Friday, April 29, 2011

5 weeks Post Thyroidectomy

It has now been 5 weeks since my surgery and 2 weeks since I started the synthroid.  I think that I am doing quite well.  I am keeping busy and trying to stay active, although my motivation isn't quite as high as it was pre-op and immediately post-op. 

The only things that I have noted to be different are the following:  I am finding that I feel a little cranky, especially in the morning.  (I will allow that those around me may argue about the "little" part  :) )  I also used to be a night owl.  I could stay up all night (although I would have difficulty getting up in the morning) but now I am finding that by 9pm I am done for the day.  I don't have any energy left for anything else and I am ready to go to sleep.  It has actually made me more organized and I am on a much more stringent routine than I have ever been before.  I don't think that it's necessarily a bad thing, just different. 

By my calculations, I should be close to the lowest thyroid level before my body begins to adjust to the synthroid so I am hoping that things will only get better from here :) 

Scar - 5 weeks post thyroidectomy


5 weeks post-op

I can't believe that it has been 5 weeks since the surgery.  The swelling is continuing to improve, but I can't say that I see much difference in the scar.  I am applying bio-oil on it now and keeping out of the sun as much as possible. 

Thursday, April 21, 2011

Diagnosis: Benign Multinodular Goiter! No Cancer!

I have been very busy getting back into my hectic routine and so have neglected this blog.  So sorry to anyone who has been following. 

Last week I did see my endocrinologist and she told me that all of the masses were benign and she started me on Synthroid.  I am starting on 125mcg a day.  I told her that I was concerned that the synthroid wouldn't be active until weeks after the cytomel was out of my system.  She told me that wouldn't be the case, but with my knowledge of pharmacolgy I'm not so sure and I still worry about becoming hypothryoid.  It has been a week now since I started the Synthroid and I can't say that I'm experiencing hypo symptoms.  Sure, I'm tired but who wouldn't be in my situation.  I am working mother, wife, daughter, friend and volunteer.  Life is insane sometimes and of course I get tired after working long hours and then coming home to work again until bedtime.  So life goes on and so far I don't feel a whole lot different then I did before the surgery.  If only I could pick up my motivation to be a bit more active.....

Today I went to the surgeon again and my vocal cord is still paralyzed on the left but he's still optimistic that it will recover.  I will need to return again in 2 months and in the meantime I will only sing while driving alone in my car where no one can hear me :) 

I managed to get a copy of my pathology report from my endocrinologist but it was only the gross pathology (what can be seen without a microscope).  I asked the surgeon why there wasn't a histopathological report (where the cells are described).  He told me there was but that he couldn't print it today.  I wonder why she didn't give me that part.  I will ask specifically at my next visit. 

I have posted a picture of my scar last week (3 weeks post-op)  http://bit.ly/iiKuQS and today  (4 weeks post-op).  http://bit.ly/hCkEzF

Scar - 4 weeks post thyroidectomy


4 weeks post-op

The swelling is continuing to go down but is definitely still present and the line is still quite red. 

Scar - 20 days post thyroidectomy


20 days Post-op
 Although there is swelling it has decreased some.  The scar appears to be a darker red than previously but I am told that this is normal. 

Thursday, April 14, 2011

First few days back to work.

Today, is the day that I go to the endocrinologist.  I am hoping that she will have the pathology report.  I will be sure to post the results when I get them.  In the meantime, I will write about my first few days back to work. 

Monday I worked a 10 hour day.  The morning was mostly catch up so I had enough energy to go for my regular lunch time walk.  It was so nice to get out in the sun with colleagues and walk.  The afternoon was busier and so by the time I got home I was tired but not excessively so.  I went to bed early and was up nice and early on Tuesday to do it all again. 

I worked another busy 8 hours and went for a run on my lunch hour.  The sun was shing and my mood was happy and light.  It was great to experience my feet pounding the pavement again :)  I felt that I had a turned a corner in this journey.  I was happy that I had decided to have my thyroid removed and felt that, now, I could move on to the next chapter.  I was excited to have an active body and mind and be free of the worry of a sick thryoid.  By Tuesday evening, however, I was starting to lose that gumption and was wearing down.  I made it to my regular Tuesday evening vonlunteer activity but everyone was telling me how tired I looked (Thanks =p), and I was starting to feel cranky!  Another early night for me. 

On Wednesday, I couldn't get out of bed.  The sky was dark and the temperatures had dropped overnight.  I was very tired!  I did manage to make it to work, and through another gruelling 10 hour day, this time without a break for lunch (Don't worry, I did eat).  When I got home I was exhausted and cranky.  I was snapping at my family when they didn't deserve it.  DH was nice enough to take the kids to the park while I cleaned the kitchen and prepared lunches for the next day.  I needed that time alone.  It helped some with those feelings of frustration but I was still tired and was so happy to see my bed last night. 

Today is my day off and I feel like I have my energy back.  I will see what the endocrinologist says today. 

Tuesday, April 12, 2011

Going back to work after thyroidectomy

Yesterday I reached another milestone in this journey as I headed back to work for the first time in over 2 weeks.   I have been home for 2 weeks after my thyroidectomy surgery, relaxing and recovering.  I have had a stress free 2 weeks and yesterday was the first day that I was back in the full swing of things.  Would I have enough energy?  Would the workplace stress get to me?  How was I going to deal with the first day back and all the subsequent days after that? 

It was a long day and I was tired at the end of it but I think that the hardest part was the change in my morning routine.  I used to get myself and the kids ready for work in about 45 minutes and I always prepared breakfast first.  I need to eat or I get headaches and so I have always eaten breakfasft dierctly after getting out of bed.  Although I haven't found any information that says that Cytomel should be taken on an empty stomach, I do know that Synthroid will work best if taken upon rising and one hour after breakfast.  Instead of waiting for the Synthroid (I know that I will eventually be taking it), I have decided to change my routine now to be able to take the meds on an empty stomach.  I am getting up about an hour earlier to take the medication before breakfast.  Now if only I could find an hour at night to get to bed an hour earlier :)

I carried off the new routine without a hitch yesterday and wasn't even rushing to get the kids to school on time.  Maybe this routine will work out better....  Then I drove into work, expecting things to be different.  I mean I felt different.  I feel lighter, healthier, less stressed.  A whole 2 weeks have gone by shouldn't it be different?  The staff greeted me and brought me up to speed, but otherwise everything was pretty much the same as I left it.  The morning schedule was light and so I was able to catch up and do some light work.  At lunchtime I returned to my regular walking routine with a colleague and then the afternoon arrived.  It was a busy afternoon.  When I saw the schedule in the morning I was concerned about the packed afternoon schedule but it worked out well.  There wasn't anything that I couldn't handle and in fact the afternoon passed by quickly and without stress.  Before I knew it the day was finished and I was back home.  I was tired but not exhausted.  I didn't allow the stress of others to get to me, and here I am ready to start all over again today.  My goal is to feel just as good by the end of the week!

Sunday, April 10, 2011

The official part of my recovery is drawing to a close.  Tomorrow I head back to work, back to my normal routine, back to the grind as they say.  I will work a 10 hour day in a stressful environment and return to a family who will still need me as well.  I will return late to a house that needs cleaning, lunches that need making and laundry that needs doing.  I will remember that this is my life; and life will continue on just as it always has.  It has been nice to have these past two weeks off, regardless that it has been for recovery.  Although I am physically ready to return to work I would love to have a little bit more time at this relaxed pace.  I don't remember feeling this good and healthy.  I feel normal and have had very little stress.  Something tells me that this is how life should be.  I am hoping that at least some of this new found peace has to do with the removal of a sick gland and that I will feel just as well when I return to work.  I am going to keep a positive attitude that this is the case. 

Although my official recovery is drawing to an end.  I know that I actually still have more recovery ahead of me.  I can see it in the lines in my neck; hear it in the volume and pitch of my voice; and feel it in the lump in my throat.  I will also still need to have my medication regulated and will have to take this medication every day for the rest of my life.  Still, I believe that the worse is over and I can leave behind the chapter of anxiety and stress caused by making this decision.  I know that it was the right one and that in the end I will be better for it. 

Friday, April 8, 2011

2 Weeks Post-Thyroidectomy



Today is exactly two weeks since my thyroidectomy.  I think that, in general, the recovery has been pretty good.  There have been a few hiccups here and there, such as, a sore mouth and some bouts with low energy.  However, overall I haven't felt a lack of energy, my weight has remained constant (after an initial drop and then a slight increase) and most days I have been able to make it through the day without any problems. 

Since it is the two week mark I thought that I would recap my post-op progress for anyone who may have just found this blog.  I had a total thyroidectomy exactly 2 weeks ago today.  The procedure took about 2 1/2 hours and then I took another few hours to recover from the anesthetic.  I spent the night and the first day following surgery in the hospital until they were able to determine that my calcium levels were normal.  My levels were just above low normal the whole time I was hospitalized and so the evening after surgery I was released from the hospital with a prescription of Tylenol 3 for pain management and Cytomel for thyroid hormone replacement.  I was told to watch for any tingling in my hands and feet or any other signs that my calcium may be dropping.  I haven't experienced any symptoms or low calcium so I assume that my parathyroid glands were left intact -Yeah! 

When I returned home I rested and slept a lot for the first 2 days, but I was sure to get some exercise each day.  I started with a very short walk 2 days after surgery and gradually increased the distance and speed each day.  I did feel out of breath the first day that I walked but not since.   I feel as though I am ready to run and start working out again but since my neck is so swollen I am reluctant to do too much too soon.  Yesterday I felt very tired, but late in the afternoon I developed a migraine. This is typical for me so I don't think that it had anything to do with recovery. I didn't drive for the first week because I couldn't turn my neck far enough to check my blind spots. This week I have started driving again, so I am feeling more normal.


The roof of my mouth was very sore for the first week and so my diet was limited.  I was mostly eating chicken soup and meal replacement drinks.  I couldn't tolerate extremes in temperature, acid, sugar or spice.  By last Friday that had resolved and I have been eating well ever since.  My weight dropped dramatically the first week after surgery.  I had started Cytomel and hadn't been eating much do to the pain in my mouth so both of these things likely played a role in my initial weight loss.  (see post on thyroid hormones)
 
The first week my incision line was covered with steri-strips.  I couldn't see it but I could tell that it was swollen.  On Monday I saw the surgeon and he removed the strips.  The incision line was almost invisible but there was a great deal of swelling.   I have noticed that the swelling is decreasing some but that the actual incision appears to be more red than it was on Monday.  I have started applying vitamin E oil. 


Scar 2 weeks post-op


Most days I have felt better than I did prior to surgery. However, I have had a few days where I have felt very tired. I had days like these prior to surgery as well so it may just be normal. I'm not sure why I feel better than ever. It could be a result of the removal of a sick gland, the medication or just a more relaxed schedule. I usually have a very busy schedule which is hard to keep up with and it can wear me down. I may be able to tell more when I get back into my regular routine next week.


I am still waiting for the pathology report and hope to have it next Thursday.

Thyroid Hormones

I thought I might take some time to try and explain the Thyroid gland, how it works and why I will need to be on medication for the rest of my life. 

The thyroid gland is a small butterfly shaped gland that lives at the base of the neck.  It produces thyroid hormones which are necessary to run our bodies by maintaining metabolism.  That is they make sure that organs are not running too fast, or too slow.  If you have too much thyroid hormone your body will overwork and this can be dangerous, especially to your heart. If your thyroid levels are too low, you feel run down. Very severe instances of low thyroid hormones can result in severe swelling of the tissues and coma. This is called "myxedema coma" and can be fatal. Therefore, it is very important that your body has the right amount of thyroid hormone. Your Thyroid gland produces two hormones T4 and T3.   However, your organs can't use the T4 hormone and so your body needs to change T4 to the active hormone T3. The half life of the thyroid hormone (T4) that your body produces is about 7 days. What this means is that every 7 days the amount of hormone will drop to half of it's previous level. So, if I started with 100% T4 before surgery, it would have been 50% last week and 25% today. The half life of the T3 is even shorter and so at this point I likely don't have any of my own T3 hormone. Without medication, my body will run out of thyroid hormone. That is why I was given the Cytomel. Cytomel is a T3 supplement which has a shorter half life. If I need to have RAI (Radioactive Iodine) which is the treatment fro thyroid cancer, I will need to be hypothyroid. Because the half life or T3 is shorter it would take less time for this to occur and the RAI could be done sooner. Also, T3 is the active thyroid hormone. T4 needs to be converted to T3 in the body to be effective. Therefore Cytomel will have effects sooner and so this may have played a role in the rapid weight loss I experienced the first week. Since I have not had any blood tests to determine the levels of my thyroid hormones it could be possible that my T3 was to high, thus increasing my metabolism and thereby decreasing my weight.

Side effects of Cytomel are related to allergic reactions or over dosage symptoms which are the symptoms of hyperthyroidism (too much thyroid hormone).  These can include:



confusion

dizziness
fast or irregular heartbeat (palpitations)
feeling faint
mood swings
muscle weakness
psychosis
extreme restlessness
light irregular menstrual cycles
heat intolerance
weight loss

In severe instances over dosage or severe hyperthyroidism can result in heart failure. 





Thursday, April 7, 2011

Tired......

Today it was even harder to get out of bed than yesterday.   I am still feeling sluggish and have what I describe as a "fog on my brain".  It is not quite a headache but just something not quite right and my concentration isn't as good as it has been for the past week or so.  I felt better last week then I do this week.  I am hoping that it is partly boredom and that once I am back to work it will all straigten out.  If I feel worse tomorrow I will call the doctor to see if there is anything I can do before I see the endocrinologist next week.  I start work on Monday and need to be on the top of my game.  It is a busy time of year and I have already missed two weeks. 

I will drag myself out for a walk this afternoon to see that may help as well.  I was walking about 6km every day as well, as running and working out prior to the surgery.   Although I have continued to do some walking post surgery I have not been nearly as active.  Maybe my body is feeling the effects of the reduced activity.  I am not brave enough to start running or doing any other type of aerobic activity, stretching, lifting, etc yet but I will try to walk as far as I can this afternoon to see if I can't get my metabolism to increase a little bit naturally. 

Wednesday, April 6, 2011

Feeling tired

I'm feeling tired today. I find that everytime I don't feel 100% I worry that my thyroid levels are out if whack! Before I would have thought that I was tired and moved on but now I am second guessing everything. I was able to reach the endocrinologist today and have an appointment for next week. I assume that she will check my thyroid levels then. Hopefully, I will also learn the results of my pathology report. If all is well I will likely start on Synthroid and begin the regulation of my thyroid levels for real. I hope that I respond well and that I don't develop symptoms of either hypo or hyperthyroidism. I am afraid that I won't feel like myself and all I want to do is move on with life. I know that I will never be able to forget about all of this but I want to get back to "normal".

12days Post Thyroidectomy


This is my scar today, 12 days after the surgery.  It is very swollen and bruised but the actual incision line is barely visible.  It is still tender but I'm sure that will improve every day. 

Singing After Thyroidectomy

Yesterday was a pretty busy day for me.  I had some errands to run and met a friend for lunch.  I was able to enjoy some time in the mall without the kids or a time limit and forgot how much I enjoyed shopping (even if I don't buy anything).  I also had a volunteer job in the evening.  I seemed to have the energy to do all of this but this morning I found it difficult to get out of bed.  I feel tired today, but not exhausted.  I plan to take it easy.  I have a sick kid home today as well so maybe we will spend the day watching movies together :) 

Although I seem to be able to talk normally, I have noted that I can't sing as well, especially in the upper ranges.  I mentioned this my surgeon when I saw him earlier this week.  He took a look at my vocal cords and noted that my left cord is slightly paralyzed.  He said that it was likely stretched during the procedure but that it should resolve with time.  I guess I won't be recording any records in the near future - haha. 

Monday, April 4, 2011

Watching my weight post thyroidectomy

I am feeling quite well today besides the lack of pathology report. I spent the weekend with friends and family and a had a good time. I seemed to have a good deal of energy and was able to carry on with normal activities. I know that I shouldn't watch the scale but I do. I have read about a lot of people who are concerned about weight gain post thyroidectomy. I want this blog to help someone; to hopefully help overcome any anxiety they may have about this procedure, and so I wanted to be sure to track my weight as well.

I had lost quite a large amount of weight after the surgery.  I wasn't able to eat much when my mouth was sore and so I think I made up for it this weekend when I was able to eat whatever I wanted.  Now I am back on track with eating a healthy diet and watching my calories (as I was doing prior to surgery). 

So from the date of the surgery I lost a whopping 8 pounds (not healthy) and as of today I have gained 2 pounds of that back.  For any of you who are concerned about the change you may experience in your weight after surgery that is a net loss of 6 pounds.  I know that everyone is different and I don't know what will happen as the weeks continue on and turn into months, but I will keep you updated on my personal journey. 






No Pathology Report - yet!

I was so anxious waiting for today to be able to finally get the pathology report and put an end to the questions racing through my mind.  So, I tried to pre-occupy myself this morning and didn't blog on purpose so that I would have some news to tell when I did.  Well, here is my news; no pathology report.....aggh!!  Now I have to wait another 2 weeks for a second follow-up appointment at which time I will finally get the results!  I know this isn't really terrible news.  I know that I will eventually get the report.... It is just the waiting and not knowing that always seems to be the worst.  Maybe I should go by the old adage that "no news is good news" . 

At least I got the steri-strips off today.  Later I will post pics of what the incision looks like without the strips.  The incision is barely visible even after such a short time but the area where my thyroid used to sit is quite swollen.  It looks like they put something in there, rather than take something out  :)  I tried to clean some of  the glue from the tape off but it is still a little tender so I will wait and soak it well in the shower. 

Saturday, April 2, 2011

The Weekend

Finally the weekend is here.  This is important to me for two reasons.  First, it means that I don't need to spend my recovery time in solitude; second it is only two more days until my follow-up appointment.  It is a beautiful day outside today so my family and I are planning to spend as much time outside as possible.  I will place a scarf around my neck to help protect it and enjoy the day. 

Yesterday was a good day.  The intense pain in my soft palate became very bearable and I was able to eat solid foods.  I felt energized enough to keep up with the day and in the evening I was able to convince my entire family to go for a walk with me.  It was great to spend time together being active again.    My incision wasn't as itchy yesterday as it was on Thursday but I can feel the steri-strips starting to curl and peel.  I can't wait for them to come off!  They are itchy and I am eager to see what the incision looks like under the strips. 

Friday, April 1, 2011

Exactly 1 Week Post Thyroidectomy

I can't believe that it has been a whole week since my Total Thyroidectomy.  I am feeling pretty good.  I did wake up with a headache but I got up and took my Cytomel and felt better in about half an hour. My soft palate is healing!  Last night I was able to eat a bowl of rice.  There is still some pain but it appears to be localized to one spot on the right side.  This morning when I woke up My throat felt dry and sore but a good drink of water and now it is merely slightly tender.  I am so excited that I may be able to eat more solid food today.  Still,  I plan to be cautious so as not have a set back. 


Last night my incision became intensely itchy.  I didn't know if I would be able to deal with the intensity.  I wondered if it was part of the normal healing process or some kind of allergy to the steri-strips.  I have had reaction to medical tape in the past so I hope it's not an allergy.  This morning that is improved as well and in 3 days I will see the surgeon and hopefully these things will be removed.  I have read that they generally fall off on their own in 7-10 days but so far mine have not budged.  I have even been taking showers without much effort to keep them dry. (My surgeon said it was ok).  They do feel uncomfortable and itchy and I can't wait for them to come off but I know that they serve a purpose and so will deal with them until Monday. 


I thought that I have been doing well, not stressing much about this whole ordeal and just taking one day of recovery one day at a time.  I have felt pretty confident that everything has gone well and will continue to do so.  However, last night I had a dream that I went for my follow-up appointment and received the pathology report.  In my dream the report diagnosed a mix of both Papillary and Follicular Cancer of the Thyroid.  My original biopsy was benign but I guess I still have unconscious concerns about a cancer diagnosis.  Perhaps that is why I woke up with such a headache this morning.  In three more days I will have the actual pathology report and then  I can put these fears to rest. 


Today the sun is trying a little harder to find it's way through the clouds but the sky is still grey.  I am imagining a nice sunny day to keep myself upbeat and happy :)  I will try to do more today.  I will walk to school to get the kids and let them play at the park for as long as they like on the way home.