Beginning of my thyroid journey

This is going to be quite a long post since it's the first one. I'll start from the beginning.

In July, when I was on my clinical rotation in Austin, I noticed my neck looked swollen on the left. I thought this was very strange, but I also wasn't sure if I was seeing things since I had never noticed it look like that before. Maybe it was my shirt that accentuated that part of my neck? How long has it been swollen...weeks, months? I was baffled, but being in PT school, I knew that it was where my thyroid should be. I leaned my head back to check my thyroid size and, sure enough, my left thyroid was slightly larger than my right. 

I asked around and everyone told me to go see a doc just in case. I got in to see a doc in Austin by the end of that week and they did blood work and an ultrasound. I explained to her that I felt like I had some symptoms of hypothyroidism, but I've had those for a while and I always have a reason for them, so it didn't really strike me as something I should have been concerned about until now that I noticed my enlarged thyroid. My blood work came back normal. The ultrasound, on the other hand, detected a mass that she said was 1.5cm in size. She wanted to do a biopsy because of it being larger than 1.3cm. I didn't want to continue my care in Austin, since I don't live there and commuting back and forth for thyroid stuff is dumb, so when I came back to Houston and saw my regular doc at the beginning of August, he referred me to an ENT. I saw the ENT on the 15th and he agreed about the biopsy and I had that done on Wednesday, the 24th. The ENT office called me Thursday and scheduled me in Friday the 26th to discuss my results. Never once did I think it would be cancer because every single doctor said, "The likelihood that it is cancer is very slim (5%) and you shouldn't worry about this at all...I'm sure it's nothing. They are almost always benign."

Friday morning, August 26th, the day before my 35th birthday, I went in to the office and I was very nervous. My blood pressure was sky high! I sat down in the exam room and he came in. He sat down and said, "Well, the biopsy came back as positive for thyroid cancer." Wait...what? Did he just tell me I have cancer? I'm young, healthy, do everything I can to take care of myself health wise, I hardly ever go to the doctor because I'm rarely sick, what?! This really isn't happening to me. This is a bad dream and I'm going to wake up tomorrow and this will all have been a dream. The next thing I heard him say was, "It's treatable and curable". So yes, I have papillary thyroid carcinoma. Luckily, I am young and the diagnosis was the best I could have received because this is the least invasive and most curable cancer. However, I am now going to have to have my whole thyroid removed because they can't risk cancer coming back on the other side. He wanted me to have surgery by mid-September. I told him if we could wait until October, that would be better because I was supposed to start my clinical rotation that next Monday. He wasn't too happy about me saying that, but he said we could work with that if that's what we have to do. 

After the appointment, I had to figure out what was going to happen with school. I spoke to the director at my school and she gave me an option for the remainder of my program. I could defer this clinical rotation and get all my medical stuff dealt with now. Go to classes with all of my classmates in October like normal. Do my clinical rotation that should have been done now in January instead of my internship. Walk in May with my classmates. Do my internship in the summer and get my paper diploma in August after I'm through with my internship. At first, I absolutely did not want to do this because I have been in this program long enough and I just want to be done. She told me that missing classes in October for a week is NOT possible because that would be like missing 3-4 weeks of classes since it's a short semester. So, after speaking with my parents about it, I took her up on her offer. This will set me back slightly with school, but not too much and I can still take the board exams in July if I want to or I'm feeling ready for them. The boards are also offered in October, so I could do that if I needed to. I'm feeling at peace with my decision about school and glad I'm not doing my rotation right now because dealing with the tremendous amount of doctor appointments would have been a nightmare if I were in the clinic. 

I saw my endocrinologist for the first time on Aug 31st. He was very nice and he is one of two doctors in the office that treat patients post-thyroid cancer. He spent a lot of time with me and explained everything so calmly. During that visit, he did another ultrasound to ensure that the cancer hasn't spread to my lymph nodes. Turns out my mass was actually measuring 4cm! That's HUGE! He only found one lymph node that was enlarged with something questionable (the rest looked good), so he did a biopsy of that one. All in all, it was a positive visit and I felt encouraged about the life-long relationship I will now have with an endocrinologist. I have heard horror stories of people switching endocrinologists many times until they found the right one for them because the endocrinologist just looks at the numbers and not them as a person and how they're feeling. I hear the hardest part of this entire journey is finding the right balance of medication to make you feel semi-normal again. I'm honestly not looking forward to taking medication every day for my entire life, but it has to be done.

Yesterday, I had my pre-op appointment with my ENT. He informed me that my lymph node biopsy came back benign, which is excellent news! This means that I will not have to go through a lateral neck dissection surgery to remove that lymph node, so the surgery will be a routine total thyroidectomy. I'm a little nervous about the whole thing because I've never gone under general anesthesia before and the only surgery I've ever had was to remove my wisdom teeth when I was in high school. Thankfully, I have my family who will be there and many friends who have offered to come visit or help in any way they can, so I know I have a huge support network cheering me on. Naturally, my blood pressure has been through the roof lately because all of this has been slightly quite stressful. For the most part, I've tried to remain as calm about this as I possibly can. No sense in getting overly and outwardly stressed about it because that doesn't do anyone, especially myself, any good. Some days are harder than others stress wise (mostly days when I'm scheduled to see a doctor), but I've been doing things to keep myself busy like reading all three books in the Miss Peregrine's Home for Peculiar Children series or going to IKEA, buying, then building a bookshelf so I could organize my son's books that have been strewn all over our bedroom floor for the longest time.

So what's ahead? 

They'll remove my whole thyroid. My surgery date is September 12th. One week after surgery, I will start to eat a low-iodine diet to ensure that my body is starving for iodine. Three weeks after surgery, I'll then have to do radioactive iodine (RAI) treatment where I'll be secluded from literally everyone for a few days. I swallow a pill and then any thyroid cancer cells or any thyroid cells that are left will soak up the iodine and die. After that, I'll have a nuclear body scan done to make sure all the cancer cells are gone and I'll have to do those once a year for 5 yrs to ensure that I remain cancer free. I'll also be put on thyroid meds for my whole life since I will no longer have the ability to produce those hormones naturally. Good thing is that once I have surgery and go through the radioactive iodine treatment, I should be cancer free.  One bummer though is that, ideally, I need to wait 2 yrs after the RAI treatment to even start trying for another baby. That wasn't quite the timeline Hector and I had anticipated, but we will do what needs to be done to ensure a healthy mommy and healthy baby. 

I will be out of commission: no lifting, exercising, or driving for about 2 weeks after surgery. I'll meet with the ENT on the 20th to remove my stitches and Steri-Strips and then later that afternoon, I'll meet with the endocrinologist to ensure that my hormone and calcium levels are moving in the direction they need them to go. 3 weeks after, if my levels look ideal, I'll do the radioactive iodine treatment. I'll have to be about 6ft distance from anyone and I have to follow certain precautions when eating, drinking, showering, etc to contain my body fluids and make sure they don't come in contact with anyone. After those 2-3 days, I'll be able to be around anyone, but can't sleep in the same bed as Hector or HG for 21 days (which will be super hard on HG) and I have to limit my time in close proximity to them since I'll still be slightly radioactive and the doctors don't want me to expose them to too much radiation. I need to make sure to ask if I can lay with him until he falls asleep and then move to the other room. Last thing I want to do is expose him to radiation!

How did I get thyroid cancer?

No one knows exactly. I don't have any family history of any cancer. But what I've read about thyroid cancer is that it is most prevalent in women ages 30-50 and higher incidences are recorded in individuals who have been exposed to excess radiation as young children or young adults. Only thing I can think of is dental x-rays...maybe they didn't cover my thyroid like they should have. Who knows? Oh well...only thing now is to spread the word about thyroid cancer and how it can be prevented. From here on out, I will make sure to demand my son's thyroid be covered at all dental appts where he will need x-rays and tell other mom friends of mine to make sure they themselves and their children to take precaution when having any sort of x-rays taken.