Thyroid update
Jul. 14th, 2004 04:17 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
annathepiperI just got back from having a consultation with my surgeon about my thyroid, and that went fairly well. Since it was just a consultation there wasn't anything to really be scary--and indeed, much of what she had to say was information I knew already, from what my usual doctor had told me about the biopsy results from Swedish. The new information was this surgeon telling me about the specifics of how she performs these things, what the risk factors are, and what's actually involved with me showing up for the procedure and in the days after.
Short form of the story, though, is I go in for surgery on August 3rd. That's in another two and a half weeks. Goody!
The longer form of the story is that first off, Dr. Stickney went over some of what I'd already known from the biopsy and the ultrasounds I'd had done. I.e., that in many cases nodules of this kind are not dangerous but that due to the size of this one alone, that's cause for concern. And she repeated what Dr. Wechkin had told me about how a biopsy on a nodule that big has a much greater shot at being a false reading just because of the increased chance of having simply missed cancerous cells in the mass. Between this and between the folks at Swedish's Cytology department giving their verdict of "intermediate possibility of cancer", that's more than enough cause to take out the right half of the thyroid right there. She mentioned the fine-needle aspiration procedure (she called it a "skinny needle", which was kind of amusing) and how it does tiny pinpricks on the tissue--and how it is therefore easy to miss cancerous cells if the mass in question is actually pretty big. Which this one is. 6.3 centimenters.
She was also pleased that Dr. Wechkin had in fact caught the fullness of my thyroid on a routine physical exam; she, too, felt my throat and did in fact find the nodule just by doing that. So while you can't see it just by looking at me, it's apparently findable if you know what you're looking for. I can't find it just by casual inspection myself, but hey.
The new information I got on this visit was the specifics of how Dr. Stickney goes about performing this procedure, and what the risk factors are. The plan would be that she'd knock me out and make an incision kind of high on my neck, above my thyroid, so that she can make it as narrow as possible; the idea here would be that she would use that to go in and down to get the nodule out. As it happens she's going to be hard pressed to get the bugger out, so it'll be interesting to see whether she has to make a wider cut than she'd like to get it out. Bah.
So she'll be taking out the right half of my thyroid in general. Then they'll test that nodule down the hall and find out whether or not it's cancer. If it isn't, I'm good and I get to keep half my thyroid. If it is, then I get to come back in 6-8 weeks after my throat has settled down from the first procedure and get the other half of my thyroid out. I won't have to go on thyroid medication if I keep half of my thyroid, because it'll take over for the half that's removed. So that definitely sounds like the scenario to hope for here.
But at least for this first (and hopefully only) procedure, I am to show up on the 26th to do some preliminary paperwork and bloodwork. Then on the 3rd, I show up for the actual procedure--and I don't eat anything after midnight the night before. They'll knock me out, open me up, and keep me in the hospital overnight; Dr. Stickney says I'll be quite groggy, and I will be off work for a week--or I would be, if I were currently employed. I will be needing to refrain from driving for the first few days after, just because of the likely difficulty of turning my head; I am amused, however, to recollect as I write this that the nurse who was giving me that advice did not mention any likely loopiness of being on painkillers. ;P :)
I'm also to keep my neck out of the sun for a bit just to keep the area from getting bleached out, which would make the scar more obvious. Eventually, the scar is supposed to make its way down my neck and wind up around the hollow of my throat, and this doctor has as a point of professional pride making her incisions as unobtrusive as possible.
It seems also that this big nodule is at least erratically interfering with thyroid function. I had had two tests done on my thyroid hormone levels; the first one, according to Dr. Stickney, indicated I was low on the proper levels. But the second one indicated I was normal.
What else was I warned about... taking care when bathing, and making certain that the area is rinsed well so no soap lingers to irritate the tissue. Watching out when eating, as sometimes foods like bread or pasta or rice will be hard to swallow due to possible inflammation. Keeping an eye on the antibiotic ointment I'll have, in case that proves an irritant to my skin (as apparently happens sometimes). A possible (but very small) risk factor involved with working around the nerves of the voice box; there is the small possibility that my voice will be weak or breathy for a while after the surgery, and a very, VERY small possibility that my voice could be impacted permanently.
This vaguely disturbs me, but only vaguely. For one thing, Dr. Stickney says the risk factor there is less than one percent, and for another thing, I've always been more of an instrumentalist than a singer anyway--so I'm much less bugged by the idea of my voice being impacted than I was by the idea of one of my hands not working while I was recovering from the broken arm last year.
She also mentioned a very slight risk factor of some bleeding, which is part of why they'll keep me in the hospital overnight. And a risk factor of the parathyroids being cranky as a result of this procedure--which was more new information I hadn't had. I didn't know what the parathyroids were, even; apparently they are in charge of regulating the distribution of calcium through the body. And they're all intertwined with the thyroid in terms of location and such, and there are four of them. I'm likely to lose two of them as the right half of my thyroid comes out; the two remaining may or may not get cranky. If they do, and/or if the whole thyroid comes out, I may have to wind up taking daily calcium and vitamin D for the rest of my life.
But, as Dr. Stickney pointed out, "daily supplements" vs. "thyroid cancer". Not a hard call to make, there. Besides, I'm already taking daily calcium now, as Dr. Wechkin had recommended I do so.
Dr. Stickney also offered me the option of a sort of pre-op briefing visit where she'd give me pretty much the same information I got today--but I elected to skip that. Partly because I don't really need to be told the same stuff twice, and partly because the whole point of such a visit seems to be to let the patient get a chance to get into the right mental space to be prepped for the surgery. But I'm really already there. Between Dr. Wechkin's firm recommendation that surgery happen, and talking to Ann from the OKP, I'm already pretty much prepared to face and deal with this--so I went ahead and had the nurse schedule me the appointment.
So here goes nothin'. Another two and a half weeks to wait, and then I go under the knife!
Short form of the story, though, is I go in for surgery on August 3rd. That's in another two and a half weeks. Goody!
The longer form of the story is that first off, Dr. Stickney went over some of what I'd already known from the biopsy and the ultrasounds I'd had done. I.e., that in many cases nodules of this kind are not dangerous but that due to the size of this one alone, that's cause for concern. And she repeated what Dr. Wechkin had told me about how a biopsy on a nodule that big has a much greater shot at being a false reading just because of the increased chance of having simply missed cancerous cells in the mass. Between this and between the folks at Swedish's Cytology department giving their verdict of "intermediate possibility of cancer", that's more than enough cause to take out the right half of the thyroid right there. She mentioned the fine-needle aspiration procedure (she called it a "skinny needle", which was kind of amusing) and how it does tiny pinpricks on the tissue--and how it is therefore easy to miss cancerous cells if the mass in question is actually pretty big. Which this one is. 6.3 centimenters.
She was also pleased that Dr. Wechkin had in fact caught the fullness of my thyroid on a routine physical exam; she, too, felt my throat and did in fact find the nodule just by doing that. So while you can't see it just by looking at me, it's apparently findable if you know what you're looking for. I can't find it just by casual inspection myself, but hey.
The new information I got on this visit was the specifics of how Dr. Stickney goes about performing this procedure, and what the risk factors are. The plan would be that she'd knock me out and make an incision kind of high on my neck, above my thyroid, so that she can make it as narrow as possible; the idea here would be that she would use that to go in and down to get the nodule out. As it happens she's going to be hard pressed to get the bugger out, so it'll be interesting to see whether she has to make a wider cut than she'd like to get it out. Bah.
So she'll be taking out the right half of my thyroid in general. Then they'll test that nodule down the hall and find out whether or not it's cancer. If it isn't, I'm good and I get to keep half my thyroid. If it is, then I get to come back in 6-8 weeks after my throat has settled down from the first procedure and get the other half of my thyroid out. I won't have to go on thyroid medication if I keep half of my thyroid, because it'll take over for the half that's removed. So that definitely sounds like the scenario to hope for here.
But at least for this first (and hopefully only) procedure, I am to show up on the 26th to do some preliminary paperwork and bloodwork. Then on the 3rd, I show up for the actual procedure--and I don't eat anything after midnight the night before. They'll knock me out, open me up, and keep me in the hospital overnight; Dr. Stickney says I'll be quite groggy, and I will be off work for a week--or I would be, if I were currently employed. I will be needing to refrain from driving for the first few days after, just because of the likely difficulty of turning my head; I am amused, however, to recollect as I write this that the nurse who was giving me that advice did not mention any likely loopiness of being on painkillers. ;P :)
I'm also to keep my neck out of the sun for a bit just to keep the area from getting bleached out, which would make the scar more obvious. Eventually, the scar is supposed to make its way down my neck and wind up around the hollow of my throat, and this doctor has as a point of professional pride making her incisions as unobtrusive as possible.
It seems also that this big nodule is at least erratically interfering with thyroid function. I had had two tests done on my thyroid hormone levels; the first one, according to Dr. Stickney, indicated I was low on the proper levels. But the second one indicated I was normal.
What else was I warned about... taking care when bathing, and making certain that the area is rinsed well so no soap lingers to irritate the tissue. Watching out when eating, as sometimes foods like bread or pasta or rice will be hard to swallow due to possible inflammation. Keeping an eye on the antibiotic ointment I'll have, in case that proves an irritant to my skin (as apparently happens sometimes). A possible (but very small) risk factor involved with working around the nerves of the voice box; there is the small possibility that my voice will be weak or breathy for a while after the surgery, and a very, VERY small possibility that my voice could be impacted permanently.
This vaguely disturbs me, but only vaguely. For one thing, Dr. Stickney says the risk factor there is less than one percent, and for another thing, I've always been more of an instrumentalist than a singer anyway--so I'm much less bugged by the idea of my voice being impacted than I was by the idea of one of my hands not working while I was recovering from the broken arm last year.
She also mentioned a very slight risk factor of some bleeding, which is part of why they'll keep me in the hospital overnight. And a risk factor of the parathyroids being cranky as a result of this procedure--which was more new information I hadn't had. I didn't know what the parathyroids were, even; apparently they are in charge of regulating the distribution of calcium through the body. And they're all intertwined with the thyroid in terms of location and such, and there are four of them. I'm likely to lose two of them as the right half of my thyroid comes out; the two remaining may or may not get cranky. If they do, and/or if the whole thyroid comes out, I may have to wind up taking daily calcium and vitamin D for the rest of my life.
But, as Dr. Stickney pointed out, "daily supplements" vs. "thyroid cancer". Not a hard call to make, there. Besides, I'm already taking daily calcium now, as Dr. Wechkin had recommended I do so.
Dr. Stickney also offered me the option of a sort of pre-op briefing visit where she'd give me pretty much the same information I got today--but I elected to skip that. Partly because I don't really need to be told the same stuff twice, and partly because the whole point of such a visit seems to be to let the patient get a chance to get into the right mental space to be prepped for the surgery. But I'm really already there. Between Dr. Wechkin's firm recommendation that surgery happen, and talking to Ann from the OKP, I'm already pretty much prepared to face and deal with this--so I went ahead and had the nurse schedule me the appointment.
So here goes nothin'. Another two and a half weeks to wait, and then I go under the knife!