Category Archives: Biopsy

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.

Advertisements

Waiting for a Biopsy

I couldn’t quit wondering what the ultrasound report said. I knew that certain characteristics were more indicative of malignancy. I called Dr. G’s office back and asked if they could print out a copy of my blood work results and the ultrasound report. I went by and picked it up.

While I was there, I asked if it was ever possible to talk to Dr. G without making an appointment. I explained that waiting so long for my results had caused me a lot of anxiety—that I felt like I didn’t matter—and that I just wanted to talk to him about it. I was trying really hard not to embarrass myself by crying. As always, the women at the desk were extremely kind, and said they would leave a note for him to call me when he had a chance.

The lab work truly did look “normal.” Most of my levels were close to the middle of the normal range. My FT4 was at the low end of normal, but my TSH–which is what they use to determine if you are hyper- or hypo-thyroid–was right on target. The ultrasound report was very short. What I learned was that I had a lot of nodules, including three larger ones—one in the left lobe, one in the right lobe, and one on the isthmus in the center. That, I figured out, must be the one I had discovered. It sounded like the one in the right lobe was the most concerning—it had “areas of calcification.” The radiologist who had written the report recommended a biopsy.

“Areas of calcification” didn’t help me out much. I had read that microcalcifications strongly suggested papillary cancer, but “coarse” calcifications didn’t necessarily, and a calcified “halo,” or “eggshell,” as it was called, actually pointed to the lump’s being benign. The report didn’t even mention the size of the more worrisome lump, though it offered measurements on two others. I would just have to wait on more details.

The woman who had given me the call had said that I would probably hear from Dr. B’s office on Thursday. I didn’t.

I did get to meet with my ladies’ Bible study group though, and I shared with them about my thyroid nodules and upcoming biopsy. As always, it was a huge comfort to know those women would be added to the number of people who were praying for me. Y also told me that I was the third person in a short period of time who had been concerned about suspicious thyroid nodules. That was comforting too.

Thursday also brought a call from Dr. G. To be honest, I was a little embarrassed when I actually had him on the phone. I told him simply about the anxiety I had experienced while I had waited for my call-back on the ultrasound. He was very kind. He also told me about being gone for a long weekend right after the report got to his office, and about some of the nightmare issues they had been having at the new office. He had come back from his vacation to an office that smelled like a latrine because the sewer line was backed up—it was filled with concrete. And he’d been battling other problems related to the new building. It sounded like a nightmare of a week.

“I don’t want to make excuses, because I hate it when someone makes excuses to me,” he said. But it helped me a lot to know that there had been extenuating circumstances. I really felt for him, and I told him so. I also told him that I really didn’t want to be a complainer or a “problem patient.” I hope I’m not on the “bad” list for him and his staff now.

Friday brought no call from Dr. B’s office. Is there a pattern here? I thought. I decided to resign myself to the fact that this was going to be a long, drawn-out process.

Over the weekend I found a blog by a thyroid cancer patient. I have always been someone who can face things better if I know what to expect. I fully realized that my odds of having thyroid cancer were small, but I needed to keep reassuring myself that if I did, the path forward was doable.

In this blog, the writer, a young man in his twenties, outlined his entire cancer journey from discovery of a lump during an MRI for something else through his post-cancer recovery years later. One thing I found interesting was that the doctor who handled his surgery was an ENT. That made me feel better about going to Dr. B. It seems like even though the steps taken on this journey are pretty standardized, they can be carried out by doctors in several different specialties.

On Sunday we gathered with our brothers and sisters in Christ to worship. B, a long time friend, lead a prayer in which he asked for God to help those who were undergoing diagnostic tests, and for the results they received to be accurate. He doesn’t know it, but he’s praying for me, I thought.

On Monday, I decided to call Dr. G’s office just to make sure that I was supposed to be waiting for Dr. B’s office to call me, and that I was not supposed to call them. The receptionist told me that the referral had been sent, and that I should hear something soon. I did. Later that morning, someone from Dr. B’s office called and apologized for it taking so long for them to call me. She was training someone new and had gotten backed up. I had the feeling that Dr. G’s office had checked in with her to prompt the call.

I told her that I was being sent to Dr. B because I needed a biopsy of some thyroid nodules. She said that I would have to do a consultation appointment first. I wasn’t thrilled with the delay, but decided not to worry about what I couldn’t change. She told me where I could fill out my patient info online, and I told her I had already printed off the new patient information packet from their website and filled it out.

“Well, Dr. B is in surgery today, but he has an opening tomorrow at 3:30.”

So he’s a surgeon, I thought. I wondered if he did thyroidectomies. I took the appointment and called Rusty to let him know about my plans. He again arranged to take a few hours off work so that Eleanor could nap undisturbed. I was thankful he had time off available and that he was willing to use it to help me out that way.

I noticed that I had already received two emails from Dr. B’s office—one to remind me of my appointment and one with a link to a their patient information site. There I could enter all my patient info directly into their system. It was basically all the same information I had already filled out on paper, but I went ahead and did it. Anything that would get me in faster.

I got a shipment of some new oils that afternoon. I used some of them to mix up the popular “Peaceful Child” calming blend for my kids. Is there a “Peaceful Mommy” blend? I wondered.

Tuesday morning I went to visit with my good friend J–the one who had ordered me to find a good doctor. It had been a long time since we’d had a chance to sit and talk together. We talked of many things, but conversation did eventually come around to my thyroid nodules. I confided to her that the thing I was most afraid of, if one of my nodules was cancerous, was radioactive iodine therapy. I felt like in order to keep my children safe while I was radioactive, I really would need to be in a separate house. In her usual way, she said she would come and take care of me if I went alone somewhere like the house in Florida.

“Isn’t Rusty going to go with you?” she asked, when I told her about my consultation that afternoon. “I could come over so that Eleanor could still have her nap.”

“I kind of feel like that would make it too big a deal,” I said. “Things may get to that point, where I’ll want him with me for appointments, but I don’t think we’re there yet. But I’ll tell him you offered.”

Tuesday I also got Rustic Youth Camp applications for my boys. We’ve been to RYC the past two years—it’ss something that we all look forward to. I immediately called Sarah, my sister-in-law to see if she had gotten her applications yet, or if she had heard whether she was accepted to work the camp or not. I had found out the week before that I was in as a teacher for Elliot’s class. Last year we had tried to get Sarah in to work camp so that she could bring my nieces and nephews with her. My idea of camp Nirvana was for all of us to be there—Rusty and me, my brother, Nathan, and SIL, Sarah, with all of our children. Barring the presence of our husbands, having Sarah and her kiddos join me and mine there was a close second.  I was hoping this thyroid thing wouldn’t interfere with camp.

Sarah still didn’t know if she was accepted. I went ahead and filled my kids’ applications out and got them ready to return.

At about 2:45 Rusty came in from work. I told him about J’s offer to keep the kids if he wanted to come.

“I just assumed you would tell me if you wanted me there,” he said.

“I assumed you would ask if you wanted to come,” I replied, smiling. “I just don’t want to make it into a big deal yet.” I took off to my appointment, calling J on the way to let her know I was going alone, and that I was fine.

“Well, call me when you’re done,” she said.