Monday, April 27

Metastatic papi- what??

It's been a few days since I last posted, so I thought I would give an update. I'm feeling better and better each day, though my skin is so dry it's ridiculous. I know it hasn't been that moist here in Colorado lately (aside from the past day or so) but I can't seem to keep my skin hydrated. I know this to be a side effect of the thyroid medicine I am on. It's alright. I'm sure it will all work out. My scar is healing nicely and I have just now come to the point where I can turn my head without turning my body. I'm slowly losing my Batman moves and I couldn't be happier about that. My voice, on the other hand...well, that's going to take some time. Don't ask me to sing any time soon, because I just can't and everytime I try I end up hurting my throat. So, as much as I hate to do so, I still need to rest my voice and hope that it all comes back soon enough. It could take months, it could take years. I think that's the first thing people are going to notice about me now. My voice is different. Expect it to sound weird. I can hum a little, and my voice is lower than it used to be, but I can no longer project my voice like I used to. This includes speaking, shouting, yelling, and singing as well. It's interesting to experience. But you know what? I am alright with it. It doesn't bother me as much as I thought it would. Now, this could be because I haven't really spoken to anyone much lately and it could all change once I am back at work and talking on a daily basis. Who knows? Just expect my voice to sound funny for a while.

Last Monday James and I went to the doctor and he gave me a copy of the pathology report along with a copy of the operative report. I got to read about what they did to me in the surgery, and it was very interesting. It was a surprise to receive the operative report and I have found myself reading it over and over again. It's just really interesting to read. Anyway, the pathology report is more scary, but still an interesting read. I thought it would be interesting for all of you to see what the final results were. Here is what part of the report said (this is the shortened version, but contains all the important stuff):
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Cancer Case Summary Protocol:
THYROID: Resection

MACROSCOPIC:
Specimin Type: Total Thyroidectomy
Tumor Site: Right lobe, left lobe, and isthmus
Tumor Focality: Multifocal.
Tumor Size: Largest nodule is 1.4 cm.

MICROSCOPIC:
Histologic Type: Papillary carcinoma

Pathologic Staging (pTNM):
Primary Tumor (pT) - pT3: Tumor less than 4 cm, but showing minimal extrathyroidal extension (perithyroid soft tissues).
Regional Lymph Nodes (pN) - pN1b: Metastases to bilateral cervical lymph nodes.
Number examined: 21
Number involved: 14
Distant Metastasis (pM): - pMX: Cannot be assessed
Margins: Tumor abuts the inked anterior aspect of the resection.
Venous/Lymphatic (Large/Small Vessell) Invasion (V/L) Present

FINAL DIAGNOSIS:
1. Pretracheal lymph node: Metastatic Papillary Carcinoma
2. Total Tyroidectomy: Multifocal papillary carcinoma (Largest lesion 1.4 cm) extending beyond thyroid capsule, and encroaching inked surgical margin multifocally.
3. Central Neck Compartment, right aspect: Metastatic Papillary Carcinoma in nine of ten lymph nodes.
4. Left aspect of central neck compartment: Metastatic carcinoma in four of ten lymph nodes, normocellular parathyroid tissue noted.
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How many times did you count the words "metastatic" and "carcinoma"? Yeah, me too. That's a lot, huh? I go to my endocrinologist on Wednesday morning to find out what the next steps are in the treatment plan. I know I definitely have to have the radioactive iodine treatment, and based on the path report I will more than likely be having a lot of it, but I don't know when and I don't know how the whole process works. I seriously can't wait until Wednesday, though. The hardest part of this whole situation has been the waiting.
I'm not scared that I have cancer, and I'm not afraid to use the word. I'll admit that when I first heard back in late January that my biopsy came back as cancerous it rocked my world. That first week after hearing my test results was tough. I spent an entire day all by myself just trying to deal with the information I had received. It was so sureal, and not at all expected. Then we met with the surgeon who said the first path report listed the biopsy's as "suspicious" for thyroid cancer. He said I should think of the surgery as a really big biopsy and afterward they would send it to the pathologist to have cancer either confirmed or denied. The first page of the operative report says "PREOPERATIVE DIAGNOSIS: Bilateral thyroid nodules" followed by "POSTOPERATIVE DIAGNOSIS: Metastatic papillary thyroid carcinoma". That's quite the jump. At any rate, I really am doing well. I have the strength of God, the strength of family and loved ones, and the strength of friends all lifting me up and helping me carry on. I'm not scared that I have cancer.

2 comments:

CrocsFan said...

Crystal i am so glad you're feeling better. i love your stories and i miss hearing YOU tell them. when you're feeling better we so have to get together. We can have dueling lisps ;-D. Love you Sista.

Melissa J. said...

Crystal I'm glad that you are feeling better and that your surgery went well. The pathology report is pretty interesting (especially from a semi-medical field perspective). I would say things are definitely going to be looking up. :)

I sure hope that your voice gets back to "normal" even if it is a little different. I had to have my tonsils out 5 years ago and it changed the way I sing just a little, but it was an easy adjustment, so hopefully yours will be similar.