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Goiter/Nodule? part 1

PostPosted: Wed Jun 17, 2009 4:58 pm
by Mrs. Ohio
I am a 45 year old married mother of two. I have had a goiter for nearly 20 years that I am aware of. My dr. has monitored it through blood work during my annual physicals and it has been normal. This April, I had to have impacted ear wax removed (I had to have this done a couple years ago also). The nurse practitioner at the ENT's office did a full ent exam and noted the goiter and felt there was a nodule present. She suggested an ultrasound of of the thyroid. This was scheduled for 2 days later. The ultrasound was quite painless. I could tell the technician was spending more time on the left side, so I wasn't surprised when I got a call a couple days later saying there was a large nodule, measuring 4.2 cm on the left side. The ent recommended a fine needle biopsy and explained to me what was involved. This was scheduled for the following week. The pathologist who performed the biopsy spent a lot of time explaining the procedure and discussing options, including not doing the biopsy. I felt more comfortable doing the biopsy feeling certain that that would be the end of it. The biopsy itself wasn't too bad. The anticipation of a needle being placed in the neck is a bit scary, but the staff was very good.
some background info: my father had his thyroid removed at age 25 due to a goiter; I have several cousins who have had thyroids removed and/or who are on thyroid medication

I had a follow up appt for the following week, fully expecting for the results to be negative. The results were indeterminate, but follicular cells were noted. Not what I had anticipated at all. The ENT recommended removing the entire left lobe of the thyroid for further testing. I folllowed up with my regular dr. who agreed and explained that the follicular cells could pose a more significant issue. Surgery was scheduled for Fri June 12 at noon.

We arrived as scheduled at 10 am. and were taken to a pre-op room. I requested a private room for post-op. Everyone was very competent and pleasant as they prepared an IV line and monitored my oxygen and blood pressure. I was taken down to the waiting area outside the OR at 11:30. The anesthesiologist spoke with me about any complications I had had related to anesthesia; nausea and a headache were my concerns. He explained that the nurse anesthetist would be by my side through the surgery. I was informed my doctor was on his way at noon. The surg nurses said that is similar to "the check is in the mail". at 12:30 they said my doctor had arrived and at 12:45 I was taken into the OR. I moved onto the cold operating table. The staff was great covering me with warm blankets; soon the nurse anesthetist put something in my IV and I really didn't care that it was cold in the OR. I felt myself going under.

Post surgery part 2

PostPosted: Wed Jun 17, 2009 5:42 pm
by Mrs. Ohio
This is where it's a bit fuzzy. I don't recall being in the recovery room. I do remember being wheeled down the hall to a room and seeing my husband there. I asked him what time it was and he said 5:15. I vaguely remember someone asking me how I felt and I said nauseated and a headache. I heard someone say phenegran. Later I remembered my dr talking to me about the testing that would take place and that it would take a few days to get the results. That's all a little blurry. Around 7ish I felt more fully awake. My husband told me the doctor said there was a lot of vascular activity and that took more time than was expected. Also my laryngeal nerve was bisected and traveled parallel (I guess this happens in about 1/2% of his cases) that took extra time also. My throat was quite sore and I was hungry. I was able to eat pretty well. I was also able to swallow vicaden for the pain. It did take the edge off, though the pain was not completely gone. I couldn't remember if I had had an itchy reaction to morphine or demoral, so they didn't want to give me either of those. The blood pressure cuff was way too tight and caused some pain. My blood pressure tends to be on the low side, but they would pump it up so tight it hurt! I also had numbness and tingling in my right thumb and pinky finger that lasted until the next day.

I fully expected to be up and moving around my room the night of surgery. I bought a new robe and pair of pajamas, brought plenty of reading material, puzzles, my new calendar to fill out. While I did walk to the restroom and take a lap around the hall with the nurse, I certainly couldn't concentrate on anything and had no desire to change my clothes. I did wash my face and put on some makeup. I have had 2 c-sections, one under general anesthesia and one spinal. I guess I forgot how you really feel.

Overall, the night went pretty well for being in a hospital. The next morning, while my nurse was checking my IV line, the anesthesiologist made a run through my room, standing about 10 feet away, he said, "I'm the anesthesiologist , just checking to see that you had no problems with your anesthesia; no problems?" then he turned around and left and I thought to myself, $200.00. My dr. came in at 9 and reviewed everything with me. He said everything went well, it just took longer than average because he had to take his time and he does not want to hurry. (He has a great reputation) He explained again about the testing that would take place and that I would see him at his office on Thurs. I was feeling a bit woozy from the anesthesia and pain medication but managed to get dressed and rest until my husband and daughter picked me up around 11:30 am. I desperately needed good coffee, so we ran through Dukin donuts for some GOOD coffee. I could drink it ok, though my neck and throat were quite sore. I pretty much laid around or sat out on the deck. I couldn't really concentrate to read. I could eat somewhat. bananas and yogurt felt really good on my throat. I took vicaden every 6 hours and the pain wasn't too bad.

Sunday, I felt groggy from the pain med, so I just took one in the morning and 2 before I went to bed sunday night. Didn't do too much sunday, except rest or sit outside for a bit. I felt groggy Mon. morning, but after a little nap was feeling much better. Tylenol is enough for the pain now. Rested most of the day. Tuesday, sat outside at a pond with my girls and a friend. Wednesday, my throat is a bit tender, especially if I cough, laugh or sneeze or it gets bumped, but it's not unbearable.

Now I'm waiting for my dr appt. tomorrow late morning. I was going to go by myself, but last time i did, I found I had to have surgery, so my husband will meet me there. A nice way to spend our 21st wedding anniversary! I am a bit anxious about it especially with the vascular involvement and the size of the nodule. I also have smaller nodules on the right side that I want to talk about. I'm thinking I may go to an endocrenologist just to be sure. I'll update after my appt. tomorrow.

Re: Goiter/Nodule? part 1

PostPosted: Thu Jun 18, 2009 5:47 pm
by Rose
Wow, you and your family have been through a lot of thyroid issues. I'm happy that your surgery went well. The part about the "laryngeal nerve was bisected and traveled parallel" scared me. You were blessed to have a good surgeon.

Most, if not all, of the forum users here have been through some type of thyroid cancer. I pray that the patholgy report comes back negative...that fact that there were follicular changes does worry me a bit. There is great support here. If the pathology report comes back as papillary or follicular carcinoma the cure rate is very high. You will be in my prayers this morning.

Please keep us updated.