User error?

Someone on the ThyCa listserv finally gave me a reason why my FT4 levels have been above range for all of my blood draws. On my blood draw days, I usually take my Levoxyl, as usual, when I get up, then 2 or so hours later, I get my blood drawn. Well, turns out that taking my Levoxyl before my blood draw can make my FT4 number higher than normal, so I am supposed to take my Levoxyl after the draw. I think there was only one time when I had my blood draw in the afternoon, not sure if that would still affect my FT4 level, but it does explain the other high numbers.

Anyway, my FT4 level is the least of my worries right now. Didn't hear back from my ENDO's office today, nor did I hear from the lady who is supposed to schedule my DCR. I have not told my boss that I may need to have this done. I still need to get a second opinion for the DCR, and a second opinion for my scar v thyroid tissue issue.....Argh!!!!

Here we go again...

I have not been told anything definitive yet regarding my neck ultrasound, but I can't help but think about the worst during these times when I have to wait for results or whatever. So, bear with me while I pity myself with some of my favorite 'realizations': 

...that I can't hide from cancer anymore now that I have had thyroid cancer. 

...that I will never lead a 'normal', carefree life ever again.

...that I should have done more research before I had my surgeries, asked more questions, gotten more tests done (like lymph node mapping).

...that although I feel so alone with my disease, there are a lot of us out there, even here in San Diego.

It is pretty clear to me that I need a second opinion on my neck ultrasound results, regardless of what my ENDO tells me next week. But I want to make sure all of his notes are forwarded to my second opinion ENDO before I make that appointment. What I need to know from my second ENDO is that my current ENDO knows what he is doing - would her treatment plan be similar or possibly more aggressive?, and what would be her plan of action for the unidentifiable tissue on the right side of my neck? I remember the conversation I had with her a week or so after my second surgery, she said she was surprised they didn't do a neck dissection to get lymph nodes since I had PTC on the right side. Maybe she would've done some lymph node tracking after the first surgery, just because cancer was already found on the left side? I just need fresh eyes on this. I just need to know that my treatment is going in the right direction. Would she do FNAs on the three benign lymph nodes that showed up after RAI and on the ultrasound last month? What would she do about my FT4 being above range? I have so many questions for her.

To add to the craziness going on with my neck, now I have to also consider having a Dacrycystorhinostomy (DCR) so that my left eye will stop tearing up on its own?!? At my eye appt on Friday, the referral doc also tried to clear my obstructed left tear duct. It was more painful this time, and he tried to clear both (upper in addition to lower) ducts. Something rolled down my check into my left ear. He said it was a white mucus like substance, from both ducts, probably a low grade infection. He said the only way to stop my eye from tearing is to have a DCR done. Then he drew some pictures and explained what the surgery entails. Outpatient, of course. An incision would be made between my left eye and my nose, he'd break the bone at the top of my nose so the tears could be rerouted to flow down that way. 5% of the time scar tissue can form to close the hole, and is only correctable by another, similar surgery, to re-open it. My odds have not been so good since my fat neck roll turned into ThyCa last year, so I can't imagine that I would not be a part of that lucky 5%. I was able to do a little research on this procedure. It can also be done through the nose with an endoscope.

He said said someone will call me on Monday to set a surgery date. I really don't want to have this surgery - isn' there another way to fix my leaky eye? I was thinking that maybe I could put it off for a while, that maybe my left eye would be good for a while since I felt something drain down the back of my throat while my left tear ducts were being stabbed. But today I had to pat my left eye dry several times. So I may have to seriously consider having a DCR, but not before getting a second opinion, and hopefully from someone who can do the endoscope version, and has done MANY of them. And, not before finding out if I need to have any thing done on my neck due to my ultrasound findings.

So not only do I have to deal with thyroid brain fog, which I am getting a lot now (it has even occurred while I was on a few conference calls with my boss!), but now I have to deal with a leaky eye? Put those two together in a meeting, and it looks like I'm not able to function. Good thing my two days in Monterey Park this coming week were moved to the week after. But that could also be a bad thing because by then, the leaky left eye situation could have gotten a lot worse. It could be an interesting distraction.

So, how lucky am I? We are not even in February yet and my year has already started to suck!

ENDO's Thyrogen question: maybe he wants a stimulated blood draw, to rule out presence of any ThyCa cells suppressed by my meds?

Dacryocystorhinostomy (DCR) - surgery I may have done to stop my left eye from tearing up on its own. Not really sure I want to do this.

Call from ENDO's office: No change in size, probably just a little scar tissue; is consulting my ENT. Am I set up for Thyrogen and scan yet? -No. In May, right?

Lymphadenopathy: a disease, disorder, or enlargement of the lymph nodes (Bing.com). It could be due to infection, auto-immune disease, or malignancy (Wikipedia).

Medical records

It must have been my lucky day today because the lady at the medical records department printed out almost all of my medical records that I was requesting. It normally takes 15 days to process the request, and there is a copy charge, whether or not I have hard or soft copies made, but she just handed them to me. Nice!

I had a few minutes to read about half of the pages in the packet she gave me before my ultrasound. I finished reading the packet when I got home, going over a few sections of interest a few times. Below are some of the those interesting sections:

NM Thyroid Cancer Survey Post Therapy (date 7/12/2010)
Reason for Exam:  Papillary Thyroid Cancer S/P Thyroidectomy

** I saw the "PTC" reference on some paper work I signed before my RAI dosage. Still confused as to why my HCC, which was a much bigger tumor and a more aggressive form of TC, is not mentioned.

FINDINGS: On the five day examination, there is very subtle low level activity within the chest with no focal areas of abnormality seen. In addition, there is activity in the liver corresponding to circulating endogenous thyroid hormone.
In the neck region, there are multifocal areas of uptake. Specifically, there are two foci with fairly intense uptake left of midline and two more faint foci of uptake right of midline. The possibility of lymphadenopathy is raised.  11-day posttherapy scans demonstrate decreased activity in the chest. The areas of uptake in the neck are redeomonstrated.

**Holy smokes! "Intense uptake left of midline", that was still present 6 days later? My ENDO never mentioned that, only that there was questionable uptake in my chest area, hence the CT scan in August. The only thing I can think of is that the uptake, intense and faint, in my neck region means that some thyroid cells, cancerous or not, were sucking up the radiation. Lymph node involvement? - I think that is what the 'lymphadenopathy' term might mean. From what I understand, RAI has no effect on ThyCa in the lymph nodes. Not sure what to think about this.

ECG done before first surgery:
Marked sinus bradycardia
Abnormal ECG when compared with ECG of 08-OCT-2009 8:10, PR Interval has decreased
Questionable change in QRS axis

Bloodwork done on 6/29/2010, day before RAI therapy dose:
TSH = 67.44 (it had to be at least 30 in order for me to have RAI the next day)
Thyroglobulin = 0.8f ng/mL (range 0.0-63.4)
Thyroglob Ab = 0.9f IU/mL (range 0.0-4.0)

Bloodwork done on 8/10/2010, first draw post RAI, and on 175mcg Levoxyl as of July 3:
TSH = .25 uIU/ml (.34-4.82 -- range for non-ThyCans)
FT4 = 1.63 ng/dl (.51-1.20)
Thyroglobulin = 0.2f ng/mL (range 0.0-63.4)
Thyroglob Ab = 0.9f IU/mL (range 0.0-4.0)

**So my Tg went down, but my TgAb stayed the same. For the most part, I guess both are considered to be undetectable.

Footnotes from the Tg/TgAb test say this: Tg results less than 0.2 ng/mL are consistent with the absence of thyroglobulin-producing thyroid tissue. This must be why my ENDO told me last month that my Tg and TgAb are undetectable.
Also, as of 11/15/2010, the lab changed its' Tg to the Beckman Access method.

US Neck Soft Tissue 12/13/2010
The left thyroid bed is unremarkable. Within the area of the right thyroid bed, there is a focal amount of echogenic tissue measuring 9mm x 6mm.
A single benign appearing lymph node is seen within the right aspect of the neck. Two benign appearing lyumph nodes are seen within the left aspect of the neck.
Impression:
1. Focal echogenic tissue within the right thyroid bed. Although this could represent scar tissue, residual thyroid tissue or recurrent cannot be excluded.

Ultrasound follow up appt - Jan 27, 2011

The tech told me no there was no change in size (9mm), it still looks the same, and that I should hear from my ENDO in a few days regarding the results of the ultrasound.

Before my mammogram, I stopped by the medical records department and got some of my thyroid cancer related medical records. So far, they have been interesting reading.

Climbing wounds

I always forget to ice any bruises I collect from climbing. This past weekend was not different. And as a reminder, it still hurt while I was climbing this evening. I finally put some ice on it when I got home this evening - a couple of days late, but at least I finally did it. My climbing bruises like to congregate around either of my knees. I tend to not realize I have a bruise until a couple of days later, when I'm in the shower and I happen to notice my painful, discolored knees.

I know the exact moment I got the bruise on my left knee this past Saturday - I bumped it on a hold on the way down on one of the routes I had trouble with. It wasn't as big as the one I got on my right knee when Viv was in town the previous weekend (that one covered my entire right knee, and hurt like a mofo the next morning at pilates!). And, to go along with my bruised left knee, I now have blisters on my left hand from this evening's climbing session. I thought for sure I'd have blisters on my right palm since the ropes were super slick and I could feel the friction start to sting a little when I was bringing Magnus down from the top of the walls. But no, they are on my left hand, so I guess they must be from the holds.

I think I may get a bit of a break from climbing again since Serena can't climb for a couple of weeks (she sprained one of her wrists a few weeks back). Magnus will be out of town for a week, so I may not be climbing until he gets back. Nice - allow my climbing wounds to heal. Sadly, the break comes once again at a time when I'm really starting to improve. I've been trying a lot of different routes, even ones that look really hard because they have a lean back, but some how I always manage to make it to the top, it may take me a while, and I may have to cheat (use a few holds that aren't on my route) a bit, but I eventually complete the route. I've also been a lot more confident in trying some of the techniques Serena has shown me, like smearing, or using a side wall ('naturals', or 'nats') when I don't have anywhere else to put my foot to get further up the wall. I even had a couple of dynamic moves on a few of the routes. Pretty exciting! I still think I need to stay on the white routes a little longer though, at least until I can climb the harder white routes without cheating.

How does my neck look? 1/24/11

My follow up ultrasound appt is in a few days. Trying not to think too much about it, but want to be ready for whatever the results are. Nothing can top my first ENT consult last March, well, nothing ThyCa related, that is. A completely different health/medical situation could equally freak me out, but I'll worry about that if/when I get to that bridge.

Unfortunately, I'll miss my ThyCa support group meeting next week - I'll be up at the Monterey Park office, working on project planning for the year. My boss said I could miss the first day of our meetings, so I could attend my support group meeting, but I really don't want to miss anything that is covered, since my work direction will be greatly influenced by whatever is decided upon. I can work right now - no treatments to worry about, etc., so I think I should get as much done as possible. I did mention to my boss that I could have....."an issue" if my ENDO calls with my ultrasound results. I think the issue would not be what the results are, but more of the fact that I won't have other ThyCans to talk to about it, esp if it is not favorable news. I'm sure my boss would not mind me talking to her about it, but I really don't want to be bothered with any news from my ENDO, good or bad, when I am traveling for work. I think if they don't tell me anything (they told me they found something at my ultrasound last month) at my appt, then I need to email my ENDO with specific instructions as to when I want to be notified of the results, whether or not the news is good or bad. If he can't call me on Monday, please don't call me until Thursday. I really don't want to wait that long, so I hope they tell me their findings, good or bad, at my appt.

Anyway, how does my neck look?

Jenny

Last night, at run club, Jenny told me it was her last day leading the group. It was a bummer to hear, and I'll miss her, but I'm totally happy for her. It is not too often in our lives that we can decide to do something else, leave behind what we are comfortable with, and search out another path. Most of the time we in fact don't have that luxury, we are just told we don't have a job anymore and the best way to console ourselves is to tell ourselves that we have the perfect opportunity to do something completely different. I look forward to hearing about her new adventures, in school, in running, in life. Whether it was a choice we made, or the choice was made for us, it really takes a lot of guts to go out there and find a new passion or a cause, or something different that you want to tackle. Good luck, Jenny!

During our run, she asked me if I had any new year's resolutions. Well, I didn't really make any, but there are some that are always at the back of my mind, like 'run more than once a week', 'run at least one race, a 5k', and of course 'have a cancer free year'. The last one I obviously have no control over, whatsoever. We can live the healthiest lives, but still die from a heart attack, or maybe you get plowed by a car....Things happen for a reason. It may not be apparent what that reason is, but one day things will all start to fit together. Me, I still don't know what my reason is. I still don't know if or when I can be considered clear of my cancer. I'm not even sure how one can be considered clear or in remission if it can come back, and when it does, it is usually an angry cancer.

I'm not too thrilled that it can come back, and it could be years from now if/when that happens. I think once I've been cleared for three to five years in a row, I may actually be able to relax a bit about it. Maybe that is when I'd be able to finally settle down and figure out what my reason is. Sometimes I wish I knew right now, so I can start whatever it is I need to start, or go wherever it is that I am needed. Then I worry how I'd be able to accomplish anything if I had to worry about my follow up ultrasound next week, or my one year body scan in May. No, I shouldn't rush it. But I also should not wait around for things to happen either. I should be like Jenny, and go out there, 'out of my comfort zone' as she put it, and see where my life takes me. So there it is, she leaves me with a bit of inspiration. Thanks, Jenny!

MLK Holiday weekend 2011 recap

My four day holiday weekend is officially over. I took my Xmas 2010 floating holiday today so I could spend the day with my sister, Viv, before she returned to Sac. It was a fun, long weekend.

She went climbing with me on Saturday. Afterward we found one of the most beautiful views in SD on a hillside in Mission Hills. Later Saturday night we went out to Coronado to take night shots behind the Del. Hit City Deli on the way home - tried the sweet noodle kugel. 

Sunday, did the usual pilates class. Took Frankie for a bath. Took some shots around Mission Bay. Did some window shopping. It was like a normal Sunday back in SF - hanging out with the dog.

Monday was my mom's 76th bday. We took Angelo for a bath (he is so clean and white now!). Took my mom out for a late lunch. Had a 6 month follow up eye appt where I was told I have nasolacrimal duct obstruction in my left eye. Took my mom out for some froyo. Dinner at home, then dessert at Extraordinary Desserts - best way to top off a bday. I had them bring out the Davenport Pavlova with a candle on it! She loved it!

Today, we were thinking of going climbing again, but she decided against it since her shoes still smelled like the rental climbing shoes she wore on Saturday. LOL. So we went out for pedis instead - her bday pedi. We had a nice dinner at home, then off to the airport.

I have a few hours to relax and get ready for my work week to start. I wish the weekend did not have to end.

How does my neck look? 1/17/11

Today is my mom's 76th bday! So to celebrate, I have decided to post a photo of her neck in addition to mine.

When I was finding out more about my alleged 'fat neck roll' last year, my mom told me that while I was still living in SF, she had two neck issues - one was a bump on the left side of her neck which was removed, a scar I didn't know she had. The other was a fluid filled cyst close to her thyroid - she was told it was not cancerous, but she was put on Synthroid for about six years (2001-2007). She only remembered this when I told her I was afraid of having my neck cut for the surgery. Seriously, all I could think of was my throat would be slit, from side to side, and in most cases when that happens, like a homicide, the person being cut does not survive. Your vocal cords, carotid artery, throat....all in that area. Much different from my arthroscopic knee surgery 12 years earlier. Much different. My mom's scar is faint and along one of her neck creases. A little reassuring, but still the thought of having my neck cut was still very freaky to me at the time.

As the weeks passed, I learned about more people - friends, family, or friends of friends/family - that had thyroid issues or thyroid surgery; interestingly enough, none that had thyroid cancer. Well, none until I heard from my aunt (one of my dad's sisters) who had ThyCa (papillary) and went through the whole process several years ago. It all helped to decrease my fear of the surgery I could not avoid if I wanted to know if my 'fat neck roll' was malignant or not.

Anyway, for a 76 year old fearless mom, how does her neck look?


And, how does my neck look?

Eye doc says

I had my six month follow up eye appt this afternoon. My eye doc wanted to do a check up to make sure my vision did not change, which is a possible side affect from RAI.

My left eye has been tearing up on its own for a few months now, but just in the last week or two has started to do so on a daily basis. Usually sometime in the afternoon, no matter what I am doing. It even started to tear up during my appt! My eye doc said there was no change to my vision - Yay!, then started to look at my tear ducts. He put some eye numbing drops in my eyes, then came back with a syringe (or some sort of implement to get into my tear ducts) filled with I think he said saline solution to try and flush out any possible obstructions in my tear ducts. The second attempt on my right eye was successful, but he tried twice on my left eye, and both times the solution ended running down my face instead of down the tear duct. So he referred me to a 'Plastic and Reconstructive Eye Surgery' doc down the street to treat the Nasolacrimal duct obstruction in my left eye. He said it was most likely a partial obstruction since it is not tearing constantly, and that it would probably be fixed with a similar procedure.

Great, so if I am lucky, it'll be a really short office visit. If I am not lucky, then it'll be some sort of out-patient surgery......

Now for the not so good news. The girl that did the pre-testing on my eyes, before my eye doc looked at everything, said her uncle just had surgery for suspicious scar tissue/thyroid tissue in his neck. She said he was told that the recovery would take at least five months. He had a hard time eating (needed a food tube). Fun. But she also said that it was cancerous thyroid tissue, so her uncle was glad he had the surgery. Ok, not what I wanted to hear, but at least I now know I am not the only person that has had something suspicious show up on a neck ultrasound. I just hope and pray it is scar tissue, and not thyroid tissue. Because in my mind, if it is thyroid tissue, that means it is most likely cancerous thyroid tissue that some how escaped the RAI ablation dose from last July, and somehow has managed to survive despite my thyroid meds and blood work.....it apparently has unfinished business with me.

Catch up

I am so behind on my listserv emails - 250+ unread messages! I like to read all of them, whether or not they apply to me, so I know what problems or issues other ThyCans are having. What annoys me are the members who don't edit or punctuate their emails. Just because you have thyroid cancer doesn't mean you don't have to review or edit your emails for grammar or spelling. Argh!

Someone finally asked the group about taking time off between surgery and RAI. I had to add my two cents for that one. I was very fortunate that my boss allowed me to take as much time off as I needed, and that my company has a very good short term disability package. Then equally fortunate that my ENDO wrote me out for four months for recovery from both of my surgeries, going hypo in preparation for RAI, isolation after RAI, and time to adjust to my meds (I was exhausted every day!). Throw in that CT scan two weeks before I went back to work. I really do not think I would have been able to get any work done even if I tried. I know for me, without those four months to absorb and accept the 'it was positive for hurthle cell carcinoma' and the 'they found papillary cancer on the other side' diagnosis, I would have had many melt down moments at work. I would have spent a lot of time with my buddies Google and Bing trying to learn more about my two flavors of ThyCa, necessary treatment, prognosis, recurrence.....no work would be completed. And then all my co-workers wanting to know what was going on, how do I feel,......still no work getting done. I totally needed that time off. I seriously don't know how anyone could go back to work three days after surgery - the incision area was all puffy, my neck/back were sore, the scar was just begging to be noticed, you are adjusting to Cytomel......

I know, everyone is different, because there are people out there who have gone right back to work. Good for them. But don't post on the listserv months later because you are at your wits end because you didn't take the time to address that fact that "Yes", you have cancer, and "No", no one around you has any idea what you are going through or how to help you. You still need to take care of yourself, and trying to be a tough guy/gal by going back to work right away, in my book, isn't the way to go. But allow me to laugh at you when you post months later that you are having personal or mental issues. Double 'Argh!'

The involuntary watering left eye is killing me! At my desk at work, driving, shopping, working out, no matter, it starts to water. RAI side affect, I believe.

Through a health program at work, I now have a health coach to help me manage my stress. Work and health stress are what I want to tackle in the next 10 weeks.

Climbing gear

I finally acquired some much needed climbing gear! One of the guys from Solid Rock said to check out a place in Escondido called 'Nomad Ventures', so we went.

I tried on four different harnesses. The first one was a women's harness, but let's face it, I'm a little bigger around the edges than most women who climb, so that one didn't quite work out. I liked the third one I tried on because it has a lot of adjustable straps, and when I tested it out (you get to hang from a door jamb), it was really comfy. I also got a chalk bag, which has flowers on it. Why the flowers, you ask? I'm not sure myself, it was just different than the rest, stood out, I guess. And last but not least, I got a chalk ball.

We're skipping pilates tomorrow morning, since our instructor is still out of town on vacation, to go climbing. I get to try out my new gear....and get a few more bruises that I won't discover until two or three days later....

To freak out or to not freak out....

Last night I was re-reading my post from the day I got my RAI dosage (RAI here I come - July 1, 2010) because I remembered my nuc med doc telling me about an RAI side affect that would cause my eyes to water uncontrollably, which I have been experiencing a lot of lately. The part that freaked me out was the first thing on this list of HCC and RAI side affects that I did not know:

1. Sometimes HCC doesn't produce Thyroglobulin, the tumor marker

Holy smokes, how did I forget that little fact?!? All I could think of was, well then the chances of that blip on my right thyroid bed from my last ultrasound looks more and more like it could be thyroid tissue, not scar tissue since my ENDO has my Tg and TgAB at undetectable.... here we go again with more surgery and possibly another round of RAI. CRAP! Yes, a freak out moment that I cried myself to sleep with.

This morning I exchanged some texts messages with Viv. I ended up telling her that I'd consult my ThyCa listserv group and do some internet research before I contacted and/or fired my ENDO about the possibility of my HCC not producing any Tg.

So, I finally got around to Google-ing it. The first article I read is from the Moffitt Cancer & Research Center (http://www.moffitt.org/moffittapps/ccj/v4n1/article1.htm), which states that HCC usually does produce Tg, but it also says some scary stuff like:

"The picture emerging of Hürthle cell carcinoma is that of an aggressive lesion, with a prognosis worse than papillary carcinoma of the thyroid.[20-22] In our series of 14 patients with Hürthle cell carcinoma, four patients have died.[20] Of five patients followed longer than 18 months, four (80%) had recurrence and three (60%) died of Hürthle cell carcinoma. Four of five recurrences were located in the neck, and two of the four deaths were due to locally recurrent disease. The other two deaths were the result of metastatic disease. In the literature, the overall cause-specific mortality rate is 111 patient deaths out of 364 cumulative cases of Hürthle cell carcinoma reported (30% death rate)."

or

"Most recurrences of Hürthle cell carcinoma are found in the neck, while the lung is the most common site of distant metastasis. Palpation of the neck may reveal recurrent disease, while chest x-ray may suggest metastasis. A computed tomography scan or magnetic resonance imaging of the neck, mediastinum, and chest are valuable adjuncts in diagnosis of recurrent disease.

Recurrent disease is treated surgically with good palliation and appreciable prolongation of life often resulting from local excision and neck dissection for recurrent neck disease or pulmonary wedge resection for lung metastasis.[20,25,26] External beam radiation may be considered for patients with unresectable disease but is not curative. Octreotide has also been employed without success in the treatment of recurrent carcinoma.[27] In our series, patients died of Hürthle cell carcinoma an average of 34 months after recurrence.[20]"

20. Grossman RF, Tezelman S, Epstein HD, et al. Total Thyroidectomy and Central Neck Lymph Node Dissection: Treatment of Choice for Hürthle Cell Carcinoma. In: International Congress of Endocrinology. 1996. San Francisco, Calif.

21. Herrera MF, Hay ID, Wu PS, et al. Hürthle cell (oxyphilic) papillary thyroid carcinoma: a variant with more aggressive biologic behavior. World J Surg. 1992;16(4):669-675.

22. DeGroot LJ, Kaplan EL, Shukla MS, et al. Morbidity and mortality in follicular thyroid cancer. J Clin Endocrinol Metab. 1995;80(10):2946-2953. 

25. Sloan DA, Vasconez HC, Weeks JA. Mediastinal dissection and reconstruction for recurrent Hürthle cell carcinoma of the thyroid. Head Neck. 1994;16(1):64-71.

26. Levin KE, Clark AH, Duh QY, et al. Reoperative thyroid surgery. Surgery. 1992;111(6):604-609.

27. Zlock DW, Greenspan FS, Clark OH, et al. Octreotide therapy in advanced thyroid cancer. Thyroid. 1994;4(4):427-431.

So, the Tg isn't the problem, it's everything else about HCC that makes it worse, in my head at least. I just need to remain calm until my follow up ultrasound on January 27. I think no matter what the results are, I should still get a second opinion, just to make sure that my ENDO is managing my case adequately.

[Try not to freak out....Try not to freak out......]

Realize

My climbing friend, Serena, told me that she will most likely be leaving San Diego sometime this year. Her husband has been working and living in Philadelphia since last February as there are no jobs in his field here. I'm bummed about it, but it is probably the best thing for them - I don't think I could live apart from my husband or boyfriend for that long. She flies back east once a month, but distance still takes a toll on a relationship.

She's not leaving tomorrow or next week, so I still get to climb and workout with her after pilates for a couple more months. But it still feels like when Jen left San Francisco to move back to La Habra, or when I left San Francisco to move back to San Diego. But, we all have to go where we need to be, go somewhere new, make things happen.

It is weird when you finally realize what you need to do. Sometimes we fight it as long as we can, we deny it. I fought for as long as I could to not have my first thyroid surgery - about six or seven weeks. It was my boss that helped me to see that I just needed to do it. I was just so afraid of that cut going across my throat - it just seemed like sudden death, a slit to my throat. Then I wanted to put if off until after my parent's 50th wedding anniversary. She told me the sooner I had it done, the sooner I would know if it were benign or not, then I could deal with it accordingly. If I was still avoiding that surgery now, who knows how big my tumors would have grown? or if it would have spread outside of my thyroid. I am glad that I took care of it when I did. I know she doesn't want to leave San Diego, but I'm sure once she gets to wherever they are heading, she too will be glad that she did.

LID cookbook

Yay!!!! Finally, the LID cookbook I ordered back in November has been delivered to the bookstore downtown. It has been on back-order since I ordered it on November 24. I've been checking the tracking via FedEx since Last Friday when I got an email notification that it had been shipped. I already have a copy of the LID cookbook put together by ThyCa, but the actual book has a lot more recipes. So I'm in business, well, as soon as I pick up my book, since I can also use my VitaMix to prepare my LID food when I am preparing for my WBS in May.

ThyCa group meeting - Jan 4, 2011

First ThyCa meeting of the year this evening. Seems like I really should get copies of all of my ThyCa related reports, going back to my appt with my PCP in November 2009 when she told me my fat neck roll was actually my enlarged left thyroid lobe. I wonder how much all those copies would be.

We never got around to polling the group to see if anyone was interested in meeting a second time during the month. I guess I'll just email the group and see what the consensus is.

Checking my health insurance coverage for my planned treatments this year. $1300 deductible. Looks like the Thyrogen shots have a $25 copay; WBS about $300.

How does my neck look? 1/1/11

Happy New Year, 2011!!! So glad you are finally here!

I can gladly put 2010 and the start of my ThyCa journey behind me now that 2011 has begun. Would I have done anything differently? No. I think my only alternative was to say 'No' to surgery and have my ENDO watch my unknown to me at the time Hurthle cell neoplasm, to see if would grow or not. ThyCa normally grows slow, and my HCC was encapsulated, so that may have been the only two things I had going for me had I decided not to have the surgery in the first place. But, my HCC was also very well differentiated and hypervascular (meaning blood was going through it like it was a normal thyroid, not one that was having problems). The three PTC foci on my right lobe did not have any vascular invasion, but were well differentiated, and were considered to be multiple small tumors. I still read my FNA and surgery reports in awe because I can't believe this happened to me, and I know I made the right decision to have the surgeries. I hope I continue to make the right decisions this year, if there are decisions for me to make regarding my ThyCa.

Anyway, below is my last neck picture for 2010 and my first neck picture for 2011.....How did and does my neck look?