The Backstory

The past several months have been a whirlwind. My thyroid, a gland I had hardly been aware of until this point in my life, is now front stage and center. I found a large lump in my neck in late summer and kept an eye on it for a couple weeks, assuming it was just a swollen lymph node. Since it didn’t go away, I checked in with my primary care doctor who told me that it is not a lump on my lymph nodes, but a lump on my thyroid. She scheduled me to get blood work and an ultrasound. The blood work came back normal, but the ultrasound showed a large vascular nodule on the left lobe of my thyroid. I was referred to an endocrinologist who told me that it would have to be removed, along with half of my thyroid.

A snapshot into my mind at this point: I am a music professor and the chair of the department. Late in the fall semester was not the ideal time to do this-lessons, classes, performances, final exams, juried exams, and final grades all loomed in the near future. However, both the endocrinologist and the surgeon suggested sooner rather than later. An excellent general surgeon in town was able to get me in the day after one of my performances and then I had three weeks to heal before my next performance, performing as a soloist on Bach’s Brandenburg Concerto No. 5.  In addition to this brilliant planning, the surgery fell over Thanksgiving, so I only missed two days of classes.

The surgery went well. I had been terrified of my usual reaction to anesthesia which has been violent vomiting, and told anyone who would listen that I had that problem. The anesthesiologist told me that both forms of anesthesia, drugs and gas, cause nausea, but the drugs a little less so. Whatever cocktail he whipped up for me did the trick. I woke with only the most minor nausea, which dissipated quickly. My amazing husband was there for me as I became alert, and patiently, oh so patiently, fed me ice chips between my numerous naps. I spent the night and was awake around the clock with visits to draw blood, check weight, and check vitals. Despite the usual busy nature of a hospital room, it was a peaceful night and I was surprised at how good I felt overall. My throat was sore from the breathing tube, my voice was hoarse, and there was some mild incision pain, but I handled it all without pain medication.

My top recommendations for an overnight hospital stay include a set of earplugs, lip balm, lavender hand or body lotion, and an iPad. Listening to music, reading, and using a meditation podcast I had downloaded were a fantastic way to pass the time. The next day I saw the surgeon who informed me that the initial biopsy was negative and everything looked good, so they left my right lobe intact. He sent me home that day.

The first week post-op was punctuated by meals delivered by dear friends, flowers from family and friends, and time to watch movies. My husband took amazing care of me and anticipated my every need. I am so lucky to have such an incredible support network.

I headed back to work the following week, in retrospect a week too early. I was tired, but feeling confident that I was well on my way to healing. I got a call from the surgeon that week telling me that the frozen section analysis had to be sent out for a second opinion. I had a dash of concern, but was too busy to worry about it. Later that week I got the final diagnosis: follicular thyroid cancer.

During the initial appointment with the endocrinologist, she had told me that about 80% of thyroid nodules are benign. I went into this thinking I was going to have a surgery just for reassurance and the initial biopsy had my hopes up that was the case. I followed up with the endocrinologist. She told me that 80% of all thyroid cancers are papillary. Again I fell into that more marginal group. Follicular thyroid cancer accounts for only 10-15% of all diagnosed thyroid cancers, and thyroid cancer overall is far less common than others. Follicular thyroid cancer is second to papillary in terms of response to treatment and prognosis. It is more aggressive than papillary, but not nearly as aggressive as the other two kinds.

Plan A was to enter into 2013 healing and getting this year behind us. Plan B is to have total thyroidectomy followed by radioactive iodine treatment to ablate the remaining small amount of thyroid tissue, then followed by a full body scan to look for metastasis and complete staging. Age is on my side: Stage I if it has not metastasized, and Stage II if it has. Overall the prognosis is good, for which I am grateful. I look forward to greeting the journey to come with grace, patience, and courage.