Another Test

For one blessed day, I was normal. Blood tests all in the correct ranges. No lingering pain anywhere, not even a screening in the near horizon to capture my concerns. Then I went so casually into my endocrinologist's office. He asked me how I thought things were with my thyroid. I mentioned about the elevated CEA and having a blood test for TSH in July which was normal. Okay, we'll try to find the results on that, he says. I told him it was 1.01 if that helps. It does, he answers, although I'm sure he prefers the actual lab results to some over-50 patient's ability to recall the precise number. (Note to self: next time, ask my oncologist's office to forward any blood test results directly to endocrinologist.) I mentioned to him that my thyroid felt larger. He asked if I was having heart palpitations or shortness of breath. Nope. He checked how my eyes tracked his flashlight. Then he had me lay down with my neck bent forward so he could ultrasound my thyroid. I think I have one of the most sensitive necks around, so this is no easy feat. Every time he pressed the wand into my neck, I had to force my mind out of the moment, breathing evenly, trying to think of something, anything rather than than the panic I naturally felt when my neck was being squeezed. (I have a hard time with turtlenecks.) The wand lingered on the left side of my neck, the doctor taking picture after picture. When I was allowed to sit up and wipe the goop from my neck, he said that one of my nodules is definitely bigger. And it has a lot of blood flow.  It seems to be a bit messy, breaking off little pieces. Okay, my mind went directly to: blood flow, breaking off...tumor?? He reassured me that the likelihood of this being metastatic from my breast cancer is slim. In fact, he's never heard of that happening. (Of course, I googled that when I got home, and while this is very rare, if metastasis spreads to the thyroid, it is often from the breast. Okay, rare is good. The link to breast cancer, however slight, not so good.)

My doctor looks at his notes, looks back at me, says we have two options and he's not sure what to do. He already biopsied this nodule and it was benign at the time. He's thinking it is a "hot" nodule, meaning it produces too much thyroid hormone. To avoid unnecessary surgery, he decides that I should undergo a thyroid scan, which uses a small amount of radioactive iodine to trace what the thyroid is doing. Describing the procedure, he says I take a pill, wait a couple of hours, then they scan my thyroid. If it is hot, we figure out how to treat it from going into hyperthyroidism. If it is cold, meaning not producing any hormones, then we'll need to biopsy it again. Hot nodules do not need biopsying. Cold nodules have a 5% chance of being cancerous. When I read that, I thought, the odds are still in my favor that this is a benign condition, even if it is chronic, and hopefully treatable.

It's been a few days and I haven't heard back from the place I'm having the scan (which I have no idea where that is!) I'll check back in with my doctor's office to make sure the paperwork hasn't been misplaced. For one glorious day, I was normal. Now, another test...another doctor...more waiting for results...the show must go on!