Dr. B for Biopsy

The waiting room at the ENT office was packed. I heard the receptionist say to someone that the wait had been running about an hour. I read some on the kindle app on my phone, having forgotten to bring the actual device. I had found a memoir called Dirty Bombshell: From Thyroid Cancer Back To Fabulous! by Lorna J Brunelle. Am I obsessed? Yes. But it’s helping me cope with my anxiety to read about people who had been through thyroid cancer and come out fine.

Finally, I was called back and seated in a patient room. I started to read a little more, but then put my phone away. If Dr. B or his nurse asked what I was reading, I didn’t want to reveal I was neck-deep in thyroid cancer obsession. Instead I checked my email. I started to read from my friend T that she was having to see a rheumatologist to find out the cause of her autoimmune symptoms. And she had gotten laid off from her job unexpectedly that day! I was clearly not the only one in the world with things to worry about! My heart was racing for her and the anxiety she must be going through.

At that moment a very friendly nurse came in—I wish I had gotten her name. I need to make sure I do on a future visit. She had me sit in the exam chair and said, “Let’s check your blood pressure.” She strapped on the cuff and said, “So we’re set up to do a biopsy today, right?” and gestured to a small counter that I hadn’t noticed was laid out with paper drapes, syringes, and…an emesis basin. Great!

I imagine myself in that moment with my eyeballs popping out of my head like a cartoon character. “I was expecting this to just be a consultation,” I said, trying to keep the panic out of my voice.

Then my brain caught up to me. A biopsy today would mean less waiting to find out if I had cancer or not. “But that will be fine, if we do that. The lady who called me had just said it would be a consultation appointment. But I don’t want to wait if I don’t have to.”

I was babbling. “I bet my blood pressure just went…” I pointed up.

She looked at the meter and laughed. “Yep!” She left me alone for a moment. I looked again at the biopsy equipment, and saw an ultrasound machine right beside the chair. That made me feel better. I had decided earlier that I would only let Dr. B do my biopsy if he used ultrasound guidance.

I found myself facing a window that looked out onto the parking lot and the road beyond it. I don’t want people to see me getting a needle stuck in my neck! I thought.

Even though my rational brain was glad to have the process moving along, my emotions were in a tizzy. Why didn’t I make Rusty come with me? my brain screamed. I tried to call him, just to let SOMEONE know that something very important was happening! They were going to stick a needle in my neck TODAY! But he didn’t answer. I wasn’t surprised. In the spring, if the weather permitted, he is usually out in our yard, making it beautiful.

I have GOT to calm down, I thought. I said a quick prayer for the Lord’s help. Then I remembered that I had put a vial of “Peaceful Child” in my purse. I gave that to J this morning! But I still had the rest of my oils. Balance. I opened the little lime green zippered case that holds my travel oils and found the bottle of Balance. I tapped some out onto my hands, and then rubbed it on the back of my neck and my wrists. I took deep breaths, inhaling the scent each time. I felt myself start to calm.

As my pulse slowed to a more normal pace, I felt inclined to laugh. Since I discovered the lump on my neck, I had wanted to speed things along. Now that they were speeding, I felt hysterical! I was chuckling over this when Dr. B came in.

“What’s got you laughing?” he asked good naturedly. I told him that I hadn’t been expecting a biopsy, but that I was fine with it—glad to move the process along. He took a look at my file, and gave me a chance to take a look at him.

He was wearing a leather band around his head with one of those reflector discs like you see cartoon doctors wearing. He also had reading glasses with a magnet in the nose bridge to make it easier to get them on and off quickly. I was comforted by the nerdiness of that reflector and those glasses. Not so much the image of the ex-quarterback I had in my mind from his online picture.  (No offense, Dr. B!  I think you’re awesome!)

“So the ultrasound report says that one of the nodules has calcifications and posterior shadowing. We’ll take a look at it, but it sounds like it does need to be biopsied.” He stood up and started talking me through the flowchart of possibilities, all the while tucking a drape into the top of my shirt, looking in both of my ears, peering up my nose, and feeling for what I presumed were the lymph nodes on my neck.  I looked up at him to respond and saw that he had the reflector flipped down over one eye to assist him in his examination.

The nurse came back in. Dr. B asked me, “Did you get to see your nodules on ultrasound?”

“No, but I’d love to,” I said.

“Let’s take a look.” He turned the machine on and put some gel on the transducer. He ran it across my neck and looked for a minute himself.

“Ok, turn you head a little this way,” he said, moving the machine more into my field of vision. “Here are the two lumps that we’re really looking at.” He moved the device around to show me the large nodule in the front of my neck, and the hidden one farther back, which had the calcifications.

“See, this one doesn’t look too bad,” he said, pointing out the nice smooth border and bland, solid gray appearance. “But this one,” he slid the transducer over, “See those calcifications? And that’s a blood vessel, so it’s vascular. It just looks a little more worrisome. Not as friendly as the other one.”

I wondered if the specks I was seeing would be considered “microcalcifications,” but I was afraid to ask. And it’s vascular. Not a great sign, I thought. From that point on, I expected that the biopsy would show malignancy. I knew that it might still be benign, but felt like the odds were against it.

“Isn’t it weird that if it hadn’t been for the friendly one,” I pointed to the bulge in my neck, “We wouldn’t have known about the ‘worrisome’ one?” I said.

“It’s serendipity,” he said.

I think I actually huffed. “It’s the Lord,” I said.

He started getting everything set up for the biopsy. “We’re going to get samples from both of them,” he said.

“How long before I hear something?” I asked—my new favorite question!

“About a week. We send them to Atlanta.” He pulled out a card and stuck it in the top of my purse. “If you don’t hear something by then, shoot me an email.” He told me that if the nodules turned out benign, it was still likely that I would have to have thyroid surgery sometime, just because I had so many lumps at such a young age.

“If I need a thyroidectomy, will you be the one to do it?” I asked.

“Yes.”

“Do you do a lot of those surgeries?”

“There’s only one guy in Alabama who does more of them than I do,” he said, not in a boasting way, just matter-of-fact. “He’s at UAB.” That sealed it for me. This was my guy.

They started to prep for the biopsy. I looked ahead, through the window, again. “Can we close the blinds?” I asked. The nurse pulled them shut without hesitation.

Dr. B injected some numbing medicine into the skin on my neck. It stung. “You’re very red-headed,” he said, “So this is really going to make your neck look splotchy for a few hours.” That was the least of my worries at that moment. But I really loved how calm and straightforward he was. I am going to have to thank Dr. G for sending me here, I thought.

“Ok, we’re going to get about three samples from each one. When I put this in, I need you to be very still. Don’t swallow, don’t talk.” He held the ultrasound wand in one hand and a syringe in the other. He was watching the screen. “Here we go. BE STILL.” The needle went in. It didn’t hurt, exactly, but it was the strangest sensation I had ever experienced. I could feel it inside my neck. It was all I could do to stay calm and hold myself still.

He took the needle out and squirted his sample into a vial. The he repeated the procedure. At one point he nodded to his nurse, “Hard drive that.” She went over and clicked a button on the ultrasound machine.

“Do you have any children?” he asked, right as he was inserting the needle for the third time. “Don’t answer that, hang on.” He withdrew the needle in a moment and I could answer.

“Three,” I said. “A ten-year-old, a seven-year-old, and a two-and-a-half year old.”

He nodded, then continued with the biopsy. “Ok, don’t talk don’t move,” he commanded, inserting the needle, now into the front nodule. I looked up at the ceiling vent and counted the louvers.

“I can tell you’re nervous,” he said. “I can see your carotid and jugular right here on the ultrasound.” I told him about counting the slats on the vent. He and the nurse chuckled. “You’re doing fine, almost done.”

After a couple more passes with the needle, he was finished. The whole thing probably hadn’t taken ten minutes.

The nurse pressed a piece of cotton to my neck. “Hold this.” I obeyed.

Dr. B was back in his seat, filling out the lab work instruction forms for the pathologist. “I want you back for a follow up in three weeks.” I remember him saying this, but at the time I was too foggy for me to process the meaning of his words.

“You should hear something by the end of the week,” he said. That, I understood.

“By the end of the week, or within a week?” I asked. I did NOT want to find myself expecting information when there was no chance of having it yet. He looked up at the ceiling, doing the calculation.

“Well, it’s late in the afternoon. If we had done it this morning…No, probably not until the first of next week.”

I mentally noted Tuesday as the day expect results. The nurse gently pulled my hand with the cotton away to check the bleeding. It must have been fine, because she held up a band aid—a miniscule circle.
I laughed. “So I get a tiny band aid?” I felt like I was going to need a huge gauze patch.

“Yes,” she said kindly, sticking on one and then another.

Dr. B handed me my discharge slip. “Come around here and look,” he said. He led me behind the exam chair and gently pointed me towards a mirror on the wall. “See how the medicine made your neck blanch? When you pull off your band aids, you’re going to have bull’s eyes.” I was thankful I didn’t have anywhere else to go that evening.

When I walked out of the room, the nurse pointed me towards the checkout desk. As I sat down in the chair, I saw the slip of paper shaking in my hand. Yes, I was glad to have the biopsy over with, but it had rattled me. Surprise! I thought. A biopsy!

“Looks like he wants you to come back in three weeks.” That was the first time it registered that I wouldn’t be back for three weeks, even though I should hear something within one. That’s how it’s going to go, I thought. I reminded myself what I had read several places, that thyroid cancer had to be dealt with, but it wasn’t an emergency. Later I realized that she actually scheduled me for one month later—the 16th of May. At the time, I was too much in a fog to notice. I paid my copay and went home.

Sure enough, when I got there, Rusty was watering some flowers he had just put in. I got out of the car.

“Guess who had a biopsy today?” I said in the most cheerful voice I could muster.

“Well, I wondered, since it was taking so long.” He gave me a hug. I followed him around the yard for a few minutes, chatting. Then I went inside. There was a message from S saying that she had gotten RYC applications for her kids. I thought that was a good sign—that she was probably in. But just to make sure I sent a quick email to the director of the camp, begging for information. Then I started calling the people I knew would want news.

I called J. “WHAAT?!!!!” She said when I told her about my surprise biopsy. But she was glad, too, that I wouldn’t have to wait any longer than necessary.

Then I called Nathan and Sarah. I filled them in, and then told Sarah that I had emailed the Rustic Youth Camp director for some answers. “I’ll go ahead and send our applications in, just in case,” she said.

I called my Dad. It was good to hear that he was now walking some without a cane, and that he thought he might be done with his IV antibiotics.

I called my Uncle Ken. I told him that I really wasn’t that scared of it being cancer, since it had such a good cure rate, but I was apprehensive about all the medical mayhem between diagnosis and cure—surgery, medication, radioactive iodine. He understood.

I tried to call Y. I didn’t get an answer from her, so I started my text message to everyone else who was following my case, putting her at the top. A few minutes after I sent the text, I got a call from her.
“I’m sorry I missed your call,” she said. “I assume it was about what your text message said. Did you want to tell me anything else?”

I am so thankful for you! I thought. I filled her in on what the ultrasound looked like, and basically repeated to her what I had said to my Uncle Ken. It was reassuring to hear the words, “I’m not really that scared of it being cancer,” coming out of my mouth. And it was true.

Eleanor woke up. I went up to get her out of her bed. “I like your band aids, Mommy,” she said, pointing to my neck. “I have a band aid on my foot. I don’t have one on my neck.” I had to smile. At least I was stylish.

I replied to T’s email, trying to keep my own update light by adding in the bit about Eleanor’s admiration of my bandages.

Band aids are always big with the toddler set, she replied.

We picked up Chinese for supper—comfort food to Rusty and me. But I knew I couldn’t keep indulging in needless expenses just because I was feeling vulnerable. I really needed to make myself stick to the same old routine until I couldn’t do it any more. All evening I got encouraging replies to the text I had sent out to my friends.  Once again, so many reasons to be thankful.

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