Why I’m thankful for a clean bill of health this Thanksgiving

As everyone is sharing what they are thankful for this holiday season, I wanted to point out we often take for granted the very things that deserve our gratitude the most. My story relates to the fact that we don’t fully appreciate the value of being healthy until we are sick. A month ago I felt completely fine, and today I am recovering one week post-op after major surgery.

Initial Suspicions

My journey started last month when I started getting some symptoms (dysphonia, dysphagia) along with a small lump in my throat. I spent half an hour logged into my insurance portal trying to setup an ENT appointment with a doctor covered by my network, but the earliest I could find was 5 weeks out.

Frustrated but undeterred, I was forced to use my connections as a physician to bypass this step and schedule an Ultrasound and FNA (Fine Needle Aspiration Biopsy) of the mass immediately. Unfortunately most Americans don’t have this option and would still be waiting for their initial appointment next week rather than recovering post-op like me.

Biopsies, Scans and Tests

The biopsy results came back indeterminate, but what does “Indeterminate” mean in this context? It can be summarized to:

• Follicular neoplasm (abnormal growth of tissue caused by the rapid division of cells that have undergone some form of mutation)
• Follicular lesion or atypia of undetermined significance (this happens when there are some abnormal/atypical cells in the biopsy sample but not enough to diagnose a cancer)
• Suspicious for malignancy (worrisome features but are quantitatively and/or qualitatively insufficient for a definitive diagnosis of cancer)

The biopsy also had Psammoma Bodies, which can also be a sign of papillary thyroid cancer. Wanting to move quickly, I networked my way to several surgeons (including an exceedingly kind and generous Chief of Head & Neck Oncology) and was able to schedule several in person and tele-visits within the week. One doctor ordered CT scans of my Neck and Chest to get a clearer picture of the growth as well as to look if the cancer has spread (metastasis or lymph nodes).

I knew to ask for a CD of the scans and was able to immediately share them with my friends and colleagues who are surgeons, oncologists, radiologists, etc. Again, I thought of those who do not have the network of physicians that I am lucky to have, and how excruciating it must be to wait for those CT scans to be analyzed, the reports to be written, and finally uploaded to the online patient portal. The uncertainty and concern of loved ones not knowing the probability for survival, or if radiation therapy would be required for several days.

The report of the CT Scans did eventually confirm the unofficial results from my network, and came back clean showing no metastasis or lymph node involvement! Every surgeon and oncologist I spoke to said this is a standard, no-surprises surgery and thyroid cancer is generally one of the most treatable cancers. All four surgeons I shared my results with unequivocally recommended Total Thyroidectomy as treatment (remove the entire thyroid gland). As a physician I already knew this, and it is easy to tell this to a patient, but I also know what can go wrong in the Operating Room, especially with general anesthesia.

I awaited the date of surgery, November 17, (a week and a half away) with anxiety and cautious optimism. The last step was to get a COVID-19 test just before surgery (48 hours pre-op).

The Day of Surgery

On the day of surgery itself, I had the typical patient experience, delays in getting a bed in pre-op, actual surgery time delayed 4+ hours, post-op I was in limbo for several hours due to issues with bed/step down availability. I was thankfully very stable, but for that I would have to wait another 4 hours to get a room post-op to stay the night as sicker patients continually took priority for being moved into available rooms.

My surgery that was planned for 11:20 am actually got me into pre-op at 1:30 pm, then into the Operating Room at 4pm, into postop around 6:30pm, and into my own hospital room at 10pm.

My father, who is a cardiologist, came to the hospital with me and was getting impatient about the constant delays and waiting. I’m certain this wait is common to all patients, including his, but doctors are unable to both be on time for all appointments and provide the best care for every patient. The nursing staff was great throughout, and I even jokingly requested specific meds from the anesthesiologists.

Post Op

With all said and done, I came out with a positive experience and was grateful for the successful outcome. This entire process that took me 5 weeks could have easily been 12 weeks+ for someone without any connections. In fact, if I only used my insurance portal’s online system, I would still be waiting for my initial appointment!

After spending a week recovering at home, avoiding narcotics and only using Tylenol for pain, my major issues are fatigue and mild pain at the surgical site. I will also be on a lifelong medication (Levothyroxine) but it’s a tiny pill once a day without many side effects.

Closing Thoughts

While doctors and other clinical staff are working hard to serve their patients, there are still so many gaps in our healthcare system. One area I have helped my friends and non-medical coworkers with many times in the past was helping to understand their diagnoses or medical reports in laymen’s terms or put them in touch with the appropriate specialist physician. There is no current standard for spending time with a patient to comprehensively explain in simple terms the reasoning for a treatment or diagnosis — beyond medical jargon, percentages and assurances.

I will continue to help and contribute some of my time towards answering questions about medical diagnoses and also accept emails to my personal email ID. Anyone who would like help in understanding their lab results or medical reports feel free to email me at MaanasDS at gmail.com.