# TT done july 5



## totallygone (Jul 9, 2012)

HI everyone! came across this board while searching online for a support group for those of us who've had TT's..glad to have found this one. As for my story, about a year ago, my PCP found that my thyroid had a nodule on it so he sent me for an U/S. It came back multi nodular goiter. My bloodwork for thyroid levels was all within normal range. He then said he wanted a FNA of largest nodule. it came back inconclusive. fastforward a year..nodule had doubled in size, another FNA ordered, still inconclusive, so he referred me to an endo who referred me to a surgeon. They both felt it best to get it out seeing now it was causing me some compression issues with swallowing and breathing. Had the surgery done 930am on July 5. all 4 parathyroids were left intact. Surgery went well, i was swollen and sore,but mainly from the tubes put down my throat during surgery. Pain meds didnt agree with me, and vomiting with a freshly sliced neck wasnt pleasant. I was discharged the next day, and told blood levels for calcium were normal, but to take 2 tums 2-4 times a day, esp. if i noticed any tingling in arms/face. Overall i felt pretty well on friday when i came home. I was discharged on 100mcg synthroid. So by sunday, i noticed my heart was racing, i felt like i'd had 10 cups of coffee, and i took my blood pressure and it was quite high. I monitored it over the next couple of days, and still feeling very jittery, i called my pcp and went in today. He said he's no endo, but feels my snythroid dose might be too high. I'm 53 yrs old, weigh 120 lbs. i personally think its too high as well. 
My incision is about 4" long and i have no visible stitches. Everything is held together with surgical glue, which i wish wasnt purple!!!!! a bit has fallen off and underneath the incision is healing nicely according to my pcp who took a look at it today. I have some discomfort moving my neck side to side, but not any problem swallowing or eating. I am going to call my endo tomorrow and ask him if i can possibly cut my dose in half to see if it helps my blood pressure and this jittery feeling. I know he told me it sometimes takes some time to get the body regulated on the correct dose...saying my prayers that this dosage adjustment does the trick. The one thing i recommend if you are considering thyroid surgery, is to be comfortable with your surgeon. Mine came highly recommended and i was very happy with the care i received from him.


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## joplin1975 (Jul 21, 2011)

Hi and welcome!

100mcgs is actually on the lower side of normal for people who have had TTs. Which isn't to say you shouldn't or couldn't go to a lower dose. I was just thinking you might still be feeling the effects of a thyroid dump. I wasn't put on synthroid immediately after surgery and I still dealt with hot flashes, some feelings of jittery-ness/agitated feeling, restlessness, etc etc. It went away after a few days. Just a thought!

I hope you feel better soon!


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## desrtbloom (May 23, 2010)

Hi!

During the removal of your thyroid, your thyroid hormones dump into your system. Sounds like you didn't need to start the Synthroid so quickly. My doc had me wait two weeks before starting Synthroid.

Patti


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## totallygone (Jul 9, 2012)

thanks for your replies..i have a call in to my endo, waiting for him to call me back...i did some research on thyroid dump and i have those exact symptoms..i havent taken my synthroid today and will wait to talk to endo b4 i take it, IF i take it today...my bp is down slightly and my heart isnt racing quite so fast...so im hoping a regulated dose will get me on track..........Patti, how are you feeling after starting your meds 2 wks after surgery? My surgeon had mentioned that my own hormones would remain in my bloodstream for about 10 days so i wondered why i was starting the synthroid immediately? guess i should have asked!!! I will keep u updated thx


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## joplin1975 (Jul 21, 2011)

Not everyone goes through the thyroid dumping process and so lots of times they like to keep people as regulated as possible, particularly if you went into the process hyPO thyroid. 

Let us know what the endo says!


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## Andros (Aug 26, 2009)

totallygone said:


> HI everyone! came across this board while searching online for a support group for those of us who've had TT's..glad to have found this one. As for my story, about a year ago, my PCP found that my thyroid had a nodule on it so he sent me for an U/S. It came back multi nodular goiter. My bloodwork for thyroid levels was all within normal range. He then said he wanted a FNA of largest nodule. it came back inconclusive. fastforward a year..nodule had doubled in size, another FNA ordered, still inconclusive, so he referred me to an endo who referred me to a surgeon. They both felt it best to get it out seeing now it was causing me some compression issues with swallowing and breathing. Had the surgery done 930am on July 5. all 4 parathyroids were left intact. Surgery went well, i was swollen and sore,but mainly from the tubes put down my throat during surgery. Pain meds didnt agree with me, and vomiting with a freshly sliced neck wasnt pleasant. I was discharged the next day, and told blood levels for calcium were normal, but to take 2 tums 2-4 times a day, esp. if i noticed any tingling in arms/face. Overall i felt pretty well on friday when i came home. I was discharged on 100mcg synthroid. So by sunday, i noticed my heart was racing, i felt like i'd had 10 cups of coffee, and i took my blood pressure and it was quite high. I monitored it over the next couple of days, and still feeling very jittery, i called my pcp and went in today. He said he's no endo, but feels my snythroid dose might be too high. I'm 53 yrs old, weigh 120 lbs. i personally think its too high as well.
> My incision is about 4" long and i have no visible stitches. Everything is held together with surgical glue, which i wish wasnt purple!!!!! a bit has fallen off and underneath the incision is healing nicely according to my pcp who took a look at it today. I have some discomfort moving my neck side to side, but not any problem swallowing or eating. I am going to call my endo tomorrow and ask him if i can possibly cut my dose in half to see if it helps my blood pressure and this jittery feeling. I know he told me it sometimes takes some time to get the body regulated on the correct dose...saying my prayers that this dosage adjustment does the trick. The one thing i recommend if you are considering thyroid surgery, is to be comfortable with your surgeon. Mine came highly recommended and i was very happy with the care i received from him.












Sorry for what brings you here but glad you are!

Did you get pathology results yet? You sound like a real trooper and I agree that it is possible that that was much too high of a dose for you.

You may end up on 100 mcgs. but to start out, a low dose is usually Rx'd.

We have many who have had the surgery and I know they will rally 'round!


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## totallygone (Jul 9, 2012)

Thanks again ladies for your support..Ok so endo says, my TSH is "normal" and wants me to continue the 100mcg daily.......i had taken my blood pressure about an hour before his nurse called me, and it was down from 165/100 yesterday, to 125/82 today. No synthroid today, and i did double up on my bp meds per my PCP...the racing heart is gone, and the pulsating in my head and feelings like im gona jump right outa my skin has subsided about 95%...I explained all this to the nurse, and she said "i know, i know, but your blood work says tsh is normal" i said, well what about my symptoms? I think i might need to find an endo who listens to my symptoms and not just bloodwork. I told her flat out, i will try a half dose tomorrow and see how that goes but i refuse to go back on the full dose cuz i cannot feel like i did the past few days.....As far as the pathology reports from the thyroid, i havent heard from the surgeons office about that yet. They said about a week to get those results. Feeling so much better today without the synthroid that i cannot imagine that it wasnt the cause of my horrible symptoms. I'm prepared to have to make some adjustments with dosing and lifestyle changes but to feel like i did these past couple of days was totally unacceptable. i will keep u posted and would like to hear if any of you had similar problems after your surgery and how long it took you to feel "normal" again! thanks!


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## totallygone (Jul 9, 2012)

another question, after your surgery, did any of you have substantial swelling just around the incision? It looks like a hot dog bun, with the incision as the "hotdog"..just puffy around each side. PCP says it looked good i just wondered if you experienced the swelling for a significant amount of time after the surgery? The surgeon said its common and can persist for a few weeks, and to let him know if there is a fever, discharge, or abnormal swelling. I just have looked at some pics on the internet of ppl after thyroidectomy's and not many had the swelling like i do...I realize the internet can be a wonderful tool, but sometimes it can make me crazy lol!!!!!!!!! I keep reminding my self, we are all different and our body reacts to trauma differently. I am still icing it and it feels good, and relaxes me.


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## Octavia (Aug 1, 2011)

I did have some hard swelling just above my incision. My surgeon said it was a "healing ridge" and was totally normal. I would say it was about the size of a pencil, sitting just above the incision (nothing below, that I recall). We did have a poster here a couple of months ago who posted a photo of her swelling (she had the same question as you), which was MUCH bigger, and not at all "normal."


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## Lovlkn (Dec 20, 2009)

totallygone,

Keep ice on your incision to help with the swelling.

As far as dosage - you likely began your replacement too soon post op. I felt like the energizer bunny day 2 with no replacement and by day 3, I was nailed to the floor.

You may have just not burned up the thyroid hormone dump from the surgery. If you wanted to you could cut your dose in 1/2 for a day or 2 and let your system catch up.

Manufacturer recommended dose for thyroid replacement is 1.7mcg per kilogram of weight.

you weigh 120lbs = 54.4310 kg z 1.7mcg = 92.53mcg

You are on a good starting dose for your weight.

One concern I have about the blood tests your doctor has run - TSH only for thyroid hormone dose replacement is a definite no no.

Insist they run a FT-4 and a FT-3 , every time as you need to be sure you are converting your Synthroid into T-3 properly.


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## totallygone (Jul 9, 2012)

Thank you !! I am seriously considering switching endo's...not at all happy how this was handled...they did order a free T4 and said that was "normal" also but not t3 was ordered. i have not taken my synthroid again today and feel fine...i will start it again tomorrow but only at half dose and gradually work my way up....i feel badly taking control of this myself but i know my body and im not gona take something that i know was making my climb the walls..eventually i might need the full 100 but i think it was too soon after surgery to start me out on it. By the way, do any of you know why some ppl are put on a synthetic T3 med as well as the synthroid?


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## joplin1975 (Jul 21, 2011)

For the t4 meds to work, your liver has to be able to convert t4 to t3 (the active hormone). A number of people without thyroids seem to have a difficult time properly converting so they need to supplement with a bit of t3 (either with cytomel or by using combination medications).

The standard protocol is to give t4 meds a shot and if those don't work, look at the other options. T3 can be a powerful hormone and if you don't need it (that is, if you are converting properly), then it won't be a good option for you.


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## totallygone (Jul 9, 2012)

thank you! I hope to hear about pathology reports today...and i will keep u posted!


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## Andros (Aug 26, 2009)

totallygone said:


> Thanks again ladies for your support..Ok so endo says, my TSH is "normal" and wants me to continue the 100mcg daily.......i had taken my blood pressure about an hour before his nurse called me, and it was down from 165/100 yesterday, to 125/82 today. No synthroid today, and i did double up on my bp meds per my PCP...the racing heart is gone, and the pulsating in my head and feelings like im gona jump right outa my skin has subsided about 95%...I explained all this to the nurse, and she said "i know, i know, but your blood work says tsh is normal" i said, well what about my symptoms? I think i might need to find an endo who listens to my symptoms and not just bloodwork. I told her flat out, i will try a half dose tomorrow and see how that goes but i refuse to go back on the full dose cuz i cannot feel like i did the past few days.....As far as the pathology reports from the thyroid, i havent heard from the surgeons office about that yet. They said about a week to get those results. Feeling so much better today without the synthroid that i cannot imagine that it wasnt the cause of my horrible symptoms. I'm prepared to have to make some adjustments with dosing and lifestyle changes but to feel like i did these past couple of days was totally unacceptable. i will keep u posted and would like to hear if any of you had similar problems after your surgery and how long it took you to feel "normal" again! thanks!


TSH is not a good guideline for titrating your med.

Here is why.........

FREE T3 explained by Woliner
http://thyroid.about.com/cs/testsforthyroid/a/freet3.htm
Dr. Mercola (FREES)
http://www.mercola.com/Article/hypot...nosis_comp.htm


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## totallygone (Jul 9, 2012)

thank you for this info!!!!!!! Just wanted to let you all know that my surgeon called me this morning and told me the good news that all pathology reports were benign! I am very thankful for that!!!!!


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## DonnaK (Mar 22, 2011)

totallygone said:


> another question, after your surgery, did any of you have substantial swelling just around the incision? It looks like a hot dog bun, with the incision as the "hotdog"..just puffy around each side. PCP says it looked good i just wondered if you experienced the swelling for a significant amount of time after the surgery? The surgeon said its common and can persist for a few weeks, and to let him know if there is a fever, discharge, or abnormal swelling. I just have looked at some pics on the internet of ppl after thyroidectomy's and not many had the swelling like i do...I realize the internet can be a wonderful tool, but sometimes it can make me crazy lol!!!!!!!!! I keep reminding my self, we are all different and our body reacts to trauma differently. I am still icing it and it feels good, and relaxes me.


Hi there! I had a TT on 6/21 and had the type of swelling you describe, but a little more than two weeks later it had gone down to just about a marble sized swelling in the middle. I now just feel a little swelling right around where the adams apple would be. I still have some purpleish color to it as well. I can't wait for that to go away as the scar itself it looking pretty good at this point.

After my TT, I felt better the first week than I had felt in years. I guess my thyroid must have dumped enough that it made me "normal" for a while, but then when it was all used up I started getting hypo symptoms again as the doctor told me it takes four weeks for the synthroid to optimize in your system. I wanted him to increase me last week, but he made me wait until I see the endo on the 31st and we get the first blood work done when I am 4 weeks post surgery. Overall, I am feeling pretty good except for the horrible foot pain. After sitting, I can barely stand on my feet as my heels are in so much pain. That seems like such a weird hypo symptom to me, but I have read others that have it too so I guess it is related.

I read that the manufacturer recommends 1.7mcg per kilo of weight, but then I read just below that if you are over 50 they only recommend 1 mcg per kilo. So at 120 lbs. and 53 years of age manufacturer recommendation would be around 55 mcgs of synthroid. Maybe your doc needs to read the fine print on the dosage recommendation.  Anyway, hope you get your dosage worked out soon and not feel so badly. I think I need to be around 125mcg so looking forward to a small increase at the end of the month and will hopefully be almost "normal" again. Whatever normal is anymore. LOL


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## totallygone (Jul 9, 2012)

hi donna!! hope you are feeling better with the foot pain...i'm feeling pretty decent overall...a bit tired today, but other than that...doing ok...the swelling has gone down quite a bit..and now there is just a small lump above the incision, and i too, still have just a bit of bruising around the right side of my throat. I see my surgeon on wed, and so i will be anxious to hear what he says. I dont f/u with my endo until aug 9, at which time i'm sure he will order me more blood work. I had also read, over age 50, and if there is a history of heart disease, (i dont have any other heart issue other than hypertension), the usual dose is 25-50mcg..with increases only if needed...so i will see if the endo agrees to keep me on the 50...if he doesnt, o well, im taking it anyhow as long as i feel good on that dose!!!! I will then seek out a dr. that not only looks at #s on the bloodwork but will also listen to my symptoms...from what i'm reading , they are sometimes hard to find!!!! Also, my bp is perfect now..110/70!!!!!! I am taking my bp med, but i no longer have doubled the dose, my pcp says as long as i stay stable i can resume my normal dose of bp med. my scar is healing nicely. I've been using the bio oil or Vit E oil on it every day/nite. Keep me posted on your progress!!!! have a good nite!


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