Pre-diagnosis thru treatment and on...

It all started with a lump on the right side of my neck last June. As background, I'm a pediatrician, in practice for 16 years at that time, healthy, and aside from pregnancy related days, had missed only 2 unscheduled days of work in 13 1/2 years. When I noticed the lump, I guess I knew it was significant, or I probably wouldn't have called Billy G., an ENT colleague. I almost dismissed it because it had benign qualities, but I thought maybe I'd felt it the month prior and and that it hadn't been that big. When Billy felt it, he thought the location was odd and ordered an MRI. That did show an abnormal node which led to the open biopsy I had July 2009. Several possibilities had been voiced, but the result presented to me at my follow up visit wasn't one of them, Papillary Thyroid Cancer. Something in the way Dr. King spoke to me post op, even though I was not fully recovered from anesthesia, raised a red flag to me that he was concerned about something. Friend's told me I was silly, but it turned out I was right. Being a doctor still didn't prepare me for the news. He handed me the path report as he started to talk to me. I heard "thyroid cancer blah blah blah, thyroidectomy blah blah blah, neck dissection blah blah blah". I tried to ask some intelligent questions and thought I was okay, but leaving his office, the last patient of the day, on my birthday, I began to bawl as I hit the hallway. That would have been tough enough, but the results were just preliminary, the slides had been sent to PA for confirmation. It was more than a week before I got the confirmation, and that was a really loooong week. From there, a visit to an endocrinologist to get plugged in for care after surgery, CXR, neck U/S, bloodwork.
To give myself a little time for recovery between the biopsy and the pending total thyroidectomy (TT) and right neck dissection, I put the surgery off until end second half of Oct. You might wonder why wait so long, but this cancer isn't presented as being anything urgent. It is slow growing and has a low mortality, it's the "good cancer" is what I heard, but 3 operations later it doesn't seem so good to me. To be continued............

My thyroid cancer journey, so far......

It was back to the drawing board last week so to speak with another surgery for thyroid cancer (thyca). The last year has been a big blur from finding the lump, to biopsy surgery, then the shock of the diagnosis and the further shock of what type of surgery would be required. The time for that to sink in, surgery and recovery, then discovery of more nodes and resigning to the fact of more surgery.
Friends and family have been so supportive throughout this saga. I'm sure sometimes I don't express my appreciation enough, often because I get choked up so easily when I start talking about the good things people do for me. It amazes me how fast that kind of emotion can jump up my throat and choke off my words while the tears start to flow so I can't talk without bawling. Blogging (though infrequently) and interacting with others with thyca on the Thyroid Cancer Awareness page on FB have been great outlets. I can keep on typing while the tears flow.
I've experienced so much as a patient these last 15 months. I hope I can use some of it as a positive in my practice or at the very least in understanding why patients act the way they do sometimes. It has really been an emotional rollercoaster,and I know I've gotten very wrapped up in those emotions at times, so it's hard to step back and find those positive spots in all this. I think that's part of what this does for me. I'd be lying if I didn't admit that this is also an escape for me from those emotions. As I think thru it and type it, I'm often not feeling it. Same thing when I talk about it in a factual, probably almost journalistic way, when friends ask about it. As long as I stick to the facts and just relay the info I'm ok, but start talking about how I feel about it and I'm thru.

the first photo is after my initial excisional biopsy, July 2009 and the next photo is how well it had healed by October, before the big surgery.

8. the third is after the thyroidectomy with neck dissection, Oct 2009 followed by one showing, fortunately, how well I healed (a point both consulted surgeons pointed out, which I found curious since either of them would potentially be undoing that soon) before having to start all over again with the most recent neck dissection, same side. I hope I'll be as blessed to heal nearly that well this time around. You can be sure I'll show you down the road.
   

It's late and I think I've wandered off course, but I will be back to this, hopefully sooner than later, to talk more about the steps along the way. Hopefully I can help someone else that is starting down the same road while helping myself, and without making my friends listen to me repeat myself :)

no such thing as good cancer

Paid one last visit to the beach and summer vacation last weekend before returning to the realities of the next school year. Had a great time with girlfriends and was treated to a glimpse of the meteor shower on a midnight beach walk just by luck because I didn't know it was happening. Half a dozen shooting stars in half an hour, that's more than I've seen in a lifetime.
My mom's node was confirmed to be melanoma. Her oncologist referred her to an even more specialized oncologist at Miami's Mt. Sinai, so next week she'll find out more. She's seemed rather determined that whatever the plan, it will not ruin her upcoming trip with my dad to see family and old friends.
My PET scan was negative. I was a bit confused by that since at least one of my nodes was positive on biopsy. 2 possible explanations given are 1) nodes < or = 1cm don't show up and 2) more aggressive cancer cells have higher metabolism and show up brighter, so I guess those are both good things. Next step then is probably more surgery, but a second opinion, or more like an overview from M.D. Anderson might come first.
to be continued because I had typed much more, thought I saved it, but much of it disappeared when I tried to publish.

My Mom

I've talked about my cancer challenges as well as my parents'. Now it's time, unfortunately, to bring up my mom again.
Almost 3 years ago she had a melanoma removed from her leg. All looked good, clear margins, etc. Not long ago she felt a small lump in her right groin, same leg as previous melanoma. PET scan lit up there, but just there thank the Lord. Lump came out last week and preliminary path looks like melanoma. Hopefully followup test results will be ready for oncology visit next week.
I know this post isn't read by many, but for those of you that do. Please add my mom to your prayer list. She's a wonderful woman and 80 just isn't old enough for her.

at least I know

The biopsy was positive. At least now I know. The next stage is waiting for my doctors to confer so we can come up with a concensus for the next steps. The nodes will have to come out, but whether or not I get some type of scan first and then whether I'll have to get redosed with I-131 afterwards are the questions. Being one myself, I know it can take a while to get 2 doctors on the phone at the same time, especially when one is a surgeon. Oh, well, like I said, at least I know the biopsy result. The rest is easier to wait for.......

Waiting.....again

Had the u/s directed needle biopsy of nodes in my neck yesterday. The procedure really wasn't bad at all. He numbed the area with lidocaine which stung just a bit. After that, all I really felt was pressure of the ultrasound transducer and from the needle when he biopsied. He did three separate passes and I could only tell he stuck me from a little pressure. I'd read accounts of it being pretty painful, so I was relieved.
Now I just have to wait for the results which will probably take about a week.