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?