The Traveling Now: Welcome to the Traveling Now

The Traveling Now: Welcome to the Traveling Now: "Welcome to The Traveling Now. Thanks for looking in. Long Story Short I was driving to work one day, listening to news on the radio, yell..."

Well, I'm surprised

I was diagnosed with follicular variant papillary carcinoma on 25 September. So, here I sit, a week after my second surgery.

My recovery isn’t going as well this time. I decided not to take any pain medication this time, so that has affected my recovery, both for the good and for the ill. I think I’m allergic to the adhesive in the Steri-Strips the surgeon used to close the wound; I had a rash on my neck extending up to my ears that is only now fading (a day after the last few Steri-Strips fell off). The incision itches like mad. Ah well, I’ll have it looked at today at my follow up.

We’re pretty sure we got this thing before it began spreading, so for that, I’m glad. And thyroid cancer is usually curable, so that’s good, too. Yet I feel . . . like screaming or having a temper tantrum or crying hysterically or something. But then, I don’t feel like doing those things. It seems overly dramatic and irrational for something that is, really, all things considered, no big deal . . . ya know, big deal wise. Like, it’s a “big deal” because it’s cancer and must be taken seriously and treated, but it’s also “no big deal” because the treatment is nothing compared to, say, breast cancer or lung cancer. No chemo, just radio-iodine therapy, which is, again, “no big deal.”

Yet I have lost an organ, an essential organ. One can only live for a few months without a thyroid—or, more precisely, the hormones one’s thyroid produces. And doctors treat this as “no big deal” because, well, “you can take a little pill,” and Poof!, “everything is all better!” But I don’t believe it.

Things are different. Things MAY BE better than they are now, at some point. But things will never be the same. My body will never be the same. My body will never be the old, comfortable friend I’ve had these 37 years. Of course, that’s life, right? Everything changes, all the time. It doesn’t have to be wrong or bad, just different. I understand that. But even good change is stressful, as the mental health people tell us, and I need a little time to mourn the past. It was change I didn’t ask for and didn’t expect. It came out of nowhere.

I’m in my last year of graduate school, trying to graduate with a Ph.D. and find a job. I’m beginning the second year of my marriage. The last thing I should be worried about is surgery and cancer and medical bills and treatment and pre-existing conditions and whether I’ll ever be able to get or afford health insurance again. But, that’s not how it works, is it? It’s irrational and just plain wrong to expect that things would be different for me because I’m me. But it’s human nature to expect that the rules don’t really apply to you, deep down in your heart. In our heads we always know that the rules apply equally to everyone, young or old, rich or poor, but we always know in our hearts that the rules really don’t apply to us, because we’re different, we’re special, that special little snowflake they always tell you about in Sunday School or wherever.

I think the first time you face something like a serious, personal illness, is when you finally grow up; it’s when you finally figure out that you ARE human, after all, with all the benefits and responsibilities thereof. You really aren’t immune to death, the universe isn’t going to re-write the laws of physics for you. There’s no screenwriter in the sky, poised to write that great escape for you, ready to provide the Deus Ex Machina that will make it all the way it was before--only you will have learned your “lesson,” whatever that was. So, you get to be wiser without actually having any consequences at all.

At least, that’s what I think has happened to me. And it hurts.

When I was 9, my dad killed himself. My mom found him. So, reacting the only way she could, I suppose, she kind of collapsed in on herself. She stopped really paying attention or caring to what happened outside of her. She began dating a junkie/drug dealer. She began drinking. Heavily. I stopped going to school at 11, just stopped. I “played hooky,” if by that you mean stayed at home and slept. We lived in the same house but didn’t really live together. We hardly noticed each other. Life was miserable. So, I prayed, with all the fervency of a childish heart, to allow me to go back in time and warn myself. It made sense at the time. I really believed it could be done. Things like that happened all the time in the Bible. They had told me in church that God could do anything. Of course, nothing happened. But worse than that, I didn’t even get a, “Well sorry, Kid, can’t do it, and here’s why . . .”

And if I can date my Aha! moment at all, I guess that would be it. There is no God. Or if there is, it doesn’t matter. And saying that God works in mysterious ways, has a Grand Plan that I just can’t see or understand, well that’s unsatisfying at the very best. If there is a Plan and I’m part of it, then I should get some bloody info. If not, then I’m playing a game I didn’t sign up for—and that’s no different than being at the whim of an indifferent universe. Why bother wasting valuable mental energy on talking to, questioning, worshiping, praising, or even thinking about an indifferent entity, no matter what stripe of metaphor: Universe or God?

So, being the (almost) lifelong atheist I am and firm disbeliever in the "power of prayer," you’d think I wouldn’t be surprised when it turns out I’m human, after all, and that cancer can happen to me too. Even if I’m only 37. Even if I’m the Fiber Queen of the Southeast. Even if I eat 5-9 servings of fruits and vegetables per day. Even if I’m a lifelong non-smoker. Even if I’m a runner. Even if.

Got to admit it, though, I’m surprised. I’m fucking surprised, okay?

Farewell, My Nodule

No one could tell anything without surgery, so. . .I had a right lobectomy and isthmusectomy on Monday, 9/13. It wasn’t really that bad—except for the intubation. I felt as if I had a scorcher of a strep infection for the first couple of days. Swallowing was very painful, and, in fact, it’s still a little tender to swallow. Oddly, swallowing liquid is a little more painful than swallowing, say, yogurt.

My digestive system was thrown completely out of whack, too; in an almost unprecedented occurrence, I had absolutely no appetite until today. Nor was I particularly thirsty until yesterday.

My voice is a bit weak still (I don’t think I could shout), but no longer hoarse—and, in hindsight, it had been a bit hoarse for a while before surgery. The incision is healing well, and I’ve been diligently stretching my neck muscles, so I don’t think I’m going to have any range-of-motion problems.

Unfortunately, I haven’t heard anything about the final pathology report. I go in Tuesday to have my stitches checked/removed and the surgeon said he would speak to me then. I don’t know if I’m going to be able to wait that long. It’s only because I’ve been recuperating from the surgery that I haven’t been calling every day to get the results. But, they never call you when the news is good—so, maybe it’s a good sign that the surgeon’s office hasn’t called me?

Confusion

My doc’s office faxed the cytology report to me this morning, but rather than illumination, I have received confusion.

Literally all the report says is:
Right thyroid nodule (fine needle aspiration)
--Hypercellular aspirate fluid composed of blood with scant colloid and cytologically atypical follicle cells
--Excision of this lesion is recommended

Note: Four smears are reviewed

It is my understanding (from the famous literature) that the “hypercellular aspirate [. . .] with scant colloid” is typical of follicular neoplasms, while “cytologically atypical follicle cells” is of no help whatsoever. “Atypical” how exactly? Okay so “not normal” but there are oh-so-many ways for a cell to be “not normal.” And are there scant cytologically atypical follicle cells, or is it scant colloid. . .AND THEN ALSO cytologically atypical follicle cells? If there are lots of cells (hypercellularity) but scant cytologically atypical follicle cells, then shouldn’t this be re-biopsied rather than sent straight in for surgery?

Well, but this paper suggests that my risk of cancer is now hovering around 25%, so not as bad as I thought, but still worse than a 1% chance.

Suspicions

I had my FNA biopsy last Friday—finally. Research is what I do, so I had read a couple of books, numerous articles, and several reputable web-sites (and some disreputable web-sites, if we come down to it). All of which is to say that I knew what to expect, and had actually read that the FNA could be “favorably compared to a blood draw.” Nor yet am I a squeamish person. I was a phlebotomist for a couple of years before I began graduate school, so I am not scared or nervous of needles. I went in as relaxed as a person probably can be to a biopsy. I feel I have a fairly high tolerance for pain. But, I do NOT favorably compare the FNA to a blood draw. It wasn’t the worst thing I’ve ever had done to me in a doctor’s examination room, but it wasn’t the best thing, either.

For some, it seems to be almost painless, but for me, it felt as if the doc was sticking a small pipe into a muscle in my neck, then moving it all around for good measure. Amazingly, I didn’t really bruise, but I had a scratchy throat and small cough for about 24 hours afterward, and I had trouble swallowing for about 12 hours. I am still a little swollen and sore a week later. Unless it’s just my imagination? I don’t remember the nodule being this big—or having any discomfort—before the FNA.

Well, but the biopsy was nothing, NOTHING, compared to the waiting. Arrrrgh! The waiting. The doc and the nurse both told me I should have my results by Monday, Tuesday at the latest. I called every day until I finally got my results Thursday afternoon: “suspicious” for cancer. Although, all I could get out of the doctor was that the pathologist could not make a definitive diagnosis of cancer, but my sample contained “atypical” cells. Doc wouldn’t explain exactly what that meant. Could be that I have cells indicating a follicular neoplasm, which, I understand from the literature, could be either a follicular adenoma (which is okay) or a follicular carcinoma (which is bad). Or, could be that I have truly “atypical” cells, which have strange appearing nuclei and chromatin, etc, which could indicate pre-cancerous cells. I need to get my hands on that cytopathology report.

But now the only way to tell if it’s cancer or not is to have that lobe of my thyroid out and have a pathologist look at it. I’m scheduled to meet with a surgeon this coming Friday. We’ll see if he’ll be a bit more explicit about what the pathology report says. All I can say is, “Fuck!” My understanding from the literature is that my chance of having cancer is now getting on 50%. Fuck!

I have no history of cancer in my family, no history of thyroid problems. Oh, we’ve got all kinds of other problems, alcoholism, heart disease, even mental illness, but cancer? Not so much. I think I had a great aunt who died of lymphoma, but that’s the only person I know of. Wow. I may have the dubious honor of breaking another barrier in the family: first to go to college, first to get cancer. What the fuck?!

Okay, enough of the pity party.

On a more positive note, my baby cousin is turning 2 on September 6, and I am knitting her a tiger cub bag. She’s a huge fan of tigers AND bags. Apparently, she’s also into shoes. Ah, a girl after my own heart. Whoever said that women were EITHER shoe ladies or bag ladies didn’t know from squat. I’m both. Oh, and a pen/pencil freak, too. There are worse/more expensive things to be compulsive about.

Patience thy name is not

A couple of weeks ago, I mentioned that my Jaxie doctor found and an ultrasound confirmed a 2.5 cm nodule on the right lobe of my thyroid. I was referred out to the only local endocrinologist. My appointment wasn’t until July 13th (6 weeks out from the date of my referral).

Well, I’ve been counting the days until my appointment, almost jumping out of my skin from anxiety. I hadn’t really noticed any symptoms before the nodule was found, except possibly some fatigue and mental fuzziness. Before the nodule, I put that down to the sauna that is a Georgia summer, or allergies, or being in grad school. Now, I wonder. For about a week after the nodule, I felt really rotten; extremely tired, headachy, and nauseated. Finally, the headache broke last Thursday, and since then, I have been exhausted, with extreme afternoon drowsiness. I almost fell asleep driving the other day, even; I just felt like I couldn’t keep my eyes open!

So, yesterday, I was fed up. What’s the deal with waiting six stinkin’ weeks to get a nodule biopsied—if they’ll even do that the first appointment? Why do we only have one endocrinologist in town? Surely, that’s not right?! So, I called the endo to be put on the waiting list for a sooner appointment. I was very polite, but perhaps my desperation came through because they called me back a few hours later to offer me an appointment this week. The squeaky wheel has gotten the oil, perhaps? Well, no matter. I go tomorrow, bag of meds and insurance card in hand. Hopefully, the doc will go ahead and do a biopsy, then, I can do whatever needs to be done.

Noduly Thyroid, Batman!

I am writing this instead of working. . .

Last Friday, I went to the Jaxie doctor for to get the yearly Jaxie check up, when what to her wandering hands should appear but a great big lump on the neck of your dear (blogger). I was referred in for an ultrasound, which I had yesterday. And it appears that I have a 2.5 cm (which, thanks to my knitting background, I know is approximately 1 inch) nodule on my thyroid. Off to the endocrinologist for yours truly, on July 13.

Yes, I’m writing all big and brave, but I tend to handle stress with humor (or attempted humor, anyway). Truth is, I’m scared and nervous. I’ve been 37 years on this glorious old mudball, and the worst health problem I’ve had to date is some broken toes when I was a kid. I’ve never been very sick. I had mono—but who didn’t? And that’s the extent of my personal brushes with illness and injury. Probably, this nodule is nothing, but, then again, it could be. . . you know. . .the “C” word (and not the “C” word that truckers and sailors like to shout, either).

Being the stone-cold researcher that I am, I’ve spent a lot of time looking up thyroid nodules on the Internet (you know, rather than, like, working). It’s a bad idea, I know. Most of the information is encouraging, yet some of it isn’t, and I don’t have enough information yet about my own thyroid nodule to judge if I should be encouraged or not. Better to write it out than research it and hyperventilate.

Sometimes, I must circle in on an idea, approach it obliquely, live with it awhile, own it--then I can let it go, or at least accept it. I don’t want to be negative and think this is definitely. . .the “C” word, but nor yet do I want to deny the possibility that it could be. Hope for the best and prepare for the worst, a clichéd motto that may or may not be advisable, but, well, at least it’s rational.