Yes, Again

Dr. Lupo is always late to his appointments.  I resigned myself to that fact when I first starting seeing him.  On the other hand, he never rushes in and rushes out.  He spends as much time with you as needed and you never feel like you are a pain in the ass to him.  He is slightly built with sharp features and a sharp wit.  Here is the doctor that watches me for signs of cancer and he always has me laughing.  An office visit with the potential of feeling like a wake is instead filled with his bright personality that doesn't allow the darkness to squeeze itself in.

I have answered all of the required questions and filled out the forms on the clipboard.  I've been weighed and brought back to one of the exam rooms and told it was a temporary pit stop because I will be moved to the room with the ultrasound equipment shortly.  While waiting, I read my book and it helps me remove myself from the current situation, but not for long.  I reach over to the left side of my neck with my right hand and find the nodule.  OK.  It's still there and I didn't imagine it.  It hasn't miraculously disappeared.  I am right to be here.

The nurse comes in, retrieves me, and we walk to the exam room with the ultrasound equipment and I am told that Dr. Lupo will be in soon to see me.  We all know it will be more than a few minutes so I hunker down again, find my place in the book, and continue reading.

There is the quiet knock on the door and in walks my doc.  I once again notice his black hair and slender fingers.  His smile softens his features and puts me at ease.  I do believe he must have changed barbers or hairdressers because I really like the way his hair is cut but I don't have the nerve to broach the topic.  It would probably come out all wrong and then I would be stepping all over myself trying to dig my way out of an increasingly embarrassing situation.

He thanks me for being there.  Say what?!  You heard right, sister.  He thanked me for coming in.  I try to turn it around and I thank him for making room for me today.  He laughs it off and says, "With your history I said bring her on in.  We'll take a look at what the problem is."

I show him where the nodule is located and he palpates it.  He doesn't think it is a lymph node but lets get the ultrasound going so we have more information.  I move to the table and lie down.  We get under way and he's thinking out loud and tells me so.  I tell him I would rather hear that than nothing.

There appears to be blood flowing through it so he suggests a fine needle biopsy.  I've been through those before and they are far from enjoyable.  Like another solar system away from enjoyable.  I would say galaxy but that would be pushing it.

He gets his nurse in the room and jokes are flying and I can't help but laugh which gets his nurse quietly giggling.  Ice is the numbing agent as the lump in question is close to the surface.  First needle, second needle, third needle.  Done.  I take in a deep breath and let it out.  Dr. Lupo comments, "Well, she's still breathing."  He gives me ice wrapped in gauze and tells me to hold it there while he and his nurse exit.

When they return Dr. Lupo isn't smiling.  He looks worried when he tells me that it is in fact a lymph node and he wants to take one more biopsy and this one will hurt more than the others.  When he left it was to look at some of the material under his own microscope and that is what he discovered.  It is lymph tissue.

I put on my life jacket because the waves have started to crash into the boat and I'll be damned if I am going down.  Ice, needle, pain, done.  Doc then tells me it hurt more because it was a larger gauge needle to get more tissue but he didn't want to scare me.

I will hear something in 3 to 10 days.  If the results are conclusive, it will be closer to the 3 days.  If more testing is needed it will be closer to the 10 days.  His office will call me and either give me the news over the phone or ask me to come in.

In my head there is now a clock with a countdown.  The only time I don't hear it ticking is when I am asleep.  

Which Leads to More Tests Monday, January 25, 2010

I have the ultrasound results. Bottom line is that there are suspicious lymph nodes on the right side of my neck 1/2 way between my jaw and collarbone deep in my neck. The left side has a bigger tumor and because that side of my neck is where the cancer mostly was is of more of a concern. Doc believes that these are the reason my thyroglobulin levels continue to increase and that these were there but not seen or removed during the initial surgery. So, I am having the needle biopsy for everything. There will be someone from the Pathology dept. during the biopsy so I will be able to get some kind of initial answer immediately. If it is all ok, that's it. If further research is needed, I will know that then, too. If the final report is positive for cancer, surgery is the next step.

At first I was very upset by this news. I am calmer now. I will keep you posted.

Just Another Test Monday, January 18, 2010

Writing for me is cathartic. It helps me sort through my feelings and gain perspective. In that vein, I write about my future.

I recently switched endocrinologists as the one I had since my thyroid surgery 5 years ago seemed to be more interested in creating commercial health plans/foods to sell than doctoring. I decided to get a second opinion and in a roundabout way was directed to a doc that practices out of Johns Hopkins. His specialty is thyroid cancer. After discussing my history, answering his questions, and him reading my 2- inch thick medical file, he bluntly told me that my previous doctor did wrong by me. That was quite a shock for a number of reasons. The first was that he did not ascribe to the "doctor not criticizing another doctor" protocol. The second was that after I was given the first radioactive iodine treatment I never should have been given the other two. The third was that I should be followed for Vitamin D deficiency. The fourth was that after the surgery an ultrasound of my neck should have been performed every 8 to 10 months. I hadn't had one since my surgery.

The blood work proved him correct. I was definitely Vitamin D deficient. That answered the question as to why when I walked down a flight of stairs I felt as if my leg bones would splinter apart.

Tomorrow is the ultrasound.

It took me 3 years to convince my Primary Care doc that there was something wrong. The blood work kept coming back as normal. Through those years I suffered weight gain, hair loss, and extreme fatigue. Also during that time, the cancer grew unchecked moving towards the back of my neck instead towards the front. My surgeon was shocked by what he saw when he opened me up. No one had a clue.

So, my new doc insisted that a Johns Hopkins technician perform the ultrasound. He didn't want to leave it up to anyone else. It will take about an hour. I am nervous not about the test itself but the results.

Something else my previous doctor did was ignore my ever rising test results that indicate any cancer left in my body. Another reason why I left him.

This time tomorrow it will be done. The anticipation alone is making my stomach queasy.