Tuesday, March 25, 2014

Not Another Horror Story Part 3

Part 1 and Part 2 of the saga.

   Part 3 of the thyroid saga. Whee! So I left off at surgery being set for March 11 where they'll remove my whole thyroid due to Hashimoto's and a 3 cm nodule. Whee!
   Since Denver is about a 3 hour drive and I'd spend at least one night in the hospital and need to be at the surgeon's office Friday for a post-op check up, Fella and I decided to head to Denver the night before the surgery and stay in a motel till Friday. Given the distance and the price of fuel, it just made more sense to do that. Both of our jobs gave us time off until Monday, so we were good to go! And since I have an aunt that lives within 30-45 minutes of Denver, she met up with us Tuesday and stayed with the Fella while I was in surgery until the weather got bad enough that she felt it might be best to leave.
   Prior to surgery I'd searched the web and found quite a few forums and such discussing thyroid issues and surgeries and a large number stated how they wish they'd never had the surgery. Not exactly comforting when you're about to do it yourself. LOL. However, after some of the rollercoaster of medical professionals I'd been to, I can see why. You get the wrong person or someone screws up and you have a hefty price to pay for it. They cut through the vocal cords and you're pretty messed up from it emotionally and physically. They remove all of your parathryoids or damage them severely and you're on calcium supplements for the rest of your life. It's a good surgery when done well, and a nightmare if it isn't. I ended up with a general surgeon that wasn't sure she could do it, so she referred me to someone that does this all the time. How come I was so blessed, I'll never know. Most I can figure is that God has His hand in it and I'm not sure why.
   So Tuesday morning, day of surgery. I hadn't had anything to eat since the night before and nothing to drink (including water) after midnight. Not exactly my idea of a great way to spend the morning, but it is what it is. Glad I hydrated myself well the day before or that'd have been hell since my surgery wasn't until 1:30pm. We didn't have to check in at the hospital until 11:30, so my aunt, The Fella, and I went over to Denver's Museum of Nature and Science and did a quick 2 hour stroll through there. Great way to get your mind off of things and it was neat to see a lot of the stuff in there. Headed over to the hospital, found a spot to park, and went to get checked in. Got all of that taken care of and left Aunt and Fella in the waiting room so that the nurse could weigh me, measure how tall I was, have me change into the hospital gown, get my IV started and they could do whatever other pre-surgery stuff they do. Talked to the surgeon for a few and after she left, Aunt and Fella got to come hang out with me for a bit. They did the pre-surgery pregnancy test (no surprises there!), got me entered into the system, we met the anesthesiologist (who was awesome!), and after a bit they wheeled me into the operating room. I vaguely remember talking with the nurse and anesthesiologist after getting on the table and next thing I know someone is trying to wake me up...
  I was hearing "Casey? Are you awake?...Are you with us?..." I tried answering, but it wasn't working so well, so I gave them a thumbs up. LOL. Then I sort of remember hearing the surgeon tell me a few details from surgery and I was fighting to open my eyes and keep them open. I remember being in a little bit of pain. No idea how long I was in the recovery room, but after some time I managed to come to enough that I could keep my eyes open better and someone asked if I wanted some water. I croaked out a yes and managed to get a sip of water down without choking. I don't remember the trip to my room, but I woke up again or became more coherent there. Not sure which. LOL. I wasn't in my room for very long with Fella came in. He said my aunt left early due to the weather (it was snowing and flurrying some), but wanted him to let her know when he saw me and how I was doing. They more I sat there and interacted, the better I did and it helped when I got more water into me. The more I croaked, the better my throat started doing and I started clearing out some of the phlegm. Fella mentioned what the doc told him (which matched what I vaguely remember her telling me). Here are some of the things I noticed after surgery:
  Effects of Anesthesia:
   I wasn't cold. At all. I couldn't figure out why Fella was constantly asking if I was cold...and why he got his coat after awhile. After the anesthesia wore off, I realized why-- the room's thermostat was set at 60F. Oops?
   TMI, but the first couple of times you have to pee, it's kinda tough. You *know* you have to go, but it takes a bit to convince your bladder to cooperate. Once you get enough water in your system, that'll clear out the anesthesia and you'll be more "normal".
   I wasn't sick which surprised me. When I had my tonsils removed when I was 5 or 6, one of the few things I remember was throwing up. This time though? I wasn't nauseous and felt just fine. Woohoo!
    When I was sleeping while it was still pretty well into my system, I'd quit breathing a little when dosing off. Nurse said that was a normal side effect, so when you jolt awake, just calm down a bit and take some deep breaths. Once the anesthesia cleared out more, I didn't have an issue with it.
 Effects of Breathing Tube and Oxygen Thing in Nose:
    Sore throat, but not horrific. Between pain killers and Cepocal lozenges I did ok.
   The phlegm. You will cough up some weird gunk. Just go with it and try and be careful when coughing because it does hurt some. You'll be doing this the next few days, so just roll with it. They give you this spirometer thing that they want you to use. Do it. It'll help with clearing that gunk out and keep it from settling int and becoming an infection. And if they let you take Mucinex, that helps too. Between that and lots of water, it'll help clear it out pretty well. Mucinex and water will thin it out a bit too and if you have sinus issues like mine, you'll want what help you can get.
    That oxygen thing in your nose? It will dry your sinuses out. Denver air is pretty dry anyway, so after a bit my sinuses were parched, cracked, and bleeding a little. Nasal spray or a sinus rinse/neti pot will help with that. I was kicking myself for forgetting my NeilMed sinus rinse kit because the nasal spray just wasn't getting it and boy were they unhappy!
   Recovery wise in the hospital, I did pretty well. My throat hurt some, so I hugged my ice pack...I hugged it a lot. LOL. Swallowing stuff hurt, but it was manageable if it was soup or soft food. I didn't keep up on my pain meds as well as I should have and the next day when they were discharging me and with all the commotion, I really let it slide. Bad idea. Try and keep up with it if you need the pain meds. I regret not doing that. I took the initiative to make sure I got up frequently. Partly because I had to use the bathroom, partly because my butt hurt from sitting mostly straight up. Uh, ouch. The nurses showed me how to turn the compression cuff things on and off and how to connect and disconnect the hose things and how to silence the O2 monitor temporarily so that I could use the bathroom or move around some without them having to come in all the time or see why my O2 monitor thing was making a lot of racket. LOL. It was nice to just know I had that little bit of freedom if I wanted it and could call them if I needed something if I missed them when they were checking in. Oh, and I had a drain in my neck too. That wasn't too bad though. I usually didn't notice it at all unless I accidentally move my hand or the ice pack across it and caught it.
  Next morning, Fella came back to hang out and the doc came in a little later. She went through what she did and found in more detail. The thyroid was way more inflamed and scarred because of the Hashimoto's Way more scarred than what the ultrasounds were showing. She ended up taking about an orange and a half sized thyroid out of my neck. Obviously, that isn't normal. LOL. 2 of the parathyroids were just fine. Once she had to cut out of the thyroid and moved to the muscle on the left side of my neck and it should work in time. The other parathyroid, well, she isn't sure if the thyroid ate that one or if it was hiding in my inflamed lymph nodes. The lymph nodes were really, really inflamed which is why I felt like crap all the time. And because of the size of the thyroid, nodule, and the weight of it, it was beginning to damage the cartilage of my trachea. It thinned out a small bit of a couple of the rings of my trachea. Not bad, but enough that there'l always be a little bit of a weak spot there because of it. Heavy exercise is probably the only time I'll really notice it. My calcium levels weren't bad and they were going up, so that was good. I was at 8.4 before I was discharged and she was hoping they'd be 8.6. They still decided to release me since I was in the area and had an appointment on Friday.
  When we got to the motel after they discharged me, I was in some really bad pain. And because I had been hunching and due to how they position your head while in surgery, my shoulders and the back of my neck hurt really bad. Fella got me some heat packs, so that helped a lot! Over the next couple of days stuff improved and stuff wasn't as stiff and painful.
  Friday, the surgeon removed the steri-strips, took out the thin thread of a suture they used, and put on a new steri-strip and told me to leave it for 2 weeks before taking it off. We went over some stuff (like take the 6,000 mg of calcium until they get my calcium results back) and were on our way home to Nebraska!
   Monday we got the calcium results back-- 9! I was able to halve the amount of calcium I'm taking from 6,000 mg to 3,000 mg and will have to take it for the next 6 weeks. And the pathology stated that there was Hashimoto's and the nodule, but no cancer which was what we wanted to hear. YAY!
   So far I've healed up pretty well. It took me about a week from surgery to regain full range of motion in my neck again and I've not had any side effects. The hoarseness is pretty much gone. Unless I talk a lot for a long time or try to sing, I do just fine. I've done really well with taking the levothyroxine and haven't had any troubles with that so far. We had an appointment with the Endo on the 19th of March and he said we'll test my blood mid-April and see what adjustments we need to make. It'll take some time to get the levels right, but it's been 2 weeks after surgery and so far I feel great. Now that the inflammation is gone I actually have energy. I can breathe normally and turn my hear without any trouble. I feel more like me, not crap heated up and walking around. And for that, this was definitely worth it.
       

Not Another Horror Story Part 2

 Part 1 of this post is here.

   I mentioned in the previous post where I started with noticing issues and what happened to me. I split the post into two parts because I didn't want the monster post to be a book and because there really are two parts to it. There was a bit of time where I didn't do anything about it. Too many other things going on and the ENT pretty much told me he didn't want to deal with it unless something new developed. I left off with the ENT visit in mid-late April...
   My fiance immigrated over the beginning of September, we married the end of September, went on a honeymoon the first week of October, and started adjusting to life as a married couple that had spent more of our relationship on opposite sides of the world. We'd been through a minor holiday, a major one (Thanksgiving), and were getting to celebrate our first Christmas together. Fast forward to mid-December.  And I was fed up with the thyroid and nodule. Not sure when the inflammation started to never change or when the hoarseness really started to stay more than go, when I started to get tired and never regain my energy, but somewhere along the line it took hold and didn't go away. It was worse. I couldn't sleep well because I couldn't get comfortable enough to sleep at night because it felt like I was being choked. I always felt like I was in that pre-cold/flu stage where I wasn't actually sick with something, but felt like I was coming down with something. I had no energy, heck a lot of times I was coming home and would nap on the couch, then sleep the whole night through, and wake up still feeling tired. I knew my neck was more swollen and it always looked (to me) like I'd swallowed a rat and it got stuck. I decided screw it. I'd met my deductible with insurance for the year and we were still on the same plan (not an ACA compliant one, but with the extension we could keep it for a little longer), so I decided to heck with it. I'm going to see what I can get done.
   I made an appointment mid-December with another of the PAs and my hubby and I went in. He didn't have his Employment Authorization Document yet, so he couldn't work and wanted to be there. I'm so grateful he was. Anyway, we explained what was going on to the PA she agreed that the thyroid was definitely enlarged. She asked if I'd been to see an Endocrinologist. I'd told her no and that was the end of it. Another ultrasound and another TSH and Free T4 test later we determines that my thyroid levels were normal and the nodule was unchanged (although, now I was hearing 3 cm, so I'm not sure what was up with that). She conferred with the ENT and he told her that since my levels were normal, that it wasn't an issue and he personally wouldn't do anything about it. Uh, yay? That still didn't explain a few things though. So I requested a copy of my blood tests because I wanted to see the numbers. Turns out back in March, my TSH was way on the high end of normal and their range was .34-4.82 and I was at a 4.49. my Free T4 was a bit high, but not out of range as well. It was .94 and the range was .59-1.17. In December my TSH was better at 2.56 (same range) and my Free T4 was up to .99. Apparently something got my TSH back down to a better part of the range, but it still didn't explain why I felt like crap. I was a bit desperate at that point.
   Well, Christmas came and went, so did the new year. I still felt like crap and wasn't getting any better, so almost a month after the appointment in December, I was making another. By that time I was kind of a wreck. Work has been a bit stressful, I felt like crap, I wasn't getting any help outside of "Well, wait and see if it goes away. These things take time, sometimes up to a couple of years." By this time The Fella had gotten his EAD and applied at a place and we were waiting to hear back, but hadn't. I was starting to get depressed. I had a headache that was there fairly frequently and just really wasn't doing well, both physically and mentally. I made one appointment, we went over to the clinic to check in and the doctor I was seeing was called out on an emergency and I would have to reschedule with him or someone else. Rescheduled the next day for a different doctor. Thankfully, this time we were able to keep the appointment and no one was called out. We told her what was going on and got the recurring question of "Have you been to see an Endocrinologist?" and told her no, no one had referred me. She decided that that might be a good place to start. She didn't know what was up, but it didn't seem like a thyroid problem, so she thought the crazy expensive bloodwork he'd do would give us an answer. About 10-15 minutes in the office. I'm seeing a trend with the docs around here I think. You spend a lot of time waiting and then see them for 10-15 minutes, then you're gone. Oi. Anyway, she set me up for an appointment with one nearby for the following week.
   We made it up to the clinic for the appointment and met with the Endocrinologist. I guess he hasn't been in the area long, the doc pointed out that they had a new one at that particular facility, but after meeting with him, it was a breath of fresh air. First thing he asked me was why I thought it was my thyroid. Pretty blunt, to the point, and kinda surprising when you aren't expecting that. I told him what I'd been going through, how I was feeling, etc. His next response was that he didn't think that was my thyroid because the changes in being too cold and too warm and a few other things were too quick. He explained that they thyroid is an organ that slowly changes stuff. It'd be stuff that happened over the coarse of several weeks, not every other week or so. He said he had an ultrasound machine in another room and asked if I was ok with him taking a look at my thyroid himself so he could see what might be going on. I was totally ok with that (someone was actually listening and considering what I said and not immediately dismissing me, WOOHOO). I'm laying on the little bed while he's doing the ultrasound and he doesn't say anything. Not one word. He lets me know he's done, grabs some tissues so I can wipe the goo off my neck, and asks if anyone has ever told me I have a very unusual thyroid. I told him I hadn't been told that and made a comment about this not being in my head then? He chuckled and said maybe not all of it. We went back to the first room we were in and he explained that there were some things he didn't have and answer for, so he did want to do some bloodwork. What he could tell me was that I had some very strong visual indicators of Hashimoto's Thyroiditis and that the nodule was a good size and near my collarbone, hence why it was bothering me. It was just in a bad spot and it was big. He couldn't believe it was still functioning, actually. It looked that bad. He didn't think it'd continue functioning for too many years though. He said while it was enlarged, he didn't see the type of swelling I was talking about, so next time it happened I needed to call and he'd get me in to look at it. The Fella and I were both just happy that someone was taking me seriously and actually acted like they were interested in helping. This was HUGE for us!
   Got a call about a week later with the results--normal! I was confused. Nothing was mentioned about the 2 thyroid antibody tests, so I was doubly confused. This seemed promising. Well, later in the day it felt like my neck was swelling again, so we called to see if he could get us in. He was as good as his word and got me in that afternoon. I left work early and headed up there with The Fella in tow. Earlier that morning he got a call from the place he applied at and they wanted him to come in for an interview that Friday! Anyway, the endocrinologist ultrasounded my thyroid again and didn't see any noticeable change and wasn't really sure why my neck was swelling like that. One theory was the change in fluid levels since the nodule is cystic with some solid components. He said that given how I felt and with the discomfort I was obviously having, he definitely recommended having the right side removed, possibly the whole thyroid if I was ok with that. Fella and I were both totally ok with that and then he brought up how he generally refers people to the ENT. Yes, that ENT. The one that travels down to the clinic I go to and had seen in April and the PA consulted with in December. Fella and I were polite about him, but stated we'd already dealt with him before and were told he personally do anything about it and asked if there were other options (part of why I'm so grateful for the Fella is that he is more than happy to speak up for me about stuff and support me when I'm worried about burning bridges). The endo stopped a moment and said there are other people. There's a general surgeon that's a lady if I was more comfortable with her and thankfully didn't push the issue. He said it's my neck and I definitely have a say in what goes on there. He wasn't so sure that the inflammation would ever go down. If I was this uncomfortable right now, having some or most of it removed would be a good idea. He thought that with only have removed that it might help, but thought there was still a good chance I'd be on meds anyway given how the thyroid looked and that it'd most likely quit working in the next few years anyway. So, he called the general surgeon's office and said we'd hear from them within the next few days. It wasn't an hour later and we got a call from them saying that she only does consults on Fridays and wanting to know which Friday worked for us. They had an appointment open for 9:30 which gave us time to meet with her, then head back home so Fella could make his interview. Finally some progress!
   We met with the general surgeon Friday and discussed what was going on. She agreed that this definitely needed to be taken care of. What got me is that at one point she looked at me and said, "I don't think you're scared of the surgery. You seem ok with that and have mentally prepared yourself for it. You just want someone to help you and you don't feel that you're getting that. Am I right?" Boom. Dead on observation. After emotionally choking out that yeah, that was indeed the case, she explained what she'd do, what the complications could be, recovery, etc. She was confident with the surgery, but wanted to do the right lobe first to make sure nothing was damaged and then do the left lobe later. Sounded pretty reasonable to me. We set up a time 2 weeks later for surgery and were good to go! And while I wasn't excited about the ENT assisting, I was willing to bury the hatchet and move on.
   Tuesday, the day before surgery-- We're at the office I work at, Fella got his job ans was supposed to start the beginning of March, and prepped to head up to the city a couple hours away since surgery was early the next morning. It's mid-morning, I'd gotten a lot done before I needed to leave and was finishing up a few things when I got a call from the surgeon. She said that she'd really been thinking about this a lot lately and the more she thought about it, the more uncomfortable with the surgery she was. She said due to the particulars of my case, she was worried that she might damage something and that was the last thing she wanted to do to me. And while she hated to tell me that and make me feel like I was being passed around, she felt it was the right thing and wanted to know if I was ok with being referred to someone that does this far more frequently than she does and specializes in it. While extremely frustrating, I did (and still do) agree that that was a good idea. I like her, but if she isn't comfortable with it, then referring me is a good idea. She asked which direction I wanted to go-- Rapid City, South Dakota, Omaha, Nebraska (figured that was a bit far), or somewhere else. I asked her to see what was in Denver, Colorado since that's about 3 hours from where I'm at and it's big enough to have a number of doctors that might handle this. Got a call a little later saying they found a lady in Denver and that they were faxing stuff over there. Her office would call within the next few days.
   Well, a few days later, there was still no call. So I called the surgeon's office making the referral. Turns out the fax didn't go through, so they had to resend it. LOL. A little delay, but not bad. Heard back the next day and the office in Denver set up an appointment and wanted me to get copies of the bloodwork from the endo and fax it over. Got that taken care of and lo! while reading looking at the tests, it turns out that the antibody tests showed positive for Hashimoto's. I guess the endo figured that since he told me I had Hashimoto's before the test, that part didn't really need to be revisited. Not sure. Either way I knew and had copies of stuff. LOL. I got a copy of the ultrasound images from March 2013 and December 2013 for them and the general surgeon sent me the stuff from the biopsy to take to Denver. Whee! In this time, the Fella started work the last week in February and since he was working nights could come with to the appointment. His workplace was awesome about letting him take time off for the surgery since we let them know we had medical stuff for me when he interviewed.
   March 5th and it's the day of my appointment in Denver! We found the office pretty easily (had more trouble finding where to park) and waited a bit before heading in since we were a bit early and they were on lunch. After killing a little bit of time, we went to the office and checked in. I forgot to mail the discs down, so the doc checked those out while we did paperwork, then went and sat in one of the rooms while she glanced over a few more things. The vast majority of the office was introduced (it's not very big), so we got to know most of them and could ask any of them anything we needed to. The doc came in and we discussed what she saw with all the stuff she looked over. She said it was obvious I had Hashimoto's. You could see it in the ultrasounds and didn't really need to do the antibody tests unless you wanted to have that confirmation as well. Then we discussed options--Partial or whole thyroidectomy, the pros, the cons, the maybes, the treatment options, recovery, and what she thought. A lot of what she said matched the endo, so it was good to have confirmation that one or both knew their stuff and were in agreement on it. Apparently, my nodule was tucked under my collarbone a bit which is why I was rather aware of it. It was stuck and had no way to really move with my neck when I'd turn my head. Heh. No wonder I was having troubles turning my head to the right comfortably! I opted to have the whole thyroid removed. Due to how ratty the left lobe looked, she said it was very likely I'd still have to take meds anyway and they'd still have to monitor the left lobe almost yearly to make sure it was still working, there were no nodules, etc., but then they wouldn't have to worry about damaging all the parathyroids. I only need one that works, but the more of the 4 that work, the merrier. I was sick of dealing with the whole thing, so I said to take it all. We set up a time for March 11th, then got my blood drawn for Vit D and went home.
   I was originally going to add the surgery in this post, but for the sake of how long it already is I think I'll do one that's dedicated to the surgery and recovery.

Not Another Horror Story! Part 1

   One thing I've come to realize is that most everything I've found online regarding thyroidectomies is that most of the stories are horror stories. I'm not saying there isn't good reason for that-- I'm pretty sure there's a perfectly good reason for this--but not everyone that goes through this has a terrible story to tell about it. I think the access to people familiar with these issues are surgeries is a big part of why there are a vast amount of not so good stories online and with living in the panhandle of Nebraska and after what it took to get to where I am now from where I was last year, well, I can see why people run to google and hope for the best with their own surgery after reading stuff online.
   My own story started the end of February 2012. I made some pretty awesome calzones out of some homemade bread dough for dinner that night. Mmmm. Toward the end of dinner I was taking a bite of the calzone and some chicken hit the floor...so, I leaned over to pick up the food on the floor. While leaning over, I swallowed the bite I had in my mouth. Nothing unusual with that, except for the fact that I suddenly felt something move on the right side of my neck near my collarbone. I'll admit I freaked out quite a bit about it. Stuff moving in your neck is *not* normal. It's creepy as heck actually. Once I calmed down a bit, I texted a friend whose husband had been through EMT training for the local volunteer EMS service and asked if they'd be willing to come over and make sure it wasn't something that required an ER visit and could wait until morning. (Hey, you feel something move in your neck and tell me how well level headed and clear minded you are after that. lol) They came over with another friend that was an EMT as well and checked my vitals, poked what was definitely a small lump, and asked some questions. We decided the spendy ER visit wasn't necessary, friend hung out for a couple of hours to make sure I was definitely ok, then I headed for bed. Didn't really sleep well that night, but I gave it a good go.
   Next morning I told the bosses what was up, made a doctor appointment, and was in the local clinic mid-morning. Great way to start off the month of March. Sitting in a clinic with a PA (Physician's Assistant) and telling her what happened the night before. After a bit of discussion and some neck poking, she determined there was definitely something not right and my thyroid seemed a little enlarged. I wasn't feeling any pain though, which puzzled her. She checked the schedule for the ultrasound and asked what worked for me to have it done. My bosses are pretty lenient about letting us employees take care of health issues as long as we let them know we're doing it, so I told her the first available opening she could get me in-- that afternoon. After having the ultrasound done and getting the results back on it later (gotta love the URGENT note on there), she had me come back to get my TSH and free T4 checked. There was a good sized nodule on the right lobe, about 2.7 cm or so and my thyroid was inflamed. She told me to take Aleve (Naproxen Sodium) a couple times a day for a week and ice it if I thought I needed to so we can see about bringing down some of the inflammation and she'd get back to me Monday or Tuesday when she got the blood results back.
   One thing to note-- try to get copies of your tests. You might not understand them, but it's always good to be informed as to what your levels are and what the outcome of something was. That being said, I didn't get the numbers for my TSH and Free T4. I was told they were "normal" so I trusted that and went with it. They were technically in the normal range...but on the higher end. I'll get to that bit later though. At some point during that time, we set up an appointment to have a fine needle biopsy done on the nodule the 14th at a hospital a couple of hours away.
   March 14th, 2013-- morning of the biopsy! I don't have issues with needles. As long as I don't watch them go in, I'm perfectly fine. I have a tattoo and several piercings. I was never bothered by needles then either. I loathed that biopsy though. The actual procedure itself wasn't bad. I just really had issues with being able to feel the needles move through the tissue. Not cool. Not cool at all. They do numb you with a local anesthetic, but you are pretty dang sore after that. My neck hurt until the next morning. Ouch. And turning my head? Not good. I'm glad I thought ahead and asked a friend to come with to drive in case I couldn't. I totally needed her help on the way home and it was nice to have some support.
   A few days later I got the results back from the biopsy-- benign (YAY!). PA asked if the Aleve helped with the inflammation. Not really. So, she prescribed me some steroids to see if that helped. I'd never taken steroids before, so I'll hit on that briefly--it made me ravenous. Now, I generally have a pretty good appetite which just befuddles people because I'm pretty tiny. I don't look like the kind of person that can eat a whole lot. I can...and I definitely did while on the steroids. And while on them, I was pretty willing to eat stuff that I later decided really didn't taste very good. While on the steroids those frozen Del Mex tamales tasted like heaven! After the steroids? Jeebies. Please tell me I did not eat those willingly. ROFL. Hot flashes? I totally had those. Restlessness and needing to be constantly doing something? Oh yeah. Lack of concentration? I had that in spades. Not fun. Worst thing was the morning I almost passed out in the shower though. Not sure what brought that on, but I started noticing that my hands were tingling and I was getting a rushing waterfall sound in my ears that wasn't from the shower. Started to see a few spots and the lightbulb went off that I better get down before I fall down. So, I sat down took some slow deep breathes and soon enough the feeling went away. I guess I know that steroids and I don't really mesh well. After a week of those, I called the PA and let her know that while they did help some, there was still inflammation...or so it seemed to me. She set up an appointment with the ENT for one of the next times he was down (about a month later).
   About a month later-- ENT appointment! It's mid-April. Since the initial diagnoses of thyroiditis and a nodule, I'd been keeping a mental list of what I had noticed. Issues turning my head, feeling like stuff was caught in my throat a lot of the time, etc. Met with the ENT that morning. I was told to show up about 30 minutes early to fill out paperwork since he's a visiting physician. Filled out a crap-ton of stuff, went back to a room, talked with the nurse. She was having a bit of trouble with the computer and couldn't seem to get the ultrasound to pull up in there. She went and conferred with the ENT and about 5 minutes later he came it. Let's just say that appointment didn't go well in my opinion. I have no idea to this day if he ever saw the ultrasound. Not sure if it'd have made a difference one way or the other if he had or hadn't. I was in the office no more than 10 minutes. He asked about my symptoms. I told him what I had going on. He felt the nodule and this is part of where I have an issue with him. I'm pretty petite. At 5 ft 4 in and at the time about 115 lbs, you do *NOT* need to press hard enough on that nodule that it feels like you're trying to pop it out the back of my neck. It hurt when he did that. I'm not normally quick to cry, but that was almost enough to make me cry. Then he sat down and basically told me that I didn't need surgery, he didn't see any swelling, just come back in a year and have the bloodwork done and an ultrasound done. If the nodule has grown significantly, they'll biopsy it again. If it started to hurt, then come back in ASAP. Then asked if I had any questions. I asked him several times-- what do I do about the swelling? His response, "What swelling? I don't see any swelling." I told him that the PA recommended taking NSAIDs and icing it. "Oh, I suppose you can do that if you think you need to. But I don't see any swelling. Someone *thought* they saw swelling on the ultrasound, but there's no swelling." I was pissed. My appointment was at 9:50am. I was out of the doc's office about 10:10am.  20 minutes in the room and most of that spent with the nurse or waiting just to be told, "I don't see any issues. You have a bit of a big lump there, but it's nothing." While I get that surgery isn't and definitely shouldn't be first resort, I'd like to hear a lot more than "Ignore it and come back in a year." I was having some issues with feeling like there was something caught in my throat and had trouble turning my head to the right because I could feel the nodule or muscles catch. I was starting to experience hoarseness at that time as well. Needless to say, I wasn't impressed with that appointment and really didn't get off to a good start with the ENT.
   After that, I kinda got caught up in some other stuff involving work, planning the wedding, messing with immigration stuff (keep in mind, my fiance was still in Germany during all of this), and a bunch of other stuff. So with being told to wait for a year and having other stuff to deal with, I just sat the medical issues on the back burner for awhile. It doesn't mean they were gone, just not top priority.

Monday, March 24, 2014

Rather Delayed Update

   Well, it's been awhile. In that time, The Fella got his employment authorization document (Early January 2014), got a job, then got his green card! Whee! It's been quite a ride lately. And best part-- he's eligible for health insurance and other benefits at the end of this month. YAY!

   The other major thing that's come up is having my thyroid removed. Not sure if I mentioned it in a past post, but I found out in March of 2013 that I had a nodule on the right lobe of my thyroid and was told "possible thyroiditis". I was prescribed steroids for a week, then told to take Aleve for a week. I had a fine needle biopsy done on the nodule shortly after stopping the Aleve and found out it was benign. Still had some troubles, but with all the immigration stuff and wedding planning (amongst other things), the thyroid thing took a back seat until a couple months after the wedding. Then, I just couldn't handle it anymore. I was tired, my neck was uncomfortable. I was having difficulty breathing (always felt like something was stuck in there and made it difficult to get comfortable at night to sleep). Stuff like that. Yet on the other hand, I wasn't experiencing many of the symptoms of being hypo- or hyper-thyroid. I was really cold a lot of the times (not totally out of character for me) and I started always feeling like I had a cold or the beginning of a really bad cold. I finally decided to go in in December. They ultrasounded they thyroid and nodule again and checked my bloodwork again. All of my stuff came back normal. No idea why.
   In January, I was *really* fed up, not feeling great, and was sick of dealing with it. Went back to the doctor and she referred me to an endocrinologist. In the end, that was one of the best things that could happen. Talked to the Endocrinologist the end of January and he did some more blood tests and did a quick ultrasound at his office. Consensus-- I have Hashimoto's Thyroiditis and the recommendation was that due to that and the fact that the thyroid was rather enlarged and inflamed (because of they thyroiditis) and wasn't going down and that I had a 3 cm nodule; it was recommended that I have the right side of the thyroid removed...at the very least. A total thyroidectomy was recommended if I was willing to go that route. Got a referral to a general surgeon and saw her a few days later.
   Well, we saw the surgeon beginning of February and set a surgery date for the 19th. The plan was to remove the right side, make sure the Recurrent Laryngeal Nerve and my vocal cords were undamaged, then do the left side at a later day. Whee! Well, that was until I got a call from the surgeon the day before surgery saying that the more she thought about the particulars of my surgery, the more uncomfortable she was with it and wanted to see if I was ok with a referral to a person that does this surgery all the time. So, they found a person in Denver that does this and referred me down there.
   So, at the beginning of March, The Fella and I found ourselves in Denver consulting with the surgeon. And much to our joy, she was friendly, informative, listened, and was totally ok with doing this surgery. It was brought up again that I could have half the thyroid removed or all of it. She discussed the pros, cons, and maybes of what both entailed and what I had to look forward to as far as surgery and complications and what options I had for medicines and treatments. By that time, I was totally fed up with the thyroid, how crappy I felt, and was ready to be done with the whole thing. So, after a bit of discussion the plan was made to remove all the thyroid...the next week.
   March 11th was the big day! Went to Denver the night before, met up the next morning with one of my aunts that lives in the area to check out the Museum the next morning before surgery, then headed to the hospital to get checked in. Surgery went splendid! There were a few surprises, like the fact that my thyroid was more scarred, enlarged, and otherwise in rattier shape than they thought. My lymph nodes were really inflamed since my body was attacking (and had been for quite some time) the thyroid and trying to kill it off, and there was a small amount of damage done to the cartilage of my trachea. Not much, just a bit of thinning on a couple of the rings, but enough to weaken that spot some. The surgeon said she was really glad I decided to have it all removed at the same time because of that. They managed to save 3 of the parathyroids for sure (not sure what happened to one of them) which is awesome! You only really need to have one functioning one, but as she said, the more she can save, the better off I'll probably be. The parathyroids control your calcium levels. So if you don't have any, you're on calcium supplements the rest of your life. Not exactly and ideal thing. Anyway, after I got out of recovery (vaguely remember some stuff from when in there, but not much) and got to my room and kinda rejoined the world on the same mental plane of existence, I was doing pretty ok. Sore and in pain, but not doing too bad. Spent the night in the hospital and was released the next afternoon. The first few hours out of the hospital and some of the next day were CRAP. I didn't keep up on my pain meds when we were getting the discharge time worked out, so I was in some serious pain when we finally got to the motel room. Popped 2 Norco, then snuggled with my favored ice pack and a couple of heat packs. Ice for the surgery site, heat for the back of my neck and shoulders because holy crapola did they hurt! Some of that is from how they have your head positioned during surgery, some is from hunching after surgery as a form of comfort and protection for your neck. Heat packs are your friend. Oh, and definitely sleep as upright as you can handle. Trying to get up from laying on your back hurts and if you're like me and have sinus issues anyway, laying down after they've aggravated your throat with that breathing tube is a bad idea. Gunk will drain and collect near the back of your throat which is not fun. Especially since you're coughing up gunk anyway.
   Fast forward to Friday-- post-op check up with the surgeon that morning because she wanted to take out the thin suture she used and steri-strip the incision. She did that so that I'd heal up with a less noticeable scar since I apparently have very fair, light, delicate skin and no wrinkles to hide a scar in. I'm just so happy to have the thyroid gone, that honestly, as long as it didn't look like someone did a botched job of cutting my throat then I was good with the dissolvable stitches or a suture like what she did. LOL.
   As of tomorrow (Tuesday, March 25), it's been 2 weeks since surgery. And I feel *GREAT*. I'm sure I'll come off of that as my natural thyroid hormones fade out of my system and I'm totally dependent on the synthetic hormones. But honestly, the fact that I can breathe normally again, swallow without hindrance, and move my head to the right comfortably without feeling a nodule catch, those alone are worth this. I've seen some pretty horrific post-op horror stories about this, but I didn't run into that with mine. It pays to have a good surgeon, I'll grant that. I honestly think if the first surgeon did it, I might not have had as good a recovery as I did. It took almost a full week after surgery to completely regain my range of motion with my neck, but with a bit of stretching and gently moving my head around I got the full movement of my head with no trouble at all. I still have to keep the steri-strip on until Friday, but from what I've seen of the incision site so far, it looks like it's healing up really well! YAY!
   And that really long post is pretty much what's going on around here so far. LOL.