thing - couldn't wait to get it off!

I remember the worst thing for me in the immediate aftermath of the surgery was the drain they attach to remove all the excess blood and fluid. Mine stayed attached for 3 days (some only need it for one); it restricted my movements, was painful and uncomfortable when trying to sleep, and to be honest I just found it quite repulsive having these bodily fluids hanging from my neck in a little see-through sack! Once the drain was removed I started to feel much better, very quickly. In total I stayed in hospital for four days before being discharged, with a follow-up appointment scheduled a week later.

Feeling much better without the drain, and with a room full of flowers

When I returned to see Dr. Abdulkader the next week, he had the look of a relieved man as he ushered me into his office. He had always been lively and positive, but this time was different; he was relaxed. "Good news from the lab. We got everything, no need for a second surgery, and no need for radioactive iodine treatment," he told me, before confessing: "I never showed it but I really was worried about your case. This is a big relief."

And so - relieved - I began my life butterfly free. 

Wednesday, 1 March 2017

From Afternoon Tea to Ultrasound... Discovering the lump in my neck

I can think of worse places to start my thyca journey...

It all began on Sunday 9th August 2015, in the most unexpected of ways. A dear friend had invited me to spend a girls' chill-out weekend at her family's beach villa in Ras Al Khaimah, to catch some summer rays by the sea. I, however, with my pasty white complexion, have never been one for tanning. So I spent the majority of the day lounging in the shade, hydrating on coconut water and taking the occasional dip in the waves to keep cool in the searing UAE heat.

We had a fancy afternoon tea booking at the Waldorf Astoria at 6pm, so we headed back up to the house from the beach in suitable time to prepare ourselves. As we went to hose off our feet before stepping inside the villa, I suddenly felt a sinking feeling hit me out of the blue. I knew I was going to faint. I placed one hand on the exterior wall of the house as the world around me began to spin, and the next thing I knew, I was hitting the paving tiles. My friend carried me into the air conditioned haven of the house (good thing she's one of the strongest Crossfitters in the region!), and I woke up with an ice cold flannel on my forehead.

Putting it down to just a simple case of heat stroke, I took on plenty of water, got my body temperature back down to normal, took a cold shower, and carried on with my day. Never one to pass up the opportunity of an afternoon tea, we were perfectly on time for our booking and thoroughly enjoyed an evening of sandwiches and scones.

As if I would miss out on Afternoon Tea...

Returning home to Dubai later that night, I thought I would simply sleep off the syncopal attack (and the sandwiches and scones), but in fact it appears that what I did was grossly oversleep. I slept through my morning alarm, I slept through the first few hours of work... And when I did wake up, I had a nagging feeling that I should go to the doctor just to get checked for any adverse affects following my fainting episode.

So, on Monday 10th August, I drove myself to Medcare Hospital with the thought in mind that I may, at the very most, be suffering from a mild concussion; little did I know that my life was about to take a turn that would impact me forever. The General Doctor gave me a thorough examination - for which I am eternally grateful - and when it came to my neck, he stopped abruptly, saying: "There's something here. I need to send you for an ultrasound immediately."

He pointed out the location of the lump to me; on the left-hand side, about an inch up from the base of my neck. Not an area I would regularly touch or feel to notice any changes. He stood me in front of a mirror and told me to swallow whilst looking at my reflection. I could clearly see it move up and down as I did, like an odd sort of off-centre Adam's Apple.

Just as the doctor ordered, the ultrasound was, literally, immediate. For the reason of sheer swiftness, I am so glad that this happened to me in Dubai, where all employers are legally obligated to provide private healthcare insurance to their employees - I can't imagine how much worse the ordeal would have been had I been stuck on an endless NHS waiting list back in the UK. In fact, I don't believe my condition would have been diagnosed at all - or not nearly as early, anyway - had it happened there.

From the ultrasound it was gleaned that I had a 4.2cm x 3.6cm mass on the left lobe of my thyroid. I was then referred for a Fine Needle Aspiration (FNA) biopsy - the procedure of having an enormously long, thin needle stuck into my neck and through into the nodule/tumour to collect cells for laboratory analysis - which took place a week later after receiving the approval from my medical insurance company. I was told the results would take 7-10 days to come back.

After the FNA - styling out in a hospital gown

When the hospital called just 3 days later to schedule an appointment with the surgeon first thing the next morning, it left little to my imagination. I remember walking into his office, seeing the lab results of the FNA on his desk with a 'HIGH PRIORITY' sticker at the top of the page, and 'Malignant' underlined 3 times. I knew precisely what that meant.

The surgeon was wonderful. A Syrian/German hybrid who had studied and practiced in France, he was warm, reassuring, and clear with his explanations. I felt comforted by the fact that he would be the one to do the procedure; the importance of having confidence in your surgeon when faced with something like this can never be underestimated. He told me we had two options: hemi-thyroidectomy - preferable, but not necessarily possible - and total thyroidectomy. He would schedule me for the surgery the instant an approval was received from the health insurance provider.

I remained calm, composed, and very matter-of-fact as I asked him a few questions before leaving his office. Of course I had already been Googling for all eventualities, but now I would have even more specifics to research, as that's how I like to deal with potentially earth-shattering news: by finding out any and every relative fact and possibility, and arranging them rationally in my head.

When I got to my car and drove away from the hospital, I sobbed uncontrollably for a while - but for no more than two minutes. Then I pulled myself together, met my best friend for a quick coffee and reassuring cuddle, and headed back to work. Life would go on.