False alarm?

I’ve been a bit short of breath since yesterday morning and inhalers and neb treatments weren’t helping.  I’d also started having swallowing problems again, after having none for a week or so.  So back to Kaiser urgent care I went today.  But hey, it’s been a week and a half since my last UC visit, so that’s an improvement, right?😄

They gave me my money’s worth - labs, EKG, CT scan of my neck and chest, palpating of the surgical site, and of course a lot of questions about how long, and how often, and so on.  The UC doc spent a fair bit of time on the phone with the ENT on call and finally decided that, because I hadn’t experienced any distress during the 6+ hours I was there, that this was probably just post-op recovery woes.

Among other things, the CT found some lung nodules, which the doc told me are “tiny”, not that unusual, and no cause for concern.  After my experience with these thyroid nodules, I’m not so sanguine.  I wanted to let my pulmonologist know about the scan, but apparently he’s no longer with Kaiser. 😢. A shame - he was a lot of help when I had a very stubborn asthma flare after my first bout of COVID.  I guess I’ll reach out to my allergist, both to tell him about the scan and to ask him to recommend another pulmonologist.

Poor Chief - he sat there with me, reading and listening to music on his phone until the battery ran down to 10%.  After that he started to get a bit punchy - “Hi, I’m Dr. Smartypants!” 😂. Well, it kept us entertained while we waited.  And waited…

The rash saga continues but seems to be winding down.

(This should have posted 3 days ago.)

This is the first day since this whole rash business started that I haven’t had some temporary (1-3 hours) rash sprout on the underside of my forearm, the back of my hand, or elsewhere.  My primary doc relayed my info, with pics, to dermatology.  The doc covering for my dermatologist recommended a different antihistamine, but this was late in the day, so that might not happen until Monday. 😥. However, given that I haven’t gotten any new rashes today (finally!), and the original rash areas are only mildly itchy now, I’m not too upset. 

I still find myself dragging during the day but can’t tell how much of that is post-op recovery and how much is the meds I’m taking for this stubborn rash.  I cut back on the Rx antihistamine, which has drowsiness as a side effect, but that doesn’t seem to have made any difference.  Twice this week I’ve slept late, had breakfast, then gone back to bed for a hour or so, which I almost never do.  I was feeling a bit out of it this morning.  The Chief and I went grocery shopping today and I was hanging on to that cart to steady myself.  Weird feeling!

Another tech week on steroids

 In June, the steroids were for the recurring sinus infections I'd been getting since the beginning of March, which made Patience tech week more stressful than tech week usually is.  This time, the steroids are for the rash that has been plaguing me.  I think the meds finally have it on the run, but the prednisone has my sleep cycle all shot to pieces.  Last night the Chief had to drive me to the theater because I felt enough out of it that I didn't feel safe to drive.  I ended up sleeping, soundly, in the car most of the way to the theater, so that was the right call.

Today I got up late, had breakfast, then went back to bed and slept another hour or two.  We both celebrated when I learned tonight's rehearsal has been cancelled so the lighting crew can replace many of the instruments.

The itch factor has finally dropped to only a 1 or a 2, though I still get occasional, random breakouts.  It's very weird - I'll get a new patch on a forearm or upper arm, which then fades after an hour or few.  However, I don't need to apply as much cream to get relief.  I also haven't applied it but once a day the past coupla days, thanks to tech week throwing me off.  I should probably go back to 3 times a day, or at least twice, just to make sure we have this thing under control.

Talking to "my" people as I'm wigging them can still be tricky.  Who knows how long it will be before that vocal fold is back in working order.  For now, I have a voice that cuts in and out, coughs that sound like sneezes, and an inhale for those coughs that still sounds wheezy.  The surgeon explained that my breathing is gonna sound weird because of that inactive vocal fold.  Oh, and the tremor from the prednisone is fun, too.  Good thing I don't have to help anyone with their eyeliner!  

 

Maybe the meds are *finally* starting to kick in?

The itching woke me up again today.  However, after the first round of meds and creams, the itch started to back off.  My face didn't look quite as inflamed by dinnertime as it does in these pics, and the itch is down to a more manageable level.  Given that I started the prednisone taper this morning that starts at 60mg, not the 40mg I'd been taking, that's not terribly surprising.  (I haven't figured out yet how to get these photos on the same line. 😖  Last night I wouldn't have been surprised to wake up with my eyes swollen shut but things seem to be calming down.

The Chief has been taking very good care of me:  fixing me eggs for breakfast every morning, trying to keep up as I figure out how to adjust to life on synthroid, helping me with theater stuff (climbing ladders in a storage bay, carrying things for me while I'm under my lift restriction, etc.), going to the grocery store for things we never used to buy (cottage cheese and canned fruit), and generally trying to help me recover so I can return to life as usual. I'll probably still ask for a little help with meals, maybe twice a week, but having such a supportive husband is making this whole business a whole lot easier!

   

"You're back *again*?!"

 This rash continues to spread and I continue to wake up scratching.  The Chief ferried me back to Kaiser (trip #4 in 6 days, for those of you is keeping score), where they gave me another 3 weeks' worth of prednisone and had me double up the Rx antihistamine I was given earlier this week.  They also recommended a stronger ointment to use on the rash except for my face.

The triage nurse recognized me; "Weren't you here earlier this week...?"  Yeah, I should just book myself a cot and a locker. 😵 

This is wearing me out.  I feel like this rash has me living at the urgent care unit, when I should be sitting around resting up.  (I actuallly did nod off while I was waiting for the doc.)  Having this persistent rash on top of the cancer is just adding insult to injury.  Or maybe injury to injury?  Anyway, this whole business of aging, with its concomitant system failures, is a system in drastic need of an overhaul!

Better?

The rash continues to spread (my face looks kinda scary now) but the steroids have finally kicked in, taking the itch from a 7 down to maybe a 3 or a 4.  It still woke me up this morning, but it’s been worse.  Talking is gonna be an effort for a while, but swallowing and yawning are back, and laughing no longer hurts.  For the first time since my surgery, I don’t feel the need to go to urgent care or even call the advice nurse.  Hallelujah!

Pathology report

This just in - both masses were cancerous, as I'd expected.  It's "papillary carcinoma, infiltrative follicular subtype".  The tracheal scrapings and lymph nodes removed were not affected - yay - but unfortunately, the surgeon was unable to get clean margins.  As a result, I'll be radioactive for a bit in a coupla months.  My endocrinologist will be the one who schedules that for me.

 

Back to Kaiser for a 3rd visit :(

 Started the new meds and cream last night.  Woke up this morning to find the rash was continuing to spread and had expanded onto my chin - oh just ducky. 😒  I got a video visit, but the doc told me he couldn't properly evaluate me that way; I'd need to be seen in person.  He also warned me that, depending on what they saw, they might need to send me to the hospital.  Bleah!

So I packed a bag, just in case, and the Chief drove me back to Kaiser urgent care.  Fortunately, at 3pm the ENT docs were still there.   The UC folks sent me up there to get my throat scoped; uncomfortable process, but learned that my L vocal fold isn't really working.  Not terribly surprising, given all the digging and scraping my surgeon had to do, but weird to see one vocal fold doing its fluttery thing while the other just sits there.  The ENT said that could take 2+ months to recover, which kinda lines up with what I found online.  That explains why my voice cuts in and out and tires so easily, and why a nebulizer treatment isn't as effective as usual - my lungs aren't the problem.  The UC doc (or was it the ENT?) did say a saline rinse could help.  I'll have to update the family SLP with this info once I get the pathology report back.

UC gave me a nebulizer treatment and a dose of steroids, which helped the rash eventually.  The itch is now down to maybe a 3 from a 7; I might actually get a good night's sleep tonight!  It no longer looks such an angry red, either, even if it has spread.  The bad news, though, is that the UC doc told me contact dermatitis rashed typically need 10-14 days to run their course!  The good news is that they sent me home instead of to the hospital.

I was amused when the UC doc popped in with the doc I'd seen at Sunday's visit - I guess that's what happens when you're a regular!  They compared notes on the state of my rash - had spread a good bit since Dr. 1 saw me on Sunday, but didn't look as red and inflamed. 

If you see me in the next week or so, the rash may still look pretty bad but rest assured it's not contagious. I may not be very talkative given that I'm working on only one vocal fold, so you won't have to worry that I'll regale you with my tales of woe. 😊

Making progress, and another Kaiser visit

Back to Urgent Care this afternoon but I was able to drive myself - no lightheadedness at all today.

The rash continues to spread, slowly but surely.  It looks angrier tonight than it did when I took these photos this morning.  I look forward to the day I don't have anything to log here.  When the triage nurse asked me.to rate my pain, I told her I don't have any, but the itching? That's easily a 7!

As luck would have it, my surgeon called while I was with the on-call doc.  They agreed this is an allergic reaction, and we're stepping up the meds - prednisone and a prescription antihistamine.  I also seem to have collected a case of impetigo, so I've got an antibiotic cream in reserve in case the other meds don't get rid of it. I sure hope all this works - it's gotten so bad that it hurt this morning when the shower water hit the rash. 😩

If Kaiser had a loyalty program…

 … I’d be in the top tier!  I’ve been calling their advice line pretty much daily since my surgery, and this morning the Chief took me to Urgent Care to figure out what combination of ointments to apply.  The verdict:  Aquaphor 3x/day on the incision itself, kenalog twice a day on the itchy area around the incision, and if I need the Benadryl cream, apply it at least an hour after the kenalog.  I can also take oral Benadryl as needed, although this morning’s dose really made me light-headed.

I just realized that I’ve probably been messing up my synthroid because I haven’t been waiting at least 4 hours to take my calcium gummies.  This is taking me back to last year, when the Chief and I both had surgery in the same week.  We were on different meds and our respective meds were on different schedules - what a complicated mess!  It took a friend close to an hour to figure out the Chief’s schedule.  This isn’t quite that complicated, but I can see I’m going to need to set reminders on my phone, at least until I get the hang of this new regimen.

One small (or not so small) mercy - I haven’t been having much pain at all.  The itching is so bad it almost hurts, but no actual pain since my first day home.

4 days post-op and a complication

 

Looks like another mouth, that took a pretty solid direct hit!  Little wonder the itching woke me up in the wee hours.  Turns out I'm allergic to the skin glue. The on-call doc recommended benadryl, both cream and pill, which I administered as soon as the Chief got home with them.  It's helping, though I don't plan to skip any doses today or tomorrow.

Three days post-op

Things have gotten quite itchy around that slash.  I ended up getting a Rx for an ointment to apply around but not on the area.  It even woke me up at 4:30 this morning, itching so much it almost hurt.  Between that and the congested, wheezy inhale, I wondered if I'd have to make the Chief take me to urgent care.

It didn't come to that but I may yet call the advice nurse, again, to see if I should be worried or just need to be patient. 

The itch goes all the way up to my jawline and down past my collarbone and out toward my shoulders.  That's a lot of area to slime with this ointment.  I may end up with grease stains on the V-neck shirts I bought for my recovery,  but oh well.

 

I need to remember to cut myself some slack.

 When I'm just sitting around doing nothing, I don't feel bad.  When I stand up, though, I sometimes feel just a touch light-headed or get a slightly unsettled stomach.  Ginger takes care of the stomach just fine.  As for the other, I need to look at that slash across my throat to remind myself that I just had major surgery. 😄

 Oh, and in that vein, I've decided not to take any classes this semester after all.  I was looking forward to getting back into a classroom but I think that wouldn't be a great idea right now.  I will still tutor in the Writing Center, though of course I'll have to take a break while I'm "radioactive". 

It was sort of a relief.

 The Chief and I have known SO many family, friends, and acquaintances who've gotten cancer, many of whom died from it.  Some of them (I'm look at you, Mom) have even had more than one kind.  The Chief's had cancer, too, so I was kinda wondering when it would hit me.  When the biopsy results came back, it was almost a relief; there's my cancer diagnosis - box, checked - and it isn't breast cancer.  I'm not feeling too great about it right now, of course, given what the surgeon found, but the prognosis for this kind of cancer is about as good as you could wish.

Post-op throat

 I had expected my throat to feel kinda raw and abraded because they would have to intubate me.  As it happens, because they both lubricate the tube and administer a local anesthetic, that hasn't been a problem.  Instead, it's been all the muscles in the neighborhood that are aching.  I saw a speech therapist last week who warned me that "swallowing will be weird" - she wasn't kidding!  Yawning is a bit of a challenge, too - my throat doesn't want to stretch for a proper yawn, at least not yet.

Things have been shoved around, pushed, pulled, rearranged (because of course there's no more thyroid taking up space), poked, prodded, and scraped.  My stomach is mostly settling down and I no longer have a headache (hangover?) in the wake of the chemical cocktail they pumped into me in the OR.  I also slept better last night - not as uncomfortable, less coughing, but still had some very weird dreams.

I find that I don't want to turn my head independent of my torso yet, or at least not very much, and my lungs definitely need their PT.  When I inhale through my mouth, e.g., prepping to cough, I wheeze in a way that the Chief admits he finds a bit scary. 

The incision is wider than I thought it would be, maybe because of all the extra cancer the surgeon found?  It's almost 4" wide, and purple, where the surgeon used a purple marker to indicate where he planned to make the initial incision.  Imagine if he'd used a red marker! 😄 

 Oh, it's starting to itch!  Unfortunately, I can't put anything on it to ease the itch until Sunday; for now, I just scratch around it and try to be content with that.

Getting my throat cut (aka thyroidectomy) and words you don't want to hear from your surgeon

 Mom used to joke, when she was particularly hungry, that "My stomach thinks my throat's been slit."  That cracked up my pre-op nurses when I told them I was getting hungry. 

 I think I scored points with my anesthesiologist when I guessed, correctly, that her name was Lebanese:  Arabic-sounding but with a French spelling.  In fact, my care team was a regular mini-UN: countries represented included Ethiopia, Lebanon, Korea, Phillipines, Nepal, and Cameroon!  Pretty cool! 

The OR was kinda fancy - narrow operating table, but it felt like it had lots of places where they could attach wedges or something to make sure I didn't move while the surgeon was digging around in my throat.  It also had 2 great big lights overhead - think an overgrown Ring light - that seemed to have a series of LEDs in them and were on moveable arms.  The anesthesia kicked in almost immediately so I don't remember a thing until I woke up in Recovery.

Except they call it the PACU - Post-Anesthesia Care Unit - which doesn't begin to convey what you go through.  Not just trying to come out of anesthesia, but dealing with the way my throat muscles feel after all the pushing, pulling and carving they were subjected to.  I got a rather lame dinner - meat loaf with gravy (which I didn't touch), some sad mashed potatoes, cooked carrots, diced pears (the only thing I finished), and a tiny container of ice cream so bad I didn't bother after the first coupla bites.  The Chief fed me some chocolate pudding once we got home, just to get some calories in me.

Practically the first thing the surgeon said when he came back to check on me was, "Your surgery was (tiny pause) challenging."  As expected, the surgeon found cancer in the R lobe, where we thought the only cancerous nodule was. It was “tightly adherent to the trachea and I had to shave a little bit of the trachea to get it out.”  Unfortunately, there was also a surprise in the L lobe:  “a similar-appearing mass that had grown through the thyroid gland and was tightly adherent to the nerve to your voice box and also was trying to extend into your voice box.”  No wonder my throat muscles are so sore!

 

That first night was rough - my face and fingers started feeling tingly, so I took some calcium, then got so nauseated that the Chief had to go out to get a Zofran Rx for me.  (Throwing up didn't feel as bad as I feared, but not what you want to be doing immediately post-op.)  Turned out, the pharmacy gave him my calcitriol Rx, not the Zofran, so he had to go back for it yesterday morning. 

Now we wait for the pathology report to come back.  Not good when the mass has grown through the original organ, but it doesn't sound like they had to take any lymph nodes, which I hope is a good sign.

They have to wait at least 6 weeks for things to heal up before the radioactive iodine, which my endocrinologist will set up.  I have a phone appointment with her on Sept. 9.

 

The medical adventures continue; cancer

 Two years ago I tore a meniscus (that HURT!!!) and started months of PT.  Whether because of the PT or the way my gait changed, the arthritis in my R hip got so bad that last year I ended up getting a new R hip, just 3 days after the Chief had surgery to remedy crippling sciatica.

In November I had an MRI of my arthritic neck.  It found a daisy chain of bone spurs, and oh by the way, you've got some thyroid nodules.  I had to have them biopsied (not fun!), twice. 

The 2nd biopsy was in January.  For some reason, the sample didn't get sent for genetic testing, as it should have been, until my endocrinologist followed up in May.  Came back as papillary thyroid cancer.  Met with the surgeon, whose colleagues think very highly of him, in early June.  Finally had my thyroidectomy the other day; that gets its own post.

I guess it's that time of year again :(

Last night the Chief had to take me back to Urgent Care because my asthma was getting bad again.  It started with Wednesday's rain, and not being able to get the vials for my nebulizer until Saturday.  They had to give me a triple neb dose and 120 mg of prednisone.  Needless to say, I wasn't good for much today.

I gotta get this under control soonest, so I can start practicing in earnest for my Messiah gig; listening to recordings & following along in the score can only take me so far.

New "shoes"

I have new "shoes" as of last week

I've been dealing w/ plantar's fasciitis since at least December, but a coupla weeks ago it was getting worse.  (Dancing a cachucha barefoot in Gondoliers' Act II probably didn't help.)  My GP sent me to a podiatrist, who told me that, in addition to the plantar's fasciitis, I have 3 inflamed metatarsals.  Who knew bones could become inflamed?!?  Anyway, left untreated, the periostitis could become a stress fracture!  He sent me home in the boot on the left. and told me to get the night splint on the right in the pic.  I have to wear the night splint to bed, to keep my foot flexed and stretch the plantar's fascia.  Yes,  it's as uncomfortable as it looks.  I've been wearing it since Friday night, but only last night did I finally get the straps adjusted so they're tight enough to keep the thing on but not so tight they dig into my foot.  Next goal - sleeping through the night.  Wish me luck!

Cancer, the serial killer, is at it again

Not only is the Chief undergoing treatment for cancer, but a friend's MIL has a stage-4 diagnosis, and another friend at church was recently diagnosed and will soon start chemo.  One of her daughters, also a church friend, lost her husband to cancer just a few years ago, so she's having a particularly difficult time of it.

Last week, a couple we know who for the past decade or more have done fund-raiser bike rides for cancer research came to the show I was teching.  (She's a cancer survivor.)  I shared about how VERY many people the Chief & I know who have had cancer, and how many we've lost to it.  "Kill it with fire!  Bury it with a mouthful of garlic and several stakes through its heart!"

This is the first January in 3 or 4 years when we haven't attended a funeral.  When I start to think of all the people I've known who've dealt with cancer, I keep thinking of more - there are SO MANY.  😢