Friday, June 26, 2009

June 26, 2009 - High Anxiety Threshold?

This afternoon I have a routine office visit with Dr. Lerner, my oncologist. He’s received a report from Dr. Sher, the endocrinologist I met with a week or so ago (I didn’t blog about that visit at the time).

Those who’ve been following this blog for a few months may recall that, back on Valentine’s Day, I had a PET/CT scan that revealed a possible nodule on my thyroid gland. A subsequent ultrasound confirmed that, yes, there was something abnormal growing out of the left side of my thyroid.

Dr. Lerner told me he didn’t think it was anything significant – most of these growths are benign, he explained, and this one was pretty small, at that – but he thought it was worth seeing an endocrinologist to get it checked out.

Through a series of scheduling misadventures, it was only a couple of weeks ago that I finally got in to see the endocrinologist. Dr. Lerner had given me the name of a Dr. Asnani, saying he wanted me to see that particular specialist, and none other – although he emphasized it wasn’t urgent, and I could meet with him any time in the next several months. Well, Dr. Asnani’s office staff told me he was in India on an extended visit, and they weren’t even making appointments for him until after his return. I called back over a month later, as they had instructed, and it turned out they had no free appointment for about another month and a half. The long and the short of it was that I finally got into his waiting room on June 16th – just over four months after the nodule first appeared on the CT scan!

Come to find out, Dr. Asnani wasn’t available that day, as he was making hospital rounds. I’d be seen by a resident, Dr. Lee, instead, and then by Dr. Asnani’s partner, Dr. Sher. Dr. Lee was actually the most helpful. She spent a lot of time with me, explained everything, and was very responsive to all my questions. She carefully probed my thyroid with her fingers, taking great pains to see if she could feel the nodule. Then, I saw Dr. Sher for all of about 2 minutes – no examination, just a reiteration of what Dr. Lee had already told me.

When I explain all this to Dr. Lerner today he says, that’s fine, Dr. Sher’s name would have been one he would have recommended – even over Dr. Asnani – but the last several times he’d tried to refer patients to Dr. Sher, they were turned away with the explanation that he wasn’t accepting any new patients! (The ways of medical scheduling are exceeding strange.)

So, what did Drs. Lee and Sher tell me about my thyroid nodule? That it’s very small (0.8 centimeters), too small to biopsy. They recommended I have another thyroid ultrasound in 6 months, and if it’s bigger than a centimeter, it may be wise to have it biopsied. Even so, they reassured me, I shouldn’t worry about it – only a small percentage of such nodules are malignant, so it’s just a precaution.

Well, I went away from the endocrinology office thinking it’s probably a good thing I’m going through this thyroid stuff after having been through a lymphoma diagnosis, chemo and all the rest – I might have been a nervous wreck, otherwise. My anxiety threshold when it comes to things medical has certainly gotten higher!

Dr. Lerner hands me a script for my next PET/CT scan in early September: time to start the whole cycle again.


Joan Calvin said...

I had nodules on my thyroid. Got them biopsied. Had a partial thyroidectomy. Begnign (but am on synthroid because they took most of my thyroid). But the upshot was that it was the endrocinologist that finally listened to me and ordered a CT scan of my abdomen. 7.5 pound ovarian tumor. I fought doctors for several months trying to convince them there was something wrong. The good news is the cancer was early and the oncologist thinks all will be well. You are right, though, about heightened anxiety. Is there something growing in my abdomen? Is the heartburn a symptom (again) of cancer? Am I bloating? Is it cancer? My prayers are with you.

Wendy S. Harpham, MD said...

Dear Pastor,
One of the challenges of Healthy Survivorship is finding an optimal level of watchfulness. If you become overvigilant, you can make yourself an anxiety-ridden puddle of Jello. If you become overly lax, you can miss opportunities to prevent and minimize health problems.

This is an instance where having a primary care physician who knows about all your medical conditions can help you keep perspective and make wise decisions not influenced adversely by emotions.

And keep in mind, the game plan changes if you notice something new between scheduled visits.

Hang in there. With hope, Wendy

Marie said...

Anxiety is my middle name, even before my diagnosis. lol Thanks Mom. lol

My crap disease is Multiple Sclerosis. Slower and less dramatic than cancer, less viscerally frightening. But crappy nonetheless.

I have experienced similar frustrations with progression, new symptoms and a plethora of providers. Sigh.

I am a neighbor to the north, with Trinity Church, Asbury Park. :) I wish you peace along your journey and will remember you in my prayers.

Carl said...

Thanks for your observation, Joan. A real testimony to the importance of medical tests. I'm certainly glad you had that serendipitous result. Kind of like the unrelated ultrasound that led to the discovery of my abdominal tumor.

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