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.