yay!

The scan was clean. (Some close to me are saying "of course," but you know, I try not to count on that.) My next follow-up will be my usual 6 month ultrasound & bloodwork, both painless (mostly) and inexpensive. I can get that done in July before the new school year starts up.

How wonderful to be able to make plans now!

scenarios

If the scan was clean, then whatever is making my tumor marker rise is too small to see by conventional methods, so no treatment is indicated now. I'll be subjected to "watchful waiting" for the foreseeable future to keep track of my numbers. The relief I feel at not needing treatment will be offset by my annoyance at having to go through all this hassle and expense only to end up with essentially no data.

If the scan showed one or two small spots, then the situation is slightly more complicated: I could go for treatment or I could stick with watchful waiting, perhaps tweaking my medication so my TSH is even more suppressed. I will feel some relief at knowing the current state of my disease progression. This will be offset by my anxiety over the sure knowledge that my cancer is back again, which in turn will/may be balanced by the fact that it took over 6 years to show up again. This particular see-saw doesn't stop there, though, because, you know, Dr. Clayman promised he got it all, and I believed him.

If the scan shows enough disease progression to require treatment, I will get the treatment, of course. It will most likely be surgery, unless it's in an inoperable place, which would be weird, and would then probably need some kind of external beam radiation. Ick. Sometimes I'm afraid that my undiagnosable headaches from a couple of years ago (which never went away, I just know how to manage them) are actually from metastases, but that's really unlikely.

Options 1 and 2 have me planning my summer vacation Tuesday evening. I'm looking forward to that. Option 3 is not exactly unthinkable, and it really does help that I've been through a neck dissection before, but I don't have any feeling about this one way or the other. I just don't know.

My general response to this situation is: I don't have time for this. Can't you see I'm working here? I'd like to continue to do that, OK? OK.

fake

Today at the end of my prep hour (in which I - for once - did actual lesson planning) I noticed that my endocrinologist's office had called. In the vastness of my classroom, I rarely hear my cell phone vibrating.

I tried to call back but got funneled through to voice mail and gave up, only to find that they had left me a message. I felt distinctly uneasy -- why are they calling me today, my appointment's not until Tuesday, they wouldn't be reminding me so soon, so there must be some news...

No such luck. The message was a simple appointment reminder. Still don't know whether I'm coming or going.

[It's not that I don't work during my prep hour, it's just that lesson planning is usually my Sunday evening activity. Prep hour is usually for cleaning, assembling or putting away lab supplies, grading, updating the gradebook, or writing tests.]

unhome

Ninja dishwasher -- so quiet you don't know it's there

So last weekend DH says, "Let's get a new dishwasher." This wasn't totally out of left field since we'd had to prop the old one closed so it would run. Still, I was surprised, because the broomstick wasn't that much of a pain to deal with. We went to the Sears Appliance Center down the street and bought a dishwasher. (We tried Spencer's first, but they were closed, and we were impatient.)

It was installed yesterday in between doctor's appointments and A/C maintenance and making Boston Creme pie for Pi Day.

Not pretty, but tasty: yellow cake, pastry creme filling, and dark chocolate ganache

We bought a new refrigerator, too, simply because the old one was 16 years old and that in itself was something of a miracle. Better to plan the switch than have to deal with it on an emergency basis. The new fridge was just delivered, a half-hour early. While normally one appreciates a delivery coming early, I was in no way prepared for it: my dentist appointment ran late. What I'd hoped would be a thoughtful process of sorting, storing, and disposing was instead a rush job of getting everything out of the old unit so it could be moved out of the way.

It wasn't that bad in the alcove, but it still took some effort to get it clean.

It's huge, but it doesn't take over the kitchen.

I basically threw everything into the new fridge. We'll sort it out later. I'm exhausted.

Between the dishwasher and refrigerator, that doesn't feel like my kitchen. I know I'll get used to it, but right now I can't help thinking if all this expense and fuss was worth it.

PET/CT

... scan this morning. It took, as scheduled, about 2 hours from start to finish. The first thing the tech did was to check my blood sugar (95, fasting) to make sure that the radioactive sugar tracer would get picked up by anything hungry. Second was finding a vein (always a joy), and finally going with one on the back of my hand in which to inject said tracer. The tech brought in a little lead-lined box (looking exactly like a fashionable little clutch, if it weren't for the radiation hazard symbols on it), and took from it a lead-encased hypodermic -- for her protection, not mine, since of course she injected me with the stuff. It was a very small amount of material, but I still had that odd, cold-veined feeling from it.

After that? Resting for an hour to let the tracer work its way through my system, while I worked on a vanilla-flavored barium contrast shake. It's a good thing I was fasting, there is no way I could've drunk that shake if I had had anything in my stomach already. As it was, it wasn't easy drinking the whole thing, even though the texture was much improved since the last time I had to drink something like that.

So, tucked up in a warm blanket, I mostly napped in the recliner for that hour, and then I was brought into the scanner. As usual, it features an incredibly narrow plank which slides in and out of the "doughnut" which is the actual scanner. This is where I screwed up, because I didn't relax my arms enough while the tech was adjusting the velcro straps that are supposed to support them during the scan. I think I just wanted to get it over with, and I wasn't really thinking about whether the straps were supporting my arms or I was.

Holding your arms at your sides for 40 minutes isn't fun, and I ended up with a headache because the cradle for my head, while lined with some type of thick fabric, was still really hard underneath. It doesn't help that I'm in a minor flare and everything hurts now anyway.

I cycled through the stages of "wow, this really hurts, and I really need to move my arms" to "relax, relax, don't screw it up or they'll have to start all over" to "OK, I can do this" at least three times, and had come back around to the "don't screw it up" point again when it was finally over.

The tech says my doctor will have results in 24 hours, 48 at the latest, but my appointment with my endocrinologist is set for March 27 and I don't expect to hear anything before then. (sigh)

I was put off today by a couple of people who know about this situation and just brushed it off as if it were nothing. I don't want to be fussed over, but I would like some acknowledgement that this situation -- waiting for test results, not knowing whether I'm coming or going -- wears on a person. Well, it wears on me.

That wraps up day two of a spring break that is full of appointments and deliveries, and will finish up with a speech and debate tournament. This is the kind of vacation that you need a vacation from.

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.

grrrrr

Saw the endo today. My tumor marker is up, and I have small, but persistent, lymph nodes near my right submandibular salivary gland.

More tests coming, and we'll have to see what they find. In reviewing my labs, I see that even my suppressed Tg (that would be the tumor marker) has been slowly creeping up over the past 4 years or so, from undetectable to .1 something to .2 something to now .32, so there's definitely something going on, even if it's not very big.

I'm meeting with my ENT on Thursday and we'll consult on whether it should be a PET scan, a PET/CT, a CT with contrast, or an MRI that could best visualize whatever is going on. The endo's going with the radiologist (who read the ultrasound report),and recommending a PET scan. I don't think I've ever had one. First time for everything, I suppose.

I never ever ever want to go under the knife again, but it's probably somewhere in my future. Perhaps I can push it off a ways...

boom!

Something loud shook the house at about quarter to 11. DD came down asking about it; it shook her loft bed, which is literally bolted to the walls. We went out to look around in the yard and didn't see anything, but it didn't take long for the sirens to start.

Something exploded, a few blocks south of us. We have a view of the smoke and flames from our upstairs window. We think it's one of the small houses in the residential neighborhood there, but we don't know for sure. Lots of speculation: meth lab? gas leak? What else could there be?

@11:15. Now DH is tuned in to the fire department's radio on our new Roku box, and we hear the address. It's a house not a half mile from here, directly south. From the size of the glow, it was not a small fire, and I can hear more sirens coming in now. People died there, surely. Neighbors most likely died, too, if we felt the explosion a half a mile away.

The older two kids are concerned -- what if it's a gas leak? I've already reassured them and sent them back to bed.

It's unsettling, to be sure. It's remarkable how safe you can feel in a place until suddenly, you don't.

follow up

I had my post-thyroid ultrasound on Monday morning, ridiculously early for a day off from work. Today, the message from Dr. O's office was waiting when I got home from school: Your ultrasound results are in. The doctor would like to see you.

This is the part where I spin my wheels trying to remember what I saw and to figure out what it means. I saw a highly vascularized blob of something, but that could have been my carotid or jugular for all I know. Dr. O could just want to see me to make sure the problems I was having in the late fall, mostly due to flaring gastroparesis, have resolved.

I like the sound of that much better than any other reason to be of interest to the doctor.

wolf, hedgehog, raccoon

Linneaus' pet raccoon, Sjupp...

Oddly enough, this weekend feels like we're finally on vacation. Last week was project work week: SLE (lupus), hedgehogs, and Linneaus. We all know a lot more about each of them, now.

...and here are the hedgehogs - European on the left, Four-toed (African) on the right, in their natural habitats

constructive forces

Reddish, rusty cinder cone dislodged from the top of Sunset Crater sometime late in its last eruption.


It's all a matter of perspective. Sometimes tearing down and building up are happening at the same time.

passed

The time is gone when any of my children will spontaneously give me a hug or kiss, so I give them both to make up for it.