The chrysalis falls off and the butterfly emerges, unsure of this new life she must now call her own. After hearing the words “cancer” my life radically changed. Now at age 24, I have learned that life is supposed to be fun and vibrant, but also about work and dedication to that which will build me up as a person working for change. I am focused on my studies to gain the credentials I need to helping me become a better educator and eventually a strong leader. I feared telling people about my experience with cancer because I did not want to make it a pity, woe is me story, but rather as a chance to start fresh. Until I did not see cancer as such, I felt it was best not to talk about a very difficult time. I have attempted in this blog to be as raw with my words and feelings as I best remembered them to bring life to my experience. I did not write this blog for myself but rather for the lost young woman with thyroid cancer, afraid, lonely, as I was, so that she knows that although each case is different, one thing remains the same, hope for life and a positive attitude will be your saving grace. I did not know how much until I was able to let go of the anxiety and put my faith and trust in God. All that is meant to be shall be and in the end I ask to know that I changed the life for one person, even if that person is myself. I believe that life is but a beautiful struggle, the more we struggle the more beautiful it becomes. Despite what the priest said in his sermon today, pain is an essential part of love. I will not let painful circumstances bring me down, instead I’ll make them the fuel for my body, the battleship, against the war of life. Cancer is not the end, never see it that way, keep fighting, keep crying, keep laughing, keep searching, keep on loving, keep on keeping on and trust that the butterfly shall fly to a beautiful paradise someday...

I decided to write this blog when I discovered that January was Thyroid Cancer Awareness month in an attempt to increase awareness. It has been nearly 9 months since my diagnosis and I am due for some check ups in February 2010. I do not fear regression anymore because I know that no matter what I am a survivor!  I do not let cancer scare me, and have faith and trust that God knows why things must be the way that they are. I wanted to utilize this final blog post as a form of outreach, asking all thyroid cancer patients to send me any information that was useful to them during their experience at amcruz0928@yahoo.com. Also, I am hoping to come up with ways to serve as an outlet to young people with thyroid cancer. Here are some links I found best useful as well as the list of doctors and their phone numbers for anyone that needs them in the NYC area. May all reading this be blessed with great happiness, and perseverance.

Dr. Laszlo Retsagi (PCP)- 212-319-3977
Dr. Jessica Lim (ENT) 212-434-2323
Dr. Martin Barandes (Endocrinology) 212-249-0622


THANK YOU to: Annie Cok and Hoyu Yiu for the beautiful photography please be sure to check them out at: http://yiuphotography.com/
Thank you to Annie Huaraca, my make up artist and costume designer and my inspirational clothing guru. Please be sure to check her out:
http://acitydoll.blogspot.com
Last but not least a special thanks to ehT Mills for his work on the blog background and layout. He is the true essence of life as a beautiful struggle. Please be sure to check him out at: www.runandeatnyc.com

Websites:
Please see www.checkyourneck.com for information on Thyroid Cancer and the Light of Life foundation.
www.cancercare.org for Counseling Services
www.thyca.org 
www.navigatingcancer.com

Books:
Rubin, Alan. Thyroid for Dummies, 2nd Edition. Wiley Publishing Inc: Indianapolis, 2006.
Arem, Ridha. The Thyroid Solution. Ballantine Books: New York, 2007.

Life is what you make it. Remember that all cancer cases regardless of the similarities are unique in its person. Stay positive, smile off the worries, and live each day in appreciation and recognition of its magnificence. Thank you so much to my readers and please spread thyroid cancer awareness. CHECK YOUR NECK… the examination could save yours or someone else’s life.

I could not believe that I was still breathing, to think I had nearly given up all of my hopes and dreams. I was even able to go to Puerto Rico for the first time, which I considered one of the best trips I have ever had. Prior to leaving for Puerto Rico, a former coworker got in contact with me about a temporary job opportunity working in a daycare, which was in risk of getting closed down by the Department of Education due to a disgruntled worker. I fell in love with those children in a matter of two and a half weeks. They were so sweet and caring and the place happened to be located in the neighborhood I grew up, and currently live in, Washington Heights. Another former coworker was also hired for a temporary position there, and together we worked to remodel the place. It was heartbreaking to see the limited amount of resources the daycare had in comparison to the surplus of supplies I am used to working with in the private school. It made me realize how much I want to make a difference for the kids in my neighborhood and ignited the passion I had in living for change. I have to fight to get better because there is still too much left to do and at this point I had no clue how I was going to do it.

It is September and work begins… mornings are rough! I am so tired, and I try to go to bed early but it does not help. I feel drained when I go into work and I cannot control it. I get moody and depressed for no reason. I stare at the blank page when I am writing my first paper for the semester. Tears stream down my face. I feel worthless. What is happening to me? I do not know what to write. I feel numb to the world, like an insignificant particle floating in the Earth. I am crying because I am crying. Upset at my upset when I should be smiling at the mere fact that I am alive. My hands type some words I am certain would get me an F, but it is the best I can do and I am happy that I was even able to complete it. At work I feel aimless trying my best to hide the pain and anguish. The smiling faces of the children brighten up my days but seeing the young child with cancer makes me feel ashamed of the hurt I feel. She is tiny yet strong, facing chemo and God knows what else, I would take all the strife if it meant she did not have to suffer anymore. My birthday arrives, September 28, 2009, my endocrine visit states my TSH (thyroid stimulating hormone) was in fact low and hence Dr. Barandes increased my levothyroxine dosage to 137mg, a thyroid sonogram determines everything looks good (no pesky nodules in sight, thank God!). My sister and boyfriend, although mostly my sister, who loves to plan parties, (I admire her resilience), set up a beautiful surprise party and all of my family and friends attended. I was so happy and know I could not have asked for more.

During the summer I had experienced some terrible neck and back pain as well as some numbness on my right arm. Dr. Retsagi sent me to an orthopedic doctor who performed an EMG and nerve conduction study. The results were radiculopathy, which is similar to a pinched nerve usually located in the lower back and neck area. The doctors could not tell me if it developed because of the immobilization of the neck during the rehabilitation after surgery, although it seems to be the case since the symptoms came then. October and November were busy times bouncing around to physical therapy, the social worker, and other doctor appointments; as well as trying to emerge out of hypo. I felt better, a little bit more energy each day and getting adjusted to the school, work, family, boyfriend, friends schedule. My boyfriend and I both stressed about circumstances take a trip on a big old roller-coaster ride that nearly ends an eight-year relationship built with so much hard work and love. Christmas is depressing until he takes me Christmas shopping for my family. It was not about the gifts but about the love I put into getting things for others. I receive my final grades on papers and it is not the grades that matter but the comments made by the instructors. I wish they knew how much I needed to feel like my input was valuable. I am so hard on myself and I know it is something I will struggle with for life. Cancer made me reevaluate things. Luckily, I adjust well to change. I am so ready to say goodbye to 2009!

Three weeks out of commission and I felt the most incredible amount of pain and discomfort. The scar throbs, for three days I couldn’t eat any solids. For a week I could barely speak. I could not walk without feeling major pain and weakness in my body and my knees. My neck is stiff. I just want to know what is happening with me. A month prior to surgery I had seen an endocrinologist, the unmentionable, after what felt like twenty unanswered calls he finally contacted me to give me the results of the tests performed on the removed thyroid gland and lymph nodes. “I am sorry I cannot give you good news. You have a muscular skeletal spread. The cancer is one with metastasis.” What in the world did this mean? He couldn’t tell me exactly until the total body scan was done. When would that be? In a month or so there was no rush. Oh Lord, what is it with these doctors? There is no “rush” for them because they are not the ones going through it! I want to live, but how if I felt at every moment that very desire was being threatened. My family, friends, and coworkers showed so much support I felt overwhelmingly blessed. I want to thank them by being strong, but I don’t know how. I call work to hear the children speak. They welcome me with their sweet chorus of “We miss you Miss. Cruz” and it all makes sense. I have to get better because I owe it to them. I owe it to the world to be the best me I can be no matter what challenges I face. God didn’t place me here for any other reason. It’s not a matter of why God did this to me but what do I do with what God has done. Cancer must be a blessing, but how could I see it this way?

The Caterpillar/ Doctor Visits and More Tests

I am 23 years old at this point. Had never been to the doctor more than once every other year if even that many and now I had to visit three different doctors in a span of three weeks. First visit after surgery was to the endocrinologist for my levothyroxine dosage, the pill that functions as my new thyroid gland. Next visit was to my surgeon Dr. Lim for the removal of the stitches. The final visit was to my PCP, Dr. Retsagi to test calcium levels and see my physical state after surgery. All check ups were fine, but I still got great anxiety from the not knowing. It was time to get help for my emotional recovery, one of my closest friends having worked for Cancer Care as an intern, suggested I contact someone over there. I was happy to know that my social worker was someone close to my age. I felt like I was talking to a friend and she helped me deal with my fears and anxieties. But it was sad knowing that she would only have a few sessions with me since she was an intern and would be leaving the job at the end of July. I attended a visit with the endocrinologist, we had previously discussed he would begin the process required for the total body scan on this visit. He acted as though he did not remember my case. I immediately contacted Dr. Retsagi and told him I needed a new endocrinologist. In June, two months after my surgery when I was supposed to have known the results of my scan, I had to start the process over and get a new endocrinologist. Best thing that ever happened to me! Dr. Barandes, my new endocrinologist, assured me that I was in good hands, I had a 99% cure rate and that this was all just a really bad episode that would soon be over. He explained what the next steps would be. First, we needed to make me hypothyroid (low thyroid hormone level) for the scan since I could not have any thyroid hormones present in my body. Next, a week prior to the scan I needed to get on the low iodine diet. Finally, I would come in for the radioactive iodine pill, and 48 hours later I would come in for the scan.  The scan determines whether there is any more cancer present in my body and if it has spread to any vital organs which in thyroid cancer tends to be in the bones, lungs, and on rare occasion, the liver.

I am exhausted! Waking up is a challenge each and every day. I need more sleep but I have to work and keep moving. I have responsibilities to my family to my friends to my boyfriend to my job, an endless list. Now I also have to get myself ready for grad school. But I am so TIRED. The mood swings come more frequently. I gain some weight. My immune system seems down since I get all kinds of infections. I want it to stop! I have to help my sister with my nephew’s first birthday party, but I am so tired! I feel awful and frustrated because I want to be there but I cannot. I get into arguments with my boyfriend for meaningless things. I want all of his attention but I cannot get it because he has his own life to live. He tries and fails, nobody and nothing can make me happy. I am miserable. I am ready to plead insanity, until I read a book that explains it all “The Thyroid Solution” by Ridha Arem. It was my bible and explained all of the chemical imbalances caused by hypothyroidism. I recommend the book for any person with thyroid disease. I spoke to my new social worker, JL. She tells me I should understand that this is just a funky place I am in due to my hormonal imbalance, but I have to have faith that things will get better. I heard it but I did not listen.

After a spot opens to work summer school at my job, I think I could use the extra cash so I take it. I need a break from the city so I go to Miami with my boyfriend’s sister (my lil’ sis) and her friend. We are blessed with gorgeous weather. I pray my rosary every day after a wonderful friend, who I hope will be the priest that hosts my marital ceremony someday, teaches me how. I believe that everyone has the right to change, and I went back into Catholicism because it felt like I came back to a peaceful and welcoming home with a mother and a father that loved me regardless of where I had been. I come back to the city ready to work, but summer school is slow, not much to do which is good for me since I am still hypo. I get on the low iodine diet, not really in the mood to make creative meals so I stay away from dairy (so hard!), sodas (easy), seafood (easy), any thing with salt (which I later realized I did not need to do), among a few of the many things I discovered had iodine. It was no fun, but only lasted a week. Finally on Monday July 20, 2009, same day I had to go to a godparent course required for my nephew/godson’s baptism, I go in for the radioactive pill. I needed to be away from people for five hours due to the radioactivity, especially pregnant women and babies. Dr. Barandes tells me I have to urinate as much as possible so that the radioactivity does not remain in my bladder. July 22, 2009 I go in for the scan. I am emotional because I felt that this day determined the end or just another part of the excruciating cycle. I lay on the machine as the examiner takes pictures he says, “So far so good, this is going by quick, that is a good sign”. I close my eyes and feel Jesus and Mary with me. I am not alone. The scan was supposed to take an hour or so, it took fifteen minutes. After the examiner is done, Dr. Barandes comes in and takes a look at the images. He sits with me and explains them to me “This scan tells us if there is any thyroid tissue left in your body in which the cancerous cells could go to. If there was any thyroid tissue left the radioactivity would seem present. But as you see here it only went to the digestive system and places it should have gone such as the remaining thyroid tissue Dr. Lim needed to leave for your parathyroid glands. You are free, as I told you, you would be. Now go on and live your normal life.”

I try my best not to cry. I am so happy I want to walk out and scream to the world “look at me, I am cancer free, I am going to live, I am going to change the world someday, my time here is not done!” Dr. Barandes said to go out and have the best meal I could think of since I had been on the terrible diet. I missed dairy so much the first thing I did was eat a parfait from Hot and Crusty, YUMMY! I send text messages to all my family and friends and cry on each single one message sent. I am so happy but I needed to thank Jesus and Mary who never left my side. I remembered the church right by my job, St. Ignatius of Loyola, and look at the sign that says mass at 8:30AM. It was 9AM but I was hoping it was not over yet. When I enter the priest is handing out the Eucharist and I was the last to take it. I pray and cry, I am sure people must of thought I was a lunatic, especially since I was not from the parish, but I didn’t care. Thank you, thank you, thank you Lord, I am CANCER FREE! I walked to work feeling like every breath was a new one, a gift from above. There was one coworker I had to tell the news to. I had only told her and two of my other closest colleagues about my situation, because cancer is something that is hard to speak about without feeling inhumane. We embraced and tears welled in both of our eyes. I was so happy I could dance. But cancer free did not mean the end of the rollercoaster. Receiving a total thyroidectomy made me susceptible to the thyroid disease, and I became hypothyroid once again. I felt extremely depressed and couldn’t wait until my monthly endocrine visit for a new dosage. School and work would be starting again soon and the summer was almost over.

Purple Hope: Stage 1: The Egg/ Diagnosis
ksk