Monthly Archives: February 2016

Clues

By February 2014 I had a lab slip for an ultrasound to check the lump on my neck from a thyroid goiter (enlargement) that hadn’t been checked in 8 years.  Back then I knew enough to ask questions and seek out answers, but I definitely didn’t carefully evaluate every doctor, specialist, lab, clinic, or testing procedure provider.  I didn’t understand the power I had to choose my care providers.  I don’t remember where I had that ultrasound test done – who performed the test wasn’t significant to me at the time.  I clearly remember the results though: my goiter had grown to 1.2cm.

A follow up visit with Dr. Elliott confirmed what I already knew: this was concerning.  I needed a fine needle aspiration (FNA) – a test where a needle is inserted through the skin of my neck into the nodule (growth within my thyroid gland) and some fluid is removed for cancer testing.  An Ear, Nose and Throat (ENT) specialist in the same medical group as Dr. Elliott was capable of performing this test, and because I trusted Dr. Elliott I trusted other doctors in his group.

I made an appointment with the ENT specialist, who I’ll refer to as ENT#1.  He seemed pleasant, and began explaining to me how the FNA procedure would go.  He would numb my skin, I would tilt my head back, he would insert the needle into my neck and extract the fluid from the nodule.  He would repeat this process 5-6 times.  The goal was to get as much nodule fluid as possible.  He also explained the spectrum of possible results: benign (negative), undetermined, suspicious, or malignant (cancerous).

I explained that I am not a fan of medication and surgery, and believe those things should be used only when absolutely necessary.  My goal was to keep my thyroid unless it was cancerous.  As ENT#1 was explaining the possible outcomes of the test, he mentioned that some of his patients have their thyroid removed “just for peace of mind”.  This was odd considering I had just finished telling him I only wanted surgery if it was necessary: if he was paying attention he would have known this information was irrelevant to me.

At the beginning of the appointment I told ENT#1 I had just come from the chiropractor because I was having some back and neck pain.  He later told me about one of his patients who was having back and neck pain.  She was seeing a chiropractor, and during a test to diagnose the neck pain (I can’t remember which test) a thyroid tumor the size of a grapefruit was found.  This wasn’t exactly reassuring.  If he’d been paying attention he would have known this would be very disconcerting to anyone with potential thyroid issues, let alone a person who had just been to the chiropractor.

I’d researched the testing procedures and read that often the FNA test was done with ultrasound guidance, where an ultrasound showed where the needle was going.  ENT#1 planned to do the test without ultrasound guidance.  I asked him about this, and he said there were some practitioners who used ultrasound, but he did not use that method.  He assured me he knew exactly what he was doing and was “really good” at finding the exact spot necessary to extract the fluid.  I was already there in his office, psyched up to have the test done, and with his reassurance that he was competent I went ahead.

I leaned on an upright examination table, then tilted my head back to expose my neck.  ENT#1 conducted the test just as he’d described.  He said he could tell by looking at the fluid that it was the fluid from inside the nodule.  He was confident.  When he was done with the test he returned the table to its normal horizontal position and left me sitting on it for a minute while he took the fluid samples to their rightful place.  The test was complete.

While ENT#1 seemed pleasant enough, I felt an uneasiness. I was nervous about the test and the possibility of cancer, so I didn’t put much credit in that gut feeling.  I put it down to nerves.  In hindsight there were plenty of clues pointing to me being in the wrong place, but I hadn’t yet learned to rely on them.

Think about the medical providers you use right now.  Are there clues that point to you being in the wrong place?

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The Question That Saved My Life

My family doctor saved my life.  It wasn’t by some amazing surgical talent or medical prowess.  It wasn’t by knowing about some new trial or cutting edge technology.  It was by asking one very simple question.  A question that can only be asked by a person who is paying attention.  A person who is engaged with their patient.  A person who hasn’t become so distracted by overburdened schedules, dollar signs or the number of surgeries they rack up that they miss the most basic elements of their job.

In January 2014 my son had Influenza.  It was terrible.  During my son’s Influenza disaster I began to feel flu-like symptoms.  I visited my family doctor, Dr. Elliott.  I had been a patient of Dr. Elliott’s for about 4 years at that point.  My influenza test came back negative (I was probably having sympathy symptoms for my son!).  Under average circumstances my visit would have been over once at that point.  Fortunately Dr. Elliott is not an average doctor.  He continued my appointment.  He reviewed my chart and said, “So I haven’t seen you in over three years, which tells me either you’re generally pretty healthy or you don’t like doctors.”  He then proceeded to ask me the one simple question that would eventually save my life, “So what else is going on health-wise that I should be aware of?”

This question forced me to take the focus away from my flu-like symptoms and really consider my general overall health picture.  I don’t remember my exact response, but I’m sure I was secretly pleased about my doctor confirming that I was generally pretty healthy (since I didn’t dislike doctors).  I ate well and exercised regularly – I’d even run a marathon a little over a year before this visit.  My response probably started out with something like, “Well nothing really.  Overall things are good.”  One thing I’m certain of is that I told Dr. Elliott about the lump on my neck – a goiter that had been discovered in 2006.  Goiter is the term for an abnormal enlargement of the thyroid gland.  Because the goiter only measured ½ a centimeter back then, I was told it wasn’t an immediate concern but I should “keep an eye on it”.  I had seen a doctor for issues with my thyroid hormone levels and been monitored with blood tests, but I never had a follow-up ultrasound.

Dr Elliott examined the lump and asked how long ago it had last been checked.  Upon hearing it had been 8 years he suggested we do a follow up ultrasound “just to make sure”.  This launched my journey through cancer.

I have a lot of respect for Dr. Elliott, and obviously I am extremely grateful to him for asking me that question on my visit in 2014.  He pays attention, answers my questions, researches things he doesn’t know, and stays current on the latest research.  But beyond that, I like him as a doctor and as a person.  I think it is incredibly important to like your doctor.  I think this is something people often overlook.  They think going to doctors is like getting your taxes done – a necessary but completely unpleasant experience.  Or they look for skills, ignoring the bedside manner or human element of the profession.  I think many of us as patients have lost sight of our basic right to be treated like an individual that matters, our ability to choose one doctor over another, and the importance of pursuing excellent care and not stopping until you find it.

You owe it to yourself to seek out a good family practitioner, specialist, surgeon, chiropractor, dentist, optometrist, lab, pharmacist, and other medical provider that gives you a feeling of competence, confidence, and personal care.  In my upcoming blog posts you’ll hear about some of my experiences with not-so-good practitioners and how I weeded through them to get what I needed.  You can too.  You have to trust your instincts, know what you deserve, don’t lose sight of how important it is, and don’t stop until you find what you need.  I’m not just talking about people with cancer.  I mean everyone.  Everyone deserves excellent medical care.  Until you stop accepting the mediocre or sub-par, your healthcare dollars will continue to support the segment of the healthcare industry that needs to disappear.  

Life Experiences

I enjoy the journey of growing through life’s experiences. I frequently challenge norms and processes, examining alternative ways to solve problems. I share my experiences with others in the hopes they will challenge the process in their own decision-making future.

I am more than the sum of my experiences. The twists and turns my life has taken and what I chose to take away from those experiences have shaped me like a river shapes a canyon. I am strong-willed, but I try to be less stubborn than I used to be. I am caring, but I try to maintain healthy boundaries and not get overly involved in other people’s issues. I believe in a strong work ethic, but I’ve also learned that it is essential on occasion to completely relax. If you want to learn how to use your power of choice to grow, adapt, and experience life to it’s fullest potential, I think you’ll enjoy my blog.

River through canyon  Photo Credit

I grew up in Auckland, New Zealand. Now I live in Nevada, USA. I’ve also lived in Nagano, Japan and London, England. I’m constantly seeking out new experiences, which means I encounter a wide variety of people. I’ve worked in many different jobs across diverse industries including loan servicing, accounting, real estate, payment processing, owning a trophy store, and implementing software. Now I’m an Administrative Services Officer for the Nevada Department of Transportation. I’ve been married and divorced, I have two amazing children, I’m engaged to an incredible man, I have a wonderful family, and I love my life.

I tend to analyze problems and make decisions much differently than other people. I think there’s incredible power in challenging the process, questioning norms, going against the mainstream, and making sure you live your life on your own terms. You are welcome to join me on this blog’s journey through my past experiences, how I made decisions, and what I learned. My hope is that you will learn something useful.

In 2014 I was diagnosed with papillary thyroid cancer. Cancer is a journey unto itself, and in my upcoming blog posts will share this journey with you.