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Statistical Outlier

When I was a kid, I thought it would be cool to have a rare disease. Hey, I was a little kid, what did I know? And I read too much 19th century literature even then. So when I got, not Type 2 diabetes but late-onset Type 1, which is so uncommon you can find doctors who don't believe in it, I figured that particular bit of bad karma had been dealt with.

Last month I saw my new primary care physician for the first time. He did basic doctory things, like take my blood pressure and temperature, and listen to my heart and lungs. He also felt my neck and jaw, and determined that one lobe of my thyroid was swollen. He sent me off for an ultrasound.

The ultrasound showed a 4 centimeter thing--a nodule, a mass, a thing. Ninety percent of all thyroid nodules are no big deal. When biopsied, the results are either non-diagnostic (translation: they can't tell anything from them) or negative for scary cells. The usual treatment is to remove the nodule, and sometimes the lobe of the thyroid it's in. Often that doesn't make a dent in the function of the thyroid.

So I got an ultrasound-guided fine-needle biopsy. This left me with a small but interesting bruise at the base of my throat. I was hoping someone at CONvergence would comment on it, because I'd invented several good stories to account for it, but I don't think the light was ever good enough to make it noticeable.

Yesterday I met with the specialist to get the results. And I quote (from the lab report):
"1. Suspicious for a Hurthle cell neoplasm... The specimen contains a majority population of Hurthle cells with a minor population of follicular epithelial cells."

Yes, as you can see from the linked article, a nodule full of Hurthle cells the size of this one has a better than middling chance of being a carcinoma. I'm going to have surgery, during which the pathologist will check the offending tissue on the spot and determine if the thing is cancer. If it is, poink, they take out the whole thyroid, I get a course of radioactive iodine therapy, and take thyroid hormone forever 'n' ever.

Apparently I'm still stuck with that whole unlikely-outcome mojo. Damn.

What I find most interesting is that I'm not thinking, "Ohmigod I have CANCER!" It wouldn't be unreasonable to do so, but I feel exactly the same as I felt on Monday before I knew about this. Except for the ping pong ball under the skin at the base of my throat (a regulation table tennis ball is, in fact, 4 cm), I have no symptoms of anything. Sometime in early August, probably, I'll have surgery, which makes me much more anxious than the nodule itself.

Did I sign up for this? Other than my dumb and transient childhood wish to be the Incurably Sick Person Who Gets All the Attention In the Novel, no. Is this going to change my life? Probably not. Why not? Because the state of Minnesota has good health coverage for poor people, that's why not.

If I were still in California, I'd survive the cancer and die of bill collectors.


( 79 comments — Leave a comment )
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Jul. 12th, 2012 03:39 am (UTC)
May it turn out to NOT be cancer. You don't want those headaches. Good luck with the surgery for this.
Jul. 12th, 2012 03:50 am (UTC)
'K- I'll quit grousing about taking my thyroid med.
We've health issues at our house also, but can still wish you positive thoughts and prayers.
Keep us posted, PLS.
Jul. 12th, 2012 03:53 am (UTC)
I had a Thyroid scare once. Aferwards, I couldn't help thinking about Randy's "very special episode" from Home Improvement about the same thing.

Jul. 12th, 2012 04:22 am (UTC)
Well, crap.

(Deleted comment)
Jul. 12th, 2012 05:14 am (UTC)
Hmmph, indeed.

Reactions are fascinating, aren't they? Yay for being in Minnesota! For the good health coverage...the proximity and access to Mayo if that ends up proving useful (they're especially good with the outlier types)...and especially the closeness of your fellow Scribblies and other dear friends.

Here's hoping your next unlikely outcome includes the word "benign." But whatever the news, know that we're all looking forward to the day when the only lump in your throat is a metaphorical one that comes from being reminded of just how very loved you are. No more swallowing ping pong balls, y'hear? They're of little use without a table, net, and paddles, and you surely don't want to go swallowing any of those now, do you?

Virtual hugs to both you and Will.
Jul. 12th, 2012 05:24 am (UTC)
I really like this line from the article:

> With up to 9 years of follow-up, there has been no tumor-related mortality.

Though of course it would be best if it weren't cancerous at all. Thinking of you, and please keep us posted!
Jul. 12th, 2012 05:28 am (UTC)
Good luck with all of it! I know several people who have, for various reasons, had their thyroid removed. As weird conditions go, it seems to be a fairly livable one.

You're the second adult-onset Type 1 diabetic that I know. My sister-in-law was diagnosed with it at age thirty-something. I gather that's not as rare as people think it is (though still less common than kids getting type 1 or adults getting type 2), and that there are probably quite a number of people who have been misdiagnosed and therefore not being treated correctly.

Hope it turns out to be non-cancerous!
Jul. 12th, 2012 05:54 am (UTC)
Best of luck, and thank you for War of the Oaks
Jul. 12th, 2012 05:57 am (UTC)
Oh gosh. Here's hoping for the best possible outcomes.
Jul. 12th, 2012 06:00 am (UTC)
I salute you for the dedication you show in experiencing new things in order to provide that extra realism and emotions in your writing.

But seriously, stop it. We'll pay attention to you without being sick.
Jul. 12th, 2012 06:02 am (UTC)
Always ask the surgeon if you'll be able to play the violin (or if you play violin, the bassoon, or whatever) after the surgery, so that if they say yes, you can say, "well, that will save me some money on lessons." Surgeons love that joke, and none of them have ever heard it before. Mmm hmmm.
Jul. 12th, 2012 07:30 am (UTC)
Frisbee! Emma, be sure to ask your surgeon if you'll be able to throw a frisbee!

On second thought, ask if the surgery can please come with a guarantee that you still won't be able throw (or catch) a frisbee. The lack of that skill has kept you alive for at least the last 30 years. I'm betting it's good for another 45....

(Obligatory Stan Rogers reference there. Emma probably noticed that.)
(no subject) - apostle_of_eris - Jul. 12th, 2012 02:09 pm (UTC) - Expand
(no subject) - lemmozine - Jul. 12th, 2012 02:48 pm (UTC) - Expand
Jul. 12th, 2012 06:03 am (UTC)
This is bullshit, and I would like the DM to let you re-roll your saving throws, indefinitely.

I'd also like to send my best wishes... and remind you guys that I am back in Minnesota in this "early August" you speak of, and I am your little fetch-and-carry tool any time you snap your fingers, day or night. You have my number. Fail to use it and Bear will kill you herself, thereby rendering your surgery quite unnecessary. :P
Jul. 12th, 2012 06:04 am (UTC)
Hope it turns out for the best, but if they do take your thyroid out, you should note that there are two parts to a possible thyroid replacement -the T3 and T4 hormones. We have two friends of similar age to yourself who had very poor results when receiving only the default synthetic T4. When they switched to taking T3 as well as T4, they got much better, energy- and stability-wise. I believe Martha also takes the animal-based form of the drug, and she thinks that makes a difference as well.

But her husband had a physician who resisted adding T3 to her husband's treatment for a whole year, and it was a very difficult year for him. So if you get in that situation you might have to advocate for yourself and should know your options.
Jul. 12th, 2012 10:18 pm (UTC)
Amen to that. Synthetic T4 did squat for me. Every doctor but one told me it was all in my head and the synthetic was as good as the natural. That one switched me to the animal based form and it did make all the difference.

Emma, we are all hoping for the best possible outcome. Arm yourself with knowledge and remember that you have a lot of people pulling for you. Oh, and make sure you get your treatments far enough away from Bordertown that the magic won't go all wonky - You might end up with horns or claws or a tail or something --not that we wouldn't love you just the same if you did -- but you don't need the hassle of having to deal with something as impractical as a tail, or trying to type with claws. . .
Jul. 12th, 2012 07:59 am (UTC)
Sympathies. Get well.
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Emma Bull

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