Detour: Cancer and the Zoo

Nearly everyday, Facebook shows me my memories. Most of the time they're pretty neat, they make me laugh or make me thankful that we are where we are. Others though, totally tick me off, period. All those feelings of seeing my child abandoned by her so-called friends and being targeted by adults come boiling up again and I just get furious. I look at how decisions were rendered to adults and then not complied with. How a child that didn't know if the didn’t evene know if her future held life or death, became even more of a target and my blood boils, I mean really boils. I think of vengeance and then God waves his magic wand and in the room flows that angel.

She smiles and hugs me and says, "I love you Mom, isn't it a beautiful day?" The anger just vanishes, she's right, it is beautiful because she's here and I smile.

Over the last several weeks, you've been learning about our journey after Cheyenne was hurt in a softball game and a nodule was found on her thyroid. We had just left the doctor's office after meeting Dr. Athanassaki (Dr. A) and her staff for the first time. Chey had also undergone an FNA (fine needle aspiration) earlier that morning. Dr. A had informed us it would be a few days until the results would be available. Ugh. The two of us walked hand in hand out of the office and across the lobby to one of the many lab draw areas in the hospital. While Chey was in getting her blood drawn, I called her father and explained all the details. He didn't have much to say. I mean really, what is there to say when you are told your child most likely has cancer? He did ask how I thought the result would be though and I told him that I agreed one-hundred percent with Chey, it's cancer. We hung up and I remember standing there waiting for Chey to return asking God, ‘What the hell? She is going through all this crap with the school district, (that's going to be book fodder one of these days) why are you doing this? Hasn't she been through enough? What is she, or we, supposed to be learning?’ Then it dawned on me, I guess that is what people call an epiphany, I thought, ‘Maybe she has gone through all this hell with that damn school to prepare her for the real battle, Cancer.’ Maybe, He had been preparing us all along, making our skins thicker in order to fight this animal.

Chey finished in the lab and walked out. We interlocked arms and started toward the elevators.

"Momma, let's go to the zoo. We need a pick me up. I probably have cancer and might not get a chance to go later," she said as my voice just stuck in my throat.

I couldn't say anything. She was so nonchalant and didn't seem fazed, at all about the words she had just uttered.

I handed her my purse and said, "Man, I gotta go, hold this."

Then I bolted. I got to the bathroom and the sobs just exploded. I was so glad there wasn't anyone in there, not that it would have changed my outburst, and I kicked the door. Then I ran to the toilet and vomited. Hot and violent, then I told myself, ‘Stop, she's out there, get it together!’ So with my insides rolling, I splashed my face with cold water and rinsed my mouth, dried off and hauled by butt out to my child. If she could tell I was upset, she didn't show it.

She simply handed me back my bag, tipped her head and said, "Zoo?"

Well, as usual, you guessed it. We headed off to the zoo. Houston is really not a hard city to navigate, outside the medical complex that is, and the zoo was easy to find. Parking, not so much, which seems to be my bane.

We drove around and around, I looked over at Chey, "Everyone must be at the dang zoo today, you sure you want to go?"

She just opened those baby blues wide and said, "Please?"

So, of course, I drove around for another fifteen minutes then Chey had an epiphany of her own. "Mom, people are coming out, let's stalk someone," she said in typical Chey fashion.

She's such a funny kid I thought before adding, "Great idea!"

So we idled and then two women with a couple kids came out. We slowly followed them, row after row.

Chey started giggling when they started looking back at us and I said smartly, "Crap, it's not funny, we are in Houston and they're probably going to shoot our butts."

She just giggled harder and slid down in the seat. As is my way, I pulled up to them, rolled down my window and told them we'd been driving around for nearly an hour.

"Please tell me you are leaving and we can have your spot," I said and they promptly just looked at me and kept walking as the lady reached into her purse.

Chey screeched through clenched teeth, "You're right, they're gonna shoot us Mom, roll up the window and drive!"

Then, the lady pulled keys out and just kind of pointed, with an extremely long nailed finger, to a Cadillac.

I yelled Thank you to them and turned to my now upright daughter, "Yay, Chey. We get a spot!" We waited while they loaded up and then we parked, moved our essentials over to a string backpack and headed towards the gate.

I was, and am still, amazed at how resilient God makes kids. We both knew, deep in our bones, that this beautiful young woman was about to fight the biggest battle of her life. Yet, here we were, giggling like two school girls as if nothing was out of the ordinary. We spent a fantastic afternoon wandering through the grounds. Chey enjoyed herself as much as she had the first time we went to a zoo. She climbed in and out of exhibits, read all the place cards and involved the younger kids that were around her. I watched her, soaking in every single moment. Absorbing how she moved, how she felt when I touched her hand. I imprinted it all to my memory, how the light shown on her hair and the way the youngster ‘ooh'd’ when she shared some magical knowledge with them. I spent the whole time just being amazed by her, period.

The stress of the day finally began to take its toll and when the light rain began to fall, she wrapped her arm around me and leaned her head on my shoulder as she hugged her stuffed red panda and said, "I'm done Momma. Thank you, it was great."

And with that, we headed back to the hotel to rest before the long road home tomorrow.

Next time, The Call...

XXOO Make Everyday Count,
Bonnie.

Hugs All Around

Do you ever have days where you feel like you could stay in the shower until the lake runs dry? Today was that day for me. My alarm went off and I hit the snooze button, which I very rarely do. It feels like I didn't even sleep 10 minutes. I laid there for about 10 seconds and it dawned on me ‘You have to get up, you have to go to work Dummy.’ So I bolted up and gathered my clothes for the day before jumping in the shower. Usually I'm in and out, it doesn't take me very long to shower, but today I just wanted to stand under the water and let it run. I started thinking about this blog post, today's the day you all get to meet Dr. Athanassaki and Alli.

We were at Texas Children's Hospital in Houston meeting Cheyenne's endocrinologist for the first time. We were here because doctors had found a nodule on Cheyenne's thyroid after a softball injury to her neck and the subsequent testing required due diligence and a full work up. Earlier in the morning Cheyenne had undergone a fine needle aspiration, she had cells removed from her thyroid to be read by the pathologist. Now we were heading for the Clinical Care Center, floor 11.

On the way there, we ran into a huge cow standing in the lobby of the elevator and stood in amazement. "Wow, that's so cool," Chey exclaimed!

I had to agree, it resembled a Cow Parade collectible -only it was life size! It was beautiful, so colorful and it just made you smile which was welcome in the face of what my daughter would soon be going through.

We loaded into an elevator with a number of other people. There were people everywhere, doctors, nurses, patients; it was unreal compared to our little country hospital for sure! We finally arrived at our destination and neither of us seemed to want to get off the elevator. I could see the trepidation on my child's face and my own heart was pounding. I reached down and took her hand in mine and out we marched.

Each area at this hospital has a sign on a stand giving you instructions to wait at a certain point several feet from the reception desk until you are called. (It's like waiting to be seated in a restaurant.) Yes, HIPPA that's exactly the reason behind it. We stood in line quietly waiting our turn and we both took in the scene before us. The waiting area was enormous and it very kid friendly. The area behind the receptionist was like a tree house that the kids could climb on. There were display cases with models of ships, bead mazes, books and movies playing on TV screens. These people obviously were all about the kids, that was for certain!

One of the receptionists called us forward and I realized Chey was still holding onto my hand, or I was, either way we walked hand in hand up to her desk and went through the process of signing in. After the paperwork was completed and I had my insurance card in hand, (I have a bad habit of leaving my belongings all over creation) we were directed to take a seat and wait for the nurse to call us back. We sat side-by-side and Chey commented on the children in the lobby. Many were being transported in wagons and several in strollers. There was a little girl that appeared to be maybe two. She had a tube in her nose and an IV with one little tuft of hair sticking up on the side of her head - she was absolutely beautiful. Cheyenne watched her for a bit and then excused herself to go to the restroom. When she came back, her eyes were red rimmed and I knew she had slipped off to cry for this sweet child. She sat down next to me and laid her head on my shoulder and whispered, "I love you Momma." God had to be sitting there with us because I was able to just pat her leg and hold back my own tears that were attempting to flow. Luckily, that was when we were called to the back.

Like most offices, we were taken into a room for Cheyenne's vital signs, weight and height to be taken before we were moved to an exam room. The room was average with an exam table, a couple of chairs and a computer on a desk. There were also educational posters on the wall showing the anatomy of the thyroid and endocrine system. We waited a very short time and a young woman entered and introduced herself as a doctor doing a fellowship. I think her name was Amy and she explained that she was going to be a fertility specialist (reproductive endocrinologist) and was doing a rotation here. She explained that she would take Chey's history and then Dr. Athanassaki would be in after. She did so, left and shortly she returned with Dr. Ioanna Athanassaki MD (Dr. A) who introduced herself and shook our hands. Dr. A is Greek. She has a very light voice with a very pleasant accent that is also light. She is a small woman with an affectionate smile and dancing eyes. You just can't help but like her immediately. She sat down on her stool and began to review what she had been told by her understudy, when there was a soft knock at the door and a smiling young woman with dark hair walked in with a chart in her arms. She immediately apologized for being delayed and started to introduce herself. There was no need, from her first word I recognized this was Alli and I practically jumped out of my seat in my haste to hug her. I had warned her previously that we are huggy people so she wasn't completely taken back. I croaked out her name and the tears started at this point with smiles at the same time. I actually think this exchange made us all much more comfortable and we just sat down and talked.

Dr. A informed us that she was aware we had more knowledge than most of her new patients.

She said, "We don't usually recommend our patients visit the Internet, but your situation is a little more unique."

Obviously, Alli had told her about my friend Dr. Google but it was alright.

She went on, "In your case, it makes it easier because you both have a good understanding of the possibilities so we don't have to necessarily spend time on those explanations ."

I told her we tell our patients the same thing, "Don't talk to Dr. Google" but it's just not in my DNA. They all laughed and she asked how the procedure went earlier.

Cheyenne spoke up and said, "I have it, they didn't make extra passes they didn't need to because they had enough cells to tell."

For about half a heartbeat I was afraid how they would react but Dr. A simply leaned in toward my child and said, "It is very indicative of Papillary Thyroid Cancer (PTC), yes, but we really have to wait until the pathology report is given. Right now I would like to examine you if that's alright."

Cheyenne said "Of course, sure."

She stood up and moved to the exam table, stepped up and sat down. Dr. Athanassaki donned gloves and told Chey that she would be gentle. She tried to feel the nodule but couldn't, she said Chey had been very lucky to have had the accident and that they call this an "incidentaloma." She said it is when a tumor is found by coincidence and with out symptoms. When Dr. A finished the exam, she motioned Chey back to her seat and sat down herself.

"Well, as it does appear to be PTC, let us discuss what would happen next," she sais as she rolled her stool closer and leaned over toward us. "We have a group of doctors that meet on Wednesdays to discuss the cases. There are surgeons, ENT's, oncologists, endocrinologists and radiologists present. We will go over the results of the fine needle aspiration, as well as all the other data. Then we decide what the best course is. Usually with papillary thyroid cancer (she can really roll that off her tongue by the way) the recommendation is to remove the entire thyroid."

I interjected, "But, we have to be careful about the parathyroids right?" (The parathyroid glands control calcium levels in our bodies. They are situated behind the thyroid gland and can be damaged during surgery.)

She sat straight up, put her hands on her knees and smiled broadly, "Yes we do, you really have done your research."
Chey said, "She doesn't know any other way, that's how she deals with things." I guess my daughter knows me pretty well too.

Dr. A continued speaking to Cheyenne, "We will do more lab work and possibly another ultrasound before setting you up an appointment with surgery. Right now, we will wait and see."

She asked if we had any other questions and Chey only said, "How long for the result?"

Dr. A answered and said, "Hopefully very soon."

We all gave hugs all around, to multiple giggles. We thanked them over and over again before they asked us to hold on and Alli would get us notes for school and work.

We sat down and Chey said, "I really like her, she knows what she is doing and I feel safe."

I agreed and shortly Alli reappeared, all smiles, she gave us notes and directed us to the lab. "Dr. Athanassaki decided to go ahead and get these done today. Don't worry and we will be in touch soon."

She wrapped us in a group hug and led us out into the hall. The fear was still there but now it was veiled by the feeling of hope, glorious hope. We both walked out of that office like we were wearing wings, it was such an uplifting feeling and I knew we were in the right place.

Quick note before I leave you, with summer around the corner posts will likely start coming out every other week! Enjoy the sun and thanks for reading!

Next time: Test Results

XXOO Make Everyday Count,
Bonnie

Here You Go Paula

As I'm driving to work today the sky is cloudy and overcast. I, as well as many others are just trying to get through the workday. Get there, get it done, get home. I watched Chey drive off this morning and with only one-week left of school, she's going to have her freshman year of college under her belt. She was a little feisty this morning, too much going on, too little time and I know she's tired but she'll gut it out like she does everything else. That's the attitude that got her through our first day at Texas Children's Hospita over a year ago. We had ended up there after an inadvertent discovery of a nodule on my teenage daughters thyroid eleven days earlier. Cheyenne had been injured in a softball game and a CT in the ER started the dominoes falling into place. We had driven down the night before, it's about a five hour trip.

We got up the next morning and had a light breakfast before heading to the hospital early. I'm not the best on directions and my little Tom-Tom is a lifesaver but sometimes even Tom-Tom can't get me where I need to go. That's not necessarily Tom-Tom's fault, sometimes I can't figure out where left is because there aren't good enough signs on top of there being too many distractions. Anyway, after several trips around the complex we finally found our parking garage and guess what? It was underground. Well, let's just say I started off the day embarrassing the fire out of my child. When you turn and go into this parking garage there's a lane in and a lane out and they are both really small! Once you navigate in, the in lane splits into two lanes and there are these little boxes on posts on the left in each. I could see the people ahead of me doing something but I was not sure what they were doing. I was praying it was going to be like the ones in the metroplex that print a little card out but nope, not so lucky. I pulled up into my spot and I couldn't figure out what I was supposed to do. It was so damn frustrating, all these people lined up behind me and no card. There was a slot like I should put money in it and a blinking green light but no instructions. What the heck? Cheyenne was in the passenger seat, already stressed out and of course, I look over and she's sliding down further and further and further in the seat so I do the only sensible thing.

I get out of the car and with my arms up I start asking the people behind me, "What do you do?"

By this time, Chey was just writhing in her seat "Mom, Mom, get back in the car!"

Luckily, the nice lady behind me motioned that you just push the button. I did and ta-da, a little yellow chip came out. You hold onto the chip until you leave and that's how you get charged for your time parking. So once we parked, and Chey climbed out of the floorboard, we looked at each other and just busted out laughing, we just rolled! Here we are, small-town America in the big city and can't operate a parking box, thing. I don't know what to call it, kiosk, I guess? It was a riot.

We eventually gathered ourselves up, got the instructions Alli had sent and headed in. We, okay I, was worried about finding our way back so while we were walking, I was taking pictures of our elevator, our parking area, the building... while trying to figure out where we were going. Once again, Chey was like "OMG Mom," and shaking her head. You’d think she would be used to this by now.

Texas Children's Hospital in Houston is like many other hospitals, being made up of multiple buildings that are connected by enclosed walkways. We had parked under the Clinical Care Center and were due in the Interventional Radiology Department, in the West Tower, for Chey's FNA, (fine needle aspiration) at 0800. The hospital was very overwhelming the first time we were there but they color-code everything and there are plenty of information desks, which helped immensely. We arrived at our destination and checked in and shortly we were escorted into a room. It was kind of like an ER bay, several rooms separated by curtains. A nurse came in and took Chey's vital signs and a medical history. She was very nice and put us both at ease (Pretty much the norm there.) She explained how the procedure would go and allowed Chey to ask questions. Chey only asked about the needles used for the biopsy. The nurse told her they would use a really small needle to extract the cells from her thyroid and then place them on a slide for the pathologist to look at. She said that one pass is usually three specimens.

Chey's face lost some color then and the nurse immediately added. "They will use numbing medicine so you won't feel much, and don't worry if they take several passes, that means they aren't finding much so they are checking more areas."

She handed Chey a gown to change into and a bag for me to carry her clothes in before leaving the room.. Soon there after, the doctor came in. He was so young! He was really tall and skinny and he had braces! I was thinking, "You've got to be kidding, I've got uniforms older than this kid." Then he started talking and I knew - Doogie Howser M.D! He was very knowledgeable and very personable. He was from India and Chey would just love him. He went over everything the nurse had said, had me sign consent forms and then we headed down the hall.

It was like a maze as we twisted and turned down back halls until we came to a little waiting area, for me. I sat down and watched as my daughter left for the most important test of her life. The hall was like a refrigerator and I was shivering. I had brought a book to read but I couldn't seem to get past the first paragraph. I tried but all I could do was keep looking at my watch and the door that had consumed my child. I remember praying over and over, "Please, let him take lots of passes." It seemed like an eternity that she was gone and sitting alone in that little, deserted area made it longer. In reality though, she was gone well less than an hour. I had leaned my head back and pulled my arms inside my shirt when I heard their voices, laughing.

They walked down the hall toward me and the doctor smiled and said, "She is really brave and she's funny too."

All Cheyenne said was "I've got it, I know it because he only did one pass plus one." The doctor, as they are trained to do, told her she needed to wait on the pathology results and led us back to the original room so Chey could change.

She told me quietly, "Momma, he did the first pass with three samples and the pathology lady was right over from us in a little room. The girl in there with us carried the slide into her and then came back and said she only wanted one more straw. I HAVE to have it, the other nurse said it was better if they took more."

What do you say to that? The room that had been so cold suddenly became like a sauna and my mind was whirling again. I was thinking the exact same thing but I told her we would just wait to see the doctor at 1100. Chey seemed very matter of fact about it and after she dressed and we cleaned the residual betadine from her neck, we left and she told me what had transpired in that room.

She was really kind of giddy and her eyes were huge and glassy. I think she was scared to death and talking was her way of working through it. She described how the room was like any other X-ray bay and they had asked her to lay on the table. She said they positioned her just like for her other ultrasound, on her back with a roll under her neck to hyperextend it and then they cleaned it with "that orange stuff that burns a little" and numbed it. She said he described the procedure to her again while they waited for the numbing and then while using the ultrasound as a guide, he took the samples and then the tech carried them to the pathologist. She said they waited for the pathologist to look at the slides.

Then she started giggling and said, "He asked what I wanted to do in college. I told him Ag/Comm. He had no clue! The guy in there with us was in FFA too and we tried explaining about showing animals and such. He couldn't believe I walked pigs!"

She said they talked about his home too. The pathologist was in a room adjacent to theirs and it only took about fifteen minutes for the decision and then the doctor told her, "We only need one more straw." He took the sample, cleaned her up and that was it.

We spent the next hour walking around the hospital just taking in all the sites, it's like several mini museums spread throughout to take your mind off of where you really are, I think. Soon enough however it was time as we moseyed on over to the Clinical Care Center towards Chey's destiny, Dr. A and Allie....

Next time; Hugs all Around.

XXOO Make Everyday Count,
Bonnie