Day 354

Didn't even realize I hadn't hit "post" on yesterday's entry till I came here abnormally early and at work to start today's.  Thought for sure I had...but it was late and I've been frustrated lately. Anyhow...


I was unsuccessful in getting anyone to call me back yesterday.  Figures, right?  However I kept checking and checking the online MyChart because I knew the radiology results auto-released at SOME point.  Well of course right after I finished my novel at damned near midnight and before I planned to start actually sleeping I had to check one last time...and the results were there. Apparently the magic number is four business days.  No adenoma seen. Not on any of the modalities.  A probable colloid cyst in the thyroid but that's nothing. So of course that meant I was tossing and turning and pondering (and texting the info to Spouse) till freaking one-thirty in the morning before I actually got to sleep...then woke up from a bad dream at 2:30 and was up for the day at 6...so even though it's barely 1pm right now I'm ready to call it a day.  Can't, of course, but that's what caffeine is for I suppose.


I was afraid of exactly this outcome and am frustrated by it but have decided not to have surgery, at least not now or any time soon.  What this means is that I still have primary hyperparathyroidism and it’s still causing the flimsy bones but we can’t easily point and say “there, that’s the spot causing the trouble.” 

Most of the studies say that only 60% of adenomas show up on scans and that surgical intervention is the only true curative process for primary hyperparathyroidism but I was much more okay with a teeny little surgery to go looking for a known adenoma than I am with doing the bigger surgery we'd be discussing now: bilateral exploration to look at all four glands, take the biggest one, do intraoperative PTH monitoring and all that stuff. Longer anesthesia time, more chance for nerve damage, bigger scar...and yes, as I think I mentioned a few days ago, the scar is an issue as it would be right on the front of my neck and I don't HAVE enough of a neck to be covering it up with scarves and such -- I've favored open and V and scoop necklines my whole life to avoid the snowman effect.  So even though it may still seem shallow and vain the idea of either showing off a scar to the whole world 24/7 (my primary choice) or having to learn an entirely new and awkward way of dressing (which wouldn't be possible at work anyhow as I wear scrubs now) is part of the decision-making process.

Another part is the whole anesthesia/surgery/hospital thing…never been keen on ANY of that. Particularly general anesthesia. I read _Coma_ the summer I was eleven and it really stuck with me over the years...aided by the fact that a beloved histology technician in my residency ended up dying of hypoxic brain injury due to an anesthesia misadventure while she was getting surgery for a freaking shoulder lipoma. So I'm not keen on "going under" for any reason.

And yes, the fact that my surgeon just doesn't do all that many of these and we're a teaching hospital with surgical residents plays into the decision too...more so for my family than me as I have to be all open-minded and understanding about it but my kids all know the teacher who got recurrent laryngeal nerve damage from her parathyroid surgery for exactly the kind of disease I have.

The bigger part, though, is that other studies seem to show that primary hyperparathyroidism doesn't get better or go away without surgery but it doesn't get a whole lot worse either.  If I had true osteoporosis instead of osteopenia (the precursor to osteoporosis)  I might consider going ahead with the bigger surgery but I don't....and I don't really have any symptoms either.  Yes, I had the totally-no-trauma stress fracture and will be running around knowing I'm at risk for another but I don't do high-impact anything and am not overly concerned at this point. Right now the benefits of NOT having the surgery seem more/better to me than the benefits of having the surgery.  Of course if I got a kidney stone or another fracture I would likely change my mind.

So that's THAT settled at least. I'm really glad NOT to be having surgery as you all know that the week I thought I didn't need it I was much happier than when it looked like I had to do it after all.  Maybe now I can start being more excited about other aspects of my life...like the idea that in less than two weeks I will have a WHOLE YEAR of continuous sobriety.

[much later]
Did all the evening stuff, finished another book and am now in bed. THIS time I'm putting down the smartphone early.

All my family and friends, including my two doctor friends, think I am making the right decision by not having the surgery. Good to have support.

Checked my mail and somehow I've gotten on a "Bible verse of the day" emailing list and the first one was Ephesians 5:18 And be not drunk with wine, wherein is excess; but be filled with the Spirit.   Weirdly appropriate. Maybe they start everyone out with that one or maybe someone's selling my browser history but it was an okay way to end this day. Sleep now.