Home again, home again, jiggety jig

Scan today went great. No evidence of cancer spreading beyond what we already knew about. Yay! Also, I got them to measure me with a geiger counter and from 3 feet away I'm almost indistinguishable from background radiation (I'm .03 mrem/hr, background is .02 mrem/hr). Up close to my neck dose rate is higher (.45 mrem/hr), but still low enough that I don't need to worry about snuggling with the kids...it means kid sitting on my lap with head right next to my neck for 3 hours would get about the same radiation exposure as they would in one cross-country flight. And given the short half-life, even that will go away pretty soon.

I have follow-up appointment with endocrinologist in October, but probably there won't really be any more cancer news until I get follow-up scan in a year.

Kids are having a great start to the new school year, and Nate teaches his first class as a Georgetown professor tomorrow. Woohoo!

Ending Isolation

So I'm basically done with my post-RAI isolation, and it really hasn't been too bad. I've been sleeping in, spending long mornings out on the porch reading, afternoons on the computer, evenings watching tennis & Gilmore Girls (thanks Meredith!) and doing jigsaw puzzles. I've felt really supported by neighbors, family, and friends here, and I'm kind of an introvert anyway, so I haven't been too lonely.

Saturday I took an outing to Hollywood Cemetery, where I miraculously found my grandmother & great-grandmother's graves. I hadn't been there in at least 15 years, and the map I had of where the plot was was just an aerial view, with no street names. After visiting the graves of James Monroe, John Tyler, Jefferson Davis, and countless confederate soldiers, I eventually found it. The hill where the presidents were buried had a nice view of the river...fun to see all the people out playing on the rocks on the other side.

Tomorrow morning I'll call the kids to wish them a good first day of school, clean up the house, pack my stuff, and go pick up my mom for the drive back to DC. My mom's coming up to help for another few days this week. We may pass Nate's parents on I-95 as they make their way back down here after being at out place for over a week.

Wednesday I have my post-RAI series of scans...will take a couple of hours to get through them all, but these will reveal more definitely if the cancer spread anywhere outside my neck. Hopefully they'll be clean, and the doc will tell me I've cleared enough of the radiation that it's safe to go back to work and snuggle with the kids.

Will update again Wednesday after the scans....

RAI treatment

Despite March on Washington road closures the drive to WHC Wednesday was easy, no traffic. When I got to my room I found everything covered: the floor, the chair & table, the phone & tv remote, the door handles & light switches. This makes it easier for them to clean up any contamination in the room when I leave. I was instructed not to bring in anything not disposable (like phone, ipad, books), since if they became contaminated they'd either need to be thrown away or sequestered for 2 months.

I finally got my radioactive iodine dose at 2:30. I spent the afternoon watching March on Washington on TV, then after dinner I discovered the show 'Castle' with that guy from Firefly. It was good and fortunately TNT likes it too, becaused they showed like 4 or 5 episodes in a row, so that was what I watched all evening. Crossword puzzle and Games magazine also kept me occupied. At some point (10pm?) I started to feel pretty nauseated, and they gave me some more anti-nausea medicine (I got some before the RAI too), but it didn't really help much. I continued to try to drink a lot and suck on the sour candies, but it got much harder when everything I put in my mouth made me feel worse. I slept for about an hour between 1:30 and 3, then puked a bunch. Slept maybe another hour before 5am. At around 9am the radiation safety guy came to measure my levels, telling me that since I had a hefty dose it was likely I'd have to wait a while longer before they let me go....but turned out I was well under the limit. Took them a long time to get my discharge papers together, so I didn't get out of there until around 11am. I think I took 5 showers while I was there (every 3-4 hours). A word to the wise: if you ever have to stay at WHC (especially on low-iodine diet), bring your own food and get the nurse to heat it up for you. The stuff they brought me was inedible, but my mom's brunswick stew was great.

So from WHC I drove straight down to Don & Ada's house in Richmond (they're at my house helping with kids this week & weekend). After I got here I unpacked and took yet another shower, then slept for four hours. Woke up, ordered a pizza for dinner (no more low-iodine diet!!) and then settled in for an evening of watching tennis and starting a jigsaw puzzle. Yay for the US Open. Isner/Monfils match was great, glad I stayed up for it.

So now it's Friday morning. I slept well last night, didn't wake up until 8am. I was still feeling kind of sick yesterday, but mostly better today. I've spent the morning on the screen porch reading newspaper, drinking coffee (with milk!), eating granola & yogurt. It's a beautiful day!

The big day

The dosimetry stuff I did the week before last (trace dose of radiation, then scans every day for 5 days) revealed that I clear radiation out of my body faster than average, so I'm getting a bigger than standard dosage for my radioactive iodine treatment: 275 millicuries. I'll brave the March on Washington traffic and arrive at the hospital at 11am, where I'll probably wait around a long time while they get my room ready and stuff. I'll drink the RAI, then stay overnight in the lead-lined hospital room. I'm supposed to eat lemon drops almost nonstop (to clear my salivary glands), drink (and pee) as much as humanly possible and shower often to try to clear the unabsorbed RAI from my body.

Whenever I get discharged (Thursday morning?) I'll head straight to Nate's parents' house in Richmond to spend the rest of my week of isolation there. Will head back to DC next Tuesday (first day of school!). I have another scan next Wednesday, and that'll be the most conclusive evidence about whether the cancer spread outside my neck.

Time to finish packing!

I'm radioactive!

(written around noon today)

I'm in the middle of my week of basically living at Washington Hospital Center (7 trips in 8 days), the dosimetry week. Monday and Tuesday I came in for Thyrogen injections to boost my TSH levels so my thyroid cells will absorb more iodine, and today I got to talk to a nuclear physicist before swallowing 2 mCi of radioactive iodine. That was at 11am. Now I'm just hanging out in the courtyard (where the weather is perfect) until 1pm, when they'll do a scan and collect some blood. Had to fast before the appointment this morning, so I'll get my first meal of the day when I get home, around 2:30. I come back Thursday, Friday, Saturday, and Monday for more scans & blood draws, then get the rest of next week off. I have to follow some radiation safety precautions for a couple of days, but this is a really low dose, so it's a lot less than what I'll have to do in a couple weeks for the big dose.

I've been on the low-iodine diet for 2.5 weeks, still have 2 to go. It hasn't been too hard, especially since my mom has cooked so much for me (she's still in Richmond, but she filled the freezer with stuff in June, and it's been great).

Other stuff that's been going on that I don't think we've mentioned:

The last week in July we took a trip to California to stomp on the old stomping grounds and see our Brass Monkey friends out there (plus a couple non-monkeys). It was great. Kids did fine with the travel, we got to visit Berkeley Bowl & Crixa Cakes, Rowan got to see the house where we lived when she was a baby, we spent an afternoon at Half Moon Bay (for the first time ever!), we walked around Lake Anza at Tilden, and we spent a whole weekend in Inverness with our Monkey buddies.

This past weekend I had a lovely time in Richmond with Sapna, Meredith, & Joy (who came all the way from Seattle for the occasion). Sapna's 34 weeks pregnant and on bedrest, so we did not go out on the town quite as much as originally planned, but we sat and talked and organized baby stuff. We need to all move to the same city so we can hang out more often.

The kids are at the river with my parents this week, having a good time playing at the little beach, picking blueberries, and hanging around the house. It's nice to have a little break from childcare, but it will be really good to see them this weekend! I'm bringing my mom back too, so she'll spend next week with us, then Nate's parents are coming the following week (overlapping with when I'm in isolation at their house), then my mom's back again for a bit. So we'll have a busy house the next few weeks!

Ok, time for me to head back inside for my scan. Will try to post this tonight....

appointment with Dr. Boyle

Yesterday Jenny and I went to see the surgeon, Dr. Boyle, about the pathology report.  She reassured us that nothing in the report changes much the prognosis.  So now we're in the process of starving Jenny of iodine and preparing for the RAI treatment later this month.

pathology report

Jenny learned the details of her pathology report last week.  The tumor was 3cm not 2cm, protruded beyond the thyroid gland, and was either near or around a blood vessel.  None of that sounds very good to us and it's been an uneasy weekend.  We don't have an immediate opportunity to run this by a doctor for interpretation -- our next meeting with our surgeon Dr. Boyle is July 30 -- so our knowledge is pretty limited at this point.

We do know that the nuclear medicine doctors now want to give Jenny the maximum dose of radiation that her bone marrow can withstand because if some cancer survives the RAI treatment there is some probability it develops resistance to radioactive iodine.  To learn how much radiation that is, she'll be undergoing a bunch of tests in mid/late August leading into the RAI treatment.  It's possible that each test will require a trip to the Washington Hospital Center, though we're inquiring as to whether we can do some of it at the nearby Virginia Hospital Center.

Our parents are coming up big for us in August.  Becky and Mike are taking care of the kids at the river one week, Becky will be up here another week, and then Don & Ada will be here the last week of August when the RAI treatment happens.  We appreciate every day that we are so close to them.  The first week of school may be a bit of a challenge as it's not clear how much contact Jenny will be able to have at that point, and I'll be in my first week of teaching.  We'll be reaching out to our neighbors for help and I'm confident things will work out for us then.

First things first, though.  This week the kids are at camp and then we leave for vacation in San Francisco, Berkeley and Marin.  Really looking forward to seeing our old haunts, showing Rowan where she was born and (of course) catching up with all our friends and teammates in the ultimate community there.

Next steps

So surgery recovery is basically over. I'm still puttting vitmain e oil on the scar to supposedly help it heal better... that'll continue for most of the summer I think, but already the scar's not so bad. I've got full range of motion. Neck is still kind of mildly irritated around the scar. At first I thought that was from the suture strips, but they've been off so long now I'm not sure I can still blame them. Maybe I'll call the surgeon tomorrow.

Other good news is that the dosage of thyroid hormone replacement they gave me seems pretty good as far as I can tell...I feel normal. They may still adjust it based on blood work later, but I was worried there would be a lot of tinkering with the dosage just to make me feel ok, and now I'm thinking that won't be the case.

A few days ago I scheduled all the radioactive iodine (RAI) stuff. It is going to be a super pain logistically, but hopefully not that bad physically. So I'll swallow the main I-131 RAI pill August 28 and stay overnight in the hospital that night (happy birthday, Dad!). In the 10 days prior to that I'll have to take 6 other trips to the far side of DC (Washington Hospital Center) for various stuff:

• four trips for Thyrogen injections - that's the drug that'll boost my TSH (thyroid stimulating hormone) levels to make the RAI more effective without me having to go off the daily thyroid hormone replacement pills. It's kind of a recent development that you can use this stuff...prior to it people had to go off their hormones for several weeks prior to treatment and scans, which meant they basically had to become super lethargic and grumpy for a couple weeks every 6-12 months, depending on how frequent their follow-up scans were. It's good I don't have to do that.
• one trip to swallow low-dose I-123 pill for pre-treatment scan - this'll help them tell if cancer has spread elsewhere, like to lungs or something, could affect my dosage of scary I-131.
• one trip for the I-123 scan. 

Most of those visits should be fast, basically in and out, assuming I don't have to wait too long for them to take my blood (though last time I did have to wait a while for that). They told me to expect to be there 3-4 hours for the scan though. Boo.

Then after hospital stay when I'm still glowing I have to stay away from people and animals for a week. Probably I'll do most of this at Nate's parents' house in Richmond. That week spans the first day of school, which I will be sad to miss, so maybe I'll come back early and figure a way to be isolated here, I don't know. The half-life is pretty short, and I'll pee most of it out in the first couple of days, so really I think I'm much less dangerous after a few days, but still will be keeping my distance.

Good news is we can still take our trip to California at the end of July, and I won't miss Rowan's birthday (August 25). The low-iodine diet will start August 5 and end when I leave the hospital August 29. My mom has already filled our freezer with low-iodine soups, bread, granola, pies, etc. 

Then the last thing (as far as I know) is post-treatment scan on September 4. Then I should get like 6 months off before follow-up I-123 scan (no isolation, but still 2-3 weeks of low-iodine diet and at least 4 trips to WHC). My endocrinologist promised that the excellence of the nuclear medicine department there would make all the travel worth it. He better be right!

Recovery update

It's been four days since surgery, and the recovery is going really well. I'm up and about, and am getting more mobility in my neck every day. I even went to the kindergarten sing-along on Friday (2 days after surgery). I've not been sleeping all that well. I like to fall asleep on my stomach and I can't quite pull that off yet, but it's getting easier to find comfortable positions. I generally have pretty good energy during the day and then not so much after dinner.

Yesterday I finally finished sewing a skirt for Lucy, and today made one for Rowan (this is a project I started several months ago and never got around to). They turned out ok! I should post photos...but Rowan ran away from the camera. Oh well.

Not much else to report. My follow-up with Dr. Boyle is on Tuesday...I'm thinking I may be able to go back to work as early as Wednesday.

Home again, home again, jiggity jig

Got home today just in time to see the last point of the Sharapova match, and then all 40 minutes of Serena walloping Errani. Can't wait for Djokovic/Nadal tomorrow morning, quite jealous of Jean-Loup who's actually going to Roland Garros to watch in person.

Recovery's going as well as can be expected I think. I've been able to eat today and have had some energy, though not a lot. Not in much pain at all, but can't move my head too much either. Hoping for a good night's sleep. I never actually got assigned to a room at the hospital (they ran out of beds I guess), just spent all night in the recovery room. It wasn't so bad, but it was hard to sleep this morning with all the commotion.

It's super-common for the parathyroids (small glands that attach to the back of the thyroid) to get damaged or even removed during thyroidectomy. I was told they found all four of mine, and re-implanted two of them (I guess the other two stay put, or maybe they just didn't bother reimplanting those?). The parathyroids have something to do with calcium absorption, and almost everyone with thyroid surgery has to take calcium supplements for some time after surgery. Usually it's just temporary, and surgeon seems confident it'll only be temporary for me. With the nausea last night they didn't give me the calcium tablets though, so my fingers and toes got tingly...felt like I'd been sitting on them too long or something. All better today.

The wound is pretty ugly right now, but Rowan & Lucy haven't been too freaked out by it. Rowan was really not happy with the idea of my neck being cut open, so I was especially worried about her, but it turns out she was more upset about our holly trees being cut down than she was with my neck when she got home from school today. (We cut down the hollies out front! Bare feet, here we come!)

Back home

Jenny was discharged this morning and we got home around noon.  Next couple days will probably be pretty low key here.  Naps, French Open, books, etc.

I was able to see her wound (?) for the first time earlier today -- yesterday it was bandaged up -- and it's very noticeably right now, to the extent that she is wary of scaring people who don't know what's going on.  As it heals it'll turn into a scar and then fade over time.

Surgery Update #1

Our surgeon, Dr. Boyle, says that everything went as planned today and that the surgery was successful.

We went into the hospital around 10am and Jenny went through pre-op for a couple hours, meeting nurses and attendants and signing forms.  Around noon she moved to the operating room (the OR if you're in the know).  Surgery took roughly 3.5 hours but it wasn't until around 5:00 that she had recovered sufficiently to see anybody.

Recovering from the general anesthesia hasn't been easy thus far.  Jenny felt nauseous a few times even though she's only had a couple nibbles of Saltines over the past 24 hours.  The doctors ramped up the meds to fix it and that makes her sleepy.  She's been fortunate in that pain has been mild so that's less of an issue.  Another thing that turned out well is her voice -- sometimes people that get her surgery struggle to speak for a few days but she is already talking clearly.  Tonight she'll sleep in the recovery room and hopefully will wake up tomorrow morning feeling much better (and very hungry).

Becky and Mike took the kids today, which was a big help because it enabled me to just hang out near the hospital.  They made the mistake of ordering only a singe pizza for dinner though.  The kids demolished it, leaving them with only a single slice each.  Lesson learned, Rowan and Lucy can eat!

Tomorrow I'll swing by the hospital in the morning and see how Jenny is doing.  The plan is for her to come home around 9 or 10am.  My last chore before bedtime is to get the French Open set up on TiVo so she can watch tomorrow.  She or I will post an update tomorrow.

Surgery countdown

One week to go until surgery (June 5)! I had a great low-key weekend hanging out with new and old neighbors, not going anywhere. Got to show Rowan high-level women's ultimate on TV (college nationals was streaming live on espn.com!). Nate's uncle Rich is here visiting for the week and helping fix up our house. Main project is making the workbench space in the cellar more usable--I can't wait!

Other things going on recently:

• I've been doing some tinkering stuff with Rowan's kindergarten class...low-temp hot glues guns, hand drills, sanding, screwdriving, etc. Mostly I just set them free to make whatever they want out the bits and pieces I bring in, but I'm thinking of doing a more structured project before the end of the year (which is fast approaching!). I'd like to let them use a hammer for something... Any suggestions? I usually have 5 kids at a time, for 30 or 40 minutes.
• I got some Montessori math beads and have been introducing the kids to them. Rowan loves counting by tens, and Lucy's making good progress on ordering 1-9.
• My new favorite song (Rowan learned it at school): The Water Cycle Song. She also came home singing 'Country Roads' -- love it!
• Lucy started drawing faces and bodies...next step: arms and legs.
• I successfully replaced the screen on my iphone after a bad drop on the sidewalk. All taken apart, the phone was in like 25 parts (including the screws)...it was awesome.
• It's Nate's last week at DoJ -- Georgetown, here we come!

Finally some good news

CT scan results are in: no evidence of metastases to the lungs. Hooray! CT scan isn't as conclusive as the scans they'll do with the radioactive iodine, so it's not for sure, but it's definitely nice to finally get some good news.

Nate's birthday is Saturday...his major plan is to distribute the huge pile of mulch in front of our house around and about. Should be fun. :)

Met with the surgeon today

Jenny and I went into Georgetown today to meet with Dr. Lisa Boyle, the head of the surgery department there and also an accomplished thyroid surgeon. We arrived 30 minutes early and (amazingly) got put right through to see the nurse practitioner and Dr. Boyle. Our interactions were friendly and positive. No real new information to report except that we now have a date for surgery scheduled:

*June 5*

Jenny will spend a night in the hospital and probably take a week off work. Still working on the details there. But we're really happy with the timing, both because acting is psychologically easier than waiting and because Jenny should be recovered from surgery by the time summer rolls around. Dr. Boyle says there is a lot of flexibility in the timing of the radioactive iodine treatment so we have increased confidence that this won't disrupt summer vacation plans.

After meeting with Dr. Boyle we strolled through the Georgetown campus and then headed home, where Jenny's cousin-in-law Lindsey was covering for us with the kids. We ate dinner on the patio and chatted as the kids ran around inside and outside the house. Good times.

the bad, the ugly, and the good

The situation

The lymph node ultrasound 2 weeks ago revealed abnormal nodules, and Dr. Wexler (the new endocrinologist) wanted me to have them biopsied before splitting open my whole neck. Today was my lymph node biopsy (procedure was a fine needle aspiration, just like the thyroid biopsy a month ago).

Bad news

Abnormal nodules in my lymph nodes were confirmed malignant, and now my neck is sore from the procedure. Last biopsy left me sore for like 10 days...I'm hoping this one won't be as long.

Gory details about my unpleasant afternoon

I didn't get into the procedure room at Washington Hospital Center until 1 hour 15 minutes after my appointment time, including like 20 minutes half-dressed in a 2x2 foot changing room, and then was left in the procedure room for another 10 or 15 minutes by myself after initial preparation (waiting for pathologist apparently). While waiting I encountered not one, but two bloody pieces of gauze on the floor, in different parts of the building (I think both dropped by the same guy). And this place was in the basement, so no cell reception, leaving me unable to coordinate help picking up kids from school/bus now that I was going to be late. Procedure itself went fine. The radiologist (the one sticking me with the needle) kept saying, 'beautiful! isn't this beautiful?' and made the tech take more ultrasound pictures (and maybe even a movie??) of my neck with needle inserted. She seemed quite pleased with her needle-inserting prowess. It didn't feel particularly beautiful to me.

Having my appointment go so late (3pm) meant not only that I was later than I expected getting out, but also that I was now in rush hour traffic trying to get out of DC, and I didn't really know where I was going. Lucy's preschool has after-care, and they've been really understanding and flexible about keeping her even though it's not something we normally do, so I wasn't worried about her. But it took a while to get in touch with Andrea to make sure she could get Rowan from the bus, so that added to the stress. AND like 30 minutes (and 1.5 miles) after I left the hospital the ultrasound tech called to say I was going to need to come back next week because they needed another sample from me(!!!). I couldn't believe it. At some point, close to 4pm, I realized I was beyond late and traffic wasn't moving and I happened to be close to Nate's work. So I called him and picked him up. This was fabulous because it meant: #1 I didn't have to drive anymore (it hurt to turn my head right, not so safe), and #2 now we could take I-66 (HOV).

Anyway, after we finally got home I talked to Dr. Wexler and he confirmed that both tumors they biopsied tested positive for thyroid cancer. The call I got from the tech was because they forgot to do the needle rinse (extra test for cancer in case looking at slides was inconclusive), but turns out the slides were conclusive, so at least I don't have to go back again Monday. I do need CT scan at some point to see if it's spread to lungs too, but it's not urgent, and I can do that at Virginia Hospital Center (MUCH more convenient). NOTE: even if it has spread to lungs, it's still thyroid cancer, not lung cancer. Prognosis would be worse if it's spread to lungs, but I'm told it's still very treatable. My neck scar is going to be wicked though--I think it'll go nearly from my left ear all the way across the front of my throat. Rowan is going to flip out.

First impression of radiology facility at WHC: Not so good.

Good news

I have an appointment to see highly-recommended surgeon Lisa Boyle next Thursday, so at least I don't have to wait so long for the next step. She recently moved into an administrative position at Georgetown Univ. Hospital (she used to be a Washington Hospital Center), so I don't know if that means it'll be hard to make it into her now-reduced surgery schedule, but I should find out next week.

Georgetown and second opinion

So obviously the cancer has been the big news recently, but we have other recent news that Nate didn't share in his last post: June 1 he starts a new job, as a professor (of economics) at Georgetown's business school. We're excited about the move. He's been continuing his research while at DoJ, and this spring he taught an evening class (on pricing) at Georgetown, so the transition shouldn't be too tough. Aside from having to switch insurance in the middle of this thyroid stuff, the timing's pretty great...he'll have a really flexible schedule this summer.

This past Friday I met with another endocrinologist, Dr. Wexler, at Washington Hospital Center. Nate came with me to the appointment. WHC was something like a 30 minute drive with no traffic, plus it took a good while to get from car into the right building, and then some time wandering around the giant building trying to find the office. So not too convenient. But anyway, I'm really glad we saw this guy...he's energetic, smart, and sees a lot of thyroid cancer patients. He didn't tell us anything surprising or particularly different, but he does want me to have the highly suspicious lymph nodes biopsied just to make sure they're malignant. If they are (and they most likely are) I'll probably have a CT scan to see if there's evidence of spread to the lungs. If the lymph nodes miraculously turn out ok I may be able to get away with a less extreme surgery. That biopsy will be next Friday. Also he sent notes to a couple of good surgeons to try to get me into their schedules. I already have an appointment with another surgeon (highly recommended by my other endocrinologist and Dr. Wexler) on May 21, which feels like a long way away, but I guess it could be worse. Once I actually meet with a surgeon it'll probably be another 2-4 weeks until surgery. Then another 6 before radiation/isolation.

We've been planning two big trips for the summer, one to Amherst, MA, and Barnard, VT in early July, and one to CA at the very end of July, and it seems like depending on the timing of things one or both of those trips might be squashed. But also possible they can both still happen...just waiting to see for now.

Thanks for all the well-wishes. We're feeling very loved. :)

Restarting the blog

Jenny and I are restarting this blog after a lengthy hiatus -- our main objective, unfortunately, is to make it easier to disseminate information about her cancer and treatment, and how the family is coping.

Two weeks ago Jenny was diagnosed with papillary thyroid cancer. Her primary care physician noticed a lump in her neck during a routine visit, referred her to get a ultrasound, then a biopsy which confirmed things. If you had to pick a cancer, papillary thyroid cancer might be it. It is relatively slow growing and, because thyroid cells (and thyroid cancer cells) are among the only cells in the body that ingest iodine, often they can be isolated and destroyed by ingesting radioactive iodine. Survival rates among women in their 20s and 30s (a main demographic that develops PTC) are very high. Treatment typically involves surgery to remove the thyroid and any surrounding lymph nodes to which the cancer has spread, followed by radioactive iodine treatment to kill remaining cells. Synthetic hormones then have to be taken forever, via pill I think, to replace the functionality of the thyroid.

None of the treatments are pleasant or easy. Jenny's surgery will be more involved than some because we have confirmed that the cancer has indeed spread to lymph nodes in her neck, including to one lymph node that is a couple inches away. Hopefully we can limit/avoid infection and the scar ends up not being too big a deal. Leading into the radioactive iodine treatment Jenny needs to go on a low-iodine diet (so the surviving thyroid cells are really hungry for that iodine), which is hard to pull off because a ton of our food has iodine in it. Then the treatment hits and Jenny becomes radioactive for a few days. Have to put some thought into how we can keep her isolated, especially from the kids, but also not just sitting looking at the walls. The synthetic hormones can be a drag but hopefully we get lucky and are able to get the doses calibrated quickly enough.

This has been scary for both of us. On my side of the family, both of my maternal grandparents died of cancer, my mom's generation (the first round of Grandpa and Grandma Hammer's improvements) has dealt with it, cancer also killed an uncle, my dad's brother-in-law... so it's personal for me. As for Jenny, there is plenty of history on her side of the family too and, well, she's the one that has it this time. One of our concerns right now is a small, persistent cough that Jenny had this winter. Has the cancer spread into her lungs? Probably we won't know until after surgery sometime but man it's hard not to stress about it.

The kids are aware that Jenny has something in her throat that shouldn't be there. Rowan was initially shocked and concerned when Jenny explained that doctors would have to cut it out, but she now seems to have internalized things for the most part. (Quick kid aside, yesterday evening I threw the frisbee with Rowan for 30 minutes at her prompting... it was bliss, the first time she has really expressed interest, and we both walked away happy. She threw with Jenny this evening, Lucy was the fetcher on the many errant throws.)

Jenny is a voracious reader and has turned her attention to learning about what we are up against... she knows far more than me about the details but I am trying to keep up to the extent possible. We have been helped in this by Paul Kaplowitz, a friend through his son Josh, and a pediatric endocrinologist, who loaned us his book on thyroid cancer and recommended a couple doctors at the Washington Hospital Center. We've also benefited from the expressed love and support of our friends and family, who have called us, left messages when we didn't pick up, sent cards, texted. Thank you, it means a lot to Jenny and to me. Our ability to get through the day-to-day remains pretty good but there definitely will be some times coming up where it will be a challenge.

The next steps for us: Jenny hopefully will have an opportunity to discuss on Monday or Tuesday the results of her lymph node mapping with her endocrinologist. On Friday, we have an appointment with another endocrinologist to get a second pair of eyes on things. My parents are coming up from Richmond to help with that appointment. On Saturday, Melissa, Chris, and baby Nicholas are visiting en route to New Jersey from Savannah -- which we're thrilled about because we don't see enough of them as it is.

Jenny and I will try to keep the blog updated as we learn more.