Tag Archive | biopsy

In Between

Last week my brother and sister-in-law celebrated their 32-wedding anniversary in Rochester, Minnesota.

They weren’t truly celebrating in Rochester by their own choice. They had traveled to Minnesota so that my brother could be examined by specialists. His local endocrinologist had sent him there for highly specialized care.

My brother and his doctor are battling stage 4c papillary thyroid cancer. He’s endured having his thyroid removed, two sessions of radioactive iodine and countless examinations. He’s endured being told that ‘this is the best kind of cancer to have’……. whatever that statement means. He’s endured two surgeries and recovery periods. He’s endured nerve pain and dealing with the scarring due to those surgeries. He’s endured bouts of sleeplessness and swelling that hampers his swallowing. He’s endured the balance of getting enough rest and trying to get back to work. He’s endured his own concern for his family and the high cost of treatment.

Last Friday, my brother called me to let me know of the results of all this testing which included a painful biopsy of tissues in his neck. (I was wrong in thinking that what I read online the day before was correct, that the biopsy would not be all that painful. I know that my brother has a high pain tolerance, so I know that it really hurt.) He told me that he met with a team of specialists.

The surgeon and endocrinologist told him that at this point, surgery was no longer an option, it is a MUST. Beam radiation treatments won’t get all the cancer cells.

The two previous treatments of radioactive iodine had not done their intended job. Now, the small amount of cancer cells that had hidden during the thyroidectomy have grown in number and have become aggressive.

The surgeon gave my brother detailed information regarding the surgery. He also gave him the golf analogy “a hard lie” to express the difficulty of the surgery. Even though my brother does not play golf, he understood the stark reference.

Now he was caught in between a difficult surgery, a known painful recovery and an unknown quality of life … or …. worse, if no treatment, way worse.

A tentative surgery date was schedule.

That’s a lot to digest and deal with.  Calls to family had to be made. Results had to be relayed.

And… as if ALL this was not enough, my brother called me the next day to tell me that the insurance company was balking at coverage. They stated the Mayo Clinic is ‘out of network’ and if that did not change and he went ahead with the surgical treatment there he would be financially responsible for half the cost. I did my best to assure him he’d have help paying for the treatment if he were to go ahead with it. I’d help to pay every month for as long as it took. I’d enlist other family to help him too. He said that they’d have to jump through hoops to get the insurance company to authorize the treatment whether in his home state at a facility approved by the company or after looking over the exam records possibly allowing treatment at the Mayo Clinic.

My brother is caught. Caught in between.

In between the specialists who know how difficult and yet how necessary this surgical treatment is and the insurance company not prepared to cover the cost at a facility ‘out of network.’

In between the necessary treatment and great concern for being so far in debt that he’d never get out.

A tough place to be, yes, ‘a hard lie.’

And, in between the team of specialists and the insurance company.

My brother’s quality of life.

In between

My brother’s life.

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Relief

Today the ultrasound guided neck biopsy was scheduled.

I can’t tell you all the uncomfortable, painful things I imagined.

Late this morning I got brave enough to google it. I was curious to learn what my brother was going through. The information I read made it seem not to be nearly as bad as I had thought. Thankfully. Not only for me, but for my brother who was the subject of the biopsy. I wanted it to be easy for my sister-in-law too, so she would not worry.

I learned that an icy cold topical numbing agent can be sprayed on the skin at the injection site to assist in some relief. To my amazement, I learned that a local anesthetic used in a neck biopsy is usually more painful than the actual biopsy. I read the biopsy does not take a long time either, yet, I don’t know how long today’s neck biopsy was as my brother has a few spots that needed to be examined. I was relieved to learn that it was probably was not as bad as I imagined.

I can imagine how brave my brother was for this procedure. He had a great example. When our Mom was battling leukemia she had to have a few bone marrow biopsies. These are a rather large needle aspiration done into the pelvic bone. Most people ask to be put under general anesthetic.  Mom never did, just a local. She was tough. A courageous woman. I was blessed to have been right by her side during the last bone marrow biopsy she had and I could hardly believe my eyes. Here was my mother, so very sick from the end stages of this horrible disease and she still would not take the general anesthetic.  She just had the local, calmed herself and stayed still so the DR could drill into her pelvic bone, get the marrow he needed to test and get done. Over with. On to relief.

Through Facebook, I was able to check on one of my nieces whom I had not made a connection with this week and relieved to hear from her. The youngest of my brother’s three daughters performs ultrasounds for a living at a large hospital.

Here is her response, “Okay…things hit me at weird times… just anxiously waiting to see what the doctors say…but I am doing my part with every thyroid Biopsy patient I get (I did 2 today) so that kinda helps me. I can’t be there with mom and dad, I try to show my patients how important their procedure is to me by caring for them as if they were him.”  

Through her words, I know what kind of special treatment my brother (and sister-in-law) are receiving even though they are at a different facility. Medical professionals are often quite similar. I know. We have many caring medical people in our family and in our circle of friends. If they didn’t care, they couldn’t do well in their profession and that would show in their patients.

Also in another Facebook post, I saw a photo of my brother and sister-in-law. The self-portrait photo showed us all two happy people out enjoying the sunshine on their 32nd wedding anniversary.

Talk about relief.

Exams of a Lifetime

Early this morning I sent a text to my brother to say:
“We’re with you. We love you.”

I had to get it to him early because he is currently in a time zone two hours ahead of the one I am in. My inner alarm went off before the alarm on my clock, so I had no trouble getting that message to him. He greeted me with a “Good morning!” and a wish for a great day, signed off with a “Love you too.”

After his initial meet and greet assessment appointment at the Mayo Clinic he sent me another text.

“Sounds like more scanning and biopsy. Will meet with surgeon Friday to see if surgery is possible. No more radioactive iodine as it didn’t work on my June scans and apparently not effective in December. External beam radiation back home if no surgery indicated.”

A bit later he texted me his schedule for the day.
10:40 Labs
1:15 Chest x-ray
1:45 Neck Ultrasound
3:05 Neck CT

and the schedule for Thursday (the day he and my sister-in-law celebrate their 32 wedding anniversary):
9:30 Ultrasound Biopsy of Neck

and for Friday:
1:30 ENT Surgical Consult
3:30 followup with Endocrinologist

Possibly the most important exams he will ever have.

At this point his whereabouts and schedule for next week are all up in the air.  All depends on IF. With this advanced stage of thyroid cancer still being in his body, becoming more aggressive and having hidden in some deep recesses of some difficult to get to places, the answer to the question IF surgery is a viable option is unknown.

The reason for all these exams today.
The reason for the biopsy tomorrow.
The reason for the consultation with specialists the next day.
The reason he is at the Mayo Clinic.

He is a beloved family man, son, brother and friend.

The one person, other than my parents, whom I have known the longest in my lifetime.
My brother, just five years younger than me.
My brother who makes me laugh because of the obscure, funny stuff he remembers from our childhood – sometimes all he has to do is look at me when something triggers one of those memories and we’ll share a big smile or laugh out loud for a while.
My brother who still remembers theme songs to several of the television shows we watched as kids.
My brother who is so supportive of me, who has counseled me on so many things and was audibly one of the happiest people when he found out I was going to marry Jeff – because he knew how happy I was.

I truly wish that I could be there with him, now, as he is going through some of the toughest exams of this life.