Much has been written, in this space and in that of countless other blogs, about the far-reaching fear of metastases. Once cancer comes to town, no matter how small the tumor or early-stage the disease, the fear of recurrence prevails. Forever. Or until it actually happens. Kinda like in the traditional wedding vows: until death do you part.
When cancer returns, you go directly to Stage IV. Don’t pass go, don’t collect $200. No matter how “good” your cancer was initially, regardless of you doing your due diligence and “catching it early,” once it returns, you. are. screwed.
I think about this. A lot. Way more than I’d like to think about it. Maybe it’s just my personality. I don’t think I’m a gloom & doom kind of girl, but my mind goes to recurrence all the time. Perhaps it’s a natural by-product of having watched my sweet mama die a nasty death from an even nastier disease. Cancer, no matter what kind, no matter what stage, is nasty, and once it infiltrates your life, it’s always lurking in the shadows, ready to pounce upon your body or mind, or both.
Cheery thoughts as we head into the Thanksgiving holiday, I know.
My recurrence fears roared to life this week. I should have been relishing the upcoming Thanksgiving holiday, my favorite holiday because it encompasses all the food & fun and none of the stress of gifts. Instead I was enduring a crash-course in thyroid issues, and in the process of seeking a second and then a third opinion for my hypothyroid, I found myself back in the ultrasound department at my favorite local hospital. My new endocrine doc ordered an ultrasound so we could have a little look-see into what is causing my thyroid to limp along like an aging marathoner at mile 25. Good thing she did: there’s some sort of party going on in my thyroid, with lots of guests: the loudest, pushiest of these guests is a 1 cm nodule on the left side of my thyroid. The size itself is not terribly worrying but its mere presence is, and especially the presence of the “debris” it brought to the party. Debris is definitely not a good thing when it comes to nodules. At best, it raises a red flag. At worst, it can be indicative of cancer.
The thyroid gland is one of those myriad body parts for which you may not even know exactly what it does until it stops doing what it’s supposed to do. If you fall into that camp but are now curious, read this. I never thought too much about it myself, being preoccupied with my more ill-behaving body parts. What I know now is that my thyroid is lazy and shiftless. Well, maybe not shiftless; I threw that in there out of frustration. But lazy, yes. It’s an underachiever in the tradition of the slackers who populated Austin, TX, in the mid-90s, scooping ice cream at Amy’s or building delicious sub sandwiches at Thundercloud instead of working a traditional desk job. Like the scoopers and sandwich artists, my thyroid is covered in tattoos, likes to sleep until 2 pm, and is slowly working on breaking through into the upper echelon of the indie music scene. What I want from my thyroid is not a 6-inch-long braided goatee and a knitted-in-a-Guatamalan village skull-cap but a three-piece suit and shiny shoes with a briefcase stuffed with pie charts, spreadsheets, and proposals.
We always want what we don’t have.
Because my slacker thyroid is sporting a nodule where a nodule should not be, and because I’ve got a dual-cancer-surviving history under my belt, my endocrinologist ordered a thyroid biopsy. It’s unlikely that breast cancer would metastasize to the thyroid, but …. She was kind enough to tell me that it’s not a pleasant procedure, but nothing I and a xanax can’t handle. Thank the pharmaceutical gods for xanax.
So basically a thyroid biopsy is just as you might envision: a fine-gauged needle stuck in your neck to suck out the cells and some of the debris that fill the nodule.
Yes, you read that right — a needle in the neck.
After changing into a gown and filling out the consent forms (yes, I understand what they’re about to do to me. Yes I agree to have a needle stuck in my neck. Yes, I know how an ultrasound works. Yes, I get that some of the ultrasound gel may stick to my hair. Yes, I absolve the radiologist from any responsibility for honest mistakes. Yes, I will donate my unused cells and debris to research. Yes, yes, and yes, just get it over with), it was showtime.
The room was freezing, as rooms in which horrific procedures occur tend to be. Esther, the sweet Nigerian nurse, gave me a warmed blanket, asked if I’ve had a thyroid biopsy before, and remarked on how calm I was (again, many thanks to the creators of xanax). She distracted me from the many sharp objects being placed on the metal bedside tray by chattering about her one-year-old’s upcoming birthday party with an “elegant princess” theme. She raved about the radiologist who would be sticking that needle into my neck and said he’s a sweetie, just a sweet, sweet, sweetie pie. Good information to have about the person who will be sticking a needle IN MY NECK.
In walks Dr Sweet-Sweet-Sweetie Pie to explain to procedure and to apologize for the unnatural position in which he needed me to prop my head so that he’d have full access to my neck when it came time to stick that needle in there. No prob, Dr Sweetie. Really, it’s all good.
He explained that he’d be giving me a shot of lidocaine, again IN MY NECK, to numb the area for when he would stick the real needle IN MY NECK. He said the lidocaine shot would feel like a bee sting (IN MY NECK). I can’t vouch for the validity of that, as I’ve never been stung by a bee (true story), but I hope like hell that when and if I ever am stung by a bee, it’s not IN MY NECK.
After he explained the part about the needles, he said he’d squirt the gunk he extracts onto 3 slides for a cytologist to look at under a microscope. The cytologist was in the next room, waiting for the gunky slides, so it’s all quite efficient. If on the off-chance — and it is an off-chance — the cytologist doesn’t think there’s enough gunk on the slides, Dr Sweetie Pie will plunge another needle IN MY NECK and extract more gunk. But, Dr Sweetie reiterated, that’s on the off-chance, and the vast majority of times it only takes one plunge of the needle to get enough gunk.
He took a peek with the ultrasound wand to what lies beneath and quickly located the offending nodule. “There it is, for all the world to see” was what he said about that nodule. Once the lidocaine had gone to work, he told me to hold my breath and he stuck the needle IN MY NECK. And left it there. And wiggled it around in circles to extract the cells and debris. Gross.
While I couldn’t feel outright pain, there certainly was pressure, and there was enough feeling to know that the needle was not only still IN MY NECK but also moving around. “Creepy” does not even begin to cover it. I tried going to my happy place, which I’ll be honest, is a HUGE room full of bottles of Veuve Cliquot accessible by me and only me. I tried to summon the sound of the cork popping. I tried to imagine the gentle upward swim of those tiny bubbles in my favorite glass. I tried to console myself with promises of a bottomless glass just as soon as I got home.
Instead, all I could think was that there’s a needle IN MY NECK.
This took me back to the recent days in which my kids were obsessed with Plants vs Zombies, and the theme song that rang out incessantly from the computer: There’s a zombie on your lawn. Instead, in place of zombies and lawns it was needles and my neck. Gross.
The needle-in-the-neck part seemed to go on forever, but in reality lasted just a few minutes. Out comes the needle, and Dr Sweetie Pie fills the slides with my neck gunk then whisks them next door for the cytologist to view. I lay there and thought about zombies and needles and bubbly. After a brief respite, Esther the nurse and the radiology tech whose name I didn’t catch came back into the room and started bustling around. Neither made eye contact with me, which is a dead give-away to bad news. If ever you find yourself in an exam room or a procedure room or an operating room and the medical personnel don’t make eye contact, brace yourself because bad news is a-coming.
Sure enough, in comes Dr Sweetie to say that the cytologist didn’t think there was enough gunk and he needed to go back in and get some more.
Dadgummit, just once I’d love to be the normal one. The one who’s not the exception to the rule. The one who is just like everyone else. The one who skirts complications with nary a backward glance. Apparently that’s not to be; there’s something about complications and me that just go together.
In he went with another needle IN MY NECK to get more gunk. More digging in a circular pattern to extract maximum gunkiness. I didn’t have the nerve to ask if um, there’s ever a need for a third pass. I did ask what happens to the patients who pass out from this procedure. Dr Sweetie laughed and said it’s actually a bit easier, and they’re already lying down so there’s no real risk. Again, I give thanks for xanax.
The second look from the cytologist was satisfactory, so Esther wiped the ultrasound goo off me, applied pressure to the puncture wound IN MY NECK, and applied an industrial band-aid. I was free to go.
I changed out of the gown and into my clothes without even looking to see if my hair was sticking up or to determine how red my neck was from that harrowing experience. I high-tailed it outta there and into the waiting area, where my trusty sherpa Amy and the Hubs waited. Neither seemed too squeamish by my description of the needles — plural — IN MY NECK. Like me, they’ve been through a lot and are a bit hardened to even the most atrocious medical procedure.
We paid for parking, navigated the hospital-to-parking-garage elevator system, and soon were on the road for home with time to spare before school carpool. I spent the rest of the day with an icebag on my neck and a cold beverage in my hand. The worst part is over, but now the waiting begins to see what the gunk reveals. Like a fortune told from tea leaves in the bottom of a china cup, my neck gunk has a story to tell. Fingers crossed that it’s a good story, a happy story, a for-once-just-once-in-my-life-for-the-love-of-all-things-holy an uncomplicated story.
While I wait, I’m sporting a pretty bad-ass-looking mark on my neck that could very well have come from a vampire. Maybe a creepy but kinda hot vampire who would do himself a favor by ditching that milquetoast and hanging out with a chica who can easily withstand a good jab to the neck.