One Little Bump...

The past couple of weeks have been full of waiting and wondering for us; and it hasn't been the fun kind of anticipation, but more of dread and possibly even fear. This will be another long post so settle in and I'll tell you about our most recent drama.

This issue began a year ago, although unbeknowst to us at the time. Brent got a sore throat and it just wouldn't go away. My husband is not a complainer, he rides out the tough uncomfortable moments in his life silently. He mentioned this sore throat to me only a couple of times over a six month period. Finally, last April (on my birthday, actually), he went to the doctor. Our family doc had a few ideas and made some suggestions. After six weeks of taking Nexium to treat what we thought might be silent reflux, nothing had changed; the pain was still there and still the same. So we went to Plan B and visited an ENT. This doc was absolutely sure it was Brent's tonsils giving him problems and immediately scheduled a tonsillectomy. After two miserable weeks in hell following the removal of his tonsils, Brent's pain persisted. He stuck it out for four additional months hoping it would go away but it didn't. Two weeks ago we moved onto Plan C.

Plan C involved a different ENT, one that came very highly recommended and who I wish we'd have gone to in the first place. We first met with Dr. Wood on Friday, October 24. He listened intently to Brent and then discussed possible diagnoses; one of which was Eagle's syndrome. Brent told Dr. Wood that he'd pretty much already ruled this one out because he'd taken a panoramic x-ray on himself at work and didn't see anything indicative of this syndrome. Dr. Wood suggested a CT scan just to make sure. Brent had the scan done and we received the results that same day. There was nothing on the scan that supported Eagle's Syndrome or anything else in the area where Brent was having this pain. What the scan did show was a 2cm calcified nodule in Brent's thyroid. Thyroid nodules are quite common; it is thought that some 60% of the adult population has thyroid nodules (multiple) and most never know it. Brent, however, has only one nodule, it is calcified, it is larger than 1 cm, he is male, and he has pain in the general vicinity. All of these things combined are cause for concern. Dr. Wood told us there was a 50% chance that this nodule could be cancer. A fine-needle aspiration biopsy with ultrasound was scheduled for the following Thursday (October 30). This would tell us if Brent had cancer or not.

The biopsy went well and there were no complications. We were told to expect a phone call the following Monday morning with the results. I called Dr. Wood's office Monday morning and was told the results weren't in yet. I called that afternoon and was told the same thing. I was a little irritated by this time, having sat by the phone all day with my stomach in knots. I decided I'd take matters in to my own hands, and I called the radiology department where the biopsy was done. I was told the samples had been sent to the pathology lab and the woman on the other end of the phone offered to find out what was taking so long. She called me back a few minutes later and told me Brent's samples were sitting in the lab and had not been examined yet. By this time, I was mad! So I called the pathology lab. The girl there was, what I considered to be rude and unhelpful, and if I were her boss, I'd have fired her. She told me they were just so busy and just hadn't got to Brent's stuff yet, because they're just sooo busy. I asked when I might be able to expect results. She said she didn't know when the pathologist would get to it and told me call back at 9:30 the next morning. I called back at 8:45 and got to talk to that same girl. How fun for me! She said, "I'm sorry, I don't have a good excuse for you, he (the pathologist) just hasn't got to it yet." I cannot tell you the anxiety I was feeling by that point, not to mention the frustration at the situation and the uncaring attitude of this girl. It took every ounce of self-control that I possessed to keep from totally ripping into her. I then asked to speak to the pathologist himself. She said sure, I'm sure she was glad to get off the phone with me. The pathologist's extension went straight to his voice mail, so I left a message. I was not rude but I was very assertive, saying that I understood that he was very busy, but that I had spent the past week wondering if my husband had cancer and I just needed to know. And would he please get to those samples as soon as possible. Dr. Wood called me 2 1/2 hours later with the results. The results were inconclusive, meaning pathology couldn't tell if it was cancer or not. (Note: This was the same day that Brent wrecked his car in the canyon. See previous post.)

When he called with the results, Dr. Wood encouraged us (Brent) to go for a hemi-thyroidectomy (removing the half of the thyroid that contains the tumor) at the very least. We met with Dr. Wood yesterday afternoon (Nov. 6) to discuss all of the options, everything from removing the entire thyroid to not doing anything and just watching to see if the mass changes or stays the same. After much thought and discussion, Brent has chosen to have just half of his thyroid removed. At that point, the nodule will be examined more closely and we'll then know exactly what we're dealing with. At this point, Dr. Wood suggested a 30% chance of cancer, which is better than 50%, but due to all the risk factors, its nothing to be too comfortable with.

We are looking at three possible outcomes at this point. 1- Papillary carcinoma, 2- Follicular carcinoma (Dr. Wood thinks this is the most likely if it turns out to be malignant.), or 3- this could very well turn out to be nothing, just a harmless bump growing in an endocrine gland in Brent's neck. Once the tumor has been removed, it will be frozen (I assume with liquid nitrogen) and examined. If its the Papillary carcinoma, we'll know immediately and if this turns out to be the case, Dr. Wood will remove the other half of Brent's thyroid as well. Follicular cancer will take longer to diagnose, it will also take longer to tell if the mass is benign so its possible we won't have a definitive diagnosis for at least another week. More waiting...

If we're looking at Follicular cancer, Brent will have to undergo a second surgery to remove the remaining thyroid lobe. I imagine some of you are thinking, why not just take the whole thing out at once and not risk having a second surgery? This was not a decision that we made lightly. You must recognize the lasting effects of losing the entire thyroid. The thyroid is an endocrine gland. Endocrine glands produce and regulate hormones in the body. When hormones get out of whack, the body doesn't function as it should. People that lose their entire thyroid gland are then dependant upon exogenous hormones in the form of a pill that must be taken daily for the rest of their lives. Dosages must be monitored and titrated and blood work is done periodically to ensure that the amount of hormone received is appropriate. There are millions of people out there who live like this and many of them don't have any problems and adjust well and easily. But Brent does not want to be tied to a pill for he rest of his life (I don't blame him), especially since he is only 32 right now. So he has decided (and I agree with and support this) to try to keep at least half of his thyroid. If at some point down the road something else has to be done, then we'll deal with that when we have to.

Brent is scheduled for surgery next Tuesday morning (Nov. 11). He'll spend one night in the hospital and we expect the recovery to be fairly quick and easy (nothing like the tonsil thing).

Thyroid cancer is very curable, in fact, if you had get cancer and you got to pick which kind you had, this is probably what you'd want to choose. Cure/survival rates are around 97%. We are optimistic of a very positive outcome. In my mind I've considered EVERY possible scenario and I know that whatever the outcome is, its out of my hands. I feel very calm and I'm at peace.

We've told the kids that Daddy has to have surgery next week because there is a bump growing in his neck thats not supposed to be there and we need to get it out before it causes problems. Brittany, true to form in difficult situations, did not say anything. Brooklyn immediately started crying (also true to form) and Damon was very concerned about Daddy sleeping over at the hospital.

Thank you to those of you that have offered help and for your love and support. I really appreciate that, we don't need anything right now but I would be grateful for prayers; one can never have too many of those. Stay tuned, I'll post updates and results as I get them.