RAI

I'm so incredibly tired, physically, mentally. 2012 has been challenging. My father died in summer. My grandma died later in the fall. My horse died 1 week and 1 day ago.

Cancer relapsed and I am going for RAI on Monday. I don't handle being isolated very well, but perhaps this is my chance to learn.

Not everything in 2012 has been bad. I have made good friends with K, fellow cancer patient, one of the bravest people I have ever known. I have made lots of progress on the new- not so new anymore- horse and that is very rewarding. I started new job in spring, and have enjoyed it tremendously.

I had a great vacation in Wyoming in August, one of those experiences I always wanted and needed.
I also had an awesome visit at MD Anderson cancer Center- can you really say it is awesome? As soon as I stepped into the hospital, it was as if it was not a hospital at all. I remember the kindness of people, staff, patients. I remember the aquarium and delicious yummy Sara Lee red velvet cupcakes.
I had great time in Herrmann Park. 

I don't know what next week brings along... but it is one step at a time. I'll be sure to update the blog and report all about what RAI really does to you. Another survival guide!

Ad Gurey Nameh

Sweetest horse, who ever lived..

"May the Long Time Sun
Shine upon you
All love surround you
And the pure light
within you
Guide your way on
Guide your way on

May the Long Time Sun
Shine upon you
All love surround you
And the pure light
within you
Guide your way on
Guide your way on"

- Snatam Kaur

In memory of Sagar, the sweetest horse that ever lived.

RIP Sagar 1984-2012
You were loved by everyone. God loves you. Death is not the end, it is another beginning and we will meet again. In the meantime, my precious horse, please find my father and grandma, who passed away this year. Lots beautiful and brilliant people have passed away this year.
You lived long beautiful life.I enjoyed every moment I spent with you. When the volcano erupted in Iceland, nothing could have stopped me coming back to you. By any means. It took 5 days, but I made it. Airport closures did not stop me, ash cloud did not stop me.
I loved you even when you bolted back to the stable, galloping and bucking.
I loved you even when you accidentally bit my thumb.
You loved grooming me, smelling my hair. You loved your watermelon.
You were a pleasure to ride. You taught me lots, you did not spook at things, well, most of the time you did not.
1984 when you were born, I was at school, being bullied every day.
I am devastated. There are no words to describe how I feel.

"

Deep in the meadow, under the willow

A bed of grass, a soft green pillow

Lay down your head, and close your sleepy eyes

And when again they open, the sun will rise.

Here it’s safe, here it’s warm

Here the daisies guard you from every harm

Here your dreams are sweet and tomorrow brings them true

Here is the place where I love you.

Deep in the meadow, hidden far away

A cloak of leaves, a moonbeam ray

Forget your woes and let your troubles lay

And when again it’s morning, they’ll wash away.

Here it’s safe, here it’s warm

Here the daisies guard you from every harm

Here your dreams are sweet and tomorrow brings them true

Here is the place where I love you."

- Katniss Everdeen

Verdict

Thyroid WBS results are finally out: treatment option, the only one is radioactive iodine, aka RAI. It will probably be done sometime in this month. Happy Halloween.
I was hoping that the scan result would be clear. It was not.
I was hoping that it would not need treatment. It does.
I was hoping external radiotherapy would have been an option. It is not.

I'm just going to let it go, and go with the flow. Thanks be to God that there is something that can be done.

How to survive Thyroid WBS, preparation by Thyrogen

Thyrogen, AKA recombinant TSH is familiar to some of us.
This was my first encounter with Thyrogen- and I do not regret it.
Thyrogen is given as injections in a muscle, and I was lucky that colleagues at work could help. I guess one of the best and most recommended injection site is your buttocks.
Injection itself did not hurt much at all. Perhaps because some very skilled colleagues were there... There aren't much of Thyrogen in the syringe, and if it is given slowly, then there shouldn't be much pain. That's the good part of it. The very best part is of course that there is no need to come off Synthroid weeks before scan, suffer the low-iodine diet and feel miserable!
I would recommend Thyrogen, even if you are not fond of needles and injections. It is worth it.
I was prepared for side-effects too- nausea and vomiting weren't good options for me who had to fly to another city and hospital for the Thyroid WBS. No one likes nausea and vomiting anyway.. And then low iodine diet does not always stimulate appetite. Shame if it all was expelled out in an instant!
I had some nausea- I was on Zofran (ondansetron) and nausea was not an issue. Headache was. It was ever present, nothing seemed to help. Only when I fell asleep it was somewhat relieved on the following morning. No big deal really, compared to what weeks without Synthroid would do. Been there, done that too and never again want to go through the same. I would not wish it to my worst enemy either.

Thyroid WBS was pretty easy. Swallowing liquid iodine (tiny dose measured in a syringe) was easy, even for me who finds swallowing tablets very hard. I was told to SWALLOW it right away, not swirl it in my mouth, which I must have done, involuntarily and unintentionally. If someone tells you to swallow, not taste, of course there may be temptation to TASTE it too. Which is what I did, and I think it showed as increased uptake in the mouth and upper throat region. Perhaps this also explains the pain and discomfort I had in my mouth- salivary glands appeared swell up. But hey, not a big deal- I was on Thyrogen! My head felt very very round, congested, huge. On the following morning most of the weird sensations had gone. I was told to drink water and I did as if my life depended on it: close to 3 liters that day. Maybe more. All I know is that I was in the restroom numerous times!

Result of the scan is another topic for another blog post... I have a feeling radioactive iodine, mega high dose is expected... Good old RAI.

I'm not sure about whether or not insurance covers Thyrogen. Some may not.
I'm also not sure if Thyrogen is available everywhere- there have been reports of shortages.

This is what Thyrogen website says:

"In order to prepare you for ablation, your physician must stimulate remaining thyroid tissue to absorb the radioactive iodine that you ingest in the form of a pill or liquid. Stimulation can be achieved in two ways. The first method, withholding thyroid hormone, was used exclusively until Thyrogen was introduced. Withholding thyroid hormone replacement allowed thyroid hormone levels to drop before ablation, therefore making you hypothyroid. The second option involves the use of Thyrogen (recombinant human form of TSH) which can be injected into patients prior to ablation thus avoiding hypothyroidism. In essence, Thyrogen allows your physician to start you on thyroid hormone therapy right after your surgery, thereby avoiding the signs and symptoms of hypothyroidism."
http://www.thyrogen.com/patient/about/thy_pt_about_thyrogen.asp 

Horses

October Breast Cancer Awareness Month- Mammogram survival guide

There are huge number of websites that list risk factors, symptoms, prognosis, treatment options etc for breast cancer. There is no need to repeat them here. www.mdanderson.org is one of my favorites, not just for finding out about cure rates, but for patient stories! Those are mostly positive, encouraging and good adverts for the cancer center too. Sure, people get cured from cancer, some recover partially and some not..

When it comes to mammograms, you can not find bigger coward than I am. I was supposed to have my first mammogram when I turned 40, but I did not go. It was in the back of my mind more than once, but I always managed to push it further back and then it did not bother me for months and months. Until thyroid WBS discovered suspicious lymph nodes in January 2012. Awww. Mammogram time.

One benefits of working in hospital is that I can usually track down the people I need to talk to. This is how I found the radiologist, who works in mammograms, sitting her face glued onto computer screen examining films. I explained what the situation was, and that panic had set in. I do not want to have mammogram, but boo hoo I may really need it now and it is better to appear voluntarily, than being dragged in in handcuffs and shackles. That would be a cartoon moment! Sure. When I entered the radiologist's den, I did not expect to undergo mammogram in next few moments, but there I was, still not really wanting to be there, but at the same time quite fascinated by all that was going on.
Pain? Yes, there was some, but it's not as bad as e.g. broken bone. It is fleeting, momentary pain, that passes as soon as your breast is no longer squeezed between the "plates". At one point all I was seeing was black, realized I would pass out, but then the exam came to an end. It was not comfortable for sure. My pain threshold can be quite high, but it depends entirely on if I am in there voluntarily, depends on what's being done. Of course I tried to wriggle away from the pain/discomfort. No one really likes it, well, not all of us anyway. Pain caused by pap smear is almost intolerable, but somehow I have survived several of those too.. but that's another story another time.
Relief? Yes, it was done. Nothing malignant was found. I did not cry, pass out, laugh hysterically, run out screaming out of the exam room. I did not punch the radiology tech- who by the way one of the most compassionate individual I have ever met.
Humiliated? No, no. I can't say I was. Not at all. It was nowhere as bad as pap smear. Ask for female technologist if you feel more comfortable that way.
Would I go back again...? Yes, and no. I guess I would. With painkiller. I truly don't know if Brufen, Tylenol or similar would make any difference, but it is worth a try. Schedule mammogram sometime in your mid-cycle. It turned out that my period started the day after- perhaps this is why I had quite severe pain at times.
Don't believe everything they write in the Internet. Google can be your worst enemy as well as best friend when it comes to finding more information about mammograms. Don't take my word for it either, go and get it done. You can always run screaming out of the room, and never return. You could also have quite a good experience and it encourages you to go back. Take someone with you, take painkiller, take Valium, have a drink, but go anyway.

Encourage your female family members and friends to get it done too.

Medical Center

Stuck...

"Please let me take you
Out of the darkness and into the light
'Cause I have faith in you
That you're gonna make it through another night
Stop thinking about the easy way out
There's no need to go and blow the candle out
Because you're not done
You're far too young
And the best is yet to come"
Nickelback- Lullaby

Next week.. I am trying not to think about it. First step is Thyrogen injection... then hop on a plane and fly to another city and another hospital, which might actually feel like home by now.
I am trying not to cry. Trying not to go too far ahead and think about my options.
It is cancer, but it can be treated. I have to keep faith and hope that the cure is out there within my reach.
What am I really scared of? Needles? Sight of blood? Pain? Bad news? Good news? Waking up to reality, realizing all of a sudden that none of this was true?
Knocking myself out with Valium sounds like a very valid option, but then I would not living this, and would probably not learn anything at all. Would not remember a thing. Yes, that is good, but it just bypasses chapter in my life, chapter that I need to live.
I will know more for sure next week.

It does not change the fact that I am scared.