- The Washington Times - Wednesday, November 20, 2002

My ideas could have killed my daughter Megaera, fortunately I was stopped in time by a correct diagnosis.
In the fifth grade, Megaera was a happy "A" student, but she began becoming "sick" on Thursdays, complaining of headaches and stomach aches. I suspected malingering. Trips to doctors brought a tentative diagnosis of migraine.
Entering middle school, Megaera's grades slipped. Teachers said she didn't pay attention. Hyperactivity, common in my family, was diagnosed and Megaera was prescribed Ritalin. This seemed to help. Her headaches declined in frequency, but she complained about being "hot." No fever accompanied this, but her body felt hot to the touch and she would perspire heavily. She would take off clothing when the rest of us were putting on sweaters.
In seventh grade, Megaera became a charity pass. She spent inordinate amounts of time going to the toilet and developed some friendships that concerned my wife and I. A friend told us that Megaera bragged to her daughter about playing "in-school hooky," during which she would wander the halls following permission to go to the toilet. At home she was moody: sometimes frenzied and distracted, other times passive, oblivious to circumstances or conversation surrounding her. Often, talking to her was like talking to a brick wall she showed no emotion, no understanding of what was being said. Her earlier problems continued, now accompanied by a significant weight loss. Concerned teachers suggested anorexia nervosa, but she ate heavily at home.
I was concerned about the possible influence of bad company. I decided that, when she entered high school I would enroll her in cross-country. Her brothers were on the team. I knew that members of the team were good students and free of tobacco, alcohol and drugs. In the interim, I insisted on a trip to my doctor, Gary Smith. Too much of her behavior appeared consistent with television warnings of drug usage. Previous reports of blood tests, including one earlier in the week, had failed to demonstrate medical problems, but I wanted a final blood test by a doctor I trusted. It was overkill, but I insisted.
Thank goodness.
Dr. Smith suspected a thyroid problem. He referred us to Dr. Najjar at the Family Resource Center in Nashville. Again there were tests. Dr. Najjar wanted to see us at her office. Immediately. My wife went.
After attempting to talk to a hyperactive Megaera, Dr. Najjar's comment to my wife was, "I suppose she is taking Ritalin?"
"Yes."
"Stop giving it to her immediately. She is also to avoid all physical activity: no running, no bicycling, no shooting basketballs in the backyard. Her thyroid is overactive. Her blood pressure is so high that any activity could result in a stroke and kill her. I also wish to see you and your husband together."
Those headaches and stomach aches in fifth grade had been real. They always followed physical education class, a fact no one had considered. That is why I could have killed her if we hadn't gone to the doctor one more time. If I had insisted on her participating with the cross-country team, she would have collapsed long before completing even the three-mile warm-ups.
Dr. Najjar told us that hyperthyroid is an under-diagnosed illness which can cause long-term damage to the child up to and including brain damage and death. She said it is common for these children to be diagnosed as hyperactive and placed on Ritalin initially. She supplied me with a series of monographs, from which I have gleaned the following symptoms:
Megaera had exhibited all of these.
During our consultation, Dr. Najjar explained that three methods of treatment were available: Surgery to remove part of the thyroid; radioactive treatment to kill part of the thyroid; or medication. Each had drawbacks. In the first two, it was difficult to determine how much of the thyroid to remove or destroy. Listening, it appeared to me a sophisticated guessing game. Medication would require rigid adherence to the medication schedule and continuing medical supervision.
My wife and I opted for medication. We did not want permanent irreversible, treatment on a 13-year-old girl as long as there was an alternative option.
Now, a year into continuing medication, we have our happy, active, daughter back. She has opted for soccer rather than cross-country.
The studies Dr. Najjar gave me reported a chance ranging from 14 percent to 40 percent most reporting 20 percent to 30 percent, for persons with hyperthyroidism going into long-term remission following two to three years of medication. So, there is a possibility that Megaera will be medicine-free some day.

William D. Dannenmaier, a Korean War veteran, has taught at various universities and conducted research for the military.


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