Cancer

In A&P2 we were assigned an extra credit project about a medical condition that has personally affected us. I decided to write about Tim, and what I wrote ended up more along the lines of a journal, and was very therapeutic. The following is what I wrote:


5/24/2011


There are four types of thyroid cancer: papillary and/or mixed papillary/follicular, follicular and/or Hurthle cell, medullary, and anaplastic. Papillary and follicular are the most common types and are the most easily treated. Papillary carcinoma, when treated correctly, has a 97% cure rate. (http://www.endocrineweb.com/conditions/thyroid-cancer/thyroid-cancer)

About two months ago, my husband complained of tightness in his chest and random occurrences of rapid heart rate with dizziness. It would happen on and off throughout the day and he would have to sit down and rest until it passed. He also complained of being constantly hungry, which I attributed to his recently quitting smoking. When he told me about this I passed it off as anxiety about something and thought he would be alright once he decided to talk it out with me. These spells, however, kept getting worse and one day he went to the nurse’s station at his work. The nurse did her thing, temperature, blood pressure…when she felt his glands in his neck, she found they were swollen fairly large and referred him to his family doctor. He went to his family doctor, who then referred him to have a fasting blood test done to check all of his levels. When the lab report came back it showed signs of hyper and hypo-thyroidism. This was most concerning to the family doctor and he referred him to an endocrinologist.
His endocrinologist ordered an ultrasound be done on the growth on his neck. He was almost certain it was just a goiter, which is an overgrowth of the thyroid gland caused mainly from lack of iodine in the diet. The ultrasound showed the growth to be a 3 lobed nodule about 2-3 cm in diameter and looked to be mostly on the left lobe of the thyroid. The endocrinologist then decided to biopsy the nodule, just to be sure that it was not malignant. He assured us that thyroid cancer is most common in women, and that there was only a 4% chance it was cancer. He had the biopsy done and a few days later we got a call to make an appointment for consultation over the results from the lab. When we sat down with the doctor, he informed us that it was, indeed, cancerous. His surgery was scheduled for May 16th.
The next two weeks went by fast but in slow motion. Worries about the cancer, upcoming surgery, hormones, how all this will affect our life. Keeping it together for the sake of everyone and especially our children was very hard. We did not tell too many people about what was going on, and we did not tell our children that their dad has cancer. We simply told them that daddy’s gland didn’t work right anymore and they had to take it out. That seemed to suffice our normally very curious boys.
Before we knew it, surgery day came. He checked into the surgery center at 8:15 am Monday morning, May 16th. They showed us to his room, the nurses did their questioning and entered everything into their laptop (which I thought was neat since that’s what I am going to school for) and had him change into the fashionable hospital gown. At 9:00 am they took him back, leaving me with bad daytime television and my thoughts to keep me company. The nurses did check on my once every so often and offered me soda and things, but I was so worried about him I only stared at the tv. Halfway through the surgery the receptionist came back to the room and told me what was going on and that he was doing okay, so I thought that was nice. A total of about four hours later the surgery nurse came and got me to let me know he was in recovery and doing well and took me to a consultation room to speak with his surgeon.
The surgeon, Dr. Dugan, is an extremely competent and friendly doctor. She came and sat down with me and told me he did beautifully and that the tumor looked to be completely contained within the thyroids capsule, which is a good sign. She also said that there were a few lymph nodes around it that she removed as well. They most likely grew there as a result of the biopsy and she did not think they would have any cancer in them. She did, however, not have to remove any of the parathyroids, which is great. Overall she was pleased and certain that the cancer had not spread, which made me feel a lot better.
When they moved him to his room from recovery I was able to stay with him. He was very groggy and sore. He did not react well to the anesthesia and did not want to wake up. The nurses had to put him on oxygen and he also had air casts on his legs all night to keep his legs awake. All night long the nurses kept watch on his calcium and oxygen levels. He woke up here and there throughout the night and was able to walk back and forth to the restroom without help. He was not able to keep food down until the next day though. The nurses think it was a mixture of not tolerating anesthesia and pain medications causing the vomiting. He jokes it was the chewable calcium they were making him take.
We are now a week out since his surgery. He had follow-up appointments with both his endocrinologist and his surgeon today. They are both hopeful that he will make a 100% recovery. We still have a long road ahead of us. In a week or so he will be called with an appointment with a nuclear medicine specialist for a full body scan using radioactive iodine to see if the cancer has spread anywhere else. If there are no large areas of cancer, he will then take a dose of radioactive iodine 131, which will be absorbed by any remaining microscopic thyroid cells left in the body. Destroying any thyroid left in his body will prevent any more mutation that could become cancer again.
He was also started on a short-acting thyroid hormone replacement pill today. He has to take it twice daily until after the radioactive iodine treatment, then he will be put on a long-acting hormone replacement that will have to be taken the rest of his life. However annoying taking a pill everyday for the rest of your life may be, I think it is a small price to pay to keep my husband around for many, many more years.