Tuesday, February 24, 2015

Lymph Nodes

What is a lymph node?  As daughter of a nurse, I consider myself pretty knowledgeable about things medical.  Since last April however, I have asked at least a half a medical degree worth of questions, and honestly, the first one was "What is a lymph node?" 

My Mom had always mentioned them when I was sick and said they helped defend my body against the bad guys, and when I had mono in my teens I knew I could hardly swallow because my lymph nodes were swollen. 

I called my ex-husband to tell him that I had just had a needle biopsy of a lymph node and he said "Oh no...."  He has had some extensive cancer experience as well, and he was able to give me a layman's terms description of a lymph node: it circulates stuff in your body, there are hundreds of them, they are like long strings of little beads, and body stuff flows along them or through them?  I could tell by his tone that if the lymph nodes are involved, I may at some point wish I had gotten that mole checked earlier.

Let me hit the dictionary:

Lymph node ~ any of the glandlike masses of tissue in the lymphatic vessels containing cells that become lymphocytes.

Lymphocyte ~ a type of white blood cell having a large, spherical nucleus surrounded by a thin layer of nongranular cytoplasm.

Lymph ~  a clear yellowish, slightly alkaline, coagulable fluid, containing white blood cells in a liquid resembling blood plasma, that is derived from the tissues of the body and conveyed to the bloodstream by the lymphatic vessels.

Here is the least gross diagram I can find to show you:

http://www.buzzle.com/articles/lymph-nodes-locations-and-functions.html<---- a bunch of these words are on my surgical reports

Lymph nodes are small, bean-shaped organs of the lymphatic system. The lymphatic system circulates the interstitial fluid called lymph to the body cells and tissues. It also collects waste substances from the bloodstream. Lymph contains white blood cells (WBCs) as its major component. It is more or less similar to the blood plasma. Lymph nodes, on the other hand, are made up of various types of cells and tissues, of which WBCs and lymphoid tissues are more abundant.
Read more: Great article about lymph nodes

Okay I find this super gross, I just spent too much time googling lymph node images - I guess I now know what they look like when they are removed from the body YUCK  I preferred not knowing that about myself!  My surgeons are gross!! I love them but wow-- I am amazed that people would want to do that to someone... blech ick yuck.. 

Apparently there are 500-600 little pea-to-bean sized lymph nodes in the body, sounds like a lot. 

In May I had 13 removed from my lower right abdomen/groin (inguinal), and in December I had 37 removed from my throat/neck/collarbone (supraclavicular). 

Doesn't sound like too many (there were more stitches and staples involved in sewing me back up than number of nodes removed), amazing the damage caused. I have numbness, nerve damage, weird scars, and a puffy right leg, I guess those little nodes were important to get out.

No wonder I freak out now when I see my CT scan reports!

Not to be confused with Lymphoma (a group of blood cell tumors that develop from lymphocytes), my 6/13 melanoma-infected nodes and 10/37 metastatic-papillary-carcinoma-infected nodes are evidence of cancer spreading from the primary sites: skin mole and thyroid, respectively.  Much of this was visible on the CT scans and ultrasounds prior, and as I have elaborated before it is what we watch for on scans every three months.  

I had a great discussion with my family doctor yesterday, and she explained more about the nodes I will be asking my oncologist about next Monday.  She said that the "enlarged" nodes described on the scan report released last week are not enlarged to a size that is cause for great alarm.  

The nodes are larger than they were on the prior scan, but they are still an acceptable size.  Ah okay, phew.  I did not know I still had nodes left in my neck/throat, the surgeon told me he removed them all - he may have been generalizing?? The way Dr. was feeling around my throat yesterday made me think she understood the report and knew where to feel. I am still puzzled as to how they learn this stuff.

She poked around and said everything feels fine (it has all along, just for the record), and that it is reasonable to expect that the remaining nodes will swell, as they are now carrying the entire workload since their dearly departed neighbours were evicted.  They may have been a bit swollen before the surgery, but they will really be working now as they are the only ones left in there.  

Dr. also explained that they can tell by CT scan what kind of swelling there is present, ie. calcification, tumour cell groupings, etc.  Apparently they look different from each other, usually by scan they can tell if a swollen node is suspicious or not.  My currently swollen nodes do not look like that.  Double phew.  

So, I will confirm all of this next week at Sunnybrook, but in the meantime I am interested to learn more about the mysterious little lymph node.  I wonder how many we have to spare?  Apparently I have lost an average amount expected for these kinds of surgeries, so... whatever that means? I know one thing, it means I have to get my butt over to the lymphedema clinic in Owen Sound to get working on my achy puffy leg.  More on that when I actually get there.

Dr. and I agreed that one month from now, once I have had the radioactive-iodine therapy to kill off any remaining thyroid tissue (cancerous or not), we will feel confident that thyroid cancer is behind us and we can focus on the melanoma.  Yep... that's right, one month from right now, there will be laser beams coming out of my fingertips.  


Yes... it may seem like I have lost it... I might have to go blog about gardening or something - I just can't get those lymph images out of my head!


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