Thyroid Photo Timeline (and brief catch-up)

This is an odd post, but I figured I'd share it anyway in case someone is going through a thyroid issue and wants to see photos of what to expect. Honestly, it looks worse than it is. I was expecting a scar, of course, but there were some other changes, too.

Anyway, here goes. Starting with a couple of "before" photos, so you can see the large lump in my neck. At that point, I had no idea it was a mass. I thought it was an enlarged thyroid--something that I'd known for 20 years. It got much bigger pretty quickly, though, which is why it needed to be removed.

This is when I really noticed the size increase. I had been taking a photo to do a Wednesday Weigh-In (which I never ended up doing) and was a little stunned to see my neck. (My neck was not the reason I didn't do the weigh in; I just didn't get around to writing it.)

I was taking a pic of my earrings (just to ask someone about a smaller stud length) so you can't see my whole neck, but this really shows the size from what you can see.

After this is when I had the biopsy, which was awful. You can read about that on this post.

This is a hematoma that formed during the biopsy. I felt like maybe I made a huge mistake in doing the biopsy (even though it was necessary)--my symptoms worsened and it looked horrible. It was very painful, too.

A hematoma is basically a pocket filled with blood. Since there is no incision for the blood to get out, it pools underneath.

I didn't realize how serious a hematoma in your neck is until after I got home from the biopsy and it was getting even harder to swallow. If it continues to bleed, it can close off your airway--so it's important to go get checked out. They didn't really do much at the ER (or even my overnight stay) but they said it was good that I went in. If my airway closed, at least I'd be at the hospital.

The physician assistant who did the biopsy told me that I "may have a small bruise that will go away in a couple of days". Well, here is the timeline for my biopsy bruise... the bruise was there for two and a half weeks. The pictures make it look not that bad, but it was very noticeable. I kept forgetting about it until I noticed people looking at it while I was out in public.

In the hospital after removing the bandage. The swelling had already gone down a noticeable amount.

Three days post-biopsy

Five days post-biopsy. The little dot is where the needles were inserted; I think there is one hollow needle and then six smaller needles were passed through that to collect samples. Or maybe I'm just making that up? I think that's what I was told.

Nine days post-biopsy

Eleven days post-biopsy

Meanwhile, I also had a CT scan and saw just how huge the mass was. It was about 5-6 centimeters, which is considered very large (even the surgeons were kind of impressed at the size). It was pressing up against my esophagus (food tube) and trachea (airway) and even my jugular vein and spine. This is why it was so hard to swallow.

I even started to eat softer foods because I'd almost choked a few times. My voice had changed (the voice box is *right* there and I was told there was a chance my voice would change permanently after the surgery (caused from a complication). I honestly wouldn't have minded! I don't like my voice and I kind of liked the bit of raspiness I'd developed.

I think the biopsy bruise was finally gone after about two and a half weeks. Just in time to be replaced by a scar! Hahaha. Thankfully, the biopsy came back negative for cancer!

I had surgery to remove half of my thyroid (including the entire mass). I wrote about the surgery on this post, so I won't write about it again. But here are some post-op photos...

Twenty-four hours post-op. I was horrified when I saw this. After removing the ACE bandage the following day, this is what it looked like. The tape on there is a Steri-strip and it meant to dissolve on its own.

Just another angle at 24 hours post-op.

The next day, I felt like it just got worse. I was relived to be able to shower, though! The adhesive on my neck collected lint and grime and it looks gross, I know. Showering was scary; I was worried I was going to open my incision or something.

Twelve days post-op. There is still some residual adhesive, but touching it gave me the heebie jeebies, so I didn't scrub it.

Thirteen days post-op. I used tweezers to gently pick away the residue from the Steri-strip, and I felt like it looked so much better after that!

Exactly one month later, which is about six weeks post-op.

Another angle. Without tilting my head back, you can see all the loose and puckered skin. I don't know if this will go away or not. It almost feels like the muscles holding my neck skin more taut loosened up or something.

The puckered skin on my neck, along with the puckered skin on my chin (which was from my jaw repair surgeries in 2010), my face isn't looking too good these days, hahaha. They aren't hidden with clothes--even a turtle neck can't cover it up, so I just have to be okay with it. The scar isn't an issue for me, but I really hate the loose skin.

And as of this moment, this is what my scar looks like... not bad at all!

The problem is that it only looks okay when I have my head tipped back. When I put my head down, it looks like this...

I don't want it to discourage anyone from getting the surgery if they need it, but I also want to be honest about what to expect. Nobody ever mentioned anything about my skin (other than a scar) so I was not expecting this at all. I don't know if it will get better over time, but I don't imagine it will.

Other than all of the thyroid stuff, not much has been going on. I'm still not feeling better mentally, but I follow up with my psychiatrist this month about the new medication, so I may just need a higher dose.

I haven't lost any weight, although I do start every day with the mindset of getting back on track with not only my diet, but my life in general. I feel overwhelmed; so far behind on everything. Including email! If you are waiting for a response, I am so sorry. I've been spending as little time on the computer as possible. I've been feeling really nostalgic for the 90's lately; I miss doing things without technology everywhere. So I've been working on that recently.

And still sewing! I've been doing a lot of hand-sewing and hand-quilting lately. My post about recent projects is about a year overdue now, hahaha. I just don't have pictures of things, so I need to take the time to take some pictures.

Noah is living at home again, and I love having a buddy here! Eli doesn't hang out with me like he used to, but Noah has been playing Dr. Mario with me (the old school Nintendo one--I am *awesome* at it, haha), chatting with me about his day, asking me to watch movies with him, show him how to cook things, etc.

I've been working on redoing my bedroom decor as well. The childish theme Jerry and I tried out was fun for a couple of years, but we were ready to move on from the black walls and ceiling! I've painted the ceiling white (and no, it wasn't hard to cover the black--one coat of Kilz and two coats of Sherwin Williams paint) and the walls a sort of medium-navy. They aren't too dark or too light.

My color inspiration actually came from a quilt I am working on right now (I swore I would *never * get into quilting, yet here I am). I bought a bunch of fat quarters (a quarter of a yard of fabric) on Ebay--they are civil war reproduction prints and I absolutely love how the colors go together. (I had to put a safety pin in each of the 806 squares to hold it together while quilting, which is why I have this spread out on the floor!). 

I have a few more things to do to my room (including finishing this queen-size quilt!) and then I'll post pictures. Rose (Noah's "girlfriend"; they broke up but it was very amicable and they are still close friends) loves to decorate and she's been helping me with ideas. I'm still leaving all the cat shelves up; the cats use them so much that I'll never be able to take them down. Most of them are at the ceiling, though, so they don't hinder furniture or anything.

So that's the gist of what's going on with me. As soon as I'm feeling better, I will write a "real" post, I promise!

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Thyroid Surgery

On my last post, written on January 25th, I said that the next step in this whole thyroid process is that I had to wait for a scheduler to call me to set up the date of surgery. Since the process of getting an appointment at U of M was quite complicated, I assumed the surgery date would be even more so.

A woman from scheduling called me on Monday, the 27th to schedule the surgery. I had already planned to ask for the first available Thursday (the doctor operates on Tuesdays and Thursdays) because I figured Jerry could take Thursday and Friday off work, and then he'd be free on the weekend as well to help me out if needed.

Apparently, there was a canceled surgery on January 30th--just a few days later. I said I'll take it! It all happened so fast that I didn't really have time to even work myself up, haha. From everything I'd read and based on the consult I'd had with the doctor, I felt like it was a straight-forward surgery and relatively simple.

I wasn't given an arrival time until Wednesday; I was to be there at noon on Thursday, with a surgery time of 2:00. The operating room was booked for 3-1/2 hours, which kind of scared me because I thought that felt like a long time for what seemed like a "simple" surgery. They said I'd be able to leave 1-3 hours after surgery, depending on how I'm doing afterward.

That part made me nervous; when I'd left my biopsy, I was back and in the ER just a few hours later. I would actually have preferred that they keep me overnight after surgery! However, it was reassuring that the surgery was likely no big deal.

Jerry and went up to Ann Arbor for a noon arrival on Thursday and I checked in for surgery. (Once again, the receptionist--a different one--thought Jerry was my son. I might as well just accept that I look very old for my age.) The system they have is pretty cool--Jerry would receive continuous text message updates before, during, and after surgery to keep him informed of what was going on. We sat in the waiting room for a little while after we arrived and it was so interesting to people watch!

The room was filled with about 20 Amish people--men, women, and kids--who I'm assuming were waiting on someone to come out of surgery. I loved seeing that not a single one of them was on a cell phone; they were all talking and laughing with each other, reading "real" books, a couple of women were even hand-sewing(!), and the kids were on the floor playing with actual toys instead of on tablets.

I know this makes me sound ancient, but I really miss the days when a waiting room was an opportunity to have a quick chat with a stranger about current events or whatever, and there were outdated magazines to look through, and a sense of camaraderie among everyone waiting their turn. It was refreshing to see this group of people using the time to chat with each other.

Anyway, when it was my turn to go back for surgery, I was taken to an area with a hospital bed and monitors and a curtain around it. My nurse gave me a gown and said I had to take off literally everything--including my underwear?!--and put on the gown. I would have liked to keep my underwear on and I have no idea why I could not, but I did what I was asked and the nurse asked all the appropriate questions in preparation surgery.

While he was doing that, someone else gave me an IV and got me hooked up to some monitors. I was a little nervous after my IV--I've never had a painful IV before, but this one was bothering me pretty badly. She'd gotten blood all over my arm and even swapped out my blanket because it had blood on it. I told Jerry it was a sign we should turn around and go home and forget about the surgery, haha. You all know how anxious I am!

After that, Jerry was able to come wait with me. My cousin, who is a nurse practitioner in the ENT department there, came to visit for a few minutes and she brought one of the doctors on my team with her. She assured me that I had truly the best team I could ask for (and I 100% trust her opinion). The doctor she introduced me to was SO nice and fantastic at answering my questions and super patient with me. I had been ridiculously nervous, but after speaking to them, I felt much more comfortable with the surgery.

The anesthesiologist came to talk to me next, and he was just as great. He's British and has a fun sense of humor; he made me feel comfortable with the anesthesia part. Finally, my surgeon came in to talk to me about the plan. I got the impression that the surgery would be very simple and nothing to worry about. They were only removing the left thyroid, so the chances of needing thyroid medications after surgery are low.

The surgeon said I'd be ready to head home shortly after surgery and that most people are fine with just the usual tylenol/motrin cycle for pain for a day or two. I certainly would not object to "real" pain meds, but it was nice to know that the post-op pain would likely be no big deal.

When it was finally time for my surgery, I said goodbye to Jerry and was taken back to the operating room. Each time I've experienced that for surgeries, it feels surreal. I think it's a combination of my nerves and knowing what's going to happen there, along with the the hustle of everyone doing their jobs to prepare for surgery. I just wanted them to hurry up and put me under anesthesia.

And the next thing I remember is waking up in (what I think was) the same place I'd been for pre-op. The details are kind of fuzzy now, but I remember being in an enormous amount of pain. My throat felt SO tight and I could barely swallow. The nurses were working on getting me stable and comfortable but I was just not expecting the amount of pain that I was in. They asked my pain level and while I wanted to say 10, I knew that everyone probably says that and it's not taken seriously, so I said "8". They gave me more pain meds in my IV. Still no change. More meds. Still no change.

[Side note: I have a ridiculously high tolerance to pain meds. My only guess as to why is because when I broke my jaw, I was on three different narcotics for over eight weeks and it made me much more tolerant of them, I guess. A tolerance to pain meds isn't something you can really explain to doctors, though, because they think you are just seeking drugs.]

They eventually maxed me out on the IV and oral pain meds--all were in disbelief that I was even still conscious--and my pain felt like it was about a 5 or 6. I don't know why I was in so much pain--whether something went wrong during surgery, or my pain tolerance is that of a five-year old child, or my medication tolerance was working against me--but I was not feeling great at all and I was totally regretting the surgery at that point.

The whole care team was SO fantastic, though. Every nurse and doctor and that I interacted with was super kind and caring and helpful. I didn't have any post-op complications that I know of (thankfully no hematoma!) and was able to leave when I felt my pain was under control. (The doctor said that everything went as expected during surgery.)

The next couple of hours were a blur. Lots of meds (and apple juice!) later, I was finally starting to get sleepy enough to go home. Jerry wheeled me out to the car and drove home. My pain was about a 5-6 and I was SO hungry. And tired. I had been awake for about 20 hours at that point (minus the surgery time, about 1-1/2 hours) and hadn't eaten in nearly 30 hours. I wanted to eat but I was extremely nauseous--probably due to the pain meds--and I only managed a few bites of a banana. And for the life of me, I could not sleep. I was wide awake until I finally quit trying to fall asleep and just got up out of bed at 3:00 or so.

I have been avoiding writing about all of this, because I just don't have many positive things to say yet. My outlook right now is not optimistic, but it's real. So, with that in mind, here is where I am at...

I was stunned at how terrible I felt. I wish my expectations had been much worse so that when I woke up from surgery, I would maybe be pleasantly surprised. But the opposite had happened. I spent the next day in a lot of pain and nausea. I was able to take off my bandage 24 hours post-op and I kind of wish I just hadn't looked. My skin looks so bad--very saggy and wrinkled. I can't see the scar yet, but I was never really worried about a scar. I just didn't expect the rest of my skin to look like this.

I am not ready to post a picture yet. I just feel really ugly right now and I'm still in a lot of pain. I've been coughing really hard and that definitely doesn't help with the pain. It made my neck muscles feel incredibly tight and sore. The coughing has gotten better since yesterday, though. My post-op appointment is in a couple of weeks, so hopefully I'll learn more about whether this is all "normal". I hoped I would feel better as far as swallowing, but it honestly feels even harder to swallow now than it did before surgery. I'm guessing this is due to swelling and that it will get better. After all, that was the main reason for this surgery!

So, while I'm feeling like a "negative Nancy" right now, I know it's early yet--just a few days post-op--and I hope that things will get better. It's just hard to do that when I'm in pain and coughing and knowing that I was "supposed" to have been feeling great the day after surgery. I guess only time will tell!

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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!

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Thyroid Biopsy

[If you didn't read my last post, regarding my thyroid, you'll want to read that first.]

My needle biopsy for my thyroid was on Friday. I wasn't dreading it--I was actually looking forward to it, so I can get all of this over with as quickly as possible. And because I am the type of person that wants to know everything I can expect going into something, I read as much as I could about it ahead of time.

Essentially, the doctor inserts several small needles (one by one) into the mass, which collect samples to send to the lab. Sounds simple enough. Not pleasant, but it's not like having surgery.

Jerry wanted to go with me, so we went to the hospital's radiology department. It's done in radiology because a tech uses an ultrasound for the doctor to be able to see where to guide the needle during the procedure.

First, the tech did the usual ultrasound to get pictures of the mass (again). It took a little while for the doctor to come in--the tech called someone a couple of times on the phone, asking if so-and-so was available for a biopsy. I should have seen that as a red flag (and my intuition was definitely telling me so, but it being my first time for something like this, I just assumed everything was normal).

Finally, a physician assistant (PA) came in and started prepping my neck. I had to lie on my back with my head tilted back, a pillow under my neck. After everything was prepped, she injected lidocaine to numb the spot that she would be inserting the needles. The lidocaine was definitely the most painful part. I'm not at all afraid of needles, but I wasn't expecting the lidocaine to burn so much. After that, though, I didn't feel much at all.

The PA took the first needle and inserted it into the mass. Then she moved it all over--if you've ever seen how liposuction is done, it's like that--about 20 times. Pulled it out, got a new needle, and repeated that five times. After the last one, she put a gauze pad on my neck and left the room for the tech to bandage me up.

The tech was about to replace the gauze with a bandaid and when she lifted the gauze, she immediately pressed it back down and said something like, "Oh! You have a pretty big hematoma." She told me to hold pressure with the gauze, as much pressure as I could without choking myself. I did that for about five minutes, and asked her some questions in the meantime.

[Side note: A hematoma is where blood pools in a space outside of a blood vessel, but since there is no opening for it to come out, it just sort of collects in the location, forming a lump.]

She had seemed a little alarmed by the size of it, which made me nervous. I asked her if that happens often and she said something like, "Not too often, but it happens and it will be fine." I just needed to hold pressure and ice it for 20 minutes every hour. She replaced the gauze with a bandaid and then gave me an ice pack for the ride home.

Over all, it wasn't a bad experience. It wasn't fun, but it wasn't painful (other than the lidocaine shot). When I got home, I was STUNNED when I looked in the mirror. The lump on my neck was huge. This made me really nervous, so I googled it. And naturally, that gave me even more anxiety about it. It said that having a hematoma in that location is serious because it can press against your esophagus and trachea (the tubes for eating and breathing, respectively).

Hematoma after thyroid biopsy

I'd already had difficulty swallowing (that was the main symptom of the large mass in the first place), but I noticed that it had definitely gotten worse since the biopsy. I had a hard time deciphering whether it was also affecting my breathing as well, but the best way I can describe the feeling is like wearing a very tight turtleneck. I kept reaching up to pull my shirt away from my neck, only to realize my shirt wasn't there--it just felt like it.

Since the tech said it was fine, I just trusted that she knew what she was doing. I sent a picture of it to my sister, basically to show her the size of this hematoma. I thought she would have the same sort of "holy cow!" reaction, but not because of it being dangerous--just impressive. She told me she doesn't think that's normal and that I should go back to the hospital.

I figured she was overreacting, so I sent the picture to Becky as well (she's an RN). Becky is always calm and somehow has this magical way of making me less anxious about things. I was expecting her to tell me it's okay and maybe give me some advice for reducing the size or whatever. Instead, she (gently) told me that I really need to go to the emergency room. She said that if it's still bleeding (the bleeding is inside--you don't really know if it's still bleeding or not without a CT scan) it can get bigger and push against my airway rather quickly.

The roads had gotten terrible because it was snowing really hard. The expressway was even closed at one section because of accidents. (Remember the last time I drove to the ER during a snow storm?) I really didn't want to go. I really felt like it was an overreaction to go to the ER over it and I thought for sure they would send me right back home, but I figured it would be better to be safe and just go get it checked out. I'd had the biopsy at 1:30 pm and Jerry and I arrived at the ER at around 5:00.

[Also, this just reminded me of the time I went to the ER for a suspected hematoma after my skin removal surgery... the bump on my hip seemed foreign and when the doctor examined me, I learned that it was my hip bone. BAHAHA, I'd never felt it before!]

Instead of sending me home, they took me back to triage immediately, bypassing the crowded waiting room, because it could apparently be pretty serious. As the numbing wore off, it was getting more painful. But the pressure on my neck was really starting to scare me.

From triage, they put me in a room to wait for a doctor. A nurse set up an IV and took some blood samples. At this point, time seemed not to exist anymore because it's so mind-numbing to sit in a small room with nothing to do. Jerry was with me, thankfully, so we talked while we waited. 

The doctor and her med student came in and WOW--this was literally the nicest, most caring doctor I've ever met. She was not at all rushed, she explained everything really well, she told me I did the right thing by going in (I know people tend to abuse the ER, and I had felt like maybe I was doing that). She even sent her med student out of the room for a moment so she could ask me privately how I was feeling mentally/emotionally about all of it. She could see how nervous I was because I tend to wring my hands and fidget a lot.

I explained to her the events from earlier and she stopped me when I mentioned the wait for the PA to come in and do the biopsy. She said, "Wait a minute--they had a PA do the biopsy, not the ENT doctor? Are you sure?" She exchanged a look with her med student, and I could tell that something wasn't right. She wanted to know the details about who did the biopsy and what instructions I was given. She said that it is NOT common to get a hematoma from a thyroid biopsy, especially one as large as mine. And it certainly IS a big deal. The PA never should have left without checking it and the tech never should have let me leave without calling the PA back in to look. (At this point, I don't know whether it's routine for a PA to do the biopsy, but from the ER doctor's reaction, I'm guessing not.)

The ER doctor said she wanted to get a CT scan to see if it's still bleeding and that she wanted to keep me overnight for observation, just to be safe. 

When she left and I had time to process all of it, I felt so let down and angry about it all. I should have listened to my intuition when the ultrasound tech was looking for someone who was available to do the biopsy. I should have seen the red flag when I noticed that the tech seemed kind of surprised and alarmed by the hematoma, while trying to seem like it was pretty routine. I felt a little uncomfortable with the fact that a PA would be doing the biopsy rather than a doctor, but I know that PA's are very qualified in their jobs, so I assumed it was normal.

At around 9:00 pm, I was taken for a CT scan. I'd had one before when I broke my jaw, but I didn't remember anything about it. I know they didn't use contrast (where they inject something in your IV during the scan and it helps them get a picture of blood vessels). I wasn't worried about the CT at all until I was told about the contrast.

I don't know why it freaked me out so much, but the CT tech explained that when they injected the contrast, I would feel a sensation of getting really warm/hot from head to toe, feeling kind of like a hot flash. And that it would probably feel like I peed myself, but it was just the contrast doing its thing. It was at this point that I started to have a panic attack. Not from the biopsy, not from the hematoma, not from going to the ER, not from the CT scan, or any of that... it was simply being told about the contrast.

I really didn't think I'd be able to go through with the CT. She called my nurse, who was able to give me some ativan and hopefully get me to calm down. The scan only took about five minutes and the worst part was the anticipation of what the contrast would feel like. It felt just like the tech had described, but it was over with very quickly and ended up being no big deal at all. (If I ever need another, I'm not going to worry about it.)

I was taken back to my room in the ER to wait for the results. It wasn't very long (maybe 30 minutes) before we got the results--the bleeding appeared to have stopped, but they still wanted to keep me overnight for observation. They said they just had to wait for a bed to open up but it should be long. Then we waited. We waited and we waited and we waited. At this point, I was drained. I hadn't eaten since Thursday, and I hadn't had any water or even peed since just before I'd left home (I wasn't expecting all of this or I would have planned better).

I usually go to bed at 9:00 and it wasn't until 1:00 am that I finally got a room. I was kind of delirious with exhaustion and I don't remember if the person who transported me explained anything before they left. But once they were gone, I realized I didn't know where the bathroom was or if I could get some water or even where the light switch was so I could turn off the light. I couldn't find a call button. And I was too exhausted to do anything but try to sleep. I had asked for a xanax to help me sleep, so that, along with the ativan from earlier, made me really sleepy.

I didn't know how to turn off the lights (there are a lot of switches and I didn't want to start messing around) so I just pulled a blanket over my head and managed to fall asleep. At some point, I remember someone asking me if I wanted them to turn off the lights and I said "yes! please!" and I fell back asleep. At around 5:45 am, I woke up. Again, couldn't find the light switch, so I opened the curtains in the room to get enough light to look around.

I finally saw a small sign on another door in the room that said "patients only" and I was so happy to see that it was a bathroom. I picked up my purse from the bedside table and discovered that there was a styrofoam cup of water there--it had been behind my purse, which is why I didn't notice it before. I was so ready to get out of there. I was starving! Since I couldn't find a call button, I walked to the nurse's station to say that my husband was going to come pick me up.

They told me that the ENT doctor had to sign off on my discharge papers but he wouldn't be there until 10:00 am and that my nurse would be in shortly to talk to me. I waited in the room for a little while and even took out my IV.

My nurse finally came in, and was extremely kind and caring. She'd had the "house doctor" come with her to explain why I should stay. They weren't planning any other tests or treatments, but they felt it would be best to let the ENT doctor make sure I was good to go. I showed them how the swelling in my neck had gone down quite a bit (I had pictures for comparison) and the tightness was back to "baseline" (still trouble swallowing, but it was back to what it was before the biopsy). The nurse apologetically told me that I would likely be there most of the day because the doctor had over 60 patients to see.

I knew I would be leaving against medical advice (AMA) but by that point, I'd stopped being so blindly trusting. I had had a bad biopsy, I hadn't eaten in like 36 hours, I was completely sleep deprived, sore, anxious, and just emotionally drained. How can anyone make good decisions in that state? If my neck had still been as big as it was the night before, I would have stayed. But it looked quite a bit better (even the nurse and house doctor said so). I ended up signing the AMA papers and heading home at around 9:00.

As expected from the biopsy, my neck is bruised and ugly and the hematoma is still there (it should go away on its own but it can take days or even weeks). There is NO way that I would feel comfortable getting the thyroid surgery at that hospital or even in the Henry Ford system. After Noah's foot incident, Jerry's horrid lumbar puncture, and now this biopsy complication, I've lost all trust. I don't have the results of the biopsy yet, but I know I won't be going back.

My cousin, who I was very close with when we were kids, is actually a nurse practitioner in the ENT department at the University of Michigan hospital. In retrospect, I should have just gone there from the beginning. But it's not the same healthcare system (Henry Ford vs. U of M) and I figured it would be easiest/best to stay within the same system while seeing different specialists. Especially considering the biopsy was "no big deal".

I asked my cousin if there is a particular ENT doctor that she really trusts and she said the ones she works with are fantastic--she gave me some names and said that if she or her family needed an ENT, that's who she would go to. I really trust her and and decided to make an appointment with one of them for a consult and plan moving forward. I really do need the surgery to relieve the symptoms, whether it's cancer or not.

I've always taught my kids how important it is to listen to your "gut feeling" (intuition), even if it makes you seem like you're overreacting. If you feel like something isn't right, there is a reason for that. I had that feeling tug at me throughout the biopsy but I convinced myself that I was just anxious about the procedure.

I'm not saying it was anyone's fault. It's possible I would have gotten the hematoma no matter who did the biopsy. But I never should have been sent home with a large hematoma on my throat, especially without a doctor looking it over first.

I realize this post is super long, but just one more thing... when I was being wheeled to get my CT scan, I thought I heard Jerry talking to someone outside of my ER room. I didn't think anything of it, but when I got back he told me that he'd run into Kelly, one of my roommates from college that I hadn't seen since 2001! My freshman year was so much fun and I have great memories with her.

I was bummed that I missed seeing her, but she ended up coming into my room a little while later because she is a nurse there. Years after I'd last seen her, when people were starting to get on Facebook, I found her and learned that she had a son on July 13, 2004--which happens to be Noah's birthday as well. Isn't that wild?

Anyway, my neck is looking and feeling better today. You can still see the hematoma bump and bruise, but hopefully that will go away soon. Next, I should get my biopsy results. Tomorrow, I'm going to call U of M and make an appointment with one of the doctors my cousin recommended. And just pray that everything goes well from here on out!

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