Thyroid Watch

Today, after waiting a month, I finally had a biopsy of my thyroid nodule. Here's why.

I have to say, I didn't much like it.

But first, the things I did like: Michael took the day off to be with me, which, though I'd like to fancy myself an independent woman who is able to handle such things on her own by now, turned out to be a really, really good thing. He was even able to be in the exam room with me, instead of waiting in the waiting room like usual. The doctor was very nice. She was a young woman, who, as it turns out, is the daughter of an imam. So one of my doctors is the daughter of a Methodist pastor, and one is the daughter of a Muslim "pastor." What are the odds? He teaches world religions at Nazareth College here in town and has a particular interest in interfaith stuff. Cool! Dr. Shafiq was very kind and compassionate, and explained things to us as we went along. I told her later how much I appreciated this, because it takes the scary mystery out of it. When she was about to start the ultrasound, she asked if I would like Michael to stand by the side of the table, so that he could hold my hand. With that question, she won both of our hearts. Michael took his place at the side of the table, and did his job well.

But first, she started with a bit of history and the usual questions. She had been unable to load the pictures that were taken a month ago, so she had to do the ultrasound again, though she also said she probably would have anyway. Usually, she only biopsies nodules when they have particular risk factors. These include: one centimeter or more in two dimensions, abnormal shape, abnormal constitution, or medical history risk factors, either in the form of a family history of thyroid problems, or radiation (usually the radiated patients she sees are Hodgkin's survivors like myself). It seemed as if I only carried one of those risks (radiation), but when she looked at the nodules on the ultrasound from a different angle, she found one of the nodules is a bit bigger than they thought (still small, though, just one centimeter).

So she said I could have the biopsy to see conclusively what's up. Or I could wait six months and see if there was any change. I chose to have the biopsy.

A few other stats: 95% of the time, nodules like this are benign. Having a history of radiation is a risk factor, but doesn't increase my risk by any sort of significant margin. I had read that pregnancy makes nodules grow, but she said no, that wouldn't happen in my case. Though 5% is a nice, low possibility, I feel like I've had enough things go the less likely way that it no longer means anything to me. Not to mention I had a close friend who was given the same odds, and it ended up cancer. It always feels a little more possible when you know someone in the minority.

So, the biopsy. Doctor numbed the skin, but the needle once it was in, was still incredibly painful, despite that she said it would be easier than a breast biopsy. Michael held my hand, and I'm sure he could attest to the fact that my squeezing got harder and harder. I couldn't swallow, move my head, or breathe deeply while the needle was in, which made the pain worse since normally I'm able to breathe through pain and tolerate it pretty well. The skin didn't hurt, but she had to dig around a bit with the needle to get the cells... so imagine someone just poking you repeatedly in the throat and you'll get the idea. She tried three separate times to get enough tissue, but after all that, they didn't have enough cells. So she tried two more times.

Each time was worse than the last. I thought about saying, "Forget it, I'll come back in 6 months," but told myself I had made it most of the way, so I could power through. But the fifth needle, I lost my composure. Tears came to my eyes. I was mad at myself for crying ("Buck up, Johanna!" I thought), but I felt totally helpless. In retrospect, I think the tears were certainly caused mostly by pain, but also by the frustration that I was having to endure such pain again. I was mad at my body for doing this to me again. Why was I here??

Poor Dr. Shafiq. She felt terrible when she saw I was crying. She said she didn't normally make people cry, and felt bad that she'd told me it wouldn't be as bad as a breast biopsy (which never made me cry!). Of course I don't blame her. She was compassionate and kind, and laughed at my jokes. And she mispronounced "component" in a way that made all of us laugh a lot, mostly her at herself. After I sat up and cried it off a bit (the tears kept coming, out of my control), she got me some ice and just sat with us for a while, chatting about her dad's work and religious beliefs generally. It was as if she had nowhere else to be, which I find hard to believe since it took a month to even get in and see her. She said for good luck she would schedule an appointment for a year from now, with the assumption that I would fall into the 95% of benign nodules.

She said looking at the cells she got, nothing jumps out at her as suspicious, but she doesn't want to give me false information so she would leave it at that. She will call me by Friday morning, if not before, with the results.

As we left the hospital, I felt a little nauseated by the lingering pain, and exhausted by the whole experience. It feels a little like I was punched in the throat, so, not great. I have been home all afternoon, relying on a pillow to hold my head up so my neck doesn't have to, and trying to rest. And my husband has been waiting on me, and my dog loving on me, so I guess things could be worse.

Many thanks for all the prayers and check-ins. I have been so touched all day by those who have checked in on me. I am truly blessed by all of you. Thank you.