Thyroid (Photo credit: Wikipedia)
It was while I was at the NAMA (National Ayurvedic Medical Association) conference that I received a telephone call about the biopsy results. Turns out it's a follicular neoplasm, which has about a 15-20% chance of being malignant. Before any friends get worried--thyroid cancer is totally curable, but at the cost of losing your entire thyroid and being dosed with radioactive iodine, neither of which are very appealing. In order to determine if the neoplasm is benign or malignant, it has to be removed.
Meanwhile, at the conference I was introduced to Renu, a thyroid surgeon. She was quick to point out the hazards of thyroid surgery. The main concern is the recurrent laryngeal nerve, which enervates the vocal cords. If that is damaged, the voice becomes hoarse and you lose the ability to sing. In addition, there are the parathyroids, which are responsible for regulating calcium balance. If thyroid surgery is done by a non-specialist, there's a 20% chance of permanently losing your voice. As a singer, I found that risk unacceptable. However, if the operation is done by an expert thyroid surgeon, outcomes are very good. My meeting with Renu showed me how important it would be to have the surgery done by an expert.
Ironically, as a junior doctor, I was apprenticed to a master thyroid surgeon! Mr Barnabas (surgeons in the UK are called Mr, not Dr.) was a Hungarian emigre, vascular surgeon and thyroid expert. He took tremendous pride in his thyroid work and was a brilliant craftsman in this regard. We used plastic surgery sutures to sew up the neck so as to leave no visible scar. So I've assisted at many thyroid surgeries and have an intimate understanding of the truth of Renu's words.
The lessons here are not only about the thyroid and its delicate anatomy. Synchronicity, Grace, call it what you will, was clearly at play here. By the will of Ram I was introduced to Renu and came to understand how important it would be to find expert treatment to preserve the 'angel voice' that has inspired many.
In the next installment, I'll talk about my journey as an uninsured person seeking specialist care. It has been an Odyssey.