# Postponing surgery?



## onlybattles (Jul 28, 2014)

Hello friends!

Real quick - I'm DX with Hashi's for almost 9 years, and the right side of my thyroid is so enlarged, it is hindering my breathing, swallowing, and overall quality of life.

I met with my endo today and she wants me to postpone my scheduled 10/15 thyroidectomy because my TSH is too high. Can someone verify if this is valid or not? Since the doctor scheduled me, I have already made the plans to be out of work, who's going to be covering my shifts, and my father has made changes to his work schedule to accommodate helping me, ect. Postponing would be inconvenient, yes; but the feeling that I have professionals who are not listening to me and not taking my concerns seriously is what is most bothersome.

in the last eight weeks, I have had bloodwork run three times, and my levels have fluctuated like crazy on the same dose of medicine. My endo now wants to raise my Synthroid from 200mcg to 225mcg. My TSH has gone from 25 to WNL to now, 23 - on the same dose of medication.

My ENT wants to do a partial thyroidectomy (remove the side that is too big, and leave the other), and I think this is a good compromise. My doctor is adamant about postponing, and will talk to my ENT, who I can expect to hear from during the week. What do I say to him? How do I relay him my thoughts and concerns without sounding surgery happy?

Is a high TSH a good enough reason to be postponing surgery? I'm so, so frustrated. Doctors hear me speaking, but they are not listening. I'm tired of not being about to breathe or swallow or function for more than four hours at a time without a nap!


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## jenny v (May 6, 2012)

Hmmmmm, I've heard of postponing surgery when TSH is too low (i.e., the patient is hyper and that can be very hard on the body with the heart issues it can cause), but I've never heard of postponing due to high TSH. You're obviously having compression issues and your thyroid sounds like it's shutting down (hence the high TSH), so I'm not sure why your doc would want you to wait even longer. Plus, 10/15 is more than a month away, things could change in that time, too.


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## onlybattles (Jul 28, 2014)

Do you have any suggestions as to how I should speak with the surgeon on this? Again, I don't want to sound surgery happy but I'd like to eat a slice of pizza without choking on it, too.


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## Lovlkn (Dec 20, 2009)

Take the whole gland out - you will be glad you did. If having the glands you do - require that much replacement hormone, I doubt it will be any more manageable with 1/2 the gland.

I think your Endo is wrong. He's probably trying to "stabilize" you prior to surgery which isn;t going to happen with a gland such as yours. The ENT makes the surgical decision not your Endo. My surgeon who happened to be a general surgeon never spoke or corresponded with my endo as far as I know. I also did not go to the surgeon my endo suggested and instead went to a surgeon straight out of residency that left me with a scar less than 1"


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## Octavia (Aug 1, 2011)

I have to agree with the others here...do everything you can to move forward with the surgery. And please consider a total thyroidectomy instead of a partial. You have an autoimmune disease, so leaving half of your thyroid in leaves something for your body to attack. I believe you will be happier and healthier in the long run if you opt for complete removal. If you don't, odds are good that you'll end up having the other half out in the future, given the condition of your gland.

Ask the endo to explain to you the risks of having the surgery when your TSH is too high. I don't get it...I'd like to know the reason. Like jenny said, it's common to postpone surgery if your TSH is too low, but not if it's too high.


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## Lulugirl (Jul 3, 2013)

I would definatly do everything you can to have your surgery on 10/15. I had my thyroid removed about 2 weeks ago, it was causing compression symptoms. Aside from issues with calcium, I can't believe how much better I feel and how much easier I can breathe. I can even wash my own hair again which I wasn't able to do before the surgery. You'll be amazed at the difference in your quality of life.


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## onlybattles (Jul 28, 2014)

Thank you all for your input!!

I haven't heard from my surgeon yet (so that means he either disagrees with my Endo or is still on vacation and hasn't spoken to her yet). Today, my Endo requested that I come in for bloodwork to see what my inflammation levels are. She wants to see if inflammation is what's causing the swelling of my thyroid.

Does this sound counterintuitive to anyone else? Did anybody's doctor give them the run around like this? I'm tired just thinking about it!

I am adamant about removal, and am debating going to another Endo for a second opinion, because it sounds like my doctor has gone momentarily bonkers. :huh:


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## joplin1975 (Jul 21, 2011)

Inflammation can make surgery a little more difficult. For example, my thyroid was awful messy and my surgery was about four hours long. The thyroid gets "sticky."

But, that said, if you have a good surgeon, it shouldn't cause significant issues. My thyroid had lots of swelling and I recovered without issues.


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## jenny v (May 6, 2012)

Ditto. My thyroid was a "big, sticky mess" according to my surgeon, but everything still went as planned. My surgery just took a little bit longer than normal.


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## onlybattles (Jul 28, 2014)

Hi everyone! Just wanted to give a quick update. My head is all over the place with my newest set of labs.

Spoke with my ENT last week, and he is adamant about postponing surgery because my the variances in my TSH. He is concerned about thyroid storm on the operating table, which is understandable. We re-ran bloodwork on Monday, and I haven't heard from my Endo yet, but I can view my labs online (this is a new thing my doc is trying, and I'm pretty happy with it!). I'm sure she will be calling me today (Wednesday) to tell me to postpone my surgery. Even I think my labs are a bit wonky.

TSH: 7.69 (range: .40-4.50)

Free T4: 2.2 (range: .8-1.8)

ESR: 6 (range: 0-20 mm/hr)

A high TSH and a high T4?! Someone please just take my thyroid out because I'm tired of this garbage. One day I'm good, the next day I cannot get out of bed. Somedays my heart races and my hands shake, others I'm pretty steady. I'm beginning to wonder if I'm hypo and hyper at the same time. Is that possible? My compression issues are getting pretty out of control (I'm going to request another ultrasound from my doc when I speak with her so we can see if there's been any changes in the size of my thyroid).

Ugh, friends, I don't know what to do.


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## Octavia (Aug 1, 2011)

Some of you who have dealt with a similar situation...couldn't the doctor prescribe an anti-thyroid med to eliminate the risk of thyroid storm on the operating table? Or in this poster's case, simply decrease or stop the Synthroid temporarily?

This is an interesting one, for sure!


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