I'm prone to sinus infections. However, my doctor's office insists on a regular exam before they'll give me antibiotics, so, I went in for what has become my twice a year prescription visit. Only this time, when the nurse practitioner did the exam, she said, "Your thyroid seems to feel a little large, I want to send you to get an ultra-sound. Also, there are some blood tests I want you to have." I made the appointment with the lab, which was also a medical imaging company and they emailed the results of the blood work and images back to my doctor’s office.
I got a phone call later that day from the General Practitioner's office, giving me the names of two specialists in the area. They strongly recommended that I make an appointment to see one of them to have further testing done. I was able to get an appointment for the next week. They also wanted to tell me that my blood sugar was elevated, and they were putting me on a type 2 diabetes medication, Metformin.
I picked up the original film from the imaging company for the new doctor and at his office, I filled out forms, and was pre-screened by one of the nursing staff. Ten minutes later, the doctor walked in to conduct his examination.
When your specialist starts his questioning by asking if you've been exposed to radiation recently, it's never a good thing.
The next thing I knew, his office had arranged an appointment at the local hospital, for another ultra sound.
Unlike the first ultra-sound where the technician moved a fist-sized scanner around my throat; this ultra sound machine was a tube that I had to be placed in. After they got the results of this ultra sound back, I have another appointment with the specialist to discuss how he wants to proceed. Then, it's back to the hospital again, this time for a procedure called "fine needle aspiration."
Fine needle aspiration is when they stick needles into a particular area to get cells samples, so a pathologist can screen them for cancer.
This time, in order to prep for the procedure, I have to apply lidocaine cream to the base of my neck a half an hour before the appointment and cover it with plastic wrap. Lidocaine is a topical numbing agent and I've had to use it before for a relatively minor procedure. It is the only thing familiar to me in this whole mess. I know that whatever they are going to do, they have to numb this area first and will follow it up with anesthetic shots, so I won't feel what's going to happen.
The reality of what I'm being tested for doesn't really kick in until I'm in a room with a doctor, a pathologist and three nurses. The doctor has stuck several needles into my neck and jiggled them around to get his samples. The pathologist (who is also a doctor) is sitting there with a microscope and she can't leave the room until the doctor poking hole in me delivers enough cells for a good test sample. She won't sign off on what he provides, so it's a few more pokes and jiggles (actually a little bit more violent than just a jiggle,) and finally she has enough samples. The nurses are there to assist the two doctors, but also to keep the patient calm, so the doctor with the needles doesn't wind up doing unintended damage to a moving patient.
Apparently epiphanies about why you are being tested and patients freaking out are common occurrences during this procedure.
What in the world am I going to tell my husband? I decide to tell him nothing except the procedure went fine and the doctor will have the test results the next day and will tell me what my options are from there. However, my husband is no fool and I'm not that good of an actress. After a couple of rather pointed questions about the possibilities of my having cancer, I reassured him that it was just a regular test that I had to have before anything else could be done and there was nothing to worry about.
I'm really glad that I had to concentrate on keeping him calm, because that kept me calm. And the next day, I got the call that the test results were negative for cancer. But, I had to come into the doctor's office again to discuss "my options."
Based on the imaging, my thyroid was at least twice as large as should be. The average size of each thyroid lobe is 4 to 4.6 centimeters. My lobes were about 8 centimeters on each side and could close around my windpipe, eventually causing death. The doctor's recommendation was to have it removed before it could get any bigger.
By this time, I felt comfortable enough with the specialist and my local hospital to agree to surgery. We went back and forth on dates, and finally after a cancellation, my surgery was scheduled for the week before Christmas. I would only be in the hospital for one night. I was given three prescriptions to fill, so I would have the medications available, when I got home from the hospital. A serious narcotic pain reliever, an antibiotic and a thyroid hormone replacement medication, called Synthroid. About three months had elapsed from my initial exam to this point in time and I had another month and a half to go before the surgery.
The doctor's office called the insurance company, where surprisingly I got the only good news in all of this mess. Circumstances had forced us to participate in the most comprehensive medical plan my husband's company had, and it paid off unexpectedly. The surgery costs were covered 100% and there would be no deductible.
Before the surgery, I had to be screened by the hospital and I had to have more blood tests.
I believe that certain natural supplements are good for you. I take Ginger Root, Cinnamon Bark, and CoQ10, to name a few. I also have an on again, off again ibuprofen habit. I had to stop taking everything two weeks before the operation. A lot of what I was taking acted as a blood thinner. No one wanted me on anything that might prevent my blood from clotting after surgery.
Two weeks before the surgery, I went to fill the prescriptions the doctor had written for my post-op care. Surprise. Because the scripts were 35 days old, they were no longer valid. I had to call the doctor's office and ask them to mail me replacements. Two days later, new prescriptions in hand, I'm off to get them filled.
The day before the surgery, I pop over to the hospital for my last interview before check-in.
Finally the day of the surgery has arrived. Hubby drives me to the hospital for my 6:00 AM check-in and by 6:05 AM, I'm getting my last set of blood tests. The operation is scheduled for ten. I had pulled an all-nighter at home to get ready for this. The house was clean, all of the laundry was done and there was enough food prepared to last a week. I figured I could rest in the hospital.
After the blood tests, it’s back to check-in, where they give me a three ring binder, with all the information they’ve collected on me, and send me up to the nurse’s station on the floor where I’ll be staying. When we get there, I give the binder to the nurse at the desk and she points us towards the room.
Because I would only be there overnight, they placed me on the maternity floor. It was a double room, with no other occupant. The nurses came in, wheeling a portable podium like structure with a laptop attached to the top. The nurse had brought a hospital gown for me to change into. My husband and I talked until it was time for them to place me on a gurney and wheel me down to the operating room.
I vaguely remember the anesthesiologist introducing himself, and then I don't remember anything at all...
...until I woke up in a total panic, because I couldn't breathe. There was a nurse standing over me looking at the monitor over my head. She told me that I was breathing fine and that I had tubes in nose and she could monitor my intake of oxygen. It took her a while to calm me down as I was having a full-blown panic attack. It wasn't the first panic attack I've had and it probably won't be the last, but the timing was unfortunate. I usually take deep breaths to calm down, and I couldn't this time. I got myself together by sheer force of will; with the nurse's voice a soothing and steady focal point. She finally gave a green light for me to return to my room and I was wheeled back on the gurney.
Once I was back in the room, I said hello to my husband and I fell asleep again, for maybe ten minutes, before the nurse came in to check my vitals.
As a matter of fact, a nurse came in every fifteen to twenty minutes to check on me. Remember the rest I wanted to get? That was a pipe dream. My doctor was a lot more proactive about my diabetes, so they were also monitoring my blood sugar levels and I was getting insulin, along with other fluids through the IV. The nurses came in like clockwork to check on me, take small blood samples and (every two hours) to ask if I needed pain meds.
My husband was feeding me ice chips and getting me cold water.
The nurses were surprised that after about twelve hours, I no longer wanted painkillers. The water and ice chips were doing a great job in soothing the pain.
And then came my first trip to the bathroom. I had said a polite NO to the question of whether I needed a bedpan. Inside my head I was shouting the word, with a couple of expletives deleted in front of it. Going to the bathroom involved getting detached from oxygen tubes stuck up my nose and taking off the pulsing plastic bags (pneumatic compression devices) that they had velcro'd around my lower legs to make sure I didn't form blood clots.
(For anyone who manufactures compression pumps, could you please make them less loud?)
Before I could go, however, because I didn't have slippers, they got me some slipper socks, the kind with a rubberized tread on the sole.
Once I had been disconnected, with my husband supporting me, and the IV rack along for the ride, we trundled across the room to the bathroom.
When they re-wrapped my bandages that night, I could see a look of horror in my husband's eyes. I didn't understand the look until I snuck a peek under the bandages during one of my later unsupervised trips to the bathroom.
I had an incision on my neck about 5 inches across, encrusted with blood and held together with black stitches. I also had had about six other little oozing holes around the incision where they had literally stitched the cover cloth to my skin, so it would not be dislodged during surgery.
Around 6:00 PM, the assistant surgeon (who is on the hospital staff, as opposed to my specialist, who is only associated with the hospital,) came by to take a look at the incision, and to give his official blessing to my chart.
I don't remember dinner; I think it might have been soup and jello. My throat hurt too much for the soup and I hate jello.
At nine pm, they kicked my husband out. And although I didn't get much rest that night, I did sleep. It was one of the few nights where the trauma of the day overrode my insomnia.
Breakfast, I remember: a cranberry scone, scrambled eggs, toast, milk, which I don't drink and cereal. Hubby was back in the room by this time, I gave him the cereal and milk, while I rediscovered the joy of scones. I hadn't had one in at least 10 years.
We spent the morning waiting for the doctor to sign me out of the hospital and being disconnected and reconnected to equipment every time I wanted to go to the bathroom. I kept reminding myself that the oxygen would help me heal, because I kept forgetting to put the nose plugs back in.
Finally, about two pm, the assistant surgeon came in, checked the incision, re-bandaged it, and gave his blessing for me to leave the hospital.
I thanked the nurses for their care, got in the wheel chair to get to the entrance to the hospital, got into the car, once hubby drove up and ten minutes later, I was home. In another five minutes, I was in bed and blissfully sleeping.
(Just a note. They put you in a wheel chair for liability reasons. If you should faint and hurt yourself on hospital property, after a medical procedure, they are at fault. Once they wheel you out, you’re on your own!)
My follow-up visit with my doctor was a week later. the specialist told me that mine was the fifth largest thyroid he'd ever removed. He took out my stitches and told me to use Mederma on the scar. He was concerned about my blood sugar levels, but that was something my GP was working on. I saw him again about a month later and then my next appointment wouldn't be for a year. My GP would take over monitoring my T levels to make sure the thyroid replacement drug was doing its job.
I discussed my concerns about my irregularity with him. He told me that was normal. Also, one of the things we'd discussed before the operation was possible damage to my vocal cords. It was hard for me to talk for more than a few minutes at a time. He told me that would go away. It's taken about a year, but my voice is getting back to where it was before. I couldn't sing for over a year, and can only do a few choruses now, before I start croaking, but it is getting better.
My GP adjusted the level of Synthroid I was taking every three months. I knew when they finally got the level of Synthroid right, because I stopped sleeping all day, and I started going to the bathroom again on a regular schedule.
I've talked to several other people who take Synthroid for various reasons, and they all seem to have irregularity problems, especially, if they are on the generic medication. While we are told that the generic version of a drug is the same as the name brand, I've been told that there seems to be a difference in the efficacy of Synthroid versus the generic medication.
What does a thyroid do?
Believe it or not, this is not something I researched until after the operation. According to WikiPedia:
The thyroid controls how quickly the body uses energy, makes proteins, and controls how sensitive the body should be to other hormones.
I've read the WikiPedia page three or four times and still don't have a grasp of what exactly what this means, but I can tell how the loss of my thyroid affected me, until they found the correct medication dosage.
The thyroid tells your body how much calcium to release and absorb. I had to supplement my diet with additional calcium pills, and found myself binging on ice cream until I increased my intake.
The thyroid tells your body how to regulate its temperature. Without the thyroid, you can find yourself abnormally cold and suffering from chills.
The thyroid regulates your metabolism. I slept for sixteen hours a day until they got the Synthroid dosage right.
I got leg and foot cramps, which I treated by drinking quinine water and was finally able to stop.
Hair loss. Loss of appetite, along with weight gain. Nails thin and brittle. Chronic constipation. Check, check, check and check.
A year later, and almost six months into the proper dosage of Synthroid, most of these symptoms are gone. But if I do something stupid, like skip a pill, my body temperature goes crazy and I get leg cramps while sleeping. You have to take thyroid replacement medication daily, for the rest of your life.
It's amazing how many friends and relatives are on Synthroid or its generic. Until I had my surgery and missed all the Christmas and New Year celebrations, no one had spoken about their thyroid problems. But when I showed up with a huge scar, complaining about the dosage adjustments, it seemed as though a third of all the people I knew were on thyroid medication, some of them for twenty years or longer.
I count myself as being very lucky. I didn't have cancer. I survived the operation. My vocal chords are coming along nicely considering how enlarged my thyroid turned out to be. They finally have me on the correct level of medication.
It will take a while before the scar fades, but that's how I always healed - slowly. I'll look up five years from now and it'll be gone. My hair is as thick as it ever was, albeit with more gray. My nails could cut glass. I'm learning more about the supplements that I need to take in larger doses, like calcium and vitamin D.
Overall, life is good.
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Contributor's Note
A huge thank you to staff of Chilton Memorial Hospital. The nurses and technicians are great people. The doctors, both on staff and associated know what they're doing.
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