About Me

This is me with my husband, Justin

My name is Katrina. I am a seventh and eighth grade teacher in a suburb of Chicago. My fantastic husband and I were married on September 6, 2009. The year of ’09 held many high points for me…I received tenure at a terrific middle school with fabulous coworkers, had a beautiful wedding that surpassed all of my expectations and took an adventurous honeymoon to Southeast Asia. The following year, I was still riding the wave of newlywed bliss when I was told I had cancer. On April 26, 2010, at the age of 29, I was diagnosed with thyroid cancer. I wrote this blog for different reasons although the number one reason is to show others going through this what to expect. When I would tell people I was diagnosed with thyroid cancer, they would bring it back to their friends, coworkers, and family and then call me and say, “My friend’s sister’s daughter had that. She is fine now.” Although this news was reassuring, it didn’t put a face on it for me and I needed that. I know there are many people out there diagnosed with this and looking for answers. If I can be of any assistance to ANYONE on speaking about my experience on what I went through or answering any questions, I would be more than happy to. I am not a doctor, obviously, so this is not a site that tells you what you should and should not do. This is just my life with a timeline of events that I encountered while on the journey of beating thyroid cancer.

Diagnosis

Matron of Honor at my sister's wedding - still "bandage free" a few weeks before the surgery

With my dad at my sister's wedding

During a routine doctor’s visit on April 8, 2010, my doctor felt my throat and asked me to swallow. She kept her fingers on my throat and asked if I could swallow again. When I was asked to do it for a fourth time, I started to get worried. The doctor confirmed she felt a lump/swelling in the bottom left side of my neck. I had absolutely no pain in my neck when she pushed on it. She explained that it may be a swollen lymph node or maybe a benign growth, but still recommended I see an ear nose throat doctor to be sure. In my mind, I was already convincing myself that there was no chance that I could have something to be concerned about... Of course what the doctor felt was just a swollen lymph node – a residual effect of that nasty cough I got in Thailand.

The next week, I met with an ear nose throat doctor. I hate seeing doctors I have no rapport with, so I had a feeling the doctor could sense I was very uneasy when he walked in. He glanced at the chart, saw my address, and brought up a random topic of discussion to ease my nerves – restaurants. After mindless chit-chat with the doctor for 15 minutes about a sushi restaurant located near my home that he highly recommended (apparently the Wachowski brothers’ favorite restaurant in Chicago), he glanced at my throat and simply stated, “Yes, it is swollen. You need to get an ultrasound.” Well thank you doctor. I could have told YOU that. He asked me of any history of illnesses and all the routine questions. At this point, the worst I had endured was my wisdom teeth being pulled at the age of 18. He also asked when the last time I had blood work done was. I honestly could not remember a time. In 1998 before I went to University of Illinois?...... I couldn’t remember. He of course gave me the typical doctor’s glance of disapproval. Before leaving the office, I got my first blood work done since college. Not wanting to put the looming ultrasound off for another day, I then called to make an appointment with the local hospital. The next day when I arrived at the hospital, I was devastated to find out an ultrasound is given by a technician – not a doctor - and then sent off to a radiologist. I asked the technician if she saw something as she was performing the ultrasound and she responded with a curt, “Please don’t ask me any questions.” I would have to wait another 24 hours for a result.

The next day the blood work and ultrasound results came back. I had a nodule (2.7 cm) on the left side of my thyroid and a nodule (6 mm) on the right side of my thyroid. I was then referred to a thyroid specialist. On April 22^nd, I went to the thyroid specialist. At first glance, I knew immediately that he was a doctor that I LIKED. I had done some outside research on his practice prior to the visit and was reassured when I found he was one of the VERY best in the country. This guy knew his stuff and he had excellent bedside manners. He assured me that even if the nodule was cancerous, generally speaking, thyroid cancer is usually very treatable in young people. Of course, although the doctor was fairly reassuring, it was still a very difficult pill to swallow. In fact, I was terrified but I knew that my highly qualified and wonderful doctor was going to help me get through this.

The thyroid surgeon looked at my blood work, focusing in on thyroid levels. It was found that the TSH in my blood was on the high end. This was a sign of hypothyroidism. Some symptoms of being hypothyroid are being overly tired and fatigued. I just assumed everyone needed upwards of 2 cups of coffee in the morning to get going. On top of the coffee, I also drank 2 sodas a day. My roommates in college and my husband always joked with me that I could fall asleep in a second and sleep through anything. I thought that was just me. Apparently, these were symptoms of having an under-active thyroid. I guess since I had no reference point of being sick, I didn’t know that I was! The nurse explained that regardless of whatever the biopsy results were, I was going to be placed on thyroid medicine to even out my level of TSH. The doctor then performed a fine needle aspiration biopsy of my thyroid. This is rather uncomfortable. He basically removed a sample of the nodule using an ultrasound to guide the needle. With the sample on its way to the lab, I would (hopefully) know the next day whether my nodule was cancerous. At this point, I had not really done extensive research on thyroid cancer because although I was frightened, I still had hope and kept trying to reassure myself: I am young AND healthy. I exercise, I have a healthy body weight…What did I have to worry about?..... Right?

Finally, on Monday, April 26^th (after waiting FOUR more days) my results were in. When I called the nurse during my lunch break, she explained to me that my results were “complicated” and that I would need to wait until later that night for the doctor to call me to explain the findings. I had waited almost a month since the original detection to find out this news and at this point, I was getting pretty aggravated and I basically knew in my head what “complicated” meant. I hastily asked if she could just tell me. She did. ”Your results came back positive for cancerous cells.”

After staring off into space in disbelief for a few minutes, I did what any normal person would do… (with the help of a friend, because at that point I was in shock) I Googled it. Well apparently there are 4 types of thyroid cancer. The nurse didn’t distinguish which type I had. I called back immediately and found I had papillary carcinoma. According to many endocrinology websites – papillary carcinoma is the most common form of thyroid cancer and is usually highly treatable. Later that week, I had another appointment with the thyroid surgeon. I asked the doctor how someone as healthy and young as me, without having a family history of this type of cancer could get something like this. He explained to me that otherwise healthy children as young as nine years old have been treated by him for the same type of cancer. I also learned that not having a family history of certain cancers does not dictate your chances of having one. The surgeon told me since I had a nodule on both sides of my thyroid, I would need a thyroidectomy, the total removal of my thyroid.

Before this, I didn’t even know what a thyroid did, nor did I know where exactly it was located. I now know the thyroid is a bowtie shaped gland at the base of your neck that controls your metabolism. During surgery, the surgeon would also take the lymph nodes on the left side of my neck. When I was told the details of the surgery, many thoughts circled through my head… 1^st - fear of the surgery/outcome itself, 2^nd- what about the weddings in May I was to stand up in – I couldn’t wear a strapless dress with a huge bandage around my neck. And what about my students…I couldn’t leave school in mid-May. Although I know my health comes first, and I am fully aware these thoughts were all minutia in the grand scheme of life, I was really looking for ways to postpone the inevitable. My doctor told me waiting a few weeks so I could stand up bandage-free in the weddings and to finish off a few more weeks with my students would be fine. My surgery was scheduled for June 2^nd.

Before the surgery, my awesome coworkers (who I couldn’t have lived without!!!) put me under their wings and helped me finish off the year with grading and making lesson plans. I still can never make up to them what they helped me to do that month and I am forever indebted to all of them. Next, I had to tell my 7^th graders that my last day at school was not June 13^th like every other teacher. My last day would be June 1^st because I needed a surgery. When I told one of my 7^th grade classes, a student said, “but you don’t look sick, you don’t sound sick, how are you sick???” This almost put me to tears but I had to remain strong. I never exactly came clean with my students with my diagnosis because I didn’t want them to worry about me over the summer and the c- word can be terrifying. I simply said, “ I need throat surgery because something isn’t working properly.” And left it at that.

Surgery - TOTAL THYROIDECTOMY AND NECK DISSECTION (lymph node removal). I know – the word dissection is disgusting. Reminds me of high school biology.

The doctor greeted me at 7 am before the surgery and asked me about the weddings. I was grateful to have been a part of them, but I also was ready to get the first step of my treatment over with. I was blessed with my husband, mother, father, mother-in-law, sister and a friend all with me at the hospital to comfort me. Of course I was frightened, but I knew I was in good hands and all the doctors and nurses introduced themselves to me before I went in for surgery. Finally, it was time and my big bed was wheeled down the hallway into the prep room and I said goodbye to my family. The worst part of the prepping was the nurse in training couldn’t find a vein for the IV. After a few failed attempts, it started to get painful. I showed him the vein my husband (the paramedic) “called.” That got a laugh from the other doctors and sure enough, Justin was right and the nurse started the IV. The best part of the prepping was when I mentioned I had a husband, a nurse seemed surprised and explained that she thought the reason my parents were there was because I was under 18. LOVED that. And thankfully, that is all I remember until after the surgery.

I woke up in the recovery room and spent an hour there. My initial reaction when I woke up was - I had to pee. This was my first time peeing in a bedpan. Not pleasant. Once the nurse was sure all my vital signs were good, my family and friends were allowed to see me. I was totally out of it from the anesthetic and laughed so hard when Justin and my friend came in wearing the head to toe spacesuit-looking scrubs. I started blabbering on about the weddings I had been in to my friend, completely forgetting I had just been through surgery. I felt NO pain… After the hour in the recovery room, I was placed in a private room. Justin was able to stay the night with me in a chair. We watched Kingpin and then I fell asleep from all the medicine. I woke up later in the night and needed more medicine. Not necessarily from the surgery itself, but from the effects of the breathing tube. My throat was exceptionally dry and swallowing, talking, and even lying down hurt. The next day, I was released and felt great. It was definitely residual of the medicine….I felt so good, in fact, I went out to dinner with my family. When I woke up the following day I painfully realized I had really pushed my boundaries and had to do some serious recovery. My throat was still in pain from the breathing tube and I spoke only in a loud raspy whisper. Not being able to speak was really irritating although I think for the first few days my husband was appreciative. I didn’t leave home for a few days and was thankful for the large stock of soup in the fridge my dad had bought for me at The Soupbox.

The bandage fell off ten days later.

On June 13^th, I felt well enough to come back to school on the last day to say good bye to my students before the summer. When I walked into the building, there were about 10 students sitting in the foyer and when they saw me they shouted, “Mrs. Moon is back!!” and started clapping. People always ask me why in the world I would ever want to teach kids in middle school. This is exactly why.

Low Iodine Diet

At my post-op visit in late June, I was told the pathology report from the surgery. Unfortunately, one of my lymph nodes looked questionable as to whether or not the cancer spread, so I would need to take the radioactive iodine. The radioactive iodine is used to ablate all remaining thyroid cancer cells in the body. In order to prepare for the radioactive iodine, I went on a low iodine diet for 2 weeks. This diet depleted my body of iodine so when I took the pill, it would kill the remaining cancerous cells. The most helpful resource for recipes to use on this diet was from the low – iodine cookbook on www.thyca.org. During the diet, I couldn’t eat eggs, dairy, salt, soy, seafood…pretty much everything that is really DELICIOUS. The one good thing that came out of the diet was that I was basically FORCED to learn how to make many things that I otherwise would never have made. I learned to make bread, chili, sorbet, and many other dishes from scratch using all organic, basic ingredients. Luckily, since I am a teacher, I had my summer off so I could plan my menus in advance and cook the recipes in the afternoon for that evening/the next day.

Initially, the diet was very difficult to understand because there are so many discrepancies on websites and within the Thyca.org cookbook. Although I was referred to use this particular cookbook, I realized AFTER baking some of the items, I couldn’t have them. For example, I made the oatmeal raisin cookies and later noticed my oncologist requested I did not eat raisins or bananas, both ingredients in the cookies. Also, on the first day of the diet I took my usual multi-vitamin in the morning. After I took the vitamin, I looked on the back of the bottle and noticed an ingredient that contained fish – which I knew contained some iodine. Luckily, I was on a very LOW iodine diet and not a NO iodine diet. The diet is frustrating because the FDA still has yet to put out a list of foods that contain iodine. This is because iodine levels vary depending on where the plant is grown (iodine is found in the soil) and where the product is packaged (some companies use an iodine based clearer to clean their canning machines). All the blogs on this will make your mind spin. So basically, my theory was not to eat anything grown or canned in an area that might potentially contain iodine. I also drank distilled water, because after doing some research, I realized some tap waters contain iodine. To help people with the diet, I have recorded what I ate and when for the first week. Every diet is a bit a different, so I would double-check all the approved ingredients specific to your diet with your oncologist and how many portions you can have of each before making some of the recipes. My diet started on a Sunday and ended on a Tuesday – a total of 17 days.

If you have to go on this diet, my recommendation to you is before you start the diet make a few recipes in advance since you will be very HYPOthyroid., therefore exhausted. I made chili, oatmeal cookies, 2 loaves of multigrain bread, peach sorbet, and salsa in advance. The good news is some of the recipes are quite tasty. My husband enjoyed many of them with me including the dinner of Greek chicken with sautéed mushrooms, the chili, chicken fajitas and the peach sorbet. The better you stick with this diet, the better your chances are of killing all the cancer is in your body. Just keep strong and don't cheat - even if your husband enjoys your favorite foods in front of you like - sushi take out and mussels at your favorite restaurant (oh yeah, I've been there).

MY DIET WEEK ONE

Mushroom Bolognese Spaghetti Sauce with yolk free noodles

This was breakfast one day - coffee, juice, oatmeal smoothie (cook the oatmeal and let cool, then blend with ice, brown sugar and maple syrup), and egg whites with mushrooms, tomatoes, onion, garlic, garlic powder, and black pepper (I got my wedding pic in this shot haha)

Greek Chicken from thyca.org

Multi-grain bread from thyca.org

Sunday:

Breakfast: cup of coffee, ½ piece of homemade multigrain bread (thyca.org cookbook) with peanut butter and jelly

Lunch: small bowl of chili (thyca. org)

Dinner: salt – free tortilla chips with salsa (thyca.org)

Snack: frozen grapes, peach

Monday:

Breakfast: cup of coffee, piece of homemade multigrain bread with peanut butter and jelly

Lunch: small bowl of chili with salt-free tortilla chips

Dinner: egg whites cooked with garlic, tomato, and onion with a slice of avocado

Snack: homemade peach sorbet (thyca.org cookbook) and cherries

Tuesday:

Breakfast: cup of coffee, small ½ piece of homemade multigrain bread with peanut butter and jelly

Lunch: small bowl of chili mac (use the chili with a very small amount of cooked yolk-free noodles)

Dinner: small piece of Greek Lemon chicken (thyca.org), sautéed mushrooms

Wednesday:

Breakfast: black coffee, grapes, ½ an apple, and cream of wheat

Lunch: small bowl of chili mac (use the special yolk free noodles)

Snack: 4 gumdrops – yellow, green/Diet Coke

Dinner: Chicken fajitas without the tortilla (thyca.org)

Thursday:

Breakfast: egg whites with tomatoes, mushrooms, garlic, onion, and black pepper, cup of coffee, cup of grape juice, shake made with oatmeal

Lunch: Peanut butter and jelly on a piece of multigrain bread

Snack: a few gumdrops – yellow, green only – don’t eat red or purple/Diet Coke

Dinner: Hamburger (without the bun) and homemade fries with salt free catsup

Friday:

Breakfast: bowl of Cream of Wheat with a cup of coffee

Lunch: fruit smoothie – mango, peach, and apple with a splash of orange juice and ice

Dinner: egg yolk free noodles with mushroom spaghetti sauce (thyca.org) THIS RECIPE IS AMAZING!!

Snack: homemade popsicle – use any type of juice you want

Using the Thyca.org cookbook, my sister made me the chicken pesto recipe and the curry chicken recipe (using beef) which were also very good.

Radioactive Iodine

Before I could take the radioactive iodine, I had to get blood work done to confirm that my TSH levels were very high so I could ablate those cells during my treatment. Luckily, I was able to stick to the low iodine diet (I didn’t cheat!) and my TSH levels were very high. I was all set to take the radioactive iodine. I was afraid of how my body would react to the radioactive iodine pill. My oncologist prescribed an anti-nausea pill to help the nausea the radioactive pill causes. It’s very important to not throw up, because if you do, you have to take the radioactive pill again.

When I arrived in the nuclear medicine wing of the hospital, I was escorted into a small room with a recliner and a bed. The doctor then wheeled in the “box of doom.” Basically this box has stickers with warnings all over it – DANGER – RADIOACTIVE….when the doctor opened the box it was metal, lined with more metal, and inside the second compartment was a tungsten cup with a small pill inside. She handed me the pill, I grabbed it and said, “bottoms up,” as I took it with water and I swallowed it as soon as possible because I didn’t want to think about it any longer. The doctor then closed the door and left me alone for a while. After some time passed, she checked on me to make sure I did not throw up. Although the temptation was very strong to throw up, I kept thinking about other things to keep my mind off of the disgusting urge to be sick. I had brought a book with me and started to read it out loud. I am sure anyone walking by my room thought I was crazy and talking to myself, but it was a last resort effort to keep my mind off of the gurgling going on in my stomach. After 45 minutes, the doctor came in with a Geiger counter and measured my radioactive level. I signed a release form assuring doctors I would sit 6 feet away from people, use the same dishes for a week, flush the toilet 3 times after use, along with many other guidelines and then I was dismissed from the hospital. Luckily, I did not have to stay the night in the hospital like many people do – I was released within an hour to go home. I then needed to drive to my parent’s house so I could have my own bathroom and area to “be radioactive”. I couldn’t do that in my 775 square foot condo with my husband and cat. While I was radioactive, I spent a lot of time by myself reading and eating candy. It's important to keep lots of candy by your side because the radioactive iodine can really impact your salivary glands. I was at my parent’s house for a week. Once the week was up, I needed to go back up to Chicago to get my I-131 body scan.

I-131 Body Scan and Bone Scan

On Monday, August 9th I went in for my I – 131 body scan. This scan takes about 30 minutes for the full body and then 20 minutes for 2 pictures of the head. I needed to lie very still as an electronic track moved my body below a camera that picked up the radioactive iodine in the body. This camera tells the doctors where the isotope is in my body so they know where the cancer is. I was very nervous for this test to say the least. After I got the full body scan and face pictures, I was then taken to another room where they used a camera that looked like a funnel to take more pictures of my chin and neck. These pictures took another 30 minutes. Again, I was still and tried not to swallow much. When I thought all was well and good and could go home, I was told the radiologist needed more pictures of me. This time of my pelvis. My heart dropped. I knew this could NOT be good. If I have thyroid cancer, unless it had spread, they should not need MORE pictures of my pelvis. They took 2 pictures of my pelvis from both angles and then I went home and waited for the results. My endocrinologist called with the news. They found a spot on my pelvis. I needed to go in on Tuesday, August 10th for a bone scan to determine whether this cancer had spread to my bones. My thyroid surgeon then called and explained to me that my results were “highly unusual” because other than the cancer in my throat region (which is obviously expected), the only other spot was in the pelvic region. Without the bone scan, they could not pin point where exactly this cancer had spread to, but my I-131 scan was showing a spot on the pelvis. This news was devastating to say the least. This means a very distant spread to the pelvic bones was a possibility and this translates to possible stage 4 cancer. My world tipped upside down. I mentally prepared to hear the news on Tuesday. When I went in for my bone scan, I took the isotope (intravenously) that highlights my bones for the camera. This shows the doctor where in the bones the cancer has spread to. I went through the same full body scanning machine as the day before. This time, the camera looked at my bones and not the radioactive iodine. They took pictures of my head and my full body. Again, I remained still for 40 minutes while the track pulled my body through the camera. The technician then told me she was going to change the setting on the camera and was going to take more pictures of my pelvic region using the I-131 scanning camera. Once this was completed, the technician came back in and told me the radiologist who saw the spot in the pictures the day before, no longer saw the spot!!! He was going to write an entire addendum to my original report and explain it was some other type of contamination on my clothing, or a button on my jeans, or SOMETHING that was not there anymore. I found Justin pacing in the waiting room and broke the news. When we were standing outside the Evanston Hospital we jumped up and down hugging each other and I thanked God over and over again. Later in the day, my endocrinologist called to confirm the results. Never in my life have I felt such tremendous relief.