# Partial Thyroidectomy



## MieMieMie (Aug 8, 2016)

I figured it was time for me to move out of the Newbie section 

I met with the Endocrinologist who explained everything a million times better than the ENT. I have a golf ball sized nodule (benign) and its right on my isthmus. That is why I'm having difficulty swallowing and breathing at night. She said that she can't prescribe me any medicine and the nodule isn't going to shrink or go away. She recommended a partial thyroidectomy and wants me to have a surgery consultation. There is another nodule that she wants biopsied. It's 1.6cm and has "suspicious" characteristics. I meet with the Endocrine Surgeon on September 7th. I have done research on her and she is a member of the American Association of Endocrine Surgeons and very active with thyroid research.

I think the thing that I'm most concerned with is removing half of an organ that is functioning well (albeit with a giant nodule growing on it) The Endo mentioned that half of the thyroid can potentially do the work of the entire thing. Since I have normal function now, does that mean that I'm less likely to need thyroid medicine after? Also, since I have so many nodules, are the others likely to grow this large and me possibly need a second surgery in the future? (There are three other nodules that are larger than 1cm) I'm okay taking medicine forever if need be, but I'm really concerned that I'll feel worse after surgery than I do now. Right now I feel fine, other than this thing making it difficult to swallow and breathing when I lay down. I just feel a little confused.

MULTIPLE B/L HYPOECHOIC COMPLEX NODULES SOME WITH PUNCTATE CALCIFICATIONS AND ONE

WITH COURSE CALCIFICATIONS

RT: MP: IRREG SHAPED SOID NODULE W/ COARSE CALCIFICATIONS 15 X 9 X 11mm, AND A MP 6mm SOLID NODULE

LP: MAINLY SOLID W/ CYSTIC NODULE 16 X 7 X 11mm

ISTHMUS: LT LOWER: SOLID W/ PUNCTATE CALCIFICATIONS W/ CYSTIC NODULE 28 X 13 X 20mm, RT: 3mm SOLID

NODULE

LT: UP: SOLID W/ PUNCTATE CALC 14 X 8 X 12mm and AN UP 6mm SOLID NODULE

MP: 8mm SOLID NOD

LP: SOLID W/ CYSTIC NOD 12 X 8 X 9mm

TSH- .67 range- .4-4.0

T3 Free- 4.0 Range- 2.2-4.4

T3 Total- 173 Range 70-180

Free T4 1.34 Range .90- 1.70

TPO- 10.2 Range 0-34


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## my3gr8girls (Mar 18, 2016)

I had my left thyroid and isthmus removed due to a "suspicious" nodule which turned out to be benign. My remaining thyroid is not doing the job so I have started taking levothyroxine. I am probably older than you and my thyroid was not functioning quite as well as yours so you might be okay.


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## joplin1975 (Jul 21, 2011)

A lot of doctors tell patients that the remaining half of their thyroid wil do the job. We don't see that a lot on these boards - I'd say more often than not, people need at least a low dose medication.

No one can tell you definitively that the other nodules will or will not grow, but usually nodules tend to get larger.

Have you had your antibodies tested? If you have them,I'd strongly consider a total thyroidectomy.


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## Lovlkn (Dec 20, 2009)

> The Endo mentioned that half of the thyroid can potentially do the work of the entire thing. Since I have normal function now, does that mean that I'm less likely to need thyroid medicine after?


Maybe - who knows - it's hard to say for sure. What we see around here is people who had 1/2 out and still need med's and usually are struggling to stabilize.

If it were me - I would opt for a total as it will be easier to stabilize post surgery without a thyroid rather than 1/2.

If you have nodules it only makes it harder as they do interfere with thyroid hormone production many times.


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## MieMieMie (Aug 8, 2016)

I had my surgery consult today. I need to have a total thyroidectomy. The way the nodule is covering the entire isthmus, she can't just take one side. My surgery is set for September 27th. I'm extremely nervous and have been researching like crazy. I think I'm more scared about how adjusting without a thyroid will be than about the surgery.


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## joplin1975 (Jul 21, 2011)

I honestly think you'll be so much happier with a total.

Did they explain how and when they will start you on meds? And who's in charge of that process?


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## MieMieMie (Aug 8, 2016)

The Endocrine surgeon will start me on medicine and my regular Endocrinologist will continue after that. Although, I'm not sure how long after I'm supposed to meet with my Endocrinologist. I should ask that. She gave me her email and I've already emailed a couple of questions and she answered quite promptly.

The more that I think about it, I agree, I think it's for the best. Now I won't have to worry about the possibility of a second surgery and I won't have to worry about what is growing in the other nodules. And no more FNAs! Thank goodness!


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## Lovlkn (Dec 20, 2009)

MieMieMie said:


> The Endocrine surgeon will start me on medicine and my regular Endocrinologist will continue after that. Although, I'm not sure how long after I'm supposed to meet with my Endocrinologist. I should ask that. She gave me her email and I've already emailed a couple of questions and she answered quite promptly.
> 
> The more that I think about it, I agree, I think it's for the best. Now I won't have to worry about the possibility of a second surgery and I won't have to worry about what is growing in the other nodules. And no more FNAs! Thank goodness!


manufacturer recommended dose is 1.7mcg per kilogram of weight - many doctors will try to start you on 100mcg. If your weight converts to a higher dose - speak up and ask for it.


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## jenny v (May 6, 2012)

I think a total will be so much better for you in the long run than a partial! It make take a while in the beginning to get your dose right, but you won't be fighting against half of your thyroid to do it.


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## Sabrina (Aug 30, 2016)

I spent my whole summer with test after test and finally a total thyroidectomy just about three weeks ago due to one nodule pretty much the size of one lobe and the other with a nodule roughly half the size of the lobe. Both tested negative for cancer following the surgery.

I am currently working on getting my Levothyroxine fully into my system, which I guess takes six weeks. I have been pretty tired but functional, pretty rapid improvement the first two weeks especially. My first endo appointment is at four weeks.



Lovlkn said:


> If you have nodules it only makes it harder as they do interfere with thyroid hormone production many times.


I think this must be true. I passed off the increasing fatigue I've had the past several years as "growing older" but knowing how taken over my thyroid was with nodules, how could it possibly have been working right?


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## Lovlkn (Dec 20, 2009)

You might also consider testing B-12, Vitamin D and Ferritin levels - all which can contribute to fatigue.

Interestingly enough - post thyroidectomy, I struggles with fatigue and was found to be low in all 3.

Make sure they test both FT-4 and FT-3 and if they refuse then you can have your own labs drawn in you are in the US.


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## MieMieMie (Aug 8, 2016)

Lovlkn said:


> You might also consider testing B-12, Vitamin D and Ferritin levels - all which can contribute to fatigue.
> 
> Interestingly enough - post thyroidectomy, I struggles with fatigue and was found to be low in all 3.
> 
> Make sure they test both FT-4 and FT-3 and if they refuse then you can have your own labs drawn in you are in the US.


I had my Vitamin D checked last year and it was extremely low. 26 (I can't remember the range off the top of my head) I was put on Vitamin D temporarily and wasn't checked after that. I have my pre-surgery appointment with my regular dr and I will ask her to put those in the blood work. Thankfully, every time I've had blood drawn up to this point, all of the doctors have included FT-3 and FT-4 without me asking.


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## MieMieMie (Aug 8, 2016)

Sabrina said:


> I spent my whole summer with test after test and finally a total thyroidectomy just about three weeks ago due to one nodule pretty much the size of one lobe and the other with a nodule roughly half the size of the lobe. Both tested negative for cancer following the surgery.
> 
> I am currently working on getting my Levothyroxine fully into my system, which I guess takes six weeks. I have been pretty tired but functional, pretty rapid improvement the first two weeks especially. My first endo appointment is at four weeks.
> 
> I think this must be true. I passed off the increasing fatigue I've had the past several years as "growing older" but knowing how taken over my thyroid was with nodules, how could it possibly have been working right?


How were you feeling right after surgery? I'm not sure how much help I'll need. I have a 2 year old and a 4 year old. My mom is willing to come in and help for a week or so, but I'm not sure if I'll need her. (My husband works long hours, but he'll be off for my surgery and day after) How long after were you able to drive?

ETA- My mom would be flying in from Alabama to California to help and I'm just not if it's necessary


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## Sabrina (Aug 30, 2016)

MieMieMie said:


> How were you feeling right after surgery? I'm not sure how much help I'll need. I have a 2 year old and a 4 year old. My mom is willing to come in and help for a week or so, but I'm not sure if I'll need her. (My husband works long hours, but he'll be off for my surgery and day after) How long after were you able to drive?


I had surgery in the early afternoon, stayed overnight (was exhausted because the person sharing the room with me had so many issues overnight). I think I was released by 9am the next morning, I had a ride home. I was pretty much able to function but tired and I was very forgetful due to the anesthesia. I took Motrin in recovery, that night and continued for a couple of days, then was off completely. I was mostly stif, not too sore, although the breathing tube made my throat sore for a week. I started Levothyroxine the morning I woke up in the hospital and filled the RX in the hospital as I was leaving.

I was very grateful to have a lot of food ready in advance and people also brought me meals, which was awesome.

I was asked not to lift anything over 10 pounds for two weeks and I think the reasons are strain on the muscles that they part to access the thyroid, plus keeping from putting pressure on the healing skin. I followed it carefully, but it's hard. Also, no strenuous exercise, keep that heart rate down.

I don't have kids so I don't know how much work they are, but I don't think it hurts to have support scheduled and then, if you don't need it, mention it. I was on my own most of the time but friends and family visited and it was nice.

I got really tired really fast especially the first week. I think I tried driving at about 5 days in, I had errands planned but once I got out on the road I tired quickly and I had to cut it short. I did much better at about 9 days and had a lot more energy, and mobility in my neck.

Part of the process is also acclimating to the hormone replacement and getting it built up in your system. I was tired but made rapid improvement the first two weeks. Week three I continued to improve, just not as fast. Today I'm at about 3.5 weeks.

I have a Sunday through Saturday pill box and I make sure I take my RX the same time every day, without eating 2 hours before or 30-60 minutes after I wait as long as I can and take with about a glass of water. And I feel a little better every day.

Hardest part for me was getting past the after effects of the anesthesia. The hospital experience was actually not too bad. Everyone was really nice and my anxiety was accommodated.

I hope this is the info you were looking for. I am glad to answer any questions you think I can help with!


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## jenny v (May 6, 2012)

I would definitely accept the help from mom--you will not be able to lift things for 10-14 days and my surgeon wouldn't clear me to drive until I could fully turn my head (it took me about 6 days to do that). It's an easy surgery, but it's still a major surgery.


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## MieMieMie (Aug 8, 2016)

Thank you so much for the advice! My mom is going to be coming for two weeks. My husband has a week long work trip a few days after my surgery, so I think it's for the best.


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## MieMieMie (Aug 8, 2016)

They moved my surgery up :/ My mom won't be here yet, but we'll figure it out. My surgery is set for Tuesday the 20th. Ready to get it over with!


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## Lovlkn (Dec 20, 2009)

I had a 3 hour surgery - stayed overnight and came home and ended up cooking dinner for my family the day after surgery. While I was tired ( anesthesia) I could function, came off the prescribed pain med's after the 2nd day and drive 5 days later to the lab for blood work. Your kids are younger than mine and I agree the help will be good for you. Do your best to avoid picking up your kids as not to interfere with your healing.


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