# So, um, why NOT have surgery???



## diva_alicia (Jun 18, 2012)

Since being diagnosed with Graves I've been weighing the three options I've been given - 1) anti-thyroid meds, 2) radiation, 3) surgery.

Regarding #1 - I hear about reactions to anti-thyroid meds and difficulty titrating the dose and relapsing as it is not considered curative just a temporary bandaid. I've also been told it can affect white blood cell counts and platelet counts so any time you have a cold, cough, infection, etc. you have to stop the meds and have blood work. Ugh.

Regarding #2 - I've read so many who had radiation, needed repeat treatments, didn't have success or had bad side effects who state they wish they hadn't chosen radiation. Then trouble regulating synthetic hormone replacement.

Regarding #3 - You just don't hear of folks having surgery and wishing they hadn't. I've only read stories of folks who wish they'd pick surgery sooner! Granted there remains the trouble regulating the synthetic hormone replacement, but that's about it. If you avoid damage to your vocal cord nerves and parathyroid during surgery, you seem to be in the clear.

So help me understand what I'm missing. I'm not personally comfy with the notion of higher dose radiation anyway, but *why is surgery not more prominent*?


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## joplin1975 (Jul 21, 2011)

Well, it's invasive. Any time you are put under, there are risks.

Additionally, there are slight risks of damage to the recurrent laryngeal nerve (voice paralysis) and damage to the parathyroid (which can cause cardiac issues, although that can be regulated post-op).

I had no real pain, but some people do. Some people don't react well to anesthesia. A family friend has a TT a couple of months after mine...same surgeon, same hospital, same diagnosis. While I was re-roofing the house ten days after surgery, she was on serious pain killers, was dealing with depression, and was out of work for some time. I think that's an exceptional case, but I doubt you'd hear about that with RAI.

I don't know this for a fact, but I would imagine the cost of RAI is significantly less than the cost of RAI.

For the record, I don't regret surgery (didn't have much of a choice). And, while my experience is probably more unusual, I had a *much* harder time with RAI than I did with surgery. All I'm saying is there are risks with both options and you need to decide which is best for you.


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## Merryj (Apr 23, 2012)

I believe that you will still have to be on medication after the surgery.
I may be making that decision in a bit - I am having a FNB on the 31st and if it comes back inconclusive or positive for C, then I will have the surgery.


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## webster2 (May 19, 2011)

I think it is also more costly than RAI, so maybe insurance reasons.


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## JPGreco (Mar 2, 2012)

Webster hit the nail on the head. In the USA medicine isn't about treating the person as much as it should be. Insurance companies run the decisions (both sides of the battle). Doctors are worried about liability from surgery and insurance companies don't want to pay for your surgery when their is a cheaper "safer" option. So RAI has become the standard treatment for those who don't react to medication. It is even suggested for those that medication works on due to the danger to the liver. Surgery seems to be withheld for those who cannot undergo RAI for certain reasons.
However, it doesn't mean that an informed patient can insist on surgery over RAI. The key there is insist and stand your ground.
As you know I had RAI because I did not have insurance. I am now applying for medicaid for reimbursements and the chance that the RAI doesn't work for me I want to be able to get right in for surgery.


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## Lovlkn (Dec 20, 2009)

Because it co$t$ more


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## rkh3 (Feb 27, 2010)

I've told my story on other posts but I had TT 5/25/12. I really didn't have a choice but have no regrets. Surgery was somewhat more complicated than usual but really not a big deal. Post op pain was minimal, really more movement induced, i.e neck movements and yes we are still adjusting meds but as I said, in the scope of things, no big deal. Put it this way, I had a colonoscopy two weeks ago, I'd rather have TT surgery.


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## Octavia (Aug 1, 2011)

rkh3 said:


> Put it this way, I had a colonoscopy two weeks ago, I'd rather have TT surgery.


Is it okay for me to say that was kinda funny? 

I've had both. Twice. I think I'd opt for the colonoscopy, all things considered!


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## Lovlkn (Dec 20, 2009)

rkh3 said:


> I've told my story on other posts but I had TT 5/25/12. I really didn't have a choice but have no regrets. Surgery was somewhat more complicated than usual but really not a big deal. Post op pain was minimal, really more movement induced, i.e neck movements and yes we are still adjusting meds but as I said, in the scope of things, no big deal. Put it this way, I had a colonoscopy two weeks ago, I'd rather have TT surgery.


If your neck hurts go get a massage and a chiropractic adjustment. You are like me - my neck tensed to a point that the pain was unreal. The muscles did not release on their own and after a few massages and adjustments it was fine.


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## webster2 (May 19, 2011)

Lovlkn said:


> If your neck hurts go get a massage and a chiropractic adjustment. You are like me - my neck tensed to a point that the pain was unreal. The muscles did not release on their own and after a few massages and adjustments it was fine.


Me too. I had muscles that felt like they were tensed all of the time. Massage and some stretching set them free!


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