Wednesday, April 2, 2014

We Slice! We Dice! Just, You Know, Later.

No one likes to hear about other people's medical problems, particularly me. I have always been in wonderment of those who become doctors, nurses, physicians assistants, and whatever else they've got these days. They see things that would completely gross the rest of us out, and then stick their hands in it. The world needs people like that. Anything beyond the polite hi-how-are-you, and it's requisite fine-thanks-how-are-you reply are the only inquiry I will probably make as to your well-being. If you've got something wrong, go pay a doctor to listen to it, 'cause that's really not my department. And then, sometimes, something is just so funny that you have to tell somebody about it.

I have mentioned before that it was discovered that I had a nodule on my thyroid, which was being checked via sonogram by a doctor who resembles this image with somewhat startling accuracy...
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He laughs too much, doesn't get to the point, and has that general aura about him that makes you want to shove him in a locker -- come on, it happened frequently in his public school years, you can just tell.

At first, he said there were two nodules, one on either side.
"Let's, heh heh, check it in another four months. You know, if it, heh heh, gets bigger or something, then, heh, we need to think about taking that bad boy out, heh heh heh."
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OK, dude.

The second sonogram showed significant growth in one of the nodules in four months, and there were some indications that it could be serious.

Everyone panicked. Well, everyone except me, for some reason. I wasn't all that bothered. I'm too busy to be bothered by that sort of piffle. Big deal, they take it out, you take some radioactive spider juice, and move to Forest Hills to live with Spiderman. Right?
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I was scheduled for a needle biopsy; the result also indicated that something suspicious was going on. Dr. Giggles scheduled an appointment with the doctor who did my septoplasty to have half of the thyroid removed. Before I walked out of Dr. Giggles's office, I asked which side was going to be taken out.
"Well, heh heh, that right side is, you know, somewhat suspicious. Let's just hope that they don't have to take out everything, 'cause, heh heh, you wouldn't need a Halloween costume. It, heh heh heh, looks pretty bad, depending on how well you scar."
Say it from a locker, buddy, the echo will make your voice sound a little better.

The right side. Hmmmmm. That's odd. At the needle biopsy, the guy taking the sample was standing on my left side, he put the nova-cane on the left side, he took the samples from the left side, and the bandage was on the left side. Are we sure that it's the right side, and not the left? I mean, they told me I had a nodule on each side, but we were only talking about one nodule getting bigger, not both. I decided to ask that question at the pre-op appointment.

The friendly nurse that discussed it with me was the same one that did all of the legal obligations for the septoplasty. She already knew about all of my special needs with the drugs, rapid heart rate, recent surgeries, that whole schtick.
"Do you have any other questions or concerns?" she asked.
"Well, everybody keeps telling me that it's on the right side, but that's not where the biopsy was taken from. How does that work?"
She looked at me with that kind of glazed over look that suggested she didn't think I was going to have any questions or concerns.
"Um. Well. Hmmmmm. You'll have to ask the doctor about that on the day of surgery. Have a nice day!"
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So, the day of surgery comes. Everything is going as planned. They've tried to put in my IV three times (I just have those kind of veins, I guess), they've had me sign all of the required papers, I've talked with the anesthesiologist twice, I've met everybody in the OR. Fine, fine, fine. We've already all had that talk about how Versed lasts about a week on me, so they tell me I won't have to take it. The doctor came in, and I asked him the same question I had asked his nurse back at the pre-op appointment.
"Well, let me just check on that. I'll see you soon."

The time comes. They wheeled me back to the OR without any medication, just as I had asked. No relaxers, certainly no amnesiac drugs. They asked me to switch to the operating table from the stretcher. They got my IV out of the way, put on a blood pressure monitor and some other devices, and wrapped me in a blanket cocoon so I didn't injure anyone. They strapped me to the table -- or, more accurately, they "belt" you to a table so they don't freak people out by telling them they're being tied down. The anesthesiologist put an oxygen mask on my face, and I could hear him getting the knock-out meds ready somewhere over my head.
"Now," said the anesthesiologist, "this oxygen is just to remove any trace elements in your blood, and we'll let you have a nice long sleep in just a minute."

Suddenly, a movie moment happened.
A nurse bolted through the door and shouted, "HOLD ON. DON'T DO ANYTHING. THERE'S A DISCREPANCY."

And everything came screeching to a rubber-burning halt.
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Don't blame me, blame the guy that originally used this as a pun and planted the seed in my head to do it, too.

The anesthesiologist quickly removed the mask, saying he couldn't give me anything until it was sorted. The nurses, already with masks, smocks, and gloves on, just stood there, staring at me like I had asked for this all to happen. Five minutes passed before the same nurse came in and told everyone it would be another few minutes.
"Go tell my mother you haven't started yet," I advised one of the nurses.

Another five minutes passed. I was still wrapped in the cocoon, strapped to the table. No one spoke, leaving only the sound of the bad pop music that was being piped into the room. Another five minutes passed.
"Are you OK with the radio station?" a nurse asked me.
"Yeah, you guys put on what you like."
Another five minutes passed. I was still tied down.

A new nurse came in, and asked me if I had had any drugs. He looked relieved when I told him I hadn't, because he needed me to be able to tell him what happened at the needle biopsy, and to sign any paperwork that needed to be dealt with. It was only at this point that they untied and unwrapped me. I told him everything that happened, and he hastily left.

Another five minutes passed. I only know this because a nurse told me that the blood pressure cuff was set to go off at five minute intervals, so I counted. One of the nurses simply left the room, and another was on her phone. The anesthesiologist told me all about when he lived in Alaska and saw Pavarotti.

The doctor came in, and, after asking if I had been given any drugs, wanted me to tell him about the biopsy. I told him everything I knew. The physician's assistant performing the procedure stood on my left side, the pin pricks were on the left side, the bandage was on the left side, everything was on the left side. He said it was impossible to take a sample from the right side of the thyroid from the left side of a person's neck. Yeah, OK, whatever, I can't help what happened. He left, and we started another five minute cycle.

I figured it would be a good idea to use our time better than just laying on the table doing nothing. All I asked was if there was a bathroom nearby. This led to many nurses sighing in exasperation. They unhooked the IV bag, moved me back to the stretcher, and began wheeling me out of the OR. On the way, I saw all of my nurses sitting in a group on a couch just outside the room, talking with a few of their other colleagues. As I was being wheeled out, another nurse asked if I had been given anything, and asked me for an account of what happened.

Eventually, I was wheeled back to the pre-op waiting room, and they went to get my mother. Nurses filtered in and out, checking to make sure I was OK. Finally, the doctor came in. He said he didn't feel comfortable doing the surgery while there was such a large issue that didn't seem to be able to be worked out.
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The worst part of that day for me was having to walk back out the door to the lobby where my dad, his mother, my sister, and her two children had been waiting. I walked out to the car and made phone calls, telling people that I was not, in fact, being sliced into at that precise moment.
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We've been waiting in this stupid lobby for an hour and a half for this? And I could have been doing something other than sitting in a stupid lobby.

So, now what?
Good question.

We've started all over. Brand new sonogram -- one not involving Dr. Giggles -- to confirm where the nodule is, including the fact that there isn't actually one on my left side. Rather than a needle biopsy, they've taken an actual tissue sample and sent it off to Houston for an expert to look at. We were supposed to get results for that on Friday, but, wait for it, there was another issue!
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On Friday morning, the friendly nurse called us up on the phone to talk about the results.
"Well, there's definitely a nodule on the right side. And they've definitely got tissue from that side. And that's all it says."
Honestly, she sounded as confused as we all were.
"Well, we're gonna hafta let the doctor look at this report. It doesn't say anything about your tissue being benign or malignant. The doctor has to look at it."
"When will the doctor be able to look at this?" I asked. "It's Friday, so..."
"He'll be out of town until Tuesday."
Tuesday. You tell me that the results I was supposed to have Friday aren't going to be ready until Tuesday? What's actually wrong with you people? Wouldn't it have been easier for the specialists in Houston to say that they had received the sample, but hadn't tested it yet? 'Cause that's so hard to do. "Results forthcoming" is such a hard thing to add to a report. Think of all the ink you waste! That has to have some kind of repercussion on the rainforest, you know, printing two little words on a piece of tree skin. Think of the polar bears, and Al Gore! No, you'll all have to wonder what we're doing, instead.

Saturday, Sunday, and Monday came and went uneventfully. Tuesday afternoon, however, is when all hell broke loose.

The doctor called to tell me that the results of the tissue biopsy were inconclusive, and, if I were his daughter, he would simply take the thing out and be done with it. According to him, it doesn't matter how many biopsies we have done, it will still show an inconclusive result. He also said he has never stopped a surgery in his entire practicing years, and that the whole event was horribly botched.
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He offered simply to watch the nodule over the next six months, to schedule another biopsy, or to schedule another surgery. Deliberation dictates that we have to go through the surgery after all. To say it's been a weird medical year is an understatement at this point.

I've put all of this ridiculousness on hold until after my spring finals. I only had ten days between my spine surgery and the start of the fall semester last year, but I hope to have at least two weeks before the summer session starts as a recovery period. It will probably be the last break I have before Christmas 2015, so it's kind of important that the dates line up.

Who knows, after all is said and done, maybe they'll figure this all out once the thyroid is removed. I'm not sure we can bet on it, since the odds are about fifty-fifty that a second surgery to remove the other half of the thyroid might have to happen. Either way, these nutjobs are going to slice and dice me. Just, you know, later.
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