Biopsy/Subsequent Results

Dr. Bentz had made arrangements for the biopsy which was done at the University of Utah hospital which is located near the Huntsman Cancer Institute and was done on January 25, 2011. During the biopsy, there were two or three interventional radiologists that were in the room along with the Pathology team. At first, they numbed up several areas on my neck before they actually did the needle passes into the masses. I felt some pressure, but the pain wasn’t really that bad although I did feel like a pin cushion as there were so many areas that they had to biopsy. I managed to muddle through it and the staff there was very nice and they even called me the following morning just to see how I was doing. Later that day on January 26, 2011 I saw Dr. Bentz to obtain the results of the biopsy. The night before obtaining the results, it was hard to sleep as I kept thinking about what the results was going to show. I was very nervous about what was going to be found, but I just had this sinking feeling in the pit of my stomach knowing there were calcifications that it was most likely going to be cancer. I had my parents come in with me to that appointment and sure enough Dr. Bentz confirmed my worst fear, I had thyroid cancer! As he said that, the reality hit me like a ton of bricks slamming into my body that yes, I have cancer. I finally said it, the big “C” word! It’s not something anyone wants to hear, but yet it was happening to me of all people.   Dr. Bentz said that it was highly suspicious of papillary thyroid cancer and was recommending a total thyroidectomy to remove the entire thyroid and the surrounding lymph nodes; he said that more information would be known after the removal of the thyroid. This all seems so surreal and I keep thinking that I will wake up and this will all just be a horrible dream!

Next, the decision was made to do surgery. I was going to have a TT (total thyroidectomy) and neck dissections on both sides of my neck to remove lymph nodes as well. The surgeon wanted to do it within the next few days. However, I had to schedule it a few weeks out as I was having another needed surgery on my foot first, and I also needed to get my husband back to the states as I was not about to go through such a major surgery without him by my side.

I made sure to ask Dr. Bentz when I could get back to the gym following surgery as I have been such an avid proponent of staying fit. I think I was more worried about missing gym time than the surgery itself. I have worked hard over the last two years getting our family on healthy eating and exercise mostly out of necessity due to our eldest daughter being diagnosed with a Pseudo tumor, which is essentially like a false brain tumor. It has caused some major issues with her eyesight and damaged some of her optic nerve. The treatment for this was that she had to lose some weight; I wanted her to have a support system and this has been something that our whole family has benefited from. I enjoy working out and I feel so good afterwards, it is the one thing I look forward to each day in doing.

I made the dreaded phone call to my husband in Japan explaining the diagnosis. He could not believe this was happening; both he and I were both hoping that it would have all been benign. Going through this ordeal was really difficult and it felt like I was ripped from my family, my teaching job and the students in my youth group. It feels as though I have just been blind-sided as though a curve ball coming out from nowhere. I had so many emotions going through my head at the time and it was hard to get a grasp of what was happening to me. Our family has been through a lot of medical challenges with our daughter the last two years, due to her Pseudo tumor diagnosis. Why was this happening now? I guess things were just going too good and something was bound to happen to stir our life up. I had many questions and no answers in sight. I had to put my trust in God that those questions would have an answer and that they will be able to get this cancer out of me!

 

Evaluation

Huntsman CI2

 

 

 

 

 

I was referred to the Huntsman Cancer Institute in Salt Lake City, Utah and saw a really excellent Head and Neck Oncology surgeon, Dr. Brandon G. Bentz on January 19, 2011. Dr. Bentz and his resident doctors had reviewed all my records and the scans that I brought with me; we discussed in length the varying possibilities but he did explain that since most of the masses seen were located on or near my thyroid that there was a great possibility that this could be thyroid cancer, especially with the calcified nodules. He recommended that biopsies be performed which will determine what exactly what we are dealing with and that more would be known once the biopsies were complete. He had also explained about the four various types of thyroid cancer: papillary, follicular, medullary and anaplastic. During the course of this visit I was also sent to the lab to get more vials of blood taken as it had been a few weeks since they had done that and I’m guessing to check for any changes or just for a comparison. From the receptionist to the nurses and the doc I felt that I was in really good hands.

Back to the States

travel

 

 

 

 

I left Japan on January 14, 2011. That was an interesting experience traveling with all my belongings, my laptop, my medical records and I had to hand carry my x-ray films as some of them they were not able to get on CD, including the MRI films of my foot (also another medical issue I was having) which I kept on the plane with me. What fun that was carrying those through the airport terminals! I always love traveling back to the states as then I can gain a day going back; you can leave and then arrive on the same day.

The flight from Haneda to Narita was pretty uneventful as I slept most of the way. However, the flight from Narita, Japan to Los Angeles, California was not pleasant as I was in the middle seats; I really hate those seats as you have to climb over everyone to get out when you need to. Getting through customs in LAX terminal was a total nightmare. The line in customs was extremely long and by the time I got through, I only had five minutes to spare before boarding my next connecting flight to Salt Lake City, Utah. Was that ever a full flight! Note to self: Never, never fly and go through LAX terminal; that has got to be the worst airport terminal ever created. When we have traveled back from Japan many times before, they have always given us flights going through San Francisco. Why, oh why did they have to send me through LAX? I was glad when my travels were finally over and happy to be surrounded by family during this difficult time. I must have looked a sight as I just felt totally drained with jet lag by the time that I arrived!

The Beginning

After we moved overseas, I really didn’t pay too much attention to my health and really didn’t see doctors on a regular basis other than those annoying yearly pap smears. I guess you could say that I kind of fell through the cracks and didn’t have regular follow-ups like I should have. I really hated going to the doctors and I was just not educated on the importance of those follow ups and things to be watching for.

This journey really all started during the summer of 2010 with the many series of sinus infections I was having. This was not new to me, as I have had a lifetime of sinus troubles with multiple surgeries and was hoping that I was not headed for that again. However, I felt this swelling in my neck and it was felt by both me and my PCP doc. Being a DOD civilian we were able to utilize the military medical system for our medical needs, while being stationed in a foreign country. My doctor just about freaked out when he felt it and asked me how long the swelling in my neck had been there. I told him a few months and he was a bit upset with me for not coming back in to let him know about this. Nevertheless, we monitored it closely as he wasn’t sure if it was related to all of the recent sinus infections I had been having, but the swelling just never went away. So by the time December rolled around an ultrasound was ordered. I kind of put it off and waited until after the busy time with the holidays was over to schedule the ultrasound which was done on Jan 4, 2011.

I remembered that exam and was beginning to get real worried as they scanned, scanned and scanned some more. The ultrasound technician went over many different areas multiple times. She left the room and in walked the radiologist. He had a real look of concern and now I was even more petrified of what he was about to say. It was explained to me that I had multiple nodules which were calcified and the radiologist was recommending a biopsy. He said it could be a multi-nodular goiter, but with the calcifications that they were more concerning as cancerous nodules. I was worried about telling my family and so I kept it to myself until after my PCP doc called me back the next day. They now wanted to send me for a neck CT scan so they could get a clearer picture of what was going on. It was at this point I knew I needed to tell my husband. He went with me for the scan, which was done at Misawa City hospital on Jan 7, 2011 as the clinic on the military base does not have the necessary CT or MRI equipment and so they refer everyone out to the local Japanese hospitals for that kind of testing. At first I didn’t think it was necessary for my husband to accompany me to that exam, but glad that I changed my mind. I had to be transported by ambulance from the 35th Medical Group and escorted by another doctor as I had an IV in place. I remember that it was snowing really hard that day and my husband, Jerome, had to follow the ambulance in his car as he was not allowed in the ambulance with me while I was being transported to Misawa City hospital.

During the scan it was really strange when they injected the contrast into my IV as I never had that before and it felt as if I was going to wet my pants! After the scan, we went back to the clinic to wait for the radiologist at the clinic to read the films. It was not good news; however, the results were not exactly cut and dry and the nodules/masses were concerning for thyroid cancer as I had multiple calcified nodules all over my thyroid. The doctor said that we really need to obtain a biopsy in order to gain a better understanding of what we are dealing with. The military hospital is quite limited as to what they can do there. If they were to biopsy it there at Misawa, it would take several weeks to obtain results as they don’t have the necessary pathology required to do this and the tissue would have to be sent back to the U.S. The doctors were recommending that I be transported back to the United States for evaluation by a medical team at a major facility for biopsy.

The base commanders were attempting to get me shipped out on a military medical transport, but we later learned that us being a DOD civilian we would have to take the commercial route out. My doc asked where our home of record was and I told him in Utah and so he was searching for doctors in the area for me. He was able to get me in contact with a head and neck surgeon in Salt Lake City, Utah which was not too far from my parents’ home. Then, I phoned my parent’s to let them know of my situation and that I was coming home on emergency leave.

I only had a few days and then I was leaving Japan by myself without my family. I had to arrange for someone to take over the youth group and notify the schools that I was going on Emergency leave. I was really heartbroken to leave my teaching job and the students in my youth group as they have become like my own children. It was fortunate that my husband’s company was able to provide me transportation out of the country back to our home of record. Leaving without my family with me was very difficult, but I was able to stay with my parents so I didn’t feel totally alone. My family couldn’t go with me because of work and school obligations; our daughters were attending college in Japan and couldn’t break from their classes.