Recently in Life Category

On Tuesday, I took a "tracer" dose of radioactive iodine.  On Wednesday, I took another.  Thursday I underwent two scans to see where the tracer doses went.  As expected and hoped, the scans showed that the radiation was pretty much confined to my remaining thyroid tissue.

Based on the result of those scans, the doctor set my "big" dose of radioactive iodine to 75 millicuries.  In terms of the range of potential doses used to treat thyroid cancer, it's in the lowest range of doses.

On Friday morning, I took a 76 millicurie dose of radioactive iodine.  Apparently, I also contracted a cold and cough.  Since the radiation, lack of thyroid hormone (part of the treatment), and restrictive diet most likely reduced the overall effectiveness of my immune system, I now have a sinus and chest cold on top of the symptoms of hypothyroidism and radiation treatment.  I'm sneezing and coughing on a pretty regular basis, and feeling exhausted and tired much of the rest of the time.

I know this is nothing compared to what other cancer patients like my mother (who died earlier this year from melanoma) have gone through, and I am both respectful of that and grateful that my situation isn't worse than it is.  Still, it's not an exaggeration to say that I feel worse than I can remember feeling in a long, long time... if not the worst ever.  While I will probably never understand what my mother went through in her final days, I think I have a greater appreciation of it than I ever did before.

Tomorrow morning, I look forward to being off the low-iodine diet.  That means I can have things with dairy (like my morning coffee with milk), sandwiches with cheese, and pizza again.  I can have sushi, Chinese food, Indian food, and more.  Perhaps even better than that, I'll once again be back on the synthetic thyroid hormone. That should be the end of the severely dry skin, muscle weakness, unexplained muscle cramps, shortness of breath, and other symptoms I've had to endure since before Thanksgiving.

This coming Friday (12/26) is another set of scans for radiation, to determine where the last "big" dose went. Friday's scan is supposed to be "more revealing" in some way than the one I had last Thursday.

After that, I'll be working with the endocrinologist to regulate the dose of synthroid I'll be taking from now on to give me a "normal" level of thyroid hormone in my blood.  I guess you could say that the end is in sight, at least as much as there is an end to this.  I'll be having tests each year from now to confirm that the cancer hasn't returned, so in a sense it will never be truly "behind me" and will always be somewhere out there in the distance.

I'm almost through my first full week of the low-iodine diet.  All things considered, it's not that bad, but it's certainly not fun.  I pretty much can't eat in restaurants.  I can't have anything with salt, because it might be iodized salt.  I can't have anything with seafood or sea-based products (such as sea salt, seaweed, or seaweed extracts).  I can't have dairy products. I can't have soy products, such as soy sauce.  No egg yolks or anything containing them.  No bread products that contain iodized salt or iodine based dough conditioners (whatever those are).  There are lots more restrictions. 

Pretty much, my diet this week has consisted of: unsalted walnuts, unsalted sunflower seeds, oranges, apples, bananas, celery, home-cooked chicken, home-cooked pot roast, veggies, a special bread from a bakery that doesn't use iodized salt, homemade popcorn with unsalted margarine and non-iodized salt, rice, and pasta.

Unfortunately, since I'm off the thyroid medication, too, I don't think I've actually lost any weight on this diet.  Being off the thyroid medication is the worst part of this by far.  I get horrendous muscle cramps for virtually no reason. For example, one day this week at work I moved my arm slightly (not rapidly, not holding anything, etc.) and suddenly the muscles under my arm and on my rib cage under my armpit absolutely throbbed in pain.  I don't think I've had that much pain in years, and it took the better part of an hour to go away.

Another added "benefit" to being off the synthetic hormone is that I'm really sensitive to cold temperatures, which is just great in December in Ohio.  What makes it more fun is that I'm in a recently-renovated area of our office complex at work.  This new area has a heating system that the engineers are still working the bugs out of.  This afternoon, a co-worker measured the temperature and humidity in our area, which was 70 degrees with 24% humidity.  He said the calculations say that feels like 64-65 degrees.  Everyone in the area, none of whom are hypothyroid, is complaining about the cold.  My hands and toes have been so cold the last couple of weeks that at times I can't even feel them.

When I got in the car, I was so cold I started shivering.  That shivering activity set the muscles in my chest off with yet-another cramping spasm.  The pain continued at a decreasing level until we got home.

While making dinner, one of our cats was lying on the floor nearby, hoping for a handout. I stepped on his tail and he let out a screech. I reacted instantly to lift my foot and get off him.  That caused my leg muscles to spasm, which made me double over in pain.  Doubling over caused my shoulder, the muscles under my arm, and muscles under my armpit to all cramp in extreme pain.  By the time the pain subsided, my dinner had pretty much gone cold.

As if the muscle cramps weren't enough, I get short of breath often, my leg muscles feel really weak, I've had memory lapses, headaches, dry skin, and have to be careful not to be "short" (mean/rude/impolite) to others.

The diet will continue until 12/22, when I'll revert to a normal diet again and start taking the replacement thyroid hormone again.  I'm looking forward to that.

On Tuesday and Wednesday next week, I'll be taking small doses of radioactive iodine.  Thursday I'll undergo a radiation scan to see where the iodine went.  Friday (12/19), I'll take the "full-size" dose of radioactive iodine.  That will begin a six-day period of keeping at least 6 feet from other people and pets.  Fortunately, that period will end on 12/25, so I'll be able to spend time with the family then, be back to a normal diet, and taking replacement thyroid hormone once again. I ought to feel a lot better then than I do right now.

I was told to stop taking my thyroid hormone the day before Thanksgiving.  It began to take a toll on me pretty early on, and it's only gotten worse.  According to endocrineweb.com, low thyroid hormone (also called hypothyroidism) carries with it a lovely list of symptoms:

• Fatigue
  Boy, have I noticed this one. Yesterday I walked a distance I used to walk every day without breathing hard, and wasn't sure I would make it to the end between feeling worn out and in pain.
  
  
• Weakness
  I've experienced this one as well.  I don't have the strength or endurance I had just a few weeks ago.
  
  
• Weight gain or increased difficulty losing weight
  This started even before the surgeon removed my thyroid, and I've been keeping a close eye on it. I don't think I've gained anything in the last couple of weeks, and may have even lost a pound or two.
  
  
• Coarse, dry hair
  So far, I haven't noticed this problem.
  
  
• Dry, rough pale skin
  The skin on my hands definitely mirrors this.  It's much drier than it's ever been, even to the point of almost cracking in places.
  
  
• Hair loss
  Fortunately, I haven't see any of this yet.
  
  
• Cold intolerance (can't tolerate the cold like those around you)
  Got this one in spades.  Doesn't help that my office is in a renovated part of the building where the techs haven't got the heating working just right yet, and that it's now December. There was a long part of today where I couldn't feel my feet and my hands were almost numb with the cold.  I'm the guy who could go outside in short sleeves for 10-15 minutes in the dead of winter, and now I can barely stand my indoor, heated office.
  
  
• Muscle cramps and frequent muscle aches
  This was the first thing I noticed, and it's been getting worse.  Tuesday, I gently set my laptop bag on the floor in the den and really irritated the muscles and joint in my shoulder.  It caused intense pain for several minutes.  Other muscles and joints got in on the act later, to the point that I took two prescription pain killers and a muscle relaxer to try to counteract it.  It helped some.  Wednesday, my back decided to flare up and cause trouble.  Most every morning I've woken up with cramps in my hands that are so severe I can't hold much of anything in them.  Even sitting here typing, my shoulders and arms are hurting.  I'm looking forward to the weekend when I can relax and move a minimal amount.  It's not an exaggeration to say that stretching, twisting, or exerting any muscle scares me.  Most of the time, those actions cause pain comparable to a "charley horse" that lingers around for a while afterward.
  
  
• Constipation
  So far, so good on this one.
  
  
• Depression
  How anyone could have any of the above symptoms, combined with the knowledge that they have cancer, combined with the recent death of a parent, and not have some level of depression is beyond me.
  
  
• Irritability
  I hadn't noticed, but apparently I do have this.  I said something I thought was slightly humorous but supportive, but dropped the jaws of everyone in the room because it was apparently "out of character" and mean.  I accidentally said something rude to a co-worker, too, in response to a comment she made... and I didn't mean to be rude then, either. So while I may not be FEELING irritable, I must be based on the way others are reacting to me.
  
  
• Memory loss
  Yesterday, I would have said "no" to this one.  It started to be a problem today.  I've forgotten several things, sometimes very basic things like words I use often, and just couldn't recall them.  I'm starting to understand what Denny Crane (William Shatner) on Boston Legal experiences with his Alzheimer's.
  
  
• Abnormal menstrual cycles
  If this starts being a problem for me, it'll be time to call the Guinness Book of World Records and maybe The National Enquirer...
  
  
• Decreased libido
  My wife probably wishes this was true.  I don't think my libido has changed, but my desire to act on it has certainly diminished based on the cramps, aches, pains, and weakness I feel.
  

In addition to the above, I've noticed my voice having trouble today.  It sounds very weak and crackly to me. I can only imagine what it sounds like to others.  According to Wikipedia, that's a symptom, too.  In fact, their list is a bit longer and indicates that I'm probably in the "late symptoms" category now. Oh, goody.

Monday I start the low-iodine diet.  This will probably take care of any potential weight gain because it eliminates nearly everything I can and do eat.  Fortunately, it does allow for an occasional beer and (homemade) popcorn.  On the serious side, it eliminates dairy products, seafood and sea-based foods, anything with iodized salt, anything with red dye #3, virtually all baked goods (due to iodine based dough conditioners in use), certain beans, more than 6 ounces of meat a day, and lots of other stuff.  What's left is mostly raw fruits and vegetables, small amounts of home cooked meats without salt, popcorn, unsalted nuts, and homemade foods that you're positive don't include iodized salt or red dye #3.

Later in the week, I go in for blood work.

The week after that, I go in for a small dose of radioactive iodine. The next day, a scan. The next day, more tests (I think). That Friday, the "big dose" of radioactive iodine intended to kill any remaining thyroid cells or cancer cells.  For 6 days after that, I'm supposed to keep at least a 5-6 foot distance from others to avoid exposing them to radiation.  Thanks to the two surgeries and my mother's illness earlier this year, I have no sick time left and barely any vacation days, so I'll have to work at least one day while I'm in this "radioactive" state.  I'll try to find a place away from my colleagues and as far as possible from others.  In a company of 1200 people that may not be easy.

On the 22nd, the worst of it should be over, as I'll start taking the permanent thyroid hormone replacement and eating my normal diet again.  By Christmas, I'll no longer be (dangerously) radioactive so I won't be excluded from the festivities.

That's all for this round. I'll share more once the diet starts.

Today, I met with an endocrinologist who will be overseeing my treatment from this point on.  He explained that based on the type of cancer I had on my thyroid (papillary carcinoma) and the fact that it didn't appear to have spread, the prognosis is extremely good. 

The next step will be for me to meet with the nuclear medicine specialist who will eventually administer radioactive iodine to me.  That appointment has not yet been scheduled, but is expected to take place in the next couple of weeks.  After that meeting, I'll most likely be placed on an iodine-restricted diet, designed to make any thyroid or cancer cells remaining after surgery starved for iodine.  Then, when the radioactive iodine is administered, they'll grab up all they can get and die out. 

As I understand it, for 5 days after taking the iodine, I'm to minimize my exposure to other people to prevent the radiation from affecting them.  If you're curious as to what those restrictions might be, there are other web sites that can tell you.

Once we've done that treatment, I'll start taking synthetic thyroid hormone.  The challenge will be to determine the correct dosage for me, as each person is a little different.  Once that's settled, I'll have annual checks to see if the cancer has returned.

Yesterday, I met with the surgeon who removed my thyroid to discuss the pathology report and next steps in treatment of my cancer.  He has referred me to an endocrinologist, who will administer the radioactive iodine and start me on replacement thyroid hormone.  I've been feeling really run down the last few days and in a moderate amount of pain, which is probably the fibromyalgia acting up.

The pathology report showed that the cancer didn't appear to extend beyond my thyroid, which means that the radioactive iodine should get any remaining cancer or thyroid cells.

The surgery is only a memory now, and will be a week ago tomorrow.  I just spent my first full day back at the office, and it was a fairly busy one.

The steri-strips over my incision are starting to come loose and are expected to fall off of their own accord in the next day or two.  The little bit of the incision that's already visible doesn't look too bad.

I'm not feeling too bad. I got a little tired late in the day at work, but walk and some decaf coffee perked me up enough to get through the rest of it.  There is a small amount of pain left in my throat, and the incision area itself occasionally burns a little, but I haven't had to touch the prescription painkillers for days.

There are lots of doctor visits in my immediate future... follow-up about the surgery, planning for the radioactive iodine treatment, working out a dose of synthetic thyroid hormone, and whatever else might arise in the meantime.  Still, I'm happy to have the cancer out of my system and to continue on.

Tuesday morning, I underwent surgery to remove my thyroid and the cancer it contained.  It took over three hours for the surgeons to do their job.  Afterward, they told me that it appears the cancer didn't spread beyond the thyroid, which is extremely good news.  If they missed any, the radioactive iodine I'll be drinking in a few weeks should take care of that.

I spent Tuesday night in the hospital, where they monitored my calcium levels and other vital signs to ensure that the surgery went well.  Although the hospital staff was very attentive and treated me very well, it was still a fairly unpleasant night.  Every time I tried to fall asleep, my mouth and throat would dry out and wake me up.  I'm pretty sure I saw every hour pass from 3pm when they put me in the hospital room until about noon Wednesday when they released me.  When I got home yesterday, I took a couple of pain medication pills and a nap on the couch.

In terms of recuperation, I've been asked to sleep with my head raised up so that any swelling caused by the surgery will be carried down to my chest rather than remaining in my neck.  That makes sleeping comfortably a little difficult, but not impossible.

Today, I was allowed to shower as long as I didn't get the surgery area on my neck too wet and didn't attempt to scrub or dry it.  That probably did as much to help me feel better as the pain medication.

All things considered, I actually don't feel too bad.  The surgery site looks like something from one of Dr. Frankenstein's experiments.  It's stitched up and covered with "steri strips" (tape-like stuff).  The steri strips are a bit bloody-looking, which contributes to the Frankenstein look.

My throat is still a bit raw and sore from having a tube stuck down it during the surgery.  That's probably the majority of the pain I'm feeling right now.  The surgery site doesn't hurt much, unless I put stress on it by moving my neck too much in any one direction.

All that prevents me from returning to work at this point is all the paperwork.  Unfortunately, it looks like I may have left that on my desk Monday.  Hopefully, my wife will be able to get that sorted out for me tomorrow.

A few months back, I noticed that it seemed like the medications I took in the morning were getting stuck in my throat.  I'd go most of the morning feeling like I had a capsule in there that just wouldn't go down.  Then I noticed on mornings I forgot to take my medications that it still felt that way.  I thought I'd massage my throat and see if it helped with the sensation any.  In doing so, I found a rather large lump. It felt like about half the size of a golf ball.

About two years ago, my mother was diagnosed with melanoma.  It began, oddly, in one of her feet and spread from there. It traveled to lymph nodes, other places in her leg, and eventually produced an abdominal tumor large enough to shut off a kidney.  Last week, she began experiencing excruciating pain in her leg and had to be taken to the emergency room in an ambulance.  My dad called me last Wednesday to tell me that things didn't look good, and that I should get there soon. The next morning, he called me at work to tell me she didn't have long and I needed to get there right away.  I called my brother, who met me at my home and we began the 7 hour journey to York, PA.

Unfortunately, before we had left Ohio, mom had passed away.  We were (and still are) devastated by the news.

Because my parents had lived in York for so many years, a funeral service was held there. I had the opportunity to see just how many others' lives my mom had touched.  It was one of the most well-attended funerals I've ever seen.  It was comforting to see how many people cared about her and my father, and yet sad to see how many would miss her.

A second funeral service was held in Portsmouth, Ohio, yesterday.  It was as well-attended as the service in York.  People from as far away as Seattle and Arizona were there.  Mom was buried yesterday afternoon.

To say I will miss her is an understatement.  We spent hours on the phone over the years, talking about what each of us were doing that week.  She would tell me about people she had met at work (before she retired), quilts she was working on, what her dog Fozzy was up to, and a million other things.  She was quite a talker!  What I wouldn't give for one of those phone calls about now.

Mom was pretty amazing.  She was very well read, certainly more well read than I am.  She enjoyed doing crossword puzzles, making quilts, baking, traveling, and showering Fozzy with affection.  She'd lived in Brazil, in the Philippines, Georgia, Ohio, and Pennsylvania over her lifetime.  She was incredibly creative, having made more quilts over the years than any of us could count, done macrame, home decorating, gardening, and more.  I can only marvel at her life and accomplishments.

Life can be pretty painful sometimes, and this has been one of those times.  I'm moving forward as best I can, but I still picture her lying in rest at the funeral home, and it brings tears to my eyes.  I expect that will be the case for a while.  Someone told me at the funeral in York that people tell you time heals all wounds, but it's not true.  You just learn to live with the pain and focus on the good things your departed loved ones brought to your life.  That's probably true enough.

The following picture was taken from the car on the way to our hotel in Indianapolis, Indiana, this past Wednesday.  My brother and I were in Indy to take part in the Gen Con 2008 game convention.  We stayed at the University Place Hotel on the IUPUI campus, taking the shuttle (or a cab) into town to the convention center each day and back each evening.  We had a good time and were a little sad to leave because it means another year of "game conventioning" comes to a close...

Earlier this year, I planted pumpkin seeds in the back yard.  They're of a variety designed to generate mammoth pumpkins like you see on contests on TV.  I've been threatening my wife that I would grow a really big one in our back yard, so it was amusing to pass this vehicle on our way to the Gen Con Indy 2008 game convention:

On Bob and Tom today, comedian Drew Hastings compared his past girlfriends to Pringles. First, he said, they're mostly white. Second, they're slightly warped. And Third, it's hard to get them out of the can...

I make no claim to the following. It's a poem by comedian Paul Gilmartin. I heard it again on the Bob and Tom show recently and it cracked me up, so I thought I'd share it with you. If you enjoy it, check out the Bob and Tom site or Paul Gilmartin's site for more humor just like it...

 

A wild rabbit finds himself caught in a trap. The next day, he's pulled out of the trap and delivered to a research lab where he's stuck in a cage with another rabbit. Having tasted freedom, the wild rabbit doesn't want to spend the rest of his life cooped up in a cage being experimented on. He turns to the other rabbit and says, "Don't worry buddy, tonight we're going to bust out of here."

The other rabbit says, "Gee, I don't know. I've spent my whole life in the lab and I don't know how well I'd do out there in the wild."

The wild rabbit tells him, "Don't worry. I've lived in the wild all my life. I'll show you all the best fields."

That night, they manage to escape the cage and get out of the lab. The wild rabbit takes his new companion to a field full of tender lettuce and tells him, "This is the third best field in the world."

Then, they go to another field, where the wild rabbit says, "This is the second best field in the world." It's filled with delicious carrots. The two stuff their faces.

Finally, they arrive at what the wild rabbit says is "the best field in the world." This one is filled with lady rabbits. The two males spend the night doing what male and female rabbits do together.

Finally, exhausted, the lab rabbit turns to his wild cohort and says, "This has been really great, but I've got to go back to the lab."

"Why?" his new friend asks.

"After all we've done, I'm just dying for a cigarette!"

I was born and raised in a small Ohio town called Portsmouth.  It's the kind of place that rarely makes the news.  Sadly, when it does, it's usually for something goofy like this...

 An Ohio historian removed an 8-ton rock from the Ohio River.  The rock is covered with a variety of carvings, dating to Portsmouth's early days, and perhaps even earlier than that.  That, in and of itself, hardly qualifies as news.

What does qualify as news is that politicians in Frankfort, Kentucky, are up in arms about it.  They're calling it a "raid", as though you could move 8 tons of rock out of a river in the middle of the night with no one noticing.  And as if there were no Kentuckians involved in the "raid".

The more ridiculous part of the story, crazier even than the fact that the politicians are up in arms over a rock, is that they're willing to fight over it in court.

It's a rock, guys.  Not only that, but you can pretty much see Frankfort from Portsmouth.  Can't you guys work something out without a court case?

How about on even-numbered years Ohio displays the rock in a public place of honor, and on odd-numbered years you have a big celebration as the rock is transferred to Kentucky for a display there.  You could turn this into a silly tradition that actually generates tourist traffic and revenue for the businesses on both sides of the river.  No need for a court case!