What it isn't
You can see the yellowing bruise caused by the biopsy needle - just edging into the shadow.
Almost two years ago Kellie, my physician's assistant at the OBGYN, felt something on my thyroid. She told me to have my primary care doc check it out, which he did. But he said he felt nothing. Last year Kellie felt something again and ordered blood work. Nothing. This year, the "nodule" had become noticeably bigger. "Yep," she said. "We need to check that out. I don't usually overstep the bounds of the primary care doctor, but in this case I'm going to."
She set me up for blood work and referred me to an endocrinologist. When the blood work came back normal again, she called and said she wanted to do an ultrasound. But by that time the endocrinologist's office had called and I had an appointment in a few days (Kellie said it could take months to get in.) My appointment was last Monday.
Dr. K, the endocrinologist didn't feel a nodule at first, but did feel quite an enlargement on my thyroid. When I laid back and extended my neck, however, he did feel it - about 2 cm by 2 cm according to his measurements. "I want to do a biopsy on this now," he said, and explained to me what that would involve.
Biopsy. Isn't that more of a surgical procedure? Iwondered. Don't they have to put you under for that? Slice into you? At the very least I'd have to be lying on a gurney in one of those backless gowns, freezing cold, waiting for ... something. Right?
"Is that to check for malignancy?" is what I actually said. Dr. K explained that the procedure was simple. (The needle is smaller than the kind used in a blood draw, he reassured.) And that it was done to find out just exactly what is going on with the nodule. Most nodules are nothing to worry about, he assured me. Fewer than 10 percent are malignant.
So OK, but still - right here, in the examination room - wearing my jacket and blouse and pants - even my shoes?
It really was nothing much - four long pokes of a single thin needle. Lots of noisy scraping on what must have been 25 glass slides. An assistant standing by dabbing at whatever blood flowed at the needle's piercing. One of those little round adhesive bandages covering all four needle entries. Fifteen minutes lying quietly afterward - to ward off any residual wooziness.
Then I went back to work.
Over these five days, I've turned the idea over and over in my mind in every way. I could have cancer. What if this is cancer? How would I weather treatment for cancer? How long would I be off work if I had cancer? How might my relationships change with those around me - if I had cancer? What would change in my life - and theirs - if it turned out that I had ... cancer?
Honestly, even though the thoughts and questions ran through my head all week, I don't think I ever really, seriously entertained the idea and all the accompanying what-ifs. I mean to say that I wasn't really, truly fearful of a cancer diagnosis. Maybe I was naive. Or hopeful. Or taking at face value what the doc had told me and the little bit of reading I'd done on WebMD. Thyroid cancer is pretty rare. And when it is diagnosed, survival rate is high.
Today I got the call. "Your biopsy results are normal," the nurse, Liz, told me. "Oh, thank you," I said, relieved, grateful. "Just keep your appointment in six months," she said. "So we can keep an eye on things."
"I don't have cancer," I IM'd a friend of mine after I got off the phone. "Yay," came the answer. Neither of us ever really thought I did. But it did give pause these past few days.

Dammit, I've been going on and on at my blog about my trip and had no clue you were in limbo over this test. Tell some friends next time...um like me.
Dave
Posted by:Dave Robison | April 08, 2008 at 01:52 AM
Thanks for your concern, Dave. Oddly, my sister said the same thing after she read this on FaceBook (via Flog Blog) :-)
I've enjoyed the Prague series - sounds like it was a great time!
Posted by:kathleen | April 08, 2008 at 08:18 AM
Was the biopsy guided by the ultrasound?
Have they try to determine the nodule type?
it looks to me like the doctor had lost the interest to your thyroid condition after he found that the nodule was non-cancerous.
As a side note the ethanol injection [PEI] was very effective as non surgical method of nodule treatment, especially fo cysts.
Posted by:898 | July 03, 2008 at 03:04 PM
OH - no ... sorry to have been misleading. I only wrote the 'drama' part of the story. I have an appointment to go back in about 6 months. If it has grown or continues to grow, he'll take steps to reduce it.
thanks!
Posted by:kathleen | July 03, 2008 at 03:30 PM