Journey to Gurney

I woke up on the morning of April 23rd with unnaturally rosy cheeks and feeling vaguely unwell.  The night before, we'd taken the kids to a Phillies game -their first!- to celebrate my son's 7th birthday.  It had been ridiculously cold up there in semi-cheap seats and I'd broken out in my customary cold-weather hives. Totally normal for me; I have cold urticaria, a skin disorder that makes me itchy when I'm chilled. What wasn't normal: I was still all hived-up in the am.  I stared at myself in the mirror and considered my situation.  For the past two months, I'd been feeling sluggish and worn-down.  I'd come from work at around 9 pm, snuggle the kiddos, tuck everybody into bed, and fall asleep sitting up on the couch before 10 pm, mid-conversation with Matt, my wonderful, understandably exasperated boyfriend.  I was sleeping for nine hours and getting up exhausted.  As someone who typically bounces awake after six hours, this was more than disturbing.  Things that usually refreshed me- brisk walks around my neighborhood, for example- were leaving me winded and fatigued.  For quite some time, I'd been chalking it up to energy drain from the long, strange work hours I'd been keeping.  My job is awesome, but those particular months had been more than a little stressful.  And my typical 10 hour day had been morphing into12 hour shifts with hour commutes on either end.  Add three busy kids at home and it was no wonder I was tired.  Right?  However, long days and spending time with my babies had never made me feel like this before.  I was exhausted and, now, itchy. 

I dreaded calling the doctor that day.  "Hi, I'm itchy and tired.  Can I make an appointment?"  How crazy would that sound?

Then call me crazy. Something felt wrong. I made the appointment.

Sitting on the exam table, explaining to my slightly incredulous-looking doctor how I was exhausted and had been "too hive-y" was not the most confident moment of my life.  My primary doctor is also my children's doc, and he knows how I balance a nine, seven, and three year old with a more than full-time job.

"Any other symptoms? Besides the hives and tiredness?"

"There's been a strange metallic taste in my mouth."

"You probably have a sinus infection. And cold urticaria, but you know that. And you're tired.  But let's check you out."

"I don't feel like I have a sinus infection."

"Okay."

Pretty sure he was just humoring me at this point.

He did his doctoring thing and I did my sitting there feeling slightly silly thing. Then he got to my neck. Took a step back, tilted his head. Felt my neck again.

"Okay," he said.  "I don't want you to freak out..."

"WHAT?"  (Seriously, why would a doctor ever start a sentence that way?!)

"...but I want you to get an ultrasound of your thyroid.  The right side is a little enlarged.  Don't look like that.  It's probably fine, but I want you to get it checked out anyway."

(Don't look like what?  I can only assume I adopted a mask of equal parts fear and and confusion.)

"Meanwhile," he continued, "we'll get some bloodwork and I'll give you a prescription for an antibiotic.  For your sinus infection."

He sent me straight to the Imaging Center, where a very nice, very chatty tech slathered my neck with warmed ultrasound goo.  She waved her magic wand, pressing firmly into the base of my neck,  taking picture after picture of the butterfly-shaped gland nestled there. As she focused on her computer screen, she became strangely, uncomfortably silent.

"Everything...okay?" I asked.

"Just taking measurements."

Ooookay.  Staring at the screen, the wavy rainbow lines and bumpy blobs meant nothing to me.

Ten minutes later and none the wiser, I was out the door. 

I went home and got drunk on google.  Everything I read was encouraging; the stats were in my favor for the possibility of a simple benign nodule. The size would determine the treatment and I should not stress. I SHOULD NOT STRESS.


When the doctor called to tell me that I had a 3 cm nodule on the right thyroid lobe and  I'd need a fine needle aspiration,  I was, perhaps, stressing a little.  He explained that a fine needle aspiration is very much what it sounds like: a very long, very fine needle is inserted into your thyroid and cells and fluid are extracted for sampling.  (You can read a little more info on that here .)  I scheduled one where he suggested, at a regional hospital.  The earliest appointment they had was nearly a month away. Okay! I mean, if they'll let you wait four weeks, you can't be that bad off, right?   A call from the lab increased my security: all of my bloodwork was normal, indicating a normal functioning thyroid. 


That weekend, I found myself in the Kennedy Emergency Room, hoping for answers to my sudden difficulty in swallowing and increasing choking sensation.  The barely-perceptible lump on my neck had now become quite noticeably larger, large enough to where even Matt, my other, more practical, half was now concerned.

That there's a goiter!

The ER doc checked me over and explained to us that he didn't think it was my thyroid swelling like that; he believed it to be a swollen lymph node.

 "Any recent illnesses? Infections?"

"Well, my doctor says I have a sinus infection, but I don't really think-"

"That's probably it, but I want to send you for a CT scan, just in case."

When the results came back, his diagnosis was different.  "That most definitely IS your thyroid," he said.  He went on to explain that he felt it was also a case of thyroiditis, or inflammation of the thyroid, caused by either a virus or, perhaps, all of the recent handling (doctor, ultrasound, etc.) of the past few days.  He said the CT scan showed two nodules and it'd be smart to move my biopsy up to an earlier date.

The next morning, my doctor arranged a visit the day after with an ENT specialist who would perform the biopsy in his office. 

Matt and I  met with Dr. Shah, an ENT specialist and surgeon, to review the films and talk about what was going on.  Dr. Shah explained that, despite the fact that 90-95% of all thyroid nodules are benign, because of the size of the larger or the two, I'd need surgery.  He said that, assuming the biopsy came back benign, the plan was to remove the right lobe, but leave me with a fully functioning left-side that should effectively do the work of two.

Because I have a long list of allergies, I elected to have him do the biopsy without any numbing agent.  Sitting in his exam chair, I tipped my head back and focused on breathing slowly and not moving. The needles were like sleepy bee stings, sharp and lingering.  I was grateful to not be able to see what he was doing.  Matt was not so fortunate. 

Afterwards, we stopped for ice cream and drowned our trauma in chocolate peanut butter bliss.

At my follow up appointment a week later, we waited anxiously for the biopsy results.  No dice.  The lab had not returned them.  Dr. Shah discussed the thyroid lobectomy and explained what I could expect.  Surgery never sounds great, but, the alternative -letting the growth continue to enlarge and press upon my windpipe- was a less appealing option.  He was kind enough to ensure me it wasn't cutting off my air supply, but suggested we do the surgery soon.  To be sure my voicebox was not being comprised, he performed a quick fiberoptic laryngoscopy. (More info on that procedure  here .  Again, this was one of those medical tests I was happy to not be able to see; Matt was not so lucky.)  I left the office a bit reassured, and, a few hours later, got the phone call from Dr. Shah.

"The pathology says its consistent with being benign."  Woot!


We celebrated by planting a garden and drinking Riesling by the mason jar. Here's to the future!

Matt and Jon-Jon plant some flowering shrubs!

 

...and I enjoy the finer things!

Up next: a simple surgery?