Saturday, January 29, 2011
Thursday, January 20, 2011
Mystery Diagnosis
Around the end of October of last year, I noticed what I thought was a swollen lymph node on the right side of my neck. I was a bit distressed because I thought it meant a cold was coming on, and that was the week I was to host our playgroup's Halloween party. However, days passed and no cold symptoms appeared. The swollen lump on my neck was getting more sore and tender to the touch to the point where I was popping ibuprofen several times a day.
When after a week the swelling had not resolved, I reluctantly decided to walk into the student health clinic. The irony of UCSF student health is that at a hospital world renowned for hiring and training the foremost physicians in every field, the physicians that are hired to treat the students at Student Health seem like they were scraped from the bottom of the medical school barrel.
After the doctor assessed my neck lump, she ordered some standard labs to look for signs of infection (CBC, mumps and mono antibody) and also suggested I suck on sour candies to induce salivation in case I had a blocked salivary gland. When I followed up with her later that week, my labs had come back normal, but the swelling had not improved. The poor student health doctor seemed at a loss. She actually told me she was going to step out into the hall so that she could pace up and down and think about what to do. After returning, she decided to empirically prescibe some antibiotics in case I had some kind of subclinical infection.
Another few days go by, and the antibiotics do nothing to help the swelling. In fact, if anything the lump had gotten worse, having grown from the size of a grape to the size of a walnut and occassionaly waking me in the middle of the night due to discomfort. Still baffled, my doctor referred me to Radiology to get an ultrasound on my neck. When I met with her two days later, she told me that the ultrasound had showed a "heterogenous mass" that was inconsistent with an inflamed lymph node or a blocked salivary gland. Then the report dropped the N-bomb: Neoplasm.
The recommendation was further imaging by MRI with contrast. I was ushered into the MRI early that same afternoon. The closest personal experiences I have had with MRI is when Ruby had one to image what was discovered to be a small teratoma on her tailbone when she was 2 weeks old and also what I have seen on House. Unfortunately, the experience was at least as, if not more unpleasant than what I imagined. The tube of the machine, although narrow-looking on TV, seemed much narrower in person. Also, perhaps because I was getting a MRI of my head and neck, my head was wedged in on both sides and something that looked like a cage ala Hannibal Lecter was placed over my face. The most unexpected part of the procedure was the sound, which made the experience akin to being buried alive with a jackhammer trying to dig me out. I was told that it was imperative to remain absolutely still during each image. Any slight movement such as swallowing, blinking, breathing too hard would render the image unusable and it would have to be repeated. Each image took anywhere from 2 to 6 minutes to take. All tolled, I spent approximately 50-55 minutes in the machine. By the end, I was ready and willing to give up military secrets.
Since the MRI was done on a Friday afternoon, an appointment was made with an ENT (ear, nose and throat) specialist for Monday morning to go over the results. This gave us the whole weekend to stew, which was more than enough time for me to convince myself that I had some kind of weird cancer. Although on the surface that weekend was just like any other weekend (we went to the zoo, hung out with friends), inside my head I was not able to stop myself from touching on the deepest, darkest thoughts. What if I am no longer able to take care of Ruby? What if I'm not around to see her grow up?
For one weekend, all of our plans for the future halted. We could not return emails to our architect regarding our planned home remodel; I cancelled the experiments I had planned for the following weeks; we held off on ordering the Thanksgiving turkey. For one weekend I could not eat or sleep or look at Ruby without crying. The doctor's words turned over and over again in my head, "I want to move quickly on this. You're young, and you have a young child ..."
To spare those of you who didn't already know the worry and suspense, I did not have a tumor, and I am not going to die. However, the journey to the diagnosis had just begun and turned out to be much stranger than I could have imagined.
TO BE CONTINUED ...
When after a week the swelling had not resolved, I reluctantly decided to walk into the student health clinic. The irony of UCSF student health is that at a hospital world renowned for hiring and training the foremost physicians in every field, the physicians that are hired to treat the students at Student Health seem like they were scraped from the bottom of the medical school barrel.
After the doctor assessed my neck lump, she ordered some standard labs to look for signs of infection (CBC, mumps and mono antibody) and also suggested I suck on sour candies to induce salivation in case I had a blocked salivary gland. When I followed up with her later that week, my labs had come back normal, but the swelling had not improved. The poor student health doctor seemed at a loss. She actually told me she was going to step out into the hall so that she could pace up and down and think about what to do. After returning, she decided to empirically prescibe some antibiotics in case I had some kind of subclinical infection.
Another few days go by, and the antibiotics do nothing to help the swelling. In fact, if anything the lump had gotten worse, having grown from the size of a grape to the size of a walnut and occassionaly waking me in the middle of the night due to discomfort. Still baffled, my doctor referred me to Radiology to get an ultrasound on my neck. When I met with her two days later, she told me that the ultrasound had showed a "heterogenous mass" that was inconsistent with an inflamed lymph node or a blocked salivary gland. Then the report dropped the N-bomb: Neoplasm.
The recommendation was further imaging by MRI with contrast. I was ushered into the MRI early that same afternoon. The closest personal experiences I have had with MRI is when Ruby had one to image what was discovered to be a small teratoma on her tailbone when she was 2 weeks old and also what I have seen on House. Unfortunately, the experience was at least as, if not more unpleasant than what I imagined. The tube of the machine, although narrow-looking on TV, seemed much narrower in person. Also, perhaps because I was getting a MRI of my head and neck, my head was wedged in on both sides and something that looked like a cage ala Hannibal Lecter was placed over my face. The most unexpected part of the procedure was the sound, which made the experience akin to being buried alive with a jackhammer trying to dig me out. I was told that it was imperative to remain absolutely still during each image. Any slight movement such as swallowing, blinking, breathing too hard would render the image unusable and it would have to be repeated. Each image took anywhere from 2 to 6 minutes to take. All tolled, I spent approximately 50-55 minutes in the machine. By the end, I was ready and willing to give up military secrets.
Since the MRI was done on a Friday afternoon, an appointment was made with an ENT (ear, nose and throat) specialist for Monday morning to go over the results. This gave us the whole weekend to stew, which was more than enough time for me to convince myself that I had some kind of weird cancer. Although on the surface that weekend was just like any other weekend (we went to the zoo, hung out with friends), inside my head I was not able to stop myself from touching on the deepest, darkest thoughts. What if I am no longer able to take care of Ruby? What if I'm not around to see her grow up?
For one weekend, all of our plans for the future halted. We could not return emails to our architect regarding our planned home remodel; I cancelled the experiments I had planned for the following weeks; we held off on ordering the Thanksgiving turkey. For one weekend I could not eat or sleep or look at Ruby without crying. The doctor's words turned over and over again in my head, "I want to move quickly on this. You're young, and you have a young child ..."
To spare those of you who didn't already know the worry and suspense, I did not have a tumor, and I am not going to die. However, the journey to the diagnosis had just begun and turned out to be much stranger than I could have imagined.
TO BE CONTINUED ...
Wednesday, January 5, 2011
Hand in hand
This morning Ruby and I went to the zoo to meet one of Ruby's newest little friends, Eva. Eva's mom and I met through one of Golden Gate Mothers Group's Specialty Subgroups for moms in their 20s. In a place like San Francisco being a mom in your 20s places you in quite a small club (there is also a subgroup for moms in their 40s, the size of which dwarfs the moms in 20s group). I connected with Eva's mom because we are the exact same age, and we both have daughters who are also the exact same age! Eva is one of the sweetest and brightest toddlers I have ever met. She speaks French and is very communicative. She loves to give kisses, and today she insisted on holding Ruby's hand at all times.
I can already tell that Ruby and Eva will become good friends.
I can already tell that Ruby and Eva will become good friends.
Tuesday, January 4, 2011
Best buddies
With the start of the new year comes the one year anniversary of our nanny share. When Ruby and her share care buddy Ian first met, Ruby was 3 months old, and Ian was in utero. Ian's parents met with us and the nanny to discuss the possibility of a nanny share. However, it was not until a year ago, when Ian was 3 months old and Ruby was 7 months old that the nanny share officially began.
From the beginning, it was clear that Ruby and Ian were opposites. Ruby was quiet and mellow and completely immobile. Ian was loud and excitable and could not sit still. Ruby would be happy to sit and listen to books and play with blocks all day. Ian is happiest when he's able to run around freely, explore every nook and cranny, and bang things together that make loud noises. Despite being almost 4 months younger, Ian crawled and walked months before Ruby gave any sign of even trying. When we first child-proofed our house, it was entirely for Ian's benefit.
Despite being complete opposites, Ruby and Ian have always had a great deal of affection for one another. When out on a stroll in their double stroller, Ian would often take Ruby's hand, and when the nanny tries to stop him for fear that he might put her hand in his mouth, Ruby would get upset! Ruby and Ian have a special greeting when they first see each other in the morning of crawling up to one another and bumping heads.
Although many of Ruby's little friends are openly affectionate with everyone they meet, offering hugs and kisses to all, Ruby has always been much more shy and reserved. The first person I have ever seen Ruby hug, aside from me, Steve, the nanny, and her dolly, is her little buddy Ian.
Saturday, January 1, 2011
Happy holidays!
Hi everybody! I hope you all had a very merry Christmas! This year, ALL of my grandparents came to see me, so I had 2 Na-na's, 2 Ye-ye's, a Mommy and a Daddy to do my bidding. Boy oh boy did I live it up!
The night before Christmas, I was so excited for Santa Claus to come that I woke up at 3am and couldn't go back to sleep! That's why Mommy, Daddy, and I look sort of tired in these pictures.
I must have been a good girl this year, because I got SO MANY presents!
I was very happy to get many new books because I've never met a book I didn't like.
I also received my first potty, but I'm not sure yet what that's good for.
I very much loved my first piano, but I don't understand why it sounds better when Ye-ye presses the keys than when I do it.
After I opened all the presents under the tree, I got even more presents out of an extra large sock!
Santa Claus must have read my wish list because inside my stocking was a brand new hairbrush!
I spent the rest of the day brushing everybody's hair.
Some people had more hair to brush than others.
Even though I loved all of my presents, the best part of the holidays was spending time with my family!
The night before Christmas, I was so excited for Santa Claus to come that I woke up at 3am and couldn't go back to sleep! That's why Mommy, Daddy, and I look sort of tired in these pictures.
I must have been a good girl this year, because I got SO MANY presents!
I was very happy to get many new books because I've never met a book I didn't like.
I also received my first potty, but I'm not sure yet what that's good for.
I very much loved my first piano, but I don't understand why it sounds better when Ye-ye presses the keys than when I do it.
After I opened all the presents under the tree, I got even more presents out of an extra large sock!
Santa Claus must have read my wish list because inside my stocking was a brand new hairbrush!
I spent the rest of the day brushing everybody's hair.
Some people had more hair to brush than others.
Even though I loved all of my presents, the best part of the holidays was spending time with my family!
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