the big neck.

To announce my pregnancy, I sent out a family-wide email with the subject "Doctors found a mass." I attached the ultrasound, and while at that point the baby was vaguely crustacean in appearance, it was clearly a fetus. Most everyone responded with congratulations, but one of my brothers apparently did not look at the attached picture. So he just thought I had cancer that for whatever reason, the doctors weren't going to bother to remove for another seven months or so.

Jokes on me, because the doctors found a mass. At my postpartum followup visit with my midwife, she noticed that my thyroid was enlarged. I had a goiter, which is one of those things that sounds like something they got in Little House on the Prairie but that should be extinct by now. Actually, goiters are pretty common after pregnancy, when your body gets all confused. Or maybe it's not confused at all, it's just part of the recovery, but now we have doctors that can diagnose you with big neck and send you round for testing. The midwife took some blood to check my hormone levels. When the nurse entered this information into the medical records program, there was no option for a goiter. So on my chart, it says that I am suffering from an enlarged neck.

Lord have mercy, I got the big neck!

The hormone levels came back within the normal ranges, so the midwife recommended that I go in for an ultrasound to see what was going on in my big ole neck. They sent me to a nondescript office building which housed a diagnostic imaging center. A taciturn technician named Debbie put some goo on a wand and rubbed it on my neck, taking pictures.

"How's it look?" I asked, trying to make some conversation while not moving my neck too much. I wondered about her job, whether she only took pictures of thyroids or whether it was other stuff, too. Was it hard to learn to read the images? Did she have a favorite body part to look at?

"I'm not allowed to say," grunted Debbie. I didn't make any other attempts to engage.

I didn't hear back about the ultrasound for a couple of weeks. I took that to mean it wasn't too serious, i.e., not cancer. I'd done some research and found that something like 98% of goiters are benign. I was not particularly worried about any of it; in fact, I was mostly annoyed at the hassle of more appointments in drab buildings. However, I have met my healthcare deductible for the year, what with getting that baby out of my body, so I was willing to be safe rather than sorry at no expense to me.

When the midwife finally did give me a call, it was to let me know that I had a multi-nodular goiter with calcified areas. Therefore, they wanted me to see a surgeon for a biopsy. I did a little googling and found out that multi-nodular goiters with calcification were more likely to be cancer than other kinds, but still only 15% likely. I also found out that they can do a biopsy without cutting into you at all. It's called a fine needle aspiration, and they just take a needle and stick it in your goiter to remove some cells. Since I was being sent to a surgeon, it sounded like they wanted to cut into my neck. I was all prepared to go into the surgical consult and demand my fine needle aspiration. Because I am an American, and I have a right to have needles stuck into my big neck! I went in there and the surgeon told me she was sending me to someone else to get a fine needle aspiration.

That's right you are. Hrmph.

The surgeon reassured me that it was most likely benign, but also that thyroid cancer was hands down the best kind to get. Usually, just cutting out the goiter takes care of it. You might have to take replacement hormones if your thyroid is damaged. If your neck is particularly big, they will give you a pill of, wait for it, RADIOACTIVE IODINE. You will become RADIOACTIVE, such that for a week, you can't sleep in the same bed with anyone else or handle their food, lest they get contaminated by your RADIOACTIVE bodily fluids. You're not supposed to be near pregnant ladies or babies for a month, and you can't breastfeed your baby anymore because your milk will be RADIOACTIVE (though you could breastfeed future babies). And if you get bitten by a spider, you just might develop super powers. Or maybe it's the spider that gets super powers? Hrm.

And that's it. A little surgery and a super villain pill, cancer over. I think probably the being RADIOACTIVE part in practice is less cool than it sounds, but still: best cancer ever, right?

If it's not cancer, then they just keep an eye on the situation, and you don't get to be RADIOACTIVE. If at any point, the bigness of your neck interferes with things like breathing and swallowing, they will go in and cut the goiter out anyway. I had not even noticed that I was walking around with an apparently huge neck, but after finding out about it, I sometimes felt a catch in my throat. I would try to decide if that was because my esophagus was partially constricted, but when you start thinking too hard about something that is usually automatic, like swallowing, you really can't tell anymore.

The worst part of getting a needle stuck into your throat is the anesthetic, which is applied by a needle stuck into your throat. It burns and stings on the skin first and then it burns and stings under the skin. And then when they poke you with a different needle to get those goiter cells, you feel a little pressure, but no pain. Since they go in three times to get the cells, I have to assume that feeling a needle once is better than feeling it three times. The doctor did this on each side of my big neck, using an ultrasound machine to find one of the juicier nodules. When she was doing my right side, my head was facing the ultrasound screen, and I remarked how I expected to be able to see the needle (once I was given permission to talk again because there were nothing sticking into me). The doctor was kind enough to bounce the needle around a bit the next time so I would be sure to see it. That was the word she used: "bounce." I couldn't feel her doing this, but I could see her hand wiggling around in my peripheral vision and it was just sorta freaky to think about a needle bouncing around in my throat. But I was able to see it, and I figured that if I was going to maybe have cancer, I might as well be able to say that I saw them bounce a needle in my throat.

The doctor finished up and said I did very well. The nurse covered the punctures with what must be the biggest bandaids they make, just in case I was hoping to be able to go back to work and not have people ask what had happened. Since telling people you had a biopsy is all kinds of neon-sign scary, I decided I'd just say I cut myself shaving. That'll teach 'em to ask questions.

I go back in a week to discuss the results of the biopsy with the surgeon. Hopefully, I just have the big neck and not a cancerously big neck.

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