So, here's the long story of my most recent adventures. After my father-in-law passed away at the end of July, as Dave and I were having lunch with Rudy and Dan after meeting with the funeral home, Rudy turned to me and said, "Dan told me the other day that he thought your neck looked swollen, and I see it now. Tell me you'll get a doctor to look at that." And considering all that we had recently gone through, I said I would; right away.
My doctor was able to see me immediately, she agreed with Rudy that I seemed to have a goitre developing, and she sent me for blood work and an ultrasound. And based on those, I was called in for a meeting with a specialist. This Dr. Gill is young and confident and he explained to me that I had several nodules on my thyroid — apparently "very common in women my age" — but as a few of them were quite large (the largest being 7.5 cm), they would need to come off and he was setting up a CT Scan next. Dr. Gill is a really confident young doctor and I had no reason to doubt him when he said, "I don't want you to worry. I'll do the worrying for both of us." I did not worry.
I went for the CT Scan (a weird experience that wasn't exactly as I expected; I suppose I was mentally picturing a full body MRI instead of just a ring of tech that moves over one's head and neck), and shortly after that, a receptionist called me to say that Dr. Gill's senior colleague, Dr. Nateghifard, wanted to consult with me; that he was willing to come into the clinic the next morning before his office opened to be able to meet with me if that would be convenient. Well, yeah, that's convenient for me. Still wasn't exactly worried.
So Dr. Nateghifard showed me the CT Scan — pointing out that that biggest nodule was displacing my larynx and forcing it to enter my lungs at a sideways angle (which I never even noticed despite high intensity cardio at the gym? I didn't even clock the massive swelling on one side of my neck until it was pointed out.) — and he wanted to do a biopsy on that big one in the office that day and schedule surgery to remove at least that one side of my thyroid (explaining that if he didn't like what he saw on the left side of the thyroid once he was in there, he would send a sample to pathology and potentially remove that side as well; and if he didn't like the look of my lymph nodes, he'd be removing those too.) Now, if Dr. Gill was like a young Noah Wiley on ER, Dr. Nateghifard is definitely the George Clooney — exuding confidence and competence, a compassionate bedside manner, with salt and pepper hair that promises maturity and experience — and I gritted my teeth through the in-office biopsy; nodded along as the surgery was scheduled, along with a biopsy at the hospital on some of the other nodules.
Meanwhile, we had Kennedy's wedding — I was pleased that none of the medical stuff interfered with those plans, and that I was able to tell my mother and brothers in person what was coming up — and I gritted my teeth through the next biopsy. This one took place in the hospital's radiology department: First an ultrasound tech took a bunch of pictures of my neck and then a doctor came and chose a 1 cm nodule on the left side to biopsy. With a small ultrasound wand in one hand and a large-bore needle in the other, he dug around in my frozen throat three separate times, not so much hurting me as making me flinch as he brushed past nerves and whatnot (it was like when you're getting a filling, and even though your mouth is frozen, when the drill hits a nerve, you jump as though your brain expects it to hurt, even though it doesn't end up hurting; I'm sure I seemed a weinie as I winced and clenched in response to no actual pain.)
A few days after that, I had a pre-op COVID test, and as this was my first COVID test, I was a bit of a weinie about that too. It didn't help that Mallory called as I was pulling into the testing centre and said, "I've had so many friends tell me that their nasal swab was the most painful experience of their lives and I just say, 'Then you haven't known real pain'." Thanks, daughter. (The nurse who gave me the swab said that it's no more painful than jumping into a swimming pool and feeling that sting of chlorine up your nose, and he was exactly right.)
A few days after that, I was pulling into the parking lot at work for my last shift before surgery (I didn't like that I was scheduled to close the night before the operation but I guess it did do a good job of distracting me), and just as I was parking, Dr. Nateghifard's office called to say that the doctor was hoping to speak to me. I had plenty of time and he got on the phone and told me that he had results from both of my biopsies that he wanted to share with me. The large nodule came back as containing "FLUS" (follicular lesions of undetermined significance) and the cells from the smaller nodule on the left came back as "suspicious". Based on that, the doctor said that he would be removing my entire thyroid and he didn't want to ambush me with that info the next morning. He asked if I had questions or concerns and I said, "I made the mistake of googling what happens when the entire thyroid is removed and I guess that does scare me." He wanted to know what in particular was frightening, and I said, "You know — reduced life span, potential for pain and mishap, the difficulty in getting the hormone replacement right after the fact." As for the reduced life span — and I haven't told this to anyone — I read that it's a reduction of 14%. So, if I was going to live to a hundred, living to 86 would probably be a relief; but if I was going to live to 80, living to 68 sounds kind of sad (and especially since I haven't any grandkids yet; 68 is just not that far away for me and I've been so looking forward to that stage of life.) Dr. Nateghifard addressed each of those points and explained that the right side of my thyroid was so distorted by nodules that it needed to come out immediately, and since the nodule on the left was "suspicious", it would likely need to come off eventually and the risk of anaesthesia for some future, second operation was greater than the risk of living without a thyroid. He assured me that this is the advice he would give a family member, the advice he would want to be given, and if I were to ask ten top surgeons, they would agree "this was the move". I told him that I could only trust his expertise, resigned myself to whatever was to come, and went in for my last pre-op shift. Not worried, just resigned.
So, to the detailed story of what this experience was like for me: I arrived at the hospital at 8:30, two hours early, as scheduled. There was very little to the registration before I was sent to Surgical Day Care, where I was given a gown, booties, and cap to change into; a bed to lie in for the next hour and a half+. My overnight bag (so, my phone) was sent "up to the floor", so while there wasn't much for me to look at, the radio was playing, and off to the right was a room where people were brought after colonoscopies — I couldn't see any of them, but over and over I heard people being told whether there had been any polyps, what they could expect after they went home, who was ready to be picked up, etc. — and to my left was a nurses' station, where for the entire time I laid there, a group of nurses complained about the fifteen minutes they were expected to work extra every day, how hard it was to get specific shifts covered (because nobody "wants to do eyes"? I had my eyes done there and didn't know it was unpleasant for nurses?), and while the care that I received in my bed was excellent and friendly, it didn't feel very professional to be listening to these complaints.
Eventually I met a nurse who would be in the OR with me — she had lovely microplaned eyebrows, tastefully minimalistic fake eyelashes, and her overall put together appearance gave me confidence that she would be similarly detail oriented during the surgery — she chatted me up, read over the charts, smiled and left. The anaesthesiologist came by — kind of a goofy, hippy-looking woman who couldn't have been friendlier — and she asked if I have ever had a reaction to anaesthetic before. I was relieved to be able to repeat what I had told the nurse in my pre-op appointment — that when I had had my gall bladder out, I vomited for hours afterwards — and this doctor smiled and said, "No problem. I'm going to give you a good deep sleep and something to make sure you don't puke afterwards, especially because you'll be..." and she made a slashing motion across her throat. I laughed because that was exactly what I was worried about. Last, Dr. Nateghifard came by and said that the OR was just being set up for me, wanted to know if I had any last concerns I wanted to talk about, and when I said no, he kind of sighed encouragingly (frowned knowingly?) and patted my calf before saying, "I'll see you in there, then."
Before I knew it, a porter was wheeling my bed down a hall, she parked it and asked if I could walk into the OR; sure I could. We walked in, her carrying my IV, and she asked if I could hoist myself up onto the operating table; it was about hip height; sure I could. I was stretching myself out and the anaesthesiologist asked me to center the back of my head on this thick doughnut-shaped gel (?) ring, the pretty nurse asked me to stretch out my right arm on this support so she could hook me up to some monitors. Dr. Gill, who would be assisting, leaned in and said, "We'll cancel the two unscheduled biopsies because we'll be able to see everything we need to see here today." I don't remember ever hearing that I was supposed to have two more biopsies, and I'm sure that I looked totally confused, this was all happening in a whirlwind, and then I felt a pain in my left arm, and when I looked down at it the anaesthesiologist said, "Yeah, that can burn a bit going in," and I said, "Oh, I thought I had pinched it on something," and the pretty nurse was gently turning my chin back towards her, she put a mask over my nose and mouth, and blackout.
I really don't know how long I was in the recovery room before being sent up to the ward, but the nurse there was lovely to me, constantly checking up on me; giving me ginger ale and offering me advil when I said that I felt a bit headachey (worked a charm; that was the only pain meds I'd need). I was brought to my bed, and not long afterwards, another woman (an older woman who had had a knee replacement) was brought to a bed kitty-corner from me, and the way that the bed curtains bunched in between us, we couldn't see one another at all. I did hear that the people who set her up asked if she was hungry — could they find her a sandwich since dinner was over? — and that made me realise that I was really hungry. And then they asked her if she needed anything from her overnight bag, and looking at mine on the windowledge beyond my reach, I realised that I should probably dig my phone out to let people know I was doing fine. It made me a little sad to hear someone else being offered things that I wasn't. I had no idea just how much had been removed from my throat; had no idea if I wasn't supposed to be eating yet; but I eventually asked someone who came to poke at me if it was possible to have a yogurt or something since I had missed dinner. She was lovely and came back immediately with an applesauce and a vanilla pudding, and I was so satisfied to scarf them both down; delighted that it wasn't really painful to swallow.
Fortified, I then got my phone and answered a bunch of texts — happy to see that people cared, but not really wanting to get dragged into multiple conversations — and I felt terrible that one of the texts was from my younger brother (Thanks for coming to the party, hope you had fun!) and that while I had told him about the nodules and the upcoming biopsy and possible surgery (which he didn't remember?), I hadn't actually said, "Just so you know, I'm going into the hospital on this day and precisely this is happening." I just don't know how to ask for that kind of attention. So I had to tell him after the fact and I'm sure he felt sidelined and I had a bunch of back and forth with him to let him know that all was good. I felt like a jerk though.
Finally done with texts, I put on an audiobook and headphones to drown out the sound of the hospital and just kind of drowsed. That eventually became annoying — brain scrambling, really, despite it being just Jim Gaffigan droning on about his favourite foods — but when I took off the headphones, the old woman was snoring (like a chainsaw with apnea) and the constant beeping from all over the floor was entirely too much noise for me to sleep through. The head of my bed was raised to 30° (I had read in my google search that this was the standard recovery position for thyroid removal surgery, so I didn't question it), and there was no position that I could put my pillows in that didn't strain my neck and back or send me slowly sliding down until my feet were scrunched against the footboard. I was exhausted and cold and annoyed at the noise, someone came just about hourly to take blood or my vitals or give me meds, and after I got up to pee the first time, I then needed to get up a few more times during the night (probably to get rid of all the extra fluid from my IV). I'd put the audiobook back on until I'd drowse and then claw the headphones back off when my sleeping brain felt scrambled, watching as the clock beside me went through all the hours of the night. The only position I could get any relief in was kind of curled tight onto my side, but with a drain stitched into one side of my neck and a plastic bulb to collect the drainage pinned to my gown, even this was hard to manage. I believe I slept maybe three half-hour stretches in this position before Dr. Nateghifard came to check on me at around 8 am, starting with, "Did you sleep well?" My "No" probably sounded pretty bitter. The doctor explained that I could eat and move around without restrictions and that the most important thing to watch was my calcium levels; if a blood test at 2:30 that afternoon tested normal, that's when I would be going home. And that perked me up enough that I gave up on sleep. The only thing on my mind — and stomach — at that point was breakfast.
Soon enough catering brought a breakfast tray to the old woman across from me, but when she saw me in my bed, the worker said, "Oh, I don't have anything here for you, dear." And I thought I would go for mock-dramatic humour, but the, "Oh no!!!!" that wheezed out of me just sounded so weak and pathetic. Catering apparently had nothing else to say to me and she left and I just felt so sad. It took me about five minutes, but I eventually called for the nurse, and when she walked in and saw me without a tray, she said, "You didn't get any breakfast!" And I croaked, "I know. What are my options?" I was honestly wondering if Uber Eats delivers to the hospital. She said she would take care of me — I was thinking maybe more applesauce and pudding — but within about fifteen minutes she had a tray for me. The Cheerios, banana, egg and spinach pie, and coffee were about the best thing I had ever tasted.
To rewind for a second: When I had my pre-op appointment, the nurse asked if I had any supplemental insurance for a semi-private room, if one was available, and I gave her my information. And the fact that I had one whole side of this quite large room to myself overnight certainly felt semi-private or better, but soon after breakfast, a PSW came in and said she would need to move my bedside table over to the other side of me because another bed was coming in, and before I knew it there was another old woman with a knee replacement right beside me (so close that with the curtain closed between us, every PSW and nurse who stood on my side of her bed was nearly upon me, draped in curtain). The chainsaw-snoring woman was released before lunch (as soon as she could prove that she could walk the length of the room with a walker; this is a fast turnaround business) and just after lunch (egg salad sandwich, turkey vegetable soup, tea and oatmeal raisin cookie; yum), an old man who had had a knee replacement was wheeled into the spot directly across from me, so the curtain was hastily pulled completely around me, the PSW shooting me a look as though I was potentially some kind of Peeping Tom. (Note: It had been explained to me beforehand that rooms could be co-ed; that's just how they do it now.) Now when I had to pee, I had to come out from my curtain right at the foot of this old guy's bed (where his curtain was not pulled across) and then walk past the new old woman (whose curtain was not pulled across) before getting to the bathroom. And I didn't like that; and while I don't think that I'm better than everyone else because I have the insurance to pay for more privacy, what's the point of having the insurance if you're still stuck on a ward? (I will also note that I heard some nurses saying that one woman was in isolation because she was unvaccinated, and I am taking that to mean that by choosing not to vax, she got my room. I know it doesn't really work that way, but I do relish having someone to blame when things don't work out perfectly for me.) I will also stress that I believe that I got excellent and compassionate care from so many people who are working with who-knows-what kind of constraints (every time I asked for something, I got it; if I was uncomfortable, I could have asked for more help), and despite the number of beds that ended up coming into that room over the course of the day, once I left, there were just the two old people, kitty-corner from one another and set up for as semi-private an overnight as I had enjoyed. (And they deserve that, no matter their insurance situation.)
I spent most of my remaining time just sitting on the bed and reading my book, someone came to take my blood at 1:30, and when the nurse told me that the calcium levels were perfect and I could go home, I was texting Dave and reaching for my clothes before she left the room. I was home by four in the afternoon, totally pain-free and feeling like myself, nothing worse than the drain still in my neck — and a hoarse voice that I was assured was just from the breathing tube inserted during surgery — to remind me of what I had been through. I saw Dr. Nateghifard the next day and he took the drain out (a little ouchy as he pulled out the stitch and the tubing) and changed my dressing. He said that they usually like to make a symmetrical incision for this procedure, but since my biggest nodule stretched nearly to my right ear, they chose not to go that far on the left for aesthetic reasons; I laughed and thanked him. I asked if they had had to take out the lymph nodes, too (someone may have told me that post-op, but I couldn't remember) and he said that everything looked good while he was in there, so he didn't remove them; he also explained that some lymph would probably have stuck to my thyroid gland as it was removed, so it will all be tested in pathology. He explained that the parathyroid is all still in place (so I haven't completely lost thyroid function and calcium regulation) and all of the major nerves and vessels were identified and left undisturbed; a textbook procedure. I go next week to get the stitches out, and probably, get the last of the biopsy results.
In all of this, no one has said the word "cancer" to me. There were "FLUS" and "suspicious" cells and a need to remove my entire thyroid gland, and I guess that's because it was cancer? Precancer? Something serious enough that something had to be done about it. It was roughly ten weeks between the time that Rudy told me my neck looked swollen and the operation to remove my thyroid, and that feels fast and efficient and, particularly during COVID-related pressures on the health care system, a credit to how things are done here in Canada (not to mention the unending conveyor of colonoscopies and joint replacements that I was privy to). I am grateful for the truly excellent care that I received, and reserve the right to still feel a little sad if I don't get a really long time to spoil eventual grandkids.
Edited to add (and change the title) a week later:
It had been my routine to have "Tunesdays" every Tuesday to focus on non-book stuff, but I haven't done that in quite a while, and the personal stories I've added this year (two funerals and a wedding) didn't feel appropriate to reduce to pop tunes. But over the past week, and based on the fact that every doctor described the thyroid to me as a "butterfly-shaped gland", I kept hearing Elton John in my head singing, "Butterflies are free to fly, fly awaaaaaaaay." But then I stopped to consciously consider that song and remembered it's called "Someone Saved My Life Tonight" and that stopped my musings cold: As I wrote above, it made me sad to think that my lifespan had been reduced by 14% (compared to someone who hadn't had their thyroid removed), but I hadn't actually stopped to think how my life expectancy was affected by me having my thyroid removed. I know that sounds stupid, but it never occurred to me to ask what my prognosis was if I had done nothing; I was thinking of this surgery as a necessary inconvenience (like having my gallbladder removed) but not necessarily an effort to save my life. Of course I should be thinking of this as a prolonging of this fleeting life and I'm grateful to Sir Elton John for reminding me of that.
