Surgery

10 January 2000:
I finally had my operation. It shouldn't have taken so long to have it scheduled, except that my old endocrinologist 'lost' the dictation that was to be sent to my surgeon. I had to find another endocrinologist that would give me a second opinion and validate my surgery with confirmation via a letter to my surgeon. It went rather well, although I did bleed a bit more than expected.

All of my parathyroids (the 4 glands on the poles of the thyroid gland that control calcium levels in the body) were still completely intact, and most of my thyroid, including my nodules, was removed. My calcium levels were too low for comfort after surgery though, and I did have to stay in the hospital a day longer than expected. We've guessed that this could be due to either shock from the surgery or permanent damage. Either way, I was prescribed calcium supplements, Rolcaltrol (vitamin D supplement), and Levothyroxine (thyroxine replacement).

Since I created 'Thyroid Info', I have received some more specific questions regarding the pre/post experience of my surgery. These are some of the questions that people asked, and if I haven't covered an area, please feel free to ask for more information by clicking here.

How long were you in the hospital and/or recuperating?

I was in the hospital for 3 days. My surgery was scheduled for 07:00, so I arrived there at 06:00 and it took about 3 hours. I was originally scheduled to stay in the hospital for two days, but my parathyroids must have been damaged or shocked because my calcium levels were extremely low. My surgeons wanted to keep me under observation until all my levels were back to a healthy status.

I had a drain inserted into my incision after the surgery (back in the operating room), and the following morning, one of my surgeons removed the drain and put gauze over the stitches and sealed the incision with a large strip of clear adhesive plastic to keep it free from water and/or dirt. You can shower once they cover the incision like this. By the third day, I was feeling much better, but it was about three months after the surgery that things were starting to feel normal again. It will most likely take you a year to fully heal.

One thing that I did, which I regret, is that I was so scared of tearing my incision I would tense up my shoulders and back muscles so as to keep everything still and safe. My back was sore for weeks after that, so try to relax if you can. Don't wear anything on your back (like a backpack) for a few months following surgery. Drink lots of fluids. Keep healthy.

Did your neck hurt a lot afterwards?

Not so much my neck but my throat. During surgery they intubate the patient to control breathing, and it's the intubation, more or less, that is the culprit.
Throat lozenges. Throat lozenges. Throat lozenges.
Buy them by the box, if you must, but at least get a minimum of three good-sized bags. Start popping them in as soon as you're in your hospital room and conscious; I swear they will help tremendously.

Your incision might sting or throb a bit every once in a while because it's healing. Take only Tylenol for the pain. Advil/Asprin may cause excess bleeding because it thins the blood. Keep your neck supported well with pillows at night, and it should be OK.

Did it scar?

Yes. My neck smiles now. Not to worry though. After the plastic adhesive bit comes off, you can clean your incision 2 X day AM/PM with hydrogen peroxide to remove dirt or soap after showering and before you go to sleep. Moisturise it with Vitamin E to ensure a smooth incision line, making the scar less visible. If it makes you really self-conscious that people are going to stare at it, give it a few months to heal up with proper airing and then you can wear a necklace or a choker to hide the scar line. Seriously though, you won't even realise it's there after a few months, so I wouldn't worry about it too much.

RAI. I see you opted for surgery. I'm more than a little frightened by the idea of destroying my gland - CAN'T GO BACK. Did your research of regretting patients change your mind?

Has your physician told you that surgery is only for thyroid cancer? That's what I was told when I asked for surgery. I kept asking. Keep asking.

It's your right to choose what you and your doctor think is best. Yes, it seems physicians generally like RIA, and they might assume that the patient does too. They'll say that it's been a time-honoured procedure used since the 1950's. One of my friends has a husband who had an overactive thyroid with Graves' Disease, like myself. It took three doses of RAI to attempt to reach euthyroid (balanced level), and by the third dose, it was too much radiation. He was then severely hypothyroid. It just seems to me, for a procedure that has been used for half a century, they should know a bit more about handling dosages other than by 'hit or miss'. Of course, Stanley's incident shouldn't be generalised. Many people have gone through RAI perfectly sound at the other end. I just didn't feel that RAI was right for me.

Was it the other testimonies that changed my mind?
It was more or less a combination. After emailing groups and individuals, I compiled a pros/cons list from all the results I had gathered. Surgery was what I deemed as my best option. I still think I made the right decision today.

Any vocal chord problems?

My vocal chords were not affected. My voice was hoarse at first, but that was mostly because of intubation (tube placed in the throat to help you breathe during surgery). Intubation was what hurt me more than the incision. What do I suggest? lozenges. Lots and lots of throat lozenges. Get bags of them. Herbal ones are yummy too. Start popping them in as soon as you're fully conscious. They will help your throat heal faster and rid it of soreness. My voice is still the same, and I have to take a few pills everyday, but I feel much better.

What else do you suggest?

I must mention that you have the right to all copies, all biopsy reports and all labs taken on your thyroid, and I thoroughly encourage you to keep your own files at home. Don't ask, just do it. Doctors can be cheeky when it comes to insurance plans.

I might also add that the Journal of Musculoskeletal Medicine has an article (volume 18, no.7 July 2001) that discusses depression of TSH levels over longtime use of corticosteroids. If you've been taking anything any type of perscription with cortiosteroids, it may have affected your thyroid. Mention it to your doctor if you think you apply.