T+1. The Day After

Okay.  Here's the latest update.

In general, we've been very pleased with the MD Anderson experience, considering the circumstances.  They provide the best care anywhere.  The staff, from doctors, to nurses, to the blue collar staff.  However, I almost lost it last night.

I had gone home last night around 8:00 to check on the kids and grandparents.  In reality, I was making sure the grandparents had survived the day.  But, I checked homework and got on to the kids for their low grades -- a 92 is low, right?  After we got the kids to bed, I headed back to the hospital, 45 minutes away on a good day.  Arrived around 10:40.  Visiting hours end at 10:00, but the patients are allowed 1 overnight guest (which, of course, is me).

Flashback to June, our last foray into the MD Anderson complex....several nights in a row, I arrived after 10:00, even as late as after midnight.  On some evenings,the security guards checked my ID, gave me an ID sticker, then sent me on my way.  Other times, they just told me to go on up, without checking ID.

Return to present:
I parked at the Mays building, a sister annex to the main building connected by a skyway.  It's cheaper and easier access than waiting for valet.  However, all the entries from the parking garage to the Mays building were locked- dangit.  I had to park valet at the main entrance.

When I walked in, I encountered the security guard and told him I was here to see Jennifer.  He asked for the room number and my ID.  He then proceeded to walk over to a phone to contact the hospital administrator and inform them of my purpose and to get permission to send me up.

Here's where I almost lost it:  they asked me why I was coming in so late.  I wanted to reply "Nunya," but I didn't think that would get me very far.  So, instead, I said I had to go home to check on the kids and grandparents and I just got back.  I did use a sarcastic tone (score one for me).  The administrator was going to contact the nurses station and call the guard back with instructions.  We waited about 10-15 minutes (him staring at me).  She never called.  He called back and was finally given the go ahead.  Dang, that ticked me off.  I don't fault either the guard or the administrator.  The guard was doing his job and the administrator was doing hers....I was tired and didn't need the extra drama (insert Oscar Winning Performance here).

Ha!  I made everybody read that sob story when I know you really care about how Jennifer's doing.

Here goes:
The endocrinologist came by yesterday and informed Jennifer that her calcium was borderline low (just below normal), and her PTH was in shock, so they'd have to keep a close eye on her to ensure her calcium doesn't drop -- very dangerous if it does.  The symptoms we have to watch out for include tingly hands and feet, and numbness around the mouth and lips.

Last night, Jennifer had a couple of episodes of the tinglies, so they started her on a calcium and vitamin D supplement.  The tinglies went away shortly thereafter.

We saw the endocrinologist twice today.  The first time was a team member (awesome guy with a good personality ---not to take away from the others).  He questioned us a bit on the episodes, and told us some general info...most importantly that they will try to get us out today.  (Arkansas game here I come).  The second visit involved the team lead (great person too).  She informed us they will up Jennifer's dosage of  calcium and vitamin D.  Then we coordinated labs and clinic visits for next week.  While at home, if Jennifer gets tingly again, she'll need to popp some heavy duty Tums or Rolaids with calcium.  It the tingle doesn't go away in thirty minutes, she should pop some more and get to an emergency room...as quickly as possible.  Great :-(

Anyway, it looks like they'll release us today.  Now all we have to find out is who has control over this dang drain tube, which isn't holding its suction.  If we can get that out, then all will be better.  However, I have a feeling it's coming home with us for a day.

We are now waiting on a blood test and a final meeting this afternoon.  Will keep you posted.

T-Day. (Updated 4:10 pm)

No.  It's not Turkey Day.  no Football game worth watching.  It's Thyroid day.  Time to get it out.

Recap of yesterday:
We arrived at MD Anderson yesterday to have an Ultrasound of Jenifer's thyroid and to go through the pre-op routine of giving blood (twice) and getting clearance from the ane anast anesthesiologist.

The ultrasound results showed spots on the thyroid.  The technicians wanted to do a needle biopsy, but Jennifer convinced them that its pointless since the thyroid is coming out today.  Score One for Team Jennifer.  The lymph nodes in the surrounding area did not sow any abnormalities....great news.  I believe that means we are only looking at a thyroidectomy with local dissection of lymph nodes...not near as intrusive as last time.

The ane anast anesthesiologist meeting was standard....don't sue us if anything bad happens.

The surgery will take about 4-5 hours.

Side note good news:  JJ, I'm excited to hear your daughter did not have to go through the follow-up radiation.  You're blessed in many ways.

Today:

We arrived at 5:15 am....geez, are there any doctors that like to sleep in?  We checked in, and went to pre-op.  the pre-op/post-op area is a large semi-private room that houses about 34 bed stations. once we were placed in station 5, we sat there for about 45 minutes (just like a regular doctors visit).   Than the flood gates opened.  Teams of surgeons, ane anast anesthesiologist, assistants, OR nurses started the cattle call.  All of our visit was completed in a span of twenty minutes.  The surgeon confirmed that the ultrasound only showed the thyroid as being problematic.  The lymph nodes looked good.

Now...I sit back in the Geranium Waiting Area with my Diet Dr. Pepper and wait.  My first update should be in a couple of hours.  I'll update my post as soon as I am able.

Please pray for Jennifer.

Update: 10:05 am
Met with Dr. Meyers.  The surgery went better than expected.  Was able to remove the thyroid, re-implant the parathyroid glands (smaller glands embedded in the thyroid).  He also removed a few lymph nodes on the left side of the larynx.  She breathing on her own which is a good sign the the recurrent laryngeal nerves were not damaged.  The also control the vocal cords.  The impact on her voice is yet to be determined.   She will be in recovery and well get to see her in about an hour.....
More to come...

Update 1:45
Just saw Jennifer in recovery.  She looks good....much better than when that Mac truck hit her in May.  She's still under the influence of the ane anast anesthesia and pain meds, but her voice is clear -- no nerve damage that we can tell so far.  I've just grabbed a bite to eat (I know-- not exciting or pertinent to the story, but I haven't had Anyang since supper last night...I WAS HUNGRY!!!!!).  Anyway, I'm going back into recovery until they can find her a room.  Talk to ya later.

Update 4:10 pm
Jennifer FINALLY left recovery and is in a room.  It took a while for her to get processed.  Met with the Endocrinologist to discuss the impact on her thyroid hormone and calcium.  Obviously, she's looking at synthetic thyroid hormone for the rest of her life...nothing new.  The calcium is regulated by the parathyroid glands that were mentioned earlier.  There is a chance that the PT may not "take" when it's re-implanted into the body.  If it doesn't take, then we'd see a significant drop off in her calcium levels.  Initial readings are good.  Still waiting on the Parathyroid Hormone (PHT) levels.

She's resting now.  I probably should too, but there's too much to do.....surf the Internet, play Angry Birds, talk to the nurses, etc.  go home to see the kids -- thanks Grandma and Grandpa for covering for us...make the kids do their homework and go to bed.  Maybe they'll listen to you.

It's Thyroid Time

Okay.  It's been awhile.  Time to get back into the groove and start my therapy.  Just when we were getting back to our normal life.  But who gets to define normal?  Forgive the following, as I'm a bit rusty.

Previously on IGC:

Jennifer had just gotten rid of that pesky deadbeat carcinoma squatting on her tongue.  Unfortunately, in the separation proceedings, she had to give up some of her tongue and her lymph nodes (Texas is a community property state).  However, Jennifer, in her resilience was able to make use of some neighboring property to rebuild and restore the tongue to almost original quality.  Last season ended with the discovery that Jennifer had uncovered more squatters in her lymph nodes.  They've been tracked to the thyroid.

The doctors discovered Papillary Thyroid Carcinoma in three of Jennifer's lymph nodes, but decided to wait until September to allow Jennifer to heal from her tracheostomy before they re-evaluate and potentially take corrective action.  September is here.  This week.  Today, as a matter of fact.

Today's episode is brought to you by Jennifer's thyroid.  It's a butterfly-shaped gland that wraps around the windpipe (see cool image in the link below).  It produces hormones that regulate your heart rate, blood pressure, body temperature and weight (NOOOOOOOOOOO!!!!!!!)

http://upload.wikimedia.org/wikipedia/commons/f/f0/Thyroid_gland.jpg

We met with the surgeon today.  We realized the "potential" to perform a thyroidectomy just became "we will" do a thyroidectomy when we were approached by a couple of residents to participate in a some studies involving frozen samples and live cell strings (stem cells) taken from the cancerous tissue.  Oh yeah.  We're part of that debate.  :-)

I digress.  The surgeon came in and described how he will excise the tracheostomy scar and make a longer incision along the neckline.  I guess the surgery is occurring.  Good thing Jennifer was accepting of it.  I was still holding out for a decision to wait and observe.  Oh well, at least well get this over with.  Jennifer will go through a radiation treatment about six weeks later.

He showed us some pictures while describing the surgery.  Lo and behold, there's another nerve he's got to watch out for.  The Recurrent Laryngeal Nerve runs down the esophagus, by the thyroid gland, into the chest, the back up between the thyroid and the trachea (hence "recurrent").  If this gets traumatized, her vocal cords could be affected.  Geez. Pesky nerves.  So necessary, but always in the way.  Looking at the picture linked above, I'm more worried about the proximity of the carotid artery.  Hope that surgeon has some steady hands.

He answered a few questions, but deferred to an endocrinologist for the specifics we had around the hormone effects or necessities post surgery and with radiation.  We should meet the endocrinologist during recovery.  Talk about living an adventure.

In a nutshell:
Wednesday, we have the ultrasound (hopefully no abnormalities in the left behind lymph nodes), meet the ana anesti anesthesiologist, and go through the pre-op check in.  Thursday is T-day.  Stay overnight and checkout Friday (hopefully).  Saturday is the A&M vs Arkansas game.  This will be Jake's first game.  AND, BEFORE ANYBODY GETS ALL WORKED UP ABOUT ME NOT TAKING CARE OF MY WIFE......your just jealous.  No. Really, I received clearance from the Boss to go ahead.  We will have that base covered....I think.  Just gotta find someone who will clean the drain tubes on Saturday --- Roto-Rooter has 24 hour service, doesn't it?

Finally, I ask that everyone keep Jennifer in their prayers again as she goes through this ordeal.