# Certain criteria for thyroid removal???????



## castledreams (Jun 13, 2011)

I have been dealing with a failing thyroid for almost 10 years now. Recently the right side began to swell. They have almost doubled my Armour since last year. I am now currently taking 120mg. I haven't went back to have my levels rechecked yet. I am scheduled to in August. I was wondering what the criteria is to have them just remove it. It is pushing in on my esophagus and each time I swallow I can feel it. They have done CT scan to check for nodules and cancer. It came back negative. I am currently at 307lbs as well. Each time I just get to a euthroid state and begin to loose weight my thyroid starts to go south and it piles back on and then some. I want them to just take it out so I can get on with my life and stop worrying about it. :sad0049:


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## joplin1975 (Jul 21, 2011)

If it is causing discomfort, that's enough for many surgeons. I would certainly encourage you to inquire about it.


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## Lovlkn (Dec 20, 2009)

castledreams said:


> I have been dealing with a failing thyroid for almost 10 years now. Recently the right side began to swell. They have almost doubled my Armour since last year. I am now currently taking 120mg. I haven't went back to have my levels rechecked yet. I am scheduled to in August. I was wondering what the criteria is to have them just remove it. It is pushing in on my esophagus and each time I swallow I can feel it. They have done CT scan to check for nodules and cancer. It came back negative. I am currently at 307lbs as well. Each time I just get to a euthroid state and begin to loose weight my thyroid starts to go south and it piles back on and then some. I want them to just take it out so I can get on with my life and stop worrying about it. :sad0049:


Go speak with a surgeon about your history and they will take it out.

Look for a surgeon that performs at least 4-5 thyroid removals weekly - experience counts here.

If you can get yourself euthyroid now - you already know how to manage your meds.

Do they regularly test your FT-4 and FT-3 to dose your current replacement?


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## jenny v (May 6, 2012)

castledreams, you've just described my situation almost exactly, we are in the same boat!

I have also had a failing thyroid for almost 10 years (and I've had high antibody levels for almost 7 years, although they are not ridiculously, scary high) and now it has swollen to the point where it gives me problems swallowing sometimes. I'm seeing one more endo in two weeks and a new internist right after that and if neither one can offer me any new answers, I'm going to see a surgeon on my own. I have high hopes for the internist, though, she comes recommended from people on this board.

Good luck to you, as well!


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## midgetmaid (Jul 22, 2010)

My endo said compressive symptoms fit the criteria for removal.

Renee


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## castledreams (Jun 13, 2011)

Thank you everyone for your replies. My endo checks mine regularly about every 3 months since I changed doctors a year ago. I was hoping that it would be somewhat easy to have them remove it. My appointment isn't until August but I will let everyone know what she says. I hope she is agreeable I really don't want to change doctors again lol. hugs3


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## Octavia (Aug 1, 2011)

Ditto what others have said about discomfort being reason enough. For me, two ENTs said they wanted to remove mine based on discomfort alone, and that was after ONLY noticing a nodule (turned out to be cancer, but we didn't know that at the time they were recommending surgery)...I did not deal with 10 years of ups and downs and weight gain like what you're describing. (I'd have pulled the dang thing out myself if that were the case!)

May I suggest making an appointment with an ENT, also known as Otolaryngologist, also known as Ear, Nose, and Throat doctor/surgeon? These doctors seem to "get it" when it comes to offering surgery and solving the problem once and for all.

Best wishes!


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## JPGreco (Mar 2, 2012)

Well, I would say that not letting the doctor tell you what to do is paramount. Make your feelings known. If they say no, pursue the why and repeat your concerns and desire. Also shop around. Ask other surgeons. If I had insurance or the money I would have insisted on surgery.


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## Lovlkn (Dec 20, 2009)

My surgeon was a general surgeon who specialized in endocrine issues. Look around and find one who you are comfortable with. I took a list of questions to ask - all of which I knew the answer to - I just wanted to be sure they knew the answers ;-)

She was a pro and performed the surgery in 90 minutes leaving a 3/4" scar.


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## webster2 (May 19, 2011)

I just said I want it out. I had been suffering with the nastiness of Graves long enough. Best decision, ever!


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## castledreams (Jun 13, 2011)

Kind of an update on my situation. I managed slip in an appt to see my endo today. Luckily my thyroid was playing its usual game lol. She was actually able to catch it with it enlarged and pushing in on my esophagus. She said it was considerably larger than it was in April when I last saw her. So in 3 months time it has grown considerably. She agreed to send me to an ENT but she wanted to do an ultrasound first. Unsure why but I am glad that she did not argue with me when I told her I wanted it out. I think the fact that it was noticeably larger since my last visit helped. Anyone with any pointers on surviving the thyroidectomy? Downtime? Pain? :a1Thyroid:


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## joplin1975 (Jul 21, 2011)

It's a good idea to get an ultrasound before surgery...if you are headed in that direction, might as well get it out of the way!

Everyone is different, but I had virtually no pain. My neck was a little sore because they recline your head back during surgery and I have a slight herniation. The incision would feel a little "pulled upon" at times, but that went away quickly...I had a slightly sore throat from being intubated. Nothing bad. I just used Advil to stay ahead of any discomfort I may have felt.

I was told to take it easy and not pick up anything heavy for the first ten days, or until my stitches came out. On day ten, the stitches came out and I was cleared to do whatever I wanted. So my husband and I re-roofed the house.  I was up walking, talking and drinking 30 mins after waking up in recovery.

They asked me to take two weeks off, but I was answering emails and taking business calls by Wednesday.

The thyroid dumping process was slightly uncomfortable....hot flashes, jittery, "keyed up" feeling, but that passes quickly.

I think you will do great!


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## castledreams (Jun 13, 2011)

Thank you Joplin1975. I hope everything goes as well for me. No one has been able to tell me why I have hypothyroidism and I just found out from my mother that my aunt and 1st cousin on her side both had thyroid cancer. Up until today I thought I was a fluke in the family genetic pool lol. They were close to my age when they found it. This really makes me want it out like yesterday. Still waiting on the doctor to schedule the ultrasound and get the ball rolling. My thyroid feels as if it has grown bigger in the last week. I did get a letter from my doctor that my levels were within her range. She prefers them around 2.0 to 0.4 but I still feel brain fuzz right now and agitation. :a1Thyroid: It's nice to be able to talk to people with the same problem. hugs3


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## Lovlkn (Dec 20, 2009)

My post surgery advise is...

- stay ahead of the pain after surgery and take all the pain meds they offer you in the hospital.
- once you leave the hospital keep your incision iced, it will help with inflammation and just feel good.
- by day 3 I was taking Mortin only so I could drive.
- have your replacement on hand and [lan to begin a few days post op. Day 1 is too soon as you will have a dump of thyroid hormone in your system and longer that 3 days in my opinion is too long.
- I cooked dinner the day I came home after a 27 hour TT event - we all react differently.
- take it easy and let yourself heal.
- If I did it over I would test for Ferritin deficiency and Vit D deficiency pre op as I struggled with fatigue for quite awhile post op and was found to be deficient in both. I also added Cytomel several years post op because I did not convert enough.


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## castledreams (Jun 13, 2011)

My vitamin D levels were 12 when she checked them a couple months ago. Been taking 3000 IU daily so far and she checked them last week and they are still low. She upped my dosage to 4000 IU a day now. Haven't checked my ferratin levels yet. That is a good idea. I have to wait until August 1 to schedule my ultrasound since my insurance doesn't kick in til then. I will repost when I have the surgery date and ultrasound results.:hugs:


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## Lovlkn (Dec 20, 2009)

castledreams said:


> Thank you Joplin1975. I hope everything goes as well for me. No one has been able to tell me why I have hypothyroidism and I just found out from my mother that my aunt and 1st cousin on her side both had thyroid cancer. Up until today I thought I was a fluke in the family genetic pool lol. They were close to my age when they found it. This really makes me want it out like yesterday. Still waiting on the doctor to schedule the ultrasound and get the ball rolling. My thyroid feels as if it has grown bigger in the last week. I did get a letter from my doctor that my levels were within her range. She prefers them around 2.0 to 0.4 but I still feel brain fuzz right now and agitation. :a1Thyroid: It's nice to be able to talk to people with the same problem. hugs3


Start asking for copies of ALL your labs and start insisting they run a FT-4 and a FT-3 on you every lab before adjusting your replacement. You might also want to ask either the endo or the surgeon for a prescription so you have your replacement on hand and you don't go into hypo hell post TT. Ask for a dose based on 1.7mcg per kilogram of your normal weight.

By day 3 you likely will need to begin your replacement eds if you are "in her range" which sounds like you are in the TSH range. Post op without antibody involvement you should shoot for mid range FT-4 and FT-3 and a TSH of 1, some people can tolerate 3/4 range and you can start to tweak your self once you get to mid range. Go by your Free's first as they show active hormone in the body - do not take your replacement before you lab.

My goal for Vit D is 20% down from top range. If it gets to the top it makes me feel anxious and gives me restless legs.

It will take awhile but you will be a replacement dose pro in no time - welcome to the TT family :hugs:


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