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Panic! At the Ultrasound

by Nicole SmithSurvivor, Papillary Thyroid CancerMarch 9, 2023View more posts from Nicole Smith

Alone, I walk into one of the buildings in the conglomerate towering over me. Past the check-in desk, then left across the atrium. Pink ribbons dapple the windows looking into the waiting room I am heading toward. It isn’t long before a young woman in pink scrubs appears and calls my name. She seems remarkably unbothered, while I am bracing for the ground to drop out from under me. It could happen at any second.

She leads me through the twists and turns of identical hallways to a small room. The lights are low, except for a bright monitor along the wall giving off a cold light. The technician has the radio on, something I haven’t experienced before. A mix of ‘80s, ‘90s, and music from today covers the beeping and faraway footsteps of the usual hospital hallway. I step out of the hospital gown I changed into only a few minutes earlier and lay down on the crunchy paper covering a tall bed. The technician tries to warm up the ultrasound gel, but it still feels cool when a large blob touches my skin.

“Your Song” plays as the technician presses the wide, smooth surface of the ultrasound wand into my armpit. My mom loves Elton John. I stare at the dim ceiling, willing the music to distract me from where I am. I remind myself to breathe and keep my gaze away from the fuzzy black and white shapes dancing on the screen.

I grit my teeth from the pressure as the wand glides back and forth over my armpit, down along my ribs, and across my chest. The technician clicks away at the computer with her left hand and navigates the wand with her right. I have had enough ultrasounds to know each click represents a marker. My mind starts to spiral. I try not to think about what she’s seeing under the surface of my skin, what hidden and unwelcome surprises are lurking there. She has spent a lot of time going over the same area again and again. How many markers does she need?

“I’m going to have the doctor come look at this,” she says dully and steps out of the room. The spiraling thoughts quicken with my heart rate. Usually, the technician consults the doctor after the appointment, not while the patient is still there. Did they find something? It must be bad. I can’t go through this. Not again. Not another cancer.

It’s been two and a half years since I was first diagnosed with thyroid cancer. I still sit in a sea of uncertainty, bobbing with the waves as the doctors and I both learn more. A month before this ultrasound, a PET-CT scan was mostly clear. This is reassuring, but my mind locks into the one suspicious spot in my armpit. It would be unusual for thyroid cancer to spread through the lymph nodes to this part of the body, so I have walked into the appointment assuming the worst; that I am destined for a second, and separate, cancer. I fully expect to leave the hospital today headed toward a breast cancer diagnosis.

The technician returns behind a doctor in a white coat. They acknowledge me and continue the ultrasound. A cover of “Somewhere Over the Rainbow” echoes from the radio. My mom loves this song. My eyes start to sting, and my throat tightens. My mom is 2,000 miles away, but I long to have someone take care of me. To lead me through the hospital maze, to translate jargon when my ears go numb, to give me a hug and tell me it will be OK, even though neither of us know. Hearing the soft ukulele is too much for me. I choke down a sob.

“Oh, am I hurting you? Just tell me and I can use less pressure,” the doctor says, startled. I shake my head.

“No . . . well, it’s uncomfortable. But it’s OK, I’m just . . . this is a lot,” I blubber. Tears roll out the far corners of my eyes toward my ears. The floodgates are opening. I can no longer stifle the panic and fear that I have been brushing off leading up to the appointment.

“Well,” she turns to me a few long minutes later, “there was something suspicious below your armpit, but it looks like a normal lymph node, maybe enlarged. I want to compare this to your PET-CT, but I don’t think we need to do a biopsy at this point.” The doctor speaks slowly, looking at me as if I will break.

The good news barely registers. Since being diagnosed, I simultaneously find it hard to trust doctors and give them too much trust. If the scan doesn’t show anything, it must be because they missed something. Nothing feels def initive enough. How do I know for sure? I stay in a state of hyper-vigilance, waiting for a new disease to jump out from behind the next test. Nothing seems related to them; nothing seems unrelated to me.

I change out of the gown and the technician leads me back to the waiting room, wordlessly. My cheeks feel hot with embarrassment and my eyes are puffy. I quickly stride back across the atrium after consulting a map for the nearest bathroom. I trek up the stairs to a door hidden behind a pillar, inside the entrance to outpatient surgery. It’s surprisingly hard to find a good place to cry in a hospital.

I let my bottled-up emotions out in big sobs until someone else enters the bathroom. Looking at myself in the mirror, I pat my swollen eyes with a cold paper towel and start mentally preparing for the next appointment. I can’t feel truly relieved until after the meeting with my endocrinologist, the primary doctor managing my treatment, and my surgical oncologist.

All I know at this moment is how tired I am. I’m tired of appointments, navigating new departments, and re-telling my story in a few bullet points. In a way, it becomes easier with time because I learn what to expect. I pick out a loose V-neck for ultrasound days, a short-sleeve shirt for bloodwork days, and plan time to nap after big appointments.

But I also learn what I’m dealing with. In the beginning, I still believed I could be invincible. Now I know how cancer can sneak up on a normal day, how informed I must be to advocate for myself, and how many hours on hold it takes to speak to the insurance company. I understand how delicate it all is—the ground could drop out from beneath me again at any moment.

“First one done,” I text my mom. “I wish I didn’t have to be here alone. But they had a radio in the room and ‘Somewhere Over the Rainbow’ and ‘Your Song’ played during the exam.”

“I wish the same! So, I was kind of there,” she responds immediately.

This article was featured in the March 2023 Unseen Challenges of Survivorship issue of Elephants and Tea Magazine! Click here to read our magazine issues.

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