The Room Numbers Predicted the Outcome

Summary:
Needle biopsies of the neck:  Recurrent metastatic papillary thyroid cancer in the neck. One lymph node involved.  Confirmed with Tg wash of sample - over 20,000.  Treatment plan being scheduled - alcohol ablation.
CT Scan:  No lung metasteses.  No other involvement - just the neck.
Parathyroid scan:  Negative.  Watch and wait approach to elevated PTH hormone and high normal Calcium.

Details:
Tuesday started with scheduled breakfast so that I started fasting by 9:45 a.m.  We checked out of room 313 at the Springhill Suites (note room number, week prior it was 213).  At 11:45 a.m. I checked in for the lung CT.  Apparently they also scanned my neck.  No contrast was used (yay, Bob said I was a sprinkler system from the 10 pokes the day prior so avoiding another was was a blessing).  The scan was two passes that took about 15 seconds each.  We went for lunch and headed back to the Mayo Clinic to see the Endocrinologist in the late afternoon.  My prayer had been a combination of "Thy will be done" and "if anything, please let this lymph node be positive, otherwise we'll go on a wild goose chase trying to hunt down the reason for an elevated Tg."  The doctor was great - his approach, his style...he said "it's amazing that this cancer grows so slowly and here we are 16 years later and you have a recurrence."  I was not surprised.  I could have predicted the outcome from the hotel room numbers.  Thirteen was Grandpa Al's favorite number.  The number has always "popped up" just before diagnoses...and I've always taken it to mean "your grandparents are with you and you can handle this."  Superstitions aside, the doctor went on to say that I'm a good candidate for ethanol ablation...the process was explained as follows:  The radiologist will look at my ultrasound and determine if the node is safely located to be ablated with alcohol...we want it to not be near things like major blood vessels and nerves.  Assuming I pass that hurdle (I sure hope so), then I have to schedule two consecutive days at Mayo.  Day one is an injection to kill the lymph node and the cancer.  Day two is to make sure the lymph node is dead.  Ultrasound and needles and pain for 24 hours...big difference from 16 years ago - anesthesia, surgery, recovery, radiation, more surgery, etc.  Also a big difference from U of Iowa where they would have proceeded as if it were 1996.  God bless the Mayo Clinic and the Drs. Mayo who founded it.  So, I should be able to do this treatment without having to go on disability at work.  Hooray!  So my prayer now is that the radiologist says we are "good to go."  Follow up ultrasounds and Tg monitoring will be ongoing...
The CT scan was interesting - found all sorts of interesting things - a formerly cracked rib (no idea I had one of those), a benign fibrous tumor in the lining of the lungs (oh, the gift of getting older), lung nodules that have finally calcified (hooray - they were always not-yet calcified in prior scans making them more suspicious), lung scar tissue and a benign cyst on my liver that I've known about for a long time.  The CT also found lymph nodes of normal appearance in the base of the neck and no sign of anything suspicious.  Lung nodules were stable from the 2008 scan at U of Iowa.  So, all good news.
The parathyroid scan was negative.  The doctor still believes I have a benign tumor on one of the parathyroids, but it's so small that imaging can't find it.  So, we'll watch and wait.  He said sometimes these things just hang out stable for 30 years.  Blood work a few times a year will be ongoing.

So, I'm so so grateful that I switched to Mayo Clinic - for my parathyroid hormone - only to find recurrent disease of the thyroid cancer.  I'm also so so grateful that enough time has passed that I can likely utilize a new civilized treatment protocol.  I am slo very very grateful to Dr. Catherine Weideman - who initially diagnosed and treated me in 1996.  She is the one who made me aware of the new protocol at Mayo when she referred me there in 2007 (did not go due to insurance at that time)...so I was aware of it now that I need it.  God bless her in her retirement.

I will of course blog about the ethanol ablation process - for the benefit of the ThyCans who read my blog - in the hopes that many of you, should you need it, can use this process.