Saturday, March 28, 2015

Fight The Good Fight

In Florence + The Machine's epic hit Shake It Out there is a line:

I can't tell you how many times I have listened to that song in the last month.  Especially in the days learning up to my surgery.  I have held fast that, It's always darkest before the dawn, as Florence sang.  I was scared and angry and struggling with not knowing what would come after my surgery.  I was quickly learning that with treatment of cancer, it is a one-step-at-a-time thing; do one thing, see how it goes, then do the next according to the result.  I am sure Dr. Lagmay, my ENT had provisions for all the variables but that was on his end and to some degree his hands were tied- he can only do his part as well as he can and then wait for pathology to come back to determine what comes next.  As a teacher, when I plan, I write lessons- each step leading to a final goal and ultimately the objective of the lesson.  On my end though, I can only do one step at a time.  It was maddening to not be able to plan all the steps ahead of time.

In pre-op waiting to go in.
By 7 AM I was all set: had been poked to death by an anesthesiology student who could not get the IV into my arm, had been asked 100 times what my name was and what I was having done, and had transformed into the foxy lady!

The surgery, intended to take 90 minutes took three hours.  The mass in my neck, now being referred to as a tumor, was larger than my fist (bigger than a baseball).  The surgical report is meticulous, chronicling each movement of each part of my anatomy as Lagmay worked carefully to remove it from my neck. In addition to the tumor, my thyroid was successfully removed and I later found out all the parathyroids were saved (they control how your body uses calcium). 

The morning of my surgery, we arrived EARLY for a 5:15 AM check in at the hospital.  Mom stayed with me while Charlie went back to his office (also at the hospital) to get some work done.

When I woke up in recovery I could not talk and there was a drain in my neck.  I was scared because I could see the clock and knew the surgery had taken longer than anticipated.  Lagmay came in not long after and told me that everything was going well.  WE were going to have to wait and see how I was doing as the day progressed- tolerating liquids and seeing how much blood was being collected in the bulb of the drain.  Below, post op, finally in my room.

I ended up spending that first night in the hospital and went home Thursday morning.  It was a long night but thankfully little to no pain.  I was alone in the room most of the night until about 5 when they brought in a women who snored like crazy and that was the end of my sleeping.  I was cleared to go home because my calcium levels were good and I was back at home by noon.

 It was a little shocking to see how big the incision was.  We had gone to the drug store on the way home Thursday and I asked her to look and see how big the wound was- I could see the shock on her face, her eyes got big, reacting to how big it was.  We were looking for waterproof bandages for showering...The picture here is before the bruising really started and the stitches are still in.

Friday I wrote this: It's Friday morning.  Today I am having some tingling in my hands, connected to how my body is using calcium (or not).  I have a call in to my Dr. but waiting to see if I have to go do blood work.  Sleep is not very restful, but I am sleeping.  I woke up at about 4:30, to the tingling, took 4 chewable and laid back down to try and sleep more.  Which I did.  I am tolerating food and liquid.  My incision is looking bruised and puffy but not oozing or red.  I have to admit, I was shocked by how bit it was- I guess I was expecting something smaller.  War Wounds.

Friday was a flurry of phone calls to Lagmay's office to talk with his nurse.  They made sure I was taking the right calcium and that I was taking the vitamin D with it. (Your body needs vitamin d to help absorb calcium.)  I made it through Friday night but by early Saturday morning the tingling was getting worse.  I was feeling it through my lips and I felt like I was slurring my words.  By 8 I woke up Mom and Charlie and told them we needed to go to ER.

The attending ER Doc ran blood tests and in fact my calcium and magnesium were both extremely low (hypocalcemia).  When the thyroid is removed the para-thyroids go into shock and struggle to absorb calcium into the body.  Calcium supports nerve and muscle function.  The Doc also did a test that you can see in the video. It is a physical response that indicates low calcium with out doing a blood test called Trousseau Sign.  It was fascinating to see my hand curl up. When I had signed into the ER, I had not been able to hold a pen in my hand and write- I knew something was really wrong.

If anyone has ever been to the emergency room on the weekend, you know nothing gets done quickly.  There are not enough staff across the board and the ER can be packed.  When we arrived early Saturday there were only a handful of people waiting and maybe 20 in the ER in beds.  By 3PM beds were three deep and it was like pulling teeth to get any answers.  Nurses are powerless, unfortunately and have little to no information to pass on.  I had IV of magnesium as well as liquid calcium.  After the second round of blood was taken after administration, a second dose of calcium was given.  Then you have to wait, more blood is taken, tested.  The ENT on call never came to see me.  Around 7:30 PM I had a melt down- in tears.  I wanted some Tylenol for the ache in my neck and wanted a decision to be made re: staying the night or not.  Tears got things going and the chief resident got someone to make the call to send me home. I would have been ok either way, I just wanted a choice to be made.  They upped my dose to 1000mg of calcium 4x a day.  The tingling was gone and I was exhausted and just wanted to go home.

The Sunday was better.  Mom and I watched movies, walked to the grocery store to stock up on dairy products.  I wish she could have stayed longer but we were to thankful to have here her to help and support.  Monday was full on binge watching The Unbreakable Kimmy Schmidt on Netflix.   It was a good day I was feeling stronger and not pins and needles. 

Wednesday, I went to see Lagmay for a check up.  I knew the pathology was back and was awaiting the news.  It could have gone one of two ways: radiation or not.  Lagmay apologized for the complications I had experienced.  He was surprised that I had been hypocalcemic. He took my stitches out and replaced them with steri-strips. He also checked my vocal cords.  I have some paralysis on the right side. I have a appointment coming up over spring break to see a ENT who specializes in vocal cord damage and I will be going to see a speech therapist to help regain the strength in my voice. It will take time.  It could be a long time but I feel stronger each day.  I'll also be seeing the new Endocrinologist over break as well.  I have felt ok on the thyroid meds but I am anxious to speak with her about ongoing care and how it may impact my weight.

March 27th
I took the rest of the week to recuperate.    It would have been foolish to go back as soon as I had planned.  Monday I returned to work.  Thankfully it was the week I had a lighter schedule and just taught one class, my AP kids on Monday.  They would be good.  They would understand. It was the 9th graders I was more worried about.  I have all these wonderful scarves that artfully cover my scar.  

Rebecca and the PTA both gave me beautiful flowers that smell amazing and have been on my desk all week.  The outpouring of support and encouragement at work has been humbling.  Colleagues have checked in, kept an eye on my through out the week and loved the fact that I am teaching with a cordless mic. (I have no vocal power and could not yell if I wanted to!)

I continue to heal.  The vocal rest today has been good.  We are going out for the first time with good friends tonight. It is nice to be getting back to normal.  Thank you to everyone who has texted, emailed and check on me the last two and a half weeks.  This is a roller coaster but I am thankful for the great care on all fronts I have received and look forward to a full recovery as the weeks and months pass.

First day back at work, trusty scarf.

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