A Whole Lotta Lobster

Too much shellfish, you say?

One of the absolutely unexpected (and unwanted) side benefits of hanging around a hospital for several hours a day over six and a half months is you get to talk health hypotheticals with people running the full gamut of medical knowledge – all of it more than you have.
In short, they are not necessarily buying the “Jose Reyes developed hyperthyroidism from eating too much shellfish with all that iodine in it.” They are thus also not buying that “all will be well if he switches to tuna and red meat and doesn’t exercise for two weeks or two months.” It may be true that he’s had a lot of shellfish lately, but that doesn’t mean it’s the only cause of his hyperthyroidism. 
This is not to say it’s not possible, but none of the medicos to whom I talked think diet is a very likely cause of hyperthyroid problems in a 26-year old guy. More common causes are an immune disorder (Graves’ Disease – his age is correct for that – doctors would look there first, especially if there’s any family history of it), or a virus, or taking medication designed for thyroid deficiencies, or delivering a baby. 
I think we can rule the last one out, but the Mets have seemingly been hit by every other injury and malady in the last eighteen months, so what the hell.
The problem, of course, for the Mets is that their recent history on reporting those injuries and maladies is that they have over-promised and under-delivered. Last season, Reyes himself was only to miss a few days, then weeks, then a month, then an indefinite time, then he needed surgery. This is not necessarily blissful incompetence: hamstring and other connective tissue problems can often take a long time to diagnose. The Mets’ training and medical staff may be as much victims here as the players or fans are.
But if it turns out Reyes has a more lingering thyroid problem – one that does not simply go away in two weeks to two months – it will be impossible to believe the team’s next injury report. More importantly, it will be a significant impediment to Reyes’ quick return, or for him avoiding surgery or long-term drug therapy.
Or maybe he consumed 10 percent of the world’s shellfish.
How much could Shellfish could an ex-Shea Shortstop Shovel, if an ex-Shea Shortstop Could Shovel Shellfish?

26 Comments

There is one other possible cause for hyperthyroidism: Cancer.

I hope that’s not the case with Reyes. I’ve known three people who have developed thyroid cancer. The hyperthyroidism resulted from the abnormal tissue (the tumor) pumping out excessive amounts of thyroid hormones. They all had to have their thyroids removed, had to drink the radioactive cocktails to make sure all the thyroid tissue was killed off, and now they’re on synthetic thyroid hormone pills (= Synthroid) for life. Two of these people live in Europe, so at least they didn’t have to worry about going broke while undergoing treatment, thank God.

Hopefully, Reyes’ hyperthyroidism isn’t anything that serious. It just strikes me as odd that cancer didn’t come up in the conversation of possible causes.

Whatever its cause, hyperthyroidism is miserable. The mood problems, alone, are horrible, and that’s not even counting the physical symptoms. The good news is that the prognosis is usually favorable, as I’ve seen first-hand. :-)

BTW, I saw your segment on Countdown tonight. I’ve been wanting info on making a living will, so I definitely appreciated the link.

Last, but certainly not least, thanks for the update on your father. Our prayers are with you, for his continued improvement.

Too much shellfish is not going to cause this. It’s more likely that not enough shellfish (or iodized salt, or produce grown near the shoreline) will cause this. If he’s eating a relatively normal diet, though, and doesn’t actually have an iodine deficiency, Graves disease is the most likely diagnosis. It isn’t the greatest diagnosis ever: there are excellent treatments, but no cure as of yet.

Another possibility (and one you’d usually be more likely to see in a pro athlete than in the average person) is excessive iodine from radioactive contrast media – the stuff they pump you up with before they give you a CT scan. I say “more likely to see in a pro athlete” because nobody will have this problem after just a few CT scans. Someone getting a CT once a week for a year because of a muscle injury, on the other hand…that’s a lot of iodine.

unpaka’s absolutely right too: cancer is a definite possibility, but given his age and sex it’s remote. I hope to hell it isn’t that. Graves disease would be a far better diagnosis.

I’m a soon-to-be 50-year-old (gasp!) woman who was diagnosed with Graves disease in 2002. While I love shellfish, that was not the trigger, in my case. According to my endocrinologist, hyperthyroidism is an auto-immune disorder. In short, your body turns on itself and begins attacking the thyroid (much like diabetes mellitus, also an auto-immune disorder, attacks the pancreas). A blood test revealed that I have the genetic biomarker which made me susceptible to developing thyroid disease. Lucky me! But the trigger could have been stress, could have been a virus. Who knows?

And yes, Graves really sucks. You feel as though you’ve been run over by a Mack truck and the truck backed up over you! You sweat a lot, your muscles feel like wet noodles, you have nighttime heart palpitations, you eat like a horse and still lose weight (mostly muscle mass in my case ? which is NOT good), and you just feel like crap. Luckily it’s treatable with medication. I chose not to undergo the next step in treatment, which would have been radioactive iodine, which dissolves a portion of the thyroid. What if I had undergone that treatment and was still symptomatic (the list of symptoms is as long as your arm)? Personally, I’m a big believer in the power of the human body to heal itself, if given the chance. So, I took the medication and gradually decreased the dosage (following doctor’s orders, of course). And now eight years later, the Graves is in remission and my thyroid is intact. Since then, I’ve continued to work out with weights and do aerobics, and am on a vitamin regimen because everything was so depleted due to the Graves. But I feel great.

Keith, thank you for tonight’s update on your dad, and the importance of having a living will in order. That cannot be emphasized enough!

Maybe he’s just been hanging out with Jeremy Piven.

“…or delivering a baby. I think we can rule the last one out…” Are you sure about that? He did look like he’d put on a little bit of weight recently… Okay, sorry. That’s just my bizarre sense of humor kicking in. You were right the other night – sometimes humor is absolutely essential when you’re going through tough times. I took thyroid medication for years, as I had the opposite problem – hypothyroidism. I also have a rare disorder that causes my electrolytes to shift sometimes, so I can sympathize with Reyes. It’s amazing how a tiny shift in metabolism or electrolytes can cause serious problems. It’s such a complex and delicate balance… even the researchers into my disorder that I’ve met can’t explain some of the issues I have, so I no longer blame my personal doctor for not having the answers. I have, however, found some solutions on my own through trial and error. Hopefully Reyes won’t have to deal with anything quite that problematic. And I have to say, I’m really glad your father is getting good care. Your piece tonight was brilliant – my mother watched it with me, and was very impressed with everything you said. It was precise, well-organized, and clearly defined, and she told me she already has all her paperwork taken care of on that front. You’re right about that – it’s a relief, knowing that we won’t have to wonder about what to do when the time comes. Your father is a lucky man, to have such a devoted and caring son – someone who is a strong advocate on his behalf. That’s one thing people often need when they’re in the hospital… a person who can speak up when necessary, because sometimes the patient isn’t strong enough or isn’t able to do so. And not just during end of life care. I’ve been in that position with my mother a few times, and she (and others) have been there for me. I’ll tell anyone the same thing I told a friend just this morning – if the patient isn’t getting what they need, whether it is medication, information, or what have you… they need someone who can advocate for them – with civility, but with strength as well. As I told my friend, be polite, but FIRM… and be persistent. It can save a life. On a side note, the Family Guy episode with you as the villain played on local television here tonight. The line “Let the pumping resume!” made my mother laugh. I think she could tell you were enjoying yourself. I know I was. Fun stuff. :) Take good care of yourself and your father, and hugs to both of you. You deserve it. Thanks for the updates, and please keep us posted.

Great discussion.

I got a pretty cool explanation of genetics recently when I underwent genetic testing for breast cancer due to a family history and a close relative?s diagnosis at a young age. I learned that we are born with pairs of genes, one from Mom and one from Dad, and these pairs protect us from various diseases. One gene works by itself until it ?breaks,? at which time the other one of the pair kicks in. Each gene lasts a very rough average of about 40 years. After both genes break, the disease manifests itself. That is why so many health problems occur in the 80?s (1st gene works for 40ish years, and then the other one kicks in and works for 40ish). However, sometimes we inherit a gene that?s already broken, so the 2nd gene kicks in when we?re born. That?s why so many health problems also occur in the 40?s. (@ashoein, this might explain why you were diagnosed with Graves diseases around age 40.) Also, in some cases, a gene can be made to break early, due to causes such as an illness, exposure to certain toxins, etc. That?s one reason that 40 is only a guideline. People sometimes get a disease at a very early age due to having one broken gene and the other one breaking early on. Also, babies sometimes are born with both genes broken. When they talk about women vs. men and young vs. old, they are going on probabilities, basically empirical evidence they have of a disease being consistent with certain levels of hormones, age ranges, etc. Honestly, low risk is only meaningful to me if I’m not the one-in-a-million that gets it.

Now, I am no expert on genetics, as I just learned it as part of the mandatory counseling that they make one undergo when genetic testing is done, to make sure the person understands the results. My counselor was awesome, and I’m sure there are some baseball fans who know much more than I about this topic. There is tons more to this, but that?s my surface-level understanding. It?s pretty cool science, and almost makes me wish I?d gone the biology route instead of math. Then I might have ended up on the proper side of health care and not felt compelled to prove something by pursuing a silly graduate degree at 40. Alas, the dead animals made me sad.

So you?ve lured me back with a health topic. Dirty trick, KO!

I was glad to hear that your father has awakened, and I’m still hoping for the very best possible prognosis. I still have that feeling that the sleep was just what he needed to get back on track. Please continue to post here and elsewhere. ;) And have a wonderful weekend. Speaking of fish, I hope you have a chance to go and get yourself some fabulous NY sushi, if you’re into that sort of thing. Makes me hungry just thinking about it.

I haven’t heard anything about Reyes actually having eaten too much shellfish, and I thought iodine was a treatment and not a cause, but I’m too numb as a Mets fan to absorb it all. but that theory does have some merit. I had kidney stones 5 years ago and ended up having to spend the night in the hospital after my stone-ectomy. While I was in that hospital bed, the doctor came in to see me and told me to cut back on red meat and start drinking more water. Now we don’t know if those were actual causes of my stones, but since I was listening to my doctor while lying in a hospital bed, I figured I had better listen. Of course, I was averaging steaks/burgers 4-5 times a week, I did what he said, and haven’t had a problem since then.

Keith, my heart is with you as you stay close to your father during this difficult period. I’m a singer-songwriter who tries to write beautiful, heart-rending music, so I know what I’m talking about here. I found a song on YouTube that is HEARTBREAKINGLY beautiful. You really must hear it — today. It’s called the Father’s Song, by Matt Redman. Go to YouTube and, in quotes, type “Father’s Song Matt Redman” in the search area. It’ll take you right there. Warning: You will cry. I know you will. But I think you’ll find it to be cathartic. Maybe one day the songwriter will give you permission to play this song on your show, with loving pictures of your father and your family while it plays.

When I was in college at Northwestern U. back in the ’80s, I played a song about my father on piano for people in my dorm, with my father there. A girl came up to me afterwards with tears in her eyes. “You wrote that about your father?” I love my father, and every time your father’s picture is shown on your show, I feel such love for him. He’s just got that kind of lovely face and sweet, sweet, soulful eyes.

I don’t believe in a god, but I pray to the gods of positive energy and all that is good in this great, big, confusing world of ours that your father gets over this difficult period, and soon.

With love, Beth

Keith, first and foremost, my wishes go out to you and your dad. Having watched my dad pass when I was 30 (and he at 64) was the most devastating event in my life. Unfortunately, only in these instances do we truly realize what we have in life, almost indoubtable too late. Second, I want to thank you for your wit and brilliant writing. I’ve watched you on ESPN as well as Countdown and have always thought you bring strong factual information to the masses with an appropriate mix of humor and sarcasm. As for Reyes, although I am not a doctor, I have a masters degree in human physiology, so I thought I would comment. Hyperthyroidism can manifest from many different pathways. It can be an issue with the pituitary (gland that releases Thyroid Stimulating Hormone or TSH), autoimmune in nature (Graves disease), neoplastic (thyroid cancer) or other less common issues. The concern here is that we haven’t heard who is treating Reyes. Since he is back in NYC, he should be seeing one of many predominant Endocrinologists in the area. The idea that Reyes has eaten too much shellfish is a bit obsurd. Had he had iodine levels elevated that much, he would most likely also have a goiter. Graves disease seems plausible, although more often then not, the person’s eyes seem to bulge out predominantly with this condition (although not 100% of the time). The more serious condition would be thyroid cancer, which would need to be confirmed via fine needle aspirate and thyroid biopsy. If this were the case, the treatment is surgical removal of the thyroid and synthetic hormone replacement – Synthroid (as unpaka mention). Your readers should be aware that thyroid disease, although serious, is very treatable. The idea that it can take up to 8 weeks to treat is possible if medication is being introduced (you need to see the effects after therapeutic levels in the blood are reached) or if surgery is needed. I’m hoping that a healthy Reyes can return to the lineup soon, not just because I am a Mets fan and know of his importance, but more because he is a fellow human being. We all put much importance on sports, but as you are all too well aware, our health is what matters most. One last though (my less serious side), could you include the Wilpons as the “Worst Persons in the World” for the PR fiasco they have help create? I’m beginning to think there is more deception here then even with President Kennedy’s assassination.

pepefreeus: Thanks for the laugh. Touche.

@entireofitself, hypothyroidism is no fun, either. Though many of the symptoms are the opposite of hyperthyroidism, one common symptom of both is the horrific mood changes. The only good thing about hypothyroidism is that doctors can usually spot that more quickly than hyperthyroidism. It’s a good thing Reyes has a doctor who was sharp enough to catch it.

Charlene brought up a point I’d totally forgotten: It is more likely that too little seafood would cause problems. That’s what my doctor suggested when I had hyperthyroidism, but blood tests revealed I was OK in that respect. She also brings up another very interesting point, about the iodine in the contrast media. Especially when it comes to athletes (high school on upward), doctors tend to pump people full of anything without much forethought as to aftereffects, because their goal is to get the athlete back on the field ASAP. Sports are fun, careers are important, but long-term good health is the most important thing of all.

Charlene, if you happen to come back and read these comments, I’d like to know if you could further explain your “given his age and sex” comment. The people I know who had thyroid cancer were admittedly female, but all were around 30 years old. Being that Jose is 26, does this mean that the people I knew were unusually young to have thyroid cancer?

@ashoein, hyperthyroidism is often caused by an autoimmune disorder, but not always. I had it when I was about 30, and it was caused by a benign (thank God!) growth on my thyroid. Like you, I lost weight at a terrifying rate, and I also suffered from extreme anxiety, weakness, palpitations, and a HORRIBLE intolerance to heat…which really sucked, because I was diagnosed in the summer. Getting out of the car to go to the doctor, I would start shaking, and literally felt like I was going to die before I made it into the air-conditioned office.

Which is why I’m hoping Reyes’ problem will be treated while it’s still early spring. Having hyperthyroidism is never good, but in midsummer it’s even worse.

Good grief, this is turning into a thyroid disorders support group, isn’t it? LOL!

Keith, I hope your dad will improve and grow stronger. And don’t forget to keep yourself healthy, as well. It’s far too easy to become ill, yourself, when under so much stress.

I’m beginning to think CitiField was built on an ancient Indian burial ground.

In terms of incompetence on the part of the Met’s trainers/coaching staff, looking at the Ryan Church concussion incident may prove this true. For now, Reyes just resting may be the best thing possible. They certainly need him healthy, because his speed certainly fits with CitiField better than sluggers like Wright (10 home runs). Plus, he’s exciting as hell.

Keith, I know how much you enjoyed showing and commenting on this:

http://www.guardian.co.uk/uk/2010/mar/12/gloucestershire-cheese-rolling-cancelled

My question is how does the Mets recent charlie foxtrot of injuries, etc. stand in the baseball record books? I think it’d be foolish to just assume that they’ve set some kind of dubious record with it…. but good grief, it’s hard not to. Have they?

Dear Keith & Family:

Our deepest condolences to all of you on your loss. Your dad will always be in your hearts and memories.

Do know there are millions of us sending our very best thoughts and wishes during this difficult time.

Sue & Peter Cohen
Rockville MD

Keith
I’ve been watching you daily since your piece on Palin’s explanation of how she was going to change things all around when she became VP! I never miss and Countdown is the source of news I trust most.

As you have been absent so long after the piece on your dad’s illness I realized the end was near and have been praying for him, you and your family.

How sad for you that he has left you.

Lawrence does a fine job but we miss you.

Yet, we extend to you the time you need to grieve praying that there are many close to you who will hug you, let you weep on their shoulders, and hold you up when you feel you can’t go on.

Praying that the love you’ve offered to the needy whom you’ve never even met, is repaid to you in good measure, shaken down and overflowing, that you might know that even in your loss, the love for you in this world is not less but more.

Praying for healing and joy even in your sorrow,
Maribeth Curry
Hamilton Ontario Canada.

Keith, I am so sorry to hear of your fathers passing.
It brought a smile to my face to read that even in a hospital, you would still talk baseball with any and all that would listen. :) It looks like you and I have something else in common, I have started the same discussions with many a doctor while staying at the hospital too.
Again, my condolences, and I hope to see you again this summer. -Sasha Gagarin, Cooperstown.

Sorry to hear of the lost of your father. I have never seen such love. You both have for each other. Your family was truly blessed to have him. If only we all were so blessed. You showed the world what love can be. I hope we all learn from you what true love can be. Thank you for your gift.

Keith…..so sorry to hear about your dad. I remember feeling, going through my mom’s struggle, that with each tiny victory there was hope that she’d somehow wake up and come back. I never gave up and her doctors didn’t either. Both of our families were blessed to have medical staffs who put our parents needs at the top of the list and I know I will be forever grateful to them for making both our parents as comfortable as possible at the end.

Keith…..so sorry to hear about your dad. I remember feeling, going through my mom’s struggle, that with each tiny victory there was hope that she’d somehow wake up and come back. I never gave up and her doctors didn’t either. Both of our families were blessed to have medical staffs who put our parents needs at the top of the list and I know I will be forever grateful to them for making both our parents as comfortable as possible at the end.

Keth

Our deepest sympathy to you and your family. Your father was a wonderful man and he must have been so proud to have you as a son. We have kept you in our prayers and hope that you and your sister will find peace.

Judy & Ernie
Pueblo Colo

Keith,
My condolences on the death of your father. Your parents must have been remarkable people to produce you. Thank you for the advice about living wills. My husband and I just had one drawn up recently and it is a relief to know it’s there. I remember you from our years in Los Angeles on Channel 2. I am not a sports fan but your wry and humourous comments made sports enjoyable. We re-discovered you about 5 years ago on MSNBC and have been watching ever since.
Keep up the good work and could you have yourself cloned? We need more like you to tell it like it is.
Dorothy, Moab UT

Keith and Family, I am sorry for the lost of your father. I lost my dad,Hero, in 1993. He came from Mex. in 1920 and met my mother here in South Texas. In 1938 he started a bakery that supported all eight of us and put us through college. With the education he and mom had given us he knew we would be OK and die happy. He also saw me return from Vietnam and was proud of me, for going. It is thier memories that will confort us and hope it will you and your family. They were so strong and accomplished so much. My heart goes out to all family members. Jesus Harlingen, Texas

Keith my sympathy goes out to you and your family as you bid farewell to your father. I hope for you all to have continued healing while always cherishing his memories. I enjoyed getting to know your dad the same as I did with your mom. Thank you for sharing them with us. I also enjoy your passion as you report the happening of the day to us on your program. Hope to see you back soon.

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