2013: The battle with the big C (thyroid cancer)

This is something I pretty much want to share with everyone because it is something common and may happen to any Tom/Dick/Harry/Betty/Mary/Sally, it isn't a joke and will be never close to that. Partly it also consist of my own reflections/attitudes/processes I've went through in case some of you out there are going through this and you are not alone. But remember, you rule your own mind, and that's the most important factor for recovery.

1) Always go for early / annual health check ups to detect any early stages of anything. It's always better to be safe than sorry.

2) If you find any lumps (be it singular or plural) on any weird and random places of your body, do get it checked as soon as possible. It could be benign if you're lucky, but unfortunately for some, it's malignant (harms your body over time). 

3) Never delay medical appointments, and always take deep breaths if you get too nervous awaiting any results.

4) GET.YOURSELF.INSURED.ALL.THE.TIME (Prudential - recommended by me ha ha)

(Getting a little too naggy)

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So basically the first ever I had noticed this lump/mass growing at the side of my throat (honestly felt like an adam's apple growing to my right side of my throat) was in February/March?

(You can actually see it sticking out of my neck on the right / 12th Jan 2013)

 I still remember those times where I would joke around with my classmates & friends and go "heyy guys check this out I'm a tranny in disguise *arches my neck back* I passed it off and told myself it's probably just the throat or tonsils swelling whenever I'm down with sore throats (at that time cough/thick phlegm/sore throats were occasional) so yep I led my life normally - school training a divs exams eat sleep chill until 2 months later I showed my mom one night and she had a shock. (By then it's April?) She dragged me to our family doctor the next day since I needed to check out why my eyes were constantly blurry (haven't recovered from 3 weeks ago's conjuctivitis properly back then). I had my blood drawn and assured by my doctor that it wouldn't be anything bad probably just a fluid contained lump, and got scheduled for an ultrasound that coming Friday. 

(Kinda huge...... / May 2013)

Both results came back as per normal, blood range were all perfectly healthy, ultrasound didn't show anything abnormal except for the mass/tumour like thingum inside the right side of my thyroid which seemed really huge (it definitely grew in size from Feb) So then, what is inside of it and is it a good tumour, or a bad tumour? Thankfully despite the assurance of the doctor that the most I'll have to go through is having a needle stuck into the tumour and drain the liquid out, my mom brought me to the polyclinic to get a referral letter to a government hospital because she felt that it was best to get it removed anyway. 

A month later on a Tuesday, I'm at Tan Tock Seng Hospital for my first visit. I had 2 things done on that day: 

1) Scope down my neck through my nostrils 

2) Needle biopsy into my neck to the lump to extract a little of it for check of whether it's benign or malignant. 

And then I went home thinking it's just nothing, prolly some random lump but honestly who would have thought so much about it if you were me? I'm 18 and active (healthy to me at least...) and the last thing in my head would be to be diagnosed with cancer. So the results were scheduled to be out a week later, and that night I went home (being kiasu) went to google the symptoms. 

(Credits to About.com)

• A lump, or nodule in the neck -- especially in the front of the neck, in the area of the Adam's apple. (Note: Sometimes, the lump or nodule will be growing quickly.)
• Enlargement of the neck
• Enlarged lymph nodes in the neck
• Hoarseness, difficulty speaking normally, voice changes
• Difficulty swallowing, or a choking feeling
• Difficulty breathing
• Pain in the neck or throat, including pain from the neck to the ears
• Sensitivity in the neck -- discomfort with neckties, turtlenecks, scarves, necklaces
• Persistent or chronic cough not due to allergies or illness
• Asymmetry in the thyroid (big nodule on one side, nothing on the other)
• Nodules that when manipulated give the impression that the entire thyroid is moving (this is often a sign of an aggressive cancer)
• Nodules that cause the wind pipe to go to one side of the neck, as well as cause superior vena cava syndrome
• Some particularly aggressive thyroid tumors can go to the brain and cause neurological symptoms

I had none, except the first about the lump on my neck so basically I just kept assuring myself the whole night that I ain't that unlucky plus I pretty much don't have majority of the symptoms. But what if it's the early stage and things are pretty much are still unknown/haven't spread?  zz

A day later I got a text from my dad informing me that our appointment has been pushed earlier to that Friday rather than next week. My mood indefinitely went from being the cheerful me to tearful me (ha ha) in geog tutorial. Everything was just running around my head coupled with the anxiety and uncertainy of what the results were that I had to go back to the hospital earlier than planned. 

So Friday...

Diagnosis: Papillary Carsinoma (Papillary Thyroid Cancer) 

"Papillary thyroid cancer or papillary thyroid carcinoma is the most common type of thyroid cancer, representing 75% to 85% of all thyroid cancer cases. It occurs more frequently in women and presents in the 20-55 year age group. It is also the predominant cancer type in children with thyroid cancer, and in patients with thyroid cancer who have had previous radiation to the head and neck."

(I don't know but I just felt as though my world cane crumbling down when I heard the diagnosis. I don't know what I had done in my previous life to have such bad luck because there is no one in my family/relatives who have ever had thyroid cancer or any thyroid problems... And the doctor said the cause of it is n o t h i n g... WHY ME?)

But what does the thyroid do that worries me so much? 

"The thyroid tissue is made up of two types of cells: follicular cells and parafollicular cells. Most of the thyroid tissue consists of the follicular cells, which secrete iodine-containing hormones called thyroxine (T4) and triiodothyronine (T3). The parafollicular cells secrete the hormone calcitonin. The thyroid needs iodine to produce the hormones.

The thyroid plays an important role in regulating the body's metabolism and calcium balance. The T4 and T3 hormones stimulate every tissue in the body to produce proteins and increase the amount of oxygen used by cells. The harder the cells work, the harder the organs work. The calcitonin hormone works together with the parathyroid hormone to regulate calcium levels in the body."

Source: http://www.umm.edu/endocrin/thygland.htm#ixzz2WFSZ3AN4 

University of Maryland Medical Center

So together with my dad, we met with a senior consultant Prof Mark Khoo (he's super nice and patient he calls me dear HAHA ok well my emotional state of mind then was haywired maybe he said dead instead) who gave us a detailed and thorough go through of the procedures that are applicable and what I will be going through thereafter, the side effects and etc.

1) MRI the next day

2) Await results - see if a PET scan is needed

3) Decide on the extent of surgery based on both scans

4) Surgery for a full thyroidectomy + removal of windpipe's lymph nodes

5) Radioiodine therapy 

6) Chemotherapy

7) Thyroid hormones (Thyroxine) pills for life

The doctor ruled out chemo because for thyroid cancers, doctors seldom resort to that unless it is of the last stage so that is something I am thankful for, in that whole particular day. 

So after my MRI I had to go for another scan which is the PET scan to determine the agressiveness of my tonsils (suspected to have been affected by the cancer) and the tumour and (thankfully) my tonsils were inflamed but on a very low level because I'm an adolescent (teens are prone to common illnesses and that in that week itself I had a bad cough) so I didn't have to remove my tonsils and the lymph nodes near the right neck-ear area. However, the bad news was that the tumour of my cancer turned out to be super aggressive on a scale of SCV 23. And cancer tumour's are usually about the range of SCV 7-14?? Non cancer tumours are below SCV 1/2?

So yep, scheduled for my whole thyroid to be removed as soon as possible (28/5) because I no longer wanted it in my body anymore but I'm really glad throughout the whole diagnosis process I emerged pretty positive. (Gave myself a miss of school day to cry over it... And picked myself up after because the nurse is truly nice she gave me a little counseling after seeing me on the phone in tears with my mom... (Thank you Prem)

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The one thing I was afraid of the most, was that I was afraid of getting fat. 

I usually have really high metabolism whereby just walking from the mrt to school would leaving me sweating buckets on the track every morning and then now, *baam* I will no longer get to experience that anymore (until I get my thyroxine which regulates it back again but the rate will take a few weeks to get adjusted to suit my body) if the dosage of my thyroxine (pills for life) is too high, I may suffer from weight loss despite increased appetite, anxiety, intolerance to heat, hair loss, muscle aches, weakness, fatigue, hyperactivity, irritability, paranoia etc. And if the dosage is too low, I experience the same just that I'll gain weight and have irregular heavy period flows. All these were all internet researched and I kinda gave myself scares just reading various recounts but there were some that were positive so those were really motivative for me.

As of now post surgery, the incision's healing well it wasn't too painful afterall as what I had expected. (The constant pain I experienced were mainly from the tubes attached into my neck to drain out fluids to prevent water retention/infection) I was shivering like mad upon being wheeled into the OT. 1) It was freezing I had almost nothing on. 2) Nervous........

(A week post thyroidectomy)

They had removed one out of four of the calcium ducts (parathyroids) that we all have and I've been on calcium pills still then for a few weeks temporarily in case my calcium level went on shock but it hasn't. My vocal cords are partially in hiberation (hopefully it's temporary) because of the surgery which had shocked it AND I can no longer sing I honestly do like singing but there's nothing I can do about it but just attempt to sing really badly now ha ha ha. As for my energy level I do get tired easily but it's honestly all in the mind!!! If you tell yourself that you're gna be tired and lazy, you will be so I attempted to make myself go out to study or meet up with my friends or even cooked lunches (and I perspired while doing so haha sense of accomplishment)

And being away from the exercising world makes me feel like a glutton I definitely had put on 1kg as of today (14/6) but I'm trying to control my food intake and the fact that I can't eat food high and rich in iodine (no seafood/seaweed/reduce intake of dairy products) until the day of my radioiodine treatment helps me a little I guess? 

RAI treatment scheduled on the 24th June (a week before BT2) but I can't wait to get over and done with so I can join everyone back in school to take the exams as a healthy student body again!!! ^_^ Scan would be on the 26th June and results will be out on the 27th/28th to see if I'm cleared of the big C.

So what's this RadioIodine Treatment all about? 

"The thyroid gland absorbs nearly all of the iodine in your body. When radioactive iodine (RAI), also known as radioiodine or I-131, is taken into the body as a liquid or capsules, it collects in thyroid cells. The radiation can destroy the thyroid gland and any other thyroid cells (including cancer cells) that take up iodine, with little effect on the rest of the body.

This treatment can be used to destroy any thyroid tissue not removed by surgery or to treat some types of thyroid cancer that have spread to lymph nodes and other parts of the body.

RAI treatment improves the survival rate of patients with papillary or follicular thyroid cancer that has spread to the neck or other parts of the body."

So I will have to be hospitalized for another 2 nights until my radiation level falls. I do hope I'll take this chance to rush my studies before BTs the next week :-( 

As of now I'll have to keep myself healthy and positive because I will fight this battle with everyone so supportive and encouraging :-')

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Back home from the docs after my final scan. Past 3 days have been pretty torturous being locked in a confined hospital room after consuming the radioactive iodine in 80mcl with standard renovations drillings at 1pm everyday (WTF..... I needed to sleep) and the constant nausea-ish feeling I get which caused me to officially give in to vomitting on Tuesday (I have always hated vomitting it's always smth I would control until I buay tahan kind). It was so tough and difficult to sleep I kept drooling and the smell of food just made my appetite vanish the oil especially ughh thinking about it now doesn't make me feel any much better either. Got discharged yesterday and never got the chance to study anything (GG.com for exams next week) and had to keep a distance from people about a few feet away but as of today my radiation level is back to normal I can now sleep with my brother in the same room!!! yipee

So had the scan done today to check if the cancer's in remission but it's still too early to see because the thyroid cell is still being killed by the radioiodine in process (discharged out of my body via urinating/shitting.....) but based on what the doctor sees, it's all good (en route to recovery!!!!!) and I can finally head back to school a normal healthy kid again (just thyroid-less) but on thyroxine pills every day. :-S

And in 2-3 weeks time I'll be able to pick up sports all over again! Prolly go for a dip in the pool to join the polo people miss them miss school miss everyoneee :-')

Praise God and I really want to thank God for being with me throughout because without His strength in me I wouldn't have made it this far, and my family for giving in to my random mood swings and food cravings and soursop (AKA american durian) which prevents cancer so.... Order it next time without any hesitation, it's good! And also my friends who are always pushing me on and praying for me and entertaining me via text like Jess about Miley Cyrus.... Hahaha :-* Love you all. Thank you so much to all my friends/teachers/relatives who have been so ever supportive w your wishes etc!!!!!! :-) ♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥

So proud of have ended this journey strong. Even tho I now have quarterly visits a year to the hospital for checkups to check if my dosage is alright / see if I'm officially in remission but I'll wait for that day to come and I'm sure it will come soon :-))

Long and wordy post but I just needed to pen these down somewhere to show my grandchildren/ kids in the future HAHAHA lame -____-

Till then xoxoxoxo :-')))