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Tuesday, June 24, 2008

My thyroid drama

Last November, my primary care provider (PCP) found that I had an enlarged thyroid during a routine physical exam. She wanted me to get an ultrasound done to examine what was going on with my thyroid. So, after the ultrasound, which I had done in January of this year, I was referred to a thyroid specialist. The thyroid specialist stated that my ultrasound showed some questionable areas, and to make sure that the cells weren't cancer, I needed a biopsy.

The biopsy happened in April, and was actually one of the worst experiences of my life. I'm lying there, awake. A nurse. And the Resident is being instructed by his Attending during the procedure. They performed the biopsy using an ultrasound to guide the needle. At one point the Attending said "You see that? That's her carotid. Don't hit that." And that is a direct quote. I'm sure my heart rate increased, and blood pressure skyrocketed as I tried to focus on not swallowing or breathing too hard. The Attending said other things like "This is very interesting." and "This is a very complicated case." and noted that my blood vessels ran right through where they were trying to insert the needle. And as a nurse, I know that some cancers grow their own sets of blood vessels to help nourish the cancer and help the cells to grow. And I am laying there thinking all of that as she continued to increase my anxiety by noting how difficult this case was. And I forgot to mention that she went through 20cc plus of lidocaine as I could feel them attempting to poke and prod at my neck. I tried my best not to burst into tears while they were doing the biopsy, because I had to hold still. But a few tears leaked out and ran down my face toward my ears (because I was lying on my back). I walked back to the waiting area where my boyfriend was waiting for me, and when I saw him I burst into tears. I cried over the pain, and the fear of it possibly being cancer, and the uncertainty of it all. My anxiety finally had a release at that point. I couldn't move my head without it hurting, and I had to call in sick the next day, because it hurt so bad. A few days later I had severe welts where the needles poked me; it itched and was puffy and miserable, and eventually I went to my PCP who gave me some steroid cream to help it go away.

So after all of that I met with my thyroid doctor again, for the results. She told me that the results showed that it wasn't cancerous now, but could eventually turn into cancer. She told me that I would either have to have yearly biopsies, or get the thyroid removed. She said that since I was young, and since the biopsy was so complicated, that it would be better in the long run to get the thyroid removed.

So I arranged to see the surgeon she recommended, and met with him today. And what he told me was completely different. He basically told me to keep the thyroid in and have yearly ultrasounds to watch the thyroid and see if it changes in size. He said that thyroid cancer is very slow growing and spreads slowly so watching it is much safer than some of the other fast moving cancers. He said I wouldn't have to have biopsies every year, just the ultrasound. He said that it was ultimately my decision, that I could have it surgically removed if I didn't want to have to worry about it. But he would recommend his daughter to have it watched instead of removing it straight away. He said that my biopsy results are actually kind of in the murky area, it isn't definitive either way, it could be cancer, it could be benign (not cancer).

So now I have a big decision to make. I went into that office visit thinking that I would have my thyroid removed. I thought I was going to be making the appointment and going over the nitty gritty details. So I was prepared to have surgery. But I wasn't prepared for him to say that I wouldn't need it.

Part of me is scared to death of surgery and the risks including: bleeding, infection, and possible harm to the laryngeal nerve, causing my voice to be hoarse, either temporarily or permanently. But I'm also thinking about how I'll always have it in the back of my mind that it could be cancerous, and will have to pay for ultrasounds for who knows how long, and eventually might have to have it removed anyway.

I'm still kind of leaning more toward having it removed. But I think I'm still in shock.

Monday, June 23, 2008

Farewell

Today was my last day caring for the patient I talked about in my previous entry. She will be discharged tomorrow and I have the day off. I nearly lost it today when I was in her room. She had music playing, and her husband (of nearly a year) was singing along, and it was a song about love, (If i ever hear the song again, I will remember which one it was...but i can't remember now...). It was heart wrenching. And yet so beautiful at the same time. I wished her luck, and told her it was a pleasure working with her. I hope she can spend the rest of her time at home, comfortable. And won't need to be hospitalized again.

I promise, not all of my posts will be this depressing...

Sunday, June 22, 2008

The Beginning

I have had a blog before, but I used it as a distraction from schoolwork when I was in college...and high school maybe? I don't remember...but anyway a friend of mine shared her blog with me and I remembered that I used to enjoy blogging. So I decided to create a new one...



As I was driving home today, I had some intense feelings...but before I describe them, you might need a little background first. I'm a nurse in Seattle, and I have the opportunity to work with many different types of diagnoses. One of which is sarcoma patients. (Patients who have cancer of the connective tissue. ie: bone, muscle, fat etc...for more info go to http://en.wikipedia.org/wiki/Sarcoma.) I also work with hip, knee and shoulder replacements as well as patient's with spine surgeries. And to make it more interesting, we get overflow patients as well, so that means I'm always on my toes...



So as I was saying...today was rough. (To protect confidentiality, I will not get too specific, and I have changed some of the details.) I cared for a young woman about my age who has no more treatment options left, other than providing comfort, because the cancer has spread to pretty much everywhere in her body. She is a mother of one, and recently had a miscarriage.



All I keep thinking about is what if that happens to me? How would I cope? What would I do? Would I feel happy that I was able to reproduce, and send a beautiful child into a world with a loving father? Or would I be distraught over the fact that I sent a child into a world, full of pictures of a lady that was there, but only fleetingly?



I don't think I'm that strong. I'm sure no one truly believes "i'm content to die" at a young age, without some sort of diagnosis that limits the life expectancy...however, there are things that I still want to do. Like be a mother. A wife. A grandparent.



I suppose he will never lose his mother. She will always be his mother. But his memories will be based on his families reports, pictures, videos and notes that she has written in a notebook. Because he is not old enough to form solid long term memories.



Realistically, I'm sure I could make peace with the fact that I was dying and not going to live past the age of 25, but I still cannot imagine doing so. It wouldn't be easy.



I'm sure she's going through this as we speak, grieving for the years she won't be around for, and grieving for her son, who will grow up without a mother. And yet, I don't think she has given up completely. She calls her family and gives them updates, she listens to her mother crying on the phone, and comforts her.



It makes my heart ache. But I enter her room with a smile. I ask her if she needs anything. And listen to her every word. Hoping she won't see how scared I am inside.