Saturday, August 24, 2013

::tap tap:: Is this thing still on? Ahem...

Well, HEY there!

It feels like a very long time since I've issued an update, but I'd wager that you've all taken that as a good sign. Yes?

YES.

Since being sprung from isolation, life has gotten quite busy again.  We resolved those pesky undissolved stitches and, upon removal, I was rewarded with a much flatter, less noticeable scar. Word.  The landscape of those three and a half inches of my neck is now less rocky inlets and craggy coasts and more gently rolling dunes and soft, sandy shorelines.  And, in just a few years, I'd expect the natural erosion to wash away even those last remaining crests of gritty beach.  Scar?  What scar?  Tide and time and all of that, y'know?

Meanwhile, what's going on on the inside:   We visited the Nuclear Med folks one more time for my follow up whole body scan.  With Colin Hay crooning in my ear buds, I gamely lay still and silent while the machine assembled intimate information with the most detailed of images.  This round of body scan was to determine one crucial thing: did it work?  Was the radiation effective at ridding my body of cancer? 

And, the short answer...

Kinda. But not yet.

Sigh.

However, this is not bad news.  This is, in fact, good news.

The longer, less enthusiastic, but still rather positive, answer...

According to my Endocrinologist and the report he was quoting, my first surgery did not remove 100% of my right thyroid lobe.  This, he tells me, is quite common when they originally don't suspect cancer (which, if you recall, was the initial diagnosis: benign, but remove due to nodule size).  Surgery two was more successful, scraping away far more of the left half and creating an excellent chance of full radioactive ablation on that side. Unfortunately, due to the remaining thyroid tissue on the right, the Radiologist had to administer a lower dose of the 1-131 than would have been necessary to totally wipe that badboy out.  The more thyroid remaining, the more radioactive uptake, the higher the chance of damaging surrounding soft tissues in my body.  So, instead of  a complete knockout round of 100 millicuries of hard-hitting radiation frying my throat, brain, glands, lungs, etc., I got a suckerpunch dose of 60 millicuries. Because, you know, having the rest of your body function is important, too.  Yeech.

But, wait! I said this was good news, right?  And it is.  That 60 millicuries still comes out swinging.  The Nuclear Med report shows a fantastic amount of ablation, absolutely no metastasis, and only some remaining uptake in my neck.

Where's that leave me?  Well, since it is absolutely impossible to determine if that uptake in my neck is malignant or from normal leftover thyroid tissue, we're now retreating to our corner to wait for the next round.  September will bring more bloodwork to check my thyroglobulin levels.  Prior to the radiation treatment, my level was 10.4.  Doctors will now use this number as my cancer marker.  Since completing the treatment, that number should be on a drastic downward trend.  0 is ideal. As thyroglobulin is a thyroid protein, anything above 0 indicates the existence of thyroid  tissue and, most likely, cancer. Here's hoping for  nothing!

The first page of the next calendar will find me under the wand of an ultrasound tech to see what's happening in my neck. This will give the doctors a decent idea of what and where is going on in there.

February puts me back with two injections of Thyrogen and the Low Iodine Diet. The Nuc Med folks will have me down a tracer dose of I-123 and attempt my best mannequin pose to get their prone closeups.  Colin Hay and I will make at least one more pass through the mouth of the great white machine in 2014.

Ideally, the I-131 I received in July will have continued to work its radioactive magic and ablated all traces of angry thyroid cells.  In a perfect world, I will walk out of Virtua with only a ticket to ride the following year.

And, if all is not ideal, they'll stamp my passport, give me that metallic gym sock cocktail of I-131, and isolate me again with my lemon drops and cheesy movies while it finishes what it started this summer.

And THIS time 

::finger jabbing:: 

 its irritating ass

::shoulder roll::

will be fully ablated.

 ::neck wobble:: 

::neck wobble::

::neck wobble::

So there.

Was it unbelievably, excruciatingly, painfully disappointing not to hear the doctor say, "Congrats!You're in remission!?"

Yes.

It hurt in a deep, profoundly personal way. A way that made me both furious and sad and frustrated all at once.

However, a lot of that was born simply of being tired of being so wrapped up in cancer, of having everything revolve around my health, of feeling that focusing on staying alive was beginning to affect my ability to essentially live.  And that, my friends, is dumb whinyness. 

The results were not unexpected. The radiologist had alluded to that every time we had discussed the treatment plan.   And the results are not uncommon.  And, in actuality, as the doctors have all stated, the results are good.  This is what we want to see.  We have brought this beast to its knees, prevented it from pillaging any other village, forced it to surrender. If it does not go quietly by February, we will undoubtedly slay it then.  Drop your sword, cancer cells!


So, am I healthy? Yep!  Am I cancer-free?  No.  I am getting there?  Hells yes!  Am I living again?  Most definitely.   Though there are occasional days where I struggle to remind myself of these facts, for the most part, I'm feeling pretty good. I'm back in public and back at work and back to not getting enough sleep and eating way too many carbs.   Slowly, I am taking my heart and head out of the hospital rooms, away from the surgeries and tests and allergic reactions and threats of missing too many minutes of savoring my babies and I am giving myself back to me.  It's not always easy and, truth be told, from the first moment my family doc uttered, "Now, I don't want you to freak out, but..." until the almostalmostthere of now, it has affected me in ways I never could have anticipated.  I'm both stronger yet more fragile, stubbornly fiercer and endlessly more malleable, oh so extraordinarily grateful for the plainest of things, and more open and raw than a slightly silly introvert like myself is prone to.  Each new day, I discover more about what my "normal" now is. And, happily, joyously, amazingly, I am okay.

Keeping the gloves handy.  Still swingin'.  We've just about got this.














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