But then 2020—and now, 2021—changed everything. Between having her life turned upside down along with everyone else’s as a result of the pandemic, Karen’s life transformed vastly in physical ways as well. In October 2020, during an in-person visit, her doctor mentioned that she should have an ultrasound to investigate a lump on her thyroid gland, but she didn’t feel terribly concerned about it at the time. A few months later in the new year, Karen decided to get that ultrasound, and the results upended her life in myriad ways.

How she learned about her condition

In mid-January 2021, Karen’s doctor sat her down and told her the news: “I am sorry to have to tell you, but you do have thyroid cancer.” Karen says that she froze for a minute, but then immediately wanted to spring into action. Next came a biopsy and a visit to an ear, nose, and throat doctor. Karen says, “That’s when I asked if the diagnosis would have an impact on my singing. His view was that I would very likely have some challenges that could be a paralyzing of my left vocal cord.” After that, Karen underwent a round of ultrasounds, visited an endocrinologist, and had a CT scan. Her surgery to remove the malignant tumor on her thyroid gland was scheduled for mid-February. Karen’s heart sank when she learned that her surgery was going to be canceled due to some concerning test results that showed a larger tumor moving in on her larynx, the organ that houses the vocal cords. Her larynx would need to be removed. On learning this news, Karen describes it as “very stunning.” It would have been devastating to anyone, but for a singer, losing one’s larynx is truly heart-wrenching.

Telehealth steps in

Since losing her larynx would understandably be quite a blow, Karen chose to explore a second opinion. She did schedule her surgery for April 12, but she didn’t want to travel during the pandemic. That’s when Karen’s nurse care manager at her insurance company, Anthem Blue Cross and Blue Shield, suggested a virtual second opinion and helped her through the steps. “Rita [Karen’s nurse care manager] told me about a new virtual clinical review program that Cleveland Clinic and Anthem developed for Anthem’s commercial members,” Karen explains. “This new service connects people with Cleveland Clinic specialists who can help them understand their medical condition and advanced care options that may be available.” Starting in early March, over several weeks, Karen spoke with medical professionals at Cleveland Clinic, who she says, “worked with me to collect medical history and test results and they reviewed my history and provided feedback to me along with treatment options.” She adds that the team at Cleveland Clinic, which Karen describes as “wonderfully persistent,” “worked hard to get all my information, pushing for the stuff to get through so that I could have my second opinion before my scheduled surgery.”

The outcome of that second opinion

As a result of the due diligence and research that the medical professionals at Cleveland Clinic completed, the second opinion revealed that Karen could keep her larynx after all. Rita Darrough, Karen’s Anthem Blue Cross and Blue Shield nurse care manager, explains that process, saying, “There was a high risk that the surgery would involve removing her voice box. Ultimately, they were able to take muscle from her leg to reconstruct her esophagus so they could remove the tumor while saving the voice box and larynx.” As a result, Karen has amazingly been able to keep her voice. It’s close to a month and a half later, and although she is continuing precautionary radiation beam treatments, Rita says that she’s eating food, advancing her diet, and beginning to care for herself. She adds, “Karen is doing her therapy and getting around her home, and she’s going to be able to drive soon. She has her range of motion back, which is great and she’s also talking.” Karen had retired from working as a cantor at her synagogue shortly before her diagnosis and says that she hasn’t exactly figured out what she’ll be doing next. She’s a grandmother, something that she dearly loves, and she also wants to teach again “once COVID is a memory.” With hope, she says, “I will also sing again. Maybe not what I did before, but it is my goal to sing again.”

The power of telehealth

Virtual appointments proved to be extremely helpful to Karen during her time of need and she sees herself continuing with telehealth. She says, “There are times when, for instance, because my husband is still working full-time, and I am not driving presently, that the opportunity to do something in a telehealth visit gives the possibility to do it in a timelier way than to try to wait until I can drive again or find someone to take me. In terms of the ease of it, I actually think that with respect to everybody’s time, it is quicker. It gives a healthcare professional the opportunity to share information with some method of efficiency.” Karen believes that telehealth works at its very best “if you already have a wonderful connection because it’s about being able to not just get information but having a relationship where you trust the information.” Throughout the process, Karen also experienced a great deal of comfort from hearing a voice on the other end of the phone or seeing a face during video appointments. She shares, “I am a clergyperson, and in that role, there were people I would visit in the hospital. They knew me. There were other times I would call home and just check-in and say, ‘How are you?’—and they would be grateful for hearing my voice. I think in that same way, there is a lot of gratitude that can be experienced, to just check-in, just get a question answered. It’s nice to know there is someone out there who you can call. It’s that kind of experience.” And in those appointments, whether virtual or in-person, you’d better believe that whoever Karen spoke with received a resounding “thank you.” She says, “Whenever I go to get lab work done, or to doctor’s appointments, I say, ‘Thank you very much for working today,’ to every person—the person who takes my blood or asks the COVID questions. I say it to everybody.” Next up, learn all about the many benefits of telehealth.

Sources

Karen Berman, interview.Rita Darrough, interview. Telehealth Patient Journey  How Telehealth Changed the Course of My Life - 79