Scars

4 Weeks In- Good News, Good Food, Good Progress, but “The Good Cancer”? by alec vanderboom


It’s April 8th—four weeks since my surgery, and a year minus a day since I released my first solo album—and I’m feeling good.
            Overall, I’m very close to where I was before the surgery. I realize now that my energy was low back then, and I’m struggling with it a bit now, but things keep getting better. Jenn and I had our first night out on Saturday (thanks to some great friends!), and it felt awesome. We also spent some time out at my brother’s place on Sunday, and I was able to go for a longer walk with our dog, Lucy, yesterday. Again, awesome. Everything takes a little more time, but it’s okay because I just don’t want to push too hard. It was estimated that I could possibly go back to work this week, but I’m relieved that I have some more time. I definitely don’t have the energy to be back in the classroom yet. Adjusting to my new medication, Synthroid, is not as easy as it sounded at first.
            One of the reasons it may be taking a bit longer to get my energy back is the fact that my surgery was a bit more extensive than just a thyroidectomy. We received our pathology report last week and found out that I had three areas of concern on my thyroid. Dr. Christian, my surgeon, mentioned that even though the cancer was evident on both sides of my thyroid, some doctors would only do a partial removal of the thyroid. I feel lucky to have had it all come out at once. After all, there was a patient in a bed next to me after my surgery who was in for his second surgery since the first didn’t complete the task. We also found out that I had 20 lymph nodes removed, nine of which were suspicious. This lymph node dissection led to the extensive scar that has caused me the most discomfort.
These four weeks have flown by. Don’t get me wrong, a lot of it was really difficult but I’m in a good spot. This gets me thinking about something I wrote about in my first blog: Is Papillary Thyroid Cancer really the “Good Cancer”? I mentioned that Dr. Christian told me that “the good cancer” is indeed what I have. Since the surgery is so effective, there are not many procedures that need to follow. But, can cancer be good in ANY way?! I read an article that shoots down this “good” diagnosis completely, and I see why (check out http://www.huffingtonpost.com/amy-graeber/thyroid-cancer-things-to-know_b_3319897.html). No cancer diagnosis, no treatment involving surgery and a permanent medication regiment is “good.” However, when I consider all of the things I was able to do last weekend, I consider myself lucky. I am looking ahead to a radioactive iodine treatment, but this involves being isolated at the hospital for just a few days. When I think of the people who need to go through extensive, painful treatments involving chemotherapy, I realize that I am in a “good” situation. As stated in this article (http://thyroid.about.com/b/2010/09/09/thyroid-cancer-good-cancer.htm), the prognosis for my type of cancer is very good, but maybe the terminology could be changed in some situations.
            Also, as I’ve written about before, the medical care I have received has been phenomenal. My follow-up appointment with Dr. Christian and Dr. Caspar-Bell, the endocrinologist, was so reassuring. Even with a long line of patients to see, Dr. Caspar-Bell took the time to speak with Jenn and find how we are both doing emotionally. She also took the time to answer every question that we had on our minds—especially regarding diet (*see below*). These simple gestures are not ones that we often hear about when people are discussing patient care. Like schools, hospitals often get compared to factories without thorough consideration of the implications of this metaphor. Dr. Caspar-Bell’s personalized efforts put Jenn and I at ease; we didn’t feel like a number or some product that will eventually come out the other end being deemed as “good enough.”

*With regards to diet, we (especially Jenn) did a lot of research on diet recently. Both doctors reassured us that a normal diet is going to be fine from now on. Of course, not many people share the same idea of what normal really is, but our normal prior to surgery will continue to be our normal now:
·      Lots of veggies and greens- We had read that there were certain vegetables that are goitrogens—they could potentially cause an adverse effect on recovery—but as with anything, moderation is key. This also applies to meat. We were considering a strictly plant-based diet, but we are just going to choose wisely. I won’t eat meat every day, and we will continue to buy the healthiest meat that we can find (“organic”, antibiotic-free, etc.). On a side note, I love to cook, so the perspective of considering meat as a side dish is a challenge that I look forward to.
·      Iodine- we were concerned about iodine levels when preparing for the iodine treatment, but Dr. Caspar-Bell told us that this would only mean that, “If you live in Vancouver, you would have to move to Saskatchewan.” What she was implying with this joke is that unless one eats seaweed and fish every day, iodine levels won’t be a major concern. She did advise to take it easy on the sushi though.

As it stands now, it’s April 8th. The sun is shining. It’s 16 degrees Celsius after a long, cold winter. My dog wants to go outside, and so do I. I’m feeling good.

Mr. Chuck D & Me by alec vanderboom

“@MrChuckD is now following you on Twitter!” My mind completely cleared when I saw this notification on my phone just after midnight on St. Patrick’s Day, 2014. The fact that Chuck D, the living legend MC of Public Enemy, made a connection with me blew me away. To think that one of my musical idols since childhood, a man who exposed me to new music and expanded my global mindset, had taken the time to click on my Twitter feed and hit “Follow,” blew me away. But what really affected me most positively was not the social media induced all-out ego-explosion of having Chuck D at the top of my list of followers, it was the timing of the moment and--specifically--the moment that preceded this connection.
When I received the notification, I was lying on my bed, trying to relax after what I might call an anxiety attack. Feeling dizzy, and trying to rid myself of the rush of negative emotions that were overwhelming me, I needed to lie down. I had just been looking in the mirror, inspecting for the first time my newly acquired eight-inch, heavily stapled incision that extends from the left side of my neck below the Adam’s apple to my right earlobe. The reason for the scar? A surgery on March 11th to remove my thyroid gland and lymph nodes on the right side of my neck. The reason for the surgery? Papillary thyroid cancer.
Now, I can imagine friends and family who didn’t know about my condition being relatively shocked at this news, so I’ll now take the time to assure you that I am going to be fine. My excellent surgeon, Dr. Christian, pointed out the oxymoron of this type of cancer being the “good cancer,” but I’ll get back to that later. (Time for a choose your own adventure here: if you’re not feeling as optimistic as Jenn and I are, skip ahead four paragraphs or so; if you’re cool with it, read on.)
So how did I end up in this position? About a year ago, I began noticing that I was clearing my throat far too much. My family doctor pointed to allergies, given the time of year, but I knew that something was different--especially considering that I also noticed a decline in my energy. By the end of June, my throat was so irritated that I lost my voice when playing my second gig at the Saskatchewan Jazz Fest. This was an anomaly for me, something that had only occurred once in my singing career. This fact became even more worrisome when my voice continued to be affected for 10-12 days after that gig. In the meantime, at the beginning of July, a massage therapist discovered a bump on the right side of my neck. “It’s probably a lymph node,” I said, like I knew what I was talking about. Jenn and I were about to travel to Croatia, so my doctor gave me a prescription for some antibiotics, and a referral for an ultrasound when we returned from our trip. When we returned from our amazing vacation, I had my first ultrasound on August 9th. The images showed two swollen lymph nodes, so I was asked to follow-up in 6-8 weeks. On September 27th, my second ultrasound showed no changes. After returning from the Break Out West music festival in Calgary, my bloodwork was normal. Again, I was instructed to follow-up in 6-8 weeks.
On December 6th, stuff started to get real. I had a different radiologist this time. He had the technician take multiple images until he was clear on what he was seeing. He sat down with me and took the time to explain, with little medical jargon, exactly what he was seeing. He pointed out how weird it was that these swollen lymph nodes were still hanging around, lining up outside the club under my right ear, so he asked if he could take an image of my thyroid. After all, when there’s a lineup outside the club, sometimes you go in to find that something’s really going down; other times, it’s just a facade and the hype will die down, so you can move on. When he returned, he took all the time necessary to explain that many people have nodules on their thyroids and these are most often harmless. However, I had one on the right side that showed signs of possible calcification. He eased my anxious mind by telling me that even in the worst case scenario, the problem would be treatable.
Six weeks later, on January 20th, I had a fine needle aspiration (biopsy) performed by Dr. Caspar-Bell at Royal University Hospital (RUH). I need to mention here that there are two things that I’ve never gotten along with: anyone (or anything) touching my neck, and needles. Well, maybe needles are actually down with me because they always get what they want since I’m usually unconscious. The biopsy was one of the more uncomfortable experiences of my life. I heard I would equate the pain with a bad bee sting, but it was more like a tattoo needle being held in one place for 40 seconds, a minute, or whatever it was. I was told that results might be available in a week or two, but I didn’t hear back until February 26th when Dr. Christian’s office called. Those six weeks or so were pretty distracting: not only would my mind wander once in a while to the lingering possibility of a problem, but my energy was continuing to drain. I had a little too much on my mind when I was gigging at the Bassment on January 31. In fact, I was concerned that I might start to cough mid-song as I had during rehearsals. Luckily, I was able to make it through with the help of my wicked band and a great audience.
February 28th was the day that Jenn and I got our answer. We met with Dr. Christian and Dr. Caspar-Bell. They quickly looked over my results (Jenn and I locked eyes when we heard the word “carcinoma”), they conducted an ultrasound, and then Dr. Christian said, “Now, we’re going to go next door and discuss your surgery.” Wait a minute! Didn’t I say that January 20th was when stuff got real?! Well, maybe this moment was unreal? Surreal??! Either way, without being told this directly, I had cancer and it needed to get out. Dr. Christian was amazing at explaining what Papillary Cancer is and how the procedure would go. At first we actually discussed how Joni Mitchell should be included in Saskatchewan Secondary English Curricula, then he used his oxymoron: I had the “good cancer.” The thing that makes oxymorons fit in with the cool kids and diss the regular morons, is that they make sense. Dr. Christian was not sugar-coating the news. The more I read about this type of cancer, the more confident I became. I realized that this is what sidelined Anthony Calvillo after the Grey Cup a few years ago, and A.C. seems to be a pretty good dude; he also seems to be a pretty dang healthy guy (except I question his mental health for his choice of loyalty to the Alouettes). Check out his story… http://www.endocrineweb.com/news/hypothyroidism/4452-canadian-football-player-reports-rapid-recovery-thyroid-cancer
Although there were six-week stretches between the third ultrasound to the specialist appointment to the date of the big news, it only took three days to get booked for surgery. Eight days later, I was on the table in operating room 4 at RUH, humming “You Love So Hard” to myself as I drifted into my medically induced sleep. I’ll write about the experience at RUH in the future. The important thing to know right now is that I received the best of care over my three-day stay.
Since then, looking at this scar has been very hard. The first time that I could really bear to look at it was before the Chuck D notification moment. All of the negative emotion that I had been going through took over at that moment. A dark wave of images took over: the staples, the surgery, what was removed, what the future could be like. I was dizzy; I needed to lie down. Bed didn’t provide immediate relief; those images were still strong, dark, and powerful. “Good cancer” or not, this was some difficult stuff to handle. As I had grown accustomed to in the hospital, I needed to reach for my phone for a distraction. That’s when I saw that @Mr.ChuckD was following me.
I can’t explain it easily. Those dark images that were dominating my psyche instantly vanished. Thoughts of the staples were replaced by the legacy that Chuck D. has created in the music industry. Picturing myself on the operating room table became the image of me in grade 8 listening to “9-1-1 Is A Joke” (when the boys were countering any presence of New Kids on the Block being played on the classroom ghetto blaster). Difficult speculative images of the future vanished to the simplicity of Chuck D pressing “Follow.” And then, I realized that all of the anxiety that was weighing on me a minute prior had disappeared completely. I had tears in my eyes as I thought of the power of music, the power of relationships, and the power of social media. The ironic thing about this whole defining moment is that when I found out that I had cancer, I wanted to avoid social media. Turns out, social media helped me fight the toughest mental battle of the journey--with a little help from Chuck D.