Saying No Without a Doctor's Note

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A photo of a redheaded woman on the couch giving a thumbs up, with a bandage around her neck where her thyroid was removed.

Everything I've learned about boundaries in my life I've learned from my thyroid — or, I should say, my lack of a thyroid.

This week is the one-year anniversary of getting it removed.

At the start of 2020, I told my doctor: I'm exhausted all of the time. But at this point I had no idea I had cancer. I just knew that I'd spent the past year clearing out my calendar, meditating, eating vegetables, getting 7 hours of sleep — and yet I still felt like garbage.

At first I tried to soldier through the feeling. I told myself that being tired and anxious was simply my default state. But when that got too much to manage, I decided to try every wellness tool and trick I could find to try to get myself back into balance.

I'll be honest: after a year of experimentation with no results, I was really relieved to find out that there was a medical diagnosis to make sense of it all.

I'm happy to say that replacing my thyroid with synthetic hormones has been, in a lot of ways, a game changer. I don't consider myself an anxious person anymore at all anymore, which is a miracle. I have what I think is a normal amount of energy for someone pushing 40. Some days that energy even goes above expectations, especially when I'm with other people or in some kind of creative flow.

But I do still have days when I am undeniably spent. I treat them as the thyroid equivalent of PMS. When I feel that twinge I know I'm going to have to clear my calendar, be kind to myself, and rest. I don't worry about disappointing people if I cancel plans. I proactively shift my schedule around. I'm transparent with my team about making sure I'm waiting to connect with them until I have the energy to truly be present and supportive.

I only feel confident doing that because I have a doctor's note that says "now and forever, you are someone with a chronic illness and you can say no."

But here's the thing: I'm not 100% convinced that all of those symptoms I was feeling before I was diagnosed were actually my thyroid. I haven't heard anything conclusive one way or the other from my doctors. My blood work was fine. So was it my thyroid causing the anxiety and exhaustion, or was I just really overextended at that point in my life?

It's the same question now. Are my "thyroid days" truly days when my hormones are out of whack? Or are those days where I worked a little too hard. Or my meetings were a little too stressful. Or my calendar got a little too full. Or I was rushing around too much. Or I was worrying about this or that.

My thyroid provided the training wheels for me to practice what it's like to say no. But I'll be prouder when I feel just as comfortable saying "no" or "not now" or "never" without a medical reason to do so.