I've labeled each section to make it easier for the reader to skip any parts that may be irrelevant/ uninteresting to them.
History
I
was diagnosed with Grave's disease back in 2013. The symptoms I
experienced included rapid/irregular heartbeat, fatigue, heat
intolerance, stomach pain, diarrhea every single day, mental fog,
confusion, a quick temper, and forgetfulness. My goiter ended up being
around 7 cm by the time it was taken out. My creative drive had all but
disappeared, and it was a feat to do the simplest things around the
house. I just wanted to lay under a fan and watch TV. My entire twenties
were lost to this shit disease, and I couldn't manage to get the
surgery working multiple part-time jobs in a state that expects low
income people to rot and reproduce. It's time, experiences, and even jobs that I'll never get back.
After
hesitantly agreeing to RAI and changing my mind a few days beforehand, I
had a consult with my surgeon. I asked him whether he took out a lot of
post RAI thyroids, and he confirmed that he had. He also mentioned that
it is way more difficult than taking it out straight away, as the
degraded tissue "sticks" to everything around it. He also informed me
that my thyroid had grown past my collar bone at this point. I scheduled
the surgery only a few weeks out from my first consult.
**Speech Pathologist Testing**
Between
then and the surgery, I had a pre-op (painless) as well as a consult
with a speech pathologist. My ENT surgeon recommended this, as I had
mentioned having trouble swallowing food and pills. He also wanted her
to check out my vocal chords due to the size of my goiter. I don't
believe most patients who don't experience these symptoms have to do the
speech battery, which is fortunate as it was honestly one of the most
uncomfortable points of the entire process. The pathologist put a scope
down my nasal cavity all the way down to my vocal chords. We could not
use local anesthetic, as this would affect my speech. With the scope
still down my esophagus, another staffer fed me muffins, cookies,
pudding, and water several times while the pathologist observed via
scope. Doesn't sound too bad on paper, but it was awful to do with a
metal rod down my nose. I had tears streaming down my eyes the entire
time. This procedure probably lasted about 20-30 minutes, though it felt
like an eternity. I had no pain after the procedure was done.
Surgery
I
had one more consult with my ENT before showing up at the hospital the
day of surgery. Once I arrived, I was given a gown and socks, removed
jewelry, standard stuff. They also put what looked like blood pressure
cuffs on my legs to prevent blood clots. I was visited by a nurse who
installed an IV on the top of my hand, as well as the anesthesiologist
and ENT for any last-minute questions. I believe the procedure lasted
about 4 hours. The surgeon mentioned that it was one of the more
challenging thyroidectomies he's done after >600 of them due to its
size and inflammation. He also mentioned that he was concerned once he
got in that I would go into a thyroid storm due to the inflammation and
bleeding, but fortunately that did not occur. In addition to the sealed
incision, there were two Jackson-Pratt drains installed beneath my
collar via surgical glue (no stitches).
I
know that every hospital is going to have a different policy right now
regarding COVID-19 measures, but I was allowed one visitor in the
waiting room who could stay with me. I brought my mother.
Recovery: My Super Happy Funtimes Anesthesia Experience
I
woke up back in their recovery room before being taken to my room. I
actually felt pretty dang good up until that evening, when I had I bad
reaction to the anesthesia and started throwing up, which lasted all
night and into the wee hours of the morning. The nurses administered
something for nausea via my IV (I'm sorry I can't recall the name). If
it helped at all, I couldn't tell any difference. I later found out that
my grandmother also reacts the same way to anesthesia. By this point,
my neck was black with bruising, and every retch made me feel like my
incision was going to explode into a not-so-radical death metal album
cover. I was really glad to have my mother there to run about and bring
more barf bags, as I could hardly make it to the bathroom. I would
probably rate this as the second most painful point of the entire
experience, which hopefully any readers of this are able to bypass.
After the first night, I did not experience any further nausea. My
surgeon said that he was glad I didn't pop off any of the clips in my
neck during this time.
Recovery: Phelgm!
While
I was still under anesthesia, my ENT put another camera scope down my
esophagus to ensure there wasn't any trauma to my vocal chords. This
broke up a BUNCH of phlegm in my throat, and I started coughing up gobs
of it in the night. It was very difficult to cough up due to the several
bruising and trauma I still had to my throat, and I started having a
panic attack after a few hours of struggling to breathe. This was the
only point at which I took any pain killer other than Tylenol, after I
reported my pain at a 7. The phelgm itself obviously wasn't that
painful, but the pain in my neck was so severe that I was afraid I
wouldn't be able to expel it and choke in my sleep. I'm sure that this
wasn't helped by the fact that I had
vomited my guts up the night prior. My neck was just so sore, and I
was exhausted at this point. The nurse administered fentanyl via my IV
and brought me Robitussin. The fentanyl was a total life saver; it
relaxed me and my breathing quickly enough to get some sleep. I
continued to take Robitussin for the next day and a half until I felt
okay enough to stop. This also helped me sleep after a day and a half of
being up all night.
Recovery: Calcium Drop
I
would have been sent home earlier, but they ended up having trouble
getting my calcium levels up, which my ENT had anticipated prior (though
perhaps not to this extent). It was explained that he managed to retain
at least three of my parathyroid glands, which regulate calcium, but
that they had gone into "shock" after surgery and would take some time
to "wake up". The pathology report later indicated that only one gland
had been removed during surgery. My ENT told me that that meant I had
one or more still under my collar, which he says will not have any
adverse effect other than taking calcium supplements permanently. I
mostly bided my time at this point until I woke up one morning unable to
move my face, and with tingling in my hands and feet. This turned out
to be due to a severe calcium drop which was resolved by administering
calcium via my IV, but it was still a pretty scary experience.
Afterwards, and endo was called in to access me and started to prescribe
high doses of calcium until it was manageable enough for me to be
released. My ENT mentioned that it was only the second time he'd had to
call in assistance with this.
Recovery: Drains
At
this point, the nurses removed my drains and sent me on my way. I
understand that most will go home with them and come back for removal. I
just popped the bulbs into the gown or a jacket while I wore them. They
were a bit of a pain to manage while I was sponge bathing, but I set
them into the gap between the wall and a handrail, no biggie. The drains
were incredibly painful to be removed, but the pain lasted for the 2
seconds it took for them to be yanked out, and then quickly subsided. As
I mentioned, I had two drains installed due to the size of my goiter,
but I was told that most only end up having one. Frankly, I felt the
pain had been exaggerated a bit compared to the brevity, but it's better
to be prepared then caught off guard! I asked to take Tylenol
beforehand, but either way, just mentally prepare yourself and don't let
yourself hype it up too much. You'll be okay, really!
Recovery: At Home
All
in all, I ended up staying in the hospital for 4 nights and one day.
I'm now 8 days out from my surgery, and I honestly feel great! My scar
and drain scars have been healing great. I haven't been using anything
on them since I had a severe reaction to Aquaphor and Bacterin ( no
surprise there- I break out just looking at scented hand soap), but
they've been healing just fine without them. My mind feels like it's
starting to clear, and I have so much more energy than I used to. I've
been taking synthoid, magnesium, and calcium supplements at home. I'm
going in next week for my followup with my ENT and endo- hoping for a
good report! I'll update a little further out, too.
I'm
sorry that this ended up being so damn long, but I really wanted to lay
everything out for those who might be questioning or unsure, like I was
before. Obviously, there are a lot of weird factors/reactions that are
probably pretty unique to my experience, but I still wanted to include
them. I felt it pretty remarkable that I only took painkillers stronger
than Tylenol once throughout the entire process. Not bad, in my book!
Please let me know if you have any questions, and I'll try to answer
them to the best of my ability. Thank you for reading!!
TLDR;
I had a total thyroidectomy; experienced some pain/discomfort at a
minimal-average level; I'm happy with my choice and would choose it
again over RAI.
