The clerk at registration took all of my information and confirmed that I knew what I was there for. Then she asked if I'd ever been there before. "32 years ago, I was born here," I replied, feeling slightly off-balance.
Hours later, I woke up in recovery, more okay than I'd expected. My neck hurt and was a little swollen, but the pain was not severe enough for me to request anything but two Tylenol. The incision was covered by a small, 3 " long, white, bandage. Dr. Shah assured me he'd been able to locate and preserve my parathyroids and, thus, I would not need any calcium supplementation. Great news!
The next morning, looking like this,
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| Cheerful, a bit swollen, and in good spirits! |
(Want more information on a thyroid lobectomy? Some WebMd basics )
Recovering was not terrible at all.
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| See? A few days after that and feeling pretty awesome. |
That Friday, feeling pretty good, I drove myself to Dr. Shah's office for my post-operative followup. Matt offered to use more vacation time to come to the appointment with me, but I declined. I was simply going in to have the bandage removed and discuss future need for thyroid testing. I also wanted to ask him about some swelling under my chin. Routine stuff that didn't need a partner who'd been burning through vaca days on my behalf.
I arrived at the ENT office and checked in at the desk. "That's strange," the receptionist remarked. "I don't see your pathology report here. Let me call over for it." I was sent back to the exam room to wait for the doctor, excited at the prospect of getting the bandage off.
Dr. Shah opened the door and my chart at the same moment.
Have you ever watched another person reacting to unknown difficult news, been distinctly outside of someone else's emotions and watched, not knowing what they know, but simply seeing how the struggle preys upon the face? In the span of seven seconds, I had a window into someone else's distress, watched the weird flinch and twist of unwelcome surprise and the swift slam of suppression as he struggled to regain professional doctor composure. I watched this and knew immediately that these emotions held intimate knowledge of me and mine and, in that instant, I knew also what the pathology read.
"How are you?" he asked, but he didn't look me in the eyes or wait for an answer.
"Well, this is not at all what I expected," he said, waving his arm, my medical file flapping like an injured bird.
"You have thyroid cancer."
Those words burned in an unspeakable way and I closed my eyes for the briefest of moments. He explained that, despite the fine needle biopsy results, cancer had been lurking in the nodule, that it was almost 5 centimeters when he freed it from my body. ("It was this big!" he showed me holding up fingers, and I couldn't help but think "halfway to the pushing phase!" But this was not a joyful birthing.) He said that the larger a nodule is, the more of a chance for a false-negative fine needle aspiration biopsy result, that, at that size, the chances of it actually being cancer had still been 15-20 %.
The pathology report identified the cancer as follicular variant of papillary carcinoma.
He told me that I had "the good cancer" and I half-laughed, even as a cavalry of tears lined up behind my eyelids. He went on to explain the treatment of thyroid cancer, of how Radioactive Iodine treatments serve as "cancer-seeking missiles" to irradiate any remaining or even metastasized cancer cells. The nerd in me, that side that forever marvels at how plants grow and buildings are built, stirred from deep under the blanket of unmoving, unallowed sadness. The idea behind the treatment is, quite frankly, fantastic and, even in moments of terror, I can't help but think, as my 5th grade science fair self, "Coooool!"
The doctor checked the swelling under my chin and pronounced it a swollen salivary gland. Antibiotics and time, he felt, should take care of that.
He removed the bandage quickly to reveal what had to be the most perfectly straight, barely visible incision scar ever. Holding up a mirror to it he said, "Well, you can see, it looks great. Sorry." I laughed and couldn't help but thank him for the great millinery job that he'd soon have to be destroying.
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| Can you even see the scar? This is the day the bandage came off. How unfortunately perfect, eh? |
The doctor suggested a second surgery to remove the other half that Thursday, saying he planned to reenter through the original incision. He also referred me to an Endocrinologist for pursuing the RAI treatment.
Knowing that he'd hit me with much at once, he graciously offered to call me later to answer any questions we may have.
I can not adequately express how much it hurt to have to phone Matt at work to tell him the news. He met me in a Dunkin Donuts parking lot nearby to make sure I was all right. I was as all right as someone whose just been told she has cancer can be.
Explaining it to these three was even more difficult:
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| The best kids ever. |
Luckily, I have the most awesome kids on Earth (I may be a smidge biased...) and they handled it like champs. Their main concern was the upcoming two week period of no snuggles.
The day before my second surgery, we met with the Endocrinologist and went over the timeline for radiation treatment. Basically, I was looking at starting the process six weeks after my total thyroidectomy. I'd take 25 mg of Cytomel daily until then. Then, I'd take nothing and deplete my body of all thyroid hormone and, a week later, switch to a low iodine diet. The process is designed to make the remaining thyroid and cancer cells "hungry" for iodine, a necessary tool for them to function. Once ravenous, a capsule of radioactive iodine is swallowed. Since the only place in the body that uses iodine is the thyroid, the radiation heads straight to those cells and destroys the cancer. Exciting, right? The process has some unhappy effects on the rest of your body, though, making those three weeks long and arduous. Okay. I put on my brave face and forged ahead.
The second surgery went just as smoothly as the first, and I woke up with even less pain and swelling than with the first go round. Unfortunately, later that evening, I developed a sudden, severe allergy to the IV antibiotic, a drug I'd had many, many times before. I spent the night in the ICU with Matt by my side. This, by the way, is not a fun place to be in the hospital. Avoid needing this ward! While the care was great, life-saving measures are never enjoyable. Unlike the rest of the hospital, however, the cable tv was free! Wahoo!
The next morning, after a visit from the cardiologist, pulmonologist, ENT specialist, and surgical resident, and now on a prescription for steroids and Cytomel, I was given the okay to leave. Wheeee!
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| Puffy but free! On the way home from my total thyroidectomy completion. |
The follow up with my ENT surgeon revealed that the left lobe had had cancer as well. Oh my. On the bright side, both wings of that butterfly are now gone. I have no thyroid left. Hopefully, all that stands between me and being cancer-free is my RAI treatment. From April 22nd until now, my somewhat silly, very comfy life has gotten all topsy turvy. I'm more than grateful for the support and love of my family and friends, and, in particular, Matt, who has been my strength by my side, fighting and praying and laughing and crying along with me. I'd like to think we're in the last leg of this thing, that we're going to kick butt and get back to enjoying the average, everyday things...soon.
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| "Second" scar! |
Now? Now I cut off the thyroid meds in preparation for a cancer-kickin' dose of radioactive iodine. Things could get interesting...
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