It was February 8th, 2017. This was the day of my first ultrasound outside my local hospital. I had just arrived at Baylor College of Medicine in Houston, Texas. The clinic was smack dab in the Texas Medical Center. The parking garage feels like a twisted American Ninja Warrior course. Objective: Reach your appointment ALIVE. I was dodging cars and people. Pro tip: If you are in a parking garage at any TMC facility, never close your eyes. Don’t even blink! Hold your eyes open as if you were waiting for expensive mascara dry, but you have to sneeze. Look at yourself in the mirror EYES WIDE OPEN with a half sneeze praying your eye shadow stays unscathed. This is what your battle plan needs to be. Running isn’t the best solution either, you’ll need to play the visibility game. If you must, flail your arms around or wear a safety vest. No judgment here. To those parking, would you PLEASE go slower? All of us have the same goal, we want to live. That is why we are going to specialty care after all. Thank you for your consideration. This concludes my public service announcement.
When I successfully arrived at the correct floor, I did the usual check in and sit down routine. I started chatting with other patients because 1. I assumed there would be a long wait and 2. I needed my adrenaline to go down from my live action Frogger experience. I was called back no more than 5 minutes later. I did what people do when they are picked out at a concert or TV show. Pointed to myself and stated “Me? Me?? ME???” several times to be sure. Surely this was a mistake, since I didn’t have to wait until I was on the fellow patient’s Christmas card list. She assured me that I was indeed the one she wanted. All without breaking into the musical number from Grease. I was incredibly disappointed.
She led me back to the ultrasound room. My tech seemed tired and not feeling social at first. Following the typical instructions, I laid on a surprisingly comfortable hospital bed. I had nice real sheets (not paper) and pillows! What was this? The Hilton ultrasound suite?? That wasn’t the only impressive thing. I stared at the ultrasound machine like I had never seen this technology before. Ooooohhhs and Ahhhhhs occurred several times during the actual ultrasound. I was captivated by how vivid and sharp the images were. I’m sure my tech was wondering “does she use a horse and buggy to get around?” but was polite enough not to ask. At some point her demeanor suddenly changed. She asked me questions like what I was told about my nodules, had they been biopsied before? Finally it was over and she handed me plenty of towels to clean up with. Ultrasound techs can’t tell you anything. We know they know, but are sworn to secrecy. After all the ultrasound goo was gone, she started to discuss thyroid cancer in general and that the survival rate was good. We parted ways with jokes and cheerful conversation.
I walked out to my mother waiting for me. Each step seemed longer than it was due to processing what just occurred. She started talking about getting lunch and where we could go shopping. After all, she knew that no news comes from the ultrasound. We would have to wait for the doctor appointment the next day. I stopped her and said “Mom, the ultrasound is abnormal”. We have a policy in our family that we try not to worry about something until it is certain, but I shared what happened. While cancer was looking like a real possibility at this point, we agreed to wait until confirmation. After arriving at the hotel later I tried not to think about it too much. I was sure an answer was coming the next day either way. Having the comfort of a definite was enough to get me through the night.
The next morning I ate a Texas shaped waffle. It was my feeble attempt to harvest the Lone Star State’s power to face the parking garage situation once again. It obviously worked because I arrived at the Internal Medicine/Endocrinology clinic for my results. After the typical vital signs I sat and waited even less than I did for my ultrasound. The doctor comes in and says:
“Hi, are you Alexa? You need a biopsy as soon as possible”
Getting told I needed a biopsy stat was quite the introduction. This was the chosen ice breaker? That would be equivalent to proposing on your new date’s doorstep. “Yeah, I saw your picture on the app and got the ring right away!” Dude, can’t we go out for dinner first? Or in this case some basic small talk.
“What do you mean as soon as possible?” I asked the doctor. She explained how my ultrasound showed signs of thyroid cancer. My nodules were solid, hypo-echoic, calcified, and with ill-defined borders. Now, these particular signs don’t always mean cancer separately. But together this was a Crocs and socks combo of the imaging world. I apologize for the disturbing metaphor, but we all know that is not a good look. I was so confused because none of my radiology reports at home had these terms. I consulted Dr. Google later to learn exactly what they meant.
I told her that I couldn’t have a biopsy. I “failed” my other one. I wasn’t a good patient after all. I would probably fail again and what would be the point. Now fully confused, she asks if a local anesthetic was used. Uh no. I had some sort of alcohol solution put on my neck that suspiciously looked like it came out of an alcohol container. Did I mention it also smelled just like alcohol? Does that count? I got the same look as the ultrasound tech gave me the previous day. Let me set the record straight: I do live in this century. I also have an iPhone and data plan if that helps my case.
I think she felt relieved that we were talking about two different types of biopsies. Mine: Unrealistic expectations, no local anesthetic, lack of skill, and not to mention lack of compassion. Theirs: As many breaks as needed, local anesthetic used, significantly quicker, and consideration of my comfort. Once we established this she returned to the urgency issue. Ideally, it needed to be done within a month, but her schedule was backed up. I was given the option of having the Interventional Radiology team do it. They only do procedures while she still has to see patients, which might help with scheduling. Not to mention they do complicated biopsies all the time. I was sold. She put the order in and assured me I could do this.
Unfortunately, for whatever reason, 2017 was a bad year for nodules requiring a biopsy. Shout out if you were part of this crew. The best I could get was in 6 weeks, and that was expedited. It was bad for my sanity. Being that far out my appointment the pep talk hype went stale. I also didn’t appreciate all the time my brain had to create bizarre scenarios. Would Steve Martin come in the room to reprise the role of Orin Scrivello in Little Shop of Horrors while mischievously looking at the biopsy instruments? This is where my mind goes people. Moral of the story: Try to get any procedure like this done as soon as possible to reduce your marathon thinking sessions. I found one upside to the wait. It gave me plenty of time to decide where I wanted be treated if it was cancer.
In our next adventure together I will walk you through the biopsy process and share some (hopefully) helpful tips.
My Broken Butterfly 