# (also on newbie board) lonely, scared/caught between tough choices/please advise



## lhc11 (May 5, 2010)

I also posted this on the newbie board; apologies for cross-posting but I realized I might get more specific help from the folks on this board.

I was diagnosed hyperthyroid on March 29th after an emergency room visit; a few weeks later, antibody testing (not sure which one, but I think it was the TSI) revealed Graves. I am not sure if I have TED or not; I couldn't get an opthamologist appointment for checking things out until May 27th; I do know I've been having trouble with my contact lenses, but then again they are a year old; my new endo said she didn't really see anything but I'm paranoid about it in any case.

Here's the thing--I have currently signed myself up for a radioiodine uptake on June 9th AND the very next day, RAI treatment on June 10th, AND for surgery (which would be a total thyroidectomy) on June 9th. I have to pick one of the two and cancel the other. I know I shouldn't rush into anything, but at the same time I'm a university professor and I've either got to take care of the problem (to the extent that one can) this summer or wait until next summer; I'm turning 39 in August, and one big reason to go for the surgery would be so that my husband and I could try conceiving again sooner rather than later (I had a m/c in September, right after we got married last July, which may be what activated the Graves but no one really knows)--though I know I would have to wait until my levels were adjusted to normal range, especially the TSH from what I've read thus far. At the same time, I'm also going through a pretty severe depression that set in after the Graves calmed down on methimazole (I started that at 60 mg/day, and am now down to 20mg per day with free T3 and free T4 in normal ranges -- I don't have the numbers on me right now). I have a history of anxiety/depression that I had under control for 7 years, but I went off Zoloft last August for the pregnancy and stayed off of it while we kept trying--then I crashed back into anxiety in late January (which is another thing that could have set off the Graves), and the Zoloft gave me strange side effects (tremors) that it never had before (which were in retrospect probably due to the Graves); I'm now on 40 mg Prozac and 200 mg seroquel at night, which I just hate being on but my psychiatrist claims he will not keep me on it long term. Oh, and xanax as needed, which seems to be about 1 mg per day or so (though it was more a few weeks back).

At any rate, the depression might argue for the RAI--taking it all more slowly, getting off the meds or at least switching back to Zoloft on a low dose, and also not crashing into hypothyroidism right after surgery. But psychologically part of me just wants to head into the surgery and get it over with (the surgeon is very experienced--trains other thyroid surgeons--and though I know about the possible complications for whatever reason I'm not too worried about them). I'm also a little worried that one RAI won't do the trick, and of course no one can predict anything, and if I rely on that, then I just wait and wait and maybe have to do it all over again. I guess I'm wondering what people think: how bad is a thyroidectomy/recovery time/etc? If you were in my shoes--39, wanting to try again for a child sooner rather than later (and my husband and I live in different cities for our university jobs, which makes it all even harder) what would you do???? Again, I know no one can really tell me, but I think I'm also posting here because I just feel so alone and scared and isolated in trying to make this decision--and that's even with the therapist (different from the psychiatrist) I'm currently seeing (who's not especially good but I'm sort of stuck with him at the moment). My husband is for the surgery because he just doesn't like the idea of RAI; my mother wants me to get the surgery so it's just over and done with and I move on; the endo said she recommended I consult with the surgeon b/c of my pregnancy desires. I think some part of me wants the surgery so that someone else just does something and I don't have to go through the low-iodine diet ahead of time etc. But I'm really scared that I'll feel truly awful after the thyroidectomy if they don't get the hormone levels figured out quickly, and lose tons of time for doing any of the academic work that I have to do this summer. I also know that it's pretty radical to choose surgery as an option for Graves, at least here in the US, so I wonder if I'm just plain nuts to even be considering it. And I also can't bear the thought that right now I feel physically normal (if mentally a mess), but that either one of these choices is going to make me probably feel unwell, and soon. I'm having a terribly hard time and I guess am looking for any kind of advice or even just moral support/reassurance that anyone here can give me.


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## Andros (Aug 26, 2009)

Welcome to the board! There are 4 reasons why I personally would recommend surgery.

1. RAI is known to make the eyes so much worse or in fact even trigger GED.

2. You would want to know if you have cancer or not. The gland will be sent to pathology, of course.

3. I had to have RAI 3 times; believe it or not!

4. And lastly, no matter what they say, the old timey docs say to wait a year or more before trying for pregnancy after RAI. Because of your age alone, you are in a high risk group and you also need to consider passing on the autoimmune propensity to your progeny.

I do hope I have been helpful to you and the others will chime in I am sure. The decision is up to you and we will support you no matter what decision you make. We are only here to offer our opinions, experiences and support. ( "Maybe a tad of knowledge; hee hee!")


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