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September 16, 2014 / 21 Elul, 5774
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Posts Tagged ‘MRI’

Coming Out Of The Cancer Closet (The Conclusion)

Thursday, February 3rd, 2011

Back in the fall of 2002, nine years after my initial diagnosis of thyroid cancer – and hearing for four years that I was cured – my doctor found, to his great surprise a lump in the area where my thyroid used to be. The pathology report indicated that I had recurrent metastatic thyroid cancer.

Post surgery, I was given a bone scan and an MRI of my brain to see if my original cancer had spread beyond the thyroid area over the years it had gone undetected – even though thyroid cancer very rarely travels to the brain. The bone scan showed no abnormalities – but the MRI revealed that I had a mysterious lesion on my brain. A biopsy to determine what we were dealing with was deemed too risky because of its location. We would have to wait three months for a follow up MRI to see if the lesion had grown.

Though I had no physical symptoms, like seizures, loss of vision, imbalance, which was a good thing, I was all too aware that I had had no symptoms at all when, on two other occasions, I had been diagnosed with thyroid cancer.

Emotionally, I was battered by conflicting feelings of disbelief, grief, hope, worry, confusion, fury, optimism and fear.

During this interval, my mother passed away from complications of a stroke that she had suffered four years earlier. My father had predeceased her by only three years.

When you have even one living parent, when you are still someone’s “child” you feel protected again death. After all, the “default” pattern in life is that parents die first.

With the passing of your second parent, you become the “senior” generation, and you in turn become the buffer for your own children and grandchildren, for it is you who is now at the front of the “line.” There was no running and burying my face in my mother’s protective lap to make the “boogyman” go away.

The news was good. The still unidentifiable lesion had not changed. I was to have more MRIs – six months later, then annually, and finally every two years. At my next to last visit, my neurosurgeon stated that he would discharge me as a patient after one more MRI, since the lesion had remained the same for over seven years.

That MRI took place last year – but I am still his patient: the lesion had inexplicably changed – it had gotten smaller. The doctor was so intrigued – and no doubt puzzled by this unexpected event – I will continue for the time being to have an MRI every two years.

Although the change was in the right direction, I would have preferred a continuation of the status quo. A parked car stays put. A car that moves – can change direction at any time.

But disconcerting outcomes seem to happen quite often when I have tests, blood work and scans to see if “the coast is clear” in terms of the cancer. There is always something they have to scan again or take a closer or second look at.

Ironically, these scares (that luckily are just that – scares) have made me into a more appreciative and happier person. When you are often reminded of your mortality, you learn to let the “small stuff” role off of you. It’s easy to get furious or stressed out while you are stuck in an airport for what seems like endless hours because of a flight that is delayed or canceled, but when you realize that you are alive to take that trip, that you are healthy enough to get out of bed and make plans and act on them, then an inconvenience is just that – an inconvenience and not worth frothing at the mouth over and sending your blood pressure into the stratosphere. You learn to not only stop and smell the flowers but to linger and enjoy their soft texture and take in their vivid colors.

In terms of the number of years we are allotted, quality can sometimes make up for quantity. Quality is attained through hakarat hatov. Appreciation for the routine, uneventful moments that make up the fabric of our daily life enriches us and leads to happiness. Something as mundane like eating a bowl of cereal for breakfast can induce simcha if you “think” about it. You can eat and taste and enjoy. You are able to walk to the cupboard, pour the cereal in a bowl, hold a spoon and swallow its contents. If you take a moment to absorb this and the myriad other run of the mill abilities you mindlessly take for granted; if you make yourself aware that your life is suffused with bracha- then you will feel joyful day after day after day -no matter what stresses, hassles or aggravations come your way.

Is it such a benefit to have “langeh yahren” ((literally long years, but meaning a long life) if you are miserable, morose, bitter and unappreciative day after day after day?

I was fortunate that I was never really that physically sick when I had my cancer and treatments. Yet due to my awareness of the real possibility that I might die sooner than later – I was able to gain very valuable perspective and understanding on how to live.

Making it a habit to appreciate everything in your life – your physical and mental abilities; the people who you are connected to; and not wasting too much mental energy on relatively minor annoyances and detours – will lead you to be b’simcha, a state of being that is a contagious gift to those around you.

I know that there is the proverbial “sword hanging over my head” that could “drop” at any time. Close to 18 years ago, when all the medical personnel fled my isolation room before my doctor handed me the lead-lined canister containing my radioactive iodine pill, I asked him if all this radiation that would be making its way down my throat, past my lungs and into my stomach and through my body would not GIVE me cancer. He told me that we had to deal with the cancer I had now, not what may or may not happen down the road. Almost two decades later, and after having had to swallow a second, more potent radioactive iodine pill – “the road” may be closer. Or not.

If it is Hashem’s will that it is, I know I will walk it with less regret and less sadness, fortified with the knowledge that I was given the opportunity to appreciate the beauty, chesed and grace that landscaped my every step. That landscapes everybody’s steps – if only they open their eyes.

Coming Out Of The Cancer Closet (Part II)

Wednesday, January 19th, 2011

Back in the fall of 2002, nine years after my initial diagnosis of thyroid cancer – the last four of those being told that I was cured – my doctors discovered a tumor in the area where my thyroid used to be. (My malignant thyroid been removed via surgery.)

Up until that day, I had never really identified myself as a cancer patient. I had never felt ill at all; I had no symptoms that would have hinted at a diseased thyroid – such as a hoarse voice or trouble swallowing, let alone cancer. My gynecologist had, during a routine examination – one that I had delayed for too long – told me that I had a multi-nodular goiter, a lumpy thyroid. This condition was indicative of a malfunctioning thyroid – not a malignant one. The odds of a multi-nodular thyroid being cancerous are about 5%.

Follow-up tests showed that I had fallen into that 5% minority and had thyroid cancer – albeit a very curable version. In fact, the Jewish surgeon I was sent told me it was mitzvah to have this kind of cancer. I was initially taken aback until I realized he had “bageled me.” (The act of bageling occurs when a “non-Jewish or non-religious individual begins a conversation with a religious Jew and makes sure to include key Jewish terms. … The goal of an individual who is bageling is simply to show that s/he has a nugget of knowledge about Judaism and that he/she is in the know. Of course bageling often backfires; since the person only has a nugget of information which he/she feels compelled to drop at all costs – from Bageling by Basya Shainer, Teens and Twenties Talk, 10-27-2010).

My reassuring, kindly doctor, had mixed up the word “mitzvah with “bracha.” He was trying to point out that if I had to get a cancer – this was one of the best ones to get.

My surgery was uneventful (except for the very long few seconds when the anesthesia kicked in but I was still awake and terrifyingly aware that my lungs had stopped working and I couldn’t breathe) and my recovery was quick.

Beside having to swallow a radioactive iodine pill weeks later, and be in isolation (total solitary confinement) for three days – until the men in the space-suits and the Geiger-counters said it was safe for me to be released into the general population- there were no other treatments.

Having recurrent cancer changed the game for me – emotionally if not physically. I still felt fine but I had to admit to myself that I was now dealing with a more aggressive opponent, one whom I thought I had vanquished but apparently had only laid low for a while. Some of those insidious cancer cells from nearly a decade ago had somehow managed to avoid the knife and the radioactive iodine that was supposed to zap them, and they had had years to hide and reproduce and possibly spread and infiltrate other parts of my body.

Cancer is like Amalek. If – as we Jews have tragically discovered – this evil is not totally eradicated, if even one individual or cell remains, then they will multiply and regroup and attack in a relentless compulsion to destroy.

I realized that I may have won the battle nine years ago – but I hadn’t won the war. I now had to defend myself yet again and launch a counter-attack.

This literally meant having my throat slit again. I remember that first time, when I was in the OR lying on a table draped with a sheet, with only my neck exposed, silently but frantically insisting to G-d that I really wasn’t korban material – I was on too low a madriga to be a fit sacrificial lamb for the klal. And I certainly wasn’t this time.

I again sailed through surgery, but according to the pathology report that was based on an examination of the tumor they had removed, there were cancer cells right to the margins. In other words, had they taken more tissue out, it is likely they would find cancer there as well.

The post-operation diagnosis was recurrent metastatic thyroid cancer. That sounded pretty ominous – but again, I still felt fine, so what was so dire “on paper,” as I rationalized to myself, didn’t necessarily translate to reality.

But there was another reality that I couldn’t be so blasé about.

I had a bone scan as well as an MRI of my brain to see if my original cancer had spread over the years it had gone undetected. And sure enough, the MRI revealed that I had a mysterious lesion on my brain. I believe the very experienced, brilliant neurosurgeon who looked at the MRI said that it didn’t look like anything he was familiar with.

At that point I became a very interesting case- doctors love cases that are atypical and therefore challenging. It is extremely rare for thyroid cancer to migrate to the brain – my doctor said he had seen that happen only once in his 35 year career (which makes me wonder why I had a brain MRI in the first place) – and it is also highly unusual to have a second primary cancer develop while you are dealing with another one.

No one knew if this lesion was benign or malignant and a biopsy to find out was deemed too dangerous. I would have to wait three months for a follow up MRI. If the lesion had gotten bigger then I would be, as they say in Yiddish in “gehakte tzurrus.”

In the meantime, my thyroid oncologist had to consult with various colleagues as to whether I should get my second dose of radioactive iodine. On one hand, they needed to eradicate whatever cancer cells the surgery might have failed to cut out. On the other hand, if that lesion was indeed thyroid cancer that had made its way to my head, the radioactive iodine could cause my brain to swell. Eventually, I got the green light and swallowed an even higher, more potent dose of radioactive iodine. To everyone’s relief, my head did not explode. And again, there were no nasty side effects. No swelling, no nausea, just curiosity if I would glow in the dark.

In the meantime, I had 12 weeks before that crucial MRI to think about my life, and possible demise – in the overwhelming context of my mother’s death a month after my treatment. I thought about my now grown children – relief that they were adults as opposed to a decade earlier when I was first diagnosed – and excruciating sadness that I might not be at their weddings or know their children.

I did a lot of praying, bargaining, pleading, yelling and ranting at G-d. I had unfinished business, and wasn’t ready to close up shop.

(To Be Continued)

An MRI That Went Awry

Thursday, July 15th, 2010

I joined the Jewish Press Emunah family four years ago when I wrote about my fall down a flight of stairs while holding my granddaughter. Baruch Hashem, my 16-month-old granddaughter came out without a scratch, but I became paralyzed and needed six months of rehab. Hashem saw fit to save me, and to help me recuperate.

Later, I wrote about the delicate spinal surgery I had to undergo to correct residual physical problems. Once again, with Hashem’s help, my surgery was successful.

Here now is an update on Hashem’s latest miracle that occurred last week: After going to my neurosurgeon for an annual routine checkup, he suggested I have an MRI. All seemed well when I was done. I was surprised, however, that the MRI lasted only 15-20 minutes, whereas my previous ones had lasted closer to 40 minutes. I called Dr. R., the head of the radiology department, and asked him to please read the results so that I would not have to wait too long for the results.

Dr. R. reprimanded me in a nice way. He said that I should have called him before the MRI so that he would have made sure to have an experienced technician administer the test, since my case was complex due to my spinal injury. He promised to call me back when he got to the hospital.

I kept my cell phone on all evening. I forgot to close the phone when I went to sleep and, lo and behold, at 6:30 a.m. I received a call from this angel. Dr. R. admonished me again for not letting him know about my MRI in advance, since he had found reason for concern. He had noted significant changes when comparing the present and previous MRIs, and he felt that I might need further surgery. He reiterated that a better-trained technician would have taken more time and administered more advanced tests, so that the results would be clearer. He insisted that I come in for another MRI that morning, free of charge. He promised to personally supervise this test.

Needless to say, I was quite nervous at the prospect of further surgery. After the test was done, Dr. R. calmed my fears by reassuring me that this test, which was more accurate and more detailed, showed that no surgery was necessary. I was stunned. My personal angel had appeared again, and Hashem had once again spared me from further stress and risky surgery.

Had Dr. R. not intervened, my first MRI would have been submitted. The neurosurgeon would have read the report and would probably have recommended surgery. I was spared this trauma due to this wonderful messenger, the head of the department, who took the time to care.

My elderly mother, may she live and be well, recites the complete Book of Tehillim every day. I believe that it is in her zechus, and hopefully in mine as well, that I merited having this personal angel come to my rescue. I express my appreciation to Hashem for always being at my side and for sending me the proper messengers at the critical junctures in my journey to good health.

Printed from: http://www.jewishpress.com/judaism/jewish-columns/lessons-in-emunah/an-mri-that-went-awry/2010/07/15/

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