Thyroidectomy, before and after

Our 5AM drive down to Yale-New Haven hospital was dark and peaceful.  My nerves were ablaze with worry and to settle me as much as possible Sean kept quiet and turned on Jackson Browne.  I made statements of should I die, be sure to... and Sean held my hand and reassured me that I would be just fine.  But just in case, I said.

Half of me wanted to get this surgery over with as soon as possible and the other half wanted to drive in the other direction. But there is no denying cancer and so we pressed on until I found myself getting IVs placed in my hand and wearing a not-so-flattering XXL hospital gown.  After checking the baby's heartbeat--the nurses gathered around and ooh'd and aah'd at her strong 146 ba-bump ba-bump--it was time to go.  I kissed Sean goodbye twice in the hallway.  My young anesthesiologist placed a warm blanket over my shoulders and hugged me as we began the walk to the operating room.  He asked about Dylan and told me that he and his wife were trying to have a baby.  "You'll never sleep again," I told him, "but having a child is the best thing in the entire world."  He replied, "I don't sleep much now with this job anyway" and smiled as he pushed open the door to the operating room.

The room was bright and filled with people in masks.  One of the nurses, a sweet woman named Mimi, knows one of my aunt's friends and had been advised to take extra special care of me.  When I walked in the room she introduced herself and talked about the mutual friend and said, "We were friends, you and me, but now we're family!"  She held my hand in those last seconds as my wonderful surgeon Doctor Udlesman instructed me off to sleep with a promise to take great care of me and the little girl in my belly.  My mind wandered before I drifted asleep from the anesthesia and I thought about how the lighting in this operating room would be perfect for a photo shoot.

I woke up groggy in a small room with nurses floating in and out.  After a few minutes they asked me if I'd like to have them get my husband from the waiting room and as soon as he came into the room the nurse made a comment about how my blood pressure immediately dropped upon seeing him.  I remember being wheeled into an elevator and up to my hospital room next, and the excruciating pain which shot through my neck as the nurses rolled me from my temporary bed.  This is what it feels like to have your neck sliced open.  The nurses had given me Reglan in recovery for the nausea and were now offering Tylenol with codeine for the pain.  The rest of those first hours in my new hospital room are a bit foggy.

I was scheduled to go home Friday morning until it was determined through blood tests that I was becoming severely hypocalcemic.  My calcium levels were a low 7.5.  They gave me six calcium pills and checked my levels an hour later.  They were dropping to 7.3.  My room was a carousel of doctors and nurses coming in to check on me, flicking my face with their fingers to monitor the twitching resulting from my decreasing calcium.  One doctor came in and advised that they were going to put me on a calcium IV drip, my levels were dropping too fast and my body couldn't catch up even with extra calcium supplements and so I would have to receive a constant dose of calcium until my body could regain control.  I was placed on a heart monitor as well and told that there was no way I would be going home in the morning.

My heart broke.  Literally.  I went tachycardic.  The heart monitor continued to pulse from a safe 96 bpm one moment to a sudden 149 bpm in an instant.  More doctors.  More nurses.  I was given an EKG.  More calcium pills, some magnesium, potassium.  I felt my body failing.

By morning I was feeling a bit better.  My heart continued to stress and the monitors continued to rise and fall, sending out shrill alarms and sending in nurse after nurse.  The doctors came in and told me that I would be staying at least until Saturday night, maybe Sunday morning.  Part of me was relieved that I would be safe in the hospital and most of me was sad that I wasn't going to be able to see Dylan who had come down with the world's worst cold.  So we took full advantage of video chatting.

I could write for days about all of the experiences I had in the hospital, but mostly my stay involved lots of pills, lots of monitors and nurses, plenty of nausea and sickness, having to pee in a plastic "hat", getting blood drawn so often that even the nurses were shocked at how bruised I was, and watching terrible television programs.  The free room service was pretty great though, and our family pulled together to watch our poor sick Dylan for a few hours each day so that Sean could come sit with me.

My calcium levels slowly improved on the IV drip 7.3 to 8.0 to 8.5 to 8.8.  They stopped the drip for an hour to give me a magnesium IV, my levels went from 8.8 to 8.0.  Apparently my body still wasn't able to regulate calcium.  I was having pretty frequent braxton hicks contractions so an OB was called in to give me a vaginal ultrasound.  This involved me laying spread eagle naked in my hospital bed propped up on a bed pan.  Pregnancy really knows no shame.  Katie seemed fine and I was not at risk for preterm labor.

On Sunday morning, after three horrid vomit-filled nights in the hospital, the doctors felt confident that my 9.5 calcium was stable enough to cut the IV dose in half to see how I managed.  Hours later I was down to 9.1.  They stopped the drip.  I was told I needed to maintain an 8.8 or higher before I could be discharged.  Sean was hopeful, I was not.  But at 3PM on Sunday my levels were exactly 8.8 and I was allowed to go home.

I haven't felt much throat pain, although I do have minor muscle discomfort.  Yawning still stinks and I can't stand up for very long.  I photographed my neck today when I gained an inch of energy.  Here it is six days post op.






I started my synthroid hormones yesterday and am feeling less anxious than I have in years. My fabulous surgeon called this morning and gave me my pathology results. The tumor was 3cm--as expected--and the cancer had spread into the surrounding muscles and into 3 or 4 lymph nodes, all of which were removed. So the doctor says everything is looking good and aside from my radioiodine therapy after Katie is born, I should have this cancer thing behind me. And I'm going to live a long and healthy life. The doctor had one request, that I send him a picture of the baby when she is born. I really could not have had a better surgical team.

And now to continue on with my life.

Standing on my knees

3AM makes me jump out of bed, my stomach in an awkward twist which sends me immediately to my spot on the bath mat in front of the toilet. I will myself not to be sick for a minute as I kneel, clutching a bottle of water in one hand and a bottle of Zofran in the other. If I could just get something in my stomach, I would feel better. But before I succeed I am retching fiery bile.

This is how I am feeling before the treatment side effects even begin, I am sure desperation will set in once the chemo starts.

Yesterday was not as bad as I imagined. I felt sad, yes, but there were long periods where I didn't even think of cancer. Life took over and I found myself pleading with a naked toddler to get off the big boy potty after practically camping out in the bathroom with him. We went shopping and picked out balloons for his birthday party this weekend, paid way too much for a mini helium tank with which to inflate them, ate breadsticks at the local Pizza Hut Express, drank decaf coffee and apple juice, respectively, at Starbucks. Yesterday was my first full day living with cancer and I found myself living.

I found myself worrying, too, mostly that the cancer is not just isolated to my thyroid. I can almost feel it throughout my body, at least I imagine I can. Instead of thinking positive, I'm white-knuckled and waiting for the bigger blow. This cancer has one of the best survival rates, most of the time in the 90th percentile, and yet I still have this fear nagging at me that I won't make it through.

I watched my dear friend Paul slowly die of brain cancer a few years ago.  He had something called a glioblastoma--brain tumor, basically--with a ten year survival rate of 1.7% yet his outlook was more optimistic.  He would joke to me that he has a dusting of cancer cells all over his brain and we should invent a brain Swiffer.  Yesterday would've been Paul's 66th birthday.  Today is the eight-year anniversary of his diagnosis.  I can't help but feel him with me.

I felt my grandmother yesterday, too, she showed up in the form of a dead leaf on my windshield.  On the night of her funeral, as I drove the hour commute back north to my tiny college apartment, a dead leaf found itself attached to my car antenna.  There was no reason for it to hold on through those highway speeds, this fragile leaf that would surely crumble in my hands had I touched it, and yet there it was blowing in the breeze as I tearfully navigated my way home.  I stopped at traffic lights and stop signs and that leaf never once wavered.  As I pulled into my driveway and put the car in park that leaf slowly floated from its spot on my antenna and danced to the ground.  Call me silly but as I mentioned I look for signs and that was hers.  I showed Dylan the beautiful orange and red leaf that attached itself to our windshield on yesterday's drive to the store and after I pointed it out to him the leaf flew over the roof and landed in the road behind us.

My third angel is my aunt Sandy.  I was pregnant with Dylan when she died and although we were kindred spirits, I didn't cry once over losing her.  I felt as if she wasn't letting me mourn her because she knew I had to protect the baby she was so looking forward to loving.  I feel that same calm now--although there have been moments of absolute heartbreak and aching--as if she is holding me in her arms once again.  Maybe she is protecting this baby inside of me.  I like to think so.

Today we will possibly find out the gender of this little baby.  I am hoping that in knowing more about this tiny person I will feel more connected and more bonded to him or her.  I've felt a terrible inkling that something wasn't right with this pregnancy from the moment I saw two lines.  My instincts told me that something was wrong with the baby and so I distanced myself and focused more on Dylan and less on his sibling.  My mothering instincts for this baby haven't kicked in yet--although they may today when I can see the baby and know that everything is going smoothly--I don't even have a guess on the baby's gender and yet I knew instantly with Dylan's pregnancy that I was having a baby boy.  I was wrong with my gut feeling this time though, there isn't something wrong with the baby there is something wrong with me.

I'm not going to dwell on cancer anymore for a while.  I've got Jackson Browne's Cocaine playing and these lyrics make me feel wild.  There's a sexy side of a man singing about being wired on cocaine.  And after an hour and a half of being awake, of getting sick and taking a bath and eating breakfast and writing, I feel better.  I may not be sleeping through the night with cancer as my alarm clock, but I sure feel like I've figuratively bawled out my negativity in these early morning hours and I am able to start my day fresh and feeling positive once I hear the patter of the dogs' feet and my groggy boys join me on the couch to watch Sportscenter and later Mickey Mouse.

This is healing.

Cancer: Day 2

I'm up at 4:30AM.  The neighbor started his truck and I startled awake and rather than lie there in bed letting my mind wander I came downstairs to snuggle up on the couch with some reality show programming.  Lucky for me Tuesday nights are filled to the brim with a terribly delicious DVR lineup.  I couldn't have gotten a cancer diagnosis on a better day of the week.

The shock of it all is starting to wear off and I posted the last blog post on Facebook and suddenly people I haven't spoken with in years are reaching out to me to tell me their stories and to offer encouragement.  This outreach feels wonderfully supportive and terribly frightening at the same time because it means that people will surely be there for me if I need them, but it also means that I might need them.

Cancer is apparently something I can't ignore.

My stomach was upset when I woke up--which is very normal during this pregnancy--so I stumbled downstairs for some milk.  I took an extra large half of Zofran because today's belly ache might not just be because of the baby, and am now feeling much better already.

I feel like crying for several hours.  So far I only cried once, while on the phone with my sister, and it was because I was feeling sorrowful for the fact that I will not be able to breastfeed this new baby for very long.  So far, the loss I am feeling is because I know I will have to be away from Dylan at least overnight in the very near future for the surgery, and then I will be separated from both kids when I go in for treatment because I will be radioactive.  I can't even stomach the thought of leaving my dogs overnight.

I keep feeling like the cancer has already spread throughout my entire body.  Most likely, since the statistics are that 75% of this type of cancer has spread at least to the surrounding lymph nodes, it is already on its way to taking over me.  I am constantly swallowing with some silly hope that I might eat the lump in my throat.

The doctor doing my biopsy said that in his experience only about 1% of lumps that he examines turn out to be cancerous.  He said, "If you end up being in that 1%, you must have terrible luck."  Raises hand.  I was scared during that exam and so I sang in my mind and counted the holes in the ceiling and cracked jokes that this spa was terrible and I will be asking for a refund.  The first song I thought of was Yellow Submarine.  From there it went To Make You Feel My Love, End of the World (As We Know it), These Days, and Baby Mine.  And then as the procedure continued and I kept commenting about how comfortable the bed was--that my Sleep Number must be hospital grade--To Make You Feel My Love kept creeping into my mind.

When the evening shadows
And the stars appear
And there is no - one there
To dry your tears
I could hold you
For a million years
To make you feel my love

It's 5AM now.  And no one is awake.  It's just me and my cancer sitting here on the couch.  Although almost fifty people have reached out to show their support since last night, I feel so very alone.  Maybe I'd feel less alone if I believed strongly in a god or religion.  Maybe if I practiced yoga or meditating, I'd feel better.  But for right now, all I want is some strong anti-anxiety medication to calm my nerves.  Sean will be awake in twenty minutes or so and I will soak him in until he leaves for work and then I will struggle to get through the rest of my day without crying in front of Dylan.

What should a girl do on the day after she discovers she has cancer?

Grieve?  Go shopping?  Cry?  Nothing seems important or worthy of my time and now listening to Adele's version of my beloved Bob Dylan tune has me in complete sobs.  How have I never heard this before?  It's beautiful.  I'd better get my tears out now before my almost-two year old wakes up because I refuse to cry in front of him today.  We're going to talk about trains instead, and watch Mickey Mouse. 

This cancer seems so dramatic.  I bet I'm overreacting. I hope I'm overreacting.   What if in three weeks or so whenever I lose my thyroid the surgeon comes in and tells me that I'm cured?  What if it's that simple?  What if I die instead?  What if I don't?  Shit, look at Roger Ebert.  He's still alive.  He can't drink root beer, but he's still alive.

So I've decided.  Today I am going to drink root beer in his honor and I'm going to tell this cancer and these tears to fuck off.  I've got better things to do than mourn all day.

The "C" word

Looking back now, my golden retriever knew that I had cancer months before I discovered the lump on my throat.  She hasn't left my side.  Before today, I thought that she was being extra clingy because I am pregnant but she wasn't like this during my first pregnancy.  I should've known something was wrong.

I look for signs of reassurance when I'm feeling desperate, for anything to jump out at me and pull me back into my safe place.  On the way to the doctor's office today Joni Mitchell's Chelsea Morning played in the background as Sean talked about his hectic day at work.  I thought, this must be a good sign, I love this song.  But I knew better.  Why would the doctor ask me to come into the office instead of simply telling me my biopsy results over the phone unless the news was bad?  He wouldn't.  I was driving us to an appointment that would change our lives and I knew it.

As soon as my endocrinologist said, "You have papillary thyroid cancer." the rest of his words slurred and I found myself watching his eyes as he talked.  I didn't care what else he had to say, Sean would listen for me and soak it all in.  I simply stared at him and willed him to stop talking.  I asked three times, "What kind of cancer?  Pap..?"  This doesn't seem real.

But the survival rate is high, right?  I asked.  He answered with an unsure, "Usually."

Usually?  What does that mean?  Why isn't he telling me that I will be just fine?  I need to hear him say it:  You. Will. Be. Fine.  He mentions the baby and how we need to take out my entire thyroid immediately since I am at the midway point of my pregnancy and it will be safest for the baby.  I will endure radioiodine treatment after the baby is born.  I will not be able to breastfeed for long.

As we ran to the car after the appointment, the sky poured--absolutely poured--on us.  That's fitting.

Sean and I have been joking around.  We took a picture of us with our thumbs up for a momento of how we looked after I was diagnosed with cancer.  We went to Subway on our way home from the appointment and Sean said that I could order whatever I want since I have cancer.  We even named my tumor Britney (a bad joke about that pair of conjoined twins on TV) and Sean started discussing what we should dress the lump up as for Halloween.

I called my parents and siblings and sent texts to family members.  But by this point--an hour after diagnosis--I was at peace with it all and they were mostly in shock.  The word cancer is a pretty hard blow.  But this cancer is a good one to have, I guess, the survival rate is high and I plan on living for a long time.