Thursday, September 30, 2010

Surgery Tomorrow!

Today Katy, my parents and I went to the pre-op appointment to meet the surgeon and confirm tomorrow's surgery.  It was a LONG appointment!  Since this is a teaching hospital, Katy was first examined by a second-year student accompanied by a resident.  The student ask a lot of questions and then felt Katy's neck, the resident made a couple suggestions to the student, and then they both left to consult with the surgeon.  A few minutes later the surgeon and the two others came back in to confirm and clarify.

The major details: The surgeon felt that a total thyroid removal was the best plan given the size of the tumor, and also decided that all the surrounding lymphoids should be removed as well.  The lateral lymph glads will stay unless he sees something to make him decide otherwise once he gets in there.  There is a chance he will remove the parathyroid glands, which regulate calcium levels, but that's not the plan.  The total surgery time should run 2-3 hours.  Katy will check in tomorrow at 9:15 am for her 11:15 am (3:15 am in Tassie) surgery, so we should have an update tomorrow evening!  As long as her calcium levels are normal she will be released tomorrow evening, otherwise she will have to spend the night while they get the levels back to normal.

The surgeon reassured us that she has only a 1 in 100 chance of permanent voice damage, but there is a slight chance that her voice will change.  Apparently the mechanisms of voice are not well enough understood to predict how her voice might change, if it does, but possibilities would include changes to her pitch, volume, or overall control.  Hopefully none of this will happen, but we won't know for a while.  After surgery her voice will most likely be hoarse and she will continue to feel like it gets tired easily, but she should be able to build it back up no problem!

Katy (and the rest of us) appreciate all the healing thoughts you can send us tomorrow and will keep you updated as soon as we know anything!

Wednesday, September 29, 2010

forget the waiting! lets go!

wow! so i was woken up with some very exciting and scary new this morning. We got a call from the surgeon and due to a cancellation he wants to do the surgery on Friday! I'm still kind of in shock with the whole thing, but it's very exciting! we've still got the pre-op appointment tomorrow so we'll see what he has to say and if he really wants to do friday. we really aren't sure what he'll say! I'm actually hoping to get it done friday as the waiting is killing me! but i'm very interested to meet the surgeon since i've never even met this doctor before and have no idea what to expect! although i have heard nothing but good things from everyone about him and he's the very top of his field, so i feel good about that! it's all starting to become very real very fast! i'll be sure to keep this up to date tomorrow with what we find out! but i could be under the knife within 2 days! We're all in shock! wow!

Tuesday, September 28, 2010

hurry up and wait!

It's been a while since i've written anything on here so i thought i might as well give an update. nothing new on the medical front. I'm feeling good all things considered. I've been having a really hard time sleeping and i'm tired all the time, but apart from that my physical health seems good! Mostly just trying to occupy my time. Never thought cancer would be so boring! It's all just a lot of waiting.

I've got my pre-operation consultation on thursday! I'm looking forward to finally meeting the surgeon and i'm very interested to hear what he has to say and find out more about the procedure. We're also hoping to make a Denver day out of it too! maybe go to the aquarium and out to dinner! always fun!

basically, all in all things are good. there's a nervous and anxious edge to everything, but we're all holding together pretty well. and if all else fails lots of chocolate always helps!

Thursday, September 16, 2010

first denver visit!

I had my first visit with the thyroid team at CU Denver Medical Campus today; all good news! We loved the doctor! He was very nice and wonderful at explaining everything and more than happy to answer any and all questions we had. We didn't feel at all rushed and I felt very safe in his hands. Everyone in the whole office seemed very component and great to work with. They all smiled and gave us plenty of opportunities to ask too many questions!

At first glance, the endocrinologist was unsure of the cancer diagnosis based on the pathology report from Barton in Lake Tahoe. Because pediatric thyroid nodules are cancerous 25% of the time (and they count up to 20 as pediatric for this particular cancer so I guess I kind of count) he suspected that Barton was correct, but wanted confirmation from their more advanced pathology lab. As he was saying this, the pathologist paged him about the slides... and confirmed the diagnosis. This means there is a 99% chance I have papillary carcinoma, so nothing new there.

It also turns out that they have assigned me one of the top 5 thyroid surgeons in the US, although he was in Paris for an international thyroid conference today so I have to go back and meet him on the 30th. Everyone in the office confirmed that he was the best, and the doctor said that he's who he would send his family to. The odds of my voice being affected are less than 1% with such a skilled surgeon, versus 3-5% with most surgeons, so that's good! Clearly it was worth waiting!

The best news is that because they are a teaching hospital, they can give me a post-op treatment that is still in the FDA approval process so no one else could offer it. With this routine, I won't have to be on any weird diets and I can start taking thyroid hormone right away, so I won't "crash" with hypothyroidism even if I do need radioiodine. Basically, the current post-op routine is to go on an iodine-free diet for up to six weeks, during which all the thyroid hormone goes away. Less thyroid hormone plus low overall iodine means the remaining thyroid tissue more readily absorbs the radioiodine. This lack of thyroid hormone causes hypothyroidism, however, which entails depression, anxiety, weight gain, loss of energy, menopausal syndromes, and other not-fun things. The new treatment at the CU Hospital involves taking a recombinant thyriod hormone (meaning a human hormone made by another species thanks to genetic engineering) that allows me to avoid hypothyroidism while still making the thyroid tissue uptake more radioiodine than it would otherwise. It also will not interfere with the testing they will do to see if I even need the radioiodine, because it will not effect the levels of the protein they measure for this. Yes, that's right: I might not even need the radioiodine after all! Of course, we won't know until after the surgery.

The other great news is that the longest I would be in the hospital after the surgery is two days, where other surgeons guessed a week, partially because this surgeon can make smaller incisions and will be less invasive. Also, if I do need radioiodine, I can do it at home. Because I won't crash, I probably would only need to be isolated for 3-5 days instead of a whole week or more, too!

Over all it's been a great and very informative day but very draining! i was so glad to have Amy and my mom with me! we even made it a bit of an outing and went and got a nice diner lunch in Denver! I've been having a great but very busy week and despite my exhaustion, continue to feel better! It's been so much fun having our great family friends Kate and Ayla Satten visiting! they're such wonderful people and full of so much love and wisdom! Frankie also officially got the keys to our new Australian home yesterday! so very exciting!!! Everything seems to be turning around and looking up! We're so lucky to have so many wonderful people and blessings in our lives!

-Ghostwritten by Amy (in case you couldn't tell from all the scientific mumbo jumbo) since my brain is fried)

Monday, September 13, 2010

things just keep getting better!

I just got off the phone with the Denver Medical Center! We've scheduled my surgical consult for the 30th of september and the surgery for the 8th of October! much sooner than we would have thought! it's all very surreal but exciting! It could mean i could have all my treatments done as early as November! I might even get a bit of Tassie summer after all! we're very excited this could be done so soon but it is also hitting us pretty hard that this whole thing is real! Also, in smaller news, turns out my appointment with the endochronologist there is Thursday not Wednesday. i'm really looking forward to talking to them! I've got a million questions! It's not even noon and it's already been a huge day for me!!! it's already exhausted me, but left me in great spirits!

now my mom and i are sitting on the lawn with the dogs and the crossword puzzle. it's a lovely day and all this great news has made it all the more brighter!

Good News!

got woken up this morning with a call from the doctor. It looks like the cancer hasn't spread farther than my thyroid which is great news! and it means an easier surgery and smaller scar! also, the majority of his other tests are back, and everything! else looks normal too! all very good news! He also sounded very happy to deliver the news and wanted to stay in touch and be a part of everything that happens from here on out regardless of if we use his surgeon or not. I really liked him too so this made me very happy!

He did wake me up, so i didn't really have time to process it and ask him any questions, but he said the next step would be to schedule the surgery. the real question now is with who? I've got an appointment with the Denver medical center on Wednesday, so I'm interested to see what they say and how soon they could fit me in. They are the most highly regarded and skilled in the area when it comes to all of this, however, because of this they may not be able to fit me in for surgery or even a surgical consult for several months. Luckily, the cancer is very slow growing and as far as my diagnosis this wouldn't too much of a problem. But mentally, i don't know how long i can wait! The other doctor in town, Dr. Fox, was also a very nice and clearly a capable doctor, and i did like him too, so i think after Wednesday we'll have a better idea of what to do next as far as surgery is concerned!

I've also been feeling better over all the past few days! my throat's been very dry, and i'm still exhausted, but i don't feel nearly as sick! And i've finished off all of my "fruitilicious" gargle which has really helped! I've even made it out of the house several times in the past few days! and tonight, our close friends Kate and Ayla Satten are coming to visit!!!! I can't wait!!!

In other news, it looks like Frankie and I (and soon to be Shana) have officially got the house we wanted and Frankie gets the key Thursday! it's all super exciting! It's so hard being on the other side of the world for all this! I feel awful that i can't help out more! I'm trying to do my best to help from here as best i can. I've been searching the internet finding cheap deals on beds and furniture, and trying to organize borrowing peoples trucks and such. I just hope it's not causing more stress for everyone there!! I'm having the hardest time not being more involved with the whole thing! but i have no doubt that by the time i get back it will be a wonderful and cozy home! I can't wait!

Anyways, Amy just got here and i hear the jingling of the kitties so I better go say hi and get some kitty cuddles! we'll keep you posted as the rest of the test results and plans come in, but as far as things go, it's all looking good!

Saturday, September 11, 2010

Today is lovely - one of those perfect fall days - good football, blue skies - wonderful brunch on the patio filled with laughter and good cheer and of course excellent food! Katy is really feeling better! We are all filled with love and gratitude for today - we hope you are having a good now as well!

Friday, September 10, 2010

finally feeling better!!!

I'm feeling much better today! my throat is not nearly as soar and i'm almost out of yucky "fruitilicious" gargle! but it seems to have really helped! yay! It's been a lovely day too! I slept nice and late, had a lovely breakfast/lunch outside with my mom and the dogs and I even made it out of the house! my mom , gram and I went and saw Inception! it's a wonderful if not mind blowing movie if you haven't seen it! although i must admit it was exhausting to watch! but i had a great time! also, I got a good laugh as my mom got a parking warning for parking at a "bad angle" even though is was practically the only car in the lot! haha! then after a good rest at home, I pulled out the guitar for a few hours and wrote another song! it's so nice to have at least a little bit of my voice back!

In other good and exciting news, it looks Frankie and I got the house we wanted!!!! Frankie moves in next week, i'll I'll be joining her as soon as I can! it's very exciting! I can't wait to get back! Frankie is my hero to be setting the whole thing up without me! I honestly don't know what I'd do without her!

Anyways, now I'm sharing the couch with Maui (the kitty) and my parents watching some classic old Americas Funnies Home Videos and getting in a few more laughs before bed. it's been a good but exhausting day!

Thursday, September 9, 2010

Lookin' Good (Greasy Hair Aside)

Katy is feeling a bit better today, and looks significantly happier overall.  Her throat hurts less, but her neck hurts where the biopsies where taken.  It looks a bit like someone strangled her, all black and blue.  Etta was chilling in her carrier this morning, ready for her usual Boulder adventure, and is now hanging out at Katy's feet while she does the crossword.  Most importantly, Katy can shower again today!  Hooray!

The winds have died down and we had some rain yesterday afternoon, but the fire has already destroyed at least 139 homes, including several that belonged to friends.  The forest service is estimating it will take at least ten days to get the fire out, and as of this morning it was still only 30% contained.  Some people are being allowed back into their homes, but are being told to stay alert in case they need to re-evacuate. 

Here's a time-lapse of the fire from Tuesday night.

Etta says, "bvhnnnnnnngo000000" (in case you were wondering).  She loves "helping" with the computer :-)

Today, more hanging out and resting for Katy!

Wednesday, September 8, 2010

Katy and the kitties

endocrinologist

So this morning I had my first appointment with Dr. Fox #2, the endrochrinologist. The appointment ended up taking much longer than we had originally anticipated. After talking with us and answering our questions he took me in to get another ultrasound and after a lot of poking and prodding discovered that several of my lymph nodes in my neck also look suspicious. So after a bit more discussing and poking and prodding I got several viles of blood drawn, and another set of needles stuck into my neck for several more biopsies. so the bad news is it looks like the cancer may have spread beyond my thyroid to the glands and tissue around. The good news is my diagnosis is still basically the same and the only thing that would change would be the surgery, as they would need to take out more tissue. We won't know anything for sure until we get the results from the biopsies and blood tests back in about a week. Also we've got our next appointment with a doctor at CU medical campus in Aurora who specializes in this type of cancer treatment and it should be interesting to see what they say!

Over all it's been a very draining morning and I'm exhausted and feel like I've been beat up so I'm not exactly in the best mood. My neck was finally starting to feel better, but after all the needles and pokes I'm back in a lot of pain today. All things considered I'm actually doing okay. I was somehow unphased by all this news, but I guess I could also still be in shock... Mostly I'm just really sick of this waiting game! Can't I get better and go home and back to my life already!?

Amy has been nice enough to wait on my every need and even bring her kitties over, so I'm getting some good cuddles in! Luckily I'm out of it enough that the terrible daytime tv hasn't been too annoying yet. I really believe in the healing power of being with animals, so if there's any truth in it I'm getting major doses of kitty and doggy love as well as all the wonderful human love you guys have been sending!

Tuesday, September 7, 2010

Big day



As Amy mentioned it's been a big day! not just for me but for all of the boulder area! My thoughts are going out to everyone involved with the fire, and i've been cheering on the slurry bomber planes that have been flying overhead all day! and while i hate to have had to have such a terrible thing happen it does help me put things into perspective and be really grateful for what I've got! all things considered i'm extremely lucky! and with everything else that has happened in my past, if i've learning anythings, i've learned that things will be ok!

on a lighter side, i did go get my hair cut and think i lost about 6 inches and at least a kilo of hair! my head feels so much lighter! still getting used to the way it looks but i'm enjoying it heaps! We even made it to the pet store, which the dogs and ginger(my frog) are very happy about! also gram has stopped by with a wonderful gift! she's given me an adorable headband and a great little pumpkin that screams when you press it! it's very handy as it hurts my own voice to scream, but it is what i feel like doing a lot these days! i'll try and post a photo of the new looks but i'm terrible with technology and this whole blog thing so hope it works, but sorry if it doesn't!

so, now we are all sitting on the couch catching up! it's been really nice to finally feel like i've done something with my day. although it has completely drained me! and as i'm sure you're all actually reading this to find out, i am feeling slighty better. the gargle seems to be slowly but surely working. I could barely move my neck a few days ago and now i'm begining to get movement back! and while i'm still exhausted all the time i feel slightly more rested now that i've been getting more sleep (thank you ambien!) hopefully i can continue to sleep well tonight! i'm very excited (hmmm maybe excited isn't the right word...) about tomorrow mornings doctors appointment! it's been just over a week since my last appointment with anyone concerning the cancer so i've thought up a lot more questions! so i'm sure we'll have more health updates soon!

Thankful

The wildfire that started yesterday morning continues to cloud Boulder in smoke, and is likely to keep burning for days.  They estimated 3,500 acres burned by last night at 10 pm, and 1,000 homes have been evacuated.  Several structures have burned, and a handful of evacuees watched their houses and/or their neighbor's houses burst into flames as they fled- the fire moved that quickly!  As far as we have heard, the fire is about five miles from Boulder and unlikely to come into the city.  The official name for this blaze is the Fourmile Canyon Fire.

It's a good reminder that, as scary as cancer is, we're still so lucky!  Katy, Karen and I evacuated from a similarly large and fast moving fire a few years ago in Lake Tahoe, so we have a slight idea of what this wildfire is doing to people's lives.  When we were there we could drive up the ridge and watch the flames, and see exactly how close the fire was getting.  Not knowing is the worst, and once you've left you can't go back to look until it's out!  We also had DAYS to prepare for evacuation, so we had loaded the car to capacity by the time we actually left.  These evacuees had minutes to get out, and many were forced to leave even their pets behind. 

Our hearts and prayers go out to those affected, and we hope that Gold Hill is spared from the flames and nobody gets hurt fighting this awful wildfire!

Today Katy is venturing out into the world to get a hair cut.  Maybe she'll even have energy to go to the pet store, but we'll see. 

Sunday, September 5, 2010

another day

woke up feeling about the same today. the worst part (as you can see in the picture from the other day) is just how swollen my throat/neck is! but we'll know by tomorrow morning if the disgusting yellow "fruitilicious" flavored gargle is working!! fingers crossed! i'm feeling very tender and grumpy! might have to invest in a punching bag! i've got a lot of anger recently but my parents assure me it's a sign that i'm feeling better and are being really goods sports about my grumpiness! i'm just getting very sick of being stuck on the couch and in bed all day!!! but hopefully this new medicine with get rid of my mouth infection and that should make me feel a lot better! and maybe let me feel like i have at least a little control!

apart from the obvious physical pain the absolute worse thing is all this waiting! before we make any major decisions i've still got 2 more doctors appointments and one of them isn't for another 10 days! it's all very frustrating! but after that we should have a better idea of a timeline for all of the treatment and such! i'm going absolutely crazy away from tassie and my life and not knowing how soon i'll be back! trying to organize my moving (me and my best friend frankie are hoping to move into a new house in the next month) while on the other side of the world is a nightmare! my friends over there are absolute champions to be packing my room up for me and everything on top of their own hectic lives! i honestly can't thank them enough!!!!! with any luck i'll be back there soon!!! (and hopefully with a beautiful house to move into too!)

I also can't believe how many people from all around the world have been sending me their support and love! it really means the world to me and is making all the difference! and I do feel slightly less alone in this whole thing! I've been hearing from people I haven't talked to in years! it really is amazing! and, almost everyone has a story of someone they know going through something similar! so i guess it isn't all that uncommon! you'd think the human thyroid would be built better! but I can't thank you guys enough! and i'll be soaking up all the love and support (and free smoothies!) i can in the months to come! thank you thank you thank you!

so i guess there really isn't to much new news, but i thought i'd give a quick update! this whole blog thing kinda cracks me up, and i never dreamed i'd be writting one, but then again I also never dream a lot of what's going on would ever happen to me! but now that i've actually started writing on it, i have to admit it is a good outlet! and it's a great way to let everyone know what's going on! technology is amazing!!! i hope you guys are enjoying it! and I'm loving all the followers and great comments! I love you all!

-Katy

Friday, September 3, 2010

Ear, Nose, and Throat Doctor Saves the Day

Papillary carcinoma is asymptomatic, but Katy's throat has still been hurting her and no one has been able to tell us why.  Karen finally let go of logic, gave into her gut, and called the ENT specialist who fixed Katy's severely deviated septum and removed Amy's tonsils.  He made time to see her right away, within an hour of us calling!

After fifteen minutes of gloating about how great Katy's nose is, thanks to him, Doctor L looked into her throat and diagnosed her with thrush.  Apparently nobody except an ENT would recognize thrush, but he and his PA-in-training both, separately and instantly, knew what was wrong with Katy's throat.  Thrush (in American terms) is a very painful fungal infection of the throat, mouth, and esophagus, which explains all of the previously unaccounted for symptoms!  He's sure that the thrush is from the antibiotics; killing all the "healthy" bacteria in her mouth and throat allowed the fungus to move in and thrive.

The treatment for thrush is an anti-fungal gargle four times a day.  Unfortunately it's "fruitilicious" flavored and thus extremely nasty to gargle!  Fortunately, the pain should subside within 48 hours.


Dr. L also looked at the pathology report from Barton (Lake Tahoe hospital) and confirmed that the only cancer that presents this way is papillary carcinoma, which is the easiest to treat and has the best prognosis of all the thyroid cancers. 

This morning Katy enjoyed a 90 minute massage that turned her into a happy blob of jelly.  She is now cuddled on the couch with naked kitties all around and Dr Who on the TV.  All things considered, life is good!

Wednesday, September 1, 2010

Feeding the Family

As many of you know, I cook for stress relief, and I believe that homemade meals are healing.  At dinner tonight Katy, Karen, Bob and Mike all thought it might be fun if I posted what I made each day for Katy, along with recipes.  In the future I'll try to take relevant pictures, too, if you like this idea.

Today I made chicken pot pie with the leftover grilled chicken from a couple nights ago.  We didn't have any parsnips, so I threw in a yam.  The cheddar biscuit topping really hit the spot for all of us!  Plenty of veggies, too.

 For dessert I made brownies with a caramel swirl, from my own recipe:

To make the caramel, dissolve 1 cup of sugar in 1/2 cup water plus a half teaspoon lemon juice over medium heat, stirring constantly.  When it begins to boil, turn up the heat and stop stirring.  Swirl the pan occasionally until the sugar is a deep amber color.  Remove from heat and carefully pour in 1 cup of heavy cream.  The mixture will sputter and hiss, just keep carefully stirring.  Stir in 1/4 cup unsalted butter and 1 tsp vanilla extract, then set caramel aside.

For brownies, melt 1/2 cup unsalted butter with 8 oz chocolate chips either in the microwave (30 second intervals, then stir) or in a double boiler (stirring often).  Add 3/4 cup brown sugar to the melted chocolate mixture.  While that's cooling to lukewarm, sift or whisk together 3/4 cup flour, 1/2 tsp baking powder, 1/2 tsp salt, and 1 Tbs unsweetened cocoa powder.  Now add 2 eggs, one at a time, to the chocolate mixture and stir until mixture becomes glossy.  Stir in flour mixture and 4 oz chocolate chips. 

Pour batter into buttered and floured 9" square pan.  Using a small ladle, make little lines of caramel on top of the batter then drag a knife through, about once every 1/2" in both directions.  Bake at 350 F for 25-30 minutes, until a knife in the middle comes out just barely clean.  Cool and enjoy!

Another day...

Katy's throat hurts worse today, but otherwise she feels okay.  At least the Ambien allowed her a good night's sleep for the first time since this started.

Amy and Mike's little kitty, Etta, had to visit the vet today for a mystery limp.  She's hairless so they could rule out punctures and abscesses pretty easily, and no swelling means fractures are unlikely.  So she gets some pain medications and a week of "resting."  Thank goodness the pain meds make her sleepy, otherwise there would be no chance of keeping her still!  For now she's Katy's kitten-shaped hot water bottle, sound asleep under the blankets.

Etta Napping

Gram and Laurie stopped by for a moment and brought Katy an American delicacy; Jamba Juice!  All-fruit (really, non-dairy) smoothies don't exist in Australia apparently!  On the TV, "Dead Like Me," and all the animals are cuddled around the couch.  Sun shining outside the window, a hint of autumn in the air.  Just another day.