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The Is A Condition Of The Illness, Hyperthyroidism. Monica And Rachel On A Beautiful Sunny Day

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I first met with Monica and Rachel on a beautiful sunny day this October at their home in southeast Portland to talk to them about Rachel’s chronic illness, hyperthyroidism. Monica and Rachel have been a couple for about four years, but have been friends for over ten when they met through mutual friends in Los Angeles. They are by their own definition “middle-aged cosmopolitan lesbians” living a life together as a married couple without the legal title. It was Monica that realized something was wrong with Rachel’s thyroid in the fall of 2013 and they have worked together and with their healthcare providers to help manage and slow the progression of Rachel’s diagnosis of Graves’ disease. This paper will talk about Graves’ disease and how …show more content…

Karen Holt describes in her 2010 article Graves’ Disease: Clinical Pathophysiology, Presentation and Treatment Options of certain genetic markers that cause the blood vessels surrounding the thyroid gland to dilate, most often occurring in the second to third decade of life. The dilation of these vessels causes an increase in blood flow and thyroid-stimulating antibodies excite thyrotropin receptors on the gland itself in the same manner that TSH usually works. These antibodies, known as TSAb, bypass the negative feedback loop that TSH works under causing the follicles to produce thyroid hormones in copious amounts without the ability to turn themselves “off”. This in turn causes the thyroid gland to hypertrophy and grow as much as 2 to 3 times its normal size (p. 13-14). In an effort to stop the overproduction of thyroid hormones the pituitary gland will stop making TSH and this becomes part of the diagnosing for Graves’ disease when assessing hyperthyroidism. Increased levels of free T3 and T4 along with an almost non-detectable level of TSH in a blood screen are very indicative of Graves’ disease (Holt, 2010, p. 14). There is no cure for Graves’ disease, but it is treatable with lifestyle adjustments as well as drug therapy it can be managed to a point (p 46). In terms of the trajectory model put forth by Anselm Straus and Juliet Corbin (2013) Rachel

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