a Hug

After my appointment today, my oncologist threw open her arms and said "I want a 5 year hug!" and with that, I was through with her and the cancer center! From now on, my appointments will be handled with a nurse and a mammogram once a year at the breast center. I have another month of Tamoxifen medication then I truly can celebrate.

I'm trying to figure out how best to celebrate--a party doesn't seem sufficient. I'm thinking of treating myself to that genetic test that tells you your body's best chance at loosing weight--since the medication weight gain side effect will be going away. And all those other lousy side-effects the Dr. said they should disappear relatively quickly. Since the only other meds out there are for post-menopausal women, the only thing I can do to help prevent a re-occurrence is eat right and exercise a lot (read loose weight).

What is the appropriate rite of passage for ending cancer treatment? And don't suggest a tattoo--I already have two of those to guide the radiation machine and that seems like plenty.

I have an anniversary trip to NY planned in July to watch the Broadway sensation Book of Mormon so I'll raise a glass with friends then but that hardly seems appropriate. Guess I'll have to call my friend Frank and find out what he did.

Pathology results

The endocrinologist called to say the pathology report on the right side of the thyroid that Dr. C removed shows "follicular hyperplasia"-- that's NO evidence of cancer to you and me. There's also no evidence of Hashimoto's disease. So now that we know we're dealing with a benign nodule, the emphasis shifts to making sure the thyroid hormone levels are appropriate. Since the thyroid regulates things like metabolism, calcium, and lots of other things, this is REALLY important. This will take some time though as it takes 6-8 weeks for the hormone levels to be affected by changes--like removing half of it. So if they took blood work tomorrow it would still show pre-surgery levels. It will probably take a month or possibly 3 (or even 6 the doctor said) to analyze blood tests which will show the gradual effect of the surgery and the other side of the thyroid which may or may not be able to maintain the right hormone levels. We'll get our first shot at blood work analyzed on June 3rd and go from there. But this a long-term process, not a quick fix. (I keep hearing "patience, grasshopper" in my head. Maybe that's leftover from the anesthesia).

Meanwhile, the Frankenstein-appearance of the incision is going away, leaving only soreness.... but nothing they didn't tell us to expect in the "follow-up instructions" sheet they sent home with us. They warn of neck muscle pain, tension headaches, and even say that the numbness over the incision will subside in 6 months! They project that people can return to "normal activities within a few weeks" of surgery. They're allowing me to go back to Jazzercise after two weeks.

I theorize that within my lifetime experts will determine that "general anesthesia" is barbaric, at least for surgeries such as this, and will find a way to do the same thing without the debilitating effects of general.

Home

NotherFrog here. FrogRev is home, sitting on the deck with ginger ale, yogurt and a book. Surgery went well, according to the doc. Can't tell anything by looking at the removed thyroid half; we'll have to wait for the lab reports to confirm this is the end of this healthcare adventure.

Get Ready

The pre-op blood work is done (I won't hear back from it unless there's a problem), the ipod is loaded with some new tunes--jazz and folk mostly--to tune out all the hospital noises, my prayer shawl is packed, and ginger-ale and Ben&Jerry's awaits my return home.

NotherFrog took the day off against my advice, so he'll be hanging out, bored, at the hospital. He'll let you know as soon as we know.

The meeting with the oncologist yesterday confirmed that it would be unlikely (although not impossible) for this to be related to the breast cancer... She said "let's just treat this as a thyroid thing and see where that takes us."

Good news on a Sunday

My endocrinologist called today (just let that sink in--a Dr. making calls on Sunday) with the latest biopsy results--the thyroid cells they were able to harvest this time look benign!

What have we learned? Don't let the generalist in Radiology attempt a difficult thyroid retrieval--let the specialists do it.

Results are being forwarded to the surgeon who will now be able to just remove the right side and we hope that the left side will pick up and make enough thyroid hormone for the missing side.

Can I get an "Amen"?

Yellow swirlies

The biopsy went fine yesterday at the Endocrinologist's office--much nicer than through the hospital radiology department with the fussier ultrasound, greater wait time, etc. The Dr tried 6 different directions for samples, hoping for a better outcome than last time. She said that at least one of the samples had yellow swirly strings which is indicative of thyroid cells. We hope so. It's been upsetting to pay all the bills from the hospital, radiologist, pathologist when there were no thyroid cells in the last sample to tell us anything. NotherFrog laughed when he had to pay the bill from lab interpretation folks who put together a report that said there was nothing to report on.

We should know something from this go round by next Tuesday.

Getting to Know You

What a great surgeon I met Tuesday. For our purposes, let’s call him "Dr. C." He has a familiar photograph of abbey ruins surrounded by grazing cows in Wales (very similar to one we took in Ireland), he loves classical music and plays the violin, and he is “annoyed as all get out” with the non-results of the first biopsy. Sounds like he’s rarely found the hospital radiology department up to the task of a thyroid FNA (Fine Needle Aspiration). So I’m back to an endocrinologist to have another FNA. He talked to the guy while I was in the office and told him what he wanted.

But in the meantime, he said, “No need to delay scheduling things-–we know it has to come out.” It’s just a matter of whether he takes the whole thyroid or only the right side. He was such a regular guy, he pulled up his calendar right there in front of me. He didn’t bat an eye when I said I’d like to wait until after Easter just in case my vocal nerves are so bruised by the operation that I have to wait to recover my speech volume. He said “of course.” Of course, my hope to get the operation right before I left town for the preaching conference in Atlanta he didn’t like. “Cattle cars are no place to recover from surgery,” he said. And my plan for a Monday surgery so that I could preach by Sunday was nixed because he doesn’t do Monday morning surgeries and if I’m not “first in” then there is NO CHANCE to get out the same day. The surgery is technically an overnight procedure and is scheduled as such, but he said that if I took the 7:30 a.m. slot, I MIGHT be able to argue that evening that I was well enough for them to let me go home. I love this guy--a surgeon who will have a real conversation, listen to concerns, and negotiate on the small stuff.

So I’m scheduled for a “full” thyroidectomy on May 8 at 7:30a.m. (arrival by 6 a.m.) with no make-up, lotion, or jewelry. We hope that, before then, the next FNA will come in showing nothing suspicious and the surgeon will be able to adjust his plans and only take out the right side. This being preferable because the left-behind half lobe will likely produce enough thyroid hormone so that a synthetic replacement isn’t necessary. My District Superintendent had already very nicely volunteered to preach for me if I was recovering on a Sunday, so we’re all set.

Fun trivial facts I learned: My scar will be in one of the “deep creases” in my neck. I’ve been developing those wrinkles all my life and now I know why. When my mom had the surgery over 15 years ago, her scar was further down at the base of the neck where it could be cleverly hidden underneath a wide gold chain. But nowadays procedures have changed. The incision is rather wide--3 to 4 inches--so that they don’t have to tear at the edges while they're working on the thyroid. When I told the surgeon that the cosmetic issues weren’t my primary concern he said, “Well, I care. I don’t want you standing up in front of your congregation with a Frankenstein neck. I have a reputation.”

More weird notes: The parathyroid (little nodules within the thyroid) are necessary to regulate the calcium in bones so they’ll be “replanted” in the surrounding muscle tissue. Cool huh?

Last weird item: The surgical intern who was working with my breast surgeon is now a resident with Dr. C so I’ll have a familiar face in the operating room, only working on me 12 inches higher up this time.