Between 2012 and 2013 was the first time my thyroid health came into question. After a routine visit with my primary care physician, I was referred to my initial consult with an endocrinologist for further evaluation of my thyroid. Interestingly, I did not have any abnormal diagnostic laboratory test results. Still, on physical examination, she noted some enlargement of my “butterfly-shaped” gland, and my thyroid ultrasound revealed a small number of nodules. Given my family history of thyroid-related disorders - some resulting in partial or total thyroidectomies - on my maternal line, she thought it would be worthwhile for me to develop a working relationship with an endocrinologist.
The endocrinologist recommended a fine-needle aspiration (FNA) as the next step to ensure the nodules were not cancerous. While the experience of having a needle inserted into my neck was quite uncomfortable, I understood the importance of this test for early detection of cancer. As a medical laboratory scientist, I have run thousands of thyroid panel tests, yet never imagined I would be the patient on the other side of the patient care management process, experiencing both noninvasive and invasive procedures. All these thoughts raced through my mind with each insertion of this thin needle into my neck to collect cells and fluid from the larger nodules for microscopic examination.
Thankfully, the FNA results came back negative, and we agreed on a plan of care that included closely monitoring my thyroid for any abnormal changes. Considering my family history, the endocrinologist advised that someday, a portion or all of my thyroid would likely need to be removed. I was simply excited that it was not that day. At the time, I was a working mom with a very active toddler at home.
During those years, I worked as a full-time medical laboratory scientist on overnight shifts, with aspirations for career advancement and furthering my education. In hindsight, I did not want to slow down my momentum, even with this looming health concern. I cannot lie – I was nervous about surgery, too. I did not want to be “cut into” unless it was urgent or emergent. In my mind, I rationalized that it was not an immediate healthcare threat, so I deferred for as long as I could. In essence, I really psyched myself out of having surgery. I figured that as long as my lab results were normal, I could cope with a slightly enlarged thyroid.
But then it grew…
Over the years, I noticed a growing pressure in my throat that was affecting my vocal cords, and I also began to experience some difficulty swallowing my food. My breathing was affected as well, especially when I lay on my back in bed. I can recall instances when I would run my hand across my neck and feel a noticeable difference in size. As I reflect on this, I am reminded that sometimes, as healthcare workers, we (okay, I) can be the absolute worst at caring for ourselves and prioritizing our medical needs. It goes back to the flight instructions before takeoff: put your mask on before helping others with theirs. I was not putting my mask on first. Admittedly, I prioritized my family, my career, my education, and an onslaught of other obligations before my medical needs.
However, life caught up with me and said that I was not being of service to myself. I realized that I could not care for or support others if I did not help myself.
Fast forward to 2025, nearly three years after losing my dad (in Fall 2022). The loss of a parent changed me in a lot of ways. My perspective regarding my own health shifted, and I realized that I needed to address the issues that I had put off for far too long. Over the years, I kept up with routine laboratory tests, though multiple relocations to different states meant I lost touch with my endocrinologist. Through my new primary care physician, I was referred to a highly recommended endocrinologist and navigated a new series of diagnostic tests, including an ultrasound-guided FNA.
During the procedure, I was pleasantly surprised to have a cytologist present to perform an in-room preliminary microscopic exam of the cells and fluid collected by a physician at bedside. It felt very different from previous encounters because the nodules were more numerous and much more difficult to access with the thin needle, requiring additional passes to ensure adequate collection of cells and fluid for testing.
At this stage, my thyroid was pressing against my larynx and vocal cords so much so that it was deviating my airway (wild, I know). If you can visualize a large butterfly essentially choking you, that’s what, in essence, my thyroid was doing to me.
Again, all my thyroid lab results were normal; however, through this new set of ultrasound images and the results of my FNA procedure, the endocrinologist confirmed that my thyroid enlargement was due to a goiter. The FNA results supported a benign diagnosis; however, they could not definitively rule out cancer. Based on this new set of findings, my endocrinologist referred me to an ENT surgeon to determine the path toward surgery – a partial or total thyroidectomy. I was hopeful that only a partial thyroidectomy would be needed (wishful thinking) as I did not want to be on medication for the rest of my life.
During my surgical consult, the surgeon illustrated my thyroid in the office (she is very talented) to show how severely it was affecting my airway and everything else around it. At this stage, the concern was the increased risk of irreversible damage to my neck region and the possible presence of cancerous cells. As she transitioned the conversation from the drawing to the scary topic of treatment, I had to laugh when she asked, "Do you work in healthcare? Then you know what this means, Dana.”
I knew what she meant, and I was saddened to admit that it was time to let go of “my butterfly.” The nodular growths were so extensive that there was no way we could salvage any portion of my thyroid, thus requiring a total thyroidectomy.
It was time to prep myself physically, psychologically, mentally, and emotionally for surgery. There was one question that remained: has my condition evolved into cancer? Although I knew statistically the odds were low for this to be cancerous, it was a thought that circulated in my mind. As prevalent as thyroid conditions were in my family history, so is cancer. In fact, my mom was a four-time cancer survivor, including thyroid cancer, so in my mind, it could really go either way for me.
In the weeks leading up to surgery, I researched several resources from non-profit health organizations. The Thyroid Cancer Survivors' Association provides some excellent resources that explain how thyroid cancer is the most common endocrine cancer detected in women, nearly three times more than in men. I learned that, according to the American Cancer Society, the average age of a person diagnosed with thyroid cancer in the United States is 51 years old. In my deep dive, I read that most diagnoses can occur between 30 and 60 years of age, and the most common medical intervention is surgery. I realized that I had been postponing what was essentially inevitable, especially considering my symptom progression over time.
On the day of surgery, I recall being transported into the surgery suite with racing thoughts about the outcome I was hoping for (no cancer) and what I feared (cancer). These fears were eased through the human touch of my surgeon as she held my hand and asked me about my family as I became unconscious under the guided care of the anesthesiologist. When I came out of sedation in the post op/recovery area, I do not remember much except for the transportation to my hospital room, where my husband was waiting for me. After an overnight stay for continued monitoring and evaluation, I was discharged home to continue my recovery and healing journey.
What I had hoped would be a swift and smooth recovery became immediately filled with unexpected twists and turns. Please bear in mind that I watched several family members undergo this procedure, so I assumed that recovery would be as seamless for me as it was for them. I was wrong (again). One stark difference was the drainage tube placed in my neck during surgery to reduce fluid accumulation and swelling around the incision site. I was not expecting it, as none of my family members had a drainage tube. Still, I understood the clinical importance of this in reducing the risk of surgical wound complications.
In addition to this, I was surprised to experience postoperative indigestion, which in turn triggered chest pain, that prompted a visit to the emergency room. I did not realize that the road to healing would be so vastly different from my mom’s or my sister’s experience; however, it was an eye-opening lesson in that the recovery process can look different from one patient to the next. My body did not get “back to normal” within the one- to two-week timeframe outlined in various texts and medical guidelines.
Most importantly, the results of my surgical pathology report revealed no cancer detected, and the final interpretation was noted as nodular hyperplasia. Nodules were diffusely present in the right and left thyroid lobes and were noted to have calcifications, with some partially cystic. I was grateful for this diagnosis and relieved to have the question conclusively answered… I am cancer-free.
My mind quickly floated to the patients who receive a cancer diagnosis following a biopsy or similar surgical procedure. I thought about my husband following a routine colonoscopy, receiving the pathology report that revealed malignancy. (Following treatment, he is now cancer-free). Preparing for the outcome of surgery is stressful in itself, but receiving and reading the surgical pathology report raised “what if” questions within me – when the clinician becomes the patient, right?
One year later, this September, we recognize Thyroid Cancer Awareness Month. Before surgery, it was an observance I was not aware of, but it is now forever marked on my heart. The lessons learned throughout this journey have been many, ranging from a renewed purpose in self-care to letting go of things that have always been with me. I am thankful for the community of family, friends, colleagues, and various groups who rallied their support around me during this time.
For anyone delaying their own medical treatment, regardless of severity or urgency, please do not postpone your care. You deserve answers and peace of mind when it comes to your health. Choosing your wellness and well-being is essential to effectively caring for others. Again, I am filled with gratitude to those who cared for me and provided the resources to support my post-surgery care. There are those clinicians who provide frontline care and those working behind the scenes who contributed to my care and treatment throughout this entire journey.
I am forever grateful to those who raise awareness and advocate for those navigating what can be a life-altering experience. Because of my incredible multidisciplinary medical team, including my colleagues in pathology and laboratory medicine, I received the care I needed not only to survive but also to continue to thrive. The lab played a crucial part in saving my life, and I will always continue to advocate for its integral role in patient care.
Newsletters
Receive the latest pathologist news, personalities, education, and career development – weekly to your inbox.
