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The Anxiety of Thyroid Cancer a Year Later

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The ultrasounds are soothing. The whir of the machine, the doctor’s thoughtful grunts as she probes my neck, the crackle of the paper on the examination table. It is very familiar to me now. I relax into it and close my eyes.

I think about my kids. I see my older daughter sitting on the couch, her attention wafting between the television and me. She smiles and rolls onto her stomach. Her younger sister is there too, waddling around the living room, looking for attention. There’s sunshine coming through our large windows. It’s warm.

That’s the scene in my mind every time I lie down on that examination table. It starts with the doctor squirting gel onto the ultrasound probe. It ends when she lifts the probe off my neck. The tension in the room lifts, and I look at her face for signs.

I don’t get any.

Today I returned to the Kaiser facility in Martinez and had an ultrasound followed by a fine-needle aspiration. My endocrinologist was looking for a rogue lymph node that caused concern during my last ultrasound a month ago. She wanted to find it, pull out some tissue and order a biopsy.

We talked briefly, and I laid down on the examination table. The paper crackled beneath me.

“OK, let’s see where this thing is,” she said slowly and squirted that gel onto the ultrasound probe. I closed my eyes and saw my daughters again. The sun was still shining. I watched them play the game of chase they invented, running back and forth between the kitchen table and the mini lounge chairs they have near the couch.

I was sitting in my own lounge chair, wafting back and forth between my daughters and the ultrasound probe. I could tell something was up last time. The technician kept returning to one part of my neck. It lasted longer than usual. The next day I got the email I expected: they found an abnormal lymph node, and I’d probably need to get a biopsy.

Today the ultrasound is also taking a while. My daughters looked at me, bored, asking what we were going to play next.

“I don’t know,” I tell them, starting to feel nervous and agitated. “I thought you were going to keep playing chase?”

The ultrasound probe lifts, and I’m brought back to the examination room. I shift my weight, and the paper crackles beneath me.

“I don’t think I got anything,” explained my doctor. “There’s so much tissue in the neck and these lymph nodes are really small. Every time I thought I saw it it disappeared again.”

She punched some notes into the computer. “Let’s order you an MRI just to be safe.”

She explained that the MRI results would help her definitively identify any rogue lymph nodes and also help a neck surgeon find and remove any other cancers. I picked an appointment a few days later.

An MRI is not relaxing. I closed my eyes as I was conveyed into the GE-branded plastic cave in a fancy trailer outside of my local Kaiser hospital. I wasn’t comfortable. My hair was caught behind my head, causing a slight pull that was just painful enough to prevent me from tuning it out.

Then came the knocks, the chest-pounding thuds that reminded me of those times I’d find myself near the subwoofer at a nightclub. My clothes shook. I opened my eyes and looked through the Hannibal Lecter-like mask constraining my head. There was nothing to see so I closed my eyes again, forcing myself to think about something, anything else.

I pictured my girls, but they looked scared, worried for me, confused about where I was and why I was so tense. I didn’t want to explain so instead I thought about work. I picked a programming problem and analyzed it. I had the full day ahead of me so I thought about what else I wanted to do.

How much longer? More knocking, screeching, buzzing. Finally, the tech told me through the speaker that he was going to pull me out and inject me with a solution to provide contrast to the “pictures” he was taking of my neck.

Great, more needles. I tried to stay upbeat as he tried a couple of times to find my vein. I rolled back into the cave, and the symphony of jackhammers, machine guns, and subwoofing bass struck up again.

Finally I was free. I thanked the kind bearded man at the MRI controls and appreciated the endless sky above me. They asked me on the screening form if I was claustrophobic. I said no, but now I’m not so sure. I really didn’t like being in that tiny plastic hole.

And then I waited for the results. I didn’t have to wait long.

I love my neighborhood for many reasons, but the biggest one is my neighbors. On my street there is a first grade teacher, a web designer, an executive director of an education non-profit and a radiologist. A radiologist at Kaiser. The same Kaiser where I had my MRI.

So of course in the days leading up to my ultrasound and MRI I gave him the play-by-play as our kids scooted around the cul de sac. He knows cancer better than anyone I know. He sees it every day in every part of the body, and when I was first diagnosed he too told me thyroid cancer is the “best” of them. He told me he would be working the morning of my MRI. When I left the trailer I texted him.

That afternoon his two boys were out playing so I went out with my two girls, beer in hand. I could tell when he walked down the driveway that he didn’t want to tell me his read on my MRI.

“Yea,” he began. “The node your endocrinologist couldn’t find? It’s there, and I found a couple other irregular ones too.”

I didn’t say anything yet.

“She’ll probably want to get them checked out. Sorry, man.”

I asked him a couple questions and then let my disappointment set in. I’d been optimistic, hopeful that whatever the original ultrasound found was simply due to one of the many winter bugs my daughter brought home from preschool.

In my inevitable Googling of lymph node maladies I read that they swell and change shape when there’s an infection nearby. It was perfectly reasonable that an enlarged lymph node would be caused by a throat infection rather than cancer.

My neighbor didn’t use the c-word, but that uncertainty was the hardest part. My MRI was on the Friday of President’s Day weekend. I probably wouldn’t hear my endocrinologists’ read on it until Tuesday.

That meant a whole weekend wafting in cancer limbo. I was able to tune it out, though, and decided to focus on things I can control.

I can control how I feel. I can choose not to be nervous, anxious and desperate.

I can control what I do. I can eat well, exercise and do things that make me happy and remove other anxieties from my life.

I can’t control cancers without medical help, but I can at least manage what I feel and do. I reminded myself of this through that weekend and into the following week.

Then I heard from endocrinologist, and it was mostly good news.

She was delayed in getting back to me because she wanted a few more opinions on my chart. There appeared to be consensus that irregularities in these lymph nodes in my neck were more likely caused by normal infections rather than cancers. She would bring my case to her monthly board review to get more feedback, but that’s where it stands now.

Relief. For now.

I’ve been intimately familiar with cancer for over a year already. It’s hard to put myself in the place I was before. Post-cancer I’m more grateful, more conscious, more vulnerable, more motivated.

I’d never been “sick.” I don’t take aspirin or Tylenol or Advil when I get headaches. Before this cancer stuff I saw a doctor every two years. At the most. Now it’s every three months. Now I have to take two pills every day.

I don’t like it, but I’m getting used to it. I’m getting used to the latent uncertainty too, the anxiety that never goes away. That’s maybe the one thing that all cancer patients share. Some cases are worse than others. Most cases are worse than mine. But we all know cancer can strike any time. It can come back, it can get worse.

That fact is you’re never really cancer-free. Sadly, no one is. You can spend your time worrying about that, a problem you can’t fix, or focus on what you can control.

Control what you feel. Control what you do.

That gives me power and that makes me happy.

Originally published: March 15, 2018
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