Another day, another biopsy… And even leaving a little bit pleasantly surprised.

My surgeon wanted me to go back in for another ultrasound, to do a full mapping of my head and neck lymph nodes. She also wrote me an order to get a lymph node biopsy, should they see anything suspicious. My appointment time was for 8:15, but I was to arrive at 8:00 to check in and fill out paperwork. This was in Fairfax, so it meant leaving my house before 7... during the summer!! After checking in, I sat down to start filling out paperwork, but they called me back within minutes, I had barely signed 1 form (just 5 more to go... why does every doctor want to know the date of my last period, that has nothing to do with my thyroid?!) The technician showed me where to change to put the gown on and then led me back to the exam room. She mapped my lymph nodes in about 10 minutes and then left to show the images to the radiologist. About 4 minutes later she stuck her head in and said, "the doctor will be in in just a few minutes."  I thought, "Oh, no!" I have to have a biopsy!!"  I started to feel sad, I started to pray as I sat alone in the room. I felt, instantly, that everything was going to be okay. The doctor came in and introduced herself and said, "I haven't decided yet, I want to take a look for myself, first."  She then did an ultrasound, telling the tech that she agreed that this one and that one warranted an ultrasound. The tech left for a minute.  While she was gone, the radiologist told me that I had several lymph nodes that looked the same, but that they didn't look how they should. "Cancer doesn't behave that way, it isn't usually uniform, so it's probably nothing, but we want to make sure." Then another doctor came in, introduced himself, and the 2 of them did the biopsy, right then.  I told them that I had a bit of a vasovagal response during my first biopsy.  The 2nd doctor asked where I had the first one done and then said, "well, you won't have any kind of experience like that... our goal is to make you wish you had come here the first time!"  It was a completely different experience.  Nothing to numb the area, but that's okay, because the needle with the numbing stuff at the other place was bigger than the biopsy needle, so it hurt more.  I thought they were just numbing me up and the doctor said, "Okay, that side's done.  Let's do the other side."  I turned my head just in time to see him smear the sample on a slide... not mark it in a tube to send off to a lab somewhere.  A minute later and the other side was done and the doctor said, "I'm going to go look at these under the microscope, right now."  He was the actual pathologist!! I knew they were in the building, I didn't know they came in and did the actual biopsy!  The technician came in and made sure I was all cleaned up and then left again.  Then the pathologist came back about 5 minutes later, checked to make sure I wasn't bleeding (or oozing - yuck!), and told me that everything looked benign, but he would look more thoroughly this afternoon, when he typed up the report.  He directed me where to go to change out of the gown, where I was then met by the technician, who smiled and told me that after I changed, I didn't need to check out, I could just leave and showed me the way to the exit.  I was out of that office by 9:10, biopsy and all!!  It was truly an incredible feat.  I was super surprised.  I texted my husband and right as I hit send, I got a text from my mom.  I called her and sat in the parking lot and talked to her for next 40 minutes!  I just kept telling her how pleasantly surprised I was at how quick the appointment was!!   Okay, so, it's 12 hours later and my neck is sore - just feels bruised, but not nearly as painful as the first biopsy was!  I'm calling it a win for the lymph node biopsy people!!  I think they are worth the drive to Fairfax...

Let's hang out... well, maybe after you cut me open...

We met the surgeon this morning.  I really liked her.  I liked her demeanor, I liked how she spoke to me.  She was professional... yet, friendly.  Is it wrong that I liked her enough that I saw her as the kind of person I'd love to sit and hang out with sometime, just because she was fun to talk to and I thought she'd have some fascinating stories to tell?

I really think she's going to do a great job.  I feel like she knows what she's doing and I left her office feeling quite confident about what our treatment plan.

She wants me to get an additional neck ultrasound... a more comprehensive one that maps my lymph nodes and studies them, specifically.  Depending on the tissue seen in the scan, then I may have to have an additional biopsy of the lymph nodes.  *Sigh*  Not excited about that, but am glad that she wants to dig deeper before cutting me open, blindly.  She said that depending on the findings of the ultrasound and possible biopsy, it could change the nature of the surgery.  She didn't go into too much detail about how it would change, but indicated that it would change her approach.

Good News/Bad News:  She complimented me by saying I didn't have any wrinkles... so it would be hard to hide the scar.  Um... thank you?

I asked her how soon we could schedule the surgery.  She said that realistically, her schedule wouldn't allow for it for at least 3 weeks, which was fine because she needed me to get the ultrasound/possible biopsy, the results from the biopsy, get a pre-op physical within 2 weeks of the operation, an EKG within a month, and then some special blood work that takes at least a week to get back, that I need to do about 2-3 weeks out.  Well, 3 weeks from now, that puts me too close to driving across country.

SO, my next question was...  "what's the latest you would be comfortable with putting this off?"  Her answer was interesting to me and answered a question that I have had since the beginning of all of this.  She said, "August.  But this thing has been growing inside of you for like 10 years... it isn't going to make much of a difference if you do it now or in a few months."   10 years...  I was wondering what a good guess was for how long it was in there and that was actually one of my guesses.  10 years was my guess for my biggest one, 7 years for my smallest one.  It was sort of nice to hear an expert tell me that my guess (based on my Medical Degree from Google) was correct.

So, based on her response and the need to make the arrangements for all of the other lab work and physicals, etc. I decided not to do the surgery in July between travel trips (I will do all of the doctor appts. then, instead).  My surgery is scheduled for August 1.  Right after we get back from the lake. The reasons this is the best time:
* That gives my husband 3 weeks to work before he takes a day or 2 off for my surgery, this will be better than him taking it off back to back after having just taken 2.5 weeks off.  That would be really bad for him.
* This gives me time to do my pre-op lab work beforehand and not trying to do that while I'm packing, don't have babysitters (they will all be gone the week before we leave), or while we are gone.
* I won't be trying to adjust to medication while traveling, at all.  This really scared me, so it is a huge relief to not have to worry about it.
* I will have my follow up appointment with her and the endocrinologist 2 weeks after and I won't be traveling then.

It's less than 2 months away and I am nervous.  2 months might seem like an eternity to someone else, but for me, it feels like I am now in some kind count down to an execution day.  I am getting closer to some kind of journey into the unknown and it is pretty scary.  I am letting them cut a piece out of my body that is responsible for my appetite control, metabolism, energy level, body temperature, and a bunch of other things.  On top of 100% possibility of losing my ability to regulate those things on my own, the risks of the surgery include damage to the nerves that power my vocal cords or the parathyroid glands (which are the size of a grain of rice and their blood supply is the size of strand of hair - so could be easy to damage)...  that means I could end up with permanent loss of my voice or the inability to regulate calcium in my body... you know, calcium that builds your entire body's framework... yah, that.   My husband is hoping that he never has to hear me talk ever again.  I think I saw him slip the doctor some money to damage the vocal cords...  Just kidding.  :)

So, to sum up:  Nervous about my surgery, but glad to finally have it scheduled.  Happy that it can wait until a more convenient time but that we don't have to push it back too far.  Grateful that I have the surgeon I have.

No Joking Matter...

When I first heard that I needed a biopsy, the very first thing that popped into my head was the quote from "My Big Fat Greek Wedding" where Aunt Voula is telling the story of her lump and she can't say the word.  She says the doctor did "the bio... the b... the... the bibs... the... b... the bobopsy."  My sister and I joked as I went in for my "bibopsy" that if I found out that I had cancer that I would simply send this picture out to the whole family:

I have to say that as I was having the lump on my back scanned, this picture was ALL I could think about. The technician was fairly certain the lump was a lipoma, just as my PCP said it was. Sorry, no twin... I was, ever so slightly, disappointed.

As I've discussed various aspects of my life recently with various people, they of course ask about my health, but then the conversation turns to the everyday.  The mundane. Sometimes I get the silence from the other person and I can see on their face, "You shouldn't have to deal with that right now..." But they wouldn't be thinking that if I didn't have cancer. So, I tend to break the silence with a light hearted, "Spencer asked if he could tell his teachers that his Mom had cancer so that he didn't have to turn in homework for the rest of the school year. I told him that if I still had to do laundry, clean the house, cook the dinner, drive them to their activities, and everything else that comes up, that he can do his homework.  We need to save 'I have cancer' for something big like not having to pay taxes or better yet... Getting to go to the front of the line at Disney World."   As for Disney, I'm looking into that, I just think I'd feel too guilty to use it, even if I really needed it.  Unfortunately, I think the government doesn't have a free pass for taxes, it would be cool if they did... A cancer card for discounted taxes or discounts on other things or something. Can someone look into starting a program like that? The Cancer Card... Some kind of discount card, good at all restaurants or stores or something or that is just society's way of saying, "sorry this happened to you."  

My husband and I have joked about me telling the surgeon to do a chin tuck during the surgery, then while she's at it, to just take care of the rest of the body... You know, just so it's all in proportion to the new, skinnier neck. It would, at that point be the only responsible thing to do, right?  (And therefore medically necessary and fully covered by insurance, right?) 

Several people, including the kids, have asked what happens to the thyroid when they take it out. We have told them that we intend on putting it in a glass display case on the fireplace mantel. Then I explain that, no, as I understand it, it is removed in small cross sections, cut much like a loaf of bread, so that they can label and categorize each piece for study. This is how they determine what stage cancer I have. 

It is okay to joke about it. If I can't keep laughing at the situation, then I might just cry about it... I'd rather laugh. Feel free to share your best jokes with me, any time!