beginnings of endings

I'm up ridiculously late, again, because I (again) fell asleep on the couch for a while, so now I'm not that tired...

Tonight was DS1's senior dinner.  It was 3 hours of listening to the faculty read a very personal speech about each of the graduating seniors, all 78 of them, and it was lovely.  The faculty member who spoke about DS1 was one I had never heard of before his thesis defense, but it was obvious that she knew him well.  She was witty and warm and everything you want someone to be when they're talking about your son.

My son, who tomorrow has his college orientation.  Who two weeks from today will graduate from high school, and about 2 months from now will move out, at least during the term.

Things are rapidly drawing to a close, but it doesn't feel real.  My technology sabotaged me viciously over the past couple of weeks: my laptop died, it's battery no longer charging.  I prayed that it was either the battery or the adapter, so I ordered new ones, but neither did the trick. (Still have to return those...)  Since my end-of-term projects were due in both my classes, I didn't have time to deal with laptop shopping, so I just picked up DS1's old Toshiba, which has a surprisngly awesome keyboard but is seriously underpowered and has a super annoying overly-sensitive touchpad.

When my laptop died part 1 of my final project went with it (it was a work in progress, and Carbonite hadn't had a chance to back it up yet).  So I recreated it, and went on to part 2... thank God I printed out the lesson map before I uploaded it, because somehow instead of uploading my copy to my Google drive, I downloaded the blank template over  my copy... and then I went a little crazy and spent hours trying to recover it, when I should have just typed it in again (I am an idiot).

I never did recover it.  I ended up re-doing most of it at school the next day ( a test day for my 7th graders gave me good opportunities); that was Tuesday, so by about 4PM Tuesday I had parts 1 & 2 done, but they weren't due until Thursday.  Part three was due Tuesday at midnight... I had most of it done by then, but some pieces were a wee bit later.  I don't think that will be disqualifying...

So yesterday I did the last little smidgeon of part 1 (samples of anticipated student work) and uploaded that, and so I'm done!  But it feels anti-climactic because all I did was upload some (OK, a lot) of files.  I didn't talk to anyone or get to have a real good bye or anything like that.  The relief hasn't actually hit me yet.

DS2 finished up the track season with substantial improvements in all his events, and one of the coaches lobbied him hard to return to the team next year, but he's cautious about managing high school, which I think is wise.  His 8th grade commencement is the night before DS1's graduation, and my own students' commencement is the night before that. DD has more or less neatly recovered from leaving classical piano study to moving into jazz and composition, and she'll be playing her own composition in the graduation recital which is the day after  DS1's graduation.   I'm getting used to having that overwhelmed feeling more and more lately.  My own children are growing up so fast (such a cliche, but it's true!) I simultaneously want to slow things down a little and speed them up so I can be on summer break...

Health-wise: better, but the new rheumatologist took a look at my labs and declared I don't have RA.  So why do my hands swell overnight then? Whatever.  I'm officially out of the flare, I'm convinced it's because I started exercising again even though it was literally the last thing on Earth I wanted to do.  I did a Google search on reversing degenerative disc disease and I found this guy's website.  I have spent a lot more than $20 and a lot more time in doctor's offices figuring out what to do, so I ponied up the cash and I bought Rebuild Your Neck almost immediately after I wrote that last post.

I've been doing the exercises faithfully (although somewhat less faithfully now that my neck feels so much better) and it's nothing short of a miracle.  I know exactly why I got into this situation, too:  too much time with head craned towards the laptop (all those school projects, and grading!), plus the damage that my surgeries have done to the musculature on the right side of my head and neck.  They still bother me, but it's slowly improving as I continue to exercise, and the neck pain itself is over except for the occasional twinge, and I haven't had a headache in weeks.  Plus, I'm not taking any meds.  I've started on turmeric  and ginger (separately) for inflammation, and they don't seem to be doing much, although the ginger helps my digestion.

The only remnant of a flare I was having was my right middle finger, which would be nearly twice its usually size in the morning -- odd.  The doctor was talking about injections or a short course of prednisone (ick) when I asked if I could just wrap it or something.  That gave him the idea to just write me a prescriptions for Voltaren gel, which has worked really well.  I mean, I used some on Tuesday night and haven't needed it since, although it's feeling a little creaky right now.

I'm exhausted, though -- late nights every day this week, between school work done, lost, and re-done, and now feeling emotional after DS1's dinner and that nap!  Tomorrow is a non-instructional school day, so it will be easy to get through, and then plenty of sleep this weekend - should be heavenly.

The Self, the State, and the State of Self

DS1 brilliantly defended his senior thesis this afternoon. I was a bit late - driving over to his school always takes longer than I think it will, and then there's the need to park-- but I only missed the first few minutes.  By the time I arrived, he was settling in to the groove of addressing the very tough but fair questions his panel of professors addressed to him.  I asked him over the weekend if he wanted to practice, but he assured me he didn't need to; he loves to talk about this stuff.  It was evident in his responses, which consistently referred back to his source material even if they did get a big circular at times (glimpses of the old expressive fluency issues, coming to the surface.)   Still, he made his professors think in a new way about personal "truth," not as something that just happens inside your head, but as something that you act upon and build your life around.  It was obvious that it was a new idea to them all, and there was some push back, but that's not a bad thing.  I am extraordinarily proud of him for making them re-evaluate their approaches to the question of truth.  It was fascinating.

This year has been marked by huge accomplishments by all the offspring (as I often call them.)  DS1 with his thesis, DD with her brilliant musical composition, and DS2 in becoming a more active participant in his own life by auditioning for, and winning a spot to perform at, the Titan Triad and going out for the track team.  After 18 years I'm seeing the first indications of the adults they will become, and it is literally amazing.  I am so often overwhelmed these days, but I will never mind this feeling of my heart being too full when I see what my children can do.

meloxicam, day 3

So far my impression is "meh."

It has done a good job of reducing swelling, so I'll give it that.  But pain in hands, collar bone, hips, etc is all still there, just slightly less -- say a 4 on the pain scale instead of 6.  So that's better. 

However, neck pain is nearly as bad as if I were taking nothing.  The ibuprofen did a much better job controlling that.  This is not muscle pain but pain at the vertebrae themselves.  It feels "crunchy" (which makes me think bone-on-bone, but I don't think it's that bad) and it hurts.

Headaches range from ignorable (1-2) to killer (7-8), which is pretty consistent with the ibruprofen.  I intensely dislike it when my front teeth hurt...

Worst of all, though, is the reflux.  I had a smidge of heartburn yesterday (Thursday, day 2), but today I feel the way I did years ago when I had gastroparesis and my gerd was out of control.  Sick.  Popping some calcium antacids helped; omeprazole would've been better but we're out. I'm not willing to get back on a drug I worked hard to wean myself from (omeprazole).  Even one day of reflux left me struggling with my voice today.

On the upside, trying to keep the reflux down encouraged me to drink tons of water today.

I don't think this is the drug for me, but I'm not sure how much longer to give it before I say "enough". I have been taking it before bed (about midnight) to help mitigate that side effect, but that hasn't been entirely (or even moderately) successful.

I'm not taking any more tonight -- I'll investigate more tomorrow and figure out if I should try to tough it out another couple of weeks, but I don't think that makes any sense.

pain management

After an inordinate delay caused by the insurance company's long telephone wait times, I was finally able to get in to see my new rheumatologist on Tuesday.  I have mixed impressions but I'm trying to remain open about the experience.

First off, his manner is a complete 180 from my previous rheumatologist, was a nurturer and very much into building a relationship.  New doc is all business and brusque, and that's OK, except he seemed to be discounting everything I said: when I told him I had RA, he challenged the diagnosis, going so far as to examine - without explaining what he was doing and why - every joint in my body (literally). 

I want to say that it was his tone that made his questions ruffle my feathers, but that's not quite true: When Dr. P diagnosed you, do you happen to know if your lab test were positive?  (I said I didn't know, but I have a feeling they were not...)  Then: How is your anxiety?  (I told him I was feeling stressed because I was concerned about getting to my class on time.)

He pretty much completely dismissed the problem with my neck, saying that arthritis rarely strikes the spine -- to which I replied, it could be osteo, but the MRI showed arthritic changes -- and his response was, "You probably have a disc problem." 

No, I don't have a disc problem, and I know that because I finally got the MRI report from my doctor's office today and it specifically says that the problem is not a disc problem.  So there.

He ordered a billion tests (I had the blood drawn yesterday) and put me on a once-a-day NSAID called meloxicam, 15mg/day, which is interestingly double the normal starting dose.  I started it Tuesday night so I have had 2 doses and I have noticed that it is helping tremendously with the swellng, but not the pain, as my hands are still killing me and my neck is now giving me more issues than it did when I was on the ibuprofen, plus the return of the ever-so-delightful headaches. 

OTOH, I have lost a few pounds of the fluid I was retaining and I'm happy about that, and my fingers don't look like little fat sausages every morning -- yesterday I could put my rings on almost right away, but today, again, I had to wait about 2 hours before I could wear them on their proper finger.

I'm seeing him again on the 28th, and I'm praying that my bloodwork shows something "real" because he seems like he might be one of those doctors who needs labs to back up a diagnosis, even though 25-30% of RA patients don't have RA factor.  All I know is, I'm miserable, and if it's not RA, what is it? 

spring

That month was a blur.  I expected to be less busy after science fair, but the two classes I am taking are keeping me hopping, mostly because I keep implementing stuff I am learning.

Also, I'm falling apart (again).  My RA is still flaring unbelievably, to the point where round-the-clock ibuprofen is having next to no effect, at least on my hands. (I've given up - I'm trying to get in to the rheumatologist for pain management.)  But the real kicker is my neck, which has been bothering me since the beginning of the year so I finally went to the doctor, who ordered an x-ray (first).  You know it's bad when you can see the problem on the x-ray.  I had the neck MRI on Friday and I'm waiting to hear what my next steps will be: most likely physical therapy, maybe a brace, but I need something to manage the pain.  600 mg of ibuprofen 3x/day as a therapeutic dose like I did last time is helping a bit but not completely. 

Then there are the headaches, which are not back-of-the-head headaches that I would get from my neck, but middle-of-the-head, behind my eyes headaches, sometimes my front teeth hurt.  This makes me nervous that it has to do with the pituitary adenoma, because I've also noticed light sensitivity and a couple of brief moments of double vision.  When I saw my eye doctor for my annual eye exam, she was concerned about the size; 11 mm is about the size that starts squishing the optic nerve, so I'm going for a vision field test to see if my peripheral vision is affected on Friday.  I'm glad I'm seeing her soon because I'm not happy about this.  I shouldn't be having headaches when I'm on 600 mg of ibuprofen...

Of course my weight is up because of all the inflammation (RA), the bad sleep, the ibuprofen which messes up my insulin metabolism. Sleep is OK with the ibuprofen but still not that good, which isn't helping either.

Meanwhile, my unit plan is due Thursday and there's gobs I still have to write up for it; plus I have to grade last week's 8th grade quiz in advance of tomorrow's test (and 7th grade quiz), and we're launching my new physics unit on Wednesday and I'm simultaneously excited and terrified.  If I felt physically better I think I would be mostly excited and only a little terrified, but since I feel so beat it's about 50-50.

So I have summer plans already, going to Mom's early in June, solo; the kids and DH will come out later.  DH will have his two weeks, and the kids will stay until the end of July.  DD is taking a summer oceanography course at WBNERR, and I've applied for the teacher course the week before (fingers crossed).  Plus I'll be working on revamping the science fair as a portfolio project, and I'm thinking that might be for credit -- so that would be two different independent studies over the summer...

... but I am NOT taking two courses during the school year ever again. 

OK, part 2

The MRI went well on Monday, once the insurance company found me in their system, and after only 3 failed attempts at putting in the IV for the contrast.

I hate MRIs because the noise is so startling, but when you're having a head MRI, they put foam around your head that helps a lot.  If I ever have to have an MRI that's not for my head, I'm going to ask for the head gear anyway, because otherwise I feel like I'm under attack (literally) from all of the loud banging sounds surrounding me, getting louder and louder until they suddenly stop.  And then start up again with little clicks that progress to a different cadence of loud banging.

I keep my eyes closed the entire time because I'm pretty sure I would freak out if I saw how confined the space is.  And I pray; that helps a lot.

The very cool thing about going through Banner/MDA is that all of my records are uploaded on to their myBanner website, so I logged on Tuesday to get the report.  I don't have it in front of me and I'm too lazy to download it again, but: results consistent with adenoma (which means benign); no unusual vascular activity (so, no sign of cancer building up a blood supply) and no sinus cavity invasion (it's not so big it's growing into my sinuses).  It is bigger than normal, there is definitely a mass there, and there is "leftward deviation of the infundibulum," which means the mass is pushing the pituitary stalk to the left.

I still haven't heard from the doctor, but I'm not sure about how or when that will happen (it may be up to me) , but it seems to me that none of this is particularly worrisome.  I'm asymptomatic and the mass is non-functioning and my pituitary function is fine, so there's no reason to do anything.

I suppose we'll just keep an eye on it.  An annual CT may be just the thing, less trouble and expense than going through the Thyrogen protocol, and I can check in on the mediastinal nodule and the pituitary adenoma in the same test.

Yay!

Did I say I'm slightly less grumpy about science fair since two of my students took first and second place at the district science fair?  Only slightly, but still - they made me look good.

I finished grading, entering, sorting, and stacking all the science-fair related materials at about 2:30 this afternoon.  I'm trying to tote up the number of hours it took: 3 hours Friday at school and then 5 hours at home and then 2 hours Saturday morning and a marathon 8 and a half hours Saturday night and then another 3 and a half today... that makes 22 hours, right? 

Thank God we have a 3-day weekend.

I am so very appreciative of how quickly I can read, how consistent my snap judgments are, and how good my addition and subtraction skills up to 100 are.  I can't imagine getting through that amount grading if I were any slower. Plus, my organizational skills came to play: I put together a one-sheet listing of all my students so I wouldn't have to be rifling through stacks of paper while I was grading their display boards.  Brilliant, and a great snapshot of who-did-what.

I haven't taken any ibuprofen today and I don't feel too bad.  I'm hopeful that my flare is subsiding now that huge stress is in the past.

Head MRI tomorrow morning, and then basically nothing, so I can get caught up on my homework and my sleep.  Glorious!

OK, part 1

Saw my endocrinologist today, and happily, all my pituitary-related labs are fine. 

She (mildly) harangued me to see my rheumatologist about this flare that is killing me, although it does seem to be letting up.

I'm getting the MRI done anyway.  Endo doesn't think it's worth it, since she says, "There's no baseline, so you don't know how big your pituitary was before anyway."  However, I have had quite a few looks at the inside of my head over the past decade or so and no one has ever remarked on my pituitary before, either from CT or MRI scans.   Even if it's benign and not pumping out hormones, it can still mess me up if it gets too big. 

Still haven't graded a bit for the science fair, but am feeling fairly well caught up on everything else, so I hope to start grading all that ... tomorrow.  Maybe.

well, that happened

Way too much work this week, starting with last weekend when I worked all the hours there were catching up on grading and prep work, but also on my own coursework.

Monday I took photos of the 35 bulletin boards showing all the in-class projects and put them into a power point presentation.  I also found a really cool "science" page border and made signs for all the tables by teacher and grade. Tuesday my students checked in their projects, and I had to review all ~150 of them to decide which ones were worthy of judging.  Then Wednesday was the actual science fair, which involved getting 300+ projects set up in the gym, and the top tier judged.

Only half of my volunteer judges showed up, both great guys who worked hard. 

I haven't been sleeping and my RA has been in a vicious flare for what seems like weeks now, so I was even more exhausted than even all this work would involve (what with full-time teaching and two grad classes continuing uninterrupted).  Maybe that's why, when a top student came by to pick up her display board, which clearly did not follow the guidelines, I commented to her that her font was too small before telling her how excellent her work was.  That didn't sit well with her father, who called me out on criticizing her after she'd worked so hard.  My apologies and subsequent praise did nothing to mollify him, and he went on to harangue me, quite loudly, for a good 10 minutes or more.

When he finally left, one of the judge (I'd only met him 2 hours before!) came over to see if I was OK, and I immediately burst into tears.  Mortifying.  I wasn't crying because I'd been yelled at, I was crying because he was so very kind, and I was so tired, and the whole situation was just so ... unnecessary.  My AP came in to see me, because the peeved parent had gone on to harangue her, too.

The DH bailed on helping me with the break down, because... reasons.  But he did drop off DD, so there were four of us to fold up and stack 300 tri-folds, stack up a few dozen binders, take down the signs, and gather up the various odd materials that the students had brought in even though we'd told them they should not.

When I finally got home, I had to sort through the ballots and figure out who won in both the elementary and junior high divisions. It wasn't obvious so I had to build a spreadsheet.  Then on Thursday morning I had to fill out the certificates and accidentally wrote in a wrong name... oops.  But other than that, and 150+ reports and the 150+ display boards that need grading by the end of next week, it's OVER.

P.S. Today, I checked in with my AP again to see if there was any fall out from the obnoxious encounter.  I was advised to pretend it hadn't happened, which  I have been doing, out there in the real world. The parent had a follow-up meeting with admin and he is "willing to let it go."  When I heard that, I thought my brain was going to explode (and given that whatever-it-is on my pituitary, maybe that actually will happen one of these days.)  That guy owes me an apology.  He chastised me for criticizing his daughter in public but then literally yelled at me for 5 minutes, walked away, and then came back to yell at me more, dragging up stuff that happened last year, when his daughter won the district fair!  It was so bad that another parent came by to tell me I didn't do anything wrong, and that she would stick up for me to the administration if there was any question, since she heard the entire encounter.   And now I really will drop this, and pretend it never happened. I'll never get an apology or even an iota of respect from that guy, so I'm not going to look for either one. 

clarifying...

I realized after I wrote it that the last post must seem absurd: I do nothing (it seems) but talk about my pains both psychological and physical -- here. 

Out in the real world, it's different.  If I'm moving slowly because I'm in pain, I'll let the family know.  Other than that, it's all just business as usual.

I'm feeling slightly less squished because I worked pretty much the entire weekend to get caught up on grades and homework, but I'm definitely in a flare because everything hurts and I'm having trouble sleeping, too.  My mammogram went fine this morning, and it's only one more week until my appointment with Dr. B, where we'll discuss what to do about my pituitary.

Off for ibuprofen, and bed.

feelings

Somewhere along the line I decided that physical feelings are OK to talk about, but emotional ones, not so much.  This is a probably a reaction (over-reaction?) to earlier days of over-dramatic responses to nearly every thing. Thinking back, I can't imagine why I got so upset over so many things in the past.

Anyway.  I'm under a tremendous amount of pressure right now because I'm balancing teaching work and two grad school classes with managing the science fair at school.  That's a freight train of some 300 projects to get set up (and judged...) and 160 papers and displays to grade.  I'm trying to clear the decks of all grading before Wednesday, but I'm not sure that's going to happen.

I haven't been sleeping well at all, so I've been staying up late and then still have to get up early for work.  Consequently, my physical feelings are terrible, too.  It was uncharacteristically rainy and cold today, and I have that vague, all-over discomfort that often - but not always - accompanies this weather.  Also, the first joint of my right middle finger has been viciously attacked by arthritis -- how weird it is, having that one joint so badly affected. It hurts! 

Sleeping has been bad because I have so much to do, but it has also been bad because my right arm keeps falling asleep/going numb on me when I sleep on my side, which I like to do. I've been getting these weird tired muscle feelings in my biceps/triceps, too -- even if I haven't worked out. I believe this all has to do with the muscles in my neck and shoulder, particularly on the right side, as stretching seems to help.

On top of all that, DS1 just turned 18 and will be going to school in state, so there have been lots of discussions about that.  I think he'll be fine, but I'm really going to miss him.

My favorite cafe/bookstore is closing in March.

And over all of this, the question of whatever is going on with my pituitary lingers.  I've had my labs done already, but I don't see Dr. B until a week from Monday.  At least science fair (if not science fair grading) will be over by then.

I made a list of what I'd like to - need to - get done this weekend and it's ridiculous.  I'm going to take some ibuprofen and pray I'll be able to sleep soon.

whoops

OK, so the CT went mostly as expected.  That node is cancer and calcified, and it's snuggled between two major blood vessels and tucked under my collar bone. Fortunately, it's operable if we ever decide it needs to come out.  But for now we'll just keep an eye on it, with CT scans every 6 months.

Now, to the incidental finding: I have a nodule on my pituitary gland.  Fortunately, research says that nearly all pituitary nodules are benign, but they can cause all sorts of other problems.  I'm asymptomatic as far as I can tell, but I'll be going for blood work and will probably be going for an MRI to get a better look at it.

So after six hours at the hospital today, I spent about another 2 hours on the phone making all the other appointments -- eyes, mammo, annuals -- that should have been made over break except I allowed myself to not think about it.   I find myself back in that thoroughly medicalized life on top of full time teaching, two graduate classes, and my first priority, my family. 

I'm so very weary of having things wrong with me.  One of those appointments was for the raging sinus infection that's bothering me again, even though I was on Levaquin over Christmas.

stretched

Quick update - too much grading to do, and I don't want to leave it all to the weekend.

My students were redistributed among my classes and overall, it's excellent.  Admin managed somehow to balance the number of students well, so I have no more under 20 classes, and only one class with 33 students. It helps enormously.  I was able to update my lesson plans straight through to spring break, which was somewhat tedious but now is a tremendous relief.

It's nice to have some comfort, because the hits have been coming from all sides.  The week before Christmas, the two older kids were in a minor car accident that nevertheless totaled our old Civic.   The next weekend, DH dislocated his shoulder.   My mom went back into the hospital, but only for  a day.  Her doctor thought she might have pneumonia but her lungs were clear, although she did need a blood transfusion.

We had a slight pause for a delightful Christmas and New Year's.  We stayed home so I could grade all the science projects and do all that lesson planning.  We ate really, really well though -- especially at our 20th anniversary dinner at Roy's with the kids.

Right before the end of the year, I got into Banner M.D. Anderson for a second opinion on my situation.  My initial consult went well, my ultrasound was pristine, and my blood work was fine.  We seemed to be on an upswing but then the transmission seized on the Odyssey, a friend from my old thyroid cancer support group died, and I feel like I'm coming down with more sinus crud. 

And I'm going for my last test, a follow-up CT scan with contrast, to put the thyroid cancer testing to rest, on Monday.   It would be easier for me to be calm about that if I didn't feel ever-so-slightly sick: head congested, body aches, chills -- but no fever according to the thermometer! 

School had been going really well, until this afternoon when all of these stresses combined with a particularly persistent attention-seeking student led to an annoyed parent.  My administration was supportive but still, I just feel like there's too much going on right now.

My two new classes started this week and I know I'm going to enjoy both of them tremendously, not least because both of them will be less work than the two I had last semester.  There's good stuff to come, too, as I'm looking into 1-week classes to take over the summer.  I may be able to finish this program more quickly than I expected!

This sounds bad, and in truth we've had more bad luck in the past month than we seem to have had in the past 10 years, but there has been so much good, too.  A few good night's sleep, and a clean CT scan, and all this tension will evaporate.

wants vs needs

What I want to do today, having finally uploaded months of photos from my phone, is write a nice long post, or maybe a bunch of smaller ones, about these past few months.  When the only thing I write about is my thyroid cancer testing, it makes it seems as though that issue is dominating my life, when it isn't.

On the other hand, I had my appointment at Banner MD Anderson this past week and that went very well; I had an ultrasound yesterday and my follow-up appointment is Wednesday.  Both the doctor and I are more than OK with "watchful waiting" if that's appropriate.  He was relieved when I brought that up, because if that really is an active node in my chest, it's in an inoperable location (they're just not up for cracking the sternum to get to it.)

More on that later, I'm sure.  Right now I'm procrastinating because I have 80 science fair papers to grade and I'm resisting!  I want to be able to relax tomorrow, it's my last full day of vacation, and I've pretty much finished everything else I needed to do over vacation.  If I can just get those papers done, I'll be all set. 

We'll be taking these down, soon. 

next...

M. D. Anderson in Houston won't give me a second opinion unless I re-register as a new patient and make an appointment to come in.   I'm not going to Houston over this.  At least not yet.

But MDA opened a new center teamed up with Banner Hospitals here in the valley, and they have a surgeon on staff that is experienced with recurrent thyroid cancer. 

I have an appointment with him on December 29.  The really cool thing is, because they're MDA, they have access to all my old MDA records.  And because they're also Banner, they have access to all my scans, too.

Just waiting on the insurance to clear, which it should... then we can put this to rest.

bah.

After repeated calls to my endo's office, the nurse/manager finally called and left a detailed message on my cell phone.  The doctor had conferred with my  usual nuclear medicine doctor, who pulled the film and agrees that it's just a calcified node.  They're all happy with that and say I don't have to do anything for a year, when I'll repeat the Thyrogen testing cycle as usual.

I don't want to complain (really, I don't), but this is bunk, and it's contrary to the ATA's long-term management guidelines for differentiated thyroid carcinoma, too, which indicates I probably should've had another dose of RAI.  (Tg>2, dxWBS positive).

I guess the thinking is, the scan was only slightly positive, and watchful waiting is a recommended strategy for low-risk cases.  I don't think I'm a high risk case, but I don't know if I'm low risk.  I think I'll send an email to MDA tomorrow and see if they can look at the scans.

wearing & tearing

No news since my appointment last week.  I'm not surprised, although I do come home every day and check the answering machine for calls from the doctor.

I try not to think about it, and generally do a pretty good job of keeping it tucked away, but that takes energy.  It's like a weight on me, one that I have no way of knowing how long I'll be squished under.

It wears on me so.  I hate all my clothes, my hair (not-so-recently cut shorter than I'd wanted) looks stupid, my class last night left me disappointed and everything just seems off.  Being tired doesn't help.

***
I managed last weekend OK: Halloween was mostly driving the 2 younger kids to and from events with friends, so that spared me from dealing with trick-or-treaters most of the night. Saturday I took the 2 older kids to Sozo to hear a 15-year-old blues guitar genius, and Sunday the entire family went to see Ballet Arizona's Swan Lake with the Phoenix Symphony.  It was glorious, and then we went to Euro Cafe for dinner because DD's birthday was fast approaching. 

She requested meat loaf and mashed potatoes for dinner, with a birthday apple pie since she doesn't care for most cake.  I spent most of the last 3 days cooking, to good effect -- the pies came out beautifully.

***

The weather has finally, finally cooled off enough to wear sweaters. Not-summer seemed to take forever to get here, but I know that's subjective, it never cools off until November.  It's amazingly delightful outside now, and quite cool in the mornings.

***

I have a week off of grad school classes, which is good because I have a paper and all sorts of other stuff to do.  So far my lowest grade on an assignment has been 17/20 and I have no problem with that grade. I didn't have time to spend 4 hours writing up a super-detailed lesson plan, so I spent about 30 minutes just giving the broad strokes.  I did what I could in the time I had, and that has to be enough.

***

Even though I'm sure, 100% positive, that whatever I've got isn't going to kill me, or even have any lasting long-term effects on me, I do have a feeling that there's going to be some disruption along the way somewhere, and I'd like to know what that will be, when that will be, and how recovery will go.   I can't manage expectations when I'm in limbo like this, but that's how my mind works best, so I'm constantly hitting this wall of No Information.

***

Time to put all this back in its box & go to bed.

mixed messages

In a completely unexpected result, my tumor marker decreased to 3.0 from 5.5 in December 2013.  That's a surprise, and good news. 

But still a surprise, because the scan was positive, with "slight uptake" in what the radiologist diagnosed as a calcified node in my mediastinum.  My endo is not complacent about this diagnosis, and I agree: if the node were calcified, there wouldn't be any uptake there.

Plus, and I told her this story, this exact same thing happened when I went to MDA in 2006 when I had my recurrence.  The radiologist read the CT and said "calcified nodes," my surgeon took one look at it and said, "I don't believe it.  That's cancer," and he took them all out.  The surgeon was right.

The endo also completely rejected the thymus gland theory, saying it is highly unlikely for it to start showing up now. I've been dealing with this cancer thing for years, and there has never been any indication of thymus activity before, and it doesn't make sense for it to just show up out of nowhere.

My collarbone was troubling me something fierce on Wednesday (the day of the appointment) so I didn't forget to tell her about it.  She expressed concern, and after doing a search on "bone pain" (because that's what it is), I can see why -- there are basically no benign causes of bone pain, and cancer is one of the leading causes.  I really tried to brush it off as probably scar-tissue related or possibly just my fibromyalgia acting up, but the endo basically told me to stop: You have a serious condition.  We should check this out. 

See, I know it's true, but I like to pretend it's not.

The plan, for now: the endo is consulting with my usual nuclear medicine doctor and seeing what he thinks of the radiologist's diagnosis.   I will probably go for a quick chest x-ray to make sure there's nothing dire going on with the collarbone. (I asked about that -- wouldn't it show up on the scan? Not necessarily, especially since you said it's gotten worse since the scan. Which it has, going from intermittent to constant and sometimes extremely painful. Sigh.)  Re-test in 9 months -- there goes the first 3 weeks of June.  But no definite plans just yet, just waiting to hear from the doctor, again, and get my marching orders.

student life

So I'm taking two classes at NAU, one on the nature of science (what we call NOS) and the other on teaching and learning science, which is the methods class I wish I'd had during my teacher certification days.  (That methods class was the biggest disappointment of my cert. program.)

It turns out, of course, that 2 grad student courses is substantially more work than 2 teacher cert courses, but it doesn't even feel like work because I love all the reading and assignments.  All my feedback has been so positive I want to go back to school full time, especially after taking a quick trip up to Flagstaff over fall break so I could attend class in person, which was a wonderful experience.

Timing is also perfect for me to be super-busy because it helps keep my mind off not having my test results yet, and not having them until next Wednesday.  I get asked how I can stand waiting so long to find out and I just say, I put it away, it's in a box.  There's nothing I can do about it so I might as well not think about it.

That all sounds so well-adjusted that I can almost believe it, and I keep it "in the box" most of the time except I've got this weird pain in my collarbone that's more on than off lately, and of course it worries me. Until I put it back in the box, and try to keep the lid on it.

spect/ct

After this infinitely long week, I had my whole body scan today.  I have a new nuclear medicine doctor, who works in the same practice as Dr. S.  I have the impression Dr. L has retired or moved on in some other way, since his card was not available in the reception area.

Dr. Y was, at first, pleased with my scan and said it was clean.  Then she asked me about my Tg and my history and when I explained she paused for a moment and pointed me to a faint spot somewhere in my chest.  "I thought it could be thymus activity," she said, explaining that's common for younger people, and not unheard-of for 50-somethings like me. "But given your history, I want you to have a spect/ct scan so we can try to get a better look at where that is."

This was new for me. I asked the technician many questions, and he was very nice and forthcoming about discussing it with me.  The spect/ct picks up the same RAI emissions as the WBS does, but it combines them with ct data to give a three-dimension image.   For comparison, here's a WBS image: 

 

You can see that it's basically a pointilist, 2-dimensional collection of I-131 emissions.  The image below is the monitor from a combined PET/CT and SPECT/CT scanner.  It constructs a 3-dimensional view that you can drill through, combining structural data with the emissions information from that same RAI. 

 

I don't remember if my hospital had this exact scanner, but the display was very similar.  You can do cross-sections both height- and width-wise (transverse and sagital views, I think...) and you zoom in and out.  There is a truly astonishing amount of data there.

Nothing really leaped out at us in our quick once-over - of course, neither of us are trained to read these things, but the tech has a lot more experience than I do.  He zoomed around a bit and found a spot in my upper left chest and we thought that might be it, so he went over to his other monitor and pulled up my whole body scan image and we compared the location of the faint spot there to the location of the bright spot on the spect/ct.  Our consensus was that was probably the troublesome area, and it appeared that there is some activity there.  It was an anomolous green spot on the display, but not very bright.   But considering we didn't see green literally anywhere else, I tend to think that was it, but it was really hard to tell where it was, and it was impossible to say what it means. (I wish I had had the foresight to snap a couple of photos with my phone, but I don't know if that would've been allowed.)

We called Dr. Y as she had gone to another department at the hospital, and she took my number and said she would call me this afternoon.  That was four hours ago, and I still haven't heard, and I feel like a complete idiot because I forgot to ask if I could go off the LID!

Odds are we aren't going to do anything right away anyway, but I'd rather have RAI than surgery so I'm thinking it's smart to keep that option open. So I'm still on the LID for now, even though I would really like to go to Joyride and get their trio of different seafood tacos that are so incredibly delicious.

I am so making jambalaya when I finally get off this diet!