# Robotic surgery about to be scheduled!



## msterra37

Hi everyone,
I had posted back in Sept about the new DaVinci surgery where they go through the armpit to take out the thyroid. Now..after much debating and waiting I found a Dr. in Ga (Medical College) that does the thyroid surgery in which he takes the thyroid out throught the back of the neck..facelift dissection in which no muscles are cut going to get the thyroid..anyone else here of this? He has been awesome about giving private email and answering back quickly all my questions etc. His name is Dr. Terris and I believe I found him from an abc.com link.


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## lavender

I have heard of the surgery through the armpit, but not the back of the neck. It does sound interesting. I had my surgery the old fashioned way and have about a 1.5" scar. Whatever option you choose, I do hope the surgeon has experience with that particular approach. Please let us know how your surgery goes.


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## msterra37

Thank you..I am already debating doing what my doctor here has suggested and that is the Radioactive Iodine first...shew...wished I could make up my mind!!:sad0049:


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## lavender

Is your doc suggesting RAI before surgery or RAI instead of surgery? I am asking because If you are intending on having surgery, RAI can make the surgery itself more difficult.

Is there some reason why you do not want the surgery, other than pressure from your doc? I think the most important thing is to listen to your gut. When you read about RAI and surgery, what is your gut saying? Are there possible complications you just can not handle?

My doc did not recommend surgery, but I knew in my gut that is what I wanted. When I told him, he said it would not be his choice because he would not want to have to go through a surgery if there was another option. I felt differently. I just could not face the possible consequences of RAI, waiting months for my thyroid to slowly die, exposing my body to strong chemicals. It was not for me, but still when the doc told me his opinion, I doubted myself. So, I read more about RAI, and the more I read, the more certain I was.

I can't make this choice for you, but I know how difficult it is. I know it was so important to get in touch with myself, my center, my inner sense of knowing, to get a good feeling of what felt right to me. Sticking up for my choice felt good. It helped me to deal with the complications of my surgery. I think I would have been a lot less accepting of some of the difficult times in recovery if I had felt pressured or coerced into my decision.

Trust yourself. You know what is right for you.


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## Andros

msterra37 said:


> Hi everyone,
> I had posted back in Sept about the new DaVinci surgery where they go through the armpit to take out the thyroid. Now..after much debating and waiting I found a Dr. in Ga (Medical College) that does the thyroid surgery in which he takes the thyroid out throught the back of the neck..facelift dissection in which no muscles are cut going to get the thyroid..anyone else here of this? He has been awesome about giving private email and answering back quickly all my questions etc. His name is Dr. Terris and I believe I found him from an abc.com link.


I have read about that technique but not about that particular doc even though I do live in the Atlanta area and keep up on local medical news. Thanks for telling us about this. Interesting.


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## msterra37

Well my doctor here suggested I do the radioactive iodine. Then when I called and spoke with Dr. T he advised that I could do that but usually the radioactive iodine is not very effective with stopping the growth. I am very cautious about putting chemicals like that in my body and have worried myself to death about it. I do think I will go see an ENT specialist to make sure nothing is going on with my throat besides the nodule. I swell in my left side of my neck..and I have been sooo hoarse in the last couple months (which is also sign of thyroid cancer). I listen carefully to what doctors say and this dr. when I explained about the hoarseness did not think that had anything to do with my nodule..but I got some thyroid cancer info in the mail and that has one of the signs of thyroid cancer on it...shew...I just wished all this was over. They just emailed me and set surgery for March 15, 11.


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## Andros

msterra37 said:


> Well my doctor here suggested I do the radioactive iodine. Then when I called and spoke with Dr. T he advised that I could do that but usually the radioactive iodine is not very effective with stopping the growth. I am very cautious about putting chemicals like that in my body and have worried myself to death about it. I do think I will go see an ENT specialist to make sure nothing is going on with my throat besides the nodule. I swell in my left side of my neck..and I have been sooo hoarse in the last couple months (which is also sign of thyroid cancer). I listen carefully to what doctors say and this dr. when I explained about the hoarseness did not think that had anything to do with my nodule..but I got some thyroid cancer info in the mail and that has one of the signs of thyroid cancer on it...shew...I just wished all this was over. They just emailed me and set surgery for March 15, 11.


Even though I had RAI and I indeed had to have RAI 3 times; I now recommend surgery for the specific reason you state.

Cancer and Graves' as well as Hashimoto's are bed fellows. I will never know but at least I do know that there is no surviving thyroid tissue. We made sure of that. LOL!

Graves' and Hashi's cancer
http://www.thyroidmanager.org/Chapter18/18-cancothr.htm

I am excited for your surgery. Before you know it, you will be on the healing pathway.

Please remind us of your surgery date so we can be w/you in spirit, thoughts and prayers.


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## lavender

Personally, I could not see exposing myself to radioactive chemicals if I had another choice. Stick with your instincts on this one.


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## Andros

msterra37 said:


> Well my doctor here suggested I do the radioactive iodine. Then when I called and spoke with Dr. T he advised that I could do that but usually the radioactive iodine is not very effective with stopping the growth. I am very cautious about putting chemicals like that in my body and have worried myself to death about it. I do think I will go see an ENT specialist to make sure nothing is going on with my throat besides the nodule. I swell in my left side of my neck..and I have been sooo hoarse in the last couple months (which is also sign of thyroid cancer). I listen carefully to what doctors say and this dr. when I explained about the hoarseness did not think that had anything to do with my nodule..but I got some thyroid cancer info in the mail and that has one of the signs of thyroid cancer on it...shew...I just wished all this was over. They just emailed me and set surgery for March 15, 11.


My very humble opinion is that you should have the "traditional" surgery. Never mind the armpit and the back of the neck thing.

The gland "definitely" needs to go to pathology to check for cancer.

Not to mention that w/RAI you have to sequester yourself from your children, your husband, your pets, babies, preg. women.....................the list is extensive!

In my particular case, I had to have RAI 3 times and the sad part is, I will never know whether the gland was cancerous or not. Knowing plays a huge role in your future medical intervention.


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## msterra37

What about losing the thyroid and being on a pill for the rest of your life...your thyroid is such a big part of the system...what if we take it out and it is not cancer..then I have lost something I really need? Ohhh man...shew...my levels have always been on the high end of normal or I should say the low end (whichever) I am borderline hyperactive...is the surgery really that bad on the front of the neck? I see one woman at the drs. office (obgyn) and she looked like she had been slaughtered!!

Edited to add...I got my CT back on my lungs today and they found 5 small nodules...but my left clavicle area stays swollen beside my neck...did any of this happen to you before you had yours removed? I am scared that if I do have thyroid cancer it is spreading or something


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## McKenna

When I was looking at surgery I came to the understanding that my thyroid was damaged anyway and would not be getting better, not working correctly and I needed medication anyway, I had a nodule which came back inconclusive after a FNA and I certainly wasn't comfortable leaving it in there, not knowing what it was. It's not an easy decision, but when I looked at the whole picture, I knew it had to come out.

I know two people who had their thryoids removed, one had cancer, the other Hashi's, and you can't see either of their scars unless you knew where to look. They are almost invisible. They both had traditional thyroidectomies. I had an endoscopic TT and my scar is very tiny. You can always look for a surgeon who specializes in this procedure if you are interested.

Sorry to hear about your other nodules. I hope you can everything sorted out soon.


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## msterra37

Thank you~ here is some information about my surgeon--what do you guys think? He does do the endoscopic procedure also...so that is great.

Best Doctor in America - Top Surgeon
American's Top Doctors - Otolaryngology - Head and Neck Surgery
David Terris is the Edward S. Porubsky Distinguished Professor and Chairman of the Department of Otolaryngology-Head and Neck Surgery at the Medical College of Georgia.

He received his college degree with Phi Beta Kappa honors from Cornell University and his medical degree with Alpha Omega Alpha honors from Duke University. He completed residency in Otolaryngology and a fellowship in Head and Neck Oncologic Surgery at Stanford University. Dr. Terris then joined the faculty at Stanford, and as an NIH-funded investigator, was promoted to Associate Professor with tenure before being recruited to the Medical College of Georgia.

Dr. Terris is a pioneer in robotic and minimally invasive thyroid surgery. He is the surgical director of the MCG Thyroid Center, and has a busy clinical practice that is limited to thyroid and parathyroid surgery. Most recently, he became President-Elect of the Georgia Society of Otolaryngology, and the Chair of the Otolaryngology Advisory Council of the American College of Surgeons.

Dr. Terris treats disorders of the thyroid and parathyroid including goiters, cancer of the thyroid/parathyroid, Graves disease and hyperthyroidism. Specializing in surgery of the thyroid and parathyroid, Dr. Terris is a pioneer in minimally invasive and robotic-assisted neck surgery. He collaborates with Endocrinology in the surgical care of patients with thyroid and parathyroid disease.


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## McKenna

He looks very accomplished. Have you interviewed him and asked him how many of the back of the neck procedures he has done? I would look at his answers to that question to see how experienced he is with it. How many complications, if any, his patients have had from the procedure. What are the possible complications with back of the neck surgery?
Are you nervous about the surgery itself? Is that why you are looking at RAI? Personally, that wasn't an option for me, but I would not have done it b/c of the other reasons listed on this thread. It's your decision, but surgery is usually very safe in the hands of a skilled surgeon. That's why it's important to interview your surgeon and ask the questions.


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## lavender

I had traditional thyroid removal surgery. My scar is less than 2" long, and 5 months later, it is healing well. I do not look like I survived a slasher movie. Most people are surprised at how well it is healing. I have seen lots of people's thyroidectomy scars, and after a while they are barely visible.

It does look like this surgeon is accomplished and the fact that he specializes in thyroid and parathyroid surgery is good. Now, the important questions are:
Is the back of the neck his usual procedure?
How many has he done through the back of the neck?
What is his rate of complications with the back of the neck style?

Usually, I would want to know how many thyroid surgeries a doc has done, how many he does a year, and what his rate of complications is, but going through the back of the neck is a new procedure which could make a very skilled surgeon less skilled if he does not know what he is doing. I would not want to be a guinea pig myself, but a scar was not my biggest concern.

Thyroidectomy is very fine microsurgery. A mistake could cost you your voice or parathyroid injury, which is very unpleasant and difficult to treat. An experienced surgeon is less likely to make mistakes.

I do not know your reasons for needing RAI or surgery. I have Graves. I know that my thyroid was so out of control that it was a relief to have it out. Regulating thyroid medications after surgery is not simple, and it takes time. But I am feeling better, and I believe that once I am regulated, it will be easier to stay there. The past 5 months have been hard, but I was starting from scratch with thyroid replacement, and I had a very very very sick body because of my thyroid.

If you are concerned about cancer, I am wondering if you have any nodules? Have you had RAIU (Radioactive Iodine uptake and scan) or FNA (fine needle aspiration-performed on suspicious nodules to test for cancer). These tests may help your doc diagnose cancer, but unfortunately, the only way to know for sure is to have surgery and to have a pathologist look at the gland once it is out of your body.


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## msterra37

Thank you guys!! I will ask those questions for sure now. I do have a nodule that is over 2cm..I have another one coming on the left side also very small. My concern is now I am getting hoarse like when I read one book to the girls I am getting that way..I am having throat pain, neck swelling (on the opposite side) and it is getting kind of hard to swallow. They want me to have RAI but I have read way to many horror stories about eyes bulging and eye surgery afterwards etc..I don't like chemicals entering my body either--they have done 2 nodule FNA's and both benign but I have spoke to a couple that theirs were benign and the nodule itself wasn't cancer but the thyroid was..someone told me on facebook this morning I could take lexothyrine (sp?) or something and completely kill the thyroid instead of having surgery (oh that is another thing..on another board 2 people have had trachs due to cutting into vocal cords etc..now that scares me) but my only concern is that if it can kill the thyroid what if it is cancer and spread to lymph nodes..wonder if I could have a test to see if it is in there...have you heard of this pill? Thanks you guys..you are wonderful!


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## McKenna

Levothyroxine is synthetic thyroid hormone, it won't kill your thryoid. It is used for thyroid hormone replacement when your body no longer produces enough, or any, in the case of thyroidectomy.

RAI, Radioactive Iodine, is used to kill off the thryoid. Perhaps the person you spoke with was mistaken?

Are you hyperthryoid that your doctor even suggested RAI?



> on another board 2 people have had trachs due to cutting into vocal cords etc


 With any procedure, there can be complications and people LOVE to tell the worst possible stories sometimes. This is where speaking to your surgeon, asking about his personal statistics and complications comes in. You have to trust your surgeon and his ability to perform this surgery. Don't be afraid to ask him how many of his patients have had complications.

If, after your thyroid is out and your final pathology report comes back as cancer, then you would be scheduled for a dose of RAI to kill off any remaining cancer cell.


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## Andros

msterra37 said:


> What about losing the thyroid and being on a pill for the rest of your life...your thyroid is such a big part of the system...what if we take it out and it is not cancer..then I have lost something I really need? Ohhh man...shew...my levels have always been on the high end of normal or I should say the low end (whichever) I am borderline hyperactive...is the surgery really that bad on the front of the neck? I see one woman at the drs. office (obgyn) and she looked like she had been slaughtered!!
> 
> Edited to add...I got my CT back on my lungs today and they found 5 small nodules...but my left clavicle area stays swollen beside my neck...did any of this happen to you before you had yours removed? I am scared that if I do have thyroid cancer it is spreading or something


Gee.......................that sure does not sound good.

Sometimes we have to have tooth pulled, hysterectomy, gall bladder removal, appendix............................removed. The list is extensive. I would not want to keep something that is making me so sick and truly, thyroxine replacement is so so simple.

Yes; it takes time to get on the right dose and yes, it takes time for your entire body to heal but it will happen.

What has your doctor had to say about the nodules on your lungs? I am saying a prayer for you.


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## msterra37

Thanks! Well I have never been hypo or hyper but borderline hyper..but my regular dr. said we would just keep check on nodules since they are so small 2mm-4mm..so they are recommending another CT in a year to see if they have grown..lol I say 6 months cause lung cancer can grow at a rapid rate! I am going to ask my dr. those questions from above now Thank you.


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## Andros

msterra37 said:


> Thanks! Well I have never been hypo or hyper but borderline hyper..but my regular dr. said we would just keep check on nodules since they are so small 2mm-4mm..so they are recommending another CT in a year to see if they have grown..lol I say 6 months cause lung cancer can grow at a rapid rate! I am going to ask my dr. those questions from above now Thank you.


Hyper and cancer often are found together.

Graves' and Hashi's cancer
http://www.thyroidmanager.org/Chapter18/18-cancothr.htm


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## Lopnslo2

MSTERRA: I think the surgery really depends on your particular situation. I just had mine done and the incision is small (~3") and I feel pretty darn good. I was able to control post surgery pain w/ibuprophen. But that's not what everyone experiences.

I think there is a HUGE matter of finding a good surgeon. Granted, I've complained here about my surgeons attitude (he seemed very disinterested in my surgery). However, I asked my endo for the BEST surgeon he knew, the person he'd use if it were his own kid being worked on. My sister did the same thing. We both have 3" incisions and healed up quickly (although her para's did go into shock which took 4 weeks to resolve).

My surgeon was also an oncology specialist (as was my sisters), so I felt confident that if he found anything suspicious, he'd know to take it out. I think my case is so uninteresting to him b/c there was nothing complicated or special about it (nothing to brag to his golf buddies about). I freaked out about that at first, but now... I don't care. I'd rather be dull 

KS


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## Lopnslo2

Also, do you know any nurses in the area or that has worked with your prospective surgeon? I have several friends that are nurses and they are usually EAGER to tell who whose patients do well and whom to avoid. They see the aftermath, they see the recovery, they see the PATIENT, so I'd network and see if you can get any insider info. I'd prefer the personal referral if you can get one.


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## Andros

Lopnslo2 said:


> Also, do you know any nurses in the area or that has worked with your prospective surgeon? I have several friends that are nurses and they are usually EAGER to tell who whose patients do well and whom to avoid. They see the aftermath, they see the recovery, they see the PATIENT, so I'd network and see if you can get any insider info. I'd prefer the personal referral if you can get one.


What a wonderful suggestion!


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## msterra37

Yes, that sounds good..not sure how I would go about it considering he is in GA and I am in VA...but hmmm..let me think Thanks!!


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## questions

msterra37 said:


> Hi everyone,
> I had posted back in Sept about the new DaVinci surgery where they go through the armpit to take out the thyroid. Now..after much debating and waiting I found a Dr. in Ga (Medical College) that does the thyroid surgery in which he takes the thyroid out throught the back of the neck..facelift dissection in which no muscles are cut going to get the thyroid..anyone else here of this? He has been awesome about giving private email and answering back quickly all my questions etc. His name is Dr. Terris and I believe I found him from an abc.com link.


Hi, 
I had the robotic surgery via the armpit. I started a thread under "Robotic Thyroid Surgery-Share your experiences" and included suggestions for choosing a DaVinci surgeon.


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## SAHM

I have never heard of this method. It sounds very interesting!

I had a traditional thyroidectomy 3 years ago and my scar is hardly noticeable.

I know the prospect of having cancer is scary. I hope everything comes back ok!

In the case of a traditional thyroidectomy, I was told to go to an endocrine surgeon rather than a general surgeon and to also look up docs on ratemd.com

Good luck!


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