Alanna and I spent the last 2 days down at the Mayo. We met with her new endocrinologist (her last one retired) and we really like her. She took her time to get to know Alanna and to answer all of our questions, and we had a lot of questions. She started out by saying that Alanna definitely has a strange presentation of this cancer, so she wants to be proactive and keep a closer eye on her. Her thyroglobulin tumor marker increased a little over these 3 months, so we also need to watch that, we do not want that trending up at all! 

She reviewed Alanna's neck ultrasound with us that showed a few questionable spots. Unfortunately we did not get an "all clear" result, but she explained that she rarely sees a "clear" ultrasound this soon after surgery. There are 3 nodules that showed up that they said are small and need to be watched.  One of them appears to be an angry lymph node that could just be due to surgery and it will likely go down. The other 2 have more questionable characteristics, but they are small, and at this point we have to keep a very close eye on them to make sure they don't grow. So instead of Alanna being able to wait for one-year for her next scans, she has to come back in 6 months, or sooner if she can feel them or starts to get other symptoms. At this point they are just too small to do anything about and it's just another waiting game.

Something I hadn't mentioned before is that there was a small nodule in her left lung that they wanted to keep an eye on. They noticed it back in August but had said it could be absolutely nothing and the only way we know is if it grows. So Alanna had a Chest CT scan yesterday to check on that nodule to see if there were any changes. I still have not received a call from the doctor to officially review the radiologist report, but from what I can tell on the report it doesn't appear as though that one has grown. The one thing that was concerning to me is that the August report mentioned one small nodule along with the dimensions. The report from yesterday's scan mentioned "several" small nodules. I am hoping that the radiologists just reported things differently and this isn't a new finding that there are now several. I hope there were always several and they didn't find it significant to mention? I don't know. But the report said they are small enough to most likely be insignificant but a follow-up in 6 months due to underlying malignancy would be recommended. 

What was really interesting that her doc mentioned is that there may have been damage in her upper airway near the vocal cords from surgery.  Alanna definitely experienced almost a month of not having her full voice post-surgery, and the damage might not have healed properly. If the laryngeal muscles aren't working correctly that could be affecting her ability to get enough oxygen and hence the easy fatigue. In addition to that, both chest scans did show that she has very unusual thickening of her bronchial walls and her endocrinologist wants her to see a pulmonologist to get to the bottom of that along with the possible laryngeal damage. Hopefully this will help Alanna figure out why she often feels so short of breath and chest pressure and her asthma inhaler doesn't seem to help much. We go back in about a month for a full pulmonology workup! And we go back in 6 months (or sooner if symptoms change) for more scans and bloodwork and to check on all these nodules in her neck and lungs. :(

Alanna started her classes up again this term at University of Minnesota Duluth and has decided to go for a biology degree, to go on to nursing and eventually on to become a nurse practitioner. While we know that Alanna's cancer has a 98% survival rate, it just sucks that she has to go through this at all. She should be enjoying the normal fun and crazy life of a 20-year old college student, not having to undergo all these tests, and stress and worry. I just hope that she can forget about it all for these next 6 months until her next scans and that next time the scans will be clear and these nodules they are watching will all just go away! Thank you for all of the love and prayers and support, we couldn't get through all of this without our village. 

-Laura