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.

New job!

This may be my last post for a while, because I start a new job tomorrow! I'll be working at Matrix Group on their MatrixMaxx product. It'll be pretty different from any work I've done before, so I'm looking forward to learning a lot. Yay! I've been trying to make the most of my last few weeks with lots of kid time, hoping I'll deal with the separation ok.

New photos September-October and November-December.