Biopsy Results and Plan

Boo! Hahaha, I had fun looking through my CT scan images and took this screenshot because it looked pretty creepy (those eyeballs!).

I realize how uncool it was to post about my biopsy and then take two weeks to share the results! I felt like the results took forever. Since the biopsy was on Friday, I hoped the results would be available on Monday; Tuesday at the latest. Usually, labs and tests are uploaded to my chart online within 24 hours or so.

By Wednesday, I still didn't have the results. I called the ENT doc who'd ordered the biopsy and was told that the doctor wanted to go over them in person. And that he was going to be out for a week, so the earliest available appointment would be on the 22nd! Hearing that, of course, I prepared myself for bad news. 

Meanwhile, I had been jumping through all the hoops to get an appointment at the University of Michigan medical center, which is very difficult to get into; it's a huge teaching hospital. (The woman from scheduling that I spoke with even had my biopsy results but wasn't allowed to give them to me.) I asked my primary care doctor to fax my referral and records (I was shocked that people still fax things...) and she did it right away. Then I had to wait for the scheduler to call me to set the appointment with the ENT (otolaryngology; "ear/nose/throat") department. I finally got an appointment for the 24th (yesterday). 

I was still waiting on test results, and I just couldn't wait anymore. I don't know why I didn't ask in the first place, but I contacted my primary care doc again and asked if she had the results and was she able to upload them. Within an hour, they were in my chart. (My doctor is the BEST at doing everything quickly.)

Anyway, the result was that my mass is benign! Which is obviously great news. Still, however, this mass is causing me a lot of discomfort--especially after the biopsy. The biopsy made my symptoms much worse and I've been super irritable. I constantly feel like my shirt is choking me, but when I reach to pull the collar from my neck, it's not there--it's just this mass that is causing the strangling feeling.

The CT that was taken in the emergency room the day of my biopsy showed that the mass had increased by about a centimeter (it was about 5.5 and now it's about 6.5 cm--that's *very* large). Since I had the appointment at U of M, I had access to their patient portal. My CT scan was in there, and I was totally fascinated looking through the images. It's like watching a video traveling through your body, looking at one plane at a time, and there are images from several directions--traveling from the front of my face to the back of my head, and from each side traveling through to the other side, and even starting at my lungs, moving up to the top of my head. You can see everything in 3D.)

Based on the doctor's notes and the images, it showed that my trachea and esophagus were being pushed to the side due to the mass pressing against them--this is why I have difficulty swallowing and what is causing the strangling feeling. It's pushing my carotid artery toward my back. It's even touching my spine, and goes down past my clavicle (collar bone). Needles to say, it's very big. I knew it would need to come out, but I was hoping that I could save my right thyroid in order to *try to* avoid needing hormone replacement medication for the rest of my life.

*I may still need it, it will depend on my thyroid function after surgery*

Here is an image that shows from the front to the back--the red line is my airway, which should be straight up and down. And the blue circles the mass itself.

CT of thyroid mass, circled in blue

My appointment at U of M yesterday did not start out well. I know most people will think this is shallow, but I've written before about how I am having such a hard time with showing signs of aging. You may remember when, in 2018(?), Jerry and I went to the lab for him to have his blood drawn and I was with him. I sat down in the waiting room and he went up to the counter to check in. The woman there saw his license/birthdate and exclaimed how young he looked and said these words which still haunt me: "I thought that was your mother with you!"

Up until that moment, I never thought of myself as looking old. But that triggered something inside of me that made me notice everything about myself that is showing signs of aging. Do I really look like I could be 60-ish+ years old?! Even if Jerry looked MUCH younger--let's say 30 (he's 44)--that would mean I'd have to look roughly 50 (today I turned 43). I started to feel extremely self-conscious of my age at that point, even though I never cared at all before. Isn't it stupid how one single comment from someone has the power to do that? Most people would probably laugh about it, but it had the opposite effect on me.

Anyway, back to my appointment yesterday. The medical assistant brought us back to weigh me and get my blood pressure. He asked me, "Is this your son with you?"

My face got really hot and my ears immediately started ringing. I was so flustered I couldn't even answer him, and Jerry, knowing I was crushed, helped alleviate the awkwardness I felt by making a joke about the fountain of youth or something. The medical assistant asked for my birthday and when I told him, he said, "Happy early birthday!". I said, in what I hoped came off as nonchalant, "Thanks, but I'm suddenly feeling very old". I kind of wanted to hint to him that instead of asking if it was my son, just ask who is with me today or something like that. 

I thought he would apologize, but he didn't catch on. I can remember being (relatively) young and never understanding why age was such a touchy subject for women. When I worked at Curves in my 20's, most of the women were in the 40 to 60-ish age range and frequently talked about aging--I just didn't get it. I never thought I would care about aging! And I honestly wouldn't mind it, if I thought I looked my age--43--but 60+?! That's hard to swallow. (Quite literally right now, haha). When it was just one person who mentioned it, it could be written off as a one-off unintentionally rude comment; but when two people say it, well... 

Okay, enough of that. I was pleasantly surprised at the minimal wait time, which was awesome. The ENT doctor was highly recommended by my cousin, who is a nurse practitioner there, and she was everything I hoped. She was extremely friendly and patient, taking the time to answer my questions and explain everything really well. An anesthesiology med student was with her and he was just as great.

They had to scope my throat, which wasn't fun (at the previous ENT doc's office, they did it as well). They put a long, thin, flexible tube with a camera on one end, through my nose and down my throat to look at my vocal cords. It literally feels like a COVID test, only like pushing the swab all the way through to stab your brain. Then it felt like I had a pill stuck in my throat. But my vocal cords aren't damaged; the change in my voice is likely because my trachea (airway) is being pushed aside by the mass on my thyroid. (My voice has gotten kind of raspy and it's a strain to talk.)

They agreed that the mass should come out, and the doctor explained the surgery to me. It's under general anesthesia, which is more complicated than the IV sedation I had recently for my tooth extraction, but I've been under three times before--for my two jaw repair surgeries and for my skin removal surgery--so I'm not too worried about it. The scariest part is that they are going to be working in a very critical area of my body--around my airway, my esophagus, my carotid arteries, jugular veins, and vocal cords--and there are risks with that. But the ENT doctor is the one who will be performing the surgery and I feel very confident in her.

When I was super nervous about the general anesthesia before getting my jaw repair, my surgeon (who was an ENT doc) told me this: If you're worried about your airway during surgery, the best team you can have with you is an ENT team. So that's comforting! Haha.

The surgery sounds very straight-forward and I'll be allowed to leave the same day (she said three hours or so). For a week post-op, I need to rest, not lift anything over 10 pounds, eat soft foods for a couple of days, and that's about it. There is a lot of follow-up lab work to see if my thyroid hormones tank. They are completely normal right now, so I am hoping my right thyroid will do just fine when the left is gone. The ENT doc said that it happens in about half of patients with this procedure.

Now, I just have to wait for a call from the scheduler to get a date for surgery. The doctor said that since it's not cancer, I don't have to do it right away--just whenever it's convenient for me--but I'm going to take the first available date. My symptoms are driving me crazy, especially since my biopsy.

Haha! Speaking of, after my biopsy I was told that I "might have a small bruise that should go away on its own in a couple of days". It is now 15 days later, and this is what it looks like:

Aside from the bruise, though, the lump is very noticeable in my neck. It wasn't like this before the biopsy. This mass grew SO quickly. I noticed sometime in the summer--I think August--that my neck looked a bit bigger in front. I forgot about it when I got COVID, and then the headache that lasted two months, and the process that led to my tooth extraction.

It was still barely noticeable in December, but now there is no way you can miss it. I'm worried it'll continue to grow at this rate. I'm thrilled that it's not cancer, even though I knew I'd be having surgery either way, but it's so uncomfortable--I can't wait for it to be gone!