Monday, December 5, 2016

Papillary Thyroid Cancer... And the Aftermath

Hello everyone. It has been a while. Last time we talked I had just been diagnosed with Papillary Thyroid Cancer. A lot has happened since then.

On October 7th of this year, I had my entire thyroid removed. This procedure seemed so different than the esophageal cancer one from the very beginning. First off, the initial time for the procedure was in the middle of the afternoon. That seemed very odd to me. They explained it this way, "We do the younger ones first when it comes to surgery here. This is because they don't understand the reason why they cannot eat or drink on the day of surgery and some don't handle it well. Also, this way they don't have to sit and wait and worry. Youngsters are not as equipped as adults when it comes to dealing with all of it." I fully appreciate and agree with that. Added to the fact this was done in a smaller town hospital with limited space and availability, it makes sense to me. In some ways I think that kids not being "as equipped to handle that kind of stress," is a blessing in disguise for them. If it is not known or not fully understood about the issues and complications that could arise, then there is not a lot of basis for worry or stress, other than the actions and reactions of the adults around them, In my opinion, they are rather lucky in that regard. Their main worry is not being around their parents or family and friends for a while, or I would ASSUME that is the case. They know they are sick and they also know that the doctors will help them to get better. They may not know all the little details of what might happen. Usually anyway. And being a parent, I would think long and hard about telling the youngster about all those details. As a parent, I want to protect them. Do I think they would understand the situation? Maybe, depending on their age and mental level. Would it help them to know about all the little things that might go wrong and what might happen to them? Again, only my opinion here, I don't think that part would be needed. At least not at that point, but again that is based on the age of the child and their level of poise and knowledge and maturity. A lot of that type of detail is scary for an adult let alone a child. Telling it to a child is pretty much cruel in my book. Do you lie to them? No. Absolutely not. If they ask questions, explain it to them as best you can and try not to scare them. In these cases I look at it as it is not a lie to keep the truth to yourself. Tell them later... After. That way you can tell them how strong and how brave they are. They can make the connection that they beat whatever they had and came through it. That way, if something like that ever happens again, the mindset they go into it with might be in a stronger place from which to fight and beat whatever it is they have. If you have been reading this entire blog you know how I feel about mental stance during and after. To me, it is very important. Also, I'm talking "worst case" types of issues here. I realize that no surgery is easy or free of possible bad outcomes, but I am also sure you get where I am coming from. If it is a tonsillectomy, or ear tubes, or something more "common," then the stress and worry tend to be a lot less because there are fewer possible issues and those issues are less common. The kids with the more emergent issues are the ones I am talking about here... But I completely have left the path I started on here.  Kids are just that important to me. Felt the need to talk about kids and their illnesses and how I would handle it, so I did. The bottom line is that I agree with taking them first. Get them in, get them out, and get them back with family to start their healing and recovery process. I'm down with that. And not back to where I was heading to begin with...

So a mid-afternoon start time for the surgery. Usually the procedure takes three to four hours. They make an incision at the base of your neck and work from there. Below is are two pictures of mine.

Taken the day after surgery, also the day I left the hospital.

 Taken after about 3 weeks of healing, the day the steri-strips were removed.
The surgeon needs to be careful of several things. These include taking great care in working around the vocal nerves and also moving and maintaining four smaller glands called the parathyroids. The Thyroid is just under the adam's apple, so it is very near the vocal chords. If they mess up the vocal nerves, the voice is messed with. That's pretty much self-explanatory. The parathyroid glands and what they do? I had no idea. Here is what I learned. They are usually four of them. They are about the size of a grain of rice and are physically connected to the thyroid gland. They control calcium levels in your body. In a tyroidectomy they have to remove those small glands from the thyroid without harming them so they can continue to do their job controlling the calcium in your body. If they get messed up it can affect your heart, nervous system, kidneys and bones if uncorrected. They can definitely correct having to remove them or whatever that with supplements and pills or whatnot, but they would rather you keep your original equipment, You'll also notice no stitches or staples on the incision. In my surgery they used internal stitches that dissolve and get absorbed by the body, and steri-strips to help keep the site closed and covered on the outside.

The surgery went without any incidents, however they did find an odd growth behind the thyroid. The surgeon took it out and sent it to be tested immediately. He got the results before the operation was complete. It was listed as "parathyroid tissue." The doctor didn't buy that. He said that if it were parathyroid, the calcium in my blood tests would have been much higher. He thinks it was a goiter, Bottom line is that it was benign, no cancer, and it was removed too. He actually said that had it been parathyroid, he "could have put it back in."  I had to chuckle at that. It wasn't parathyroid and my calcium is pretty much normal. The morning after surgery it was a bit low... 8.0, Normal is 8.5-10.2, so they were thinking about not letting me go home.  I got some higher calcium food and took a couple of calcium tablets, and it was 8.4 later that day and we all felt better about that.

Another oddity, pretty much immediately after I got out of recovery and into a room, I was given supper! They gave me meatloaf, mashed potatoes and gravy, corn, jello and juice. And with no swallowing issues I might add. That part amazed me. Lea Ann too. We both figured I would be on liquids or soft foods for a while after. To be honest, nothing in that meal was overly hard, but it sure tasted good! Good tasting food at a hospital is an oddity in and of itself, let alone eating that soon after getting out of recovery.

More oddities... Had surgery on October 7, got discharged on October 8. Wham, bam, thank you ma'am. And after maybe 3 days of slight soreness, I was pretty much back to normal. Yes, I had to limit lifting and straining to allow the incision to heal well and not rupture. Compared to the esophageal cancer surgery, this was an absolute cake walk, at least as pertains to things physically. Don't get me wrong, it is still cancer and that is not anything to joke about or make light of, but this seemed almost easy. Admittedly, I am not done yet. I still have to go through the radioactive iodine capsules and all that entails (which I will write about further in another blog entry later), and I will have several follow ups with radiation oncology and also the endocrinologist.

Lastly, the pathology on the thyroid went as follows:

  • 1.5cm (0.6") nodule, right lobe of thyroid, tested positive for papillary thyroid cancer
  • 0.8cm (0.3") nodule, right lobe of thyroid, tested positive for papillary thyroid cancer
  • 0.4cm (0.15") nodule, right lobe of thyroid, tested as a benign goiter
  • Left lobe of thyroid - clear
  • Extra tissue behind the thyroid removed, tested as benign parathyroid tissue, but the doctor disputes that
So the cancer was staged at Stage 1, no metastasis, no lymph nodes involved (S1N0M0). We were also ensured that this was not a metastasis from the esophageal cancer from 2012/2013. So we caught it early again. I cannot stress enough how much it means to catch these things early. Listen to your body, and follow the schedule of doctor visits and tests so that you can catch anything as quickly as possible. Early detection and correction is the key! 

Thank you all for staying with me through all this. I appreciate your reading and your comments! I can only hope that they writing is helping someone somewhere to understand how someone may be thinking... at least as pertains to cancer.

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