# I need an opinion



## mkh1987 (Aug 30, 2009)

Hello everyone,

So, i posted several weeks ago about being scared and since then I've calmed down. Today I saw my doctor to get my test results and he confirmed that I do have Grave's. When we started discussing treatment options he left it open for me to decide. Seeing as I don't know that much about any of the treatments I was wondering if anyone could help me out.

The two treatments are either the meds (I can't recall the name of the ones he suggested) or the RAI. He explained some of the pros and cons of both options but it was a lot to take in. I'm meeting with him again soon to tell him which treatment I'm choosing to take. Can anyone help me with making this choice?

Thanks, Mary


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## Andros (Aug 26, 2009)

mkh1987 said:


> Hello everyone,
> 
> So, i posted several weeks ago about being scared and since then I've calmed down. Today I saw my doctor to get my test results and he confirmed that I do have Grave's. When we started discussing treatment options he left it open for me to decide. Seeing as I don't know that much about any of the treatments I was wondering if anyone could help me out.
> 
> ...


Hi, Mary. Good to hear from you again. Actually, there is a 3rd. option which is surgery and is highly recommended. RAI is known to make the eyes worse (and or trigger Graves' Eye Disease.) I personally would ask this doc why the surgery option was not mentioned.

In any case, the options are before you and you are the one that has to decide. Many do opt to try the antithyroid med and I don't blame them for doing that. There is always hope that one will go into permanent remission. I must say though, that permanent remission is rare. I have seen a lot of cases of temporary remission though.

This could provide the "time" you need to weigh the other 2 options by gaining more information and chosing the option that suits you and your life-style the best.

We are here for you!


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## chopper (Mar 4, 2007)

The choice must be yours obviously.

For me, I would heavily weigh RAI and surgery, leaning towards surgery.

For some, RAI is non-eventful. They swallow the glow in the dark pill (just kidding) and 3 weeks later they are hypo and can take Synthroid and go about their lives as if nothing has happened. For others, the thyroid can grow back or they have trouble titrating their replacement hormone so they never seem to feel "quite right". Additionally, "thyroid storm" is a concern and one of my main concerns as well. After you swallow the pill, the iodine kills off so much of your gland so quickly that the thyroid releases all this fresh hormone into your system at once. When this happens, you can go very hyper at once, prompting a possible emergency situation. RAI usually does not result in thyroid storm but it can happen. More typically, the thyroid dies off slowly over 8 to 12 weeks or so and you don't notice any thyroid "dumping".

With surgery, the thyroid is gone - dead, bye bye - problem solved. The drawbacks of this are the parathyroid glands which control calcium are burried in the thyroid sometimes and when they remove the thyroid, they nick or accidentally remove the parathyroid glands too and then afterwards, you have calcium stability problems and may need to take large amounts of calcium for a few months afterwards or the rest of your life. Additionally, you can have some problems with your voice box and vocal chords. Most "problems" are usually temporary and after some proper healing, you titrate yourself to a steady level of replacement hormone and go about your business. Surgery is of course much more invasive than RAI where you just swallow a pill or drink. You also need to be put to sleep (in most cases) with surgery which has its own risks. Surgery can also cause "thyroid storm" just due to the fact that the surgeon has to physically handle your gland while removing it and can cause the release of fresh thyroid cells into your blood stream but this is even more rare than with RAI. The "good thing" about surgey is that when its over and done with and you are properly titrated, you are nearly certain to be done with your thyroid trouble forever. Go about your merry way and live life to the fullest.

Thyroid blocking meds are always going to be a temporary fix. In most cases with meds, you are just prolonging the inevitable and the portion of your life spent on the meds never seems to be quite right according to most of the stories I've heard. You may feel good for a while and then need to tweak your meds and then your thyroid changes again and you have to tweak your meds, etc. It becomes a lifelong bother for many. Some of course believe simply taking a pill every day is worth not having to go through surgery or RAI - that's up to you. Should you choose this route, you will need to take meds for the rest of your life most probably and at some point you'll probably tire of the routine and end up with RAI or surgery any way as many do for a more permanent fix. Thyroid blocking is a good place to start however. Try it and see how you feel while you educate yourself and contemplate a more permanent option. You very well can end up feeling well for a long time on meds and since its the least invasive of them all, what do you have to lose other than time?

My belief is the real question refers to timing. Would you prefer to get it over with, heal, and move on with your life or would you rather prolong the inevitable by taking meds, potentially requiring surgery when you are older and more frail? How much life are you willing to donate to trying to feel well? You need some introspection to come up with the answers as everyone is different and everyone has different beliefs. I've shared my opinions but Im not a doctor. I too may be faced with this same decision so I've already contemplated this myself.


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## mkh1987 (Aug 30, 2009)

Thank you for your opinions! I really appreciate it! I tried the medication because my doctor said to start it while i made my final decsion and I had an allergic reaction to it. I meet with my doctor in the morning but I had a question for y'all (I'll be asking my doctor too obviously). How intense is the surgery? Do you know the typical recovery time?


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## Andros (Aug 26, 2009)

mkh1987 said:


> Thank you for your opinions! I really appreciate it! I tried the medication because my doctor said to start it while i made my final decsion and I had an allergic reaction to it. I meet with my doctor in the morning but I had a question for y'all (I'll be asking my doctor too obviously). How intense is the surgery? Do you know the typical recovery time?


From what I understand, only a couple of weeks. But I am sure that varies from person to person. I did not have the surgery so I hope others will be along who did and they can offer better information.


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## cj41 (Sep 13, 2009)

I am scheduled for surgery on Oct. 19th. Have been dealing with thyroid issues since 96. My doc says without complications, it is about 1-2 days in hospital and then about a week of feeling a little out of it. I have had several people I know have it out and bounced back quickly, but they were all for nodules and cancer. No one from Graves. I have been on Inderal and PTU for 2 weeks now and am just starting to feel tired...in bed for the last 2 days. I am assuming it is from the Inderal. My resting heart rate has always been 90-110 so I need the meds to slow it down before surgery.

I went back and fourth between my options, but then just came to the decision to get it out!! It is not an overnight fix, but is the best option for me. I know there will be time to regulate meds, but I am ok with that.

Good luck to you and I am sure you will make the right decision for you.

P.S. Andros...
I met with a GYN this week about weather my symptoms could be pre-menopause vs thyroid. She completely agreed with my decision to have the thyroidectomy. She said lost of times, other issues will resolve by treating the thyroid issues. I was so glad to get another confirmation that this is the best decisions for me.


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## Andros (Aug 26, 2009)

cj41 said:


> I am scheduled for surgery on Oct. 19th. Have been dealing with thyroid issues since 96. My doc says without complications, it is about 1-2 days in hospital and then about a week of feeling a little out of it. I have had several people I know have it out and bounced back quickly, but they were all for nodules and cancer. No one from Graves. I have been on Inderal and PTU for 2 weeks now and am just starting to feel tired...in bed for the last 2 days. I am assuming it is from the Inderal. My resting heart rate has always been 90-110 so I need the meds to slow it down before surgery.
> 
> I went back and fourth between my options, but then just came to the decision to get it out!! It is not an overnight fix, but is the best option for me. I know there will be time to regulate meds, but I am ok with that.
> 
> ...


And I am glad you are glad. You did not make a snap decision so I know you are comfortable with this and you "will" be glad. Your body will start to heal and you will have a life back again.

I can't wait.arty0006:


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