Decision

Okay, so I am stressing over making a decision and I think it might help me think it through to write it out.

I went to see my endocrinologist today. I was planning to start trying for Baby #2, but I wanted to double-check with him first to see if I needed any follow-up stuff for my thyroid cancer that would interfere with that.

I had follicular thyroid cancer that was diagnosed in December 2005. I was treated with radioactive iodine in February 2006 and had a follow-up whole body scan in August 2006. The scan also used radioactive iodine, and although the dosage was lower, it was the same basic process and involved the same precautions afterward. At that time, the radiologist said I would need follow-up scans at least every 5 years. Some online sites I've found recommend getting them every year.

My endocrinologist monitors my blood and the thyroid hormones that I take each morning. In the past he has told me that he wouldn't insist on a whole body scan as long as my lab work all looks good. Today I asked him about a whole body scan and discussed my plans to try for Baby #2. He said, sure let's go ahead and do a full body scan before Baby #2. We have to wait until I am completely through breastfeeding to schedule it. He's waiting to get my lab work back from today, but past lab work has been good and he said the scan is a precaution and he's pretty confident they won't find anything. So, assuming the lab work from today looks good I think I could talk him into delaying the whole body scan until after Baby #2.

So the way I see it, here are the advantages to doing the scan now:

*Peace of mind. I understand there is a 30 percent chance of thyroid cancer recurrence and, frankly, I don't trust my odds. I've also been reading online and I keep reading stories of people who had all the same treatments I did and then found out the cancer had metastasized to their lungs, etc. My understanding is that it is usually still very treatable if it does metastasize, but still it's always better to catch it sooner than later.

*Fewer kids to impact. No matter when I do this it is going to be very inconvenient. Last time I did a body scan, I lived in the basement for 3 days so I wasn't exposing anyone else to radiation. That's going to be more difficult with Sandy and will probably only get more difficult the more kids we have.

Here are the advantages of waiting to do the scan:

*Family planning. Okay, so I really would like to have another baby and if we do the scan that pushes it out by however long it takes me to wean Sandy + however long it takes me to get in for the scan + 6 month waiting period because of risk to fetus of the radiation in my system.

*Lower radiation. The radioactive iodine has a risk of causing other types of cancer. The risk is fairly small, but each dose increases the risk. The radiation also affects my eggs. They recommend waiting 6 months to a year before getting pregnant, but every dose of radiation increases risks of birth defects.

We've been praying about having a second baby and so far I haven't really felt like I've gotten an answer one way or the other. I do feel quite a bit of anxiety about the possibility of the cancer returning, but I keep finding articles about the psychological impacts on thyroid cancer patients that make me think I'm just overreacting.