What Matters Most
musings on the mundane and magnificent from a Christian perspective
Bear with me. This post has a point, I assure you. The story I’m about to relate may not be the most light-hearted thing you read today, but this is me. This is real life – with all its craziness, all its ups and downs – and all its lessons learned.
In August 2014, after a radiation treatment for papillary thyroid cancer, I had a full-body scan to determine if the cancer had come back or spread to new areas. It does this by showing if the patient has any areas of abnormal iodine uptake from the radiation.
And in my case, I did. Among other things, my results showed “a focus of increased activity” on my lower left chest that “may be due to metastatic disease to a rib or other etiology.”
In October 2014, I had a PET/CT scan which showed no distant metastasis. The scan showed that my cancer had not spread to my ribs. (It had returned in my lymph nodes, but that’s another story.)
My understanding is that when cancer spreads to your bones, it’s usually incurable. You just treat the symptoms, manage the pain…and wait. Thankfully, the second scan clearly showed that I did not have cancer in my bones, but from August to October, I did not know that. For two months I lived with that “or.” Either that spot was due to cancer in my ribs or some other benign cause. Either I was dying, or I wasn’t.
Did I overreact? Absolutely.
Being a cancer patient can make you hypersensitive to things you wouldn’t otherwise notice. When you spend so much time thinking about what’s going on inside your body and discussing it with doctors, you end up having the body on the brain constantly.
And in the weeks leading up to that first scan, I had the feeling of a constant cramp in my lower left chest. (Looking back now, it was probably just from exercising the wrong way, but who knows? It literally could have been anything other than cancer.)
Perhaps the scan results wouldn’t have alarmed me so much if I didn’t have a symptom that matched up with the worst-case scenario. But annoyingly, I did. So, for two months, I waited, and I wondered.
I couldn’t stop the thoughts that inevitably came. I thought about telling my family and friends the news and telling them how much they mean to me. I thought about what my funeral would be like and what worship songs I would want played. I thought about what kind of legacy I’d be leaving at this age. And I thought about all the years that would be left unfinished.
I couldn’t help but think and feel these things in that interim of ignorance. I carried on as normal – went to work, did the dishes, and planned for each next day. But it was an eerie time. I didn’t know if my days were suddenly coming to an end due to an incurable cancer or if I was going to be just fine.
I am just fine. But those two months taught me a lesson I hope I’ll never forget. In those two months, I was reminded to set down the to-do list and pick up the phone. It was easier to not let little things turn into a big deal. I was quicker to give unconditional love. And I took greater pleasure in the simple everyday moments with the ones I love.
Why is it so hard to live with this mentality every day? Why is it so easy to get lost in the busyness and specifics of day-to-day life that we forget the big picture? We let details drive us and we forget about purpose, about what matters most.
We all live with the reality of certain death. Whenever it happens, however it happens, we all have an inevitable end. And though we don’t often think about it in the midst of day-to-day life – paying bills, running errands, clicking on the next show in our Netflix queue – we need to remember this. We need to remember that our time on Earth has an expiration date. And we need to let this breathe life into the time we have left, however long or short that is.
Living like you’re dying is not merely the cliché of going skydiving, or on a shopping spree, or devoting more time to hobbies and pursuing passions. It’s not just conquering your fears or doing what makes you happy. That’s part of it, but there’s so much more to it than that.
For me, it’s loving myself enough to say no to another brownie because too much sugar saps my energy, and I want to be alert and ready for everything in my day today. It’s opening my mouth to speak up in small group even though it would be easier just to sit and listen. It’s putting down the novel I’m currently devouring and picking up my laptop to blog because I want to do the work God has called me to do.
It’s being an active participant in life and not just a spectator. It’s choosing to take responsibility for my own life. And it’s leaning into life as God intends it – life lived in love and service to God and others. Because there’s so much more to life than another brownie or the number one show on Netflix.
God has so much more for us. And I don’t want to miss out on a single thing. I don’t want to waste any time in the short time I have. I don’t want the potential He’s placed in me to remain unfulfilled. In His strength, empowered by the Holy Spirit, I want to live “the life that is truly life.” (1 Timothy 6:19 NIV)
And that life is something that is available to us all – whether we are pre-teens or senior citizens, whether we’re in perfect health or have cancer in our ribs.
So, let’s go through the daily details – the mundane tasks, the larger responsibilities, everything we face – with the knowledge that each day is a precious gift. And let’s choose to live life to the fullest – each and every day we have left.
“So teach us to consider our mortality, so that we might live wisely.”
Psalms 90:12 NET
My cancer story has finally, thankfully come to an end, for the most part. It’s not something I think about or deal with day to day. My morning pill is a rote ritual, as mechanical as breathing or brushing my teeth. My yearly check-up with my endocrinologist at Mayo is something that is built into my calendar; it falls in the summer, so we plan vacation around it. It’s just something that happens every year, and then we move on.
And the visit is the same every year, a routine that feels familiar and easy: bloodwork in the morning, followed by an ultrasound of my neck, then lunch at one of our favorite restaurants near the hospital, then a meeting with the doctor in the afternoon.
We make a trip out of it. I have family in town we look forward to seeing when we go. We may plan a trip to the beach or a fun dinner out. We may get some good time in at the pool. Or we may laze around doing not much at all but enjoying being together. My annual Mayo visit doesn’t feel like a chore; it feels like the precursor to a mini vacation.
Which is a good thing! I’ll be having these annual check-ups for most of my life, I understand. My endocrinologist explained to me that this type of cancer, mild as it may be, requires a lengthy follow-up. So, these visits will continue indefinitely. Thankfully, we don’t live too far, and thankfully, the care at Mayo is worth the drive.
In the beginning, we were making that drive every three months. After I had surgery there and things started to settle down, it was every six months. When I graduated to once a year, I thought I had conquered Mount Everest. It felt like a huge accomplishment!
And that’s where we’ve been for the past few years – making our yearly trip to Mayo, not concerned about what may happen, just taking it in stride. And for the past few years, my ultrasounds have been clean and my bloodwork stable. I remain cancer-free.
But I don’t remain unchanged. I don’t think it’s possible to go through cancer and not learn something, feel something, or change something.
My takeaways:
I may be the only person in the world who loves hospitals. I just like the mix of people – all walks of life congregating in a place devoted to wellness, to making us better. It’s where professionalism meets compassion. I thoroughly enjoyed all the volunteer work I’ve done in hospitals, so maybe that’s one reason why I feel at home here. Or maybe it’s because hospitals are where I’ve come to spend so much time.
So. Much. Time.
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After weeks of diagnostic procedures culminating in a diagnosis of metastatic papillary thyroid cancer, my attention turned to treatment. The first step: goodbye, thyroid!
In August 2013, I underwent a six-hour surgery to remove my entire thyroid and several lymph nodes. Of the 31 lymph nodes removed and sent to pathology, 21 tested positive for cancer.
Surgery was later followed by radiation. The radiation used to treat thyroid cancer is in the form of a pill, a huge horse pill that is brought to you in a metal canister and administered in a very specific way. You can’t touch the pill, and the technician can’t touch it. The whole thing was like something out a science fiction movie. I half expected smoke to seep out of the canister when it was opened.
Treatment Plan: Netflix
After the patient swallows the pill, they give off radiation. So, when my science experiment was over, I was given very specific instructions on what to do next: go straight home and begin my quarantine. Yes, I was quarantining even before the pandemic hit!
My quarantine was three days holed up in our guest room with books, magazines, and Netflix. I had a stash of food and a dedicated bathroom. My stepson was at his mom’s, and my husband knew he was on his own. It was only for three days, and we knew about it ahead of time, so we were able to prepare. And for an introvert like me, it was kind of nice!
After the first three days were up, I still had strict guidelines to follow. For the first seven days from ingesting the pill, I had to sleep alone. I had to maintain a distance of three feet from children and pregnant women. I had to avoid situations where I was close to people for more than five minutes, such as movie theaters and most everything else in life. So… staycation continued!
Better Than a Horse Pill
After radiation and quarantine, I went back to the hospital for a full body scan. After this, I was cleared to start the next step in my treatment: medication. Every day since that day in 2013, and every day for the rest of my life, I start my morning with a pill – Synthroid. This replaces the hormones that my thyroid produced.
I once had a pharmacist tell me that there are over 200 different doses of this medication. 200! Since getting the right dose is critical, bloodwork is a staple for thyroid patients. Through simple lab tests about every three months, our hormone levels can be monitored, and our medication adjusted as needed. I have been on about five different doses over the years, but my current dose seems to be my sweet spot since I’ve been on it the longest. I now only have to get bloodwork done once a year.
Fast forward about six months from the last scan. I’m going to work, I’m taking care of my family, I’m taking care of me. I’m taking my pill faithfully every day. And I’m cancer-free, or so I thought. I started experiencing some swelling and tenderness in my neck, so I went back to the doctor.
In May 2014, I had a CT scan which showed enlarged lymph nodes on the right side of my neck. I remember that follow-up appointment well. I remember asking the doctor what enlarged lymph nodes meant. “Does this mean the cancer is back?” I asked. I still remember the sinking feeling when he answered yes.
Here We Go Again
For me, that was harder than hearing it the first time, way harder. When this all started, I knew my sister had been successfully treated for the same cancer, and I knew, in the world of cancer, it was fairly mild. So, I took a deep breath, braced myself, and went through the initial surgery, radiation, and medication – all with a view to beat this. But now, here I was having to go through it all again.
We had not beaten it.
That summer, I went through radiation again – therapeutic I-131 radioiodine at a dose of 154 mCi. Another horse pill, another quarantine. In the fall, I was referred to the Cancer Center at my hospital. I’ll never forget the feeling of walking into the Cancer Center for the first time – as a patient. It was sad, overwhelming, and exhausting all at the same time. I was so ready to be done with it all, but at that point, the end was nowhere in sight.
The result of my appointment with the oncologist was a PET/CT scan, which showed “intense activity consistent with metastatic thyroid cancer.” Something about seeing it in black and white just broke my heart. If thyroid cancer is the “easy cancer” then why was I still dealing with it? When would my cancer story come to an end?
The Next Step
At that time, we were preparing to relocate for my husband to start a new job. Since we would be having to change doctors anyway, and since we would be closer to my hometown of Jacksonville, Florida, we switched my care to Mayo Clinic, where I have been seen ever since.
In October 2014, we met with an oncologist and an endocrinologist there. My endocrinologist, who is my main doctor, is a past president of the American Thyroid Association. His resume is as lengthy as it is impressive. We felt relieved to be in such good hands since we wanted to tackle this aggressively.
A few more months, a few more ultrasounds, a CT scan, and a biopsy by fine needle aspiration all led to a second surgery. In February 2015, I had a subsequent neck dissection to remove more lymph nodes. (I don’t have any more thyroid tissue left to take out!) The second surgeon cut along the incision from the first surgery, using my long scar as a guide. Of the 25 lymph nodes that were removed, this time only five were cancerous.
The next few years unfolded in a pattern of Mayo visits. I had ultrasounds to check for enlarged lymph nodes. I had bloodwork done regularly both there and at my local lab. My Synthroid dose was adjusted as needed. I had another fine needle aspiration biopsy. And I waited. I waited for the all-clear, the words I wanted so long to hear – cancer-free.
It’s been said that ignorance is bliss. This has certainly proved true in my life, and the evidence is staring back at me in old photographs of myself. Below my smile, beneath my then unlined neck, cancer was lurking – a tumor concealed, undetected, yet steadily growing. What I was ignorant of would later come crashing into reality at the most inopportune time.
Almost everyone has a cancer story or knows someone who has a cancer story.
This is mine.
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In January 2013, I was a bride of all of six months. I was 35 years old and adjusting to a new home in a new city, a new job, a new last name, and new roles as a wife and stepmom. Or rather, trying to adjust. To say I was overwhelmed was an understatement. Even little things were exhausting, like dealing with an extremely stubborn cold. The common cold is, well, common, but the cold I had that winter was uncommonly persistent. It left me with swollen lymph nodes and a desire never to get sick again.
Fast forward a few months. My lymph nodes were still swollen. I thought that was strange but wrote it off as prolonged effects of the cold.
A Lingering Lump
Fast forward a few more months. I had a routine doctor’s appointment with my gynecologist, and I told her my husband and I were ready to try for a baby. We discussed this at length, and as she was preparing to leave the room, almost as an afterthought, I mentioned the lingering lump on my neck. She looked at it, felt it, and told me in no uncertain terms that I shouldn’t even think about getting pregnant until we got it looked at. I can still hear the gravity in her voice.
What followed next is a blur. I had so many doctor’s appointments and procedures that I had to start a binder to keep it all straight. Bloodwork, CT scans, ultrasounds, follow ups with the doctor – it was a rapid succession of diagnostic procedures and information. The hospital became my home away from home that summer. I knew the floor plan by heart! I was on a first-name basis with my nurse in my doctor’s office. It was a lot, and it all led to the stunning revelation of what had been there all along but what I had been blissfully ignorant of.
Cancer Concealed
In July 2013, within just days of my one-year wedding anniversary, I was diagnosed with metastatic papillary thyroid cancer. I was stage T3 N1 B since the cancer had already spread to my lymph nodes. What I had so carelessly disregarded as swollen lymph nodes from a cold was actually a tumor sitting on top of my thyroid gland, a slow-growing tumor that had been steadily increasing over the years. While I was going to work every day, when I met my husband and stepson, even on our wedding day, cancer was there – we just didn’t know it yet.
My husband was the one who broke it to me. The final diagnostic procedure was an outpatient surgical biopsy, and I remember it like it was yesterday. For weeks, I thought everything was much ado about nothing, that there would surely be some easy explanation for whatever was in my neck. I felt fine! I had no other symptoms. And quite frankly, I didn’t want to deal with it anymore. I just wanted it all to be over, and I wanted to enjoy what was left of the summer. It took lying on a hospital bed and being prepped for surgery to finally get my attention, to acknowledge that maybe there could be something to this after all.
Eventually, I was wheeled away – to my first surgery ever, but not the last. The surgeon cut a small incision in my neck and removed a lymph node that was sent to pathology for testing. When I awoke in the recovery room, my husband told me the result: cancer.
A Jarring Revelation
I was shocked. I bolted up right away; the anesthesia had already worn off because the surgery was so short. With my mouth agape, I struggled to take in what he was telling me. Surely it would have been something else, something minor – anything but this. This is what happens to other people, never what you expect to have to deal with yourself.
I had the same reaction earlier that year when my sister called to tell me she had cancer, the same cancer I was now diagnosed with. I remember being so utterly shocked when she told me her news, so completely blind-sided. It was a lot to digest, and now here I was having to digest it all over again. What are the chances we would both be diagnosed with the exact same cancer within a few months of each other?
But we were. It was a reality we were forced to accept, and the quicker we could do so, the quicker we could begin dealing with it. My sister was by then treated and doing very well. To this day, she has had no relapses. Walking with her through her process helped me when I went through mine, once the shock wore off.
Sadness Sets In
Besides feeling shocked, I remember feeling sad – sad for my mom that she had another sick daughter, and sad for my husband. He had barely gotten settled in the waiting room after going for a quick bite to eat before the surgeon came looking for him after the biopsy. He told me how serious the surgeon was when he told him, and now here he was having to tell me, having to say “cancer” to his wife.
I felt bad that he was the one who had to do that, that he was so quickly having to live out his vow of “in sickness and in health.” But he did, faithfully. Throughout that summer and everything that came after, he was there for me. And I believe we’re stronger now for having faced cancer together.
Cancer. The one word you never want to hear. And for me, especially not at that time in my life. I was about to celebrate my first wedding anniversary and, hopefully, about to become pregnant. Cancer is never convenient. We did celebrate our anniversary, but we had to put pregnancy on hold – for longer than we thought.
My New Normal
The way I processed it all was to ask questions, lots of questions. I did my own research, wrote down questions in advance, and took my binder to every appointment. I processed it step by step, with each appointment, with each new piece of information.
What I learned is that papillary thyroid cancer is a very slow-growing, non-aggressive cancer. It’s typically not treated with chemotherapy, and its patients usually have a good prognosis. It is treatable.
Treatable. That was the word I clung to once I digested the word “cancer.” As I adjusted to my new normal, a game plan presented itself, a course of action to tackle this unexpected and unwelcome development. I’ll save my treatment for another blog post because it was filled with its own challenges – stops and starts, highs and lows, a meandering journey that continues.
I had just wanted it all to be over, but it was far from over.
It was just getting started.
This is going to be a tough one. Another seemingly innocuous situation that should be easy, but for me is anything but. It comes in different forms – a conversation, a moment in a TV show, a scene in a book – but it always has the same effect. Some reference to motherhood makes me flinch. The ramifications of infertility are endless.
Today, it’s in an English lesson I’m teaching online to a seven-year-old boy in China. I’m supposed to be teaching him to say, “This is my mom.” Slide after slide in the lesson shows a happy mom cuddled next to her child. Mom and daughter hugging. Toddler son kissing his mom. Mom after mom after mom.
There will never be anybody who says of me, “This is my mom.”
I do not resent the chain of events that led to this. It just is what it is. I was single throughout the years of my peak fertility. Once I finally got married, I was diagnosed with thyroid cancer, so we had to put pregnancy on hold. By the time my doctor gave us the green light to try for pregnancy, we were hardly spring chickens. My peers were posting pictures of proms and graduations of their kids – budding young adults – while I was just hoping for a baby. Just one.
We tried everything. I took medication to stimulate ovulation month after month until I hit the maximum dose. Then, we met with a fertility specialist. I read article after article. And I did all this prayerfully; I fasted, and people laid hands on me and prayed for me. We believed, and we hoped. And we waited. And then we tried again the next month. We exhausted all options including adoption, which my husband didn’t feel led to pursue because of our ages and season in life. We tried everything until there was nothing left to try.
My journey to motherhood came to an unexpected end.