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| 'Roid Rage | Bill Gresham |
| February, 2010 | |
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“Oh my god!” Those are words you definitely do not want to hear uttered by your physician, when he or she is looking at your diagnostic images. But hear them I did, when my ear, nose and throat doctor took a look at the ultrasound images of my neck. On a mid-January Friday morning, I had just finished shaving, when, while still looking in the mirror, I noticed something when I swallowed. My thoughts were “What’s that? That big lump, next to my adam’s apple?” I pondered what it could be, but decided not to panic. No need to run to the doctor immediately. By Monday, though, I’d had enough time to think about the situation, and, lacking a good excuse to ignore the lump, I called the doctor’s office. They got me in early that afternoon, and, upon taking a look at my neck, my primary care physician confirmed what I had been suspecting - it was my thyroid. He wanted me to get an ultrasound done right away, and the imaging facility was able to get me in on Tuesday afternoon. So after a score of relaxing minutes in a semi-darkened room, having a tech run a probe back and forth and up and down my neck, I emerged into the daylight, and commenced my drive home. I may have been a bit over 5 minutes out of the imaging center’s parking lot when my phone rang. My primary care physician, calling from his personal phone, already had the result of my ultrasound, and wanted me to see an ear, nose and throat doctor soon. That should have been my first clue that this was serious. He gave me the names and numbers of two specialists. I called the first one right away, but it was after hours. I left a message, but, having not heard back by about 9:00 the next morning, I called them back. Yes, the doctor could see me - on Feb. 3. I took the appointment, but, keeping in mind that it was only January 13, and the urgency apparent in the behavior of my primary care physician, I called the other specialist who’d been recommended. He could see me that Friday. I took that one, and cancelled the first. And that Friday, he uttered those words - “Oh my god!”. Yes, the right side of my thyroid resembled a chicken egg, which really isn’t what you’re going after with a thyroid. I’d had time to read up on thyroid disease a bit, on what is typical, on how diagnosis and treatment often goes. So when the doctor said he wanted to stick a needle into my throat, I wasn’t surprised. A “fine needle aspiration” it is called. Actually, the needle didn’t hurt much. No local anesthetic, either. Just a small stick, followed by the pressure of the doctor pumping the hypodermic plunger in and out, to extract fluid and cells. The pressure itself was more unpleasant that the needle, and the procedure was over with quickly. With the material extracted, the doctor and nurse prepared a couple of slides, which were sent off to a lab for evaluation. Unfortunately, results wouldn’t be back for 7 to 10 days. But I wasn’t experiencing any symptoms, so, no biggie. The doctor did say that, no matter what the results, he thought at least the right side of my thyroid should be surgically removed. Having someone cut my neck isn’t my idea of a good time, but, people have this done a lot, right? It can’t be that bad! So, on Tuesday, January 26, I went back to the specialist’s office. Without saying much, he handed me the report. “Suspicious for papillary carcinoma” were the words which jumped out at me. We exchanged some dialog on what needed to happen. Since the results from the first biopsy did not declare with certainty that the nodule in my thyroid was in fact cancer, there would be a two-step process. He would surgically remove the right half of my thyroid, and frozen sections would be prepared. Those sections would be analyzed on the hospital premises. If they came back affirmative for cancer, the remainder of my thyroid would be removed. If negative, I could keep the left, healthy half of my thyroid. With luck, it would produce enough thyroid hormone that I wouldn’t need medication for the rest of my life. So surgery was scheduled, for March 1. Yes, more than a month to wait. The doctor’s assistant said that, if there was a cancellation, they would contact me and I might be able to have the surgery sooner. Imagine my surprise when, that Thursday, a mere two days later, I got a call from the doctor’s office. Would I be interested in having the surgery the following Tuesday, Feb. 2? Yes, I said, I would. The sooner the better, in my opinion. On Feb. 2, I was wheeled into the operating room at North Kansas City Hospital. Remember, the first ear, nose and throat specialist couldn’t see me until Feb. 3? Through a rather serendipitous process, I was able to see the specialist, get a biopsy, and have surgery one day sooner that I’d originally been scheduled to see the other specialist to start that chain of events in the first place. Our health care system works pretty well, for those of us who have good insurance. Events like the one I’ve been going through serve as an effective reminder to us. Many times, we complain about having to go to our jobs, or do the work associated with our professions. And it is kind of strange, when examined just right, that we trade so much of our lives for pay. But when we’re struck by serious illness, it brings into sharp focus that we’re dependent on a system which provides us benefit, if we play by the rules. That we must play by those rules, that we’re held captive by that system, that health care costs are astronomical and are rising like a rocket, those are all reasons that congress has been debating health care legislation for most of the last year. Some warn that a potential consequence of a managed health care system would be rationing. My response to that is, what do you call telling a sick person he can’t see the specialist he needs to see for more than two weeks, or get the surgery he needs for more than a month? I call it rationing, by another name, and I’m just lucky that I was able to get the care I needed sooner rather than later. Should it be that we have to have been among the fortunate to receive care for a serious illness? Do the less fortunate not deserve compassionate and decent medical care? After the kindnesses heaped upon me by friends, family, acquaintances and the folks providing my care, I know how I feel. I don’t deserve better care than anyone else. Through good fortune, though, I’ve received it. And I’m very, very grateful. And, despite the length of this tome, I’m humbled almost beyond words. Over the past 30 years, I’ve lived what most people would judge to be a pretty healthy lifestyle, eating wholesome food and getting plenty of exercise. I’ve never smoked. I meditate daily. I’ve never killed kittens or pulled the wings from flies. My wife’s aunt used to say I was so good I didn’t even chew gum (let’s not go overboard). Yet I have received a cancer diagnosis. The universe is funny that way. You hear anecdotes all the time about the old guy who smoked and drank his whole life, and died in his nineties. People like that must have very strong constitutions, or good genes, or favor from a higher power. Your choice. I look at it this way: out of the people who develop thyroid nodules, fewer than one percent end up having thyroid cancer. What were the chances I’d get thyroid cancer? It is like winning the lottery, almost! As I write this, it is February 3. The nurses tell me I’ll be discharged today. I’ve not yet seen the next physician in my array of specialists, but he’s supposed to arrive shortly. It appears that I will require radioactive iodine to kill off any remaining rogue thyroid cells. But prognosis is generally pretty good for cases like mine. People often live a long time having had papillary carcinoma, with little complication other than the need for daily medication. Kind of like being diabetic. Another reason to be grateful. I’d be even more grateful if everyone, whatever their economic circumstances, could receive equal care, and that all sick people had good reason to be hopeful about their futures. Oh my god! Effective, compassionate health care for all! It would be nice if we could say that’s a future about which we were all hopeful. For now, I’ll have to be hopeful about more elementary things, like living this moment, while I have it. And statistics indicate I might be OK if, in those moments of real daring, I might think about tomorrow, too. |
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