*** hrvatska verzija: http://papilarnikarcinom.blogspot.com/ ***

Ingredients:

1. Health checkup

2. Fine needle biops(y)ies

3. Second opinion

4. My opinion

5. Surgery

6. Recovery

7. Photos

Preparation:

Read carefully all the ingredients. Put in a dry place and leave overnight to rest. Use in a manner and in the amount based on your own preferences.

1. Health checkup

Before I get to the point, maybe I should say that I am writing this for all those who found themselves in a similar problem as I did, but simply don't have enough answers to the questions that “haunt” them ... I wish to use this opportunity to encourage all of you who are facing the diagnosis of thyroid papillary cancer.

So, as the title says, in February 2, 2012 (02/02/2012 - numerically interesting date :)) I went to a regular health checkup that I normally go to every year. I have 31 years, I am physically active, I do not have any health problems, and my only vice are cigarettes, but it is not something terrible (5-7 a day). So, basically saying - I am a healthy female creature. :) With all the other checks, this time was the first time I did a thyroid ultrasound which was a completely painless and harmless control. The doctor told me that everything was generally fine, but that I had some blurred nodule of 8mm, so he advised me to go to fine needle biopsy. He mentioned to me that it was probably nothing, but that it was better for me to do it than to "speculate".

I must admit that I really was not thrilled to go to fine needle biopsy of my thyroid, especially because all the other tests and results were perfect. By that I mean that all my blood tests, including thyroid hormones, were not only normal, but in the middle of the scale and I thought to myself "why the hell do I have to go to do that”? But, as my dad is a doctor, he also told me to go to biopsy because that nodule could mean a lot of things and that there’s no reason to (what?) "speculate".

That is how I, with indignation, went to fine needle biopsy of my thyroid gland.

2. Fine needle biops(y)ies

The week after the checkup, I had scheduled a fine needle biopsy at the Institute for Tumors. It’s definitely not a place where people feel comfortable, but when there is no other option... The biopsy itself is not terrible. Well, it is not pleasant either, but it’s bearable.

Here’s how it goes. After waiting in the waiting room (which has not been renewed since the WW2), I entered into a miniature chamber where they managed to squeeze everything - the doctor who looks at the ultrasound, and a nurse who takes notes, and a curtain behind which you should change, and the equipment, and everything. I felt like I walked into a Chinese store and instantly thought: “where the poor people work all day… no wonder they have forgotten what a smile looks like...”. Anyway, I laid there on the bed, threw back my head and watched upside down the ultrasound monitor so I can see the nodule (again). At that moment, the door opened, and my cytologist came in, so, to my joy, there were 4 of us on 2 m². She looked at the nodule and said that it should be “punctured”. I adjusted the neck for the biopsy and the nurse gave to cytologist a larger needle and, after they warned me that I have to be calm and I cannot swallow, she stuck my neck with this needle and sucked out a sample. She looked at it quickly and said that she would have to repeat the biopsy once again because this sample was not a satisfactory one... On my overall delight, we repeated it all over again. Afterwards they put a piece of a cotton wool onto my neck, patched it and that was it ... All in all, it was really not a big deal, but more of an uncomfortable, slightly painful experience, which, luckily, does not last.

Results were in a week.

3. Second opinion

As you can guess from the title of this blog - the results were not great... The diagnosis was chronic lymphocytic thyroiditis with suspected elements of papillary carcinoma. I made an appointment with Dr. Renato Janušić, who was nice and clearly explained what my diagnosis meant. Under this nice and clear, I refer to the approach of Dr.Janušić who impressed me with his behavior - I did not feel like a patient (even today I do not like that word), but as a normal 31-year-old person with a problem to be solved. After all, his site speaks for itself...

But to return to the diagnosis - chronic lymphocytic thyroiditis (also known as Hashimoto's syndrome) is an autoimmune disease of the thyroid, where (for who knows what reason) the body recognizes the thyroid gland as a foreign body and destroys it. It is necessary to make the blood test for anti-TPO antibodies and that proves the existence of Hashimoto's syndrome 100%. Suspected elements of papillary carcinoma, mean that there are certain changes in the cells of punctured nodule, but these changes are not so clear under the microscope to say that it’s cancer 100%. So, the only answer to my "unclear" case was a surgery with a complete removal of the thyroid due to Hashimoto that would eventually make the thyroid gland to stop working completely ... Still, I had to make the aforementioned anti-TPO testing to be sure of Hashimoto, but basically - that was it.

Of course, I was not happy with what I heard and I went to get a second opinion in the hospital called “Rebro”. There, they did again an ultrasound and concluded that my thyroid was definitely for a surgery and should be removed whole… But, in the meantime, I got the anti-TPO results – and they were perfect, so no matter what everybody said – I didn’t have Hashimoto’s syndrome!

To make the long story short:

I need the surgery 100%, but since I don’t have Hashimoto, we will remove only one half of my thyroid, i.e., the right lobe and lymph nodes on the right side. That way we could see if it was the cancer (and it was 95% according to the puncture results) and, if it was, whether it had already spread.  

And there it was - the "revolutionary" fact in my case, because the majority of our doctors would decide to remove the entire thyroid gland due to suspected cancer. However, Dr.Janušić proposed this option, considering my age, general physical condition and size of nodule (less than 1.5 cm). This way I have the possibility that the left lobe overtakes the full function of the thyroid and I can continue to live normally without any therapy (similar to what people normally live with one kidney). The downside was that, if the finding is bad and they find metastases, then I'd have to go one more time under the knife to have my left lobe removed...

The decision was up to me - take the plunge or not ...?!

4. My opinion

It is difficult to count everything what was going on in my head. I'm not a crybaby, but a realistic type of person, so to me my diagnosis was a bit funny – like: "What do you mean under suspected elements of papillary carcinoma – either there is or there isn’t cancer... The same way you said I had Hashimoto - and in the end it turned out that I hadn’t!"… Today, I’m aware of the fact that it was a subconscious fear in me and the negation of one of life's most difficult realizations which was the possibility that I had a cancer ... What – me and cancer – no way?!

The most comforting fact was that nothing was urgent. It was all in the initial phase and I could go on vacation that I already had planned and paid for, before this whole adventure. I must admit that this was the best possible decision. I had plenty of time to clear my head, to realize that my throat would be cut (actually that was the most terrifying thing – scalpel on my neck, pain and a scar as a “souvenir”) and, in general, that I was facing the first surgery in my life. Still, I decided that I would accept the doctor's suggestion and listen to my inner voice that said: "Take a chance to live without pills and without any therapy… At least you know you tried!".

I thought twice about having the operation in the private clinic of Dr. Janušić or operations at the Institute for Tumors. In the end, I decided to go to his private clinic and make my operation as comfortable as possible. Somehow, I explained to myself that it was all one big adventure for me and a new experience and, at the end, I was waiting for that day to come and go.

5. Surgery

And the day has come - March 30 (again, numerically interesting date – first there were twos and now the threes... :) ). At the entrance, nice and smiling sisters welcomed me, the music was playing in the hallways and even in my apartment - at one point I forgot that I had a surgery. :) The fear was almost completely gone, and I knew I was in good and safe hands. About 15 minutes before the operation the nurse gave me a pill for courage, and then they put me to sleep. After an hour and a half - it was all over. I woke up a little later, with a pain in the neck similar to a stronger sore throat, and that was all. The first people I saw were my anesthesiologist and Dr. Janušić standing next to my bed and looking at me with so much care and attention as if I was their first patient ever - it was a great feeling because I was not left at the mercy of nervous sisters in state hospitals, with another 100 patients such as me. We talked a bit to see if I was ok, and then came my family who stayed with me until 10:00 pm when I went to sleep. In the meantime, I ate soup, normally got up to my feet and the only thing that bothered me a bit was a drain tube out of my neck, but it was really not a big deal. The second day, Dr. Janušić came to remove the drain tube, which almost I did not even feel and he taped waterproof plaster, so I could take a shower. That was what I did afterwards and I went home. Actually, first I went to grab a cup of coffee in my favorite bar and then home. :)

All in all it was an experience one could almost wish for - I came with a smile and left with a smile, and this was the most important!

6. Recovery

Recovery is the best part of the story. Suddenly, everybody was so caring, sincerely wondering how I was, etc. :) Maybe the worst part was the anticipation of the analysis of the removed right lobe and lymph nodes, but it was all over some five days after the surgery. The results were relatively good, i.e. the nodule was papillary carcinoma, but everything else was clean - no metastasis, nothing! Unlike patients who had the entire thyroid gland removed, my recovery was resting and hoping that the left lobe overtakes the whole function of the thyroid, so I don’t have to drink any pills. 5 days after the surgery I got my stitches removed (it was done in a couple of seconds and it is not painful), and the first blood test was scheduled in a month and a half from the operation, and ultrasound in 6 months. Month and a half flew quickly by, and the blood test was within normal limits. :) That is to say that I do not have to take any treatment, but only make blood test regularly.

To summarize - it's been almost 2 months since surgery and I feel great! :)))

6.1. news 
The check up after 6 months with the ultrasound and thyroid hormones was great. The left lobe of the thyroid gland works like a clock, I'm not taking any medicines and Dr. Janušić says that everything is by the book. What is the most important – I feel this way too! :) 

6.2. one year after the surgery

...went quickly by and I feel great! Although, in February 2013, the TSH hormones were a bit above normal value (5.6, and the normal value is up to 4.2), but we decided that I shouldn't start the therapy right away, but I should repeat the hormone analysis in 3-4 weeks. I did that, and everything was perfect, as well as the ultrasound. The results in February were just a “normal abnormality“ which happens with whole thyroid glands and Dr. Janušić said not to worry. So, now, without any therapy and pills, my ½ thyroid and me are entering our 2nd year and we expect to live happily ever after. ;)

6.3. two years after the surgery

You know what they say: "No news = good news...". The same is with me! Still no pills, I go to a regular check up once a year and that would be it. I was thinking to stop writing the blog, but when I recently looked at the statistics and saw that over 4,000 of you read it - I simply felt it was my duty to let you all know: "Chin up! Everything will be allright... ". Talk to you in a year! ;)

6.4 three years after surgery
Here, it's been three years of operation and the other day I was on a regular control and the thyroid hormones are all great. My left lobe works fine, I do not drink any pills and I feel good. Dr. Janušić did a great job, and so did my body too!
6.5 four years after surgery
Four years have passed quickly by and the other day I was on a regular control. The thyroid hormones are great and my left lobe has a little rougher structure on ultrasound, but there's no need to worry, since all the hormones are good... I'm not worried and I can tell you - if something goes wrong again - I'm happy because I received (so far) four years of completely normal life!

6.6. five years after surgery

I cannot believe it's already been five years ... Time flies, and I'm still great! Hormones are good, the remaining lobe works just fine, and the scar is almost invisible. In fact, now you can see wrinkles on the neck better, than the scar itself. :) Since this is a mini anniversary, I'll put the new photos, and see you next year!
6.7. six years after surgery
Still without any changes and in full health! My doc says that if something new happens to me - it will no longer be treated as a relapse, but a new disease. So we can definitely say Darja vs Papillary Thyroid Cancer 1:0. :)
6.8. seven years after surgery
No news is a good news! I'll keep you posted!
6.9. eight years after surgery
With all the madness about the corona virus, I almost forgot about my thyroid ... Because of everything, I was a little late with my annual check up, but it's never too late for good news - and that is that everything is still unchanged!

6.10. nine years

…have passed quickly by and I’m feeling great. Next year we’re celebrating together 10 years anniversary! ;)

6.11. ten years

The big 10 is here and everything is fine & dandy! I'm sending warm regards to all of you who read this, and if you have any questions, write them in the comments. Cheers!

7. Photos
As pictures say more than 1000 words, below I enclose a couple of photos. In the meantime, this blog has come to an end, but I'll check in periodically with the news.

my neck before the surgery

me before the surgery

me 2 hours after the surgery

my neck 2 hours after the surgery

my neck 1 day after the surgery

me 1 day after the surgery

my neck 1 week after the surgery

me 1 week after the surgery

my neck 6 months after the surgery

me 6 months after the surgery

5th anniversary

   

5th anniversary