Zonked!

Years ago, Monty Hall stood on a stage in front of an oh-so-live studio audience and offered hopeful contestants the opportunity to win big.  Clad in bear suits and spacealien'd tinfoil, and tutus with fairy wings, the chosen "traders" would throw chance and bravado into the air and see what stuck.  If the players were really lucky, they'd get the try their hand at selecting the correct entryway to the best prizes. "Monty," they'd say, surveying the trio of closed curtains, "show me what's behind door number three!"

The door would whoosh open and, if luck or the producers' need for better ratings were on their side, the room behind would hold a new car or an exotic trip or piles of cash.  If not, well, our trader had just been Zonked.  Congratulations, enjoy your llama!

These days, I think there's livestock in my future.

My most recent visit to the Endocrinologist yielded some frustrating results.  After playing around for some time with my Tirosint dosage, we thought we'd have one that would balance the level at a good smidge-too-high.  What we failed to consider, however, is my extreme love of chocolate. And cupcakes. And bagels. I'll explain.  Sigh.

So, I've been hitting the carbs a bit heavy.  I won't sugarcoat this...er, actually, I guess I will.  Or, I did.

Mmmmmm, sugar...

Which is how I managed to pack on an extra 5 - 8 lbs (depending on whose scale you believe and which shoes I've donned) since October.  It's winter. I'm hiding under bulky sweaters during perfectly cozy snuggle weather, and it's too cold to jog, and it's baking season, and I'm a known stress nibbler.  Matt will tell you all about my ability to "Tiffany-bite" -- That means deliciously ittybitty slivers, if you haven't experienced the phenomenon -- my way through pans of brownies, batches of cookies, pints of ice cream...  Much like a grizzly, I pad myself with an extra layer to help me hibernate the winter away.

Aside from being a poor lifestyle choice (aaah, chocolate, my friend, my vice!), apparently, this can greatly mess with one's need for thyroid horomones.  Even a weight change that doesn't require bigger pants does result in a shift to one's TSH.  Sigh.  Soooo, my TSH went from being a not-too-awful, almost-surpressed .59 to a ridiculously high 1.84. Yowza!

Hey, you over there with the normal functioning thyroid?!  Yes, YOU. You're probably rocking a 1.84.  Me?  Thyroid cancer warrior that I'm supposed to be?  NOT allowed to ride the triple digit TSHs.  Eeek! 

To counteract the rise, the Endo upped my Tirosint dose again, hoping to bring it down to closer to the .4 he'd ideally like to see it at. 

So there's that.

My Thyroglobulin paraded in at .7.  Ideally, this should be at a big, fat 0.  Since Thyroglobulin is an indicator of body-made Thyroid hormone, the presence of any in a thyroid cancer patient indicates that somewhere thyroid cells (i.e. the cancer) are active.  If you've been following along, you may recall that my last Thyroglobulin number was a .6.  On the plus side, this change is not significant enough to indicate anything.  On the less joyous side, it is still not zero.

Add all of that together with the troubling ultrasound results (hey there, lingering thyroid tissue!) and you have one cautious and slightly aggressive Endocrinologist.  He's signed me up for a neck biopsy in a couple of weeks to get a closer look at the 8x6x3 mm nuisance hanging around.  And, now that the Thyrogen shots have officially been approved, the week that follows the biospsy has me swallowing the I-123 and sliding into the Whole Body Scan.  And then?

Well, we finally talked about the "and then."

My Endocrinlogist delved into the dangers of not addressing the tissue and/or "or what" that still takes up residence in my neck.  He feels that we'll soon be making a decision to do one of three things...

Hit it, Monty...

Door #1:  Surgery again.  We could go back in attempt to rid my body of the slice of thyroid the surgeon left behind.

Door # 2: Radiation again. Another blast of the ol' I-131 to zap any cancerous cells looking to start a fight up in there.

Door #3:  Nothing.  Watch and wait.  Continue to monitor closely that 8x6x3 foe to see if it makes a move.  This is, by far, his least favorite option, as it allows our adversary a chance to attempt a sneak attack.  The benefits, however, include no more risky surgery, no more chancing IV antibiotics I may be allergic to, no more heavy exposure to radiation that can cause other cancers.


We'll wait to get through the biopsy and Whole Body Scan before we start laying out a plan of attack, however.  Until then, I glance from door to door to door, praying not to get Zonked.

Meanwhile, a recent trip to the GYN has me heading to the Women's Imaging tomorrow for a mammogram and an ultrasound.  You know what's the easiest way to take your mind off of thyroid cancer? Find a suspicious lump in your breast. Wheeeeee!

Oh, look, a cookie!

I'm starting to think I should take more vitamins. 


In other, much happier news, Matt and I are frantically finalizing plans for our wedding celebration party.  Yay!  While eloping in a giant elephant on New Year's Day was so ridiculously fun and amazing and perfect, we're excited to be able to share all of the love and warm fuzzies with our friends and family. C'mon, April!

And then, the honeymoon!    :::biggestgrinever:::

Hitched! Inside Lucy the Elephant in Margate, NJ

The next few weeks will be filled with pokes and prods and intrusive and obnoxious tests and scans.  But, I've come dressed to this gameshow in my best ninja garb, determined to dodge as many sneaky opponents as possible.   I'm not choosing a door yet, but I know a definite pull of a curtain will eventually be required.  Fingers crossed, I'll aim for the grand prize and if, in the end, I take home a camel instead...well, you're all welcome to hop on a hump and come for a ride.

.

A snapshot of the inside.

I lay on the exam table, eyes following the wormhole paths in the pocked white ceiling tiles, trying hard not to swallow against the lump forming in the back of my throat.  The ultrasound tech waves the probe over the contours of my neck, pausing to capture still frames on her screen.  The gentle "click-click-click-click" as she traps her quarry with mouse and wand is all I can hear, save Matthew's soft breathing and the heavy beating of my own heart.  Hospitals smell like hospitals.  I have never liked the scent.

I am here for a head/neck ultrasound, an event which stresses me out more than I have cared to admit.  All of the hard work of Endocrinologists and Phlebotomists and Radiologists and Pharmacists and BillingDepartmentists have brought me to this day and this table.  It's the great Follow Up, a time to see exactly what's been happening in my neck since the radiation treatment. The hope is that her magic wand reveals exactly nothing.  No tissue, no growth, no crazy, involved lymph nodes.

She finishes up the right side - where I've already warned her she'll find residual tissue - and hops over to the left "just to be sure."  I stare at the abandoned worm colony in the plaster above, getting used to the slick smear of warm gel on my skin. On days like this, I am still not used to me.

She finishes, one final frozen view of my innerworkings on the screen.  I sit up and rub the rough towel over my gooey neck.  She tells me, even though she technically shouldn't - an untechnical tech, thank god-  no suspicious lymph nodes, nothing causing huge amounts of concern...except "there's something there" - the right side - and she "can't be sure whether if it's a lymph node or tissue or what...could just be a lymph node." Brightly. Calmly.  But, the right side is where the radioactive whole body scan told us before that the surgeon left a little behind, forgot the last scalpel scrape, and gifted me with an unwanted hive fit for hornets to take hold. "Could just be a lymph node."  But, in this small, sterile room, with these heavy ceiling tiles being held up by hopes and prayers and hospital-grade putty, we know, of course, of course, it's not a lymph node.  I ease into breathing, because this gets easier with time and, despite that it's only been nine months since the thyroid alarm was sounded, I know that, most likely, it's probably tissue, the last of my forgotten friend, and not, not, not the "or what" this lady in the scrubs cheerfully references.

I have had enough of "or what."

Three full business days later (I count them Friday-Saturday-Sunday-Monday-Tuesday on nervous fingers) the results to my ultrasound pop up in my online Penn Medicine electronic basket.  It's as the tech says: fantastic lymph nodes.  No idea what that other stuff is.  It hovers, 8 x 3 x 6  millimeters, in the bottom right of my neck, its existence just troublesome enough to add another layer of complication to a new life I felt I was finally settling into.

The Endocrinologist calls me later that night as I pull into my driveway.  I put the car in park and he explains to me what I'm pretty sure I don't want to hear:  time to bring out the big diagnostic guns.  Another Whole Body Scan is in order.  I'll spend two weeks once again on the Low Iodine Diet, receive two more Thyrogen shots to propel my TSH upward, and swallow another capsule of I-123, a low dose radioactive iodine.  Then, I'll return to the belly of the great white beast for some explicit closeups of the whateverness hovering in my throat.  And then...well, we don't get that far in the conversation.  He says his secretary will call me the next day to get the ball rolling.

I wait for his office to call, anxious to hear the timetable for this next round of upheaval, but, when no call comes by day two, I phone them.  She's still wrestling with insurance for the order for Thyrogen, she says, and will call me once the approval goes through.  I brace myself for the $500-$2000 bill that will soon follow.

I try to shake off the frustration and fear that comes with all of this.  I am working through the multiple dose changes of Tirosint, the artificial thyroid hormone that needs to be kept at precisely a high-enough level to suppress my TSH (and thus, provide personal chemo for the cancer) and a not-too-high-enough level that will negatively affect my heart, head, and various other vital systems.  This wibblywobbly balancing hits me with hosts of bothersome effects, including heart palpitations, hot flashes, wavering  jittery-ness, and bizarre episodes where I can not not not find the word I was trying to speak and I stand there, fish-mouthed, until I can pluck it from wherever my hormonal brain has hidden it.  I take a pill each day and wait four hours to eat, knowing I need to absorb as much as possible even as I worry that "as much as possible" is technically more than my body is happy with.

The anxiety about achieving that balance is enough to permeate my daily happenings with constant thoughts of my health.  I hate thinking about my health.  This is what we have doctors for, I think.  To think about our health for us.  I hate feeling so helpless in all of this.

But, this is not every day.  Many days I feel strong. Grateful. Accomplished.  Kickass, even.  Some days I know that I am fighting this better than I would have believed possible.  Most days I can not believe it has only been nine months.  I gulp that amber-hued capsule at 4:18 am each day, gratefully aware that each one takes me closer to officially cancer-free, that each one is serving to fight my battle for and with me.  I chase it with a full bottle of fresh, clear water, filling each steady swallow with a reminder that I will not always have to endure these jacked up Tirosint levels, that, one fabulous, future day, the doctor will look at me and my prescription and my by-then-improved test results, and say, "It's time to let you feel closer to you again."  I'm so excited for that day.
 

Fireside chat. (No thyroids allowed!)

Happy holidays from my neck of the woods!


Heh. Neck.  See what I did there?

2013 is drawing to a close and, between frantic Christmas preparations, end-of-semester busy-ness at work, and children zipping in and around the house, it seems like a lovely time to take a break from the hecticness and update you all.  I'm going to grab my cup o' decaf and settle down here.  You want to get yourself a hot cuppa, too?  Maybe a Christmas cookie?  G'head, I'll wait.

Okay, then. If you're comfy...

Let me take you back...

The last of summer's sizzle was still upon us, the wicked sticky heat was flashing vicious claws, slicing deftly through our thin skin of centrally air conditioned bliss, dragging those foes swelter and scorch inside to curl damply around our ankles and slide lithely up our spines.  Ahh, summer days!  100 micrograms of Synthroid had me feeling mostly human, despite the baked August.  I was a bit slow and fried-feeling, but happy to be altogether still Tiffany.

 I returned to work, both excited and nervous to be back among the normal folks.  My first day was a success; I arrived home sleepy yet satisfied.  I'd forgotten what a ten hour work day was like and I was unprepared for how my body would feel with my new, artificial thyroid hormone.  Day 2 threw another curveball my way; while applying my makeup at 5 am, my eyes became suddenly, terribly, painfully irritated.  We're talking fire dancing across my lashes.  Lava on my eyelids. Flames at the edges and in the creases.  This was hot.  I left for work that morning with a freshly scrubbed face and a brain full of frustration.  Was I mysteriously, suddenly allergic?  Was this from the radiation?  What was going on?   Experimenting and googling both lead the the same results:  for whatever reason, I was now unable to wear eye makeup. I was devastated.

This affected me more than any other change I'd experienced. I could deal with the heavy swoop of a scar across my neck.  I could get used to the change in the texture of my hair, the subtle differences in my skin.  I could work with the inability to eat anything for four hours after taking my thyroid meds. I could even reconcile myself with having to take that pill every morning at 4:20 am. I could learn to get comfortable with the too-frequent doctors' appointments, the never-ceasing bloodwork, the knowledge that I'd be tested and treated -and on guard - for the rest of my life.   But no eye makeup?  Sob!    As small and silly as that may seem, it sent me reeling.  I'm a woman who loves her liner and savors her shadow.  I've never been particularly girlie and many a time I've happily faced the public au mostly naturel...but not without my eye makeup.  And, with everything else the summer had brought me, this seemed like one more stupid, unnecessary injustice.  Looking in the mirror, the person staring back at me seemed foreign.  Less vibrant, less engaging, less attractive.  Walking out in the world sans sparkle seemed almost uncouth.  I felt like an imposter.

But, life moves forward whether we slather purple on our peepers or not.  Days and weeks and months and still my naked face looked back at me.  I stared with unadorned eyes, getting used to this new me.  Did people notice? Sometimes.  Did my new look terrify the masses? Nope.  No small children ran screaming in horror, no old ladies beat me off with their bags, no one recoiled in disgust.  And, slowly, I got more comfortable with me.  And I found one rather obvious truth:  no one really cares all that much what you look like.  We take vague pictures of people we encounter and carry them with us as impressions. It matters not to your memory if I have a sweep of shadow below my brow.  It matters more what I do, what I say, how I carry myself, if I smile widely at you and am pleased with your presence, how my being makes you feel about you.  These are the things stick with you.  Do you see me more fondly if I have my signature cat-eye?  Probably. But, 20 minutes later, you'll have forgotten that, too.

The ol' standard.

Sans sparkle, avec my love.

But, even with my newfound comfort with me, I still had no idea why I was suddenly experiencing these problems.   I declared it my mission to find the answer.  All avenues lead back to my thyroid...either radiation or imbalance.  Eventually, a dermatologist dubbed it eyelid eczema and gave me two options: time or a cream that had been known to cause cancer when taken orally.

Erm.  Think I'll wait this one out.
 

In the meantime, I switched medications from Synthroid to Tirosint. This stuff rocks!  Within a week of switching, I shook off that vague groggy, fatigued feeling that I'd been fighting for two months.  And, my TSH , or Thyroid Stimulating Hormone, took a dramatic drop. Wahoo!  Previous blood tests had announced that my levels were higher than recommended, that in order to control cancer, I'd need to lower my TSH from the 1.49 it was coming in at to the recommended .1 -  .4.  (You can read more about that here.) Six weeks on Tirosint returned lab results of .59.  Getting there!

Also in the mix: I changed Endocrinologists.  At the recommendation of just about everyone I met at the ThyCa Conference, I found an Endocrinologist at University of Penn. Reading over all of my previous labs and reports, he unhappily announced that my surgeon had left too much thyroid tissue in my neck and, thus, he was going to approach my treatment aggressively.  According to the doc, if my Thyroglobulin starts to rise (an indicator of thyroid cancer a'happenin'), he'd not call it a recurrence, he'd consider it spread of the original cancer.  He's ordered ultrasounds for January to see what's going on in there and upped my Tirosint to 112 micrograms. This increase should drop my TSH to that optimum suppressed level of .1-.4 and will effectively make me hyperthyroid.  This comes with it's own set of potential problems, from anxiety to tremors to heart issues.  While it's not something I'm overjoyed with, it is something that's necessary to kick this thing's butt - and keep saving mine.  By now, you've probably realized how medical intervention freaks me out (I'm not a good pill-taker, for a multitude of reasons!), so upping medication to a level that is specifically too much and more than what my body wants is a bit a lot scary.  I'm keeping my focus on the end result through; images of destroyed, ineffective, uninvolved cancer cells leaving my body counteract the fear that shimmers in the background.   As Matt tells me constantly, we've got this.


These past couple of months have been eventful and not in just the cancer category.  On the super high note, Matt asked me to marry him and I gave him the finger.  Don't worry; it was the best one! Upcoming nuptials are planned for April 2014.  Yay, cake!

The front-runner invite.

Otherwise, the kids are writing out their lists, getting excited for Santa's arrival, and our new puppy, Gidget, is tearing around the house, getting excited for anybody's arrival. Life is wonderful, though crazy, and I couldn't be more grateful and happy.  This past year has brought us over much hilly terrain and through some pretty intense weather.  With Matt by my side, we've managed to stay on course and donned some fantastic storm gear that has kept us mostly warm and dry. And, I'd like to think that we've arrived comfortable and safe, ready to snuggle up by the Yule log and enjoy this season of joy and peace with the people we love.
 (And, as a bonus Christmas miracle, I've managed eye shadow for three whole days now. Yaaaay!)

Now refill your empty mug, have another cookie, and tell me what your holiday holds... 

::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.

Release these (imaginary, not so bad, really kinda boring) shackles! I am free!

I am unisolated!

Yesterday marked day seven of my required week-long isolation period.  Am I excited to be able to leave the house and interact with people not wearing protective gear?

It's 8 am and I'm typing this from aisle 12 of my local Walmart as I sing showtunes over their PA system.  Price check on my freeeeeedom?!


I kid.  But not much.

I've spent this past week catching up on my reading, my Netflixing, my Pinning, and my project-ing (shhh! that last one is a surprise for a someone for a something on suchandsuch date. Forget I even mentioned it. ;) )


Today, I have a ENT doctor's appointment to look at and hopefully remove the few centimeters of dissolvable stitches that never dissolved (!) that are currently poking out of the end of my scar.

Tomorrow: Whole body scan! And end of low iodine diet! Yay!


BREAKING NEWS:  Matthew has just informed me that we did NOT win the Powerball last night. I'd wager you didn't either.  Soooo, in honor of numbers that are not going to make us millions, here's some numerical facts from my week...


59.8    - millicuries of radioactive iodine I received
43       - miles to home from hospital
2.5      - trash bags I filled with empty bottles of water. Gooooo hydration!  Gooooo kidneys!  Gooooo radiation out of my body as quickly as possible!
8,765  - approximate times I said, "ewwwww!" as the hot, metal radioactive sweat sock tang flooded my  mouth
54       -  lemon drops sucked in an effort to help prevent the radioactive assault on my salivary glands
1,893  - quality massages I gave my jawline, bottom of my chin, and neck. Much like the lemon drops, but more painful.  
 0        - times I've lost my sense of taste. Wahoo!  Here's hoping it stays that way! 
 1        - terrible movies I had the misfortune of believing the Netflix recommendation of.  Avoid Happy Poet.  It is not about a happy poet.  It's just dumb.
2        - movies viewed simulateanoeusly in the bedroom and in the living room so that Matt and I could  watch a movie "together."
5       -   channel we eventually located on the walkie talkies that was "trucker-free." Not that we didn't want to open up the party line for discussion, but some things aren't meant to be shared with the gang at the gas pump.
14      - times I ate chicken breast and steamed zucchini.  Thanks to this low iodine diet, there's some decidedly flat-fronted fowl running around. (What I wouldn't do for a cheese burger, some mac and cheese, and some sauteed spinach!)
2       -  times Matt Betty Crocker'd it...and produced some extraordinarily delish LID blueberry muffins and chocolate brownies.  
50    -  Shades of Grey.  Finally found the time to read it.  What? Don't judge; you read it, too! ;)
2      - walks per day I've been taking. Sunshine always feels good!
1 million  - times I've missed my kiddos
1              - more day until they're home!
Several bajillion  -  number of thank yous I need to give to everyone who has been supporting me and continues to support me.  Even just knowing there's people out there, praying and hoping and thinking positive thoughts on my behalf, helps more than you could possibly know.  For serious: you're great! 
12 - minutes it's going to take for me to shower and dash out the door...and into the general public.

Here I come, big world!  I will try to restrain myself in Walmart.

It's Glow Time!

The elevator at Virtua Hospital's Health and Wellness building has the most depressing way of announcing its descent. "Going doooown," the robotic lady moans, and you can't help but feel that she'd be better assisted on her journey with a Xanax or two. 

Fortunately, Nuclear Medicine is located on the the second floor and the ride in either direction is brief, leaving you little time to worry about the mental well-being of your transport.

And, on this past Wednesday, my concern for that sci-fi tin gal ranked even lower.  Becoming my own radioactive laboratory experiment, however, raced to the top. 

We arrived to the Radiology Imaging department at 1 pm and checked in.  Within minutes, we were ushered to the back. Steve, our friendly radiologist, took us to the scanning room and explained the upcoming full body scan procedures:  I'd lay on a flat board, neck hyper-entended, legs bent over an oddly-placed pillow, while the scanner took picture after picture of my neck and body to view where all of the I-123 radiation from the day before had landed.  This would help determine the correct dosage of I-131 I'd need that day for treatment. Cool.  The process would take about 45 minutes. Still cool.  And - "Arms at your side, please...Now hold still!" - they would be wrapping me up like a little mummy and taping the sheet closed. Erm.

Thank God for my iPod and Colin Hay.

Meanwhile, Matt amused himself by taking pictures...

After the scan, I was brought to another room for a thyroid uptake test to measure the amount and location of the radioactive iodine in my neck.

That machine only involved holding still for a minute while it worked its gamma magic:

This is what 60 seconds of fun looks like!

After that, Steve told us we had about an hour's wait while he ordered the I-131.  He suggested taking a short walk and returning in half an hour to go over my instructions.  I suggested making a break for it.  Matt sided with Steve, so we ventured down to the parking lot to enjoy a non-nuclear, sunny bench for a bit.

Preparing to glow...

Inside of Nuclear Medicine, you'll find maze of hallways and doorways and rooms with crazy, yellow radioactive symbols. If you continue through the labyrinth, you'll notice the signs getting yellower, the warnings larger, and the doorways more prohibitive.  Follow that last hallway allllllll the way back to a deceptively sunshiney window and hang a right.  There, in a small, rather ordinary room with a firm, rather large hazard warning hung by the door, on this previous Wednesday afternoon around 2:30 pm, you would have found me.  There I sat, Matt by my side, as the tech explained all of the precautions I'd legally be required to take once I ingested the I-131 pill. As she went over the precautions, I calmly nodded my consent.  And then I definitively signed my consent on their papers, because the law and the hospital like to know that you really, really mean it.

Steve dropped in to tell me how much I-131 he ordered:  59.8 millicuries.  He explained that the amount was rather low because I still had a decent amount of thyroid tissue hanging out in my neck and a higher dosage might damage the surrounding tissues and organs.  Ookay. He also said that, depending on how well this round went, there was a good probability I would have to repeat the process in six months...but, there'd be no way of knowing until the first RAI was complete. Oof.  On the positive side, my initial scan did not reveal any metastasis. Yay!

And then we waited.

After another half an hour, two men with a handtruck passed by my door.   One wore a hospital security uniform and carried a clipboard. One wore khakis and a polo shirt and pushed the truck.  On the truck was a black box emblazoned with more yellow hazard signs than even my door. Yikes.   

"You don't suppose that's the pizza I ordered?"  I whispered to Matt, but he didn't think so.

The tech led the guard and truckpusher  in through a locked door across the hall and closed it behind them.

And then we waited some more.

Still not nuclear!

Time passed.  We continued to wait.

Not glowing!

Even more time passed.

Just me, two cups, and a Geiger Counter!

Eventually, Steve stopped by to let us know that the Radiology Oncologist, a necessary component to delivering the medication, was still stuck in his 3 pm consult, but he'd be there real soon.  Ooookay.

And, eventually, he was!

We saw them walk by.  Heard them unlock the door across the hall.  Listened as heavy sounding things thudded against other heavier sounding things.

"Release the Kraken!" I hissed at Matt, but, instead, they returned with a silver cylinder about eight inches tall.  It was covered in even more warnings of terror and danger.

Steve had me put on some blue, plastic gloves, to help prevent me from accidentally touching the pill.  I chose not to remind Steve that I'd soon be swallowing it.  If the gloves made him feel better, well, whatev.

He reviewed the procedure with me again. "I'll dump the pill in the empty cup.  You prime the well with the cup of water.  Then the pill. Then the water.  See?  Chaser. Pill. Chaser.  Got it?"

This was like no bar game I'd ever played.

Steve unscrewed the top to the metal canister and tipped the capsule into my plastic cup.  It was blue and white and innocuous-looking.  It could have been a simple vitamin or a headache remedy.

Except it wasn't.  It was 59.8 miC of radioactive iodine, which I would be swallowing in concentrated effort to send it on a mission of thorough cancer-eradicating/ass-kicking.

Bottoms up!

I chugged it down in a way that would've made a frat boy proud.  Steve used the geiger counter to measure the radiation filling my belly and then led us back through the maze to the the front.

"See you next Friday!" he called, from a safe distance.

Matt and I walked to the parking lot, not touching.  I slid in to the backseat, as far away from him as possible.  43 miles to home with a tummy full of radiation.  Mindful of the expectation that I spend no more than an hour in the car with another person, he set off.

Matt, happy not to be seated any closer to me.

We drove homeward, catching the opening chords of rush hour, but, fortunately, missing the melody.  While Matt deftly avoided traffic jams, I sat in the backseat and tried to think cancer-kicking thoughts.  And then I tried to ignore the fantastically terrible, burning taste that was spreading through my mouth. It was like hot metal sweat socks. Yuck.  I sipped my water and focused on the knowledge that, while radiation is not delicious, it is life-saving and extremely helpful.  And I'll take a mouth full of tinny, smouldering, locker room gear any day if it means victory over cancer.

Tastes like winning!

Day 16 and a smidge: Almost glow time...

It's Wednesday!

::trumpets and fanfare::

I don't think I slept more than four hours last night, if you gather all of the little bursts of slumber and toss them together into a sleeping bag.


Yesterday was an adventure in last minute prepping as we set up my personal containment unit (aka the upstairs).   This will be my home away from home within my home for at least the next eight days. Matt's limbering up in preparation of a week's worth of couch riding.  Trail mix has been bagged, LID Peanut Butter Oatmeal Chocolate Cookies have been no-baked,  Dual Mad Libs have been purchased, walkie talkies have been batteried, and the kids have been briefed on the appropriate use of Skype while at Daddy's.  We are as ready as we can be.  I hope.


I received my second shot of Thyrogen at the Endocrinologist yesterday and was relieved to experience, once again, not a single side effect, aside from a sore butt. Whew!

At Virtua Nuclear Medicine later Tuesday afternoon, I received my test dose, a small, gray capsule of I-123.  This non-damaging radiation dose is used to allow for the thyroid uptake and full body scan I will have today, Wednesday.  Once the doctor has a clearer picture of how much thyroid tissue and/or cancer is present, he will be able to determine the correct dose of the knock-your-cancer-socks-off I-131.  He'll place an order for the pills and, an hour or two later, I'll be saying a prayer, swallowing those bad boys, and getting the heck out of the hospital before I endanger the masses.  Wheeeeee!
 

Meanwhile, I'm off to snuggle my babies for just a little longer...