Thursday, April 23, 2009

I don't WANT to dance.

It's always one step forward, two or three steps back. F'reals. I've been busting out on getting all of my requirements taken care of, and each time I finish something up I find out I need to get more testing done. I'm also finding out just how UNhealthy I am. And here I thought I was rather healthy for an overweight 33 year old woman! Notsomuch.

At my initial appointment with Dr. G, he was taking a look at my labs and asked me if I had ever been told I was diabetic. Um, no, I knew I was borderline, but that was it. Turns out my fasting blood sugar was 132 for that particular screening, so he told me that I am now "officially, full on diabetic." It's controllable with diet, and I keep track of my sugar a few times throughout the day. I can pretty much tell now about what my sugar is by how I'm feeling. And when I eat right I feel MUCH better. AMAZIN', ain't it?

At the same appointment he also asked me if I have a goiter, or if I've ever had any thyroid issues. I've asked docs to check me for them before, but they always just brushed me off. He said that my TSH was elevated but not horrible, but he wanted me to have some further testing. He felt my thyroid, and sure enough, I do have a goiter. I told him that my daughter has Hashimoto's and asked if she could have gotten it from my thyroid issues. (It's really rare for such a young child to have it, she was diagnosed when she was 7.) Thankfully, her issues and mine seem to be unrelated. Anyway, we set up an ultrasound for my thyroid, did it a few days later, and the results on that came back that I have a 2 cm leison on my thyroid. (For reference, there's 2.54 cm in an inch, so a 2 cm leison would be about the size of my thumb from the bottom of the pad to the tip. On a gland that's supposed to be the size of a large egg but is swollen to the size of a small orange.) Whenever I hear leison it immediately brings to mind cancer, so I was rather concerned.

Dr. G was as well, so he also sent me to have a radioactive scan & uptake done. On day one I had to drive all the way up to the hospital way on the other side of town TO TAKE A PILL. If I had known that I would have asked them to prescribe it at Tinker so I could just take it there. Anyway, I had to take a pill of radioactive iodine. Brian was with me and he asked if I was going to turn into the Incredible Hulk. Sadly, they said I would not. (Although I kind of did later. Hehehe) The next day I went back in so they could do some slow exposure imaging of my thyroid. It took about 40 minutes of completely lying still on an uncomfortable board, with a pillow under my shoulders so my head would tilt back. I never realized how uncomfortable that would be. OW. When they finally let me sit up I was dizzy, just from that slight backwards tilt. They also did an uptake, which I think measures the radiation that was absorbed by the leison. If it absorbed a lot it was hot, if it didn't absorb it was cold. Finished all that, got to go home.

A few days before I had gotten a call saying that my sleep study results had also come back, and they were contradictory. The report said that I didn't have sleep apnea, but had an average of 5 apnea arousals an hour (I stupidly giggle when I hear arousal. Shuddup Beavis!). The pulmonologist also said that I would benefit from having a CPAP during sugery recovery. NOOOOOO, I hate having things on my face! I called the Sleep Center to ask them to look at it again, because the results were so contradictory, and they called back pretty quick, I needed to do another sleep study, this time with the CPAP all night. And the earliest they could get me in was April 15, the night my mom got here. So Brian had to pick my mom up as I was getting all wired up like a Borg. I was so wiped out by the time the tech came back to turn out the lights that I actually passed out pretty quick, and the only time I really remember waking up was when I moved to my side and the condensation rolled down my face. Ick. I haven't heard anything about the results from that, but I'm assuming that I'll be getting a CPAP before long.

So back to the other issues. Friday I got a call saying that Dr. G. wants to meet with me to go over test results. I decided to go ahead and hope that since he's not sending me for MORE tests that everything is good to go and I can finally progress with surgery. Set up the appointment for Tuesday at 1, got a call Tuesday around 11 saying that Dr. G. had emergency surgery and we'd have to reschedule to Wednesday. FINALLY. Went in yesterday with my mom & Aunt Debbie, Brian couldn't come.

When Dr. G. came in we talked a little bit about the irritation in my duodenum, and he said that I need to be taking the Nexium every day (done) and that surgery will actually help take care of it. Then he moved on to the results from my thyroid uptake and scan. (Let's see if I can be accurate and objective about this.)

As we learned from the ultrasound I have an enlarged thyroid and a 2 cm leison, or tumor. It did NOT show on the radioactive imaging, so that test was inconclusive. Pretty much, it didn't absorb the radioactive iodine. On the uptake, it came back as a cold leison. Now, it made sense to me that cold was bad and hot was good, but it's actually the other way around. Hot means it's an active thyroid, cold means inactive. So essentially, my thyroid is not doing what it's supposed to be doing, and it's enlarged because my brain is sending it messages that it needs to work harder. Tumors are just masses, they could be malignant, benign, or nothing, but the only way to tell is to completely take it out or to do a biopsy. (BIBOPSY!)

Dr. G. made it clear that this is the same advice he gave his wife, mom, and MIL when they each had large lesions on their thyroids, so that was reassuring. Obviously, the best thing to do would be to completely take out that part of the thyroid, and check it from there. However, recovery time is 8-12 weeks. I don't want to have to delay my WLS any more than I absolutely have to, so I'm going with the second option. I'm going to have a fine needle biopsy done. If it's just a mass all I'll have to do is take the Synthroid (synthetic thyroid horomone) and monitor the mass. If it's benign I can have my WLS, and once I've recovered from that we'll proceed with removing the lesion. However, if it's malignant I'll have to have my entire thyroid removed immediately. Which means I'll have to put off WLS until I've completely healed from the removal, which can take a while from what I understand from people that have had it done.

The biggest reason I'm choosing to do the biopsy first is that if I DO have to have my entire thyroid removed, I only want the one surgery for it. I asked Dr. G. if I have the lesion removed now and it turns out to be malignant if I'd have to have the rest removed, and he said yes. I've had so many surgeries in the last few years, I want to keep it to as few as possible. So BIBPOPSY it is.

I was pretty frustrated on my way home from the appointment yesterday. Logically, I know this is all to make sure I'm at my prime health before I do WLS. However, it just feels like it's test, test, and more test, all of them leading to more problems. I want this DONE, I want to have my WLS!! I'm an incredibly impatient person and I want things done when and how I want them. This is God's way of telling me, "My will, NOT yours!" He does that a lot.

In all of this, though, there IS good news. I've fulfilled all my requirements from Dr. G. in order to submit the request to Tricare for approval, so he said he'd give my chart to his coordinator. She says that it will take about 3 days, so hopefully Monday or Tuesday it will be APPROVED. Once the biopsy comes back benign or completely clear (positive thinking, right?!) and Tricare approves WLS, I can get my surgery date, do my nutrition class, and get on with my 10 day diet. Is that a LIGHT AT THE END OF THE TUNNEL THAT I SEE? It is!!

If you read all that...I heart you. Thanks for putting up with my word salad!


Amy said...

Its so funny you said shut up beavis bc I just posted something about vitamins and I asked if people chewed or swallowed and I thought of beavis and butthead giggling.

Anyways...WOW. I feel for you. And your insurance has to look at all this and say "Yes, she would benefit from this surgery". Think how much better you will feel now that they have discovered all of this (physically better...perhaps not mentally yet)! Keep us posted.

Meg said...

It's pretty much a given that it's going to get approved because I have every single co-morbid that Tricare requires. (So watch them not approve it!) And in my head I know that it's best that I get all this extra stuff taken care of now. It really blows my mind, though, just HOW unhealthy I really am, since I thought I was fairly healthy other than my weight.

BTW, neither, I spit. (Kidding! Ew!)

Debra Kay said...

I like your reasoning-biopsy first. My dear friend just had her second surgery last year when the first one came up malignant. Since you are already looking at two surgeries (one being WLS), this makes the most sense. Hang in there.