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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.

Under the Knife with Thyroid Cancer (A.K.A. Saskatchewan Nurses Rule) by alec vanderboom


On March 11, 2014, I had surgery to treat Papillary Thyroid Cancer at Royal University Hospital (RUH) in Saskatoon, Saskatchewan (Check out the backstory in my first post, “Mr. Chuck D & Me”). The procedure not only involved a thyroidectomy, but a right side lymph node dissection as well. I want to write about the hospital experience to: a) inform anyone who may go through a similar surgery (I didn’t really know what to expect, so maybe this information will help the process a little); b) Give a few insights into the process, specifically what I saw during my time in the hospital. I’ll admit that I can think of things I’d change, and the tone of this blog may come across as being negative at times, but I guarantee that I’ll end on a positive! After all, the care that I received was excellent, and my wife and I see this surgery as an opportunity for renewal—a chance to start fresh with a clean bill of health.

Pre-Op Visits
Before the surgery, I had to go to two pre-op appointments: one with my family doctor, and another at the hospital. Since I was lucky to get my surgery booked to take place 10 days after the diagnosis, I actually completed both appointments on the same day. My wife, Jenn, and I found that both of these appointments put our minds at ease about what to expect before, during, and after the surgery.
The hospital visit only took about two hours to complete, and most of that time was spent waiting. After registering at Admitting, I completed a blood test and had my vitals checked—something I would get extremely used to over the next week or so. I was told that because of my good health, I didn’t need to have x-rays or an ECG. We then met with a nurse who asked a lot of general questions about my health and outlined the procedures for the days leading up to the surgery, the day of the surgery, and a bit of information about what to expect after leaving the hospital. I was given two sponges to use in the shower on the two days prior to the surgery, and a general information booklet. A meeting with an anesthesiologist confirmed my clean health record and that everything on the day of the surgery would be relatively routine.
My family doctor admitted that our visit with him was a bit of “red tape.” I just needed to obtain my physical record, so he asked me a lot of questions that had already been covered at the hospital, checked vitals again, gave me the paper to take to the hospital on the day of the surgery, and then I was on my way.

Two-Days Prior
Getting ready for the surgery was simple, but there were a few things that I had to do:
·      Cut off solid food at midnight the night before the surgery
·      No alcohol for 48-hours prior
·      No Omega oils (this is a blood thinner)
·      Use the cleaning sponges twice
·      Pack an overnight bag
·      Leave jewelry and money with someone else

Day Of the Surgery
6:30 am: Check in at admitting
6:30-7am: Change, check vitals, sit in waiting room
Just after 7: moved to a pre-surgery room with a few other patients. Seeing these other people who were going to get opened up just like me was quite surreal. This was actually something that bothered me a bit about the process. Each patient met with a surgeon and anesthesiologist separately, but these meetings were all conducted in one big room. Hearing what everyone else was going through seemed too public considering the severity of some of the procedures being discussed.
8ish: A nurse walked me to Operating Room #4. I jumped up on the table, got the meds flowing, heard the surgeon say my name and the procedure (for a recording, I imagine), and then I drifted off.
1:45pm (I think): This is the first time I remember seeing the clock. I was awakened in the Recovery Room. I was asked about my pain level, and I was glad they did because I was definitely uncomfortable. I reported an “8,” got some morphine, and then drifted in and out for the next hour. My surgeon, Dr. Christian, came and talked to me to tell me that everything was a success and that he had met with my family. He was also happy to hear that I had my voice; this was one of the possible side effects of the surgery since the thyroidectomny was so close to my vocal chords. However, the risk was less than 1%.
2:45ish: I was moved to the Observation Room.  The nurses actually forgot to inform my family (haha), so I was left in the hallway for a bit so that everyone could come and see me.

The Observation Room Experience:
I was in this room for about 20 hours or so. Honestly, this was the toughest time in the hospital. I mentioned how the pre-surgery meetings lacked the privacy that the patients deserve; well, I had no idea how much I would value my own privacy after the Observation Room.
·      There were six patients in this room, separated by curtains, with the eyes of nurses on us constantly (for good reason).
·      On a night that I really wanted to sleep, I couldn’t. Let’s just say that I got to know the other strangers in my room extremely well without saying a word to any of them. I heard things, saw things, smelled things that I never want to experience again. A very loud patient next to me was moved out after 1 am, and replaced by a patient that the staff kept saying “shouldn’t even be there.” He was in bad shape, and had to be awoken every 30 minutes or so. Needless to say, sleep was hard to come by.
·      I got to shower the next morning. Again, the walls of privacy came down quickly with this experience. Nevertheless, it’s amazing that no matter how difficult it was to actually complete the task, the shower was unbelievably refreshing. Discovering things like how I had been prepped in the operating room and finding a patch of dry blood on the back of my head were things that I didn’t expect. It was also very awkward, and slightly painful, to handle the two drains that I had at the base of my neck. All in all, this wasn’t a spa treatment, but it was refreshing!
·      Another aspect that was a bit shocking was the size of my scar. Since the lymph node dissection was required, the incision ran horizontally from the left side of my Adam’s apple to my right ear, and then vertically toward my ear lobe. The 45 or so staples caused discomfort, and the procedure caused numbness that I am still experiencing as I type this two weeks after the surgery. I was told that the numbness will eventually go away, and that it was caused by work being done around nerves in my neck. I’m still not used to barely being able to feel the right side of my jaw and the bottom half of my right ear.
·      I had some devices on my legs that pulsated regularly to help with circulation. These were removed after my first night.
·      I only experienced nausea after taking my first Calcium supplement. It wasn’t pretty. I’ll leave it at that.
·      Sidebar: patients and visitors should have limitations on cell phone use in these rooms. When I was fresh out of surgery and trying to sleep, hearing personalized ring tones and loud conversations didn’t help at all! Why aren’t there any rules in place for this?

Semi-Private Room
When I checked into the hospital, I requested a private room for a $120/day fee. Unfortunately, the facilities weren’t available so I was moved into a semi-private room. An older lady and I shared the room, and two other people also called the room home at separate times over the next two days. The fact that there were more than two people in a room only designed for two showed me how stretched our hospital facilities are. I hope the Children’s Hospital will alleviate some of this pressure.
Anyways, I was quite comfortable in this room, and the procedures were routine:
·      I ate regular meals. I should mention that the Chief Resident was disappointed to hear that I had only received Jell-O for my first meal. He wanted me on a regular diet right away. This was a pleasant surprise since my radical surgery was focused around my throat. Although, I had to change my eating habits because the staples made repeated chewing painful. Also, I found that I was only comfortable swallowing small bites of food or sips of a drink at once.
·      My vitals were checked regularly and my blood was taken a couple of times a day. Checking calcium levels was very important after this surgery.
·      I got up to shuffle around for some walks whenever I felt like it. It was a bit awkward to be carrying around my two drains and being a little hunched over, but the air in the 5th Floor Atrium was a nice change from what I was becoming accustomed to.
·      I stayed in this room for two nights. We were originally expecting one, but it was decided that my drains should be kept in for an extra day, and then some time was needed to monitor how I’d react after they were removed. I was nervous about the removal process, but it only took a maximum of ten-minutes, and it wasn’t very painful.
·      My pain was managed mostly with Tylenol. Measuring my pain on a 1-10 scale was a difficult process since the cluster headaches that I’ve had since grade 10 have built up an extremely high pain-tolerance. I’d say to the nurses, “I’m at a '5' right now, but that might be someone else’s '8'.” Does anyone know how these discrepancies from patient-to-patient are dealt with?

Discharge
            When the Chief Resident came on his rounds on Friday morning, I found out that I could go home. Even though I knew it was coming, I was so relieved to get the news and to hear that everything was progressing as it should. When he left, I put on my headphones just as Curtis Mayfield’s “So In Love” started playing on my IPhone. It was one of the most joyous moments of my life. Maybe that sounds like hyperbole, but that song just seemed like the only song that should have been playing at that moment. The groove, the organ, the horns, the space, the honesty of the lyrics: “So in love. You do so many things with a smiling face.” That first line got to me when I considered all of the stress that my wife had put up with over the few days that we were there.

The Positive Ending that I Promised!
            I have a profound respect for nurses. Teachers and nurses always seem to share a mutual appreciation for each other’s professions—perhaps it’s the multitasking and the long hours, but the most significant common ground has to be in the personal touches that excellent professionals strive for. The RN’s, staff, and nursing students who cared for me made me feel secure and comfortable throughout the entire experience. Esther, Amber, Paul, Grant, and Ben are a few of the names that I can remember of people who went out of their way to make me feel like I was their only patient.
            Also, despite some of the uncomfortable moments, I can’t say enough about how grateful I am to be Canadian and to have access to our health care system. I am going to live a long and productive life because once I received my diagnosis I received efficient and personalized care for a grand total of $0 out of my pocket (with the exception of parking fees for my visitors). This is something that I will never take for granted.

Take a listen to Mr. Mayfield in order to solidify that positive vibe...