Monday, March 21, 2011

Thyroidectomy

January 31, 2008

That was the day that I had my thyroidectomy.  A thyroidectomy is the removal of all (or part) of your thyroid.  How much of the thyroid gland that is removed will depend on how large your cancer/nodule is, where it is located and what you and your doctor come to a decision on.

I elected to have a total thyroidectomy (TT) as opposed to the partial thyroidectomy.  I decided on this because my lump was a little large, and the surgeon indicated that I would probably have to have the second side removed eventually.  So rather than going in a number of times, I decided to have a TT.  

To be honest, I had a difficult time deciding on a surgeon.  As I mentioned in a previous post I had issues with physicians talking down to me, not even listening to the fact that I had research experience in neuroendocrinology.  Thus I didn't need the typical "your thyroid is a butterfly shaped organ...."  So I actually interviewed a number of ENT physicians that specialized in thyroid cancer/thyroid surgeries.  Finally I settled on one... he was a bit of an (ermm....) ass.  But I liked him.  In fact, he was the first physician that looked at me and said, "Well you know already what your options are, you know the data is" (I brought evidence-based research and case studies with me to my appointment).  So the physician was like... "what do YOU want to do?  I know what you need.  You know what you need.  You need to decide when you want to do it."  Ha!  What an ass.  I loved him for it!  So I went with the physician that didn't have the BEST bedside manner.  However he had the best reputation (known as the best in this state).  I grilled him on current research and he knew it all.  He was pompous.  I was pompous.  It was a perfect match.

I had to wait for about a month for the insurance to clear because I chose a surgeon out of my network of coverage.  Sure it cost more.  But I wanted a surgeon that I was confident in and comfortable with.

The end results were great (well as great as having an organ ripped out of ya...).

If you want to see some additional post-op pictures, I have it posted on my other blog that you can see here.  Or on my Facebook album here.



Not my hottest pictures ever. I wanted my husband to take pictures so I could catalog everything (I'm sick like that).  I even told him that no matter what, even if I kicked, screamed and cried to not take pictures.  I ordered him to take the pictures because when everything was said and done I would have wanted them.  However in the end, I was too doped up on the pain meds, I never even argued!  So I didn't yell at him, I was doped up, and I got my pictures!  

All kidding aside, I ended up spending a couple of days recouping in the hospital.  My mum never left my side (my husband slept in the hotel next to the hospital because there was only one chair in my room).  And even though I had my whole thyroid removed, I was 27 and had cancer and I was in pain from surgery, it still never felt real to me.  I think I had spent the previous month preparing everyone else, including myself.  I had educated myself on the procedures (I even made my mom see pictures of people with the drainage tubes because I knew she would FREAK out -- and good thing too because she later admitted that if I didn't explain that to her ahead of time she probably would have fainted).  So when I was in the hospital recovering, it was surreal and I was okay with everything.  To this day (three years later) I still am amazed at how smoothly and confidently I took to the process.  I want to say it was the power in knowledge, just knowing what to expect.  Or maybe it was because I had to be the calm one so everyone else around me was okay.  But either way, the thyroidectomy - the most invasive aspect of the whole thyroid cancer procedure, was actually the "easiest" part for me. 

Odd, huh? 

Next time I'll tell you the dirty little secret no one ever talks about with the thyroidectomy and thyroid cancer -- issues with calcium.  Fun times!

Saturday, March 19, 2011

The Diagnosis

Approximately 3 years ago (November-December 2007) I was diagnosed with thyroid cancer.

I had gone to a new general practice physician just for a basic check up and as she was checking me over she commented that I had a really large thyroid - especially for my body size.  She indicated that she was concerned so she sent me to get blood drawn to check thyroid hormone levels and to get an ultrasound.

A couple weeks later I found that I did in fact have a lump (thyroid nodule) and next was to get a biopsy to check for cancer cells.  Up until that moment I really didn't have much thought about the process that I was following.  However during the fine needle aspiration (FNA) the physician started telling me how his wife recently was diagnosed with thyroid cancer and had a thyroidectomy.  This thought about having an organ removed had not previously occurred to me... I was a young (27 yrs old), very healthy young lady!  I was not the "type" of person who should be diagnosed with cancer.  My thoughts were going crazy during the FNA - which by the way - when people say the FNA is an easy, non-invasive, doesn't even hurt procedure... HA!  The FNA hurt like heck!  I felt as if the guy stabbed me in the throat (ok that is literally what happened but I didn't realize it would hurt so bad!).  After he was done he said good luck and that the results would be in soon and they would call me.

So I left.

At that point I was a walking zombie.  The notion of having cancer and having to have surgery had never even occurred to me.  I walked out of the facility with my SO and didn't say a word.  As soon as we got into the car I started bawling.  I think this surprised my SO because I'm typically a strong-bull type.  But this whole procedure was finally starting to become a little too real.  Prior to this the most invasive procedures I had experienced was oral surgery for wisdom teeth extraction and a broken arm.  Not very big on the invasive-procedures scale!  So to actually potentially have cancer and have to have an organ removed was a whole new territory that I had never even considered.

Later in the week I got the diagnosis: papillary carcinoma.

From this point I became an advocate.  At the time I was a research scientist - therefore I did was any research scientist would do.  I searched high and low for ANY information about thyroid cancer.  I was not going down without a fight.  And the next couple of posts will describe how I chose my particular treatment and therapy procedures.

Freakin' cancer... turns your life upside down... but also makes you stronger.

Friday, March 18, 2011

RadioActive Girl Returns - For the 5th Time

I'm going to take some time out of our Reflective Posts (the posts that I'm creating to update the past 3 years of My ThyLife) to give you a current update on My ThyLife.    

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Isn't it bad when you have a particular procedure so many times that you lose count?  Especially bad because I have lost count how many times I have consumed radiation.

I have had therapy and body scan doses of radioactive iodine so many times that I have simply lost count.  Each time I feel a little more queasy than the last... regardless of the dose.  Granted these nauseous feelings are most likely psychosomatic and I'm just doing it to myself.

Regardless of the cause of the nauseous feelings - I am currently in isolation with a low dose (2.0mCi) of radioactive iodine.  This is for a 1-year follow-up body scan.  I had the Thyrogen injections on Monday and Tuesday and took the hot pill on Wednesday.  I will be getting scanned on Friday and lets hope that I haven't decided to grow another thyroid (as my awesome body tried to do back in 2009).  So as long as I'm clear RadioActive Girl won't have to return again until next year!  I'll update as soon as I get the results!

Photo Credit: http://www.spreadshirt.co.uk/wine-radioactive-girl-t-shirts-C4408A4985715

Thursday, March 17, 2011

What the heck is a thyroid?

So before I start explaining how My ThyLife became My ThyLife, I should take a step back and explain what a thyroid is.  Here I'll describe a little about the structure and function.  

Anatomy
The thyroid is an organ located in the neck region that is part of the endocrine system.  It is shaped like a butterfly (see below on why this description makes me cringe) and it has two lobes (think: the wings) and connected by the isthmus (think: the "butterfly's" body).  The thyroid lies against the larynx and near the trachea (see the image below from the Mayo Clinic).  The parathyroid glands (four small glands) are located on the "back side" of the thyroid gland.  I will explain more about the parathyroids in another blog post at a later date.      

Photo Credit: http://www.mayoclinic.com/health/medical/IM01872

Physiology
The primary function of the thyroid gland is to produce and excrete hormones.  The thyroid hormones are triiodothyronine (T3) and thyroxine (T4) and calcitonin.  Most of the T4 is converted to T3 by peripheral organs (the liver, kidney and spleen) because T3 is the more active form of the hormones.  Within the thyroid both T3 and T4 are synthesized using iodine and tyrosine, thus iodine is important in proper thyroid tissue functioning (this is why a lack of iodine is bad for thyroid function and also why radioactive iodine is perfect for treatment).  Thus, by using iodine and the amino acid tyrosine, thyroid tissue synthesizes T3 and T4 and then excretes the hormones into the body.  The hormones are involved in the control of metabolism, growth and development and so much more.  To see a list of what T3 and T4 are involved in see The Endocrine Surgeon.  

Photo Credit: http://www.endocrineweb.com/conditions/thyroid/how-your-thyroid-works

The thyroid is regulated by thyroid-stimulating hormone (TSH) which is produced and excreted by the pituitary gland.  The pituitary gland is regulated by the hypothalamus which releases thyrotropin-releasing hormone (TRH).  These hormones regulate by a negative feedback loop.  When there is not enough T3 and T4 in the blood stream, the pituitary will release more TSH to signal to the thyroid to produce and release more hormone.  But when there is enough hormone, TSH will not be released.  


Photo Credit: http://en.wikipedia.org/wiki/File:Thyroid_system.png 

There is a basics of the anatomy and physiology (structure and function) of the thyroid gland.  To learn more please see the references cited at the end of this blog post.  These resources have MUCH more detail about the thyroid... I just wanted to give a basic overview about this tremendous little organ.

In closing, I have to admit -- As someone who studied neuroendocrinology I started to get peeved when a doctor told me basics, such as "Well you see your thyroid is this butterfly shaped organ..."  Grrr dude!  I KNOW!  Many have suggested that as one lives with a condition, you actually become an "unprofessional expert" on the topic.  I think with my previous research experience I jumped to this status quickly.  As such I became frustrated with physicians who talked down to me about my condition and what was next in the procedures.  So this is my backwards way of apologizing to those who have stumbled onto this blog post and see that this is a simplistic explanation of the thyroid.  But you have to start somewhere... and because this is the start of My ThyLife, the beginning is a good place to start.

References
Endocrine Surgeon. (nd). What does the thyroid gland do? Retrieved from: http://www.endocrinesurgeon.co.uk/index.php/what-does-the-thyroid-gland-do


Endocrine Web. (October 13, 2010). How your thyroid works. Retrieved from: http://www.endocrineweb.com/conditions/thyroid/how-your-thyroid-works


Mayo Clinic. (April 10, 2009).  Thyroid cancer. Retrieved from: http://www.mayoclinic.com/health/thyroid-cancer/DS00492


MedLine Plus.  (March 15, 2011). Thyroid diseases. Retrieved from: http://www.nlm.nih.gov/medlineplus/thyroiddiseases.html

Wednesday, March 16, 2011

Start of Something New

This blog is a personal journal of my battle with thyroid cancer.  Because of the recent re-occurrence and the current focus on thyroid cancer in the media I am going to start to chronicle my ThyLife.

Because it seems that my life is more focused on thyroid cancer and awareness as it gets closer to radiation, body scan and check-up times, this blog will be an on-again/off-again process.  However I plan on updating occasionally as I find thyroid cancer research in the medical literature as well as in the media.  Overall this is a personal refection of my ThyLife and as such, any medical talk in this blog are my own personal thoughts and ideas and should in no way be used to personally diagnose or treat.  All health-related concerns should be directed to your personal health-care provider.  If you would like to contact me about issues you may do so through the comments or via a PM.  However, I cannot provide medical or health advice; I can only direct you to where you can find additional information.

With all this being said...
Welcome to My ThyLife