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.
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
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