low

We did some shopping over the weekend.

Young Chang Y-131 52" upright, aka "a real piano"

Sounds phenomenal, and plays like a concert grand. It's to be delivered Friday, and we are all very excited for its arrival. The old Reed Music Co. console has been dead for a while, and I just didn't want to admit it. I only realized how bad it was when I started practicing a new piece, and now I feel rather bad about having the kids play on such a wretched piano for so long.

Still, I'm feeling beset from all sides. There are no new catastrophes to deal with, and I'm matter-of-fact about my follow up tests, now. I just don't like how any happy news only "sticks" for a moment or two and then I'm right back down in the pit. I'm not sure what's going to get me out, although a clean PET/CT scan would probably do it.

Retail therapy is usually a lot more effective.

next...

After three rounds of telephone tag, my endocrinologist's nurse/manager finally called me at a time when I could answer my phone. (The messages we were leaving for each other would have been hilarious if they had not been so frustrating.) The conversation was brief; the nurse manager is refreshingly direct. It's all well and good that the biopsy came back negative, but given that my tumor marker is increasing, the endo wants me to have a PET scan.

That is quite a reasonable course of action, and it aligns perfectly with the ATA guidelines for this situation.

I've never had a PET scan, but it doesn't sound much different from other scans I've had. I tend to doze off during whole body scans, since they are silent and take about 45 minutes. I'm quite happy to hear that this scan will not involve the horrible banging and clicking and buzzing of an MRI.

Scheduling this will be interesting. DS1 will be having two different oral surgeries in the next month or so, plus we've got two more debate tournaments, DS2's field hockey tournament, and spring break coming up as well.

DS1's surgery and the State tournament make extended travel that week impossible, but I'd love to get away for just a day or two. I just have to figure out how to do that.

status quo

Finally spoke to the doctor today. The results were good, in that they didn't find any evidence of thyroid cancer in the samples they took. However, as always, the pathologist did that CYA routine where he noted that the conclusion is only valid for the materials that were extracted and that we can't be sure there isn't something going on in all the stuff that was left behind. To be really really sure there's nothing going on, you have to do a surgical excision.

The ENT thinks that's overkill, and I agree, but given my rising tumor marker (Tg), we are leaving it up to my endocrinologist to make the call as to what tests to do next.

So I still don't know what's going on, but I'm so used to it by now it doesn't make a difference.

I stayed late after school today so I could go with the high school science club to the open house at Microchip, part of the Arizona SciTech Festival. It was a great event, and the kids had a fantastic time seeing all of the cool technology and how it's applied.

It was a wonderful tonic for me, too, as I have been struggling so much with my students. So many of them just don't want to be there or put in any effort at all that it is disheartening. It was a joy to be around students this evening who were engaged and interesting and polite and fun to be with.

missed message

I clung to my cellphone all afternoon so I wouldn't miss the doctor's call with my biopsy results. Of course, that's what happened anyway, when I set my phone down at the music studio this evening (kids' piano and voice lessons) and didn't hear it buzzing when he called. I did not expect him to call at 6:24PM.

I can call him back tomorrow after 1:30PM, he said, "to discuss the next steps, given the biopsy results," which of course he did not divulge.

(bangs head against wall)

There are three possible outcomes of any FNA. Positive, they found cancer cells. Negative, they didn't find cancer cells. Indeterminate, they didn't find much of anything and are unwilling to say anything about what they did find.

Pretty much the only difference that would come from one result versus another is the type of tests that are ordered as the next step. If it's negative or indeterminate, it might be OK to put off further testing until the summer. If it's positive, that may be reason enough to try to move things along more quickly.

Tomorrow I'll find out what I should already know by now, but really, one more day isn't going to make that big a difference.

back in the real world...

Yeah, expecting to hear results after a mere 48 hours was a pipe dream. I still haven't heard anything.

On the other hand, I spent all weekend cooking and eating, as DS2 turned 11 and had a sleepover party, necessitating brownies, cupcakes, and fresh-squeezed orange juice, among other things.

My neck hurts less than it did last week, but still isn't "right", and I have a headache most days which Tylenol helps but doesn't eliminate.

I go long stretches without thinking about the cancer situation, mostly because I have that "beating my head against a brick wall" feeling regarding my teaching. The class average for my seventh graders on our last quiz was 8/20, and I fear that my eighth graders will do just as poorly on the quiz they are having this week. In one review session this morning, I said something like, "The last question is something we talked about during the lab last week." One student -- a pretty good student, too -- replied, "But that was on Thursday, I don't remember anything from that far back!" The lack of continuity and opportunities for repetition over time in the block schedule is killing me.

In spite of that, I know I'm a better teacher this year. It's such a shame it won't be reflected in any of my students' standardized test grades.

group

An hour goes by fast when you're talking to, with, and about other people's problems. It went by so quickly today that I didn't get a chance to mention my biopsy, and no one noticed the faint bruising or swelling under my jawline.

I did get a chance to talk to my co-facilitator to let her know what's going on. She has her own distractions to deal with. We left it at keeping each other posted if we hear any news, especially if it means we won't be able to make the group. There's not much else we can do at this point.

that was easy

Well, as easy as could be expected.

I had a very kind and competent ultrasound technician and an equally kind and experienced radiologist for my FNA biopsy today.

As these things go, that was the best so far. The doctor used an absolutely tiny needle to administer the anesthetic, so it burned much less than it has in the past. He made four passes at the lymph node, and the sensations of the needle hitting the node and then drawing out its contents were painful in a way that is hard to describe if you haven't experienced it. It just 1) feels weird and 2) hurts to have someone poking around your innards, no matter that said innards are fairly close to your skin. But today the pain was bearable, maybe because I've been through it before and knew what to expect, or maybe because I have so much residual nerve damage in my neck from previous surgeries that I literally couldn't feel it as much as I have before.

Whatever the resaon, it wasn't nearly as painful or exhausting as it has been in the past. I'm left with a slight bruise but it's in a location that most people are not likely to notice.

The doctor made a point of showing me the node-with-needle image on the ultrasound, so I could see how well he was able to target it (very well). I asked him if I could see how vascularized it was, and he was very obliging, and had the tech image the node and turn on the Doppler, and then freeze the image so I could turn my head to see it. There were 4 tiny red specks around the perimeter, and no signs of calcification. I would have preferred only one tiny red speck, but the 4 tiny specks were not so bad. If there's anything going on in there, it's just getting started.

The tech told me that my ENT would have results "within 48 hours," which approaches miraculous. After that, I have no idea.

habituated

It took a little more than a week for the shock to wear off. Now I can go entire consecutive hours without thinking about the fact that I have a recurrence (of indeterminate size) and that I am having a biopsy tomorrow.

Then I remember.

It's surprising how future-focused day-to-day life is. With school, it's planning the next lesson, and the lessons for the next day and the days after that, all the way out to spring break. With my family, it's figuring out who has to do what, when, and who needs a ride where, and all that.

What we'd like to be doing, what I would be usually doing at this time of year, is planning our spring break activities and starting to look at flights back east for the summer. That's where my mind goes when I forget, and then I remember.

next step

I'm scheduled for a biopsy on Wednesday.

I've said it before and I hope I never have to say it again, but a day that includes the decision to jab needles in my neck is not a good day. There is no way around that.

My ENT assured me, several times, that even though I have a recurrence, it won't kill me. Of course he didn't use those words, since he has both tact and charm, but that's what he meant. Me, I can be as blunt as I want in my blog.