# just thinking ahead



## StacyAr (Nov 10, 2012)

If I wind up not tolerating the meds and have to either have rai or thyroid removal, how does one decide? Ive read the pros and cons but I'm still torn. Id lean toward the surgery so I don't have to wean but I wonder if a thyroidectomy wouldnt cause my milk to stop.?? Also there are so many different opinions as to when you can safely hold your kids after rai and the most conservative one I read said three weeks!!! That's near impossible with an infant!! Also wondering everyones opinions on future cancer risk elevation from rai. Those are the three questions I wanted to run by you all.


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## webster2 (May 19, 2011)

I opted for surgery. I had had half removed in my early 30's and RAI was not an option then, so I went with the devil I knew. It is not a difficult surgery.


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## StormFinch (Nov 16, 2012)

1. I've seen estimates of separation from children for as little as 5 days, as many as 11 and on up to 2 - 3 weeks. HOWEVER... I've also read that breastfeeding should be stopped 6 weeks before RAI and cannot be continued afterwards (pump and dump only, RAI builds up in the ducts), although it can be done after subsequent pregnancies which are not advised until 6 months to a year after the procedure. On the other hand, I haven't seen anyone mention that milk production stopped after thyroid surgery.

2. If you have any eye symptoms AT ALL you want to go TT. RAI makes eye symptoms worse according to patient accounts and scientific studies.

Admittedly I'm biased, but with an experienced surgeon TT is easy; in one day, out the next with not a whole lot of physical symptoms. I felt better a LOT faster than I did with either of my pregnancies, or any of my other past surgeries for that matter.

Something lead me to believe we might live in the same state. If you decide to go TT give me a yell and let me know which state you're actually in. I *might* have a really good Endo surgeon for you.


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## Lovlkn (Dec 20, 2009)

I am a firm believer in surgery.

One and done - get on with your life.

If you have any eye involvement at all then you should absolutely choose surgery.


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## joplin1975 (Jul 21, 2011)

I think if you have kids - especially a small one - surgery makes the most sense. I don't know if surgery would impact your supply, but there's lots of hormonal upheaval after surgery, so it seems reasonable to assume it could impact how much milk you produce. But having a dip in supply seems a lot more tolerable to having to quit cold turkey.


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## jenny v (May 6, 2012)

I haven't had either RAI or surgery but I have seen stories on this board of people having to have RAI more than once because the first dose didn't kill off their thyroid entirely and their symptoms came back. I would opt for surgery, personally.


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## StacyAr (Nov 10, 2012)

[Hey..thanks. I'm in upstate new York. You? Definitely interested in recommendations!!

Why on earth would you have to stop nursing 6 weeks before rai?? Ugh!!!!!!!
!

[/B]


StormFinch said:


> 1. I've seen estimates of separation from children for as little as 5 days, as many as 11 and on up to 2 - 3 weeks. HOWEVER... I've also read that breastfeeding should be stopped 6 weeks before RAI and cannot be continued afterwards (pump and dump only, RAI builds up in the ducts), although it can be done after subsequent pregnancies which are not advised until 6 months to a year after the procedure. On the other hand, I haven't seen anyone mention that milk production stopped after thyroid surgery.
> 
> 2. If you have any eye symptoms AT ALL you want to go TT. RAI makes eye symptoms worse according to patient accounts and scientific studies.
> 
> ...


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## joplin1975 (Jul 21, 2011)

I'm an Upstater, too. I adore my surgeon and would be happy to PM you his name, if and when you get to that point.


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## StacyAr (Nov 10, 2012)

joplin1975 said:


> I'm an Upstater, too. I adore my surgeon and would be happy to PM you his name, if and when you get to that point.


Oh id love to know.. message me when you have time if that's okay?


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## StormFinch (Nov 16, 2012)

Looks like joplin has you well taken care of. Not sure why I was thinking we were in the same state, but turns out we're not.

As to the six weeks before, I think it has to do with the fact that the radiation can build up in the milk ducts. If you're dry it's less likely to. I've seen a few days before also mentioned so that's probably the time when pump and dump is required.


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## Jackajacka42 (Aug 18, 2012)

I have graves with slight eye irritation but I went with rai because... Well... I'm not sure why now. At the time it seemed easiest. I regret it only because it has taken so long to get things back to normal. So much waiting! A least with surgery they know for sure you are done and hypo and can start you on meds to level things out. I feel like with rai it was a big roller coaster if misunderstandings and confusion as to what was happening and why and I was stressed and agitated for 3 or 4 months before going to my GP in tears because I didn't understand the endo. I have a better grasp now only because of months and months of my own research. If I had to do it again I'd opt for the surgery, but only to save myself all the heartache of waiting and wondering.


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## StacyAr (Nov 10, 2012)

It's all so scary, and the more I read, I feel like, if Graves is an autoimmune disease that attacks the thyroid, what happens next when the thyroid is either out of commission or removed from the equation?


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## webster2 (May 19, 2011)

Hey, I just read this...I am in Vermont, not sure how close you are but the ENT I had was voted in the top 20 in US News & World repport recently.


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## StacyAr (Nov 10, 2012)

Webster, I am trying to go to one an hour away next week. If that one is also unsatisfactory, I may take your recommendation. How far into Vermont from the Troy NY border is he? I am an hour from Troy. Thanks!!


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## webster2 (May 19, 2011)

I hope your doctor will meet your expectations but if not, he's in Burlington...our only big town!


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