Cancer v. Nanobubbles

So I'm a big sci-fi dork, and find the idea of nanobots battling cancer full of cheesy sci-fi movie potential, while also being awesome. I do realize the article says nothing about nanobots, but rather nano particles... but for sci-fi purposes, it would be nanobots... But still, nanoparticles and lasers sound like something from a book. Particularly interesting is how they can target specific individual cells and can make them larger, and has been used in head and neck. I don't know about you, but for someone that deals w/ thyca, this could be huge. I mean, think about it... instead of using I-131 to eradicate leftover cells after surgery, using these little buggers instead? An end to potentially positive tests but where things are too small to biops to be sure. Maybe I'm jumping the gun a little bit here, but there seems to be sooooo much potential. Interested to see where it goes next

Nanobubbles: A New Weapon in the Fight Against Cancer?

The Verdict on a New Doctor

Things that are helpful... actually writing a post before I publish it...

So, after weeks of anxiety, mental exercises, and kicking myself for not going to the doctor sooner, the day of the appointment came and went. I was planning on posting something about my anxiousness before now... but by the time to do it came around I had so much going through my head I frankly didn't care about the endocrinologist any more (after 5 years, I have finally learned how to spell endocrinologist). And things couldn't have gone much better than they did.

I went into this appointment, not really praying for some good, or even using positive thinking... it was more the mentality of this has to go well, there is no other option. Rather than spend the day studying beforehand, I spent my day trekking up and down virginia beach and norfolk hunting down eye doctors and dentists and others to fill out my peace corps paperwork. I figured, why not do multiple things that bring me stress and anxiety all at the same time, and just get it over with. It helped. I was pretty pumped by the time I had to go in.

I got there 45 minutes early... as one of the local high schools was letting out, passed the building, and went to turn around on this back road where apparently all the high schoolers park. You ever want to feel real fear when you are driving, drive down a small road of a parallel parked teenagers trying to get out of school. By sheer luck, the end of this road actually went into the building I needed to go to, so I didn't have to attempt to turn around. As I pulled up there was a very angry man standing in the parking lot, pointing me back to the road. Yelling out, "this isn't a road, this is private property can't you kids read the sign." I had just been mistaken for a highschooler. My shocked response was, "I'm not a highschooler"... his response back, "It doesn't matter this still isn't a road."... "But I'm a patient"... "Oh... these people just cut through here all the time real fast, its dangerous"... He didn't apologize, but I think the sheer embarrassment of yelling at a patient trying to park was enough.

First impressions of the office: I hit the restroom before I went in. It was trendy. After the sterile environment of UPMC... being somewhere trendy was amusing. The walls were done in shimmery tiles, and the sink was a bowl sink... where there's a bowl... that has a drain in it... like i said trendy. I couldn't help but acknowledge this appointment may in fact cost more than I realized. I also picked a doctor in the wealthier part of Va beach, which may have hit on the trendiness. The waiting room was a fantastic deep turquois, and again, shimmery tiles. Probably the most calming waiting room ever.

The doctor: Mellow. Probably in his 40's/50's. As is per usual, he hadn't read through my file earlier. But we sat through it together. He was impressed with my care up till now, and agreed with everything done. Chastised me a little for not coming in sooner, and apologized for the wait. Then to kick off the actual exam, he took me back and ultra sounded my neck right there in the office. No waiting, no prep time, no radiology technician or student. Just him. Honestly, I wasn't mentally prepared to do an ultrasound right off the bat. It really is my least favorite thing to do, and I panic a bit. But he went hrough, and as he finished a section told me what he saw, and when my head was towards the machine, watching him measure nodes, he pointed out that it was benign and the middle bit I saw was just some fatty deposit. And then he cleaned me up like a baby, and told me everything looked clear, even my thyroid bed, which is what they had concerns about a year ago.

The plan: So we developed a new plan of action, pending blood work. Basically, he pointed out that the last round of radiation was based on a slightly elevated Tg level, and something that showed up on a pet/ct, but not on a RAI scan. So technically, they never really confirmed there was in fact cancer there. And now he didn't see anything on the ultra sound, so pending the blood work, things there's a possibility that I could have been cancer free for a while now, or at least everything slowly disappearing. He pointed out that the Tg could have just been some lingering thyroid cells, that weren't actually cancerous, but w/o biopsy no one would ever know. He still agreed w/ the course of treatment I was given b/c of how unusually aggressive my thyca was (he even broke that down to say i'm probably in a bout a 5-10% group w/ papillary thyca that aggressive). But he doesn't think a thyrogen stimulated round of blood work would be particularly helpful now, and maybe my body's been run through the gambit enough over the last 5 years. Needless to say, i'm cautiously happy about his opinion.

Blood Work: Our only point of contention was here, and it was only minor. I asked him if he tested free T3, and he said not normally, and asked me if I wanted it tested. I told him I did, and he let me know it wouldn't change his course of treatment, but he was willing to do it. This is also the point that actually impressed me. He asked if I've ever had a CBC work up, which I haven't, and he was like, "I want to run this because of how much radiation you've had." Shock and Awe! He wants to follow-up to make sure the radiation hasn't damaged my blood. I also told him to throw in my vitamin D levels for good measure.

Follow-up and the peace corps: I told him about the peace corps and gave him the paper work at the start of the visit and he never blinked an eye... except to ask me w/ my education if I would be getting a bit higher of a position. When talking about when my next visit would be, we planned for 6 months, so he could see me before I shipped out. It was like it never even occurred to him that the whole cancer thing might be an issue, and be part of the reason that I was sort of twitchy and anxious during the whole visit. So finally, I asked, do you think this should be an issue? And he just looked at me, sort of surprised, and was like, "no, why should it? Get blood work done once or twice a year. Do you have a plan for getting it done already? Both morocco and jordan have decent medical facilities that should be able to look at your TSH, T4 and Tg... be great if i could see you once a year, and there's always Dubai." My response was, "you should write that down on the paperwork... the peace corps needs to send me to Dubai once or twice a year for blood work." And that was that. A doctor told me that I should be fine, and even though he didn't really know me, it sounded like I would do well.

And that was it. 2 hours of my life w/ a new doctor, and the rules of the game have suddenly changed, and things are looking better than they have in a long time.

And a final story, while the nurse was taking my blood pressure, she was reading my wristbands, and was, like, "stupid what?"... "stupid cancer"... she looked a little closer at the wrist band, saw it was flipping her off, and just started cracking up.

So this is my "Fuck you cancer, you can kiss my ass, I'm getting my life back," moment.

How do you move forward in life, if you can quite seem to move on from cancer?

This is actually a post I wrote back in June. Though a little out of date, a lot of bits are still relevant, and I figured I should just go ahead and publish it for all to see.

By now, you should have gotten the point that things for me are sort of in a rapid state of stagnation. I've finished with school, I've moved from Pittsburgh, I'm supposedly looking on to bigger and brighter things. Rapid amounts of change, with certain constants. I still have cancer. I still need to block out time in my life to deal with cancer. I'm not even technically in remission, so I still need to be on high alert if I can feel anything change. In the ideal world, my last round of radiation would have obliterated whatever cancer cells I had left. I would be on a set schedule of six month-year check-ups, w/out extra testing or scans, or uncertainty. The drama tagged along with actively still having cancer would be done. And that would be how I wrap up one chapter of my life, in a nice little package, so I can start fresh, with the next chapter. Only minor strings and hassles attached.

If only the world functioned that way.

Am idolizing that sort of situation a little too much? Can cancer survivors really move on with their lives w/out it plaguing them? I almost feel like, and especially for young people, cancer just stays with you. I'm a bad person to judge on this. I've had too many false hopes, and too many recurrences. I think it would take me at least 2 years before I would accept a clean bill of health. And even then, and I know this from the 1 year of "clean" health I had, I wouldn't know quite who I was without the cancer label; how I should react, trying to figure out what really is and isn't worth worrying or caring about.

I think thyroid cancer has its own special ways of reminding us we will never be better, or who we were before. You lose an organ. A whole one, right off the bat. You will be taking a pill every day for the rest of your life. And for young adults, the rest of your life is a pretty long time.

Which leads me to the question... is it different for older people? People who have solid lives; who aren't necessarily at a point of massive change? People with jobs, and families, and homes?

And suddenly there was conversation

Sorry for the bombardment of posts... really, I had decided to pre-write a post a week until at least after the Bar was over so I didn't spend so much time doing it... only to start randomly have things happen, so now I've got like 6 weeks of pre written posts lined up, and still keep throwing things in the middle.

But, yet another extraordinary thing has happened thanks to the Peace Corps nomination. My friends are actually talking to me about my cancer situation.

I'm floored.

Its such a taboo issue, and had settled so far back into people's minds, that every time I tell them about the nomination, but warn I still have to pass the medical, its sort of like a reality smack. For most people its the first time I've told them that the docs told me I would probably always have cancer. For others, its explaining the risks, and talking about why its even an issue. As far as they can see, I'm fine.

I told my best friend the other day that I would not be getting radiation again... ever. She bout damn near flipped. Her sister, a couple years after me was diagnosed w/ Hodgkins... I can't imagine how she must feel. But I explained to her the new thyca guidelines. How 5-600 mCi accumulated in a life time significantly increases the risk of secondary cancers, and I've already had over 500. I told her about how I'm not going to do biopsies on things that are smaller than a centimeter anymore, and how I would need good reason to cut back into my neck for a third time considering how much scar tissue is already built up. It was a conversation I hadn't even really had with myself, but it all just spilled out. I am tired of aggressively fighting my cancer, and its time to take a step back and reevaluate things.

Further, things have caused me to think a lot about whether I realistically could do the Peace Corps. I understand entirely why they wouldn't want cancer patients. But, my meds are level, I'm getting into great shape. Overall, I'm pretty healthy. I'm not going to die or have ridiculous symptoms that would need me sent to a hospital. I would be fine just getting some blood work once a year to keep in check. I am a fully functional human being. I'm surprisingly confident about all that.

So what is it that makes me a bit of a neurotic cancer patient? I think its the little things that go along with cancer. Its being jobless, and going over the what-ifs. Its the loss of independence, and the constant reminder of everything I've done. I'm angry and I'm frustrated that this stupid little thing could have any impact on my life. And I'm worried, and justifiably so, that it will continue to do so. I'm not afraid of cancer, or it coming back, I'm afraid of how that might effect the life I've built. And I'm afraid of building that life in case I lose it again.

Twighlight Zone: A positive experience navigating the health world....

So, with the Peace Corps nomination comes the absolutely terrifying part... the medical evaluation.

Today, I got to see everything I need done, not actually a bad list, and probably a lot of stuff people should have done every once in a while anyways. Yes it means a few extra doctor appointments and a few more needles than usual, but, and I think for the first time ever, I'm sort of excited to do it. I'm not usually big on positive thinking, but in this case, I can't seem to conceive of not getting to do this. And while I'm wary of things that are too perfect, I really want this.

So I decided to start with something easy: hunting down my immunization records. Most normal people probably have these somewhere in a file folder. But due to the fact that I'm a travel junkie, I've probably had about 50 million times more immunizations than the normal person. The last time I think I got like 6 different ones. And they all got written down on this little card that was to stay with my passport. This little card did not survive the border check, I believe into Cambodia. I find this pretty amusing on some levels... So, the options are lie about what I've been immunized for and on what dates(b/c I don't really remember), get all the vaccines again ($), or go through the epic battle of fumbling through medical record offices, slicing through red tape, and hoping that they even keep this info on file. Oh, and I couldn't even remember where I got this done at. Amazingly, the hardest part of all this was messaging a friend and saying, "what is the place next to Arby's in Oakland where you get immunizations done?" County Health Department. I only had a main phone number; I prepared for the epic wait and phone maze. With in seconds of dialing and explaining I got an, "Sure, let me transfer you to the clinic."... Where the woman was like, just fax me a letter that says I can release your info to you. No form or anything. The whole thing took all of 5 minutes. I was in shock.

I then proceeded to call up my insurance company to see what they would cover, again prepared to be sitting on the phone with horribly unhelpful people. After arguing with the machine over whether I was saying "Y" or "9" for my id number, I was definitely mentally prepared to take on the customer rep. I explained what I needed done, gave her a list of the tests, and she was like, "yeah, they should all be billed as routine services and covered 100% through a participating provider." ... "let me just go ahead and pull up the list to double check for you."... "did you have a doctor in mind, I can check that for you too."... OMG she didn't send me to the internet to look up my own provider.

This whole experience has put me in a state of total shock. Enough so, that I thought I should share it with you all, since I'm sure most of you out there are like me, and used to the angry frustrating experiences of dealing w/ insurance and medical reps.