Feeling low, here I go

So I'm not really sure what to do here, and I'm kind of freaking out.

Ever since they removed my thyroid, my whole metabolism depends on a pill. A handful of pills, actually: little white and pink pills, smaller than a string of beads. T3, TSH, T4...these letters and numbers are meaningless to most people, but not to me. Every night, I line them up along the crease in my palm and gulp them down, like clockwork. They control my life. I wouldn't mind, actually, but the thing is that they aren't very good at their job. Everyone's metabolism is different; every thyroid patient responds to an individualized dose of synthetic hormones. In my case, regular doses don't work. We have to bump mine up, again and again, just to keep me functional. Bump too low, like we did in England, and things crash. Depression, lethargy, weight gain...Low thyroid levels pull me down a dark, cavernous hole until I can't see the surface. So I came home, and we bumped back up.

Now, six months later, it appears that the dose I've been on is a bit too high. I found out the hard way when I was speaking to a group of undergraduates today. Suddenly, an ancient symptom I'd forgotten completely came rushing back, and in the middle of my impromptu remarks, my tempo accelerated. Then, my heart started pounding. And then, best of all, I started shaking. Like, scared shitless of crowds shaking. It's not something I can control, because it isn't psychological. It's like a shot of adrenalin straight to the heart, or a quad-shot espresso slammed back, chased with sugar. It is an absolute nightmare. Four years ago, I'd reasoned away every indication that I was sick, and then I stood in front of my favorite class and quivered like the last leaf in fall. It was humiliating, and I finally had to admit that something was deeply awry.

I love public speaking, which is what makes this symptom the worst -- when I'm up there, and it happens, people look sorry for me. Some avert their eyes, and others smile reassuringly as if they think they can soothe the wild creature flying around the front of the room. This, of course, actually makes me nervous, and then my voice starts galloping like a horse unbridled.

I am about to interview in the final round of a job opening which involves a lot of public presentations, as do all of the other positions which I have a chance in hell of securing. I can try to knock the dose back down, but it will likely take months again (all after I see my doctor, which itself takes weeks). Worse, for the rest of my life I have to operate without knowing when this is going to hit. Hormone levels fluctuate, even when they're strictly prescribed, so I get to attend every presentation for each of my jobs knowing that at any moment I could blow the talk. I had no real indication that things were askew again until today! What's to stop that from happening years from now, when I'm giving a talk that really matters? Heck, I could get hired by this current place, only to be fired within weeks for acting like a frightened child in front of a major board meeting.

I'm suddenly so sick over this that I'm wondering if I should maybe stop thinking about careers that involve talking to groups of people. What can I do? Get hired by some company and say, "Oh, by the way, I have this autoimmune disorder that's been treated, but the side effects of the treatment can include adrenaline-fueled craziness in front of an audience."

I feel really, really sick. Most of the time, I manage to live with this disease without thinking about its implications on any meaningful level. Last year, I battled through some of the worst depression of my life in a new country, and I was so relieved to get home because at last, I thought, I'll get to be normal again. What the hell am I supposed to do now?