Double diagnosis: How an ER visit after a fall leads to a cancer discovery

The story of Marilee Wires’ journey with thyroid cancer began by accident. She fell down a flight of rickety steps in February 2021. When she tried to get up, her left arm didn’t work.

Alone and in pain, Marilee collected herself as best she could with one good arm. She drove herself to the emergency department at Goshen Hospital and called her husband. Then she waited to find out if she had broken any bones in her dominant arm, the one she depended on for nearly every move.

A nurse practitioner in the ER asked Marilee if she hit her head when she fell. Everything had happened so quickly, Marilee didn’t have an answer.

“Then she asked if I had a headache,” Marilee said. “Well, yeah, but I'm crying because my arm hurts.”

As a precaution, the ER team put Marilee in a neck brace and ordered a CT scan to rule out a brain bleed or head trauma. She also had X-rays of her arm and shoulder.

The good news from the test results – no broken bones. Marilee probably had torn tendons or muscles in her arm and needed to see an orthopedic surgeon.

More good news – Marilee didn’t have a brain bleed. However, the CT scan picked up images of her neck that caused a new concern.

Marilee’s thyroid gland was full of nodules, the nurse practitioner said. She needed to see her family doctor as soon as possible.

Thyroid cancer grows with no warning signs

Marilee was all too familiar with thyroid disease. Her father was diagnosed with stage 4 throat and vocal cancer in his 70s. It had already spread to other parts of his body, leaving him with no good options for treatment. An aunt – and identical twin with Marilee’s mother – had treatment for cancer in her thyroid in the 1980s.

After an ultrasound of her neck, Marilee learned her gland was filled to capacity with nodules. That’s when her family doctor referred Marilee to Goshen Center for Cancer Care.

“Here I am with my arm in a sling from surgery on my torn rotator cuff and bicep muscle, and I have to go see the surgical oncologist,” Marilee said. “He said I needed to get a biopsy on the nodules.”

Biopsy results came back inconclusive for Marilee. That meant doctors could not determine with certainty if the cells were cancerous or benign.

“With my family history and with as many nodules as I had, the oncologist said let's go ahead and take out the thyroid,” Marilee said. “I said that’s fine, schedule me for surgery and get it done.”

Radiation after surgery destroys remaining cancer cells

Initial results from the surgery gave Marilee hope that the nodules posed no great concern. However at her follow-up appointment, everything changed. Lab results on tissue taken from the gland confirmed Marilee had thyroid cancer.

Still in a sling and healing from her fall, Marilee learned she needed another procedure called radioactive ablation. That meant she needed a dose of radioactive iodine to destroy cancer cells that remained in her neck.

One round of radioactive pills sounded do-able to Marilee. The bigger struggle would come after treatment. She would need to isolate herself from other people for several days while her body continued to give off radiation.

“Nobody could be with me because I was radioactive,” Marilee said. “Here I am with a bum arm, and I have to sit at home alone.”

Marilee had already navigated surgery, doctor appointments and recovery on her own during the pandemic. Now she had to rely on FaceTime, phone calls and strict distancing from visitors when family and friends checked in on her.

“I had days where it was stressful for me,” she said. “My arm doesn't work, now I've got all this radiation to do. It all caught up with me.”

Treating the whole person, not just the disease

When Marilee looks back on those dark days, she remembers the rays of hope that seemed to come out of nowhere. A nurse stopped to comfort Marilee in the cancer center parking lot after a stressful day of appointments. Follow-up calls after her ablation from co-workers, doctors and her imaging coordinator made the days go by more quickly.

A blanket made by volunteers at the cancer center brought tears of gratitude to Marilee when she arrived for her final oncology appointment.

“This blanket came out of love from somebody I don't even know,” she said. "Cancer is such a life-altering thing, and you need the kindness of all those people who touch your life."

At last, Marilee could get back to her life. The ablation had worked. She was free of cancer.

With the radioactivity out of her body, it was time to embrace her family who had given her tremendous support throughout her journey. She and her husband could venture off again on their Harley, discover new backroads, or find a favorite fishing pond.

As Marilee walked out of the cancer center for the last time, she heard herself say out loud, “If I could ever get a job here, I would come back to help somebody feel like they mattered and help them go through the journey that I just did."

Months passed. Then Marilee saw a job posting from a friend. The cancer center needed an oncology information specialist.

Marilee’s journey had come full circle. She got the job at Goshen Center for Cancer Care, helping patients collect information they need to start treatment. In her own quiet way, Marilee knew this was a job where she could make a difference in someone else’s life every day.

From patient to Colleague to patient again

Marilee’s story about her journey as a patient at Goshen didn’t end when she became a Colleague.

“I was having problems with my legs, so I made an appointment with my family doctor,” she said. “He thought I had multiple sclerosis and sent me for a brain MRI.”

Days later, Marilee got a call from her doctor while she was at work.

“He said you don’t have MS. You have a brain tumor,” Marilee said. “I thought 2022 was going be a little bit better, but it turned out to be really rotten.”

Once again, Marilee found herself surrounded by support from everyone at the cancer center. Co-workers sat with her while Radiation Oncologist Houman Vaghefi, MD, explained what he saw in the images from her MRI.

A neurosurgeon confirmed Dr. Vaghefi’s suspicions. Marilee had a benign meningioma brain tumor behind her left eye. That left her with three treatment options. Watch the tumor to see if it changed. Take it out during surgery. Do targeted radiation to hopefully stop the growth.

Marilee chose radiation therapy, knowing she could get treatment at the cancer center. Not only would Dr. Vaghefi be in charge of her radiation therapy, a whole support team would be with her every step of the way.

“They don’t just treat what’s wrong with you,” Marilee said. “They care about you as a human being.”

After five radiation sessions, the therapy did its job for Marilee. The tumor showed no signs of growth. Marilee had a sense of calm, knowing an entire team of providers at the cancer center still watched out for her.

“I'm in incredible hands at the Center for Cancer Care,” Marilee said. “They gave me my life back.”

Knowledge is a powerful tool when it comes to you and your body. That’s why our Oncology Information Specialists at Goshen Center for Cancer Care are ready to help you understand your disease, prognosis and treatment options. Contact us to talk with our cancer care specialists, schedule an appointment, or get a second opinion, (888) 492-4673.