The C Word is back...and no it's not Christmas.

This past Friday John and I headed up to San Francisco for about 24 hours because I had my 'second opinion' appointment with Dr. Orloff at UCSF. (Which my local dr. recommended since my multiple scans hadn't located the mysterious thyroid cells in my body).

Before my appointment John and I met up with my uncle Eric for lunch. I got a recommendation from the doctors office of where to go and she suggested Ocean Taqueria. Let me just say that it was awesome! First of all it looked totally sketchy...sign number 1 that it's a good Mexican place, (Mr. Kin Burrito, John, taught me that). Second of all it had homemade tortillas and horchata! Our burritos were SO good. I swear...nothing beats a homemade tortilla!

After lunch we headed over to my appointment. I started out answering a bunch of questions for the doctor's assistant and then she wanted to take a look at my vocal cords to make sure they weren't damaged from my first surgery. No prob, I thought. Then she pulls out this device that is about 9 inches long and my stomach just sank. I think she saw the look on my face because she then told me that she wasn't going to put the whole thing down my throat. Thank god!

At the end of the device were two small lights and a video camera. She had to hold my tongue and then put the device at the very back of my throat. She then ask me to make some sounds like a vocal coach would. (I only gagged a couple of times.)

Where I was sitting, I couldn't see the video monitor, but John could, so I had to watch his reaction of watching the video. He made it seem like it was super exciting and it was killing me not being able to see it. However the nice lady did let me see the video after she was done. It was totally cool! It was neat to see how my vocal cords worked, but the whole area looked like an alien...or the mouth of the Predator. I also got to see my windpipe, which was neat. I asked her if she was going to be printing any of the photos, (in hoping that I could get one), but she didn't. (Later we realized that John could have videoed the video with my camera. Dang!) The video image kind of looked like this, but a lot grosser:
After that the dr. came in and asked more questions, and then did a neck exam where she felt all around my neck. I could tell that she knew exactly what she was feeling as she went over every part of my neck. She then asked me if I was left handed, (and I said yes), because I was more tight on my left side. So crazy.

I thought that she would just look over my test results and give me her opinion, but I was wrong. I was also going to get an ultra sound. Even John knew that. I don't know why I didn't think I would get one. My dr. here in SLO had told us that she was specially trained and performed all of her own ultrasounds. That is why her skill is so valuable and why can find things other technicians can't. Then she told us that she had to go to Germany for the training, and just now doctors in the US are getting the ultrasound machines in their offices. Talk about being behind in the times!

She was so thorough with the ultrasound. She took her time, and took a ton of screenshots. It will be great to have those images in the future to use as a reference to see if any of my other lymph nodes have grown. On my right side she noticed some calcium sparkles in one of my lymph nodes. She told me it was unusual and that it's something to keep an eye on. Thank goodness she found something! Then as she continued, she noticed more calcium in another lymph node. She then said since there are two that she'd like to try to biopsy the bigger one, even though it was only 1cm at it's widest point. I was in total shock. I biopsy right then and there? Now? Today? Crap. My first biopsy was really awful because the first dr. thought the numbing juice had kicked in, and it hadn't. John was sweet and asked me if I was ok because he knew how much I disliked my first one. It all happened so fast.

I asked her if I could see the lymph nodes so she showed me the sparkly calcium on the screen. She also told me how if she got any blood in the sample then it wouldn't be readable and how the lymph node is really small. I had total confidence in her though. She also marked the spot on my neck with a marker, just like Uma in Pulp Fiction! That was cause for a photo:
John was also trying to capture all the goo on my neck since it was all over. Even my hair was sticking to my neck, but I had to hold that out of the way so you could see the mark. See how high up the mark is?

I found this image online that shows where some of the other lymph nodes are in our head/neck...in case you were wondering.
Before the dr. started the biopsy, we had to wait for the pathologist to show up, because she was going to look at the cells RIGHT THERE IN THE OFFICE. Can you believe it? I then asked the dr. how long I'd have to wait for the results, and she said that the pathologist could tell me right there if I wanted. I couldn't believe the service. Here in SLO, you have to get your ultra sound and biopsy in two different locations and then wait a week for the results. Here I was getting everything in one room...and in one day!

Once the pathologist showed up, (she got stuck in the elevator), the dr. did the biopsy. Let me say it wasn't that bad at all. Granted she only had to get one sample, unlike the first one I had done. John was fascinated to watch it, because he said you couldn't see the needle on the screen, but you could see the lymph node move when she was gathering the cells. While she was gathering the cells the pathologist was also watching the syringe and checking to see if any blood got in the sample.

So within 2 minutes she took the sample, looked at it under the microscope, and told me that once again I had cancer. Crap.

Dr. Orloff said that they would need to remove the lymph nodes, and that they would remove all of the ones in that area. She also said that she was booked in January as most people wanted to get their surgeries after the holidays. Sounds like I might have the surgery in February. I'm hoping someone will cancel and I can get in earlier. I've love to have my surgery before I get a job. I'm also not 100% if I will have the surgery in S.F. She is going to talk to my dr. this week and give me a call.

I really can't believe I have to have another surgery. Why can't we leave the lymph nodes in there and hope they disappear? I know that's really not an option. I'm not sure if I'll have to have any more radioactive iodine, but I will be surprised if I do. I will also have to protect my scar from the sun for a whole YEAR again. That was a total pain...but I've done it before. Heck I've done this whole thing before. Will that make it easier? I'm hoping it will. I don't think it will make the time before surgery easier as I'm totally dreading it, but I'm hoping I'll be able to handle the pain better afterwards.

Overall I was so impressed with Dr. Orloff and how knowledgeable she was in the neck and with thyroids. I had never been to a specialist before, but I loved it! She even had all sorts of thyroid diagrams, handouts and models in the rooms. I'm so thankful I have such good doctors. They are actually the best doctors I've ever gone to for anything.

After the 2+ hour appointment I got to go to this art store that my uncle recommended. Let me just say that it was AWESOME! They has so much great stuff in there. I had to be somewhat in control, as my main reason for going there was to get a new portfolio, which I did, but man did I want to buy more stuff. Maybe next time. On our way there I saw this old Tab sign. I thought it was pretty cool:
There was also this graffiti wall that was so pretty:
That night we stayed with John's friend Scotty and he took us to this GREAT Mediterranean place call Fattoush. John's other college roommate Nory and his wife Jessie came up from the East Bay to meet us as well as an old high school friend of ours Mike and his girlfriend. Dinner was tons of fun with great company and great food. How could we go wrong?

After we went out for a few drinks. Here is John and Nory with their Irish Car Bombs.
Are you wondering whose eye ball that is on the left? Well Scotty decided to wreck the photo so I cropped him out. He deserves his own photo:
Here is Jessie and I:
Right before this photo was taken, Scotty came over to harass us. I can't even remember what he did, but this photo cracks me up.
So overall I guess you could say it was a productive/fun/downer sort of a visit. One thing is for sure...I'll have to wait a few months before I can wear my cancer survivor shirt that John got me. Good thing it's winter right now!