# Between a rock and a hard spot.



## laneygreen (Feb 15, 2017)

Okay, ill start with some back story. I am 20 years old with two little girls. One is four years old and the other is six months old. In November of 2016 I went to the ER for feeling weak and dizzy. Well turns out my heart rate was 187! Now i am on a beta blocker to keep it in the 80s and 90s. I just got my labs done again, I am awaiting those results on the 23rd (February). The lab that diagnosed me with Graves disease was my TSH Antibody Receptor, which was 6.51. That is the only one I have gotten back. I don't know the normal range for that.

Anyways, I have horrible Anxiety and depression. I have chest tightening, Chest pain, extreme fatigue, and numbness. I have talked to my GP about these symptoms and it is my anxiety acting up. I cant keep on my days thinking I am having a heart attack three times an hour. If my labs have increased on the 23rd I am considering a TT. I honestly don't want to go through the Methimazole treatments and upping and downing the dosage, especially breastfeeding my 6 month old. My heart rate is already out of whack.

Anyways, I have quite a few questions about TT. What is the Pre-Op like? When is the breathing tube placed? When you get out of surgery what is it like? What is the recovery like? What is the chance of something going wrong? I am a mess. Im an over thinker and my anxiety doesn't help. My mind goes straight to "What if you die?". I know thinking like that DOES NOT help me one bit, but its me right now. Do your symptoms improve afterwards? It would be my first surgery.

Im not sure I want to get it taken out, but i'm not sure how much longer I can deal with these symptoms.


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## Lovlkn (Dec 20, 2009)

Welcome to the board!



> I am considering a TT. I honestly don't want to go through the Methimazole treatments and upping and downing the dosage, especially breastfeeding my 6 month old. My heart rate is already out of whack.


I would have to agree with you. I had small kids and was on them for 4.5 years - the endo kept me mostly hypo which caused a whole group of new symptoms.

I will respond in bold inside the quote.



> What is the Pre-Op like? *No big deal. They talk to you about the anesthia and I highly suggest asking for a smaller breathing tube. I had a D&c and came home with a wicked sore throat. I have had several surgeries since and always ask for a small breathing tube and have no throat pain.*When is the breathing tube placed? *When you are asleep *When you get out of surgery what is it like? *I felt fantastic - I am sure it was the anesthesia and pain med's given. They will dope you up with pain meds for the first 24 hours. They will likely keep you in the hospital over night - not an official check in but rather a 24 hour post surgery recovery - mine was in a private room. Stay ahead of the pain which means - when they offer, take it, just for the first 24 hours. Then the next day you will probably sleep and take some perkiset level pain meds. *What is the recovery like? *For the first few days take it easy. I cooked dinner the first night I was home**, Started hormone replacement day 3 - I drove day 5 for first lab draw. My kids were 8 and 10* What is the chance of something going wrong?* Rare - but do ask your surgeon if he has ever cut the laryngeal nerve of a TT patient. Your surgeon should be performing 4-5 thyroid removal surgeries weekly. You want someone experienced. *I am a mess. Im an over thinker and my anxiety doesn't help.*Ask for some lorazapam. Your issue is due to having Graves disease. I was on Lorazapam prior to my surgery and in pre op I asked for some and the nurse chilled me out in no time. I was a complete wreck - thought the worst ( death would occur) and woke up feeling like I was in heaven. It was the right choice for me. * My mind goes straight to "What if you die?". I know thinking like that DOES NOT help me one bit, but its me right now. Do your symptoms improve afterwards? *{{hugs}}*


Ask for copies of all your labs - post results with ranges.


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## joplin1975 (Jul 21, 2011)

I was a nervous nelly about surgery - I DID NOT WANT IT. And after all was said and done? It was a piece of cake. In retrospect, I wish I had asked for anti-anxiety drugs.

Pre-op was pretty non-eventful. They went over the procedure, asked me to sign a bunch of forms, started an IV, talked to my husband about how and when they would be in touch etc. I was then given versed and can remember being wheeled toward the OR, have a faint memory of seeing the OR and saying hi to my surgeon, but after that, I don't remember a thing. The breathing tube is placed after you are out of it -- you'll have no memory of it.

I had no pain when I woke up. The biggest issue was that I was hungry and had to pee. They put a thin layer of vaseline over my eyelashes so the tape that they use to close your eyes won't stick and I remember that my eyes felt gooey. But that was it.

I had to stay over night. They want to keep an eye on your calcium levels post-op. Your parathryoid glands sit on your thyroid and control the calcium level in your body. When they remove your thyroid, they "implant" the parathyroids into the strap muscles in your neck. Some people's parathryoids start working right away. Others take a while to "wake up." If your calcium drops too low, it can be dangerous, so they like to monitor that.

I couldn't sleep in the hospital or for about 12 hours after I got home. Sometimes when you have thyroid surgery, your thyroid "dumps" excess hormone into your system. So I was jittery, anxious, and had heartburn. But, about 24 hours after surgery, I crashed and slept well.

Recovery was easy. My doctor insisted I stay out of work for two weeks, but I started answering emails and taking business calls at home two days after surgery. For me, the surgery was the easy part. Getting my meds regulated after surgery was more of a challenge...but it was also where this board played a critically important role in my recovery and my ability to self-advocate.


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## jenny v (May 6, 2012)

Apparently I was the lone person who woke up sick after surgery, but I had a jackass of an anesthesiologist (my dad, who is an anesthesiologist himself, is still angry with her 3.5 years later, lol). If you get car sick or nauseous easily, tell your anesthesiologist ahead of time and make a big deal about it if you feel they aren't taking you seriously.

Most people don't get sick, but some do, and good anesthesiologists know the ways to avoid this.

I was back to work in a week and it was an easier surgery than my gum surgery a few years ago.


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## blackngold (Oct 28, 2011)

Did they run a complete blood count ? You should avoid stress like thinking you should need a TT when you don't even know what your results are pregnancy can trigger things make sure you're not anemic nursing takes alot out of you especially if you're hyper I hope you have a good doctor


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## Lovlkn (Dec 20, 2009)

> If you get car sick or nauseous easily, tell your anesthesiologist ahead of time and make a big deal about it if you feel they aren't taking you seriously.


Quote above from JennyV

Tell them even if you do not - they will make special precaution. My husband is a post surgery puker - found out after wisdom tooth removal. Now it's just easier to tell them and the anesthesiologist will take precautions which do indeed work.


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## Sabrina (Aug 30, 2016)

laneygreen said:


> Anyways, I have quite a few questions about TT. What is the Pre-Op like? When is the breathing tube placed? When you get out of surgery what is it like? What is the recovery like? What is the chance of something going wrong? I am a mess. Im an over thinker and my anxiety doesn't help. My mind goes straight to "What if you die?". I know thinking like that DOES NOT help me one bit, but its me right now. Do your symptoms improve afterwards? It would be my first surgery.


I can't help with the other questions, but I can say that the surgery was not a big deal (in hindsight). I am an anxious person with an incredible imagination that can forsee any and all things that might go wrong.  I was very nervous before mine, and didn't really have a ton of time beforehand to prepare.

I did do a will and living will, and authorized certain people to be able to ask questions about my medical condition in the event of emergencies, beforehand.

I made 100% sure I liked my surgeon and that he did at least 25 of these annually (he does about 100). I asked about neuromonitoring, which helps them ensure minimal impact to vocal cords. In the event of nerve stress they told me they would stop at one lobe and do the other later, very rare, but better than having vocal damage. By the way, I was able to talk in recovery, just hours after the procedure.

Again, I am a nervous person so they gave me something to take before going to the hospital, then something gentle in pre-op, even used lidocaine to do my IV, and I got in early for surgery and was out in about 2 hours I think? They were reall nice, and I vocalized my concerns along the way and everyone accommodated them the best they could.

I had to stay overnight which sucked. My brain was foggy from the anesthesia for about four weeks. I couldn't drive for about a week because it was hard to turn my head.

My surgery story is in the link in my signature line and I am glad to answer any questions you think I could help with.

Wishing you the best.


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## laneygreen (Feb 15, 2017)

Thanks. I did my complete lab Wednesday, I will know my results Thursday (23rd). I keep looking and looking for more information about Methimazole and breastfeeding. I'm honestly really hoping it was just postpartum hyperthyroidism. Which is quite common. I'm hoping my labs went down. I'm always tired. It sucks. My pulse is still up, but I take metoprolol for that. I know being hyper can wear you out, but now i'm tired, like always tired. Fatigued. Exhausted. Ive been reading on my options since I found out about it. My family has ZERO history of graves or any thyroid disorder. Which makes it odd that I would have it. See ive never had surgery, the thought of it just scares me half to death. I know if my labs are down, I wont have to start any medication or even think about surgery again. I got diagnosed with my panic and stress disorder when I went to the ER back in 2015 when my left arm was completely numb. I've since had two EKG''s and an ultrasound and everything looks great on them. Does anyone on here is/or has taken Metoprolol with Setraline?? I got it prescribed again, but i'm not sure about the whole low blood pressure interaction with the baby.


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## Lovlkn (Dec 20, 2009)

> Setraline


I have no idea about interactions - I just wanted to mention that when in my DX phase my doctor tried and tried and tried to get me on antidepressants. Being hyper can really make one feel on the edge or in the middle of everything you describe below...



> Anyways, I have horrible Anxiety and depression. I have chest tightening, Chest pain, extreme fatigue, and numbness. I have talked to my GP about these symptoms and it is my anxiety acting up. I cant keep on my days thinking I am having a heart attack three times an hour.


Nobody had started you on PTU for the Graves DX yet? If you are breastfeeding you need PTU not Methimazole.


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## blackngold (Oct 28, 2011)

I hope that is all it is and you can just move past this !!! good luck with everything <3


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## laneygreen (Feb 15, 2017)

Lovlkn said:


> Nobody had started you on PTU for the Graves DX yet? If you are breastfeeding you need PTU not Methimazole.


 No. I start today. I am updating with my labs. PTU is not what they recommend for pregnant or breastfeesing women. It has far more side effects than Methimazole.


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## laneygreen (Feb 15, 2017)

Okay so my labs came back. I am comfirmd i have Graves. I start 5mg of Methimazole today.

Thyroglobulin Antibody is 413.0 range is 0.0-4.0

T4 is 1.88 range is 0.71-1.85

Thyroid Peroxidase Antibody is 1819.0 range is 0.0-9.0

TSH is <0.015 range is 0.49-4.67

Red Blood Count is 5.29 range is 3.80-5.20

TSI is 249 range is <=122

T3 free is 5.39 range is 2.18-3.98


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## joplin1975 (Jul 21, 2011)

Wow - those are some really high antibodies. If you don't have surgery, make sure you have an ultrasound.


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## laneygreen (Feb 15, 2017)

joplin1975 said:


> Wow - those are some really high antibodies. If you don't have surgery, make sure you have an ultrasound.


I have one scheduled for the 3rd (March). My endo said if I were to have surgery right now there's a high chance my heart would go into shock from all of the hormones. His plan is to do a month of 5 mg taken once a day of Methimazole and see where my labs are at on the 30th (March) to see if we need to up it. He said the way it looks I could be on Methimazole for roughly 2 years before I go into remission. I'm glad he doesn't think I need surgery right away. I read the numbers and I was like "there must be a mix up" but nope, those are it.


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## jenny v (May 6, 2012)

Wow, you are definitely hyper! Those are some pretty crazy antibody levels, so I'm glad you're doing an ultrasound soon. 5mg of methimazole is probably not going to be nearly enough, so make sure you check things as much as possible. Breastfeeding is hard on the system and so is Grave's, so you want to take extra care of yourself right now. I've seen studies recently that say methimazole is as safe as PTU for breastfeeding, but if you are feeling any side effects, know that you have options.


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## joplin1975 (Jul 21, 2011)

Yup, you definitely need to get things under control before you do surgery.


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## Lovlkn (Dec 20, 2009)

Apparently the recommendations have changed due to some recent studies - regarding PTU vs Tapazole.

5mcg is considered a low dose so looks like all will be fine with breastfeeding.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2726094/


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## blackngold (Oct 28, 2011)

Dang girl sorry this was the result we wasn't looking for anyway stay positive !! I hope you get a remission


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## laneygreen (Feb 15, 2017)

Its ok! Yeah I get my blood drawn again on the 23rd to see if we have to up the dosage. I know I can safely take up to 20mg daily of methimazole. Yeah, we discussed surgery and basically said my heart will go into shock, so yeah. Im hoping the methimazole does its job!


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## blackngold (Oct 28, 2011)

TSI is not too bad mine was 480 something when diagnosed stay positive always let TT be last resort always good luck !!!!


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