My Story, Episode VI: Return of My Health

Emily came back around 7am, with Jamba Juice in tow.  I felt really bad for her, she loves to get her 8 hours of sleep, and she couldn't have gotten any more than 5, but she was a trooper.  Unfortunately, I wasn't able to keep the Jamba Juice down, as the nausea continued.  Luckily, by around 8am, I got a new nurse named Alex.

I want to try to focus on the positive on this blog and not vent, but I will say the difference between a bad nurse and a great nurse is night and day.  Let's just say the assistant nurse asked me, probably around 2 or 3am, if she could borrow my phone charger...Emily had plugged my phone in and put it o my bed tray before leaving.  In my nauseous and pained state, I think I mumbled "yeah," but really wanted to mumble, "that's really weird, borrowing a patient's phone charger."  When Emily arrived, she noted my phone was unplugged; I was just glad it actually got returned.

Alex, the awesome nurse, gave me some Zofran and instructed me to let it dissolve under my tongue.  Emily and I looked at each other and then gave her a confused look.  "My main nurse last night didn't tell me anything, so I just swallowed it whole."  Alex, confused, replied with, "Hmmm...no, Zofran should be dissolved under the tongue."  Yup, last night's nurse wasn't that great either...and this was just one example of how we knew this.

Anyway, the Zofran finally kicked in, thanks to proper medical advice, and so by noon I was ready to have my first ever hospital meal, since I had to let my breakfast sit on the bed tray untouched due to my nausea.  I tried not to go too crazy, to let my stomach start to adjust, but I definitely ate as much as I could.  It felt good to have something in my stomach other than applesauce and water.

During all of this, I had complained that I was starting to feel tightness in my chest and windpipe, likely due to post-op swelling.  While it wasn't causing much pain, I was worried that if it progressed any more, it would start to compromise my breathing and/or swallowing ability.  Alex called Dr. Sigari, and he visited at 10am to check.  He was concerned that there might be a bit of internal bleeding, so he examined what was going on and asked if I could stick around at the hospital until the early evening, just for monitoring.  Worst case, if any bleeding worsened, then I might have to go back into surgery for a repair session.

Yeah, I was not happy about that.  But, Dr. Sigari came back around 1pm to check on me and noted that the swelling had not gotten worse, so he thought things would be OK.  I also started to ice down my neck after his initial visit, so I think that helped.  In any case, he told me he'd return one more time at around 6pm to make a final check and discharge me, so I obliged and began to hang out with Emily.

I said earlier that I'd write more about Emily...she'll get her own post(s) eventually, but I have to point out that she was at the hospital from about 2:30pm to 12:30am, and then 7:00am through my eventual discharge at 6:00pm.  I think that's pretty amazing.

We hung out and watched TV, and several friends came to visit, including my old co-workers from eHarmony down the street, which was nice.  At 6pm, after eating my second (and final) hospital meal, Dr. Sigari came by, made a final examination of my neck, and decided to discharge me.  WOOHOO!

My discharge face.

We thanked our nurses and high-tailed it out of there.  Emily drove me to my apartment real quick to pick up food in my fridge that she had cooked for me and my family for my recovery phase, and we drove out to Baldwin Park.  We got to my parents' house at around 9pm, and my hyper niece greeted me at the door by colliding into my legs and hugging them.  That was nice, but I was kind of car sick from the ride, so I went into my room, popped a codeine, and passed the F out.

And that was my surgery journey.  Next stop, recovery town!

Stupid thyroid.

-W

My Story, Episode V: The Thyroid Strikes Back

The first double-doors opened, and then once the nurse hit a button on the wall, the second set of doors opened automatically, and all I could see without my glasses on was this:

The Bridge of the USS St. John's Hospital.

Well, not really.  But it was bright, everything was white, there were monitors on the wall behind a nurse's station.  Very surreal stuff.

We hung a quick right and went through another set of double-doors, and then we had arrived at the Operating Room.  The dreaded OR.

Artist's rendition of OR.

I could see the large lights hanging from the ceiling, and I could feel the freezing cold.  Dr. O'Neill, who we established earlier was half-Filipino (I, on the other hand, am 100% Filipino), mentioned that one of the OR nurses on my case was Filipino as well.  So I said hello.  Dr. Sigari then chimed in that his college roommate was Filipino, and went by the nickname Lechon (which means whole roasted pig, a celebratory Filipino feast dish).  I joked that he shouldn't talk about that since I had been fasting since midnight.  I think I got a decent laugh out of that one.

Up to this point, Dr. O'Neill had been telling me that he had started giving me something to relax, but I didn't really feel like anything was hitting me.  Maybe that meant it was working.  In any case, this was the point when he started to lean into my ear and talk to me.

Dr. O'Neill: "So, Walter, where do you want to go?  What's your favorite city in the country?"

Walter: "Umm...New Orleans!"

Dr. O'Neill: "OK, great.  So when you get there, what do want to do?"

Walter: "Well, I'd eat food...and then..."

Then I woke up in the recovery room.  

Anesthesia is a funny thing.  It is very deceptive.  As soon as I came to, mentally I thought I was pretty much 100% alert and functioning.  I spent some time with the post-op nurse, whose name was Destiny (how...profound).  While I recalled having some full conversations with her, she only recalled me mumbling various attempts at sentences.  When I was more alert, my parents and Emily came in to say hello.  I remember bragging to them how great how felt and how alert I was, proud that I wasn't going to be one of those people who mumbles embarrassing or offensive things coming off of anesthesia.  Apparently, this translated into me repeatedly using the word "lucid" to describe my mental state.

This would be my last smile for about 14 hours...look at me, so naive of the pain that was to come.

In any case, a little after 10pm it came time for my parents to leave, as they had to pick up my sister and her family at LAX and bring them back home, as they were flying in to spend the weekend with me as I recovered.  This left Emily with me, and I was so glad she was there.  I remember feeling bad as it was probably pretty late at night and she was probably getting sleepy, but in any case, she stayed with me until it was time for me to get transported to my observation room.  I said goodbye to Destiny, who game Emily my eventual room number.  Emily headed down to the room, and I waited for the transport guy.

He came over and then started wheeling me down.  I took an elevator to the first floor, and then I arrived at my home for the next day.  It was right when I got here that sadness hit me...the anesthesia was wearing off, and quickly.

I immediately became overcome with nausea, and vomited into the kidney bean shaped bin that I think is supposed to be for brushing your teeth.  Emily, poor Emily, helped me with that.  She left around half an hour past midnight, and I was left with two not-so-good nurses, and screamers down the hall.

Throughout the night/early morning, I would awaken to screams of patients coming from other rooms.  Some of the screams were obviously over-dramatic, others were from patients who were sadly not at full mental health.  Whatever the case, it did not make for a pleasant start of my recovery.  I remember being awake more than being asleep, and started to see the sky get lighter outside my window as the sun came up.

-W

My Story, Episode IV: Surgery Day

With the surgery 3 days behind me now, and things quieting down as I recuperate at my parents' house, it seems like a good opportunity to recall the entire experience of my first hospital stay ever...

I had gone to my parents' house the day before the surgery, in order to unpack all my stuff and get ready for my time at the hospital.  Once I was discharged, we had decided that I would recuperate there, so that I could be under the watchful eye of my recently-retired parents.  The 24-hour countdown clock had begun, and I couldn't think of anything better to do with myself except play Hearthstone on my tablet.  Really meditative/introspective stuff, I know.

My pre-operative preparations.

It was also around 7:45pm that I had my final meal.  The pre-op instructions stated that I couldn't eat or drink anything after midnight on the day of my surgery, so I tried to eat a larger dinner than normal.  After a small sip of water around 11:30pm, I went to bed.

It's really weird to say, but I was never really nervous or anxious on the day of the surgery.  It just felt like something I had researched so heavily that I had somehow tricked myself into thinking I knew precisely how the next 24-48 hours would go.  I woke up, didn't join my parents for breakfast, played more Hearthstone, packed up my overnight bag, didn't join my parents for lunch, and played more Hearthstone.  Around 12:30pm, it became time to go.  We had to get all the way out to Santa Monica, and President Obama was landing at LAX at approximately 2:20pm.  

We got to the hospital, left the car with the valet (the hospital's only parking option was valet...go figure, Santa Monica), and went inside.  We went to the information desk and checked in, and they directed us to a waiting area on the second floor.  We got to that area, and the woman at the desk told us that this was the POST-op area, and directed us to the pre-op registration room on the other end of the floor.  We walked over there and were greeted by a dark (literally half the lights were off) reception area with an empty reception desk.  We then went down the hall, and someone directed us to the Diagnostics reception area on the first floor, which became the surgery pre-op reception in the afternoon.  Going downstairs, we took a wrong turn and were told we were at the emergency room reception area.  That guy then directed us to the Diagnostics lobby...and then we finally found the right place!

After checking in and signing several forms, the receptionist walked us to the second floor and into the real pre-op registration room from earlier (where the lights were off).  We buzzed the door and a nurse greeted us and escorted us into the surgery pre-op room.

I know all of that sounded like it took forever, and quite possibly it did, but at this point everything felt like it was going at super speed.  After speaking to the nurse and getting a brief orientation, I disrobed and was lying on a bed in my surgery gown.  I don't remember what time it was exactly, but I felt like I went from exiting my parents' car to naked in about 20 minutes.

The nurses were great.  The first one stuck a tube into my gown that was blowing hot air, something about how regulating the body temperature within the gown (which I then realized was somewhat air-tight) helped with patient comfort.  So, once the air started flowing, I looked kind of like this:

LOVE ME.

So...was it comfortable?  You're damn right it was.

I wish I had this in my living room.

It was at this time that I also got my first IV line ever.  It was weird, but the nurse was very sweet about it when she realized I had never had one before.  She even congratulated me.  It certainly felt like my greatest accomplishment in life up to that point.  Have you ever gotten an IV fluid drip?  The cold sensation in your arm is the strangest thing.

With all that done, I looked on the clock and realized we had about an hour to go until 4:00pm showtime.  Emily arrived during all of this.  Because I was the last patient in the pre-op room, the nurses pretty much threw the "one person at a time" rule out the window and let all three of them hang out with me, which was really nice.  My good friend Esteban came from work some time around 3:30pm, so we chatted a bit.  My surgeon, Dr. Sigari, also arrived during this time, so he met everyone and answered any last-minute questions that we had.

Maybe 10 minutes before 4pm, my anesthesiologist, Dr. O'Neill, came by to give me the orientation.  All the nurses had been singing his praises, and it was fairly obvious why.  He was very charismatic, and easy on the eyes for the ladies.  I was instantly jealous of his good looks and likely income level.  He walked me through what was going to be happening and what his job was going to be during all of this (i.e. make sure that I don't wake up).

Surgery is...fun?

This whole time, I had clear view of a wall clock across the room, so I knew exactly how close 4pm was.  And sure enough, at 4:06pm, I was told that it was time to say adios to my family and friends.  I handed my glasses to my mom, and they started wheeling me toward the double-doors at the end of the hall...

Read on, reader.

-W

Mission Accomplished

...more updates later on.

-W

It's the Final Countdown

A magician named "Gob."

It is indeed the final countdown.

Tomorrow (Thursday, June 18th), at 4:00pm, I will be in the operating room at St. John's Hospital in Santa Monica.

It's a weird feeling.  I've been busy over the last four weeks; doctor's appointments, transitioning at work, telling people about my cancer, getting all my paperwork and such in order.  

Now, on Surgery Eve, I'm alone with my thoughts.  Well, not really alone, I'm at my parents' house, since they'll be taking me to the hospital and then I'll be recovering here for the next week or so.

I'm not really sure it's fully hit me yet, my diagnosis and what is happening to me.  I'm worried it's going to hit me like a ton of bricks tomorrow when it's time to change out of my clothes and into a drafty hospital gown.  I hope I can be calm though.

I just had dinner at around 7:45pm.  That will be my last meal for about 24 hours.  I can't eat or drink anything (including water) after midnight tonight.  I feel like I should have gone to Soupplantation and ate all I could eat...and maybe hide out until 11:59pm to get my last bit of food in.

Just add Jesus, and this is what heaven looks like.

Emily sent me home with food that she made, an orzo salad and a soba noodle salad.  I may sneak that in before going to bed as my official "last meal."

I don't really know what to do with myself at this point.  I'm slightly nervous, but I'm not tense, and I'm not a wreck or anything.  I guess when I wake up, I'll still have several hours before it's time to drive out to Santa Monica, so maybe that's when my nerves will start to act up.

Also, I found out yesterday that President Obama is in town tomorrow.  He lands at LAX a little after I'm due to arrive at the hospital.  Really nice of him to show his support in person.

Obama-rama.

I found out I had cancer almost exactly 4 weeks ago.  4 weeks of waiting for the surgery seemed like it was so far in the future.  Now, it's pretty damn freaky that the day is here.

Anyway, I'm rambling now...although I guess it's not much different from the rest of this blog.

Wish me luck!

-W

A Weekend Escape

With my last day of work being the Friday before the surgery, Emily and I headed out of town for the weekend for a much-needed escape/  Her sister and brother-in-law had been so kind as to offer some of their Hilton points that they hadn't been using since they had become new parents, and though I wasn't sure about taking them up on the offer, I reluctantly accepted.  Man, I was glad I did.  After weeks of appointments, late nights at work trying to transition work off of my plate, and generally increased stress-levels, I found myself desperately looking forward to the weekend.

Our destination was sunny San Diego, CA.  After getting off of work, we started the drive down and got to our hotel by about 9:15pm.  We checked in, and took in the scenery of our corner room:

Petco Park, home of the Padres and about a decade of "sports."

It was a great weekend.  While it was cloudy all weekend, we had a blast!  Had an excellent beer at Ballast Point (Big Eye Ginger), walked around Little Italy, took in the Gas Lamp (my first time), and had amazing meals at excellent restaurants.  We even got in some pool/jacuzzi time during the half hour that the sun creeped out.

The weekend ended with the Dodgers vs. Padres at Petco Park.

Let's go Doyers.

Emily's family friend got us tickets, which was great.  We actually stayed through the middle of the 6th inning, when it looked like the Padres were going to win.  It wasn't until we got back to LA that we learned the Dodgers made a comeback and won.  Whoops.

-W

The Value of a Second (or Third) Opinion

Before all of this happened, I don't think I really understood the value of a second opinion.  Perhaps I figured I'd never be in a position in life where I'd need one.

Even as this whole process got started, I decided in my head that I really liked my ENT surgeon, and so I would stick with him and whatever endocrinologist he recommended, and that would be that.

However, that didn't end up being the case entirely.  The first item of business was my ENT surgeon.  I knew Dr. Sigari was my guy, since it was because of him that my thyroid nodule had been followed so diligently in the first place.  However, everyone I spoke to and all the literature that I read said that you should almost always get a second opinion, if anything just for peace of mind, and that at worst it would cost you time and a copay.  So, even though I (for some reason) felt like I was turning my back on Dr. Sigari, I found another ENT online and made the appointment.

I was definitely glad that I did!  While our meeting was brief, this ENT surgeon did many things for me:

1) Confirmed that she knew Dr. Sigari, and that he was a good surgeon,
2) Revealed that she herself had thyroid cancer 2 years ago!  At that point, I saw the scar on her neck and ultimately realized she knew exactly how I felt!
3) Confirmed that Dr. Sigari's intention of not removing any lymph nodes unless they appear abnormal was a sound strategy, given the relatively low risk level that my case appeared to be at.

With a surgical second opinion out of the way, I turned my attention to the second, and perhaps more important doctor that I would need on my team: the endocrinologist.

Making calls to various endocrinologists around town recommended to me by various people including friends of friends who had thyroid cancer in the past, and my girlfriend's cousin who works as a pharmaceutical sales rep, I made a very shocking realization: Even though my surgery wasn't for about 3 and a half weeks, most endocrinologists don't tend to have openings until about 6 weeks out.  And that was even after I told them I had thyroid cancer!  I don't know how diabetics get treated, with endos being such a hot commodity.

In panic mode, I made appointments with any endocrinologist in the greater west Los Angeles area who had any kind of availability before June 18th.  In all, after at least 10 phone calls, I had lined up "auditions" with three endocrinologists.  As the endo would be the one monitoring my hormone/blood levels and arranging the radioactive iodine treatment, I knew this would be an important decision.  Even though it felt like I had another full-time job, I proceeded with my auditions.

First up was a random endo that was pretty far south of me, in Redondo Beach.  She was very sweet, and in our discussion she revealed that she was in the middle of breast cancer treatments, having already gone through chemo and waiting for her second surgery .  Yikes!  What was with all the cancer-surviving doctors these days?  Not complaining though, it certainly promotes an aura of sympathy.  In any case, I liked her a lot and she seemed knowledgeable, so at that point my nerves started to calm as I knew I wouldn't be left stranded without a thyroid or an endocrinologist.  Solid backup plan, but perhaps I could find something closer to home.

The second endo was the train wreck...and to this day I haven't met (nor do I think I ever will meet) the actual doctor.  This was the endo across the street from my ENT surgeon's office, so it is where he tended to send most of his patients.  I called and told them I had thyroid cancer, but they said the endo didn't have availability until after the surgery.  So, I asked if there were other doctors in the office, and they said there was one more.  At this point, I was just in pure research mode, and I thought it was more important for me to just get my ass in front of an endo, and not necessarily find the right one.  They said they coujld get me an appointment with him, but if I did see him, then I couldn't switch to the doctor that my ENT surgeon was referring to me.  Something about two doctors and two separate businesses, so they couldn't allow patients to switch between the two.  Seems like an arbitrary rule to be putting on a paying customer, but at that point I made the appointment with this secondary endo (who has some terrible reviews online, btw), just as a placeholder.

A couple of days later, the lady in the office called me and said they received my charts from Dr. Sigari, and so they wanted to get me in the office to see the endo's nurse practitioner, to get the process started.  At this point, I'm confused, as telling them I had thyroid cancer didn't spark any sense of urgency on their part, but now that they had my paperwork, they were going to make accommodations?  And even then, just to see the NP?  Fine, whatever, so I made the appointment.  Once I finally got in there, I see the office, which is definitely the darkest and dingiest office I've visited during this whole experience.  After a very long wait, I finally met with the NP.  She was perfectly nice, but was unable to answer my more detailed questions and said they were best asked of the doctor.  And then she said she would walk me to the front desk to make sure I got an appointment with the endo before my surgery.

Wait...what?  I suddenly got pissed.  I had to deal with a run-around from the front desk and making an appointment with a sub-par doctor who shares the same office, but who this endo seemed to avoid like the plague.  Then, when my surgeon's office "proved" I had cancer, I got the privilege to be "screened" by her NP, I guess to confirm again that I had cancer, so that I could get forced onto the endo's schedule?  How did my first phone call not accomplish any of this?!?  Needless to say, this endo dropped to the bottom of my short list.

My third and final meeting was with Dr. Janet Winikoff at UCLA, in Santa Monica.  I got to my appointment early, took the elevator up, and went into the beautiful Endocrinology waiting area.  The front desk staff was friendly, as was the nurse who took my blood pressure reading.  So far, so good.  As I waited in the exam room for Dr. Winikoff to come in, I looked to my left out of the floor-to-ceiling window and saw this:

Fun fact: Not the Santa Monica Church of Scientology.

My fate was staring at me through the window.  It was St. John's Hospital, the site of my future thyroidectomy.  Eerie.

Dr. Winikoff came in, an older lady who was nice and polite, but could be just a little blunt and prickly with her answers/demeanor.  For some reason, I took a liking to her.  She took her time answering all of my questions; our meeting must have taken about 30-40 minutes.  She was very thorough, and by the end I was sold.  When she asked where I was having my surgery, I pointed out the window at the hospital across the street.  She then looked at her schedule and realized that it was possible she would come over to check on me after my surgery, but if not her, then another endocrinologist from the same office.

It all seemed to come together with that meeting.  I was locked in with my surgeon, and I had found my endocrinologist.

Most of my anxiety went away at that point.  There were no more appointments to have before the surgery.  I just had to wind down at work, and then prepare myself for my date with the operating table.  It was time to do this.

Arnold doesn't like thyroids either.

-W

P.S. When I tried to call that second endocrinologist to cancel my appointment, I remembered something else that ticked me off about calling them.  Their system didn't have the ability to put people on hold, so after a few rings, if no one picked up, I got a message saying they were busy, so I had to leave a voicemail.  I remember calling a few times within the same hour span the first time just to talk to a live person.  So, I cancelled via voicemail, and never heard from their office again.