It’s 9 o’clock at night and the edges of the Band-Aid that was adhered to the front of my neck five hours earlier are starting to itch. I’ve already performed the painful, rip-it-off-fast procedure to the cloth tape that, earlier, secured a bit of gauze against the vein on the inside of my left arm where the nurse drew blood. Now, the remnant adhesive causes my skin to stick together for a moment when I straighten my arm back out, and the red areas from where I pulled the tape off is much more angry-looking than where the needle pierced my happy-to-oblige vein.
I want to remove the Band-Aid from my neck, but I’m too tired to take a hot shower to melt any leftover adhesive, and I know I’ll just get angry if my hair sticks to it in my sleep. Then again, there’s also that thought that if I remove that Band-Aid I’ll see the spot where the ENT specialist injected a numbing agent under my skin, causing my mom to exclaim, “It looks like you’ve got an Adam’s apple!” This is also the spot where, a few minutes later, he performed a fine needle aspiration on the nodule on my left thyroid.
There were no mirrors in the exam room. I never saw my momentary man-throat, and I did not watch him pierce the sensitive skin of my neck, or see the dark chocolate red liquid (blood from the cyst) fill the syringe — although I did see him eject the sample into a vial for the pathology lab. That being said, I think a part of me is operating under the “if I don’t come face-to-face with the reality of what just happened, maybe I can get away with not thinking about it for a little while longer.” Hence, leaving the itchy Band-Aid where it is. At least for now.
This story actually started on February 1. It was a Sunday and I had scheduled an MRI of my cervical spine, or my shoulder/neck region. The MRI results came back: “Incidental note is made of a prominent somewhat heterogeneous appearing thyroid with an approximately 1 x 1.5 cm dominant hyperintense left mid pole nodule.” Whatever that means. The doctor that ordered the MRI called me, and told me to come get a prescription for an ultrasound.
The ultrasound was completed on Wednesday, February 4, and it found that my right thyroid lobe was normal, and so was the isthmus, which is the part that connects the two lobes (making a butterfly shape, if you will). But my left thyroid was of concern: “The left thyroid lobe measures 4.9 x 1.7 x 2.6 cm. At its middle pole there is a 2.9 x 1.6 x 2.2 complex, hypoechoic nodule of irregular borders, with microcalcifications and with central color flow.” The ultrasound recommended a fine needle aspiration, and I was referred to Dr. J. Michael Pardo of Annapolis ENT.
Which brings this story forward in time, to today and my 3 p.m. appointment with the ENT (ear, nose and throat) specialist. I was incredibly impressed with the way Annapolis ENT’s office was handled. I thoroughly enjoyed meeting Dr. Pardo and found him to be brisk (but not cold), knowledgable (but not a know-it-all), and considerate. I felt that he listened to me, and was pleased that despite a busy waiting room he did not hesitate to explain things or to perform an aspiration that he initially wanted me to schedule with another lab. But I’m getting ahead of myself…
Upon reviewing the written results of both my MRI and ultrasound, even the doctor himself couldn’t help but allow surprise to register on his face when he saw how big — in relation to the left thyroid lobe — my suspicious nodule is. The first bit of good news was that even though there is a relatively significant discrepancy between the estimated size of the nodule from the MRI and the exact measurements of the ultrasound, since the two tests were conducted only done three days apart he didn’t think my nodule was growing exponentially fast (which would be a very, very bad thing).
After delivering that bit of news he grabbed a stool, sat down and rolled on over to me and delivered the rest of the news plainly and without embellishment. The bad news is that I have the worst kind of nodule a person can get — a singular, relatively large one (it’s 2/3 the size of my left lobe). These ENT docs much prefer to see a greater quantity of smaller nodules, which are almost always benign. The good news is that of these singular, large nodules about 10% are cancerous, which leaves me with a 90% chance of NOT having thyroid cancer. Looking back, I’m not sure if a large benign mass itself is something to worry about, but I’m sure we’ll discuss all of that soon enough.
Dr. Pardo could feel the nodule with his fingers, and was in the process of telling me that I’d need to get it biopsied at a lab across the street in the Anne Arundel Medical Center when my mom spoke up and inquired, “Do you think they’d take us today?!” It was already 3:30, and we explained that we had driven almost two hours up from Southern Maryland, and if I had to schedule a biopsy at another venue it would mean a second day off of work. Dr. Pardo seemed genuinely surprised we had come so far, and immediately set his mind to coming up with a new plan of action.
He had already told me that my nodule is large enough that the biopsy would not have to be ultrasound-guided, so next he volunteered to take the sample via fine needle aspiration right then and there. The deal was, I would still make the appointment with the other lab for next Thursday — because that lab has the ability to take the sample and put it right under the microscope, and if the sample does not contain enough cells to make a determination they would be able to take another sample and try again. But since he — Dr. Pardo — does not have the lab capability in his office to “read” the sample, he has to send it out. So, if it turned out that he didn’t get enough cells in his sample then I would already have a date scheduled for a re-do. Pretty smart, Doc.
What stuck with me is that apparently there is a reason — aside from Dr. Pardo’s upcoming last-two-weeks-of-March vacation — to get all of these tests completed and the results in as soon as possible. Dr. Pardo was rather unwavering that we take care of this NOW, but he was also extremely considerate of the fact that I’m traveling quite a distance to come to his practice. He said we’d talk on the phone Monday or Tuesday — after he gets the lab results back of his submitted sample. The possible results could be: a) cancer; b) possibly cancer; c) incongruent results; or d) not enough of a sample to make a determination.
He sent me down the hall to have my blood drawn for a full thyroid check-up, the results of which should be available when we chat early next week. If I need to keep my Thursday appointment I will, and we will reconvene via the telephone with those results afterward and discuss a plan of action which may or may not involve removing half or all of my thyroid.
*deep breath* No, I don’t think I’m quite ready to remove the Band-Aid on my neck just yet.