Between home and home

A very strange feeling this is. I’ve been away from home for more than three weeks, and I mean from my current residence in Sydney. I’m coming home soon, but I’m also leaving home in the process, and I mean our family home in Manila where I grew up in and lived until less than two years ago. I am excited to get back to my place and start the rest of the year, but at the same time feel that little bit of sadness as I again leave my original home and not know when I’m coming back next.

This trip has been a great opportunity to reconnect with people who have played significant roles in my life, both in the past and at present. I also rekindled my entrepreneurial passion and will be revealing my new business venture soon. I truly savored being able to celebrate Christmas and New Year back home like years past. Met up with my truest friends (who were in town) over coffee, breakfast, brunch, lunch, dinner, or anything in between and shared so many stories that we have missed from each other. Spent time bonding with my sister and my cousins.

I somehow feel part of this world once again. But in reality, I am not. My current life now revolves in Sydney, and this is really just a break, a holiday from it all. Back to real life for me soonest. I’m not complaining though, cos my real life is also amazing. It’s just hard to reconcile that one cannot live two different realities at the same time.

See you next time Manila. ♥

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A letter to my (maybe non-existent) future husband…

I don’t really know if there is any point writing to you again. I remember writing my first letter to you many years ago. Has it been six years past? More or less.

Sometimes I don’t really know if you even exist. And if you do, where in the world have you been hiding all this time? Because I’ve been trying so hard to find you, and I’ve been through so many disappointing situations in my search. I’m extremely exhausted. I no longer want to move, because no matter how much I move, it seems like I’m not getting any nearer to you.

I am okay. I’m doing fine. Life is not perfect, and I do wish things could work a little bit better. But I don’t mind being where I am right now. And to be honest, I don’t need you. I’m confident I can make it on my own even if you do not exist. I can make things better, in time.

But how I long for you. How I long to find you and finally be able to show you all that I have saved up inside. I know that I have a worth on my own, but I have a feeling that it will be so much better to have you around.

Maybe you don’t exist. Maybe you are just a figment of my imagination and this search is all in vain. Maybe. But what if you do exist? That would be the sweetest discovery.

Tale of the nodule

Disclaimer: I am not a medical professional. The things I write here are just based on my own personal experience, how I understand my doctors’ explanations, and some online research I did to help me understand more about what was happening to me.


It was just a lump. One fine day in July while I was putting on moisturizer on my face and neck, I felt a firm lump at the front left part of my neck near the base. It felt as big as a cherry (or specifically I described it as like having a “sinigwelas” stuck in my neck). I knew it wasn’t there before, not that big to be felt anyway. My mom was around that time so I told her about it. She told me to have it checked by the doctor.

I never thought I would be dealing with any major medical issue anytime soon, but that’s how simply I discovered it.

I went to the GP to have it checked. He did a simple physical examination of it, then sent me for an ultrasound. The ultrasound confirmed a solitary thyroid nodule in my left thyroid about 3.3cm. I went back to the GP with the results, and he sent me for more tests, blood tests to check my thyroid hormones, and fine needle biopsy (FNB) for the nodule. This entire thing, from the first GP visit to the FNB results, went on for a few weeks. When my GP got my FNB results, he referred me to a specialist.

I went for a consult with the specialist, who then sent me for another set of tests – more blood tests, and a thyroid scan (where they give you a small amount of radioactive iodine which should be absorbed by the thyroid and shows the level of function of the thyroid). Immediately after my thyroid scan (I think my specialist was around during the scan, and came over while I was still on the scanning bed) told me that my nodule was cold (or it wasn’t absorbing the radioactive tracer, thus, was non-functioning thyroid tissue) and that he would need to refer me to a surgeon on my next visit. So I went back a week after when the rest of the test results were ready, and the specialist referred me to the surgeon, who luckily had a free slot for a consult on the same day.

I went to the surgeon who checked through my previous test results. He checked my thyroid again with an ultrasound in his own clinic, and noted that the nodule was around 3.7cm (but initially he said the size difference from the first scan may just be due to viewing variances). He also did a nasolaryngoscopy to check my throat and vocal chords. He explained to me the results of my test, and why surgery was recommended to take it out. During that first visit with the surgeon he scheduled me for an operation in less than a month (which I eventually rescheduled a little bit later to time it when my mom can come over to provide support).

During the following weeks while waiting for my surgery, I was starting to feel the lump as a mild pressure inside my throat. Perhaps it was getting a little bit bigger, or maybe it was shifting positions, but I couldn’t really tell.

I don’t think I ever stopped reading any and all online references I could get my hands on on the subject of thyroid nodules and thyroid cancers. I’ve read about the different kinds. I’ve read maybe a hundred times (a lot of times the same articles) about how they are diagnosed and treated. They were mostly saying the same things. And somehow, most were also pointing to the direction that all the characteristics of my nodule were somehow indicating higher risks for malignancy.

Just to review, here were the characteristics of my nodule:

  • Solitary – there were no other visible nodules in the scan
  • Cold – it was comprised of non-functioning thyroid tissue
  • Atypia of undetermined significance – it could not be determined if the mass was benign or malignant based on the FNB alone
  • Bigger than 3cm
  • Thyroid hormones normal
  • Family history – mom had her entire thyroid removed a few years ago and findings include microcarcinoma

I guess that’s the reason why all the doctors I consulted recommended to immediately remove the mass to get a definitive finding if it is benign or malignant. I was undergoing a hemi-thyroidectomy – removing the left lobe of my thyroid. The doctors told me that there is a possibility that they may need to do a second operation to remove the rest of my thyroid if the nodule turns out to be malignant. So I was also trying to ready myself for that possibility.

Mid-November, I finally had my surgery and it went smoothly. The only thing that got me is the horrible nausea and headache after the operation, which was probably the side effects of the anesthetics. Once I got over that, recovery went well.

A little over two weeks after the operation, I had my follow-up appointment with the surgeon and he told me the results of the biopsy. Findings was Hurthle cell adenoma – it was benign! I was relieved. I get to keep the rest of my thyroid for now. The surgeon also told me that it was a good that we have already removed the nodule because there may be a risk of it becoming malignant if it wasn’t removed.

There is a “thin line” between Hurthle cell adenoma (benign) and Hurthle cell carcinoma (malignant).

“If vascular invasion, invasion of adjacent tissues or complete capsular penetration (if the tumor is encapsulated) is demonstrated the tumor is considered malignant” (http://www.med.harvard.edu/JPNM/TF99_00/Nov23/WriteUp.html).

“Unlike many cancers, Hürthle cell cannot be definitively diagnosed with a fine needle aspiration (biopsy). While the biopsy may be suggestive of a tumor that may or may not be cancer, called a Hürthle cell neoplasm, the large majority of these will be found to be benign (called a Hürthle cell adenoma). The only way to confirm the diagnosis of cancer is by identifying capsular or vascular invasion (that is, invasive growth that is seen with cancer). This can only be determined after the nodule is surgically removed and examined by a pathologist in the laboratory… Once there is a diagnosis of a Hürthle cell neoplasm, surgery to remove the affected thyroid lobe is typically the next step to clarify the diagnosis. Only 15-30% of patients will receive a diagnosis of carcinoma after surgery, with the remainder finding the nodule was benign.” (https://www.oncolink.org/cancers/thyroid/all-about-huerthle-cell-carcinoma)

I’m super glad that its Hurthle cell adenoma and not Hurthle cell carcinoma.

“Hürthle cell cancer has the highest incidence of metastasis among the differentiated thyroid cancers… The lungs, bones, and central nervous system are the most prevalent sites of metastases.” (http://emedicine.medscape.com/article/279462-overview)

“No widely accepted paradigm exists for the pathogenesis of follicular and Hürthle cell cancer of the thyroid. Some evidence suggests that a multistep adenoma-to-carcinoma pathway may be involved; however, this concept is not universally accepted. Many of the cells probably develop from preexisting adenomas, but a follicular carcinoma in situ is not recognized pathologically.” (http://emedicine.medscape.com/article/279462-overview#a5)

During that same follow-up, I also asked the doctor about the size of the nodule they removed, since I had a feeling before the surgery that it was slowly getting bigger. He told me that it was possibly around 4cm – indeed a little bit bigger than when it was first diagnosed just four months earlier. I’m so thankful for the perfect timing of when I noticed the lump, when it was diagnosed, when the doctors decided to take it out, and when I finally had the surgery. Otherwise if I or any of my doctors have ignored it, the outcome may have been different.

I’m almost back to my normal self, although I’m still avoiding heavy physical activities and my wound is still recovering from the swelling. I can move my neck, but not yet 100% back to its normal range. I have yet to see my specialist to find out if my remaining half-thyroid is producing enough hormones or if I need to take hormone supplements. But everything is good and well. I no longer need another operation or other therapies. I can start planning my life for 2017.

Christmas came early this year

There are just so many things that should excite me in the coming days. There’s the Coldplay concert next week, the family trip pre-Christmas, and most of all, spending Christmas and New Year back home. There are even more exciting things coming early next year – Adele, travels, and so much more. But somehow I feel like I’m not as excited as I should be for all those other things.

Perhaps it’s because of the health-scare I’ve had in the second half of this year. It’s quite unsettling to be face-to-face with that big word – cancer. I had a solitary thyroid nodule which was suspicious on tests. They couldn’t determine from initial tests if it was benign or malignant, and a lot of parameters were pointing to a risk for malignancy. The only way they could find out is to take out the entire lobe and do a biopsy of the entire mass.

Hence, I headed for surgery mid-November. I’m super thankful to my mom who came over to help me out pre- and post-operation. And my brother who has always been great support. I was lucky that I got myself a good private health insurance earlier this year. I am also very happy that I have good doctors and an amazing surgeon.

Christmas came early for me this year, as two weeks after my surgery, my surgeon gives me the great news that my nodule was benign! It’s the best news for me all year. Thank God.

Let me savor this moment to realise how truly blessed I am.

 

Post script:
Being the inquisitive geek that I am, I have been reading and I continue to read about my entire thyroid nodule saga. So beyond what my doctors were telling me up front, I was also researching and reading relevant references in my own time, because I wanted to know what it was all about. My surgeon just confirmed with me the findings of the biopsy, and I am also reading more about it. I might do another post later on with the more medical side-story.

Come Alive

“Don’t ask what the world needs. Ask what makes you come alive, and go do it. Because what the world needs is people who have come alive.”
― Howard Thurman

I go through phases. Been through a stoic state for quite some time. Days go through like clockwork of things that need to get done and need to happen. My “adventures” were adventures of other people that I only ride along with, or serendipitous incidents, or things that I have forced myself to participate in and enjoy. A steady boring cruising through life for the past few months. But how I long to come out of it soon. I’m slowly feeling like someway somehow I’m on the way to coming alive again.

Humming music, singing songs in my head through lull moments – it may seem a simple thing, but it’s somehow a significant change for me. Music is a piece of my soul, and a piece of my soul is starting to speak to me again.

I crave for more colors, more glitter, more bling to cover myself with. I crave to garb myself in nice clothes. I want to look beautiful, to feel beautiful. It matters to me again.

I miss that feeling, that passionate aliveness. I’m not there yet, but I’m longing to be closer to it again.

“I did not know I was on a search for passionate aliveness. I only knew I was lonely and lost and that something was drawing me deeper beneath the surface of my life in search of meaning. There is a hunger in people to go to those deep depths; to know that our lives are sacred; that our hearts are truly capable of love. It is a yearning to be all the we can be. A longing for what is real.”
― Anne Hillman, The Dancing Animal Woman

Bridget Jones and my raging hormones

bjdThe trailer for ‘Bridget Jones’ Baby’, the newest Bridget Jones movie was very much appealing to me and I’m meaning to watch it soon, but I honestly haven’t seen any of the previous movies yet. That was until two nights ago, when I chanced upon their first movie, ‘Bridget Jones’s Diary’ showing on TV. Watching it for the first time, I found it to be much of a delight.

I don’t know really. Is it because she’s single and on a challenging search for that elusive love, and it is something I can pretty much relate to? In the movie though, in the craziest way, in a wonderful chance, she found a wonderful gorgeous man who was willing to take a chance on her. Mr. Darcy.

Wait, he sounds familiar. Oh yes, Pride and Prejudice. A little googling told me that Bridget Jones book and movie are actually loosely based on Pride and Prejudice, especially on the BBC series starring Colin Firth. Oh yes, Mr. Darcy. I was also in love with the Mr. Darcy from the 2005 movie version of P&P.

Okay, back to Bridget. And her Mr. Darcy.

Oh, I don’t really know if it was such a good idea to watch the movie while I am hormonal, highly emotional, and all that shiz. Somehow it has uncovered and unearthed all that subconscious longing and that unfulfilled desire for the love of my life, who somehow hasn’t shown himself yet after all these years.

I’ve enjoyed watching Colin Firth, Mr. Darcy. Where do I find myself a real life man like that? So I was pining for my own Mr. Darcy during and after the movie. Then went to bed (alone).

Lo and behold, my dreams may have revealed to me my hidden desires. Wonderful vivid dream about a guy I was in love with from long ago. It was the sweetest dream I’ve ever had for the longest time. I wish it never ended.

Honestly, I don’t really think I want him back, whoever that specific person was in my dream. But how I long for that feeling again. Why has it always been so elusive?

I had to watch the second movie too, ‘Bridget Jones – Edge of Reason’, since it won’t be long until the third movie is available in the cinemas for me to watch. I watched it tonight, and again just fell for Mr. Darcy even harder. Perhaps I did not relate with Bridget in the second movie as much as the first, since I didn’t agree with her reasons for questioning her relationship with Darcy. But Darcy has just been such a delight.

Within the next hour I shall go to sleep, but now I am already wondering what dreams will come this time around.

Good riddance

I was pining for a boy for the past few months…

I was pining. Longing, waiting, hoping that this certain someone will cast upon me his attention.

It was a boy. I no longer dare call him a man, since most recent realisations revealed that he is nothing but a boy.

It went on for a few long months. Call it madness. But mostly a waste of time.

But most of all, this statement is now in the past tense. The madness has ended. I have been set free. Good riddance.

Perhaps it’s a certain weakness of mine. Sometimes I waste my precious time not seeing the futility of certain things. I have awaken from this stupidity by some profound revelation – a truth that I spite from the deepest of my soul.

I know what I want. At the same time, I know what I don’t want – my non-negotiables. I have decided to tolerate most things that I can for the sake of someone I desire or love, unless non-negotiables present.

If there is something that makes your gut twist with disgust, something that makes you fear for your safety or for your life, or something that you know will bring out the worst in you, then you know those things are non-negotiable. No amount of love or care or desire can compensate for any of that.

Aside from the fact that I now know that he does not like me in a way that I wish he did, I have realised how immature he views love and relationships. Though not really a non-negotiable, that in itself ended it. Add to that a non-negotiable that goes against my sense of morality.

The best thing about all of this is I have been set free, and my attention shall no longer be captivated by an undeserving boy. I have regained my entire energy to spend on someone who so deserves it.