Wednesday, February 17, 2010

These Boots Were Made for Walking

Continued from here

There ought to be a rule for surgeons - no haircuts the day before surgery. Some young rookie lookin' doctor showed up to discuss my surgery with me minutes before I headed back to the OR. Underneath all that mountain man hair, my doc had a baby face - who knew?

I'm not sure which look was worse, mountain man or newbie. Once I got over the shock of that, we went over the particulars again. My nurse could not place an IV in me to save her life - 3 blown veins. So I asked if the anesthetist could do it, he knew his stuff and got it on the first try.

The next thing I knew, I was waking up to the sensation of someone squeezing my feet and pointing my toes - first the right, then the left - back and forth. It was a pair of mechanized booties designed to simulate walking and deter any blood clots (good for your health, but not so much for sleeping). I could not talk, had a throbbing ache at the base of my neck, and felt like I had eaten a pair of wool socks - so scratchy was my throat. I was vaguely aware that it hurt to turn my head. One thing they are quick to do in post-op care is to get you on pain meds. You have only to blink funny and they will bring you a darvocet or some other such pill of peaceful oblivion.

The surgeon told me that the tumor had invaded some nearby neck muscle and he'd had to remove a strap muscle. There were numerous tumors in the left side of my thyroid as well. The cancer had been headed for my voice box next, so it was lucky we got it out when we did (not too sure the kids feel the same about that). The frozen section came back positive for papillary thyroid cancer. He had been able to save my parathyroids, but they monitored my calcium levels to make sure they had not been too traumatized by the surgery.

Because I was under 45 when I was diagnosed the survival rate to 5 years out was 97% - very good news. I stayed in the hospital for about a day and a half and then went home to rest up. In the days that followed, we heard back from pathology that one of seventeen lymph nodes taken was positive for the cancer and the size of my tumor was 1.6 cm in diameter. An appointment was made for us to meet with an oncologist.

One other thing, no one had told me about the wonder that is a surgical drain. I went home with a test tube on the end of a length of catheter tubing poking out of my neck. It was a surgical drain stitched into place. I was to change the tubes and record the fluid amounts and colors as it filled. I have done some pretty grody stuff in my life, but that one is up there near the tippy-top.
I remember feeling good enough to help out in Michelle's class at school, while there a remarkably astute 2nd grader looked up at the dressing on my neck and the tube disappearing into my shirt (where the vac-tube was nestled in my bra) and asked me about it. I told him I had had an operation on my neck. He thought about that a moment and then said, "Lady, they forgot to take some of that stuff out of you." Like I didn't know I had a 12 inch length of catheter tubing hanging out of me. Just for kicks, I pulled out the test tube full of surgery drainage and showed it to him.

Was that evil? Nah, but perhaps a whole lot of misguided fun. I'm blaming the pain killers.

Maybe collecting the ooze from my neck was nasty, but it was nothing compared to the feeling when the surgeon said this might hurt just a bit and he snipped a stitch and pulled that tube out. It must've been buried about 3 inches into my neck and fished around my esophagus. I cannot describe it but I never want to go through that again. Gross.

Usually I heal fine and my scars turn out lovely, but this time was different. The doc likes to look at my neck and tell me he can fix it (um, no thanks - I'm okay with my Franken-neck).

I met with the oncologist - a woman whose typical patient suffers from breast cancer. The first thing she told me was that I had the "good" cancer. This was the third doctor to tell me this and I was not amused. I can appreciate the fact that she sees several women far worse off than I everyday and that I will most likely not die from this cancer - but it really isn't something 'good' to have. Nobody says, "Hey, can I have me some of that? That's the good cancer you know - I'd like double."

Cancer or disease in any form is a major inconvenience and usually it's still painful. Please doctors, don't discount your patients and what they are dealing with.

Okay, off the soapbox now. The oncologist, which is a fancy name for bad a** cancer doctor, told me that I would have to allow my pituitary to realize that I didn't have a thyroid anymore, thereby making it send out signals to tell existing thyroid cells to make more. While it sounds counter intuitive to force the cancer cells to reproduce, it is what lets them know you are ready to nuke the hell out of the cancer.

With thyroid cancer, you don't do chemo and rarely do you do beam radiation, rather you nuke it from the inside out. Literally. But, I'm ahead of myself. Your thyroid is an important part of your body, it takes the iodine found in different foods and converts it to thyroid hormones, and releases them into your bloodstream where they control your metabolism. Every cell in your body needs thyroid hormones to regulate their metabolism. Know what happens when you don't have enough thyroid circulating?

Everything sl o w s d o w n.
Like that. And when you are thyroid deprived and getting prepped for a Radioactive Iodine scan and potential treatment - you must eliminate as much iodine as possible from your diet. Which is actually quite a healthy way to eat, but requires mucho effort on the part of the patient.

Some of the side effects of being hypo (very low) thyroid are slow reflex times, poor concentration and memory, depression, hair loss, extreme fatigue, feeling cold all the time, and last but loveliest - potential tremendous weight gain. It is basically like you are living under water in a very cold swimming pool. Everything moves slowly and you freeze your butt off, and you can't spell to save your life.

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