Category Archives: Test Results

Moving On

I can’t believe it’s taken me a week to sit down and update since my post-op follow up appointment!

I’ll start there…

First of all, the path report on the left side of my thyroid was cancer free.  Woo hoo, right?  So was the lymph node that he removed.  Dr. B offered me the option of a referral to the nuclear medicine doctor, but he and I both felt that I didn’t really need RAI ablation/treatment, so we are just going to skip it for now.  Double woo hoo!

The other side of my thyroid did have some weird stuff…for one, it had a LOT of nodules, which I knew, and “hurthle cell change,” which I was pretty sure they would find.  They also found some “giant” cells, which can be associated with Hashimoto’s (which I have–or had?), but also has an association with PTC and even Anaplastic cancer.

I was a little afraid ahead of time that if no cancer was found in this second surgery that I would regret having it done….but I don’t.  I just know with all the weird stuff that was in there that I would have required a lot of monitoring to stay on top of it, and I feel, myself, that some of that would have morphed into more cancer at some point.  No, I’m just glad it’s out, and that we know for sure there wasn’t any cancer there.  If it had stayed in there, I would have wondered forEVER.  I have this feeling like I am “clean” now.

Dr. B does want me to have a WBS (Whole Body Scan–they use a small “tracer” dose of RAI) to check for any possible metastasis, but I get the sense that it is just kind of a formality, just to make extra, extra sure. That will be at either 6 months or a year, I can’t remember which.  Beyond that, I will have my thyroglobulin  levels tracked.  (That’s a protein only made my thyroid cells.)  As long as they stay stable, it’s unlikely that cancer has returned.  And I will also have periodic neck ultrasounds to make sure there’s nothing abnormal springing up in the thyroid bed.  But that’s it.  Nothing more than a low-level annoyance, if things go as expected.

I am so, SO thankful that God has seen fit to give us a favorable answer.  I look around at others who are going through so much more right now–one college friend who just had a kidney transplant, another whose four-year-old daughter is in a battle with leukemia that could last for years, another whose younger brother has just learned he has stage IV, terminal stomach cancer.  I feel like I have gotten off pretty easy.

I am also SO grateful for all the kindness we have been shown.  I have gotten so many cards from people.  Our brothers and sisters in Christ are STILL bringing us food to help us out.  Jessica stayed with me overnight in the hospital AGAIN.  I could go on and on.  I LOVE being part of God’s family.  His children are the best siblings I could ask for.

I am also doing pretty well so far on my thyroid medication.  More about that next time!

Today is Mom’s birthday.  I bought some Mayfield Brown Cow Jr. ice cream pops at Publix to celebrate.  She used to always have them when her grandkids–my kids and Nathan’s–came to visit.  She called them “Cow Bars,” and that’s how my kids know them now.

I miss her SO much, but in many ways, the intense, sharp pain of her loss has faded.  She’s been gone just over three years now.  Happy Birthday, Mom!  I raise my Cow Bar in salute.

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It’s the good kind….Really!

“The Good Kind” is a catch phrase/byword in the thyroid cancer world.  Thyroid cancer (thyca) in general and Papillary Thyroid Carcinoma (PTC–which makes up about 75% of thyca) specifically are known as “The good kind” of cancer or, “if you’re going to have cancer, that’s the kind of cancer to have.”  There’s a reason for that….the survival rate for PTC is better than just about any other kind of cancer out there.  Some question whether it should really even count as cancer.

I know that some people hate this generally optimistic feeling about thyroid cancer, mostly because they feel that it minimizes their fears and the difficulties that treatment involves for them personally.  Also, there are some types of thyca that are not nearly as easy to treat as PTC and whose outlooks are not nearly as favorable.

So today I found out I had Papillary Thyroid Carcinoma, not Hurthle Cell Carcinoma, as I feared. And my first reaction when I saw that lab report was relief.  Because I know that PTC actually is “the good kind.”  Because HCC was really a scary thought for me.

Wanna know the crazy part?  The PTC was in that ugly looking nodule with the calcifications, the one that I originally “knew” had to be cancer.  The one that tested benign on FNA and frozen section.  The Hurthle cell lesion was just a big lump in a lumpy gland.

I guess that’s my only real whine at this point.  Why couldn’t we have just found it on the first biopsy and gotten all the surgery over to begin with?

Possible reasons:

  • I needed, for some reason, to not go around knowing I had cancer in my body for that period of time from FNA to first surgery–It was better to find out after it was out.
  • I needed time to work on a gentle weaning process for Eleanor.  More on that later…
  • I needed to be really afraid of having HCC so that PTC wouldn’t seem bad at all to me.
  • Something I haven’t even thought of yet.

Whatever the reason, I am going to trust my journey because I trust my Guide.  He knows what I need and what I can handle.

He answered my prayer to be spared HCC. He let me have a big benign lump in a visible place so that I could find the cancer that was hidden farther back in the gland.

I embrace the label “The Good Kind,” because this is NOT my mother’s cancer.

Ok, so here are the details:

  • PTC Nodule was 1.2 cm.
  • It was completely encapsulated.
  • It had no vascular invasion.
  • It was widely invasive of the capsule. (So glad it is O-U-T!)
  • It looks to be unifocal and confined to the thyroid. (That would make it stage I. This could change after the findings of the 2nd surgery.)
  • Also, I have Hashimoto’s Thyroiditis (or at least I do for the next few weeks.  I think surgery will “cure” me!)

Here’s the plan:

  • Have a great VBS.
  • Go to camp and have a GREAT time!
  • 7/11, have the rest of my thyroid removed.
  • recover
  • meet with the nuclear medicine doctor and talk about whether or not I need RAI.

Somewhere in that plan I need to include finishing Eleanor’s weaning.  Rusty got up with her this morning (bright and early) and fed her some breakfast before I made an appearance.  She has asked me to nurse a couple of times, but I have been able to put her off so far.  We’re going to see how far we can go with this.  I may go get my nail polish in a minute and work on my own toenails, and see if she wants me to do hers.

Third Day Post-Op

Today is Monday, three days out from surgery.

First, a couple of details from my surgery that I haven’t recorded yet.  My parathyroid glands on that side did great, according to Dr. B.  So that’s a definite positive. Also, the “other” nodule, the one that initially was more scary on ultrasound but came back with a benign FNA still looked benign on frozen section.  Of course, I still want to see the report on it, but I am not worried about it at all.

We are still nursing in the morning.  I’m kind of glad I can provide that kind of continuity for Eleanor during this time.  Bless her heart, it’s hard when Mommy has a big boo boo on her neck and can’t pick you up.  We’ll get that last feeding gone sometime.

One thing I didn’t think through before surgery was making sure I had enough scoop-neck and v-neck t-shirts to wear for the first little while.  Down the road, I am going to be glad my scar is low enough for a regular t-shirt to cover it, but right now having something against it doesn’t feel great.

My incision is looking a little more gnarly today–more bruising etc.  But still not bad. Check it out:

IMAG1120

Also, I am not having much pain at all today. Really, my pain has not been bad from the beginning.  But I have still been feeling sort of crummy and tired.  Ever since I got home, I’ve felt like I might have a little fever.  Today I finally checked it, and it was 99.3.  Not too high, but enough to make me feel punk.  My discharge instructions say to call if I have fever over 100.4.  So I’m not too worried about it, but will keep an eye on it.

I’m also faithfully taking my antibiotic, even though I wasn’t originally sure that I would.  Dr. B, when he saw me the morning after surgery, said that it was mostly precautionary since they wouldn’t be watching me in the hospital. But that first day home, when I first started feeling a little hot, I decided to go ahead and take it.

I have been coughing some (not super comfortable, but normal, from what I’ve read), and my throat feels a bit more “gunky” on the inside today.  So I’m now sucking on On Guard throat drops.

One question I’ve had is whether I will be up to teaching my childbirth class tomorrow night.  Part of me says that I don’t feel that bad and not to be a wimp, but my rational brain is telling me that I’m still mostly affixed to the couch and don’t need to push it.  I just dread trying to make the class up.  Maybe by Friday I will be feeling better?

My follow up appointment is scheduled for Friday morning.  The old me, pre-surgery, would not have been content to just wait until my appointment to find out what my pathology report said if there was any way to know earlier.  The new, just-trying-to-get-over-this-surgery-and-a-little-scared-I-might-need-another-one me, is going to wait.  If I need to know before Friday, say, because we need to schedule a completion thyroidectomy, I am confident that Dr. B will contact me.

About that.  I am ashamed to say that I am having a hard time praying right now.  Is my faith really that wimpy?  I think I am a  scared to pray very hard that my lump is not cancer because I don’t know if God will spare me this, and it’s hard to be disappointed that way.  I  KNOW he knows what’s best and what will work out for my ultimate good.  I know he can use whatever Satan throws at me to refine and shape me into the person he wants me to be.  I just really don’t want to have Hurthle cell cancer!  “Let this cup pass from me!” I want to say.  I should say it.  I’m just afraid His answer might not be what I want it to be.

That’s not to say that I haven’t been praying at all.  I just haven’t been doing the kind of serious intervention type prayers I normally do when there is something big going on.  May He have mercy on me in my weakness and give me the strength to turn to Him the way I need to.

The really, really good news is that I know there are a lot of people praying for me right now.  Obviously, that doesn’t mean that I don’t need to pray too, but it’s very wonderful and comforting to know.  Also amazing and comforting is the meal list that Mrs. D put together for us…we will be getting meals EVERY NIGHT for the next 10 days.  I think it’s way more than we will need, but I am SOOOO thankful.  It will make things so much easier on Rusty.

My dear friend R is coming in tonight on her whirlwind visit from Brazil.  She and her kiddos will only be here in the evenings, so we decided not to cancel her stay after my surgery was scheduled right before her visit.  She generally uses us as a hotel while she visits with her in-laws in a nearby city, getting in two visits at once.  She called me to let me know that her husband’s grandmother, who has been sick for a long time, passed away this morning.  So she will likely be here another day or two beyond what she originally thought.  I am sad that they have this loss to face, but glad that I will get a little more time with her.

The next thing I remember…

Surgery went really well. My nurses were all super sweet. And it wasn’t crowded or backed up like I thought it would be. W, C, P, and J came and hung out with Rusty while I was in surgery. I was so glad he didn’t have to sit in the waiting room alone.

In preop, they got me situated–stripped, gowned, I.V.’d, etc– and then called Rusty back to be with me. We hung out while they gave me my first and second dose of sedative. I don’t remember much after that…Rusty says he kissed me as I left.

I have a foggy memory of them shifting me to the operating table.  After that, the next thing I remember a nurse in post op saying, “It’s all done, and it’s benign!”

That’s the only thing that has bothered me about the whole process. To be told, “It’s benign,” the instant I wake up, when really, we won’t know that until final pathology is done, seems PROFOUNDLY irresponsible. It wasn’t the nurse’s fault. She was repeating what she’d been told.

Dr. B was also very positive when he spoke with Rusty after surgery. Which was fine, given that surgery went so well. But he basically led Rusty to believe that all worries are over. And I hope they are, but I won’t be able to rest completely easy until that final report is back.

I wanted to talk to Dr. B myself to see if there was something he saw during surgery that led him to believe that all worries were over, like maybe if the Hurthle cell lesion was unencapsulated, which would suggest benign metaplasia. Fortunately, he came by to see me this morning, so I got my chance.

Just as I thought, when he said, “benign,” what he meant was no malignancy found on the frozen section samples during surgery. Then he told me they were 90% accurate.  Which is misleading. Because when they find malignancy in a Hurthle cell or follicular neoplasm, frozen section testing is very accurate. But for those two kinds of thyroid lesions, frozen section analysis has only a 20-40% sensitivity. That means that it fails to catch 60-80% of malignancies.

That’s because frozen section testing only looks at a few samples from the tumor, and if there is capsular or vascular invasion at even one point, the lesion is malignant. I’m not even sure why they do it, to be honest.

So I asked Dr. B if it was encapsulated, and he said that it looked like it, but he only final pathology will tell for sure. Which is what I thought. I just hate that we probably got some people’s hopes up prematurely. But maybe those hopes will be fulfilled, and they need never be the wiser.

So the words we are hoping for now are “Hurthle cell adenoma.”

My dear friend J stayed all night with me. We were able to catch up, and she pampered me, rubbing my calves where they were sore from the compression stockings they used during surgery.

The boys, of course did fine with Aunt Sharon, and so did Eleanor, for which I was SO thankful. She slept late yesterday morning, which made it possible to skip her nap, completely avoiding that sticky wicket. Then because she was sleepy, bedtime was a breeze.  And getting up this morning she was a little sensitive, but got through it ok.

She has not nursed all day, although she has asked a time or two since I’ve been home. I wonder if I’ll be able to just cruise on out and be done with it. The morning will be the test, I think.

I am so thankful to the Lord for helping things go so well. And also for all the good friends and family he has blessed me with, who have helped me and prayed for me through it all. May all our prayers be answered with a benign final result.

Macrophages

Ok, so I couldn’t leave well enough alone.  I HAD to keep on researching.

Let me back up.  Here is the word-for-word write up of FNA of the the larger nodule on the isthmus of my thyroid:

Hurthle cell lesion–see comment

COMMENT:

The specimen consists of numerous Hurthle cells and fragments of Hurthle cell epithelium, with a population of macrophages.  The differential diagnosis includes Hurthle cell change in a background of thyroiditis or a hyperplastic colloid nodule versus a Hurthle cell neoplasm.  Clinical correlation recommended and follow up as indicated.

So that actually didn’t sound too bad, especially the idea that it could be “Hurthle cell change in a background of thyroiditis.”

But I couldn’t leave well enough alone.  I wanted to know what, if any, meaning the macrophages had.  I had some vague memory that macrophages were immune cells, maybe a type of white blood cell?  I knew that certain cell types like lymphocytes tended to point towards a benign nodule.  So I went looking, using “macrophage” as a term in combination with “Hurthle cell lesion,” “Hurthle cell adenoma,” “Hurthle cell FNA,” etc. ad nauseum.

I found one case study in which two different patients had similar FNA samples that included Hurthle Cells and macrophages.  One ended up being a Hurthle Cell Adenoma (benign) and the other a Hurthle Cell Carcinoma (malignant).  So I know that macrophages could be present in either.

Then, for whatever reason, I searched for “macrophage thyroid cancer.”  From that I learned that macrophages are generally present in tumors (benign or malignant) and that a certain type of macrophage, known as a Tumor-Associated-Macrophages can sometimes make up up to 50% of a tumor, and that their actions tends to help the tumor grow and spread.

I found this article.  The title alone almost sent me into a panic attack.

I had a little freak out moment, feeling SURE that the “population of macrophages” meant my nodule is FOR SURE cancer. I have reeled it in a bit, and I’m now back to the recognition that “tumor-associated” doesn’t have to mean “cancer-associated,” and that, once again, I cannot find out if my nodule is cancer or not by doing research.  Still, I am not comforted.

I’ve also learned that “hemosiderin-laden” macrophages are usually associated with benign tumors; they “digest” red blood cells when a colloid nodule (always or almost always benign, from what I understand) undergoes “hemorrhagic decay”.  My FNA report didn’t say whether the macrophages were “hemosiderin-laden” or not.  So I really have no idea where I stand.

Before I made my macrophage discovery, I sent Dr. B an email to ask how long surgery should take (45 minutes to an hour)  and where pathology would be done (right here in our local hospital).  I have now looked up the pathologists on staff and am considering sending them gift baskets the day before my surgery, to make sure they do top-notch work for me.

Also, my sweet, sweet Aunt Sharon has said that if I need her, she can come for a few days.  We are going to play it by ear to see how things go.  And UK is in Uganda, preaching.  Love it.

Ok, I REALLY, REALLY need to forget all about this until maybe a few days before June 7th!  Although, I think it would be good to work on some things that would be helpful to accomplish before surgery. I am going to put my “folder” (containing my lab reports, surgery instructions, etc.)  somewhere out-of-the-way.

Should I Google “Hashimoto’s macrophage,” just to make myself feel better?  You see how sick I am?

ETA:  I did Google some more.  I am back to the realization–full realization, not just what I’m telling myself to think–that macrophages don’t mean I have cancer, and very well could point to a Hurthle Cell Lesion associated with Hashimoto’s.    Must.  Stop.  Googling.

“Either way, you will be fine.”

11:45 am
They’re cutting down the Toomer’s Corner Oaks today. One of them (the one on the left) looks like it’s already down. Watching on and off on the webcam. Wondering if there will be something else to mark this day as significant for me.

I am fighting edginess today. Have yelled at the kids several times. Thank you Lord for Clary Sage. I am really, really, really trying to Remain Calm. I also need to get my head around the possibility that I may not hear anything today, even though today is when the news is “due.” I will not die from waiting.

6:30 pm
Biopsy results are back.   I sent Dr. B an email this morning, and he answered me this afternoon.

One of the nodules tested as benign with inflammatory cells, which Dr. B says is consistent with Hashimoto’s thyroiditis.

The other nodule was a  “Hurthle Cell Lesion.” This can be because of Hashimoto’s. It is probably not cancer but since there is still a small chance it is, they usually recommend “surgical excision.”  He says we need to talk about whether to remove part or all of the gland.

“Either way, you will be fine,” he said.  I appreciate his reassuring words.  He laid out the facts, but isn’t lacking the human factor to go along with them.

Pretty Hi-larious how far off I was in my latest theory! Should teach me not to speculate. But of course I have already started looking at Hashimoto’s and Hurthle Cells on the internet. Really haven’t found much to tell me any more than Dr. B’s email. And I still have to WAIT! :) It’s probably good for me.

So I still don’t have a yes/no answer on cancer, and I will probably need surgery this summer. Some good news, for me, is that Rusty can go to Utah on his business trip this weekend without the stress of leaving behind a cancer-diagnosed wife at home.

So should I go ahead and start to wean Eleanor anyway, knowing that I will probably at least need surgery? I think I will.

Ultrasound and Waiting

The ultrasound was on Friday morning, April 29th. It was the day we were scheduled to leave for our “spring break” trip—even homeschoolers need a spring break!—to Panama City, Florida. I arrived at the diagnostic imaging center for an 8:00 appointment. The lobby was full. I read on my kindle while I waited. Eventually, my name was called, and I was ushered into an area plastered with pictures of….babies!

As a childbirth educator, I am fairly familiar with the OBGYN practices in our area. I knew for sure that the largest practice had their own ultrasound staff and equipment; I had assumed that the smaller practice did as well. So I was surprised to learn that the smaller practice actually sent their patients over there for their ultrasounds.

So I sat on the table in the ultrasound room and gazed at adorable art pictures of newborns while the tech dimmed the lights in the room and applied her transducer to my neck. She complimented me on wearing ideal attire for a neck scan—a blouse that left the area around my neck bare to just below my collar bone.
I am normally a chatter—I like to make conversation with the people I have interactions with, from the girl at the Publix check out to the guy that comes to work on our appliances. But with an ultrasound transducer on my neck, talking wasn’t the thing. Instead I waited in silence while the tech did her job. After a few minutes, she was done, and she started wiping the goo off my neck.

“Can you tell me anything?” I asked.

“Well, you have some thyroid nodules,” she said.

Nodules? I thought. More than one? She went on to run through what I had already learned from the limited research I had allowed myself on the internet: Thyroid nodules are common, they are usually benign, if they do turn out to be cancer, I would have to have surgery and maybe other treatments. She told me that my doctor should have the results within 24 hours. Since it was Friday, I assumed that meant Dr. G would have them sometime Monday.

After I got home, we finished loading the car and took off for our vacation. During our drive to the beach, I got a call from Dr. G’s nurse about my blood work. I was unsurprised to learn that my thyroid levels were normal, though I wished for more detailed information. She asked about my ultrasound. I told her it had been that morning.

“When we get that report, we’ll give you a call,” she said. I did the mental calculation and figured I’d have a call by Monday evening if I was lucky, but surely by Tuesday. What I didn’t know was that the imaging center was not known for their quick turnaround on reports, in spite of what the tech had told me.

I was determined not to let my thyroid nodules dominate my mind or conversation while we were on vacation. I knew that Rusty was worried, and that talking about it would make it worse for him. I am also all too aware of my own obsessive tendencies—when my mind becomes occupied with a topic, I have a very hard time thinking about anything else. It’s all I can do to keep from spending large portions of my day searching for information on the subject du jour. I tried to redirect my thoughts to my new interest, essential oils. I had brought a couple of books, as well as my small supply of oils. I had fun experimenting.

Still, I couldn’t stop myself from doing a little bit of covert investigation, both via internet on my phone and through a book that I found in the kindle store. I gathered a basic outline of the likely next steps and also got a good idea of what my current odds were of a cancer diagnosis. I knew that regardless of what the ultrasound showed, I was probably at least in for a fine needle biopsy. I learned that it made a difference whether the doctor doing the biopsy was experienced in the procedure and if he or she used ultrasound to guide the placement of the needle.

I started doing a little research on endocrinologists in the Auburn-Opelika area, as well as in Birmingham. “I want you to promise me you will find a good doctor,” my friend J said when she called me on the phone during the week.

I also learned about the different types of thyroid cancer and a little about their respective treatments and outcomes. The outlook wasn’t too bad. Even if I had thyroid cancer, odds were I could be cured. Anaplastic thyroid cancer looked pretty scary, but it is also very, very rare. I decided it was so unlikely that it was safe to ignore it as a possibility. After all, only 5% of thyroid nodules were malignant, and then, of those, only 1-3% were diagnosed as anaplastic cancer.

So I thought I could see the path ahead, at least for a few steps. I would most likely have a fine needle biopsy (FNA). If the results were benign, my nodule would probably be monitored every 6 months to a year. If the results were unclear because of an inadequate sample, I would have another biopsy done in a few weeks. If the results were inconclusive because it was too hard for the pathologist to tell if the cells were normal follicular cells or not, I would probably have at least half of my thyroid removed to be on the safe side. If the surgical results showed cancer, I would have my whole thyroid out, most likely followed up by radioactive idodine treatment (RAI) to make sure there weren’t any traces of thyroid cancer left in my body. If it was anaplastic thyroid cancer….well, I wasn’t going to think about that.

Monday passed without a call. Then Tuesday. On Wednesday, I left a message for Dr. G’s nurse, asking if my results were back. My anxiety to know what the ultrasound looked like was building. I knew enough now to be aware that some nodule characteristics, like irregular margins, microcalcifications, and centralized vascularity, were more indicative of cancer.

Wednesday also brought Rusty’s mom, and brother to join us at the beach cabin, along with their two small dogs and our nephew. My boys were thrilled their cousin was coming to play; Rusty and I were happy that his brother and mom were getting out of the house to do something recreational. His brother had come far enough with physical therapy to be walking some now.

It was a very pleasant week. The temps at the beach were a little on the cool side, but my boys at least did not find the cold water a deterrent from cruising on their boogie boards and exploring the sand bar that appeared towards the end of the week. Rusty and I read, listened to the waves, and watched the dolphins and pelicans pass by while Eleanor played in the sand. In the evenings, we went to our favorite local restaurants, hitting Boon Docks twice. Then we would shop, play mini golf, or head for the rides at the Miracle Strip.

One night, while poking around in Target, I almost bought a new nursing bra. I was still nursing Eleanor, at two-and-a-half, and my bras were a little worse for wear. I picked up a bra that looked comfortable, but quickly put it back on the rack. What if I have cancer? I thought. I’ll have to wean her for radioactive iodine treatment, and this will be a waste of money. I know some people would say I was long past the time to wean, but we had both enjoyed our extended nursing time. I had nursed each of my children longer than the one before, finally coming to the full realization that the way our culture does breastfeeding is WAY outside the norm for all cultures and all times.

On Thursday I still hadn’t heard anything, so late in the afternoon I called the front desk at Dr. G’s office to see if they could tell me anything.

The very friendly staff person took a peek in my file on the computer. “Well, it looks like we got the results in yesterday, but the doctor hasn’t reviewed the results yet.” It relieved my feelings a little to know that the report hadn’t just been sitting in Dr. G’s inbox all week. What she didn’t tell me was that Dr. G had just left for a long weekend with his family. He wouldn’t be reviewing that report until sometime next week. I thought, surely I’ll get a call before the end of tomorrow. I had no idea I still had almost a week before I would learn what the ultrasound said.

By this time, I was starting to get phone calls and texts from friends and family. Have you heard anything yet? When will you hear something? Why is it taking so long? I was glad to know that my friends cared for me, but it also ramped up my anxiety over not hearing from Dr. G. They think I should have heard by now, too, I thought.

Friday came and went. When we went out for dinner Friday night, I realized my chance to learn something was over until Monday. On Saturday, our extended family headed home. Rusty’s brother, still dealing with his neurological problems, was finding it hard to get comfortable on any of the family cast-offs that supplied the beach cabin’s furniture, and was ready to get back to his recliner.

We packed up and left for home on Sunday. Monday we worked on getting back into our regular routines—but there was still no call from my doctor’s office. My family and friends, however, kept calling. I hated not having any answers for them. I knew that a biopsy was almost certainly my next step, and I was eager to get it over with. I was on and off the internet, reading bits about nodules, ultrasounds, and biopsies. I even found out that there has been a fair amount of research done on the anxiety caused by waiting for medical test results!

I was spending increasing amounts of mental energy trying not to stress about what my ultrasound looked like and when I would hear about it. I carried my phone with me as I moved from room to room in the house, so that I wouldn’t miss a call.

On Wednesday I got to talk with my dear friend, A. A few years ago she’d had surgery to remove half her thyroid for a nodule that was causing the gland to be overactive. I asked her what she had thought of her endocrinologist. I was determined to find someone good to go see, and wanted to be ready with a name when I got a call from Dr. G.

Later that day—one week after the office had received the ultrasound report—I finally got a call from one of Dr. G’s staff. She was very kind. She informed me that Dr. G thought I needed a biopsy (Duh!) and wanted me to see Dr. B, a local ear, nose and throat specialist. I was kind of surprised—I had expected to be referred to an endocrinologist. She reassured me that Dr. G had a really high opinion of Dr. B and sent people to him all the time. I asked if she could give me any details about what the ultrasound report actually said. “I don’t have those details. You’ll be able to talk to Dr. B about it when you see him.” So my assignment was to wait on a call from Dr. B’s office to schedule an appointment.

When I got off the phone with her, I looked Dr. B up online. He was in practice with two other doctors. I saw that “thyroid nodule” and “thyroid cancer” were both listed in the conditions they treated. One thing I really liked was that I would be able to email questions to Dr. B once I was officially his patient.  In his picture on the website he looked kind of like an ex high-school quarterback, and maybe not suitably nerdy.  I decided not to hold that against him.