Thyroidectomy and it's After Effects

December 2007

Early in December, the endocrinologist gave me the names of two surgeons that specialized in thyroid removal. I scheduled appointments with both of them to see which one I wanted to do my surgery. The first ENT (Ear, Nose and Throat Specialist) was extremely cold and businesslike. He didn’t have a great bedside manner and I didn’t really care for him, but I was resolved to work with him if he turned out to be the best I could find. After all, I wasn’t there to make friends with him. The second surgeon was wonderful and I liked him immensely! He was warm, funny and took the time to patiently answer all of my questions. It was clear that he was very experienced and comfortable doing this type of surgery. I immediately chose him to do the procedure. The thyroid surgery was scheduled for January 3, 2008 at Mercy Hospital in South Buffalo, NY. In the meantime, I returned to the endocrinologist to report on my scheduled surgery and asked for something to slow down my thyroid. She prescribed a medication to calm the hyperthyroid symptoms because I was informed that the surgery would be cancelled if I were hyperthyroid. That was the very last thing that I wanted so I took that medication exactly as prescribed. She also told me that after the surgery she would be prescribing Synthroid for me (she did not believe in the natural Armour thyroid!). Given that, I knew I would never see her again but would return to my functional primary care doctor to receive my Rx for natural thyroid hormone.

Despite now knowing the reason for all of my baffling and terrifying symptoms, that knowledge did nothing to diminish the symptoms. In fact, they seemed to intensify. I was scheduled to prepare Christmas Eve dinner at my home for my daughter, mother, sister and brother and I had absolutely no idea how I was going to do that in my condition. I managed to put the Christmas tree up along with some Christmas decorations and was really glad I did so. It somehow soothed and relaxed me to see the Christmas lights and decorations. I somehow managed to pull Christmas Eve dinner together thanks to the purchase of a number of prepared side dishes and store-bought desserts. But that accomplishment was marred by the discovery that I was developing a bronchial infection! On Christmas Eve I was scrambling to not only get dinner on the table but to get a prescription for antibiotics! I wanted to be through the course of antibiotics before my surgery so that there would be absolutely no reason to cancel the surgery on the 3rd!! I managed to get the prescription at a local pharmacy and somehow got through Christmas Eve dinner. This left me exhausted and in a full-blown panic attack on Christmas Day. I was supposed to visit a good friend from New York City who was in town visiting family for the holiday, but I had no choice but to cancel our visit. I felt horrible to do this to her on such short notice, but there was no possible way that I could interact with her or anyone else while being so panic stricken. Pretending I was normal would be impossible; she would surely notice how insane I was acting. And she would have been absolutely right! My symptoms were now so bad that should the surgery be cancelled for some reason, I was fully willing to rip out my own thyroid with my bare hands at that point!!

I was also tormented by the thought that I could once again have cancer. Were these nodules actually cancerous this time? If they were, I knew I would be pressured to undergo a course of radioactive iodine to “mop up” any stray cancer cells. I knew without a shadow of a doubt that I did not want and would NOT have radioactive iodine! I prayed with everything in me that no cancer would be found in my thyroid gland!

January 3rd, 2008

The day of my surgery finally arrived. I was instructed to be at the hospital at 6:00 AM. So on a cold, snowy January morning, my brother, daughter and I made our way to the hospital in the predawn hours. On the way there, my fear wanted me to tell my brother to turn the car around and take me home. But I knew that was no longer an option. My thyroid was so far gone and my symptoms were so severe that surgery was now the only way out of the mess I was in. We found the hospital parking ramp and made our way into the hospital. My brother and daughter were directed to a waiting room and I was taken to the appropriate area to be prepared for my procedure.

After changing into a hospital gown and vitals were taken, I was wheeled into the holding area where I was prepped for surgery. While waiting for my turn in the operating room, the anesthesiologist explained what would happen next and I was given a mild sedative intravenously. Apparently, the sedative was enough to knock me out on the way to the OR because I have no recollection whatsoever of entering the surgical suite. Thank you, God!!

Upon awakening in Recovery, I remember experiencing a lot of pain and nausea. I was quickly given something for the nausea and it vanished fairly soon. After about one hour spent in Recovery, I was transported into my room. There was another female patient on the other side of the curtain and I was to overhear that she had had her colon removed. A therapist was explaining to her the ins and outs of using her new colostomy bag. I suddenly didn’t feel so bad about my situation. She had already been there for several days and I was only scheduled to be in the hospital overnight. My daughter and brother were then allowed to come in and see me. They delivered the wonderful news that the doctor had told them that no sign of cancer had been found in my thyroid! I was so relieved!! The whole radioactive iodine ordeal had been averted and was now a non-issue! Thank you, Jesus!!!! The remainder of the evening I felt very uncomfortable. Swallowing was next to impossible. I was given only liquids as nourishment, but I don’t recall having much of an appetite. A Catholic chaplain visited the woman with the colostomy bag and on his way out, asked me if I would like him to pray with me. I figured I could use all the help I could get and gladly welcomed his prayers. I found his prayer soothing, comforting and reassuring. To pass the time I watched some TV. I vividly remember news of Britney Spears going berserk and shaving her head. I did not have a Smartphone at that time, so TV was all I really had to keep me entertained and to pass the time until I could go home the next day. My surgeon did visit me that evening to repeat the good news that no cancer was found in my thyroid. He assured me that the surgery went quite well and what I could expect over the next several days. I summoned the nurses a couple of times that evening for pain medication and for assistance in using the bathroom. The following day I was given liquids again for breakfast, but during the latter part of the morning an aide brought me a sandwich for lunch. I stared at it for a bit wondering how I was going to be able to swallow that. By now I was quite hungry, so I was quite surprised and pleased to find that it went down rather well. I was continually checking myself for signs that the once ever-present anxiety was returning. Thankfully, it had not as yet reared its ugly head. At this stage, I was really itching to be discharged from the hospital. Once the surgeon gave me the OK to leave, my brother and daughter soon arrived to take me home. The nurse gave me the requisite discharge instruction papers along with a date for my follow-up appointment with my surgeon.

I was happy to be home and to be in my own bed once again. But for the next month, I fearfully waited for all of the old symptoms to return: the horrible anxiety and panic, the loss of appetite and the inability to sleep or relax. Could they really all be a thing of the past? Gradually, the realization settled in that those terrible symptoms were really and truly gone! My surgeon had told me that my surgical scar would eventually fade into a near-invisible white line. In the meantime, however, my scar looked as though I had grown a second pair of lips. It was hideous!!! Thank God for turtleneck sweaters! But my surgeon was right; within several months my new “lips” had vanished and my scar was barely noticeable. I visited my primary care physician who gave me a prescription for Armour thyroid. I filled the prescription but was reluctant to take it for fear of bringing on the hyperthyroid symptoms I had experienced for what seemed like an eternity. The first few weeks after my surgery I felt so good! I must have been operating on all of the leftover thyroid hormone that my very sick gland had been producing. But after about five weeks, I realized I had exhausted all of the thyroid hormone remaining in my body. I started to experience excruciating muscle spasms and charley horses with no effort whatsoever. I was also experiencing numbness and tingling in my extremities. As much as I feared it, I knew I had to start the thyroid medication. I started VERY slowly——only 15 mg at first. I continued to increase the thyroid medication very slowly by 15 mg increments. When I got up to 60 mg., my primary care physician at the time felt that was the right dosage for me. What a ludicrous statement that was, especially coming from a functional physician who should have known that 60 mg. was in no way an adequate dosage for an adult woman! But frightened that I might trigger another “hyper” episode, I remained at that dosage for awhile. When I realized that I would need a different doctor to guide my thyroid dosing, I found a great holistic MD in a nearby city. She prescribed Hydrocortisone which enabled me to gradually enabled me to increase my thyroid dosage to around 180 mg per day split evenly in AM and PM doses of 90 mg. It was a real roller coaster over several years to arrive at the right dosage; there were a lot of emotional ups and downs as I attempted to zero in on the right dosage for me. The Thyroidless Yahoo Group online and the Stop the Thyroid Madness website were both huge resources for me and their expertise guided me over some really bad rough spots. I was able to wean myself off of the Hydrocortisone after one year and still increase my dosage without any side effects. I still dose by symptoms rather than numbers on a lab report and that seems to work well for me.