Being an orthopedic surgeon, my doctors tend to speak to me in doctor speak rather than the more normal understandable language most patient’s expect. But I was still fuzzy from the anesthesia. “….well differentiated papillary carcinoma spread to 3 lymph nodes”, my surgeon related. It was pretty easy to make sense of it once the drugs wore away: In the blink of an eye, I had been transformed from the healthiest 52 year old I knew, to a patient with metastatic cancer!
“You can’t possibly have cancer, you are the healthiest, most energetic, active person I know” most of my patients and colleagues responded to my news. “If you have to have cancer, this is the one to pick”, one colleague reassured me. “It’s so commonly cured, I haven’t ever had a patient who didn’t do well with it”, asserted another. Still, as I poured over the internet gobbling up everything I could learn about the recommended radioiodine treatment, I was overcome with the realization that treatable or not, mets are mets. Although the radioiodine treatments are described as quite well tolerated, they do make the patient “hot”, with the attendant requirement to “go away from people” for several days. No problem, I thought, I’ll just head out to the lake and play golf or work out. “Well, you can’t really grocery shop or check into a golf shop in the beginning, since the person helping you may be pregnant.”, I was warned. Ok, this isolation thing was going to be a little harder than it first appeared, but I dutifully scheduled the treatment, the time away from work, and eagerly looked forward to my definitive cure.
Resigned to taking thyroid replacement on a lifelong daily basis, I thought it might be a good time to take on my elevated cholesterol with meds as well. After hovering around 225 to 240, I had known for years that it was higher than ideal, but since I exercise so aggressively , have no other risk factors, and maintain a healthy diet and lifestyle, it hadn’t seemed like that big a deal. “ Let’s get a cardiac calcification CT scan” suggested my cardiologist. “ If it comes back 0, your risk of a cardiac event is quite small, and you really don’t need any treatment after all. “ 10 seconds of high speed CT scanning and $150 out of pocket ( insurance doesn’t consider it as good an idea as my cardiologist and I did ), produce the classic good new/bad news story. “ The good news is you have 0 calcifications in your coronaries, the bad news is you have a football for a right kidney. “ I felt like I was under anesthesia again, but this time I was wide awake. Yep, I had probably lived my entire adult life with a single functioning kidney, and the other one was hugely dilated, 22 by 18 centimeters, tenting my vena cava ( the main vein leading to my heart ), and displacing my intestines.
Now my world was really spinning. Two months ago I’m the healthiest 52 year old in the history of the planet, now I have metastatic cancer, and a giant barely functioning cystic kidney. My scan became famous throughout the medical center in short order. How could I have not felt it, everyone who sees it demands to know. I am an avid golfer, I had just run a serviceable half marathon in 1 hour 49 minutes with my 21 year old son less than 6 weeks ago, I work out like a maniac. How could I have no clue that this beast was inside of me?? I had no good answers to any of it.
That I have benefited greatly from modern medical science is without question. I have successfully had my thyroid and nodes removed with a 1 night hospital stay. I have successfully had my abnormal kidney removed with an entirely laparoscopic ( rather than open ), retroperitoneal ( rather than opening the abdominal cavity ) approach, also with a one night hospital stay. Thanks to modern day recombinant technology, with thyrogen injections done 2 consecutive days before the radioiodine, without compromising my chances of curing my cancer, I have had the luxury of taking thyroid medication straight through my treatments , compared to the old approach of remaining off thyroid medication for several months, gaining weight, feeling lethargic and concentrating poorly.Although the wonders of my treatments, and the personal experiences of being a surgeon patient in the medical system give rise to all sorts of interesting experiences and feelings, what I would like to concentrate on here is really a simple message. See your doctor regularly. Do not take your good health for granted. I wasn’t really trying to be macho or cool by not seeing a doctor. I just had no symptoms, felt great, and had completely normal labs across the board whenever I bought life insurance. With a busy orthopedic surgical practice, it is all too easy to not find time .
I have been quite lucky. My normal kidney function by virtue of my normal left kidney, both hid my condition from childhood till age 52, but also makes it likely that I can live many more years in good health. My cancer, even having spread locally, is likely cured with my surgery and radioiodine, so that I have a great likelihood of never needing anything else done but monitoring. I will likely die of something else. And I can promise you, I will never take my good health for granted again.
