# Surgery is scheduled



## melissafitz (May 5, 2013)

Hello everyone,

I met with a surgeon yesterday, and am scheduled to have surgery on August 20.

Briefly, the history is that I had thyroid nodules identified about 4 years ago. They were small then, and have been followed over the years and have been growing. At the latest ultrasound in May, there was a nodule on the left side that was 5.3 cm and one on the right that is 2.3 cm. There are others, but they are smaller and I don't have measurements. I've had FNA biopsy 3 times over the years, most recently in May, and all have been benign.

Throughout all this, my thyroid hormone levels have been fine. Latest labs (in June) were:

TSH 0.80 (0.3-4.7mcIU/mL)
Free T4 1.4 (0.8-1.6 ng/dL)
Free T3 338 (249-405 pg/dL)

I can't say that I've had any dramatic or consistent symptoms. I do get fatigued, but not all the time. I would like to have more energy, but honestly, I'm not sure that my energy level is out of range for a 46-year-old working (part-time) mom of an active, curious, bright, talkative (oh, so talkative!) 7-year old. Sometimes I feel anxious and jittery, but not all the time. I believe I am perimenopausal, and have chalked up some of the fatigue and occasional jitteriness (and irregular periods) to that.

Overall, I feel pretty healthy. I am a healthy weight, and I try to be active. I used to bicycle a lot (have done a few endurance events on the bike). Lately, I don't bicycle as much, but I have been running a bit, slowly working up to the point where I can run for 2 miles. During the school year, I volunteer at my daughter's school, and also volunteer as a coach for her sports team.

My former primary care physician is the one who first discovered my thyroid was enlarged and sent me for imaging and biopsies over the years. After the most recent biopsy/ultrasound, she told me nothing looked too alarming and was dismissive about my concerns. I self-referred to an endocrinologist, who said I would need to have surgery, just because of the size of the nodules and the fact that they are getting bigger, regardless of the benign biopsy results.

Since I have nodules on both sides of the thyroid, I was expecting the surgeon to say that I needed a TT. However, he left the decision up to me as to whether I wanted a total or half. I am leaning towards having the TT, because even the smaller nodule has been getting bigger (1.5 cm in 2009, 1.8 cm in 2010, 2.3 cm in 2013 . . . which, now that I look at it, doesn't seem to be dramatic growth, but it is growth). That's the biggest nodule on the right side, but there is at least one more, that I don't have the size of.

I feel torn. It would be nice to keep half of the thyroid, and maybe not have to take medication. But at the same time, if I take out half now, I am wondering if the other nodules will just grow and I'll need to take them out anyway. And I would rather only have one surgery than two.

I know no one can tell me what to do . . . but I am wondering if anyone has any thoughts about this. Right now, I am scheduled for a TT on 8/20, but the surgeon says I can change my mind and have a lobectomy if I want.


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## joplin1975 (Jul 21, 2011)

I'm a big advocate of a total...but there are others who have been faced with the decision...they'll be around shortly to tell you their opinion.


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## Octavia (Aug 1, 2011)

Do you have antibodies? If you do, then a total would likely be the better option. If you don't, then it's not so clear-cut in my opinion. But since you have nodules on both sides, getting a total would mean one less thing to worry about later.


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## Andros (Aug 26, 2009)

melissafitz said:


> Hello everyone,
> 
> I met with a surgeon yesterday, and am scheduled to have surgery on August 20.
> 
> ...


I believe that most of us vote for TT; especially if you have antibodies indigenous to the thyroid.


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## melissafitz (May 5, 2013)

Thank you for the replies. This last blood test, they did not test for antibodies. The last time I had them checked (Feb 2012) the results were:

Thyroglobulin Antibodies: <20 (with normal range given as <20 IU/mL)
Thyroid Peroxidase Antibodies: <10 (<35 /mL)
TBII: 1 (< or = 16% inhibition)

I could ask to have that re-checked. Even though I keep questioning the decision, I am leaning toward the total simply because it seems likely to me that the nodules on the right side will continue to grow and will need to be taken out eventually. And I'd rather have one surgery than two . . . well, at least I have some time to keep thinking about this . . .


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## DustingMyselfOff (May 17, 2013)

I vote TT but since I only had mine two days ago maybe it's a biased opinion.  My rationale is that if you leave half, you will still be going for frequent bloodwork and chasing that rollercoaster of a sweet spot as the remaining thyroid waxes and wanes. With a TT, my HOPE is that once we find a sweet spot with replacement meds, the dosage will stay consistent pretty much for life.

Good luck whatever you decide....... tough call..... don't you almost wish they would tell you what to do sometimes?
Sue


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## Octavia (Aug 1, 2011)

melissafitz said:


> Even though I keep questioning the decision, I am leaning toward the total simply because it seems likely to me that the nodules on the right side will continue to grow and will need to be taken out eventually. And I'd rather have one surgery than two . . . well, at least I have some time to keep thinking about this . . .


I agree. I had two surgeries...would have preferred just one.


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## KarenB (Jul 19, 2013)

melissafitz said:


> I know no one can tell me what to do . . . but I am wondering if anyone has any thoughts about this. Right now, I am scheduled for a TT on 8/20, but the surgeon says I can change my mind and have a lobectomy if I want.


You're right, no one can tell you what to do. From my own perspective, I just came through a PT (6 days ago) and have been rescheduled this coming Friday for a TT. With the benefit of hindsight, I sincerely wish I had told him just to take the whole damn thing.

It's such a personal decision though. I wish you the very best of luck.


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## Mac409 (Jul 22, 2013)

I'm scheduled August 7 th for a total. I was told I could leave my left side in( I have 3 small nodules on that side) but if the right side comes back cancerous I would have to go back and remove it. Family discussion , and we decided total. I'm scared of what's to follow. I'm 56. The more I read, the more frightened I get.


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## Octavia (Aug 1, 2011)

Good choice, Mac409. What are you frightened about?


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## Mac409 (Jul 22, 2013)

Having to take meds the rest of my life. I'm worried about weight gain. Depression and hair loss. Hot flashes. I read about all these things that will happen. I am so scared.


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## melissafitz (May 5, 2013)

Thank you everyone for the responses.

I am thinking I will have the total . . . unless I change my mind at some point between now and Aug. 20!

Karen, I am so sorry to hear you have to go back for a second surgery. I hope the second one will go as smoothly as possible for you!

Mac, I can understand your fears, as I basically have the same fears and apprehension! For what it's worth, when I expressed these to my primary care physician, she said that once they get my dosage right and if I remain active and take care of myself, then I should not gain weight. It is scary, though . . . I've never had a weight problem and I am apprehensive for sure about what will happen now. maybe someone who has been through it can speak to these issues. I understand it does take some time to get adjusted and on the right dose.


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## KarenB (Jul 19, 2013)

The weight gain thing is a big concern of mine, too. Over the last 3 years I've lost a total of 59kgs through diet and exercise, and I am honestly terrified of gaining that weight back. I am assured, though, that if I can work with my endo to get my dosage right, an if I continue to be active, any weight gain I have will be temporary and my metabolism will be more or less normal.

I'm running with that. Can't say I'm not anxious though :/

I am sure we will all be fine. Mac, you and I will get through this and Melissa, whatever you decide to go with, I know it will be okay in the long run. I have taken a lot of solace from the number of people on these forums who have been through this and lead normal lives.


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