RSS

Time flies by when you have no thyroid…

Hi.  It’s been nearly two years since my Total Thyroidectomy in April 2012.  I am doing well.  I moved to Denver in the fall of 2012 after traveling to Africa for three weeks – something I didn’t think I’d have been able to do before the surgery.  The thought of sitting on two 7-hour flights in a row knowing that if I had a thyroid storm, I wouldn’t be able to get treatment 30,000 feet over the ocean, and I’d die was too much to risk.  That sucks for someone interested in international travel…

So here I am in Denver, I found an Endocrinologist named Eric Albright who spent a full 30 minutes with me on my first appointment!  He’s knowledgeable, listens, informs me of things I’d never even heard of, even after 6 years of obsessive information searching for anything thyroid related.  I have appointments at 6-month intervals for the first time in almost 8 years.  I just realized that I’ve been going to an endocrinologist at least every two months for over seven years.  That blows my mind.

I’ve been steady on 125mcg plus an extra half pill on Fridays – which is very close to the 137mcg dose, but I’m fine with the extra half.  I lost almost 10 pounds last spring – intentionally, by recording my food intake – to get rid of what had built up during the roller-coastering.  I’ve been keeping it off, but it’s a little hard in the cold, snowy weeks interspersed in a Colorado winter.  My activity of choice is running.  The stability of the post surgery levels has allowed me to make steady progress.  In the last six months of casual jogging, I’ve been able to double my mileage and decrease my average pace by a full minute per mile and hit a couple of personal records while I was at it.  And that’s on top of a full time MBA program with a 3 hour commute each day.

That’s another reason for my disappearance – I just finished my first semester in the MBA program at CU Boulder.  As someone with little to no background, this has been a really intense learning experience, and not just academically.  It’s the hardest thing I’ve done since the decision to remove my thyroid.

I got a really sincere comment recently and wanted to address it before the semester starts up again and it gets lost in the shuffle.

Just came across your post… Wondering how you are doing now post surgery.. Also wondering why RAI wasn’t an option. I was diagnosed with Graves’ disease 2yrs ago and just ended 2yrs of methimazole on 12/30/13. I’m scared for what’s next- hyperthyroid symptoms coming back. I have felt good with the treatment (except for the awful mood swings & craziness) and got my fitness back. Our stories sound similar; I run and have had three pr’s in the last year since thyroid levels normalized. I don’t want to start over again. So, if you wouldn’t mind updating me on how you are doing, I would really appreciate it. My endocrinologist is not as understanding or receptive as I initially thought. Hope you are doing well :)

 

So, I’m doing great!  I’m in a really intense and stressful period with grad school and facing my fears about this huge financial risk I’ve taken.  Without the stability, post TT, I doubt there’s any way I could be dealing as well as I have been, and believe me, it’s not been very graceful.

Stability.  That was the main reason for my choice to finally have a TT after six years of the roller-coaster that is Graves’ Disease.  I can’t believe my relationship survived those mood swings, though I did lose others.  Perhaps more disturbing to me were the body changes.  With each recurrence of hyperthyroid, my thyroid got a little larger and more visible; I lost muscle tissue and even if my weight did not fluctuate much, I gained a larger percentage of body fat as a result and lost a lot of fitness.  I just had to wait for my levels to come down before I could even do muscle building exercise, let alone make any progress.  I also lost a lot of the fatty tissue underneath my eyes at one point, and though I feel some of it came back, I think the disease aged me faster than time.  Given the nature of the disease, how could it not?

Another form of stability present since my surgery is that my anxiety has all but disappeared.  I may have said this previously, but I’d like to reiterate.  I used to have to talk myself down from panic attacks all the time.  I’m so grateful for that to be gone.  It used to happen, less so, but still happened even when my levels were “normal”.  Also, no palpitations.  My heart muscle was stressed and now it’s not unless I do it on purpose with strenuous exercise.  It’s a huge relief.

There were three main reasons why I decided that RAI was not an option for me.  First, there is evidence that Thyroid Eye Disease – the bulging eyes – occurs more frequently in patients who have undergone RAI.  Some endocrinology surgeons have suggested that removing the thyroid rids the body of the antigens, thereby decreasing incidence of TED.  Not sure how much credible, peer-reviewed research has been done on that, however.  Second, the stabilization period is much longer and more frustrating with RAI.  You still have a slowly dying organ in your body making thyroid hormone at unpredictable rate and levels, respectively.  It’s often the form of treatment recommended by the medical community, because to them, it’s relatively cheap, “convenient” and definitive – a relief to the medical community, but not to me.  I didn’t suppose it to be any of those things, except for cheap compared to my shite insurance deductible.  The third reason I chose the surgery over RAI was that my thyroid was enlarged and visible.  It changed the way I interacted with the world.  I withdrew and couldn’t get past feeling like a circus freak.  If I really believed it was the best treatment, perhaps I could’ve found a way to deal with that aspect, but considering the other two, it didn’t seem worth it.

I have to admit that sometimes it freaks me out that I have to take a pill to stay alive, but those are the circumstances I chose based on the cards I was dealt, and I am still content with my decision.  For the first year, I was on a high, so much relief.  I felt human again.  I felt like I could engage with the world again.  I was high on happiness and relief.

That’s my story.  That’s where I’m at.  School starts in a week and it’s probably a safe bet that I’ll disappear again for a while, but do know that I receive email notices when someone comments, and I will respond.  I know how difficult it is to navigate this disease, particularly when the internet contains mostly people’s horror stories while the success stories are so few and far between because we are then allowed to go on with our lives rather than living in a world seen through the lens of thyroid disease every moment of the day.  So I’ll leave you with that run-on sentence and please feel free to contact me personally at kat (at) sudstress (dot) com.

I wish you all the best and keep moving forward one day at a time.

 

 

 
 

Tags: , , , , , , , , , ,

Reply and Update

I just received the following comment and wanted to write a proper response, so I thought I’d make it a post rather than a short comment. I’ve been meaning to write anyway, so this is a great reason to do so. I swore I would keep up, but alas, life keeps moving swiftly.

Hi Kat

I’m curious how you’re doing now. I’m having a TT for Graves Disease on Jan 3rd and I’m soooo anxious about life without my thyroid. All of the horror stories on the Internet have me so scared. Your story seems like a positive one so far. How are you doing now? I’m hoping that the few posts/updates means you’re out there living your life and not worrying about your thyroid anymore!!! Please let me know there is hope after TT!!!

Jen

Hi Jen, thank you for the comment and for the nudging me to update my story. I have indeed been living life like crazy for the last few months, which is why I haven’t written. Since July, I’ve done/am doing the following:

  • moved from my apartment of 6 years into my boyfriend’s house
  • studied for/took the GMAT
  • quit my job (to travel and move)
  • received immunizations for Polio, Typhoid, Yellow Fever, etc.
  • traveled within Africa for 3 weeks
  • was on anti-malarial preventative medication for a month
  • sold my car and half of my furniture
  • traveled back and forth from Atlanta to Denver/Boulder three times to piece together a multistage, cross-country move
  • moved from Atlanta to Colorado via moving van for three days
  • finishing up my application for an MBA program

I’m still in the process of getting settled, looking for a job, finding my way around, writing application essays, dealing with car insurance bureaucracy for a complicated car-borrowing situation, looking for a new endocrinologist, etc….

Indeed, living life.

Things have been a little irregular with my TSH levels, but I attribute that to the travel and transition from Atlanta to Colorado that is still in a bit of upheaval.  I realize you probably deal more with T4 and T3, as I did since my TSH was pretty much at a constant .01, so relying more on TSH is something you’ll get used to after your TT.

I started with 112mcg of Synthroid (brand specific!) and my TSH shot up to about double the “normal” range.  I was then put on 137mcg (two notches up in dosage) and at 6 weeks my TSH was headed back down toward hyper-range, and I was put on 125mcg.  This seemed like the Goldilocks method (too little, too much, just right) so I figured we’d found our stable dosage.  The catch is, I left for Africa the week I started on 125mcg and had little control over what I was eating – and we were all eating A LOT!  Go figure.  There could have been soy oil in everything for all I knew.  When I did my labs (at only 4 weeks due to out of state circumstances) my TSH was way up and she wanted to put me back on 137mcg.  This did not make sense to me because I was headed toward hyper on that dosage just weeks earlier.  (I may be one of the few people you hear of that refuses a higher dosage, but I was having heart palpitations on 137mcg like I did when I was hyper naturally)  So I held off and did my labs a couple of weeks later (again, still too soon, but necessary due to circumstance) and it appears as though my TSH is headed back in the right direction on 125mcg.  Another kink in the chain, I was on Malarone – an anti-malarial for almost 30 days and that could’ve had an impact on my absorption.  The color of the pill looked like it had pigment made from iron oxide – and that could have interfered with absorption.

As you can see, there were way too many variables to really be messing with dosage.  I have to say, I’ve felt great and not great on each level of medication I’ve been on.  It’s been so long since I’ve lived without an awareness of thyroid levels that I forgot what used to be “normal” for me.  I’ve always been hyper-aware of changes in my body and when my levels fluctuated while I still had my own thyroid hormone, I could predict my lab results based on various physical symptoms, my menstrual cycle, and anxiety levels.  With Synthroid, my T4 hasn’t fluctuated as much as my TSH, and perhaps that’s why I don’t feel the changes as subtly as I did previously.

Since my surgery, my menstrual cycle is exactly 28 days no matter where my levels are.  That’s kind of weird.

Since I’ve stopped living out of a suitcase, remained in one time zone, and resumed cooking for myself, I am starting to feel better.  I had put on a couple of pounds before I left for Africa, looking back, it seems stress related, but nothing anyone besides myself might notice, and then added about four more in Africa.  I started to freak out, wondering if this was going to spiral out of control.  I think indeed it easily could if I continued to eat road and restaurant food I while remaining sedentary as I couldn’t help but do, whether due to the moving truck, sitting on one of my 13 plane rides or even in Africa where it wasn’t safe or possible to go out for a jog among the hyena of the Masaai Mara or get lost out in the the middle of the Great Rift Valley in a little place called Ewaso.

So, as my life begins to stabilize, I predict that so will my TSH.

If I could offer some words of encouragement…

I would tell you not to be scared, but I know that’s impossible.  I was absolutely terrified before my surgery.  The best thing that I did for myself was finding a way to just let go.  It was the ultimate lesson in learning to stop trying to control.  You are the only one who knows what your personal lessons are surrounding this and it is a huge opportunity for personal evolution and growth that many people do not have the chance to undertake.  Perhaps that sort of perspective can help calm your mind as it did mine.

Aside from the fact that I wake at 4 a.m. to take my pill every day, Graves’ Disease has been MUCH less intrusive in my life than it has been the last six years.  I still feel relief.  I still am thankful and find it difficult to believe that I have already gone through surgery.  It still feels like a weight has been lifted.  I still have $14K in debt, but after the initial sticker shock, that even feels okay.  I’m alive, I’m functioning well, I feel positive about my future.  I don’t have a single, miniscule thread of doubt or regret about making the decision that took me the better part of three years to make.

My scar is longer than most people’s because my thyroid was pretty big.  It’s still red, but I haven’t bothered with Maderma or anything to minimize it.  As soon as I find it, I’ll start using it.  I kind of liked the novelty of it, it was something awesome to show for what I went through.  Now it just clashes with necklaces…  I don’t really have any hang-ups about scars, so it’s not an issue for me like it can be for a lot of people.  My concern has always been the weight, muscle-wasting, and heart damage issues.  I feel the surgery definitely mitigated those for sure!  One more thing…  I’ve stopped obsessively searching the internet for answers that don’t exist.  What a relief.

I hope what I’ve said encourages optimism in you.  I feel that above all, my greatest asset was my positive attitude that came from I don’t know where, just in time for the surgery.  I think it was a gift that I was too sick for the original surgery date, as I was not in the proper head space for the best outcome.  Attitude will be your best ally.  That does not mean you can’t be scared, but you can feel the fear and still have a positive outlook.  There is no other way to look at it.

If you want more detail regarding any aspect I may or may not have mentioned, ask away!  I’m very open to sharing, just busy🙂

I wish you the best of luck, Jen.  You will be fine.  Just take it one thing at a time.

Sincerely,

Kat

 
 

Tags: , , , , , , , , , , , , ,

Snack interlude.

  1. Toasted piece of whole grain bread (preferably not a national supermarket brand where they add sugar, extra gluten, modified this and that…)
  2. Herbed goat cheese (chevre) spread on toast.
  3. Fresh basil leaves laid over the goat cheese.
  4. Sliced cherry tomatoes and kalamata olives (if you like them)
  5. optional grind or two of fresh black pepper.

Enjoy your simple and delicious snack.

(as you can see, I couldn’t wait to enjoy mine before snapping a pic)

 
4 Comments

Posted by on July 10, 2012 in Food, Lifestyle

 

Tags: , , ,

Proper Progress Report: First official labs since surgery

I finally had my first significant labs done.  My endocrinologist had me wait until the end of June to get my labs so that she would be back in the office to take a look at them.  Considering the last time she was out of the country and the medication mishap that occurred, I didn’t mind waiting an extra couple of weeks.

To my surprise, my labs came back as follows:

T4 (Thyroxine Free) 1.1 ng/dL  (Ref Range 0.7 – 1.8)

TSH (thyroid stimulating hormone) 9.63 mcIU/mL (Ref Range 0.55 – 4.78)

So obviously, my TSH is about twice what is considered the upper end of normal.  What surprises me is that my T4 is pretty much right in the middle.  I was feeling pretty fine, sure, a little bloated more often than not, but a small price to pay considering all the things I was fretting about pre-surgery.

What I’m confuses me is that it’s not as though my thyroid is not producing enough and therefore my pituitary gland says “make more TSH”…  I don’t have a thyroid, I take a consistent dose of T4 that goes into my body every day.  I wonder if it’s just the shock of the gland disappearing or lifestyle functions that interfere with absorption…  In any event, they raised my dose from 112mg to 137mg, which I began on June 30th.  I’m curious to see how this will affect me.

Here are the lifestyle modifications I’ve made thus far:

  • Wake every day at 6:30 a.m. to take Synthroid pill, go back to sleep for 2-3 hours, wake up and have lemon-water (try to do this daily before breakfast or coffee) then coffee.  I’ve been drinking coffee every day and many times feel as though I need it, and that bothers me.  It’s all borrowed energy and the adrenals are what pay the debt in the long run, so maybe it’s good that I’m getting a higher dose.  The reason I get up to take it is that I feel better than if I take upon waking and watch the clock while my stomach growls, or worse yet, have to run off somewhere without being able to get a healthy breakfast.  I don’t know if it’s in my head, but I feel better if I go 2-3 hours between pill and anything other than water rather than the suggested one hour.  Yes it’s a pain in the arse, but you can be sure I think it’s worth it to take such measures.  A person can get used to pretty much anything.  Ever watch Hoarders where one spouse is a hoarder and the other lives with it for a decade or two?  It could be worse….
  • Avoid Soy.  Okay, this is something I was already doing for the most part before the surgery for non-thyroid related reasons, but I’m continuing to do so.  Previously, I’d eat fermented soy which limited me mostly to tempeh, but now I avoid that as well.  Sure, on the rare occasion I’ll eat a square or two of junk tofu ( Asian style from the farmer’s market cafeteria line), but it’s really only three squares every few months.  Avoiding soy means more than just avoiding tofu and edamame.  It means avoiding most salad dressings (I like to avoid Canola as well for the Omega 6 overload) and packaged food.  If it is in a box, it’s more than likely got soy in it.  Again, I was already doing my best to avoid processed food, but now I have even more incentive.  Making your own salad dressing is super easy and you have greater control of what you consume.  Something I’m in favor of already.
  • Not avoiding a high fiber diet.  This is something I refuse to modify, not that it was suggested by the doctor, but two of the things I eat a lot of are listed as interfering with the absorption of Synthroid on the brand’s website.  One is walnuts and the other is high fiber foods.  Now there is no f-ing way I’m avoiding those!  That would mean reducing the amount of fruits and vegetables I consume and that is the most ridiculous notion.  They’ll just have to increase the dose.  Oh wait, they did.
  • Keep my Synthroid in the refrigerator.  It is HOT y’allz!  I don’t care where you are in the country (except the pacific NW), it is balls-frying-on-the-pavement hot!  My old apartment and my new digs are similar in that the air conditioning does not really cool the joint down when it’s 106 degrees outside… and inside.  According to my research, Synthroid readily degrades when exposed to heat, so I keeps it in the fridge, yo!  That is, until the night before I take it, then I place it in a little shot glass next to the bed so I can wake up, take it (with a full glass of water), and lie back down and (sometimes) fall back asleep.
  • That’s it!

So, my lifestyle hasn’t changed that much.  I still have weird sensations at the incision site.  It feels itchy at times, like it’s being stretched at others, and then there’s that weird pinchy, burny feeling that I believe is my nerves growing back together.  All in all, it’s not too uncomfortable.  I forget it’s there most of the time, which is a vast difference from being hyper-conscious of my enlarged thyroid 100% of the time.  It’s been just three months and the ‘surgical ridge line’ has completely flattened out, though it’s still quite red.  I find I don’t wear necklaces these days because I feel like the scar competes with the necklace and it just looks cluttered, like I’m wearing two necklaces.  Hmph.

I haven’t really been putting anything on it other than sunscreen, which I’ve been lax about, but it’s not like I’ve stepped outside other than to walk to my car or work.  It is HOT y’allz!  When it feels itchy, I’ll rub some of my shea/coconut concoction that I sell in the winter time on it because it’s too rich for any other part of my body in the summer.  I did buy Mederma, but I’ve only used it about 4 times.  I guess I just don’t really care enough to make it a priority.  I figure I can get around to it when I get tired of looking at it.  Really though, putting an acid-peel type substance on a fresh surgical scar just feels counter-intuitive.

I think my least favorite thing is the strange sensation when I yawn.  Since there’s no thyroid there to separate my trachea from my neck flesh/skin, when I yawn, it feels scratchy and weird when my neck skin rubs on my trachea.  I bet you’re working up an appetite, huh?

On a related topic, I was listening to an episode of The Moth podcast whilst making a batch of soap this evening and there was a story told by Jennifer Fitzgerald in which she does her best to “slut it up” in an effort to get a boyfriend to prove her parents wrong (funny story, that’s why you should listen) and the captain of the wrestling team ***SPOILER/VULGARITY ALERT*** shoves her hand down his pants and she exclaims “Jesus Christ!  It feels like chicken parts!”  Tantalizing, no?  I had a good laugh at that one…

Progress report so far:

  • zero pounds gained (aside from normal fluctuations)
  • zero pounds lost
  • mild occasional bloating – not the worst case scenerio
  • frequent stomach aches – not inclined to think this is thyroid related, but thought I’d mention it
  • plenty of energy to do the things I need to do and the body tells me when it’s time to rest
  • some annoying short term memory malfunction – again, not the worst case scenerio
  • fairly stable mood – no pronounced depression or anxiety
  • dosage increase 6.30.12 – will update accordingly

Most days are good, others, I feel like I’m just hanging on, trying not to fall over the edge, but mostly, they’re good.  I think that’s the best that anyone could ask for Total Thyroidectomy or not.  So, I guess I’m doing fine.Image

“A little perspective, like a little humor, goes a long way.”
Allen Klein

 

Tags: , , , , , ,

Abbreviated Update

I keep meaning and meaning to write, but have had so much on my plate lately.  It’s like my life went from zero to sixty after my surgery.  In fact, I had the surgery and just continued on as if nothing had changed.  In fact, it gave me a stable base, I feel.

I was so worried about what a roller coaster post-op would be, but I think that’s mainly the norm for RAI patients.  For me, the roller coaster was the part where I came to peace with my decision and finally went at it with some grace.  Physically, though with RAI, there’s no way to fully know how much or how long it will take to kill off some/all of your thyroid cells, so there is major fluctuation between what your thyroid is producing and the meds.  With surgery, once it’s out, you can calculate that it is producing exactly zero thyroid hormone and you start with a simple formula for replacement medication:

1.7 mcg/kg/day

So, if I weigh approximately 66.5 kg, I multiply that by 1.7 = 113ish

I started on a dose of 112mcg/day and am due for my labs at the end of the month.  Actually should be sooner, but my Endocrinologist is out of the country until then and it’s a fairly simple calculation – and she is flexible with my requests because I’ve been such a responsible patient, and she’s seen me every 3-4 months for the last 6 years….

But, I feel pretty good. Here are the bullet points that may or may not be related to the actual surgery or synthroid:

  • Skin has been more sensitive – more prone to contact dermatitis from a specific pair of shoes that were mildly irritating pre-surgery
  • Went through a period of intensely dry lips & cracking on the corners – have a feeling it was any combination of the following: hard to keep hydrated no matter how much water I drink (strange sounding, I know, but don’t ask me how I figured this out); slight anemia during one week that coincided with my worst symptom; good bacteria had not grown back sufficiently after all the harsh drugs and prophylactic antibiotics (was having severe digestive issues for the first several weeks)
  • Have added B-12, probiotics, and Vitamin D to my daily regimen

Hard to remember the transient symptoms, but bloating easily from any food by the end of the day.  Frequent, persistent stomach aches (these come and go already, but they were more frequent).  Sensitive skin & dry lips feel related to me.

Also, for the last couple of weeks, I’ve been having the weirdest sensations at my incision site.  I think it’s the nerves growing back together.  I was aware that the skin above the scar would be numb for several months and it has been.  First it started as a weird itching directly on the scar, like dry skin that’s being stretched, it itches but some shea butter would make it feel so much better.  So that’s what I did, I applied shea butter and it made it feel less itchy.

*I should note here that I bought Mederma, but haven’t really been using it.  It seemed too harsh to put something that dissolves layers of skin somewhere that’s trying to grow new layers.  I’ll try it a bit later, just seemed too soon even if the package says it’s okay.*

Now that itch has turned into a pinching/burning sort of sensation that lasts for 20-30 seconds at a time.  Then it disappears and comes back randomly throughout the day or night.  I really think it’s the nerves growing back together because when I rub the numb area, I’m starting to feel it a tiny bit nearer to the either end of the scar.  It’s very similar to when you go to the dentist and they numb you.  As the feeling comes back little by little, just imagine it dragged out over the course of several months.

I have to say, if these are my only issues, it’s not so bad.  The dry lips thing is highly irritating, but it’s better than palpitations and panic attacks.  It’s like the layer of skin is tight over my lips, it’s not cracking and peeling, or anything really gross.  You couldn’t even tell by looking, it just feels annoying.

So, sorry for the disjointed post, but in winding down from work, with the limited brain capacity I have after a Friday night of non-stop action, I thought this might be the best use of my time since I can’t really do anything too demanding.  I’m not even going to bother re-reading and editing, which I normally would do because now I’m tired and need some sleep.  I hope most of my sentences aren’t too awkward.

P.S. – Go back one post and look, I added a picture of my accidental dessert for breakfast.

 

Tags: , , , , , ,

Accidental Dessert For Breakfast

Quick post before my full fledged 5 week update.

As you may or may not know, I make my green smoothies with frozen bananas.  One of my many endearing idiosyncrasies consists of only eating fresh bananas within a two to three day window of proper ripeness before they gross me out and I will not eat them.  At this point, they are best suited for baking or smoothies, so I freeze them since I don’t bake.  Although I have recently been browsing online info about vegan baking, for the record.  That aside, I used all my kale and collards for my salad greens, so I was looking around for a suitable breakfast in my relatively bare cupboards and came up with the most awesome accidental dessert for breakfast!  I suppose some might call it a smoothie, but I put it in a bowl and ate it with a spoon, so I suppose it’s sorbet.  I realize I did not invent this, but I am still impressed with myself.

I put the following in a blender:
1.5 frozen bananas
1-2 c. of frozen raspberries (any mixture of berries would be great)
1/2 c. of water - enough to allow it to blend but not get too liquidy
optional - 1 Tb. of that heavily processed So Delicious brand french vanilla coconut milk creamer that I reserve for special occasions 
optional - vanilla extract ( do not use too much or it's gross)
optional - 1 tsp chia seeds

 

Top with a few raw almonds or fresh berries, yum!

 

blend and WHAAA???  The most amazing, thick, vegan ice “cream” ever!

Along with that I had a small Ezekiel sprouted tortilla (I know it has soy in it, but I realized this after I bought it and my fridge is pretty bare right now, and I was hungry) with some ground peanuts and honey from the farmer’s market (I don’t call it peanut butter because it is not pre-made; does not have added oils, salt, or sugar and is ground to order into the container from straight peanuts – wish they had raw!)

What a heavenly dessert.

I am going to post about salads as well.  Mine have been intensely flavorful lately without drenching them in dressings.  But for now, I have to get ready for work.

Vegan Ice “Cream”

 
Leave a comment

Posted by on May 12, 2012 in Food, Lifestyle

 

Tags: , , , ,

Pathology, Gross Description, Etc.

I had a follow up today with my surgeon and am happy to report that healing is on track.  He said my scar is still a bit puffy (I already knew that, thank you) and that complete healing from surgical scars takes 6 months to a year.  Aside from minor maiming by my Phlebotomist today, all is well.  Stabbed veins are painful!  I received the Operative and Pathology Reports, and though both were in language unfamiliar to me, they were fascinating!  Being that it’s all done and over with, it’s quite interesting to know exactly what took place while I was under.  I’ll summarize:

Operative Report:

Basically, they put me under, prepped me, gave me some drugs and put an inflatable cuff around each of my lower legs to prevent blood clots.  Then, they slit my throat 9 cm across and 2.5 cm above my clavicle, first superficially, then through muscle.  They folded my temporary neck flaps up and clamped them open.  Then they cut through more muscle, ligated several veins in my hypervascular thyroid, snipped here, snipped there.  They identified and spared my superior laryngeal nerve, identified and biopsied nodes determined to be benign.  The left upper parathyroid was identified and spared, the lower left parathyroid was not encountered and the left thyroid lobe was inspected and no accidentally removed parathyroid was seen.  The recurrent laryngeal nerve identified, spared in situ, and viable; lobe is passed off and returned finding hyperplastic (extra cells) tissue consistent with Graves’ Disease with no carcinoma seen.  Likewise for lymph nodes.

Onto more dissecting, snipping, and sewing; right lobe removed, the right upper parathyroid vasculature was compromised by my anatomy and was therefore “minced finely with … scissors” and grafted into my neck muscle.  The right lower and a third rogue parathyroid “labeled the right middle” were viable and left in situ.  My guess is that the “right middle” parathyroid was the lower left that they couldn’t find, which must have taken a wrong turn at Albuquerque.  Then, they basically burned the rest of the gland off of my trachea and stabbed two holes in my neck in order to place drain tubes.  Then it says ” Hemostasis was adequate with a valsalva maneuver,” though I’m not entirely sure what that looks like…

Pathology Report & Gross Description:

Specimen A – Pretracheal lymph node measures 1.4×0.6×0.3 cm.  It is frozen and sectioned for diagnosis by touch preparation.

Specimen B – Left thyroid lobe weighing 24.5 grams (finally, I know!)  –  Normal weight of a thyroid is 10-30 grams, so you can see that my left half was as big as a full thyroid.  It measured 6×4.8×1.8 cm while the isthmus (the middle part that I found so bothersome) measured 1.5 x 0.7 x 0.6 cm.  The lobe was reddish-tan and “diffusely heterogenous” – I think this means it was multinodular across a large region.  Consistently inconsistent, if you will.  No distinct nodules identified.

Specimin C – Right thyroid lobe weighing 15.7 grams (for a total of 40.2 grams) and measured 5.5 x 2.5 x 1.5 cm.  This lobe was “beefy red” and homogeneous.  No discrete lesion identified.  I could’ve told you the left one was the problem.

It’s weird how 99% of my physical ailments happen on the left side of my body, my thyroid being no different…

  • One reactive node tested negative for metastatic carcinoma.  That’s always a good day…  I think this was referring to my lymph node.  Both lymph node and thyroid nodule tested negative for carcinoma.  Yay.
  • At surgery the patient was found to have an enlarged, hypervascular thyroid consistent with the diagnosis.

Hemovac drains are then placed, I’m stitched up, and sterile dressing is applied.  The next thing I remember is the nurse telling me to take deeper breaths to bring my blood pressure up and they brought in my mom and then my boyfriend.  The transfer to the room is a bit hazy.  I remember coming out of the elevator on the cart and accidentally bumping into my mom, who didn’t recognize me at first.  Getting off the cart and into the bed was the hardest part.

I had to stay in the hospital overnight, but the morphine they gave me kept putting me to sleep, so for the first few hours, my mom, my boyfriend, and I napped on and off since none of us really got much sleep the night before.  That evening I told them both to go home and get some rest – only one person is allowed to stay in the hospital room overnight and I wanted both of them to get some sleep after the whole ordeal.  I knew that Anto had to work the next day at 5 and he’d gotten only 45 minutes of sleep the night before due to having to close at work and then be at my place by 6:30 a.m.  I felt fine and sleepy and wanted him to get a good night’s sleep before having to bear the brunt of working a Saturday night with little to no sleep two nights in a row.  He left reluctantly and then texted me about every 8 minutes upon returning home, making sure I was alright, asking if I wanted him to come back, etc.  All I did was watch episodes of House Hunters International between drug laden snoozes, I felt fine and told him to stay home.

As it got to be around ten o’clock, the nurses kept returning to poke me with needles, take my vitals, bring me ice chips, etc.  All I wanted to do was go to sleep and every time I started to drift, in came the nurse or the tech to make me do something.  Just when I was starting to realize that this wasn’t going to be the restful night I thought it would be, the door opened and Anto walked in!  He had come back, a blanket under his arm, to stay the night with me.  I was and still am thankful that he returned because that night would’ve been a very different experience had I been on my own.  The poor guy got woken up just like I did every hour, on the hour, the entire night.

I was supposed to be released around 11:00 the next morning, but there was a mix up with my labs – they had to monitor my calcium and the last batch of blood-work was entered under the wrong date in their computers, and it took until about 5pm to sort out.  Poor Anto stayed with me all the way until 3, and only left because he had to be to work at 5.  My mom came to take me home and faithfully crushed my pain pills up into apple juice for me for the next few days.

You already know the story after that.  How much energy I had, how I tricked myself into mild dehydration and exhaustion.  I made myself take it easy the last few days and am due to return to work tomorrow.  I feel great, optimistic, and generally lighter – even though I’ve gained seven pounds.  Blech.  I’m not letting panic get the best of me.  After all, I’ve been doing nothing but eating and laying around for the last couple of weeks with a couple of slow paced walks thrown in the mix.  I asked the surgeon today if I could start running again next week and he gave me the green light.  I think a return to routine, work, and more rigorous exercise will be effective.  I’m also looking forward to having income again.  I *think* I’m at peace with the fact that there is bound to be a little bit of weight fluctuation and that it will even out in time once I find the right fit with my Synthroid dose. I have been experiencing pretty significant abdominal distress with the slightest stray from non-processed food, so even though I already make mostly healthy food choices, this might ensure stricter adherence to them.  Not sure what’s going on, but I’m keeping an eye on things.

Still, overall, I’m feeling positive and thankful.  *Exhale…….

 

 
2 Comments

Posted by on April 23, 2012 in Total Thyroidectomy

 

Tags: , , , , , , , , , ,

 
Follow

Get every new post delivered to your Inbox.