"I have thyroid cancer...but I'm going to be OK, I swear!"

If you ever want to be on the delivering end of an awkward topic of conversation, try telling people you have cancer.

Well, I hope that you are never put in that position, but it's the position that I am in now.  Again...and again...and again.

For the most part, it gets easier with each successive delivery.  Until you don't have to tell colleagues at work anymore, and you have to tell your friends and family.  People you've known for years...since college...or since you were a little kid.

Me, immediately after telling someone I have cancer.

[Note: Super stoked that animated .gifs work on Blogger]

I decided very early on that the same coping mechanism that I had used in my own head (Excellent prognosis!  Not as bad as other cancers!  Huzzah!) were the ones I would use when telling people about my diagnosis.  This made my delivery very business-like at work, as I told more and more of my colleagues.  "I received a diagnosis of thyroid cancerbutthesurvivalrateis97-99%!"  I would speak in a run-on sentence that put the focus on the prognosis rather than the actual disease, as if I was telling people that I caught the stomach flu.  This was probably the best way to approach this talk with co-workers, so that I can put up the wall of professionalism in front of me to avoid from accidentally releasing a tear, or allowing my voice to crack.

But when I finished up tour at work and the weekend came, it became time to tell my closest friends, people who I consider to be family.  All of a sudden, that same tactic didn't work.  I had already rehearsed the speech, but when I gave it the words seemed emptier...almost pathetic or desparate.  These were people who had been in my life through its highs and lows, who knew me inside and out, and who genuinely cared about me.  And I was throwing this wrecking ball at them from out of left field and trying to pass it off as common conversation, as if I was talking about something as routine as my opinions on the latest Avengers movie.

It suddenly became almost as hard as the first time had to talk about it, but I got through it.  I did my best to look strong and act like it was all in the bag, that it was going to be a summer of inconveniences and then life would continue on as normal.  I'd like to think that, but it doesn't really make the anxiety go away completely.  This time around, it kinda hurt to tell people what was happening, even though it's not like I was saying anything bad to them.

I'm just rambling now.  Maybe because that's what I tend to do when immediately after I deliver the bad news to people.

-W

Appointments for Days, and Other Musings

I spent most of Memorial Day weekend trying not to think about my diagnosis.  It was my Mom's birthday on Memorial Day itself, so I went home for the weekend and spent time with my parents.  Highlight of the weekend, taking her and my uncle to see Mad Max: Fury Road, which is when I realized my true life's calling: to become an electric guitar player who calls a road-faring group of post-apocalyptic warriors into battle via killer sick riffs.

My future...no...OUR future.

Once the weekend ended, it was time to face my situation head-on.  As soon as I came in to work, I spoke to my boss, who had been in the know through most of the initial false negative biopsy experience, as well as this latest ordeal.  She was very supportive and understanding as I ducked out for multiple doctor's appointments, so she was sad to learn my latest test results, but was ready to do whatever it would take to transition things off my plate and make sure that I did not have to think about work at all as I recovered.

After talking to HR and learning more about all those parts in the welcome packet that you figure you'll never need, I retreated to my office, closed the door, and got to work on making some calls.  First item on the agenda: surgical second opinion.  Even though I was very comfortable and confident in Dr. Sigari, everyone I had spoken to had said the same thing: "a second opinion won't hurt you, so why not get one."  I had to agree, so after some googling, I settled on a surgeon with excellent reviews and made the appointment.  Done.

Next, I had to find an endocrinologist.  With thyroid cancer, it seems that oncologists rarely get involved, except only in the more complex cases; it is an endocrinologist that drives all of the hormone prescriptions and the radioactive iodine (RAI) treatment, once the surgeon is done you.  Dr. Sigari had referred me to an endocrinologist across the street from his office, so I called and found out that she did not have any openings until after my surgery.  I wasn't too comfortable with that idea, as once my thyroid was out, I felt like the clock would be ticking in terms of getting me on the proper thyroid medication and getting me ready for RAI.  So, back to Google I went. 

After finding some endos that looked good, I called each and learned the same thing: they did not have any open spots until July.  I quickly realized that endos were the hottest thing since sliced gluten-free bread.  Emily's cousin who works in pharmaceuticals was nice enough to do an extensive hunt on her end as well, and all of her recommendations did not have any openings either.  

Tip: If you will be in need of an endocrinologist, make sure you make the appointment before you're ever aware you need one.

Mmmkaaay?  Thaaaaanks, Peter.

But after a lot of searching, I finally made appointments with 3 different endocrinologists.  Since they're so important to the whole process, I figured might as well audition them, right?  

This is how I plan to show up to my appointments.

This week, I've felt like I've had three full-time jobs: my job as an accountant, being on the phone making doctor's appointments, and telling people about what was happening to me, both in my personal life and at work.  The whole weekend I had thought that the surgery would be the most strenuous part of all of this, but this last week has been exhausting.

But enough of that.  Time for the weekend!

-W

My Story, Episode III: Revenge of the Thyroid

Star Wars: Episode III is half-decent and ends with the descent of Anakin Skywalker into evil.  This episode of my story ends with the descent of my thyroid into cancer.  My story might also involve an epic lightsaber battle.

The months after my benign diagnosis were great.  My parents enjoyed their time in the Philippines, and I got to do the occasional Google Hangout with them to catch up.  I took Emily to the Ojai Valley Inn & Spa over Valentine's/President's Day weekend to celebrate her birthday, and we had a wonderful time.  I celebrated/mourned my 30th birthday on April 5 with friends and family on Easter Sunday, as well as a trip up to Ventura for an oyster picnic (at the Jolly Oyster).

Standing over the vanquished corpses of our oyster victims.

To be honest I didn't really think about my upcoming ultrasound follow-up.  5% chance of false negative, man, for reals.  But, the follow-up approached nonetheless.

I went into the imaging center on Friday, April 17th, for a quick 30-minute ultrasound.  To be honest, my mind wasn't really there.  The next morning, I was going to board a plane to join Emily in Nashville.  She was already there for a work conference, so we were going to tour Nashville for 2 days, and then head down to New Orleans for 2 more days.  New Orleans is my favorite city in the US, and this was going to be my third time there, although it was Emily's first, so I was excited to play tour guide.

Nashville was tons of fun, mainly because I got to celebrate the greatness that is Hootie:

Darius, there's nothing I can do.  I only want to be with you.

Bread pudding souffle @ Commander's Palace in New Orleans.  Got-to-get-the-puddiiiiing.

I didn't really think about my thyroid during that whole trip.  It was just too much fun.

Because I was gone for the rest of the following week, I had made an appointment to discuss my follow-up results with Dr. Sigari on the morning of April 28th, 11 days after the ultrasound.  I came in at 9:30am, pretty calm and having decided in my mind that this would be a quick and easy meeting.  Dr. Sigari came in, and shared the results with me.  An except from the radiologist's report:

1) Decreased size of cystic nodule in the lower pole of the left lobe [W's Note: Hollah!]
2) Heterogeneous solid nodule in the midpole [Yes, I knew that.] of the left lob with possible microcalcifications [Yup, nothing new here.] which may be slightly enlarged compared to prior study [Wait, what?]

Damnit.  The solid nodule got bigger.  But whatever, benign nodules can grow too, and the doctor said while it was growing, the rate of growth wasn't necessarily alarming.  However, he floored me by what he said next.  He said that at this point, because of all the risk factors, he would be happy to remove the left half of my thyroid in order to get a 100% accurate diagnosis, and lobectomies often meant that the person would not need synthetic hormone supplement for the rest of their life WAIT WHAT?

Security camera footage of my face during this meeting.

He could tell what my face was saying, and it was saying "whoa!", so he quickly told me that what he was presenting was just an option, and certainly the more aggressive one, but some people just like to go forward with the surgery for peace of mind.  The thought of a neck incision did not give my mind peace though, so he did his best to tell me that because of the initial negative biopsy, there was no rush here, and that repeating the FNAB was the other perfectly acceptable route.  He also continued to stress that this was not an emergency, and that I did not need to make a decision right then and there.

Having never had surgery outside of my wisdom teeth extraction (does that even count?), I immediately agreed to the repeat FNAB.  He told me that it was a good route to go, but that if it came back negative and then another ultrasound in 3 months showed more growth, then he would enter the "cut it out of there" camp at that point.  Fair enough, doc.  He wrote down the order for another FNAB, and I took it downstairs to get it on the schedule.  When I handed it to the front desk, the woman asked, "Again?  You're having another one?  You just had one, right?"  Yeah, lady, I just had so much fun last time that I wanted another whirl.  I'm obviously having another one because of shitty results, so maybe you shouldn't act like I'm abusing my right to have a needle stuck in me like some meth addict.  Sorry...perhaps I was just in a pissy mood due to the news I just received, but her reaction and tone really bothered me.  Anyway, May 14th was the date, about 2 and a half weeks away.  

While a bit unnerved, I still remained pretty calm (that previous brief tirade aside).  I think I had experienced enough anxiety to last me a lifetime during the first round of all of this, so there was none left for me to have.  This time, I kept my family and Emily in the loop.  Learning from last time, I think this helped me to stay calm as well.  The days passed, and I got closer to my repeat FNAB, but I remained calm.  But finally the day came, and I went back to the same radiologist's office, my 3rd visit there.

This time, the radiologist seemed looser and more talkative.  He even cracked a joke when referring to my first biopsy, saying, "Well, that was my first time, so I think we'll get a better sample this time," and then laughed immediately to signal it was a joke.  He was so dead-pan that it made it more hilarious to me.  Plus, I knew exactly what to expect this time around, so those nerves were gone.

We went through the same procedure, except this time he chose only to biopsy the solid nodule, since the cystic nodule was so low-risk and it had shrunk.  So the whole thing was even quicker.  I finished up, got my band-aid, and headed into work after lunch.  

Work had sent Emily to Hong Kong for a little over a week, so I talked to her about the procedure afterward via Google Hangouts, which was nice.  I'll probably devote entire posts to the topic of Emily later on, since I realize so far that I've only made passing mentions of her during my story.  She's very important to me, I swear!  I'd just rather talk about her in more positive contexts than while recounting my diagnosis story.  Let's not mix the bad with the good, people.

It was after the FNAB that the nerves came back.  Although not as severe as last time, my anxiety and chest pains returned.  I guess there was no way to avoid it this time.  I started to freak out a little.  But...5% chance of false negative.  5% chance of false negative.  This was my mantra.  Some people meditate by saying "ohhmmmmmmm."  I did it by repeating "5% chance of false negative."

I had an appointment for Tuesday, May 26th (12 days after biopsy), which I had set out that late in the event that the pathology took a long time to get back.  Also, the Memorial Day holiday was in the middle of that lag.  But if the results had come back sooner, then Dr. Sigari's office said I could just do a same-day or next-day appointment.  By Wednesday, May 20th (6 days after biopsy), I hadn't heard anything, so I called the office hoping to get them to tell me the biopsy came back negative again over the phone, just like last time.  They told me that they had just received the results the previous evening, so the Doctor was going to review the results that afternoon, and they would be in touch.  Wednesday came and went, and I received no call.  Given how accommodating they had been last time, I was surprised and then started to worry a bit.  Emily came home from Hong Kong that day though, so it was nice to see her.

Thursday morning came (May 21st), and still no call.  I called shortly after lunch, and I started to sense something was up.  The woman at the front desk, who was super friendly by the way, said something about how the doctor was at the hospital, so she didn't have any way to get an update.  That's when it really sunk in.  She was stalling.  They didn't want to talk about my results over the phone.  Or maybe I was just reading into it too much, I don't know.  But then she mentioned they did have a 5:15pm opening that afternoon, and the doctor would be back and would be able to review the results by then.  So with a heavy expectation of what was about to happen, I made the appointment, told my boss why I was leaving, and left work at around 4:30pm.

The streets were packed with people leaving work to start their Memorial Day holiday.  I was driving to Marina del Rey to start off my weekend with a different kind of bang.  There was tons of traffic, but I eventually made it, albeit 10 minutes late.

Dr. Sigari's office always runs on time, so they were already waiting for me when I came in, and I was seated in the exam room within about 5 minutes of my arrival.  Jen, the nurse who had been so accommodating with me over the phone back in January, came in to take my blood pressure readings.  159/90.  I made a passing comment about how I had never seen my reading that high.  Jen mumbled "yeah," input the reading into the computer, smiled and told me the doctor would be with me shortly.  She knew what was about to happen, and knew why my blood pressure was alarmingly high, but couldn't say much else (understandably so).  What an awkward position to be in, and in her job a position that she's probably in fairly often.

It took about 30 minutes for the doctor to come in.  I could hear him talking with another patient about sinus issues, and then he took the person into another room to perform a CT scan.  He discussed the results more, spent a lot of time answering the man's questions, and then eventually I could hear him say farewell to the patient.  I knew my wait was about to end, which was great because it was starting to feel like an eternity.  Finally, at about 5:50pm, he came in.

After asking how I was, Dr. Sigari cut straight to chase and said the magic words: the biopsy had come back for Papillary Thyroid Carcinoma.  All I could do was nod.  I pretty much already knew what the paper was going to say.  He even commented, "Judging by your reaction, it seems like you already knew...?"  And all I could say was that I had a feeling.

This is the moment that people always write about in articles and blogs, or it always shows up highly dramatized in movies or TV shows: the moment that someone finds out they have cancer.  I kinda think everyone has imagined this happening in their own life at some point or another, perhaps out of some morbid curiosity to figure out how they would react.  Would you break down in tears and freak out?  Would you be upset or pissed off and start second-guessing the results?  Would you faint and wake up with someone fanning you and giving you water?  Would Ashton Kutcher burst out of a fake wall, to tell you that you had been Punk'd, while wearing a fashionable Von Dutch trucker cap?

I was actually HOPING I'd see this douchery in real life.

I think I went through my own hypothetical reactions in my mind a thousand times in the leadup to this moment, given the events of the past few months.  All I could do was nod and try to signal to the doctor that I understood what he was saying.  I did understand most of it, mainly because I had read about it online already (thanks again, Google), so thanks to the interwebs a lot of what he was saying was stuff I had already ready at least a hundred times, with a hundred different interpretations.  But that was it.  I nodded.  And nodded.  Yeah, my eyes were watering just a bit, and I could barely utter a sound, but I remained shockingly calm.

Just the week before, I was listening to NPR, and Tom Brokaw was on Fresh Air, talking about how he was diagnosed with a form of blood cancer about 2 years ago, but was now in remission.  He talked about this moment, and described his reaction as being disconnected.  He became a journalist, asking the doctor questions and making mental notes of his responses as if he was going to write an article on it.  I guess that's how I kinda felt.

Dr. Sigari was awesome.  I could tell this wasn't his first rodeo, and he approached this whole moment with graciousness and reassurance.  I feel like some doctors might take the "do you have any questions?" approach, answer only those questions, and then send the patient on their way.  I felt like Dr. Sigari was launching into discussions on his own, almost to answer questions that I might not realize I had.  He went through previous, more complicated cases, in order to tell me that in even worse situations like those, his patients have come out completely fine.  In any way he could, he tried to reassure me that while this diagnosis carries the word "cancer," it just does not carry the same risks and medical obstacles as other cancers.  He answered my questions too, but overall, it was a great conversation, and because of it and my previous meetings with him, I pretty much decided that I would do the surgery with him and not shop around for another doctor.  This is the dude that is going to put me to sleep and open up my throat.

Right there in the exam room, he opened up his surgery schedule and we decided that Thursday, June 18th was going to be the day I would have a total thyroidectomy.  He said it would take 3 hours; many doctors would do it in 1.5-2 hours, but he said he likes to take his time and be thorough.  No argument there.  He talked about the very low risk of complications with the surgery, the relatively quick recovery time from it, and what to expect in terms of treatments after the surgery.  And he stressed the ridiculously high survival rate for this kind of cancer, but I already knew it from my Google explorations.  It hovers somewhere around 97%.  His advice in the short-term?  Try to enjoy the long weekend, and do my best to avoid the doom and gloom that comes with this sort of thing, because the outlook was extremely positive.

After he was absolutely sure I had no more questions, he did a little bit more unsolicited reassuring, and then we walked out together.  Jen, the poor nurse, was sitting outside waiting for our meeting to end, in case she was needed.  It was about 6:30pm by then, I think.

I took the elevator down, paid for my parking, drove out, and stopped the car as soon as I found an empty lot.  I called Emily in tears, and she told me she would come over and bring dinner.  I went home and called my sister and brother-in-law via video chat.  My roommate came home during that conversation, so I went out and told him since I figured he might hear me freaking out through the walls of our apartment.  And finally I called my parents.  It became slightly easier to talk about each time.  Slightly.

Yes, Jimmy MacMillan, you are actually 100% correct.

And that was it.  On Thursday, May 21st, at 5:50pm, I developed a new mantra: 97% survival rate.

-W

My Story, Episode II: Attack of the Nodules

Star Wars: Episode II was slightly better than Episode I.  Barely.  This part of my story is actually the only good part of my origin story, although its goodness was fleeting...

Nervous, dizzy, and filled with anxiety, I woke up on Monday morning sweating bullets.  What would a needle in my neck feel like?  How much would it hurt?  It was time to find out.

I drove the length of the 90 Freeway (all 10 yards of it) to the Marina, where I parked and headed up to see Dr. Sigari for the first time.  Shaking in my boots, I was called in and sat down in the exam room where the nurse told me they had just received the medical supplies for the biopsy (called a Fine Needle Aspiration Biopsy, or FNAB), so they were ready to go.  Another person did what I assume is the standard ENT visit checkup on my ears, nose, and throat (hence, "ENT."  Mind.  Blown).  She said something about how my right nostril was slightly obstructed.  I nodded and mumbled something resembling acknowledgment.  "Lady, I'm in here to check for cancer!  I don't care if I snore!" was the thought in my head.

In came Dr. Sigari.  As you can tell from the fact that this blog exists, this won't be my only rodeo with this guy, so more on how awesome he is later.  He came in, felt the nodule, and stated that while he could perform the FNAB purely by feel (or by palpation, for your medical folks out there), he felt the most accurate way to do it would be with ultrasound guidance.  Essentially, he was happy to perform it, but to do so would have resulted in a higher likelihood of inaccurate results.  The irony of this will be apparent in this and the next blog post, but I was inclined to agree with him, as the only thing that seemed more annoying than having a needle stuck in my throat was to do it twice.  The doctor referred me to the radiologist on the first floor of the same building, so I left, took the elevator down, went into the imaging center/radiologist and set up the appointment for an ultrasound-guided FNAB on January 21st.

Everything had happened so quickly, and now it all had ground to an abrupt halt.  The next action on this nodule/cancer scare wouldn't be for another 10 days.  I had psyched myself up to get this biopsy done, only to be greeted by this:

Damn you, Yao Ming.

At this point, on the verge of a nervous breakdown, I called my parents.  Important to note that up to this point, I hadn't told anyone about what was happening.  Not my family, nor my girlfriend, nor my roommate.  I had decided to keep it secret, because...I actually don't know why.  I figured I was sparing them the anxiety?  I figured it would turn out to be nothing, and then it could just be an interesting cancer-scare anecdote weeks later?  Not sure what I was thinking, but a tip to anyone that may be facing this in the future: don't keep it to yourself.  It'll only wear you down faster when you have no one to talk to about it.  You don't have to tweet your experience to the general population, but the ability to talk about your fears and hopes with someone can go a long way.

Anyway, I decided to call my parents primarily because every doctor I had spoken to so far had asked if there was history of thyroid cancer in my family.  All I could say was that I think my aunt and my grandma had their thyroids removed, but I wasn't sure why.  That's all I knew; asian families don't exactly disclose medical histories very openly, as any of my asian friends can probably attest to.  Am I being racist?  Yes.  But it's OK, because I'm asian.  I'm also good at math and can't drive.

After talking with them, we figured it would be best to call my aunt in Texas to get the accurate scoop on why her thyroid was removed.  So that afternoon, I called her from work and learned the truth: while my grandmother had her thyroid removed for malfunction and overgrowth (called a "goiter"), my aunt had thyroid cancer in the late 1970s in the Philippines.  My heart sank.  There it was.  While family history of goiters was enough to increase the likelihood of thyroid cancer, an actual case of cancer made me feel even worse about my fate.

The days passed and I became increasingly worried.  I started to have anxiety attacks and chest pains.  I read somewhere that studies have shown that the anxiety from waiting for biopsy results can have the same effect on the human body as actually being told you have cancer.  I believe it...I hadn't even had the biopsy yet!

January 21st came around, and it was time for my biopsy.  My parents came by to pick me up and take me to the radiology office.  After waiting for a while, I was taken into the dark ultrasound room.  After taking initial scans, the ultrasound tech called in the radiologist.  He came in and seemed friendly, but was obviously a man of few words.  He explained what was about to take place, and began to disinfect my neck with that orange stuff that you always saw on episodes of ER.

The way these work is pretty simple: the radiologist holds the ultrasound wand in his left hand, and is watching the insides of my neck on the monitor.  With his right hand, he holds a fine-gauge needle, thinner than the one typically used to draw blood, in some kind of device that makes it look like a gun, trigger and all.  With one eye on the monitor and the other on my neck, he then proceeds to stick the needle in, aiming for the nodule.  Once he confirms he hits paydirt on the monitor, he then starts to poke the nodule from several angles, jabbing the needle with small "punches" forward, in order to force thyroid tissue to go into the syringe.  The goal is to poke as many areas of the nodule as possible, in order to get an adequate representative sample, almost like an audit (shoutout to my fellow former Deloitte auditors).  Even of a nodule is cancerous, it doesn't mean it can be found throughout the nodule.

If it all sounds awful, it is, but only in theory.  In practice, it honestly didn't feel like much.  The doctor had numbed my skin with the first injection, so the actual needle pricks felt like nothing.  The rest of the procedure just felt like he was poking down on my neck multiple times, and no pain was felt really.  His first offensive was against my liquid cyst, which he tried to drain as much as possible, although he explained it might or might not come back.  However, cysts are considered to have little-to-no risk of cancer.  The solid nodule was in a deeper, more awkward position on my thyroid, so that took a little more work and a little more discomfort for me before he was able to attack it.  About 30-45 minutes after starting, we were done.  He thanked me for not squirming too much, and left to do other work, so I sat there while the nurse applied pressure to my neck (which was more out of procedure, as there was no bleeding), and we talked a bit.  She actually told me she was going to have a biopsy for a lump on her breast in a few weeks, so we wished each other luck on our respective biopsies.  She was really sweet.  I hope her results ended up better than mine did.  The ultrasound tech was a big LA Kings fan, so we talked about that too.

I went to grab lunch with my parents at the local pho spot, and then they dropped me off and headed home.  After replacing the band-aid on my neck with a less conspicuous one, and putting on a high-necked sweater, I drove off to work and finished up a half-day, my neck just slightly stiff from being in an awkward position during the procedure.

Imagine my face on this cat, and you get the idea.

My parents were about to embark on a five-week vacation to the Philippines on January 29th, their first time home since 1995, so the clock was ticking on these results.  Even though I was told the results would be in by early next week, I called Dr. Sigari's office on the 27th in panic mode when I hadn't heard back, explaining that my parents were about to leave the country for more than a month, and if anything was going to happen, we needed to know ASAP.  After some digging and investigation on their part with the radiologist and pathologist, on Wednesday, January 28th, I finally received a voicemail from Jen, one of Dr. Sigari's friendly nurses:

"Just wanted to let you know that we just received the final pathology report, and it came back negative.  No malignancy, no cancer.  We thought you'd want to know ASAP, so please call us back when you have a chance so we can schedule an appointment for you to follow up with Dr. Sigari, so that we can establish a plan to monitor you going forward."

Well, those weren't her exact words, so perhaps my use of quotation marks was a bit disingenuous.  But that was the basic gist of it.  So stop treating my like I'm Brian Williams.

I don't remember seeing you there, Brian.

So that was it, just like that my month of panic was over.  I called my parents to tell them the good news, about 36 hours before they were set to take of from LAX.  I then told my boss Peggy, who had noticed the band-aid on my neck the day of my biopsy.  With all the doctor's appointments I was going to, she put two and two together and had told me she hoped that I was OK, but that I didn't need to tell her anything more if I didn't want to.  I had ended up filling her in on what was going on with me, just because I preferred she not be worrying about me while completely in the dark.

Meeting with Dr. Sigari on February 5th, and got a copy of my pathology report.  More beautiful words have never been seen on paper:

DIAGNOSIS:
1) Benign follicular nodule, consistent with colloid nodule, FNA of left thyroid cystic lesion
2) Benign follicular nodule, FNA of left thyroid solid lesion

He then told me that because of the suspicious nature of my solid nodule on ultrasound (the microcalcifications), because I was male, and because of my family history, he wanted to follow up with another ultrasound in 6 months.  He then doubled back, saying "no, no...let's do 3 months, and then 6 months".  I told him we could ultrasound every month if he wanted to, so I took his order for a 3-month follow up down to the imaging center and set my follow-up ultrasound appointment for April 17th.

With everything now settled, I felt like I had a new outlook on life.  I told my girlfriend Emily what I had been through, which was a bit more awkward then I had imagined in my head.  "Oh, BTWs, I just had a month-long cancer scare, but it's benign, so yeah, that was pretty crazy.  Is the new episode of The Americans on the DVR yet?" was what I had imagined, but as I got ready to tell her, I realized it made me sad that I hadn't told her about what was going on.  I already gave you the tip about not keeping stuff like this completely secret.  This is why, suckah.  But I had that conversation, as challenging as it was, and she was very understanding and glad that everything turned out OK.  I then told my sister and brother-in-law and a few other close friends, who were all also relieved.  I didn't really see the need to tell a lot of people though.  I mean, it all ended up being nothing.  So, I decided to just go on with my newly renewed love of life...

...because ultrasound-guided FNABs have only a 5% chance of false negative readings.  You are sure about that, right Google?

-W

My Story, Episode I: The Phantom Neck Menace

Star Wars: Episode I was an awful origin story.  The origin story of my thyroid problems is also awful.  Well, not THAT awful.  There's no Jar Jar Binks in my life.

It all started around Christmas 2014.  My sister was in town with her husband and their daughter (my niece) Alayne.

Apples are amazing.

Alayne, as she is during all major federal and religious holidays, was sick as a dog.

All the way on the other side of town, my girlfriend's brand-spanking-new nephew, Jackson, was also harboring respiratory ailments aplenty.

Naturally, spending so much time with both of them ignited the inner-hypochondriac in me.  So, I dug deep and summoned my inner Filipino-nurse instinct, and decided I was medically qualified to palpate and detect swollen lymph nodes.

Low and behold, EUREKA!  I went digging for gold, and I found myself a nugget.  I actually felt something strange at the base of the left side of my neck, and for the rest of the holiday season, I thought I had found a swollen lymph node.  Great, I'm about to have a gnarly cold, just in time for New Year's.  But the cold never came, and the lump never went away.

By the time the new year rolled around, I had convinced myself through extensive Googling that I had some kind of lymphoma, and that I was in trouble.  So, I made an appointment to get a physical on Wednesday, January 7th, 2015, something I had been meaning to do in the new year, since I was approaching the golden age of 30 and hadn't had a physical since I was in high school.

I made an appointment with a PA in El Segundo (Rebecca Pestle, I highly recommend her if you need to visit a general practitioner), and figured I'd bring up the lump, so that she could tell me it was no big deal and I could get on with my life.  So, after going through the physical routines, I brought up the lump.  Luckily, she was very attentative to my concerns and didn't just write it off.  After feeling around, she decided to call the doctor in for his opinion, which is when I briefly met Dr. Mellman.

That's Dr. Michael Mellman.  No, not the guy at the podium, that's Laker legend Magic Johnson announcing he was HIV-positive in 1991.  Look to the right.  No, that's former NBA Commissioner David Stern, look to MAGIC's right.  No, not the guy who Magic is covering with his right arm, I don't know who that is.  Are you even paying attention to me?  Focus!  Find the first guy on Magic's right whose face ISN'T being blocked.  That's Dr. Mellman.

Yup, he was the doctor who told Magic Johnson that he was HIV-positive.  Obviously, I was nervous as I sat in the exam room.  But anyone knows me knows I'm a diehard Laker fan.  So, in a weird way...a part of me was excited that I was in the same room as this guy!  Is that morbid or inappropriate?  Sorry.

But I digress.  Dr. Mellman, who was also awesome, stood behind me, pressed down firmly on my neck and asked me to tilt my head up and swallow.  And in that moment, he immediately declared that the lump moved up and down when I swallowed.  It was not a lymph node, which would have remained relatively static; the likely culprit was my thyroid.

The doctor said that while thyroid nodules were very common among the female population, they were much less common among men.  Still, my nodule was probably nothing.  He said the best thing to do would be to have an ultrasound, so that the nodule could be checked for suspicious characteristics.  He went off to see his next patient, and Rebecca (she insisted I call her by her first name) referred me to UCLA Radiology, since it was so close to my office in Westwood.

The very next day (Thursday), I left work in the early afternoon and headed to the Ronald Reagan building on the south end of the UCLA campus.  I went in, had my ultrasound done by the friendly tech, and went back to work.  I couldn't have been gone longer than an hour.

The day after that (Friday), Rebecca called me with the (not) exciting news.  Three nodules had been found on my thyroid.  In the words of the radiology report:

- a subcentimeter cystic and solid nodule in the inferior right thyroid lobe which is not clearly suspicious. [W's Note: Not alarming at all.]
- 2.2 x 1.9 x 1.6 cm cystic nodule in the left thyroid lobe [W's Note: Cystic nodules are rarely cancerous]
- 1.0 x 1.3 x 0.6 cm solid nodule in the left inferior thyroid lobe with multiple peripheral microcalcifications [W's Note: Microcalcifications are considered to be highly indicative of cancer.  Gulp.]
- IMPRESSION: Multinodular thyroid gland with nodules demonstrating suspicious sonographic features.  FNA (fine needle aspiration) is recommended of the solid nodule and the cystic nodule in the left thyroid.

So that was it.  Suspicious.  Time to go in for the biopsy.  Rebecca referred me to Dr. Farhad Sigari in Marina del Rey, an ENT Surgeon, and I was set to go to his office for the needle biopsy on Monday, January 12th.  I had gone in for my physical on a Wednesday, and by Monday I was set to have a needle stuck into my neck, and have tissue extracted and sent to a lab to test for cancer.  Happy New Year!

Still though, through all this, I figured it had to be nothing.  I mean come on, only 5% of all thyroid nodules are cancerous...right Google?  You're not lying to me, are you Google?  I thought we were friends, Google!

...by the way, I still don't know what an actual swollen lymph node feels like to this day.

-W

Porque?

So first thing's first: why does a thirty-year-old Filipino guy who just got diagnosed with thyroid cancer feel the need to start his own blog?

To be honest...I'm not really sure.  As I write this entry, I do it after setting my blog to 100% private.  Maybe I'll publicize it in the coming weeks, maybe not.  But for now, I'm doing this for purely therapeutic reasons.  According to many people I know, some even with personal experience blogging about their own cancer ordeals, there is a lot of value to writing down your thoughts and feelings.  Whether just as your own private personal journal (old-school-styles), or as a public online blog in the new era of social media where people assume you've died of starvation if you haven't posted a sepia-filtered image of your lunch in over 48 hours, they say writing it all down can help you process what is happening to you, and deal with it better.

Truth is I've never had my own blog before.  I never figured I was that important.  Besides checking in to cool or fun places on Facebook to prove that I don't spend EVERY moment of my free time binging on Netflix while wallowing in my own filth, I consider myself a pretty private person online. My Facebook feed is pretty much a list of my favorite pictures/videos/articles.  I only joined Instagram 2 weeks ago, and that was because I was bored when my girlfriend went out of town for work...and even now, I only have one picture posted.  And according to what the kids say these days, that picture is a #latergram.  #Lame.

But I've also been doing a lot of blog-reading over the past few months, of blogs belonging to others who have survived thyroid cancer, and I've gotten a lot out of them.  They've been comforting and reassuring to me.  I also noticed that, since less men are diagnosed with this than women, so few of these blogs and stories come from a male perspective.  So what the hell, I figure if I can write about my experience and help calm the nerves of or make sense of it all for some other young relatively-healthy dude (or dudette) out there, then perhaps it's worth it?

Or maybe I'm just writing all this so that one day, I can go to my friends in a fit of rage and ask:

So what's my plan here?  Not sure yet.  First-hand account of someone going through thyroid cancer treatment as it's happening in real-time?  Sure.  My chance to unleash my sad attempts at humor at an unknowing and unwilling public?  Yeah, that's likely.  Random thoughts that may come to me in a moment of inspiration?  You know it.  An excuse to post my favorite memes?  Done.

Anyway...I welcomed you to my blog in my first post, and I've explained why I'm blogging in this, my second post.  On to my story (so far)!

-W

Welcome. Willkommen. Mabuhay. Hola. Yo.

Hello there!  If you've stumbled across my blog, you've come to the right place.  Or maybe not.  I don't know what you're doing here to be honest, or what brought you here.  Perhaps you googled "awesome" and my blog was the first search result.  #humble

Do hashtags even work in blogs, or are they only for the Tweeter and the Instagraph?

In any case, allow myself to introduce...myself.

Walter vs. Walter

This is a tale of two Walters.  One is the meth king of New Mexico, while the other is me.

One of them got diagnosed with terminal lung cancer, beat it, and then built a drug-manufacturing empire that went down in a blaze of glory.  The other got diagnosed with papillary thyroid cancer on May 21, 2015, with plans to beat it and then take over the world via his quick wit, mad accounting skillz, and blind devotion to Scientology (Praise be unto Xenu).

If you want to know more about the first Walter, watch Breaking Bad.  If you want to learn more about the second, then read on, brave soul.

-W