Sandi’s Thyroid---Here We Go Again

Back last Friday I was very happy to report that Sandi was declared by her cancer doctor to be in remission. I said then there were some issues that needed to be looked at and some more tests would need to be done. Over the course of this nightmare that started back last November, I have learned that when the doctors and hospital staff expedite things there is serious concern no matter how much they tell you not to worry.  The faster they move the more you need to worry.

We knew the cancer doctor had some concern about several things and one of the issues was/is Sandi’s thyroid. The last PET SCAN back in February showed three nodules on the right side and it was believed to be no cancer activity. The latest PET SCAN still showed those nodules and also showed some activity so he wanted her seen by an endocrinologist at the hospital.

 That was last Friday. By Monday at noon she already had doctor appointments and the first was with the endocrinologist. That happened yesterday morning with Sandi suddenly being the first patient of the day. By noon Sandi suddenly had another thyroid ultrasound scheduled for tomorrow morning. 

As we understand it from the endocrinologist, her right thyroid is definitely very active. The chemo did not kill it as expected and believed back in February. The endocrinologist believes the thyroid was the starting point for both of the two types of Non- Hodgkin’s Lymphomas she developed that did their damn level best to kill her. The fact that it has reactivated itself and seems to be building strength is not a good sign. His concern is that some patients during chemo can have those cancers killed and then have the thyroid develop a new totally different type of cancer that runs rampant very quickly because of the chemo and its aftereffects.

In short, she could be in remission from what they were treating for and rapidly become ill with a totally new and very different cancer.

So, tomorrow morning she will have an ultrasound of her thyroid. The plan, as we understand it and the information has been a bit conflicting from the hospital today, is that there will be a surgeon on standby to do a needle biopsy of her thyroid if necessary.  That biopsy will be done only if the doctor thinks it is a necessary risk based on what he sees on the ultrasound tomorrow morning.

Theoretically everything is okay and most patients don’t have this sort of nightmare scenario develop but everything that has happened with Sandi on this has not fit the expected pattern at all.

If that wasn’t enough tomorrow, Sandi will be seen by the skin cancer doctor tomorrow afternoon. Not only has a mole suddenly gone very strange looking but she has developed one for sure and maybe a couple more very strange spots on her face. In each case it is a dark circle, almost the size of what a black magic marker would make and black. They look like what you would get if you through a marker at somebody and it hit the person straight on in the side of the face. What they are we have no idea and neither did the cancer doc who thought that whatever they were they needed to be checked immediately.

Apparently another possible wonderful side effect of the chemo is that some patients develop melanomas because of the destruction of the immune system. While the chemo cured one of her cataract she had since birth it may have also set the stage for skin cancer. The theory here is that whatever these strange skin marks are they can’t be too extensive or extend any distance at all downwards into her skin tissue or the PET SCAN would have showed that and it didn’t.

At this point we have not heard from the staff of the cardiologist about scheduling another echo cardiogram to check and see how much, if any, damage the chemo did to her heart. With Sandi’s cardiac history we knew there was major risk to her heart to have any chemo done. But, as Sandi put it at the time, it wasn’t like she had any choice at all. It was chemo and hope ….or certain death.  So, you roll the dice and hope the stuff works and doesn’t kill you in the bargain.

One hopes it did not damage her heart. We are pretty sure it has made her diabetes worse and for now she is still able to control that to a certain point. What that will mean in the months to come we don’t know just yet. Sandi remains convinced that everything is fine and she will be back at work this summer.  As I write this she is out with Karl taking a short after dinner walk as she works to get her strength back up. She still tires very easily, her blood pressure still swings wildly at times, and the headaches come that worry me because of her history of strokes.

But, she believes all is fine and she is still here.  More than anything that is what matters.

Kevin