# Scheduled for the week of July 16th. Advice?



## MJRusso

Biopsy came back suspicious for papillary carcinoma. There's a discrepancy on the size of the tumor (CT scan estimated 6mm, but Dr. said during U/S guided biopsy it was 1.1cm. I think he's right). My surgeons want to take a closer look at the CT scan but we're starting off with an 8cm incision across my neck and a partial thyroidectomy on the right side, then they'll do a frozen section while I'm still under. If the tumor is 1.1cm they're going to do a TT regardless of the frozen section results. If it's small and/or the frozen section comes back inconclusive/negative, they'll sew me back up and wait for the full path report then bring me back in a few weeks to take the rest out if needed.

RAI is still up in the air, but deep down in my gut I'm expecting it. They said if it comes to that they may push it out to 8 weeks after the surgery because of the iodine still in me from the CT scan (though it has already been almost 2 weeks and it'll be 5 weeks by the time the surgery is done, so I don't think it'll be pushed that far). That's all down the road though. I'll worry about that when I get there.

Anyway, I've read through a lot of other surgery threads, but was hoping to get some direct advice on what I should bring to the hospital with me, what I should have ready at home once they release me (certain foods? OTC medicines?) and other things I may not have thought to ask.

How long did it take for you to get up and get out of the house? How long before you started driving again? Talk normally? Did you experience any fatigue and how long did the thyroid meds take before having any kind of effect? I have several evening meetings a week every week throughout the summer and I'm trying to gauge how many of these I might miss after the surgery(s).

Thanks in advance!

~Mike


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## webster2

MJRusso said:


> Biopsy came back suspicious for papillary carcinoma. There's a discrepancy on the size of the tumor (CT scan estimated 6mm, but Dr. said during U/S guided biopsy it was 1.1cm. I think he's right). My surgeons want to take a closer look at the CT scan but we're starting off with an 8cm incision across my neck and a partial thyroidectomy on the right side, then they'll do a frozen section while I'm still under. If the tumor is 1.1cm they're going to do a TT regardless of the frozen section results. If it's small and/or the frozen section comes back inconclusive/negative, they'll sew me back up and wait for the full path report then bring me back in a few weeks to take the rest out if needed.
> 
> RAI is still up in the air, but deep down in my gut I'm expecting it. They said if it comes to that they may push it out to 8 weeks after the surgery because of the iodine still in me from the CT scan (though it has already been almost 2 weeks and it'll be 5 weeks by the time the surgery is done, so I don't think it'll be pushed that far). That's all down the road though. I'll worry about that when I get there.
> 
> Anyway, I've read through a lot of other surgery threads, but was hoping to get some direct advice on what I should bring to the hospital with me, what I should have ready at home once they release me (certain foods? OTC medicines?) and other things I may not have thought to ask.
> 
> How long did it take for you to get up and get out of the house? How long before you started driving again? Talk normally? Did you experience any fatigue and how long did the thyroid meds take before having any kind of effect? I have several evening meetings a week every week throughout the summer and I'm trying to gauge how many of these I might miss after the surgery(s).
> 
> Thanks in advance!
> 
> ~Mike


Sorry to hear your news. If your nodule is over 1 cm, you will most likely have RAI. It is probably best to expect it.

The hospital stay isn't usually too long. Some people have enjoyed having an i-Pod or MP3 with them. I was all about comfy clothes.

Ice packs can be handy to have at home after to ice the incision. Some people have had soft foods available, but I ate French Toast for breakfast on discharge day. I drank a ton of ice water at home. My throat was scratchy, but not horribly so. Some people have mentioned that sleeping on their side was troublesome after surgery.

I didn't take pain meds or OTC meds at home after a couple of days. TUMS were suggested for awhile to replace calcium from the parathyroids gettting bumped around.

I was up and around taking walks outside within a day. My voice was weak for awhile, can't say how long. No driving until the neck can move smoothly, for me it was about a week or so. The big surprise for me was that I had planned to catch up on reading and movies but I had no attention span for awhile. It was very strange.

You might find yourself tired in the evenings for a short while. If RAI is a possibility, you most likely won't start on replacement right off.

Best wishes to you!


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## joplin1975

Ok, let's see...

1) I did not sleep in the hospital after surgery. I don't know if it was the pain meds (I got a small dose in recovery), the hot flashes, or the noise in the hospital, but I was up all night. I watched TV and played around on my phone, but I would have loved my iPad to play games etc.

2) Webster's right...I, too, planned on doing a lot of reading, but my brain was total mush and my ability to concentrate just wasn't there. I watched a lot of crap TV and would have loved to stock up on "easy" movies to watch.

3) I also had french toast the morning of discharge (must be the meal of choice at hospitals!) and had no issues eating it. I also was begging my husband to sneak me in a cheeseburger.  That said, while I had very little to no pain, my thyroid was so enlarged (at least, this is my theory) that when I did start up eating again, I had a weird "stretching" sensation on the side of my throat where the largest tumor was...I presume it was pressing on my throat for years and now that "stretching" feeling was my throat having room. Again, no pain, but it bothered me, so I did tend to eat softer foods -- pasta, scrambled eggs, soups, yogurt, oatmeal, etc.

4) I was talking fine in the recovery room (was having a VERY vivid dream we were in Mexico doing tequila shots, so my first words about waking up were "What happened to my tequila shooter??"). I never had an issues and was on the phone with my mom the next day. After I got home, friends sent flowers etc and I had to holler at my dog to stop trying to dismember the Fed Ex and was easily able to yell at her.

5) For some reason, the muscles in my neck got really sore if I tried to drink without a straw. And, I really liked the sensation of cold drinks. So for the first week and a half, I drank from a large insulated cup with a straw.

6) I did not ice much -- maybe once or twice. I did not like the sensation of anything being in contact with my incision.

7) On that note, I lived in low-cut/v-neck/zip-up/button-up shirts. I doubt everyone does that, but I would suggest you have something like that for discharge from the hospital.

8) I was not on thyroid meds immediately, so I was pretty tired. I went to bed most nights around 7:00 or 8:00. Lots of people say they took lots of naps. I frankly didn't -- I've never been a good napper -- but I did do a lot of laying around. My surgery was on a Monday and I was taking work calls on Wednesday. If I could nap, I could probably make evening meetings.

9) I didn't start driving until about a week and a half out. The pulling sensation on my stitches really bothered me, so I didn't like turning my neck. Once the stitches were out, it was much better and I just had to work the stiffness out of my neck.

10) I took three advil three times a day for the first four days. I probably didn't need it, but I wanted to "stay ahead" of any pain. I pulled back from that schedule pretty quickly.


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## joplin1975

Also, I'm a visual person...I don't know if this helps, but here are pics of my scar. Keep in my I had a TT and a central neck dissection (10 total nodes removed):
The morning of discharge, approx. 12 hours after surgery:









One week out:









Three weeks out:









Today ~10 months out (don't know why my neck looks so weird! You can't really see it unless you are looking for it):


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## DonnaK

I'm only one week post TT as of today. I was in the hospital less than 24 hours, but only had ice chips and apple juice while I was there, but I was down to practically not being able to eat anything because of the way my thyroid was wrapped around my esophagus and I think I was still afraid to try and swallow for a while. Ice water has been my best friend for the last week. I finally had some cream of wheat on day 3 and scrambled eggs on day 4. I only wanted my comfy pj's and tv for the first 24 hours, oh and pain killers.  I did ice the first 48 hours, but after that didn't really feel like I needed it. My voice was fine after two days and today I drove down to the grocery store, but it's only a mile down the road. Not sure if I could do any long trips. I am exhausted by late afternoon and need to rest for a while. I was answering work emails on day 5 - didn't want anything to do with any of them (at work) until then. LOL

Low cut is a must - no way could I put on a shirt that came near the incision right now. I'm not sure yet how long that will last, but I am thinking until the stitches are out. I can't wait to get that done on Monday!!


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## webster2

I am still wearing V necks!


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## DonnaK

Really, webster? Is it because of the surgery it still bothers you to have anything around your neck? I could never do turtlenecks my whole life - I have a very short neck and they bothered the heck outta me. I was always able to wear shirts at the neckline though, in fact two of my pj's come right at the incision and I am totally staying away from those right now but they were fine before.

When you had your surgery last summer, what did you do when you went out in the beginning and the incision was still kinda open looking? I taped a big bandage on mine today but had everyone in the store getting out of my way. LOL


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## angel1976

joplin1975; your neck looks wierd because the camera was to close so it made fish-eye lens effect!


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## Abcdefg

Good luck MjRusso with your surgery. Best wishes to you, and hoping it turns out to be benign. *hugs*.

If it's any consolation, I'm having my surgery on Friday the 13th lol.. I'm trying to find a bit of humor in it, it just seems so fitting with the whole situation.


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## MJRusso

Thank you all again. The tips and pics have/will help a lot.


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## webster2

DonnaK said:


> Really, webster? Is it because of the surgery it still bothers you to have anything around your neck? I could never do turtlenecks my whole life - I have a very short neck and they bothered the heck outta me. I was always able to wear shirts at the neckline though, in fact two of my pj's come right at the incision and I am totally staying away from those right now but they were fine before.
> 
> When you had your surgery last summer, what did you do when you went out in the beginning and the incision was still kinda open looking? I taped a big bandage on mine today but had everyone in the store getting out of my way. LOL


Yeah, even the seat belt still bothers me if I drive. I do have 2 new benign growths in there and swelling on the left side. I used to love turtle necks, not any more.

I am not sure how far down your scar is but the ENT used the same line as my old scar which is really low. He said he normally placed them higher but since I already had one he didn't want to add another.

Did have have stitches or glue? I had glue this last time.

I use sunscreen all the time. I spend a lot of time on the water. I wore a lot of funky scarves especially at work since it was summer vacation and the kid traffic was higher. One kid could not take his eyes off my scar when I first went back to work. I wanted to make up an outlandish tale involving reprecussions from overdue library books but contained myself! 

I am glad you are feeling well enough to go out!


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## adenure

Hi!

I'm 3 weeks post- op. I was sent home about 4 hours after surgery. My surgery was about 2 hours & 45 min. I had a TT for Graves (the ATD's were damaging my liver). I just brought a shirt that had a low enough neck line to be comfortable going home (and for a few weeks after). I took 600 mg. of Advil 3 times a day I think for the first 3-4 days. I never took the Vicadin (not a big fan of that stuff). I was able to swallow the Advil even after surgery. My surgeon had me take Tums 1 gram (1000 milligrams) 4 times a day the 1st week, 3 times a day the 2nd week & twice a day the 3rd week. My parathyroids were not damaged, but bc they get inflamed from surgery, he said the Tums was important for a few weeks.

I had to sleep upright (relatively- 3 pillows, but I slept in a recliner) for 3 nights per surgeon's instructions (he said gravity helps with drainage). I could talk, swallow, drink & eat, and breathe easily after surgery. I would say day 6 is when I started to feel better, but I was able to get up and walk around pretty well on my own about 48 hours after surgery. My voice was weak for about 2 1/2 weeks I'd say, but I could talk; my voice just got tired easily and I found that I talked from the "higher" part of my vocal chords for awhile. I can talk perfectly fine now and don't tire much, but I can't really shout loudly. My surgeon said it would take about 6 weeks for my voice to be 100% again. He said in 3 months it will feel as if I never had the surgery.

I had a subcuticular stitch and a suture. The suture was removed 2 weeks after surgery (but 1 week would have been fine). I was able to shower 24 hours after surgery.

I'm on 100 mcg. of Synthroid (brand name) and am feeling pretty good so far. I get my labs done in another week or 2 to check my levels. I take it first thing in the AM with a lot of water and wait 1-2 hours to eat (just me being cautious- 1/2 hour to an hour is fine) and the Tums 4 hours after Synthroid. I started the Synthroid the 2nd day after surgery.

I'm happy that I had the surgery, but I would say making sure you have a great surgeon is super important. You could ask if he uses a nerve stimulator to locate the RLN--recurrent laryngeal nerve-- to avoid vocal chord damage. Good luck to you & I hope all goes well.


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## DonnaK

webster2 said:


> Yeah, even the seat belt still bothers me if I drive. I do have 2 new benign growths in there and swelling on the left side. I used to love turtle necks, not any more.
> 
> I am not sure how far down your scar is but the ENT used the same line as my old scar which is really low. He said he normally placed them higher but since I already had one he didn't want to add another.
> 
> Did have have stitches or glue? I had glue this last time.
> 
> I use sunscreen all the time. I spend a lot of time on the water. I wore a lot of funky scarves especially at work since it was summer vacation and the kid traffic was higher. One kid could not take his eyes off my scar when I first went back to work. I wanted to make up an outlandish tale involving reprecussions from overdue library books but contained myself!
> 
> I am glad you are feeling well enough to go out!


Dang.....I am sorry to hear you have new growths. I didn't realize you could have that once you had the whole thing out. :hugs:

My incision is just above my collar bone. I am already okay wearing a necklace, but the seat belt still bothers me although it has always bothered me where it hits since I am so short.

I had three stitches - one at each end and one in the middle and two layers internally. I am using mederma with spf during the day and put vitamin E on it when I go to bed. Since the stitches are out and the steri-strips(?) are off, I just go out with it the way it is. You can't really tell anything is there anymore unless you look really close and I am only 16 days post-op! I think they did a really good job considering it is about a six inch cut.

LOL......the overdue books story could have been hilarious!!

Sorry, to have gotten a bit off subject on your thread MJ.


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## Andros

DonnaK said:


> Really, webster? Is it because of the surgery it still bothers you to have anything around your neck? I could never do turtlenecks my whole life - I have a very short neck and they bothered the heck outta me. I was always able to wear shirts at the neckline though, in fact two of my pj's come right at the incision and I am totally staying away from those right now but they were fine before.
> 
> When you had your surgery last summer, what did you do when you went out in the beginning and the incision was still kinda open looking? I taped a big bandage on mine today but had everyone in the store getting out of my way. LOL


I never had the surgery but I did have a goiter and I absolutely cannot stand anything around my neck.


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## MJRusso

Adenure, thank you very much for the post. Very helpful.



DonnaK said:


> Sorry, to have gotten a bit off subject on your thread MJ.


 No worries! Chat away.


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## MJRusso

Well, talked to the surgeon again yesterday and the surgery is scheduled for Wed July 18th at 8 am. Going for a prep visit and some blood work on Monday.

Also found out yesterday that I have a chronic infection in my sinuses (Chronic Sinusitis). Apparently I have benign, infectious growths that are closing up my sinus passageways, which the Dr. said may be adding to my fatigue and headaches because my body is constantly in "fight mode". It's going to require endoscopic surgery after all of this and I was told I'd probably be pretty sick for a week after that surgery.

Man.... it just keeps piling up. But I'm glad it's all coming out now and it's good to know that in a few months time I should feel better than I have in years. At least I hope so anyway.


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## webster2

Thanks for checking back in, I have been wondering how things are going for you. You sure deserve to feel better.


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## Octavia

Sounds like a big step forward. Is the same ENT doing yout thyroid surgery and your sinus surgery? (Can you get a two for one deal?  )


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## Lovlkn

Mike,

Have you asked about having your entire thyroid removed?

I've heard too many stories of the partial becoming a full thyroid removal - thus 2 surgeries.

Keep ice on your incision to help with swelling.

I too have the low cut neckline issue - post surgery it drove me crazy.

Have a massage of your neck muscles to release them after the surgery - mine were tight as could be and likely a result of my neck positioning during surgery.

Stay ahead of the pain with medication , especially the first 2 days. after that I was on 600 mg of Motrin for a few days.

I drove day 5 for lab tests

Fatigue was my main complaint post op and it was bot enough replacement meds, low ferritin and low vit D levels.

Calibrate your replacement dose based on 1.7mcg per kilogram of weight to start. Insist on FT-3 and FT-4 testing to calibrate doses.


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## MJRusso

Lovlkn said:


> Mike,
> 
> Have you asked about having your entire thyroid removed?
> 
> I've heard too many stories of the partial becoming a full thyroid removal - thus 2 surgeries.


 I did ask. My surgeon discussed both options: total removal and a partial, which like you said would include a 2nd surgery if the path report came back positive. But, he said because I'm male and have a history of cancer that it would be better to do a total removal. So I'm opting for that just to get it over with.


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## MJRusso

Octavia said:


> Is the same ENT doing yout thyroid surgery and your sinus surgery? (Can you get a two for one deal?  )


 It is the same ENT! I think I might actually ask for a discount deal...lol


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## Lovlkn

I highly doubt they would do 2 surgeries at the same time - liability.

When I had my c-sections I asked about a tummy tuck and they said NO. However I must say they did an awful nice job on sewing me back up.

Mike - make sure your surgeon performs at least 4-5 thyroid removals a week. You need to be sure you have experience with this surgery.

Also, don't sweat not having a thyroid - you will adjust and as long as your replacement meds are proper you will be fine. I was paralyzed with making the decision to remove mine as I did not have cancer - just graves that was completely uncontrollable.


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## Octavia

Lovlkn said:


> I highly doubt they would do 2 surgeries at the same time - liability.


I was kidding about that. 

(While it is a nice thought to get it over with all at once, it would be too risky, not to mention miserable afterwards.)


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## MJRusso

Lovlkn said:


> Mike - make sure your surgeon performs at least 4-5 thyroid removals a week. You need to be sure you have experience with this surgery.


 Thanks for the advice. I did ask about that. He said he does them every day. I feel pretty good about who I've got here.


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