When it rains it pours. That’s been my life in 2009. This year will go down as the year that my life was turned upside down and rebuilt from scratch. Not only have I moved to a new town and changed jobs, but I’ve had my share of medical issues. My left ACL was torn and rebuilt, I took a silly fall which resulted in a small scratch that turned into a huge infection, and now I will be having a thyroid lobectomy.
Lets rewind to 6 years ago. It was the end of the school year and I was visiting a doctor (a PA to be exact) in Boulder because I had an unimaginably painful sore throat. While I was swallowing, she noticed a small lump in my neck. She said, “Do you have a thyroid nodule.” “Huh?” She recommended I get the lump checked out by the Boulder Medical Center’s endocrinologist.
So, I did. The endocrinologist I saw there was an unpersonable old man who had a very matter-of-fact way of treating a thyroid nodule. He basically told me that I had a tumor in my thyroid, which may or may not be cancerous- like it it was no big deal. As I spiraled through the emotional roller-coaster of how this was going to impact my life, the doctor decided to do biopsy. He told me it came back with only cystic fluid, so the tumor must be benign. But then he came out with this- “Oh, but you need to take thyroid medication for the rest of your life.” Typical doctor. Like it’s no big deal I’m on some medication for the rest of my life.
He put me on Synthroid, a thyroid hormone. Basically, he was treating me with thyroid hormone replacement therapy. Your thyroid produces hormones which are eventually involved in regulating your metabolism. By replacing this hormone, a message is sent back to the thyroid that there’s enough in your system, so it doesn’t need to produce as much of this hormone. Essentially, the thyroid barely does any work anymore. It’s put on retirement. The theory behind this is by preventing the thyroid from having to do much work, the thyroid nodule will hopefully keep from growing any larger.
So, I stayed on this plan for a number of years. But the move to Crested Butte made me seek out new health insurance and new doctors. In June, I saw Dr. Maruca, an endocrinologist located in Grand Junction. He took one look at my old medical records and basically told me they were a load of horse-crap. My old endocrinologist simply didn’t keep good records. There was no record of the original size of the tumor, to compare and see if it was growing. And I distinctly remember doing two biopsies in Boulder, yet record of the second had mysteriously disappeared.
But, the worst news was that my old biopsy was in fact inconclusive. Dr. Maruca explained to me that to have a true idea of what is actually in a thyroid nodule, solid components need to be obtained from five different sections of the tumor. Well, I remember the biopsy needle poking into my neck five times (how could I forget that!), yet it came back with mere blood smears. There were no solid components. So, in essence, whether the tumor was malignant or benign was inconclusive. Yet, my doctor at the time decided to tell me it was benign. Because of this, Dr. Maruca suggested that I have another biopsy. Believe me, I wasn’t thrilled about having a needle poked into my neck five times again. But, I saw the value in it. Plus, due to my ACL surgery earlier this year causing me to meet all insurance deductibles, the otherwise costly biopsy would be basically free.
I did the biopsy and then went home. I kind of put the whole thing out of my mind. Though, I was expecting a phone call. But, doctors rarely call when things are fine. They just don’t. So, that’s what I assumed was going on. I assumed my test results were fine. But then one afternoon at the end of June I checked a message on my voice mail and it was Dr. Maruca himself. “This can’t be good,” I thought to myself. So, I called him the next morning.
Dr. Maruca basically informed me that the results of my biopsy had come back from the pathologist having a specific kind of cell that may or may not be cancerous. He went on to explain that you can’t tell if this cell is cancerous until you take a larger sample, which would involve thyroid surgery. “There’s about a 1 in 20 chance that it’s cancerous,” he said, “I think you should just have your whole thyroid out.”
The thought of having my whole thyroid removed was not new to me. This was presented to me as an option by my old endocrinologist, although he did not recommend it. Thankfully, I was able to work past Dr. Maruca’s matter-of-fact statement that I need to have surgery to remove my whole thyroid and ask the right questions. He investigated my medical records further. And I did some research on the Internet. With all that is at stake between cancer vs. my metabolism being messed up sans-thyroid I decided that the best route for me was to have a partial thyroid removal.
Today, I visited Dr. Harthorne, an otolaryngologist/surgeon in Grand Junction who will be performing my surgery. I was able to set a surgery date- it will be Monday, August 3rd. And he was able to answer the last few remaining questions I had about the procedure. Based on the research I’ve done and what Dr. Hartshorn explained to me, I will do my best to explain the procedure.
The surgery is done with general anesthesia. They pump your neck full of saline, so this can make your neck very sore. But, this allows them to make a smaller incision which will scar less. The saline will be used to expand the working area. They will take great measures to protect my parathyroid gland, which regulates calcium levels, and also my vocal cords which can easily be damaged in this surgery. The surgery will last somewhere between 1.5 – 3 hours.
The thyroid is divided into two lobes on the right and left side of your neck, connected by something called the isthmus. Since the tumor lies my left lobe, this half will be completely removed. Thyroids are a unique organ in the sense that they have a huge blood supply. Blood is always being fed to the organ. This makes removal of a partial lobe basically impossible. They can’t remove just the tumor itself because the thyroid tissue around it will bleed too much. This internal bleeding can cause a lot more problems than actual removal of the thyroid itself. So, if a tumor is found in a lobe, the whole lobe must be removed.
Remember, the reason why they are removing this left thyroid lobe on me is to be able to take a better look at the tumor. They want to determine if it’s cancerous or not. So, they will take out the lobe, remove the tumor, instantly freeze it, and then slice it. This is called a “frozen section”. They will send this frozen section down to pathology where they will run tests to decide if it is benign or malignant. If it is malignant, the other half of my thyroid will need to be removed, on the spot. If the tumor is benign, or even if it is questionable if it is benign or malignant, they will leave the right half of my thyroid in tact. Here, there is a small risk that I may need to have another surgery to take out the right half of my thyroid – if the tumor is questionable, and they have to do more extensive tests that cannot be done within the timeline of my actual surgery. But, this is a small risk.
When the surgery is all said and done, there are risks of certain side-effects. Aside from the normal problems with possible nausea and infection associated with all surgeries, I will likely have trouble swallowing and eating for a few days. But there are two relatively common side effects that pertain directly to this surgery. One is damage to the parathyroid gland. This gland regulates calcium levels. There is one of these glands on each side of your neck. With a partial thyroid removal this is hardly a problem, because if one parathyroid gland is damaged, the other just takes over. But, another main risk is damage to the vocal cords. Vocal cords can be severed in this surgery, which results in completely losing the voice, permanently. But, this risk is rare. More common is damage to the vocal cords which causes them to become temporarily paralyzed. It is not uncommon for people who’ve had thyroid surgery to lose their voices for somewhere between 1 and 3 months.
I must say, this vocal cord thing is my greatest concern. I suppose I can handle losing my voice for a couple of months. But, to lose it permanently would be devastating. I mean, I can’t be a teacher if I can’t talk. It just won’t work. But, the doctor saw my concern about this and elaborated . He explained that there are two vocal cords and the likelihood of both being severed is very very rare. He said that the vocal cords work by kind of squeezing together back and forth. If one is severed, a gap occurs which prevents the full squeezing from happening. But, a plastic implant can be surgically placed there to allow the other vocal cord to squeeze it instead, making it so you can have your voice back. Knowing this bit of information has calmed me considerably.
If I have half of my thyroid removed, I don’t need to spend the night in the hospital. But, if it turns out that I need to have both lobes removed, I will have to spend one (or more if my calcium levels are not right) nights in the hospital.
Generally, the first few days after the surgery will suck, obviously. But, it seems that most people continue regular activities within 2-3 weeks after surgery.
Check back, for more blogs about this. I’ll be doing some blogs about how the actual function of the thyroid as well as what my life will be like with only half a thyroid.
For those who care, I found this to be one of the best sources of information about the surgery I’ll be having.
Texas Center for Facial Plastic and Reconstructive Surgery
Thanks for reading!
[...] Brittany Walker has a tumor on her left thyroid lobe and has to have a thyroid lobectomy. Posted on July 22, 2009 at 7:02 am, filed under BlogHer, Fitness. Bookmark this entry.Follow any comments here with the RSS feed for this post. Post a comment or leave a trackback. [...]
Brittany,
WOW. I am so glad to have found your blog!! You have written the most amazing and incredible post here! I have thyroid disease myself and am always searching the internet for other patients.
Your ordeal with physicians seems to unfair and unwarranted and just plain unacceptable. Unfortunately, for so many of us, we go undiagnosed or we get undertreated for so long. Finding a DR who we like and who is knowledgeable is sort of a rarity in terms of thyroid health.
I write for a website that focuses on thyroid health, http://www.dearthyroid.com. We’d love for you to come check it out! We have a whole community of people who understand what you’re going through and who support each other. Unfortunately, there ARE alot of people who have been where you are. In a weird way, it’s nice to know that.
Liz
I hope this is received. My name is Alice Sanchez. I am recovering from a right lobectomy. MY neck does not feel the same. It’s sore and stiff. My concern is having to have to take levothroxine @ mcg every day for the rest of my life. I also take a multi vitamin and a vitamin for my Glaucoma. Just looking for anybody that is on this medication and if there are alternative medicines out there. Thank you
Hi Alice,
I am on Levothyroxine and have been for a number of years. I have a friend who has had a full thyroid removal and is also on it. My body took a few weeks to adjust to the levothyroxine, but now I feel fine. If anything, I think it helped me, long before even having my actual lobectomy. What is your worry about taking the levothyroxine exactly?
How many days are you out of surgery? Your neck should be stiff and sore for about a week.
I don’t really know of very many alternatives to taking levothyroxine except taking Cytomel which mimics T3, where levothyroxine mimics T4. Having only half of your thyroid removed you could technically be fine without taking any medication at all, although it may be difficult for half your thyroid to do the full thyroid function, but it will usually be close enough.
Skim through my other thyroid posts and see if you find them helpful!
http://14erskiers.com/brittanysblog/?s=thyroid
I am so glad I found this blog because I am about to have surgery as well for a thyroid nodule that may or may not be cancer. I have only been able to find people explaining how horrible their experience was so it is refreshing to read someones point of view on going through the surgery. Did the doctor give you a name for the diagnosis of the cells that were possibly cancer. My doctor has told me I have follicular adenoma and I was wondering if that was the same diagnosis you had.
So glad to hear that everything worked out for you and you are doing well.
I’m glad you found my blog and that it has given you some relief
The cells my doctor originally diagnosed were called hurthel cells. I hope that your surgery goes well and that your body is cancer-free!
Hi Brittany
Thank you so much for the insight, I’m getting ready to have a left thyroid lobectomy 4/19/10, my concerns is having my vocal chord damage and just being in pain. Thanks for sharing your experience, I have been doing some internet research myself.
I am a 50 yr old male, and have had these two nodules on the left side for quite sometime, I was told that my biopsy came back benign, but like your doctor, I was by my doctor he would no more once he gets inside.
I am not looking forward to having the difficulty in swallowing and the stiff, sore neck, but if everything comes back fine, then it will certainly be worth it.
Again, thanks for sharing your story, quite a bit of encouragement for me.
I’m so glad that you found my blog encouraging! I truly believe that if you have a good surgeon it makes all the difference
Good luck with your surgery. I hope that everything goes well and that the tumor is indeed benign. The surgery is painful at first, but hopefully you will have a quick recovery like I did 
I am 6 days out of a right thyroid lobectomy. I had a fast growing cyst on my thyroid that the surgeon said had grown in the 2 weeks since I discovered it and my surgery on March 22, 2010. It was over 3mm. For me, the worst part of the surgery so far has been the soreness in my throat and lack of voice. No damage to my vocal nerve occurred…but 6 days out I am hoarse and have no energy behind my voice. I still have pain around the incision area and desperately want the surgical tape to fall off.
I was down for the count for about 4 days, and then slowly started to to get my energy back. I am due to go back to work tomorrow (day 7), but will see what happens with my voice. I am a teacher and lack of voice is never very helpful.
This blog was very helpful. Thanks for posting.
Corey- I’m sorry to hear that you don’t have your voice right now! Though I never had that issue, I was really concerned about it, being in the field of education myself. My surgeon told me that this was a common side-effect, but said that voices usually return in a month or two… which isn’t great to hear given that you’re a teacher. But, it will return. I’m sure the surgical tape will fall off soon:) If it’s any consolation, they removed my stitches after only 8 days, so I’m sure you could start giving that tape a good tug!
I must have the best doctor on the planet! I had my left thyroid lobe removed on Friday, May 28, 2010 and was able to eat the next day. I didn’t have near the amount of pain I thought I would. I hate to say it, but I google everything and read some very horrific stories! I was freaked out before I even had the surgery. I was sore for a few days but was eating normal food three days after surgery. If you live around Savannah, Georgia, check out Dr. Yeager! He is the greatest!!!
Hi Brittany my name is Susan I just found out I have to have thyroid surgery and I fond your blog it was very helpful thank you but I am scared to death to have this surgery I want to know how life is after wards I have lots of questions and I don’t no any one who has had this so called common surgery and my Dr. tells me we just need to get it out I am concerned about weight gain I’ve struggled with my weight I don’t want to gain any more if you could please add me so I can ask you some questions if that is alright with you it would be so helpful and mean so much I have my surgery on Tuesday June 15 sorry about the short notice thanks again!
Hi Susan,
You can ask any questions you like!
I am not sure if you are having an entire thyroid removal, or a lobectomy. I had a lobectomy- the left part of my thyroid removed. It generally is easier to adjust after this type of surgery rather than a full thyroid removal. Still, I have had several friends who have also had their entire thyroids removed. While everyone handles these things differently, I can tell you that my friends and I have all had successful recoveries. Weight gain has been negligible. We are all athletes, and continue doing the athletics that we love and live normal lives. The only difference is that we are all on synthetic thyroid hormone medication. Once a dosage is determined for you, you’ll have to get your blood checked for thyroid levels every year. Be careful with this. My doctor was only checking my TSH levels, not my T-3 and T-4. In the fall and early winter this year I was tired a lot, had low energy, and wasn’t eating as much as usual. I thought maybe I was just “getting old”. But, I had my blood levels tested. My doc said everything was fine, but when I looked into it, he only looked at the TSH levels. I read from multiple sources that your T3 and T4 levels matter even more so I went to a different doc and had her prescribe another blood draw to test these levels. She confirmed that my medication dosage was indeed too low and bumped me up to the next level. Within a week or two I felt back to my normal self- normal energy, not so tired, and had my appetite back. Other than these minor things I really lead a normal life, and so do my friends with full thyroid removals.
I hope your surgery goes well and if you have any more questions, don’t hesitate to ask. I know this surgery seems really scary.
Brittany
thank you for blog . Tomorrow Dr will remove cyst by leftlobe
and do biopsy on two nodules . Your description of procedure enlightened me.
My concerns needless to say is to get bad stuff out and to keep my voice.
Thanks again
Rick
Best of luck with your surgery!
Brittany all went well left lobe with cyst removed /spent night in hospital . Pain was minimal due to drugs . Today feel incision a bit more may take a vicodin tonight. Also voice a little raspier today . As a precaution taking Keflex and have a drain which will be Removed tomorrow.
Thanks for your informative blog . My situation was very similar to yours in re to diagnosis etc.
Good health
Rick, Glad the surgery seems to have gone well! Best of luck to you and my best wishes for a speedy recovery!
Hi Brittany
My situation is remarkable similar to yours. 2010 has been my upside down year. Aside from my nodule saga I detail below, I was diagnosed this spring with an inguinal hernia that will need surgical repair. Six years ago they discovered I had 2 nodules on my left lobe when they were ultrasounding a bump on my adams apple-(which turned out to be just cartilage). I was referred for an FNA biopsy on the larger nodule which showed atypical cells (Hurlthle cellls). I was referred by the surgeon to an endocrinologist for his opinion “just to cover all the bases” and he said we could just watch the nodule and do annual ultrasounds, that surgery at this point would be “premature”. For the first couple of years afterwards I was good about getting them done but there was not much noticeable change , so I figured ” I am all set with this thing” and I let 4 years go between scans! This Feb. I had an ultrasound done and it showed a “slight increase in size and complexity ” of the nodule. I went back to my endo doc and he wanted to repeat the FNA. After reading way too much about it on the web and scaring myself out of my wits, I questioned the medical advice I was getting , and did not do a repeat FNA. Through the web I found Dr. Randolph at the Mass Eye and Ear who specializes in thyroid cancer, and went and saw him for his opinion. He told me that he would not even consider repeating the biopsy since even if it came up normal, there was atypia there in 2004, and the only way to be certain one way or the other would be to remove the lobe. Needless to say I was a bit shocked that the advice I was getting from my endocrinologist was so far off base. I am scheduled this Wednesday July 14th to have the lobe removed. Having never had surgery , and having a 10 yr old son and a 6 yr old daughter, this is a very scary ordeal for us all. I am glad and thankful to have found your website
Roger- Good luck with your surgery. Hope all goes well! Funny how endocrinologists can have such differing opinions, isn’t it?
Had right thyroid lobectomy last week. As soon as operation had finished I started bleeding heavily and had to go back for 2nd operation to stop blood flow. However first I knew about it was once it was all over and I was drinking a very welcome cup of tea! Very little pain, slight sore throat and could eat normally straight away. Wound looked awful but already much better after a week. Still waiting for tests to see if I need thyroxine. For anyone worrying about pain of opeation – stop! Really not a big deal! Waiting for op was worse than the event itself. Best Wishes from England.
Hey Brittany,
THANKS FOR SUCH AN UPLIFTING STORY. I AM SCHEDULED FOR A RIGHT THYROID REMOVAL ON AUGUST 6, 2010. I AM A TEACHER ALSO. I BELIEVE THAT ALL THINGS ARE GOING TO WORK OUT FOR MY GOOD. THANKS AGAIN FOR SUCH AN ENCOURAGING STORY. MAY GOD CONTINUE TO BLESS YOU.
WoW. this is almost my entire story. Except for the beginning. Mine is the right side. I’m scheduled for surgery on the 13th of august. The vocal cord issue is my big concern also. My dr. recommends doing both as in most patients they will need to have the other removed within 5 years. My only concern with that is the Metabolism issue. I have read to many horror stories of gaining alot of weight. I have always had a hard time lossing the weight. Do I really want to have the left removed and dealing with weight gain? IDK what to do.