Tuesday, May 14, 2013

Kat's Surgery is MAY 14th

Many of you know most of these details, but many more of you don't.  Feel free to skim or even skip over this post.  :)

When I took Cadence in for her 9-month well-baby visit, the pediatrician looked at me and asked, "Are you currently taking any thyroid medication, or being seen about your thyroid?"  That was a surprise, because I was there for Cadence.  When I told her I wasn't she said, "Well, I see you've got a goiter, and the thinning of the hair can be a symptom of thyroid problems, too.  So I want you to be seen."  I never noticed a lump on my throat, and I knew my hair had been thin for a long time,  so I didn't think anything of it.

It took me about a month to really decide to actually go in to be seen.  By then I did start to notice that the left side of my neck didn't look like the right side, and my hair elastics wrapped around my ponytails 2-3 times more than they used to.  So I figured it was probably a good thing to get checked out.  The PCP I met concurred that it was a goiter.  He advised me to get an ultrasound (which I was able to do right after my appointment with the PCP because there was an opening, fortunately!!) and to go see an ENT within 2 weeks.  Well, thankfully there was a cancellation a couple days later... I was able to get in right away.

Dr. Scheuller the ENT told me that the ultrasound found a singular large nodule on my left side of the thyroid.  It has grown to be 9cm x 2.7cm x 6cm, whereas the right side is normal at 4cm x 1.2cm x 1.3cm.  So you can see that it has grown to be pretty HUGE!   How did I not notice that!?!?  I guess it was such a slow-growing process that it was never obvious from a day-to-day observation. He said that 80% of my thyroid was now nodule, and the healthy side is only 20%. The ENT also told me that he was pretty sure that my thyroid wasn't really producing the hormones that it should, "basically not even functioning" were his words. So his suggestion was to remove the entire thyroid.  This would avoid any future hassles; like if I had more nodules grow on the right side and need to have a second surgery to remove them, ultrasounds to be continuously checking-up on that healthy side, trying to regulate medication against what the partial thyroid would be putting out as it may fluctuate in productivity, etc.  Plus, apparently it's a trickier surgery to go in a second time.  So, I understood where the ENT was coming from, and I believed that his suggestion was probably right.  So I went ahead and scheduled the surgery for June 26th, after our family vacation to Newport Beach.  (It was for insurance purposes that I thought this would be best, since the ENT didn't see that it needed to be rushed.)

After many phone calls talking to family about my situation, I decided to get a second opinion.  There were too many "what if's" in my head.  Did I really need to remove the whole thyroid?  Is it possible to not really need medication if I kept the healthy side?  Couldn't I use homeopathic remedies to assist the thyroid and not really need to be on synthetic drugs?  I rescheduled my surgery for May 14th, and was able to get in to see an Endocrinologist on May 7th.  It was good timing I thought because if she concurred that I would need surgery, then it was already set.  If she thought that it wasn't necessary, then I still had that 7 days to cancel.

Dr. Schneider the Endocrinologist sounded very hopeful that we might be able to get away with only removing the bad tissue and leaving the right side alone.  When I asked, she told me that my levels were "completely normal" which is not what the ENT said.  She believed that it was possible that the healthy side might pick up the slack and produce enough hormone without the aid of supplements.    However, there was no guarantee that this would be the case.  Especially since I have a family history of low-thyroid problems.  So she wanted to perform a blood test to check for familial antibodies, which would prove that I would be at a higher risk of thyroid failure in the future.  Dr. Schneider is the type who would recommend less surgery if more wasn't needed.  She explained that there are more risks to surgery, and was wary of messing with perfectly healthy tissue.  So her recommendation was to have Dr. Scheuller remove only the left side, and look at it while I was still sedated to check for signs of cancer.  If it's fine, then just sew me back up, but only if it's suspicious of cancer should he take out the other side.  She made it sound like the follow-up ultrasounds wouldn't really be a big deal, not much of a hassle, which is not how the ENT made it sound.  She also said it's really a non-issue to regulate the medication because all the thinking of how much hormone to produce is processed in the brain.  So there really wouldn't be as much fluctuation to deal with.

Then I got the results from the blood-work.  I tested positive for those antibodies, which means that I most likely will have a failing thyroid at some point in my life.  Knowing this, my healthy side is much less likely to pick up that extra slack... at least not for very long.  It's no longer a question of "if" but a question of "when" my thyroid will give out.  So, the endocrinologist then told me that she was more indifferent as to whether I do only the one side or the entire thing.  I asked her about health in pregnancy whether I had partial natural as opposed to fully synthetic hormones, and she said there really is no difference.  There are some people whose hormone levels once on medication just never seem right, like the never feel like themselves.  However, most people do just fine with medication.

Weighing the factors involved, I've decided to have the entire thyroid removed.  That way I will no longer be asking any questions, wondering if everything is working properly or not.  If I take the whole thing out, I know I don't have a thyroid.  I know I won't need an ultrasound on it every so often to check on it.  I know that I will have to be on medication and no longer wonder when it will have to happen.

So, I had a priesthood blessing from Mark and a member of our bishopric.  In it I was promised that the surgery would go smoothly with no complications, that I would recover quickly.  He also mentioned that I would be a good teacher to those in Church through my good example and love.  Hmm, interesting!  Well...I'm feeling a little nervous, but confident that I am in good hands.  Prayers will be appreciated.  Wish me luck!

Love you all!