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Request:  Lisa Yoder
Posted by Steve Byler

3/22/2014
Friday

My lovely sister and squishy, adorable nephew accompanied me today for my SPECT scan, bloodwork, and ultrasound. The scan was uneventful other than a bit of paranoia at one point when the machine kept inching closer and closer until I was sure it would crush me at any moment. There were screams on the tip of my tongue, but I survived, believe it or not!



The ultrasound tech got the pictures quickly and was tight-lipped throughout the ordeal...



SO......all this to say, I have NO results yet! Sorry, folks. We have a follow-up appointment with endocrinology on March 31. Hopefully Dr. Shonka will call us before then. I was hoping we could end the week with some happy news, but that will have to wait!

Meanwhile, I'll be enjoying being close to my sweetie pies, eating foods with iodine to my heart's content, and flushing the toilet only one time (flushing twice is important to eliminate any radioactive particles). The week is behind us. Thanks to all for your prayers. They carried us through.

Heidi Good



3/19/2014
3/18/14

Today's injection went much better. Nausea and fatigue were present, but improved. Thank you, Lord! Tiredness is one thing, but nausea is another in light of the radioactive iodine pill tomorrow. Radioactive vomitus is not something to be taken lightly! I can see it now...the haz mat team swarming our home.

We also met with Dr. Shonka, our beloved head and neck surgeon. He examined some swollen lymph nodes. Because of their location and size, he says there is a low chance that they are cancerous. (Yay!) They will pay close attention to those areas on Friday in the scan and ultrasound. In the last two months my left salivary gland has been causing pain. After examining the CT images from Sept, he pointed out noticeable damage to that side probably from the radioactive iodine treatment. For some reason, the salivary glands can get "fried" during that time. The best coping treatment is to stay well hydrated, massage the area, and use warm compresses.

Thank you for your words of encouragement. What would we do without community?! You are such a blessing.

Heidi Good

3/18/2014
Monday

We were able to make it to our morning appointment despite snowy roads, thanks to my dad. I received my first injection of Thyrogen which artificially raises my TSH (as opposed to having to go off my thyroid meds for several weeks) in anticipation of the upcoming scan. After I received it I was grateful I did not notice any side effects, but two and a half hours later it hit... nausea, fatigue, drowsiness. Back at home, I was too tired to watch the girls, so I made them stay in bed with me while I rested. They crawled around the bed, hid under the covers and popped out periodically, but I was glad for the chance to lie down for a little. :)
Please pray for the nausea. My next injection is tomorrow. I have mixed feelings about these medications that are being pumped into my system. It is a necessary part of the treatment, but I hate the thought of taking all the unnatural chemicals. At the same time, we appreciate the wonderful care at UVA.
Many thanks to you who are praying. I have felt peace through the past few days; that is a direct answer to some of your prayers.

Heidi Good

3/14/2014
March 14, 2014

One Year!

It's hard to believe that an entire year has passed since surgery and treatment. Some days it seems more like 5 years and some days it seems like yesterday. As we think of the journey, we are so grateful for God's healing and above all, for His FAITHFULNESS. He has given "strength for today and bright hope for tomorrow."

I love to run and it had been a long time dream of mine to run a 5K. God graciously bestowed the energy and stamina to train and run a 5K with Keith on New Years Eve. What a gift! We had a total blast!

I read a comment recently in a magazine article that someone was "blessed with poor health." What?! I'm still mulling over that one. Even after a year, my thyroid medications are still needing adjustments. Just a month ago, my energy and health had deteriorated to the point where I couldn't read books to Jacqueline anymore because I couldn't think of how to say the words! After skipping a dose or two of meds and a new dose adjustment, I am glad for return of mental function. :)

Fatigue has been frequently present since my last post. I hope for clear scans so that we won't need to focus on suppressing my TSH. Speaking of scans, that is what prompted this update! My one year scans/tests are coming up next week at UVA. I will be going over for appointments every day of the week except Thursday. Please pray for physical stamina, rest in God's love and sovereignty, and accurate evaluations. This week has brought a lot of flashbacks from last year. I am currently on the same strict diet I was on a year ago in preparation for my radioactive iodine pill next week. This dose is for the scan and will not be as strong as the treatment dose last year. However, they want me to maintain a distance of 3 feet from the girls for two days and sleep alone for one night.

I will try to update if I find out anything noteworthy! Thanks for your care.

Heidi Good

6/27/2013
Graduation Day

June 23, 2013

Like a woman in her ninth month of pregnancy, I began to believe that physical therapy was going to last forever. But on Friday, I "GRADUATED"!!! Yay! My MWF trips to town are hopefully over for now, and Peggy's gracious help is hopefully not needed any longer! They released me with the assumption that progress will continue to be super slow so I will continue daily exercises at home and see the therapist occasionally if my strength and/or tension doesn't improve. Also he recommended getting a professional massage every month for the first while. Now who am I to argue with doctor's orders?!

I'm glad to be out, but I'm disappointed to be leaving therapy without being completely healed (my back and neck muscles are improved, but not back to normal). It feels like the responsibility is now thrown into my lap to continue with strengthening, and I don't know what the new normal will be.

I am grateful for the progress we've made over the past several months. I can now lift my arms, twist around in the car to hand things to the kids, rotate my head freely from side to side, and lift my head (kind of). The photo to the side is my graduation T-shirt (woo-hoo!) and proof that I can extend my arms! Thank you, Jesus!
-----------------------------------
I've also included a few pics from the last few weeks:

A lovely mountain getaway last weekend. It was true refreshment of our weary souls.

The latest family photo shoot (Photo credit: Thanks, Rhonda!)

An unflattering pose that shows nerve damage to the left side of my mouth. Kind of like a stroke victim...the one side just doesn't want to cooperate. We hope this will clear up in a year...?
-------------------------------------

My next big appointment/CT scan is in September with bloodwork in July. I probably won't be posting much until then. Thank you so much to those who read my site. Your love, prayers, and care for us during this last half year (Has it really been that long?) has been such a blessing. I've asked myself so many times, "How would a person go through a rough time without knowing Christ and without the support of other Christians?" Truly, God has been faithful and we've been upheld by you, our friends (some of you we've never met!)

I've been asked several times if I'm considered cancer-free. I like to think so; however, my husband reminds me that while there is no evidence of cancer now, one cannot prove it doesn't exist in microscopic cells. This is why every cancer patient has to be monitored so closely. My story has not ended, but I'm grateful for the healing that God has granted thus far.

Heidi Good

6/5/2013
Endocrine Appointment:

Keith was able to be at my endocrinology appointment at UVA. Lovely. My lab results were surprising to us. I've been feeling so run down and exhausted, but the lab results for the TSH came back at 0.8. This is down from 284 in mid-March and 19 at the end of March. However, they would like the TSH to be undetectable (as in lower than 0.1) to discourage regrowth of tumors; so they increased my meds again. Jitters and heart palpitations, here we come!

Pros and cons of CT scan vs. ultrasounds were discussed. CT is more accurate imaging, but the downside is radiation exposure and expense. They preferred the CT because of the significant number of cancerous lymph nodes. We decided to go ahead with a CT in mid-September. We will use the results of this scan mainly for a base-line for the whole body scan next March, as well as for future ultrasounds which will occur on a regular (annual?) basis.

I am so done with this. I find myself focusing on what I CAN'T do. As I've mentioned before, it is so easy to forget how God has provided so far. He has healed above and beyond our expectations. I can enjoy and care for my girls. I can manage the household chores and even do a little gardening. I've been convicted lately of my sin of ingratitude. Bro. Paul preached a sermon from Habakkuk about rejoicing in Christ independent of one's circumstances. Applied to my life, I can be completely wiped out on the couch, have a very fussy teething one-yr old, have no AC on a 90 degree day, still have supper to make; yet God can give the grace to have a thankful heart that rejoices in Him. Not there yet.

Coincidently (or not!) my most recent yardsale purchase was a clock with the verse, "The joy of the Lord is your strength." Love it!

Heidi Good

5/28/2013
And on and on

Written May 25, 2013
I went to therapy yesterday right after posting the last entry. For some reason, he did an evaluation yesterday and informed me that we are looking at four more weeks. So the original six weeks has now been doubled. That news was....."deflating" is the word that comes to mind. These silly muscles/nerves. I wish there were a way to whip them into shape. Patience. Perseverance. What we have here, folks, is a character-building opportunity (she says trying to be optimistic).

Heidi Good

5/24/2013
The official word is two more weeks of physical therapy. That will take us to May 31 at which point the therapist will re-evaluate the progress and then make a call. The extension was disappointing. I am ready to be done with being gone all afternoon three days a week and needing a sitter for the kids. On the flip side, the physical therapy is making a difference. I can now awkwardly lift my arms straight out. I can also sometimes lift my head from a lying position. For both of these things, they say I still compensate with the wrong muscles, but we are making progress and the other muscles are "waking up." Keith and I both agree that we don't want to stop therapy prematurely and regret the decision in 5 years.

My next appointment with endocrinology is in a week and one half. This appointment will include re-evaluation of TSH and calcium levels and a discussion of the plan for our 6 month check-up. Apparently Keith and I need to decide between a CT scan or an ultrasound to check for regrowth of tumors.

My other sweetie turned three this week. She wanted a dinosaur birthday! I off-handedly asked her what she wanted for supper. She did have a menu in her head...lima beans, meatloaf, mashed potatoes, peaches, strawberries, dinosaur cake, ice cream! All of this on a 90 degree day. Whew!


Heidi Good

5/2/2013
Written Apr 29, 2013

No days alone last week. A sick baby, migraine, and physical therapy consumed my life. However, this past weekend brought a noticeable improvement in energy. Our little family mulched, trimmed grass, and planted a few things in our garden. I cooked a simple meal from scratch, the first since January! I also washed the dishes for all the meals on Sunday, the first for months. I didn't know that dishwashing could be so fun! We are celebrating these things that indicate progress!

Another indication of progress is increased metabolism. Some days I finish eating one meal only to find that the energy that it took to eat the meal has made me hungry for another meal. It is not uncommon to eat six small meals in a day.

According to our original schedule, we are over half finished with physical therapy. On Friday my therapist told us that progress is slow, but a lot can happen in two weeks! He will re-evaluate next week. Last week, the athletic trainer tried a new exercise. I thought I was doing a great job only to find out that I was compensating with wrong muscles and that I needed to be stronger before we could proceed with it. So it goes...at least we're having slow progress and not a plateau or regression.

On another note, our sweet little ladybug turned 1 last week! (see pic). This picture was just after she grabbed the candle flame and snuffed it out with her hand. Thankfully she didn't suffer any burn and proceeded to dive into the icing.

Heidi Good

4/19/2013
Written April 18, 2013

I have been having more time alone at home with the girls this week. Yay! On Tuesday the housework was relatively caught up, supper was scheduled to arrive that evening, and there was no physical therapy appointment. I decided that it was the day to take the plunge to see if I could manage alone. Sophia was a mess and one half. She was teething and super high maintenance. The only way she was happy was 1) if she was outside in the wet grass or 2) if she was getting into trouble such as throwing all her sleepers into the wet bathtub, clearing shelves and drawers throughout the house, digging in house plants, eating crayons, and finding any other opportunity for destruction. Also she is not a napper. By 2:00 I had put her down for the umpteenth time and collapsed on the couch in utter exhaustion only to hear her awake after a cat nap. Then my blessed mother "dropped by." She didn't exactly drop by because she ended up watching the babe for an hour and worked in my flowerbeds while I slept. Maybe I'll think twice next time about braving the day alone.

In preparation of my visit today with Dr. Shonka, I asked my physical therapist to write a progress report. He said that my cervical (neck) range of motion has improved. The main problems are "significantly weak middle and lower trapezius [shoulder blade muscles]." I also present with a "forward head posture and inhibited deep neck flexors and 'hyper' active SCM."

It's crazy. My therapist can actually act as some of the muscles around my shoulder blades that aren't functioning. He had me try to lift my arms straight out. Fail. He pushed on those trapezius muscles and my arm went up like magic. He volunteered to follow me around to help me reach up to get things off shelves in my kitchen or reach for things in the grocery store. So next time you see me and a man trailing behind, that's my physical therapist, not my body guard.

The appointment today with Dr. Shonka, my surgeon, was uneventful. Basically he said the incisions look great. Continue with physical therapy. I don't need to see you back. Follow with endocrinology.

My next visit with endocrinology is June 3. Meanwhile, physical therapy is Monday, Wednesday, Friday with exercises to do at home several times a day. BTW, I did find a drill sergeant for those. Come to visit and you will hear a little voice saying, "Open, Mommy!," "Shut, Mommy!" "Now it's time to do your butterflies, Mommy!"

Heidi Good

4/10/2013
Written 04/10/13

Has anyone heard of a cold-blooded species of humans? For the last several months I've felt like a lizard living in the Arctic The warmer weather of the last three days has thawed out my body and with it came increased energy. Yesterday I was on my own in the morning until 10:30a. That felt like an accomplishment!

Physical therapy continues to be a positive experience. Every time I come away with my neck/shoulder muscles and bones feeling loosened and stretched. On Monday, the therapist enthusiastically took measurements to track progress. He was silent after the evaluation, and I didn't dare ask any questions! :) And for the records, physical therapy is not pain-free as anticipated by the original consult.

As for the girls...they are loving the weather. Sophia is having her first real summer experience in which she must sample (as in taste) everything she sees. This consists of gravels, sand, horse manure, bugs, dirt, acorns, and much more. Jacqueline has her entourage of imaginary friends. Along with the long list of actual two-year olds from church, she insists on including two friends named "Meatball" and "Potato." Since she is our firstborn, we'll assume that personification of food is normal. And if you are wondering, Meatball and Potato drive a yellow van.

Heidi Good

4/4/2013
Adventures

Written April 3, 2013

"Adventure" would be the word for the day. I began physical therapy. The first sign that I was in the right place was the wardrobe choice. I wore a uniquely coral-colored dress that matched the shirt and tie of my physical therapist. He noticed it and then a few minutes later someone yelled across the room to comment on it too.

My preconceptions of physical therapy were completely blown out of the water.

Myth #1-Physical therapy is a one-on-one endeavour in an isolated room
The exam, consult, and therapy all happened in one large room with 40 or so people milling around doing their thing. There were many physical therapists, athletic trainers, and PT techs there helping. The room looked a little like a gym with massage tables in a part of it.

Myth #2-Physical therapy is for the elderly.
The facility was not filled with grandmas recovering from hip replacements. With the exception of one elderly gentleman, many of the people there were young and recovering from sports injuries.

Myth #3-Physical therapy is only composed of exercises.
The physical therapist used osteopathic manipulation and massage in addition to the exercises. It was wonderful!

Myth #4-Physical therapy is painful.
The therapist and athletic trainer assured me that these exercises should never hurt or we are working against ourselves.

Myth #5-Physical therapy is grueling.
Forget the book clubs, the mommy's groups, the AA, or any other support group. I've got my physical therapy! Everyone was just working away on their exercises and shooting the breeze as a group. It reminded me of a big, happy social club. We had all kinds of conversations going...dying hair, what different people wear to bed, rackety old cars, and so on.

Timers kept going off as people would finish a set of exercises.

Lesson learned: dress like you are going to a gym work-out, not spiffy like you were going in for a doctor's examination.

After an initial consultation about medical history, he had me do many different exercises and took measurements. For example I could tilt my head 30 degrees to the left. Many of the diagnostic exercises were difficult if not impossible. He seemed pretty impressed with the amount of work to be done and rattled off the names of the muscles with limited or no function. After a few initial stretches, he did some neck/shoulder/back osteopathic manipulation and massage. Another lady deeply massaged my incisions to prevent scar tissue from forming and adhering to muscle tissue. The therapist thinks that I can be back to normal muscle function in 6 weeks if I come to the center 3 days a week and do a workout at home 2-3 times per day. This seems like a lot of time away from home, but I'm so excited to see light at the end of the weak-painful-muscle tunnel!

I was at physical therapy for 3 hours and then had a massage scheduled at a local spa (complements of my generous sister Gloria). This was a completely new experience as well. The massage therapist used hot stones to hold heat as well as in the actual massage. It was so luxurious to relax and let them do their magic.

The newness of the events of the day took a lot of energy. I came home and slept.

In six to eight weeks my thyroid hormones should be back to normal (energy). In six weeks my muscles should be back to normal functioning (strength). Six weeks is my new hope date. I am hoping by that time to be primary caregiver of my children and manage household duties. Currently someone is here whenever Keith is at work. Occasionally I am alone with the kids for an hour or so. This hour or so consists of damage control and not constructive home-making! Baby steps, baby steps.

Heidi Good

4/3/2013
endocrinology visit

Written Apr 1, 2013 6:14pm
Keith was able to get off work to go to my endocrinology appointment this morning. I think I had unrealistic expectations from the visit because I came away somewhat disappointed. I expected them to say that everything looks great, you are cancer-free, see you in a year for a little scan or blood test, and cheers to your healing!

Because of the original "significant disease" (i.e. significant spreading) in the neck, they are wanting to be "vigilant" about recurrence of the cancer. In six months they want to do an ultrasound or, more likely, a CT scan of the neck. Checking for recurrence would be a lot more straightforward if they could to a simple Thyroglobulin blood test. Unfortunately since my body makes antibodies to Thyroglobulin, the test is less accurate. I am to return in 2 months to discuss meds and the plan of action for the six month test. They will make decisions as we go.

The immediate focus is to get the TSH under control. Today they increased my thyroid meds. They want my TSH to be as low as possible (without becoming hyperthyroid) to suppress regrowth of tumors. I'd say that we've made some significant progress with the TSH coming from 284 down to 19 in less than 2 1/2 weeks. The goal is between 0-1.

Remember how Dr. Shonka tried to rescue the parathyroids during surgery? They are the glands right around the thyroid that help your body produce calcium. He was able to save three of the four. I guess you can say "saved" for the third one. That's the one he chopped up and buried in the muscle tissue with hopes of it reviving. The other two took a pretty significant beating. They were getting their blood supply from some of the thyroid tissue so he had to strip them really well. He told us that it would take a while for them to recover. During the week in the hospital after surgery, I had IV calcium as well as mega oral doses of calcium (she says as her stomach does flips as it recalls the nausea). Today, Dr. Brown told us that since we are this far out from surgery and I am still needing to take my calcium supplements, she expects it to be a lifelong need. Bother.

My first appointment with physical therapy is scheduled for Wednesday. Dr. Brown heartily affirmed this decision. She said that full recovery from the double neck dissection can be quite difficult and that therapy can be very helpful. Right now I'm trying to think of it as a gym workout instead a painful experience that makes my physical limitations glare. Sigh.

The journey continues. Today I kept hearing things from the doctor that made me begin to worry once again...we were surprised to see that it hadn't spread to your lungs and bone marrow (so did they just miss that on the scan?), we may need to eventually do a PET-CT scan, lifelong problem with calcium, and on....

And so I ask God to strengthen my faith and to remember His provision in the last several months.

To remember His answers to prayer for a successful surgery, stamina for the rough times, for helping the kids to sleep better, restoration of the soul, and so many other things.
To remember how He has healed my body in miraculous ways so far.
To remember the celebration of a test that showed no spreading to the lungs.

In fact, I think that it would have been a good idea to put a huge rock (as a monument like they did in OT times) in our front yard every time that God provided in a specific way. No doubt there would be a gigantic rock pile, and the grass (or house!) would not be visible.

Heidi Good

3/28/2013
Written 3/27/13
I think we may need to go into hibernation! The household is trying to fight off the latest virus/GI bug (complete with nasal congestion, fever, diarrhea, vomiting) making its rounds through the community. Jacqueline has been hit the worst during the last two days (but has made an impressive improvement late this afternoon). Sophia is still in the beginning stages. We've been attempting to practice strict hand sanitation as much as possible with children who cough and sneeze over everything including straight into your face. I've been experiencing mild nausea since yesterday, but thankfully it hasn't gone beyond that. Keith has managed to escape so far.

So my most recent days have been spent rocking babies, reading books, holding cool washclothes to brows, and wiping noses every 5 seconds. But I won't complain...at least I can hold them! Imagine looking over the fence at two sick babies who can't come close! I'm also so glad to have someone here to help with childcare and housework.

The most work that I do every day is probably my neck/arm exercises. It is success if I make it through all of them once. These are incredibly frustrating, not to mention painful. Even though I use a heating pad to make the muscles flex, they tend to cramp and spasm a lot. We are considering seeing a physical therapist because of some handicaps. I'm just realizing how my body has learned to cope with some of these limitations. For example, last night I realized that I've been using my arms to lift my head when I'm lying on my back and need to sit up. In the middle of the night when I want to check the time, I just grab a chunk of hair to lift my head far enough to see the alarm clock! :) Among other things, I can't lift my arms straight out from my body. If I keep letting these muscles get away with being lazy and not functioning, I'm afraid they will die off! No pain, no gain, right? Any volunteers for a drill sergeant?

Heidi Good

3/26/2013
Baby Steps

We have been enjoying life as a family...playing Legos together on the floor, reading books, playing in the snow, and even taking a stroll on Saturday. I can honestly say that every day my body is slowly getting stronger. I am so grateful. Today for the first time, I was alone with my girls for a few hours. While I enjoy having others here, it felt so good to be a mom and manager of our home for a little.

We just keep praising God for the answered prayers of last week! It is such a relief to be cleared of further cancer involvement. I was thinking I had 20 days to gain back my strength; but now that the restrictions are lifted, the only thing we are waiting on is my body to kick into gear! This has been more frustrating than I anticipated. However, the antsy feelings themselves feel like a blessing when I compare them to the lethargy of the last several months. Baby steps.

Heidi Good

3/22/2013
Celebration!!

Written 3/21/13

I could hardly wait to write this post. I have 1) miraculous news, 2)splendidly wonderful news, and 3) could-be-worse news!

1) Miraculous news-The cancer has not spread to the lungs! Dr. Rehm (textbook writer, chief of her department, and reportedly one of the best nuclear medicine physicians in the country) seemed to have expected it to have gone to the lungs. She said, “You must have been praying since last Thursday!” We claim that as a miraculous answer to prayer. Dr. Shonka did a wonderful job in the removal of the thyroid and the 94 lymph nodes in the neck; however, there was some residual tissue in the neck area that showed on the scan. This is expected and should be ablated by the past week’s radioactive iodine treatment.

2) Splendidly wonderful news-Remember I was originally told 10-14 days of separation from my kids? Then after the treatment, my body did not shield well and the restriction was lengthened to 20 days (aka…forever). They re-measured the gamma ray emissions today to see how my body was processing everything. After the calculations by the safety officer, the tech came back in to inform us that I AM FREE TO BE WITH MY GIRLS!!! As in right now. TODAY!!!! Talk about a shocker! My mouth dropped open. I threw my arms up in the air and whooped and then started weeping (happy tears, of course)! I looked up through my tears and saw the most hilarious sight that made me start laughing hysterically. We were in the room with the huge scan machine and the techs have this large glass window to see into the room. There was a cluster of male techs in the tech room. They were all craning their necks around their monitors openly staring at me with the most bewildered looks on their faces like “Shall we say…female???!!” And so I declare another answer to prayer… after only 7 days my body went from not shielding well to not emitting enough rays to be dangerous to my girls.

3) Could-be-worse news-The thyroid produces something called Thyroglobulin. They use this to annually measure whether or not there may be other thyroid tumors in the body. My extra special body has decided for some reason that it doesn’t like Thyroglobulin and has produced antibodies against it. Because of this we cannot trust the annual Thyroglobulin tests. There is a lab in California (the only one in the country) that can do specialized analyzing of the test results. We will likely be sending our results to this lab. Weird, yes.

My dad stopped by DQ on the way home and we celebrated with a specially made-to-order mini blizzard. You should try my personal blend…cappuccino and peanut butter cup with cocoa fudge and peanut butter sauce…SO delicious. When we got home, Fed-Ex had just delivered some gorgeous pink flowers from church friends (Thanks, Tony and Kim!). My girls both came over for some snuggles and I could indulge for as long as I pleased!! Dad ripped down the fence, and Peggy returned the timer to its rightful place on the stove. Jacqueline stated emphatically, while snuggling on my lap, “We don’t need the timer a-n-y more!” And so it is celebration time in this household! I am completely exhausted. Besides the emotional drama of the day, I have been fighting a migraine all day. I feel like a train-wreck. A very happy train-wreck

Heidi Good

3/20/2013
Written March 20, 2013

This morning I woke up. Sun was streaming in the window. The sky was clear blue. Birds were singing. I had no nausea. I had no pain. Tears of gratitude trickled down my cheeks.

Tomorrow is the day for the total body scan at UVA. They expect it to take two hours, and afterward we will meet with Dr. Rhem, the nuclear med physician. We are praying for physical strength for the trip. Although I am feeling stronger, I tire VERY quickly.

Heidi Good

3/20/2013
Musings...

Written Mar 18, 2013 1:55pm

I urge you therefore, brethren, by the mercies of God, to present your bodies a living and holy sacrifice, acceptable to God, which is your spiritual act of worship. Romans 12:1

For years, I’ve wondered the meaning of this verse. Today a book from my aunt entitled Living Sacrifice by Helen Roseveare brought some new meaning to this verse combined with the foremost commandment: “and you shall love the Lord your God with all your heart, and with all your soul, and with all your mind, and with all your strength.”

I will quote from her prologue:

“To love the Lord my God with all my [heart] will involve a spiritual cost. I’ll have to give Him my heart, and let Him love through it whom and how He wills, even if this seems at times to break my heart.

To love the Lord my God with all my soul will involve a volitional and emotional cost. I’ll have to give Him my will, my rights to decide and choose, and all my relationships, for Him to guide and control, even when I cannot understand His reasoning.

To love the Lord my God with all my mind will involve an intellectual cost. I must give Him my mind, my intelligence, my reasoning powers, and trust Him to work through them, even when He may appear to act in contradiction to common sense.

To love the Lord my God with all my strength will involve a physical cost. I must give Him my body to indwell, and through which to speak, whether He chooses by health or sickness, by strength or weakness, and trust Him utterly with the outcome.

The sum of these apparent costs…could be considered as the sacrifice that I am invited to offer Him as the response of my whole being to His love for me in that one ‘full, perfect, and sufficient sacrifice, oblation, and satisfaction for the sins of the whole world.’ It is my way of expressing my gratitude to Christ for all His is, and for all He has done and given for me.”

Dare I consider cancer as a “privilege” to enter in a small way into the fellowship of His sufferings and trust that He is using it for a higher purpose? That seems completely radical. Then I read James 1. “My brethren, count it all joy(!) when you fall into various trials, knowing that the testing of your faith produces patience. But let patience have its perfect work that you may be perfect and complete, lacking nothing.” These verses imply the God uses trials to make us more complete in Him! Ahh, what beauty there is in knowing Christ and in the hope that no experience is lost or beyond redemption!

Praise the Lord!


Heidi Good

3/20/2013
Home!

Written Mar 17, 2013 2:24pm

The view from the fence. I moved home yesterday late afternoon. Keith and our friend Jim had worked that morning to create a "doghouse" (as Keith likes to call it). It is MUCH nicer than a doghouse and is as lovely as a human pen could be complete with plants, lamps, and magazine holder! It seems to hold some charm for the girls. They enjoy getting their little stools and peeking over the top to converse. (See pic) We are still trying to figure out how to monitor the allotted amount of mommy time with each child. Right now we are using a stopwatch to keep track of the time. Thirty minutes passes quickly!

I'm also happy to say that while I'm not feeling well, I am feeling a bit better than I did on Friday. PTL! Baby steps....

In the photo section, I've also posted two snuggles pics from before treatment.

Again, thank you, thank you, for the overwhelming prayer support and encouragement. We have not felt alone in this. I am so amazed how the broad body of Christ can help bear each others' burdens. We are humbled and so grateful for your care.

Heidi Good

3/20/2013
Written Mar 15, 2013 7:48pm

Yesterday was a reprieve from the physical and emotional struggles of the last while. I think it was largely related to the anointing service the previous evening. The beautiful service was not focused only on the physical healing, but also the healing of the soul. And that happened. Something was restored in my soul, praise God, and I was able to face the big day with a serene, overflowing sense of God’s presence. I would describe it as a green pasture with a happy bubbly brook.

When we arrived at my sister's, my room was overflowing with gifts from my church family and friends. I was shocked and felt so loved!

Last night I was up around 5 times trying to faithfully eat, drink, and use the restroom. This was necessary to flush the body of the excess radioactive iodine and stimulate the salivary glands so they wouldn’t get plugged (something that doesn’t happen till about 2-3 days out…except in my case, of course. I must begin BEFORE day 1 is up!). It was quite the uncomfortable night trying to massage my jaws, drink, and suck on candies without throwing up. Last evening ended fairly dramatically. I am staying for the first two days with my sister Gloria. She was working in the kitchen and had a mixture of oil and water exploded all over her entire face! Horror! She was in incredible pain. Keeping my safe distance as a radioactive leper, I called Dad for his silver and B&W ointment. When mom and dad arrived, Gloria’s husband Jake welcomed them to “Rockingham Memorial Hospital.” She suffered some pretty serious burns that are swollen today, but dad’s remedy worked wonders like always. Gloria told some of her clients today that she was tired of me getting all the attention so she had to do something! :)

Today has been a doozy. It was probably one of the lowest days yet. I was so weak that to sit up required too much energy. Nausea, no appetite (yet knowing that I MUST eat and drink constantly for the previously listed reasons), energy about a negative 100, and just feeling like one of those construction machines with the big, heavy rollers with spikes had gone back and forth over me 10 times then just parked on top of my body (with the roller part) for the night while the workers went home for the weekend….In other words, I was completely incapable of taking care of myself. So I called for some “angels” (as in family members) to help heat up some drinks, food, and compresses for my painful glands. They were willing to risk radioactive exposure to help take care of me for a while. I’m grateful. After an afternoon nap, I took my first dose of Cytomel (thyroid hormone replacement) after I woke up. My diet restrictions were lifted at 3:24p this afternoon. Cynthia sweetly dropped of some DQ soft-serve to celebrate, and I enjoyed a few bites of that!

The health crumminess continues. Oh Lord, will it end? I beg for strength to go on and eyes to see and radiate Your glory.

Heidi Good

3/15/2013
treatment day!

Written 3-14-13

Today after I saw some patients at the office, I went with Lisa and her dad in a 15 passenger van to UVA. First, she had a neck ultrasound that was looking for residual lymph nodes, then to the cancer center for the last part of the 24 hour uptake test to see how many gamma rays she was radiating from the pill she took yesterday.

She also found out there were no intake restrictions (contrary to the literature we received which said no eating 2-4 hours before the pill) for today, so she was happily snacking throughout the day. Her nausea was present but greatly improved.

Next was our consult with the nuclear medicine physician Dr Rhem. It involved multiple details about the treatment and the specifics of handling radioactive effects of the treatment. She said the dose of the radiation is dependent on the extent of the disease in the neck as well as the results of the test done today. If the dose is over 200 (millicuries), Lisa would need to stay in the hospital to contain the radiation. The dose that she ordered was 195.6! They gave her this dosage because of the 50/50 chance that it has spread to her lungs. Her radioiodine pill was specially made in a pharmacy across town after the doctor ordered it. We had to wait for the delivery car to drive her special dose to the hospital so we had some time to eat another snack. Lisa also took an anti-nausea pill and anti-acid pill to protect her stomach from the radiation.

The pill finally came in a lead-lined container and Lisa swallowed it. Several minutes later they used a Geiger counter to measure the radiation coming from her, since everybody shields radiation differently. Based on those measurements they calculated that after her 2 days of isolation from the children, she can spend up to 30 minutes each day holding them for the next 20 days. Those numbers will probably be changed next week when she goes back for another scan and they see how fast she is breaking down the radiation. Lisa will be at her sister's house for 48 hours while she is the "hottest."
Remember how they wanted Lisa's TSH level to be over 30 for the treatment? (Normal is less than 3). Well, you could say she succeeded in that. Her latest TSH was 284. And when you consider that TSH goes up when thyroid levels go down, it is no wonder that she has been feeling run down.

She did very well today with the treatment and the ride home. There was little to no nausea and best of all no vomiting! The picture is Lisa holding her special pill in its lead-lined container.

Next week she goes back for the follow up scan which will show where any remaining cancer may be. Hopefully it will be nowhere, but if it is she may need another dose of radiation in 6-12 months. If it is in a place that can be surgically accessed, the preferred method is to remove it surgically, but since it tends to spread to lungs or bone, the radiation is often used. Please keep praying!

Heidi Good

3/13/2013
Written March 12, 2013

The Lord has heard the prayers of His people! After lunch today, the nausea greatly improved, and I was able to eat an entire 3-inch pancake at one sitting! Thank you, Lord! I did stop taking some of my meds which seemed to help. The relief is great. On Sunday, I had just told Keith that I thought that last week I was feeling the lowest that I could feel, yet every day has continued getting worse. The mental and spiritual anguish is intense and dark. Quitting sounds so much easier. Then that night the nausea and vomiting began. My only comfort is that God knows how much we can handle. The to-do list for this week is to stay alive. Some days holding a book takes too much energy. Yet, there are times when there is no doubt that God is carrying me and I have enough energy to pick up my baby or sit outside on the steps. This afternoon has been amazing. I was able to sit in my chair, get up and pack some belongings for the next several days, and write this post! What a blessing. On a similar note, the girls slept all night! Keith woke up this morning and said, “Sophia forgot to wake up last night!”

Tomorrow is the beginning of the two days of treatment at the cancer center. At 8am, I must swallow my first radioactive pill. This is a tracer pill that will light up my tissue and allow them to scan and collect pictures at 11a. The dose is so low that I will not be harmful to others. I plan to come back home for the night to get in some last “squishies” with my little girls and hubby. In the evening, we look forward to an anointing service with our discipleship group.

For knowledgeable praying, Thursday appointments are as follows: 11a-ultrasound at the main hospital, 12p-scan, 1p-consult with nuclear medicine physician, 2p-ingest the pill of life and/or death (depending on your perspective!). After taking the high dose of radioactive iodine, I will travel home in the back of a van diagonal to Keith, the driver. My sister Gloria has so generously offered her home as a place for me to spend my first two days of isolation.

Specific requests:

Physical stamina (traipsing from appointment to appointment, that nausea will stay at bay, my body will tolerate the lack of food and water for the allotted times before and after testing requirements)

Mental, spiritual, and emotional strength in abundance for Keith and me

Security for the girls while they are away from home and parents


Heidi Good

3/13/2013
prayer

Written Mar 11, 2013 12:31pm

Please pray for Lisa today. She had some vomiting overnight and today is feeling nauseated and very tired. She is not really able to eat anything. This is a concern because of how important it is NOT to vomit when she gets her treatment on Thursday. We are hoping another adjustment in medications will help. The doctor is supposed to call her back today.

Keith


Heidi Good

3/13/2013
Treatment Scheduled!

Written Mar 9, 2013 4:21pm
My iodine results finally came back from being sent to the Mayo Clinic. They needed it under 150 (ideally under 50) to be able to go ahead with treatment. After 4 days of dieting, mine came back at 12. It had been 220 during my hospital stay. Thank you, Lord.

The next hurdle was scheduling*. The endocrine and nuclear medicine docs had to get their heads together and form a plan and also figure out a space in the schedule. The paperwork sent to me a week ago showed that I was scheduled this coming Tues, Wed (Mar. 12, 13). When I called yesterday, my original appointment had been mysteriously cancelled and the soonest appt was after the 19th. A few days may not seem like a big difference; but right now every day is a marathon, and I was incredibly disappointed. After speaking with the helpful coordinator, she said that she would see what she could do. Within an hour, she called me back and said there was a cancellation and I am down for W,R (Mar. 13, 14)! That was an answered prayer!

This radioactive pill sounds like a mess with so many safety precautions. The previously-mentioned, helpful coordinator took the phone call as an opportunity to tell me half of the 5 million details (okay, slight exaggeration). For now, I just share some of my list to buy in preparation for the first two days of isolation: large quantity of a variety of fluids, snacks, large bag of lemon drops, paper eating utensils, latex gloves, lysol wipes, Zofran (anti-nausea), and Prilosec OTC.

The fluids are, of course, to flush the excess radioactive material out of my body. The snacks and lemon drops are to keep my salivary glands flowing. Apparently the radioiodine localizes not only in your thyroids, but also in your saliva ducts. Eating tart foods constantly can help keep the saliva flowing to minimize damage such as permanent dry mouth or taste alteration. The one paper says that I will need enough lemon drops to take every 5-10 min. starting one hour after I take my pill until I go to sleep! They also want me to set my alarm to eat, drink and use the restroom at night. I have a feeling that I'll never want to see another lemon drop for the rest of my life. :)

The gloves and paper eating utensils and lysol wipes are to keep the radioactive material from spreading to others. Everything must be placed in a double-lined trashcan.

I must take the anti-nausea medication every 8 hours so that I don't throw up the pill. The Prilosec is an anti-acid to keep my stomach calm.

Yesterday was Keith's 30th birthday! Mom made some cookies to drop off in the OR lounge for Keith's co-workers. In the evening, Rhonda watched the girls here at the house while Keith and I relaxed and watched a movie in room away from the kiddos! (How many months has it been since we've watched a movie?! I'm a stickler about kids and screen-time.) Rhonda also decided to stay the night so Keith could sleep. Don't you think that was the sweetest birthday gift ever?

As far as the health of the little family. Jacqueline is better. Sophia is over the worst part of her cold, but has teething and diaper-rash woes. Keith is in the final stages of his full-blown cold. I was grateful to escape the worst part of the cold with only a sore throat and runny nose. I still feel incredibly tired and horrible, but then there are times through the day when I specifically feel God carrying me. I know those are the times that God is hearing and answering the specific prayers of the saints. Thanks to those of you who are praying so fervently. We are humbled.



*The papers say: "Please anticipate some waiting at each stage of the treatment. Although our goal is for everything to occur in a timely sequence, waiting cannot be avoided. This happens because many people are involved and many actions must occur in sequence. To give you an appreciation of the number of people involved in your care, a list is noted below."

The Radiation Safety staff
Your Endocrinologist
The commercial company, who manufactures the radioiodine
The airline company, who flies your dose to the hospital
The local radiopharmaceutical company, who delivers your dose
The Nuclear Medicine Technologist and physician, who administer your dose




Heidi Good

3/5/2013
3/4/13

Very tired, irritable, cold, emotionally unstable...Call me human. Call me a sinner. Call me female. But know that whatever you call me would probably make me cry! :) I just know that I have no thyroid or no thyroid hormone and something is completely wacko in this body of mine! The above things are definitely on the list of hypothyroid symptoms. God, give me the grace to be loving and Christlike to my sick, demanding kids and to everyone who passes through this house. Keith and I are now both coming down with the kids' colds.

The first two weeks after surgery were difficult, but everyday I could see improvement, gradually getting stronger and back to normal. That came to a halt when I had nausea/vomiting for the third week. After getting my meds adjusted, I assumed the fourth week would be a continuation of the progression of the first two and we'd be back on the road to recovery. Not so much. OVERWHELMED is the word for the fourth week. I had zero energy and that made everything seemed like a mountain...the strict diet, the out-of-balance hormones, the radioactive iodine details and logistics (for example, how exactly am I going to stay three feet away from my babies for 10-14 days??), the comment from the head endocrinologist that because of how far it had spread up both sides of my neck, they "would not be shocked" if it were in my lungs and bones (While this does not necessarily change the prognosis, it still feels scary. They will give me higher dose of radioactive iodine), and discovering that I can't raise my arms with them extended from my body (temporary nerve/muscle damage from surgery?)...these things left me fearful, discouraged, and, yes, overwhelmed with life.

But, GOD. He has been showing me a few things through different Scriptures. One is Isaiah 41. While my mind is racing about and worrying, God says to be silent! Focus on ME. I'm GOD. I am the One that moves nations and directs the hearts of kings. And something does change within as we turn our eyes off ourselves and focus on God's greatness, goodness, and faithfulness.

The other Scripture is written on our bathroom mirror with a bathtub crayon. "Be anxious for nothing, but in everything with prayer and supplication, with thanksgiving, let your requests be made known unto God; and the peace the peace of God, that passes all understanding, will guard your hearts and minds through Christ Jesus." (Phil 4: 6, 7) Notice the command not to worry followed by the command to ask for our specific needs (with a GRATEFUL heart). When we do this, we are granted the promise that follows: supernatural peace that guards our hearts and minds. How beautiful and soothing is that promise!

Everyone has "stressors" that are a part of living in our broken world. Whatever you are currently facing, I invite you to join me in claiming these verses!

Heidi Good

3/4/2013
3/3/13

From my sister Cynthia:

Many of us feel helpless in the face of illness such as Lisa faces. What we can do, however, is storm the gates of heaven on their behalf. If you would like to join in organized 24-7 prayer for Lisa and family, please check out the pages set up for them at 24-7prayer. click here  (please go to the Caring Bridge site to join the prayer chain) http://www.caringbridge.org/visit/lyoder
Choose any or every day in March and click on "The Yoders". Add your name to the time slot you wish to designate to pray for them. Note you do not have to add your contact information (this is a public page).
A list of specific requests is on the page when you sign up.
Thank you for your care and prayers.

Keith


Heidi Good

3/4/2013
Written Mar 2, 2013 12:41pm

This is Keith updating for Lisa because she is too tired to do so. Lisa has been feeling more tired than usual this week, to the point that yesterday she was eating a sandwich and stopped partway through just to rest because she was so tired.
It's hard to know why her TSH levels are so high and when they went up, but it surely seems like it is affecting her energy. The doctor called again yesterday and said they would like to take advantage of the high TSH and get her radioiodine treatment done sooner. That is good news, but the limiting factor is her iodine level which was elevated for unexplainable reasons at the hospital. She has been on a low iodine diet for most of the week, so they want to recheck the iodine level to see where that is. If it is low enough, they might be able to do her treatment at the end of next week if the nuclear medicine people can work her in the schedule. Just to be safe, they told her to stop taking the thyroid medicine so that her TSH levels stay up for the treatment.
In addition, the kids have been suffering various afflictions. Jacqueline has a cough and runny nose and Sophia is teething and has a runny nose. They have had croupy coughs at night. Jacqueline is peculiarly fussy about her nose, and comes over to our bedroom multiple times through the night crying because her nose is running and sore and she wants us to wipe it. Last night I finally slept on the couch next to her so I could just reach up and wipe her nose whenever it bothered her. Needless to say, this also makes for longer days for Lisa, and it is not helped by my extra busy schedule which had me working from early morning until late evening/night twice this week. We appreciate the help of family and friends who come to our house to help while I am at work and bring meals for us.
We would appreciate prayers for several specific things:
- daily strength for Lisa (and Keith)
- healing for both Lisa and the girls
- that the radioactive iodine treatment could be done soon. This depends on both her current iodine level and the schedule at the nuclear medicine department.

Heidi Good

2/28/2013
Written February 27, 2012

This evening Dr Gibert called regarding the multitude of labs that I had done on Monday. The calcium has come down slightly (but still normal). One of the labs was testing TSH (something that your brain puts out to tell your body that it needs more thyroid hormone). When I took the same lab in January, my TSH was 1.2 which was normal. It shouldn't go above 3.0. In preparation for the radiation treatment they will give me two injections that will make the TSH sky-rocket to 30. The lab results for Monday came back at a shocking 88.8!!!! Keith assured me that I had good reason to feel like I'd been run over by a semi for the last while with no energy! If it weren't for the high levels of iodine in my body, we could possibly have had early radiation and skip the Thyrogen injections. Unfortunately we will still have to wait 2-3 weeks for the iodine to come down. Now we are reconsidering withdrawing the Cytomel after all leading up to radiation because I can at least somewhat tolerate the low thyroid level. Meanwhile, they are concerned that we get the TSH down to a reasonable level, which we will try by taking the Cytomel at a different time. It probably was not getting well-absorbed with the other meds I was taking.

Unfortunately the girls had some regression last night. They were up quite a bit. Around 3a, I finally dosed Sophia up with some Tylenol and Orajel. That seemed to help. Jacqueline was having a nightmare of some sort. Keith soothed her and when he came back to bed I asked him if she was having a bad dream. His response was, "Did she get an X-ray?" It's all in a days work!


Heidi Good

2/28/2013
Written Feb 26, 2013 9:14pm
Just a quick note from a nausea-free lady! Yesterday (Monday) and today have been world's different than last week. Ahhh, so wonderful! I ate food and more food that tasted SO good. Then. Then I went to my appointment yesterday and was put on a VERY strict diet for three weeks. A low iodine diet. Never did I realize what that meant. I thought maybe it involved foods with no salt or such like. The papers they gave me had lists and lists of foods not allowed: no milk, cheese, whole eggs, seafood, turkey, soy, rhubarb, breads with enhancers (like lecithin), most beans, most rice, some nuts, casseroles, chilis, iodized salt, etc.

All of that focus on the "evil" left me discouraged and overwhelmed, wondering if there was any "good" left (Isn't that just like life?!)! Thankfully there was a "foods allowed" list. Plain potatoes (with skins removed), sweet potatoes, 5 oz. of fresh meat (specified kinds), 4 servings of grains, broth-based soup, most fruits and veggies, and salt with no iodine, etc.

On the way home, I called my sister Gloria and Mom. Talk about stepping up to the plate! Boy, they were on that one. I stopped by the store for some uniodized salt and unsalted peanuts. Gloria came over soon after I got home and made special pancakes for my breakfast the following morning, peanut butter with the unsalted peanuts in my Vita Mix, tomato soup for my supper, and then she got up at 6a this morning to grill some chicken for my lunch. Mom made me some milk using pecans (one of the "allowed" nuts). What a blessing to have such a caring, supportive family! Peggy assured me this morning that I'm not going to starve.

The point of the this diet is to lower the iodine levels in preparation for the radioactive treatment. For some reason, my levels were quite high when they tested it during my hospital stay. In fact it was so high they incorrectly assumed I had a CT scan. At this point, we're looking three weeks. There are SO many scary and fascinating details that I want to tell you about the whole nuclear medicine world, but I'll have to wait till another time.

The Lord has graciously answered prayers. The kids continue sleeping so much better at night. My nausea has improved after the decrease in meds. This diet is a nuisance, but I'd sure rather be eating plain, skinless potatoes three times a day (which I'm not) than be nauseated. And so we continue trusting God to give us the strength that is needed one day at a time.

[Disclaimer: This post has not been edited by Keith. I take full responsibility for medical mistakes that I can hopefully correct later. He's working late...as in 10p!]


Heidi Good

2/28/2013
endocrinology visit

Written Feb 25, 2013 6:09pm
Today we had our first follow up with the endocrinologist. Lisa says there is too much to put in one post, so I will start with the medical stuff...
Our endocrinologist is Dr. Brown, and she has a fellow (as in MD in training for the specialty) who is Dr. Gibert. They both exclaimed when they saw Lisa that she looked SOOO much better than she did at the hospital.

There were several issues for discussion today: 1- How to stimulate TSH for the treatment phase; 2- Which thyroid medication to use until then; 3- How to reduce iodine levels until then; 4- What strength of treatment to use. The discussion was held largely between Drs. Brown and Gibert in our presence because they hadn't had a chance to discuss it before our appointment.

1. TSH is a hormone produced by the brain in response to low thyroid levels. When Lisa was pregnant, her TSH was around 3 (three), so they gave her thyroid medicine. Now they want her TSH to be above 30 (thirty!) for the treatment. To do that, as I think we previously explained, you need to be off of thyroid medicine for several weeks. The problem is that you feel very crummy for those weeks. The other option is to use "synthetic" TSH injections a few days before treatment. This has been shown to be as effective as the other method and more humane as well. Dr. Brown recommends doing the injection (Thyrogen). I think it is mainly because she saw how sensitive Lisa was in the hospital and she doesn't want to "rock the boat" (her words) by taking her off thyroid medicine.

2. When they decided to use Thyrogen, they also decided to switch her from Cytomel to Synthroid (thyroid meds, Synthroid is more stable than Cytomel and is what she will be on for the rest of her life). Just a technical point, but Cytomel has a shorter half-life (how long it lasts) and so she was on it so they could take her off before the treatment. If she had been on Synthroid it would take longer for her TSH to go up after stopping the med. But since they don't need to take her off at all because of the Thyrogen, they are putting her on Synthroid now.

3. Lisa will post on this later.

4. "Treatment" is a pill of radioactive iodine. The dose is measured in millicuries (mCi). Dr. Brown called the nuclear medicine doc and they decided to use a dose of 150 mCi. At first Dr. Brown was thinking of doing 100, but the nuc doc thought 150 would be better because of the extent of the cancer in her lymph nodes. There is still a chance that she has cancer in her lungs or bones, so a higher initial dose would be better to treat that. One week after the treatment, she would be scanned to see what areas "light up" to indicate other areas of cancer.

The next step is meeting with the nuclear medicine doctor to set up the final details for treatment, which hopefully will be in about 3 weeks.

~Keith

Heidi Good

2/28/2013
Written Feb 24, 2013 7:25am
We woke up this morning and realized the kids slept all night, 10 hours long!! Thank you Lord! It was so nice!

Heidi Good

2/28/2013
Written Feb 23, 2013 12:35pm
The nausea has gotten increasingly worse. I'm unable to eat much and/or keep it down. The scales keeps counting backwards. Yesterday was definitely not the best day I've had. After having a night of helping Keith care for the kids, we were low on sleep. The nausea worsened with vomiting. My neck incisions hurt worse than usual. On top of these things, I came down with a migraine. My usual migraines include headache, partial loss of vision and mental function, and numbness on one side of the body (including half my lips and nose...weird, I know!). With all of these things combined, I was really wishing someone would hit me over the head with a frying pan.

Dr. Gibert called me in the late afternoon and kindly asked me how I was doing. It was all I could muster to not to break down in a pile of sobs. After telling her that I still wasn't feeling well (since Monday morning), she gave me some beautiful words of hope (which did leave me sobbing after getting off the phone). Part of the frustration this week has been not knowing the cause for the nausea. She said that she believes that the calcium pills are to blame. I've been taking such high doses for such a long time that my stomach is becoming irritated. She greatly reduced my calcium supplements. Praise the Lord! Of all the pills that I take those are the worst ones that like to poke their sharp corners on my sensitive throat and get stuck several times before I manage to gag them down one by one by one by one at a time.

So I skipped my calcium last night with supper. This morning my nausea was noticeably improved. I actually combed my hair myself! Then I ate breakfast and took my pills. Now we're back to square one with nausea. Sigh. Hopefully it will improve as the day goes on.

Josh and Lawina, my oldest sister, travelled in from DE just to see me! I felt quite honoured, and it was wonderful to see them. Last evening, we had a family reunion of sorts...but I didn't participate too well!

Recently the girls have been sleeping some better than before. Thank you, Lord! I think we were spoiled by the previous months and months that they were both sleeping 10-12 hours solid at night! Somehow the Lord is upholding Keith. It boggles my mind how he can get up during the night then go work 10-12 hr days, especially when those days sometimes include standing still for long periods and focusing on surgeries. He's my hero.


Heidi Good

2/28/2013
Written Feb 20, 2013 6:30pm
The plan: Keith desperately needs a good night of sleep. Lisa will not take pain meds overnight so she can have the alertness to care for Sophia during her night-time parties. Jacqueline will continue sleeping well and getting up for her one-time potty break.

The outcome: Sophia slept better than she has for WEEKS!! She only woke up several times and Keith patted her. Thank you, Lord! Jacqueline got up more than usual causing Keith to have an interrupted night of sleep. Lisa did not sleep because of pain.

God did answer the prayer that Sophia would sleep better! Now for the rest of the family... :) Sleep is such a sacred thing.

As Keith mentioned, I've been having nausea and feeling over-all "crumminess" since Monday morning. This has not gone away. I went to RMH for labs yesterday (a day early) to make sure abnormal levels weren't to blame. Dr. Gibert, my endocrinologist (fellow), called today with the lab results: calcium 9.7 (down slightly from last week), phosphorus 4.9 (high end of normal), and magnesium 2 (perfect). She was happy with the levels, but unsure what would be causing the nausea. She will ask her attending physician tomorrow.

The girls have been so happy during the days. Jacqueline's imagination is as wild as ever. It is not unusual to have most of the 14 pillows off our wrap-around couch arranged into a house, playground, or church. She emptied the apple sauce tote and we found her using it for a car to take her to the ocean. Then it became a boat, and she began exclaiming about the whale she saw. Next she began putting foam alphabet blocks on her legs while telling me they were her wet suit so she doesn't get wet.

We continue to be so grateful for the help of family, Peggy, and a number of friends who stay with me during the days. Also, the meals and other gifts of love have been so encouraging.


Heidi Good

2/28/2013
Written Feb 18, 2013 6:24pm
Yesterday was our first time back at church. It was good to get out and see other people again. We went after Sunday school and Lisa spent most of the time in the recliner in the mothers' room. Her neck is still recuperating from surgery, which means that it gets tired very easily. Some people who noticed her holding her head while sitting in the pew thought she must be feeling pretty bad, but it's just her way of supporting her neck. She still does require lots of rest through the day. Today she has been feeling some nausea and overall "crumminess." We hope she didn't pick up a bug while out and about.
The last labs showed her calcium is still going up. This is good news, and Lisa has been able to reduce her calcium doses, which makes her very happy. The calcium level gets rechecked this Wednesday along with phosphorus and magnesium. Her endocrinologist has been good about calling to adjust her meds after lab results are back and we have the first office visit with her next Monday.
The girls have been sleeping a little better. Jacqueline (the 2 yr old) is pretty much back to her normal routine, but Sophia likes to wake up every 30-90 minutes. She usually goes right back to sleep when patted on the back, but it makes for a long night. We have discussed the various options and theories regarding self-soothing, but have not come up with any good answers yet.
We are undeserving of all the support we feel from you. Thank you for your continued gifts of prayer and encouragement. Please pray for continued strength for Lisa, and if you think about it, a few good nights of sleep for all of us would be nice too.


Heidi Good

2/15/2013
We had a great appointment with Dr. Shonka yesterday. He never ceases to impress us with the way he is so likeable yet professional and skilled. If he had not reviewed the MRI with the UVA radiologist we would be looking at another major surgery before the year is over. (You get what you pay for... we went to a cheap imaging center in PA. The original radiologist missed the cancer on the left side of the neck as well as many of the cancerous nodes around the bottom part of the neck).

He seemed happy with the way the incisions are healing. They have paled significantly. He said to wash them with soapy water and press a warm wash cloth against them when I shower. Other things important for the healing/concealing process include keeping the scabs picked off (This seems contrary to our mother's advice when we were growing up! He even picked them off during the visit!), keeping off sunlight for the first year, and using Vaseline to keep them moist. He seems to think that they will heal to the point where you won't even be able to see them at all. He's a plastic surgeon so I'll take his word for it.

He put the scope down my nose (can't think of the name) to check the vocal cord function. Everything looked great. That was the third time this test was performed. I was naive enough to agree to watch it on the screen during one of the other times. Never again. It is completely gross to watch parts of your throat flash by as it makes its way down to the vocal cords. Then to watch the cords move back and forth as you breath, sing, say words and various phonetic sounds, and all the while you look past this tube protruding out of your one nostril...shivers! It's amazing how God created our bodies, but it would be easier to stomach if I were watching it on another person.

We also heard the official pathology report, all eight pages worth. He removed a total of 94 lymph nodes from my neck. Yes, 94! I didn't know there were that many in your entire body, let alone your neck! Of those 94, around 20 were cancerous. Most of them were on the right side and on the central neck in and around the thyroid. Several were on the left side as well.

Since surgery, I've experienced numbness on both ears extending down around the chin. Probably the most frustrating issue has been not being able to pull down my lower lip. This makes it a bit more difficult to speak, smile, floss, eat and many other little things we take for granted. These things seem minor compared to many other possible significant complications from this surgery. Dr. Shonka said that these things result from irritated nerves and muscles and may resolve in the next year. I am grateful for that hope.

The best good news of the visit was that I CAN LIFT MY BABY!!! That's right, I can work up my stiff muscles and lift her whenever I want now. The only problem is her flailing arms and grasping hands. I haven't found a way to keep her away from my tender incisions. Once I can lift her out of the crib, that will mean that someone won't have to be here at 6a when Keith leaves for work. At the end of next week, I can work on lifting Jacqueline.

More later...


Heidi Good

2/14/2013
Written 2/13/13

Nothing major has changed in this little corner of the world. Each day I am getting a bit stronger. Yesterday I even when for a walk in the beautiful sunshine. I'm also grateful to be using fewer pain meds. We're still trying to figure out that fine line of pain management to use fewer meds with tolerable pain without it suddenly springing out of control. Tomorrow we have a follow-up appointment at UVA with Dr. Shonka, as well as a lab appointment at RMH.

I believe that God has protected the girls from a lot of the stresses. My mind goes back to the night we heard the diagnosis. Keith was on the phone with his parents. I was weeping in the chair, and the girls were playing peek-a-boo with the bathroom door and giggling hysterically over and over again. It was so beautiful to witness their oblivion to the pain in the world. Currently, they are understandably feeling unsettled. Both parents have been absent a lot recently, they have been passed from one grandparent to the next, Mom is not able to care for them, and someone is always with us. Their stability varies throughout the days. Neither of them have been sleeping well at night. Jacqueline gets up several times a night begging to be rocked. Sophia gets up for other various reasons. The last two nights they have been home have been quite rough. Last night for half the night, Keith was getting up with one of them about every 1/2 hour .

This ordeal has been more than a pain in the neck for me (literally!). Keith, the girls and the rest of our family have experienced added stress in their lives. So pray for continued strength (an extra dose of it for Keith!), a sense of security and emotional protection for the girls, and of course, that they (and their parents) could have a restful night of sleep. Thank you for lifting us up to the Father!


Heidi Good

2/14/2013
Written Feb 11, 2013 1:48pm
After a horrible bout with the GI bug and a splitting headache yesterday, I woke up feeling much better this morning! Thank you, Lord! I was able to keep my meds down, and we were so grateful to avoid an ER visit for IV calcium. Today I got bloodwork done and the levels were at 8.8 which is up a bit from last Thursday. My next lab is Thursday. Hopefully the numbers will continue to rise so that the dose can be reduced.

Keith's parents kept the girls overnight last night so we could get a night of rest. What a blessing!...especially after we heard that Sophia was up from 11:30-2:30am. Jacqueline did not sleep well either for some reason. Maybe that means a full night of sleep when they are back home tonight?! Keith escaped the bug and is was off to work at 5:45a this morning to do rounds at RMH. He seems quite happy to be back at work, and I can't say that I blame him!

Since I can't lift the girls, we need someone to be at the house whenever Keith isn't home. Rachel is my caretaker/sitter for today. Peggy Byler offered to help us out several days a week and family/friends will be filling the holes. It will be wonderful to have the same person helping consistently and I think she will be a great fit!

Feeling overwhelmed by God's goodness,
Lisa


Heidi Good

2/14/2013
In sickness and in health

Written Feb 10, 2013 9:49am
Lisa was going to update yesterday. She was going to say that she was feeling better every day and that yesterday was the best day yet. And I would have agreed. She took fewer pain pills than before. She was up more than before. She was looking pretty and good.

Then suddenly after supper, she "hit a wall." The pain that had been lingering hit full force and she could no longer function. She was too dizzy to take a shower but I couldn't help her because I had 2 little kids that needed baths and beds. I gave her some pain meds and guided her to bed. After putting the children to bed, I gingerly crawled into bed beside her. She promptly grabbed her emesis bag (souvenir from the hospital) and emptied her stomach contents. Throughout the night she did it 3 more times.

Fortunately the kids slept relatively well through it all. Lisa ended up sleeping on the recliner in an attempt to find a comfortable position. This morning my sister Monica graciously picked up the kids for the day and we are left to recuperate.

Lisa has not vomited for about 8 hours, but she has very little to bring up anyhow. I called the endocrinologist at UVA for advice on medications, since Lisa was too nauseated to take her morning meds. In characteristic fashion, the doctor advised to "go to the nearest ER," which is of course the same advice I would give, but not the advice I wanted to hear. The risk is that her calcium levels will go too low and she would need more IV calcium. But given her past experience with low calcium, it does not seem that she has symptoms of it now.

I gave her a nausea medicine that dissolves under the tongue, then a few sips of Sprite. That stayed down, so I crushed her calcium pills and she took that with little bites of applesauce and toast. It has been about 30 minutes and it has stayed down, so we are cautiously optimistic.

It seems Lisa caught the bug that has been afflicting the rest of the family. Hopefully it will be short-lived, but we were hoping to avoid it. That leaves me to be the next victim, and I was planning to (finally) return to work tomorrow.

And as the title implies, today is significant because 6 years ago we held hands and pledged our love to each other for the rest of our lives. I am honored to be the one who walks with Lisa in sickness and in health. She has been a true friend and loving wife and a dedicated mother to our little girls. I look forward to many more years together with my beautiful bride.
Keith


Heidi Good

2/14/2013
Written Feb 8, 2013 6:53pm

My mom brought the girls home today at lunch. The excitement that I felt when they pulled in the drive was similar to a child's first visit to the zoo. When they walked in the door, Jacqueline clung to my mom and didn't want to get down. Sophia openly stared...forever...with no expression on her face. Just those big gray eyes looking up at me. Then I broke down. Big sobs. Weeping on Keith's shoulder. Next there was a sweet little voice behind me, "What is Mommy doing?" Granny answered, "Mommy wants to hold you but can't." I sat on the floor with them and watched the sweetness ooze out of them as they played. Before long squeals, giggles, toothy grins, toys banging, and baby babbles filled the house. Such a sweet happy place we call home.

Heidi Good

2/7/2013
I'm back!

The mission all night and all day has been Operation Bowels. After surgery I had some diarrhea. However, the endocrinologist warned us that high doses of narcotics and high doses of calcium would cause severe constipation. Boy, was she right. Last night my bowels felt like they were molded with concrete and my stomach and abdomen were hard and distended. We tried various things. After a miserable night of pacing the house, things began improving after Cynthia made an early trip to the drugstore for an arsenal of constipation weapons. I cannot begin to describe the relief to have things on the mend. I think this will considerably help with nausea. Next time if I have to choose between surgery vs. constipation, I'm choosing surgery!

We had a bit of a field trip this afternoon to the RMH outpatient center to get labs drawn. My, I felt like such a rarity or something. We had people doing near 360 degree turns to take in this 26 year old that hobbled around like a 90 year old with a sliced and diced neck.

I'm so giddy about seeing my girls again. I find myself fantasizing about kissing their squishy cheeks and hearing their babbles and giggles. Maybe tomorrow? They were still vomiting today.

I must brag a little on Keith. He is the most loyal, loving person ever. You have seen through the posts how deeply involved he is and cares about all the little details. He has cared for me in little ways and enormous ways. I was struck again by his care this afternoon when he was combing my hair. Seriously, how many males can braid? When I asked him where he learned, he told me that he learned that in fourth grade art class from his teacher Mrs. Betty Hershberger. (Teachers, take heart!). God has given me a good man.

Friends, I have read and much appreciated your care and comments. Thank you for your encouragement. We have so appreciated the food, treats, flowers and cards. Thanks to everyone who has been so generous.

Heidi Good

2/7/2013
Home again

02/06/13

We did come home today. The picture is just before leaving the hospital. We left around 11:30 but stopped in town to drop off prescriptions and pick up some OTC meds. I got a burrito at Qdoba for Lisa to nibble on while I looked for calcium carbonate. Did you know that virtually every variety of calcium on the shelves has Vitamin D or something else added to it? That's actually a good thing, but not for us because she is on specific doses of Vitamin D and calcium and the mixture is not the correct dose for her. Since Costco did not have any, I went to Walmart and found what we needed. As a note of interest, the maximum daily dose is usually 1200 mg, but she is supposed to take 8000 mg. Since her parathyroid glands are still recovering from surgery, they are not telling the kidney to save the calcium that goes through them, so she tends to lose more in the urine. Additionally the parathyroid hormone tells the kidneys to convert Vitamin D to an active form that helps the gut absorb calcium. Once the PTH kicks in again, she should be able to back off the massive doses.
So, until we got home, Lisa was totally exhausted, nauseated and in pain. She took 2 pain pills and was able to sleep for 2 hours. After that she got up and took her first shower in a week and washed the blood out of her hair. The shower felt "amazing" and she was able to sit down at the table afterwards for some home cooked food. (Not that we cooked it). Now she is feeling clean and tired and achy.

It is so good to be home but difficult not having the kids here yet. It will be challenging to have them at home while Lisa is so weak. Furthermore, they came down with a stomach bug today so we don't want to expose Lisa to any of those germs. We are blessed to have supportive family in the area who are able to help us out, as well as all our friends and church family who have been giving us so much.

We are not sure how the next days and weeks will go but hopefully she will get stronger every day. The itching has let up a lot, probably because she doesn't need as many pain pills. The last 2 drains were also removed the other day, so she is looking more and more normal. She is still having a fair amount of nausea, so keep praying for that.

Heidi Good

2/7/2013
Going home

Written Feb 6, 2013
Yes that's right, although it has not happened yet. The docs have made their rounds and are happy with her progress. Calcium has finally stayed up overnight but we will need to keep checking it a couple times a week. Nausea is still an issue but not something to keep her in the hospital for. We will keep you posted.

Heidi Good

2/7/2013
Another prayer request

Written Feb 5, 2013
Lisa is feeling very nauseated today. She has only been able to eat bites of food but taking her medicine on an empty stomach makes the nausea worse. We have cut the pain medicine in half in hopes of helping some of the nausea and fatigue. She asks that you please pray for relief because she is very miserable.

Heidi Good

2/7/2013
Written Feb 5, 2013

Lisa is feeling much better this morning. Thank you for all your thoughts and prayers. Lisa specifically appreciated the written prayers we received. She said it gave words to the prayer she had when she was too weak to think of words.
I think it may have been a combination of things that hit her last night. I started just as we prepared to eat supper. She had tingling around her mouth and hands, classic symptoms of hypocalcemia but new for her. She got very tired and was unable to eat. She did manage to get down the oral calcium she was given but then she fell asleep. A little later she started saying that things were "shutting down" and "going black." I took that as a sign that something needed to happen fast. Her nurse was busy so I found the charge nurse and asked that the doctor be paged immediately. They showed up pretty quickly but it still took a while before their orders got processed. If UVA asks me, I will have some suggestions for improving their systems.
Fortunately the resident was aggressive about moving things along which helped us feel like we were not forgotten. They checked a metabolic panel, mag, and phos and did an EKG. Because of a national shortage of IV calcium the pharmacy would not release the meds until the labs were back to prove the calcium was low. After about an hour she started feeling a little better, probably because the oral calcium was taking hold. They finally hung the IV calcium as well as more magnesium.
The other factor that may have contributed to the feeling of shutting down was her high doses of pain meds. She is trying to cut back as much as possible without having the pain go out of control.
The plan for today is to increase the dose and frequency of oral calcium to see if that will sustain her. Her Vitamin D level also came back a little low so that may be contributing. Also her low magnesium and high phosphorus levels can each cause low calcium. There really is a complex interaction of vitamins and electrolytes to keep things in balance.
Tomorrow is (again) a possibility for discharge. Thanks again for all your support.

Heidi Good

2/7/2013
Pray for a good night

Written Feb 4, 2013
Lisa had a rough evening. It is not clear what was causing it but they did a bunch of tests. Her calcium was low but not enough to explain her symptoms. Pray that she can rest well tonight and experience healing and peace.

Heidi Good

2/7/2013
Still here!

Written Feb 4, 2013

The short version: we are not going home today.

The longer version... Yesterday was very rough for several hours while trying to get the pain under control. I have a new appreciation for nurses who go beyond the call of duty to make patients' lives better. Our nurse was very proactive and did all she could to make sure meds were given on time (or early) and once when she wasn't immediately available she sent in another nurse to do the job. She called the doctor to ask for more pain meds when what we had wasn't working. So- to all the nurses out there: be good.

Overnight Lisa's calcium was 7.8, down from 9.4 yesterday morning. So she got 2 more doses of IV calcium and it was back up this morning. Her magnesium was even lower today (maybe because of some diarrhea issues, if that's not TMI), so she's getting another IV dose of that now.

New issues today are nausea and itching, possible related to the high levels of narcotics she is getting. Nausea is better now but still itching a lot. They gave a dose of Benadryl but that knocks her out and she doesn't like that feeling. Lisa asks that you pray about the itching. Other options are to change pain meds, but she is very hesitant to change it since it is working now.

Good news is that one of her drains was removed this morning! It is the one on the right side, so it will be easier to lie on that side without putting pressure on the drain. The others will come out as the output slows down, maybe later today or tomorrow. As we know, don't count on it until it happens.

Going home will be nice, but when she is feeling as up and down as she is now, I am just as glad to be here where she can get the care she needs.

This song has been a favorite of mine the past month. Thank you to all who have been raising us up to the Father:

"You Raise Me Up"

When I am down and, oh my soul, so weary;
When troubles come and my heart burdened be;
Then, I am still and wait here in the silence,
Until you come and sit awhile with me.

You raise me up, so I can stand on mountains;
You raise me up, to walk on stormy seas;
I am strong, when I am on your shoulders;
You raise me up... To more than I can be.

Heidi Good

2/7/2013
Written Feb 3, 2013 1:34pm

Lisa's calcium was still ok at noon but her magnesium was low normal. Since low mag can cause low calcium they are giving her some IV magnesium to be safe. Also they are checking her Vitamin D level because that can effect it as well.
Pain control is still an issue because they stopped the IV pain meds. We hope to find the right combo of pills soon but she is becoming a real druggie. :)
Tomorrow is a possibility for discharge. We shall see.

Heidi Good

2/7/2013
Patience

Written Feb 3, 2013

Lisa's calcium levels went up yesterday afternoon but back down in the evening, so they put her on a calcium drip for about 6 hours overnight. They checked her calcium levels every 2 hours as well so her night was interrupted regularly. She had a rough period last night where it was difficult to control the pain but after some adjustments in her medications she is feeling better this morning. She talked quite a bit yesterday and I think the movement of the muscles in her throat made everything more tender and inflamed. So today I have her on quiet treatment. I don't think I will talk enough to make up for her being silent but hopefully she can rest her voice.

Since she got the IV calcium, she will not go home today. Tomorrow is a possibility but I am not counting on it until it happens. The surgeon is happy with her overall progress but we just need to take it one day at a time to follow the calcium.


Heidi Good

2/7/2013
To see pictures please visit the caring bridge website: http://www.caringbridge.org/visit/lyoder

written February 2, 2013

I added 2 pictures to give an idea of what Lisa has been through. She sat in a chair for a few hours and for lunch. She wants to advance her diet tonight, so things are moving forward. Haven't heard what the latest calcium level was, but the nurse said their target is 8 or more. Enjoyed some visitors earlier today, and we expect family to be here this evening.

Heidi Good

2/2/2013
From Caring Bridge:

Our night was a little long but with periods of sleep, more for me than for Lisa. She was up pretty much every hour for this or that. The main issue last night was nausea and pain. Pain was controlled with IV pain medicine, but it had to be given every hour to stay effective. This morning she was able to eat some applesauce so they gave her a pill which should last longer.

Her swallowing is slowly getting better. Last night she was hardly able to swallow the water from ice chips but she ate oatmeal and pudding for breakfast with no problems. I think her throat is inflamed from the surgery as well as the breathing tube she had.

The main issue now is getting her calcium levels to a good place. They have been on the low side and she has gotten 2 doses of IV calcium. This is not totally unexpected but is something that needs to be addressed. The surgeon felt that he was able to preserve 2 of the 4 parathyroid glands (they are very small and easy to sacrifice during the surgery). He took out a third gland, minced it up and buried it in the pectoralis muscle. The gland is supposed to be able to get enough blood supply from the muscle to regenerate and keep functioning. So the calcium issue is likely temporary and should stabilize when the oral calcium she is taking starts to absorb and take effect.

She also has a curious pain in both of her elbows that prevents her from being able to straighten them out completely. Also on the left, her thumb and index finger are numb. These are probably related to both positioning of her arms during the long surgery as well as low calcium levels. The surgeon was a little puzzled because they are always careful to position the arms to avoid cramping or pinching anything. If anything, the ulnar nerve (funny bone) may get irritated but that would effect the last two fingers.

The endocrinologist stopped by this morning for an initial visit and she seemed to think it was more likely related to low calcium since that can cause random muscles and nerves to be more tempermental. We will be seeing the endocrinologist over the next weeks and months for radioactive iodine therapy and then replacement thyroid hormone.

Lisa is a new person from what she was last night but still a long ways from feeling great. If she continues to make progress she hopes to be discharged tomorrow.






Heidi Good

2/1/2013
From Caring Bridge:
Lisa has been up in her room for about an hour. She is very sleepy from her anti nausea meds but they are doing their job. She has impressive wounds and drains but her surgeon also does plastic surgery so I am sure she will heal up nicely.
My family members who were here complimented me on my appearance of exhaustion. It has been a long day and I hope we can both sleep soon. There is a decent cot in her room I can sleep on.
The next step is getting her strong enough to go home. She has not tried to eat anything yet but she has ice chips by her bed when she is ready for those. Hopefully the nausea effects of the anesthesia will wear off before long. She has been talking some but her throat is pretty sore from the surgery and breathing tube.
Thank you to each one who has been praying for us. We appreciate your comments and Lisa will treasure each one when she is alert enough to read them. I also felt your prayer support helping me to be at peace throughout the day. It really felt like I had a large support team holding Lisa and me before the Father.
Good night to all!

Heidi Good

2/1/2013
From Caring Bridge:

Finished

They are finishing the operation, surgeon is pleased with the results. No complications at this point. She will be in recovery an hour or so until We can see her.

Heidi Good

2/1/2013

From Caring Bridge:
Just got an update from the OR. Things are going "as expected" and it will "be a while" until they are through. The nurse said Dr Shonka is being very meticulous which is comforting. Pray for endurance for all!


Heidi Good

2/1/2013
From Caring Bridge:
The nurse called from the OR to say the lymph nodes on the left are positive for cancer. They will dissect all the lymph nodes on the left as well. Keep praying!

Heidi Good

2/1/2013

Lisa was taken to the OR at 0734. Dr Shonka met with us beforehand and explained that the MRI showed 2 lymph nodes on the left side of the neck and some around the thyroid in addition to the others on the right. They will do a central and right side node dissection and take out the nodes on the left for biopsy. The biopsy results will come back before the surgery is over so if they are positive they will also do a left node dissection.
This is more than they expected originally so she will very likely stay for two nights. In addition it increases the risk of injury to the nerves that control the vocal cords. If both nerves are damaged she may need a temporary tracheostomy or stay intubated overnight. Dr Shonka's highest priority is doing the surgery so Lisa can wake up breathing well on her own. Her voice will likely be weak or hoarse for awhile but it's more important (at least in my opinion) to breathe. There is also a bigger risk of injuring the parathyroid glands which means she would have to take calcium for the rest of her life.
Please pray for a conclusive biopsy of the nodes on the left. The way they do these biopsies (frozen section) is not as thorough as a regular pathology but it is designed to give rapid results in a setting when the results effect how surgery will proceed. Pray also for endurance and wisdom for the surgical team. It may take up to 8 hours (or more) if they need to do the left neck.
My parents and sis-in-law are spending the day with me so I should be well cared for. Please excuse any typos in this post as I am doing it on my ipod and cannot scroll through to proofread it. Thanks for all your continued support. I will update as I can. Keith

Heidi Good

1/17/2013
From Lisa:
On January 3, 2013 I saw general surgeon Dr. Mansfield for a lump on my neck that had been there for several months. He sent us to RMH for a needle biopsy the following week. A day later the final pathology diagnosed the lump as metastatic papillary thyroid carcinoma. An ultrasound of the neck on January 14 revealed the presumed primary tumor as a 1.75 cm mass in the right lobe of thyroid. It also showed the 3 cm mass in the right neck.

Please pray for Lisa and her family. You can follow her case at http://www.caringbridge.org/visit/lyoder.

Steve Byler


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