Happy Freaking Birthday!

So, if you ever find yourself in the unenviable position of sitting in a doctors office, waiting for the results of your latest cancer scan (and please note, I do not wish this scenario on my worst enemy) and he walks in and says "I have good news and bad news" I hate to break it to you -- it's bad news.

"Good news" is: you're clean. Cancer free. As in "Get out of here and I'll see you in six months." THAT is good news. Anything else sucks.

Hate to come across as negative and those of you who know me, know my spirits have been pretty good through this entire ordeal, but I have to call it like I see it.

Anyway, this is how things went down last Monday, April 30th -- my 41st birthday, btw -- at my appointment with my endo. I've been so dispirited that I haven't been able to blog on this until today.

There's no use bellyaching anymore, but I'd be be less than truthful if I didn't tell you I was pretty crushed by this news. I really thought this nightmare was going to be over last Monday.

To make matters worse, I had a fake out earlier in the morning. I was waiting with April for my film from radiology, when the technician came in and said that pathology wanted a few more shots. I wasn't terribly surprised, as they were having some problems with the MRI machine. So, I walked back in and was told they wanted to reshoot my pelvic region. At which point my heart dropped down to my toes.

Those of you who are familiar with my story, know that during my last scan in September, they found a "hot spot" on my hip. It was such an anomoly that my doc had me come back two days after my RAI to have it retested. Of course, it was still there. A subsequent PET scan, however, showed no invasion into the bone, which was obviously good news. So, it was treated as a renegade node which somehow made its way down to my hip. My only consolation: it landed in my hip, versus chest.

Anyway, the technician must have seen the look on my face, because she quickly added "No, no. It's good. The hip is clean. He just wants to make double certain."

That's when I thought maybe -- just maybe -- it was going to be my day.

Alas, it wasn't meant to be. A bit more background: my original scan from last September showed three "hot spots" of uptake: two in my neck (not enormously unexpected, given that I had six bad nodes removed during surgery) and one in my hip, as described. For some reason, I assumed the radiation was going to have eradicated everything in my neck. Key learning Number 4,365: with cancer, don't make assumptions.

So, the "good" news, if you will: we're down from three hot spots to one -- one straggler in my neck, sitting there on my scan as clear as day.

The bad news -- questions persist as to why the node did not respond to the treatment? 150 milicures of RAI really should have done the trick.

My endo said he was surprised and dismayed but noted that this happens in 30% of cases that he treats. If there is one trend that's become abundantly clear to me, it's that I am consistenty falling on the wrong side of the odds, every step of the way. This is a subject that probably merits its own discussion.

Anyway, he suggested thatI plan on another dose of RAI this coming December. Keep in mind this is really two more cycles: going hypo/diet from hell for a big dose, followed six months later by going hypo/diet from hell for a full body scan. So, this whole sordid affair is getting stretched out by another 12-18 months.
F*(&*ing lovely. He also suggested I see Dr. Orlo Clark at UCSF, thyroid surgeon extraordinaire.

I'm not certain how to describe Dr. Clark, other than "rock star" and by that, I almost use the term almost literally. His waiting room is a zoo, it takes months to book an appointment, and the guy has a bigger entourage than Vincent Chase.

The scenario that Dr. Clark laid out is fairly straighforward:

1. The remaining hot spot is microscopic tissue (vs a node) which will hopefully be taken care of with another whopping dose of radiation.

2. Its not tissue, but rather a decent sized stray node. This will be confirmed (or not) in the coming weeks via a series of CAT scans and MRI' s. If he can pinpoint it, he'll go in and pluck it, though the surgery is unfortunately a tad more complicated than that. It *appears* right now to be located in my central neck, so he has to navigate through my vocal cords. And given that this is now my second neck surgery, he has to navigate around scar tissue. Oh, and one other thing too -- he wants more PET and CT scans of my hip as well, because he finds that utterly mystifying and maintains that if there ever WAS cancer there, it would likely be in bone. Good times, eh?

Man, I tell you -- to quote Terrence Howard --it's hard out here for a pimp.

Regardless of the scenario, and oh, by the way, Dr. Clark's opinion is that "I'm 90 percent certain we are looking at scenario number two" I'm looking at more RAI, a thought I do not relish. Aside from all the hypo/diet nonsense, we're talking another level of high toxicity radiation. Not to mention the stress of explaining this to the kids, getting them out of the house during radiation, etc.

What a freaking hassle. "Good cancer" my ass.

Tests are scheduled for the next several weeks. Next appointment with Dr. Clark is on June 13th. At that stage of the game, all scans will be completed, and he'll be presenting a detailed gameplan.

So ... that's where I am today and that's the story of how I spent my 41st birthday.