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8.5cm Mass on Thyroid; awaiting surgery.
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8.5cm Mass on Thyroid; awaiting surgery.

I was diagnosed in November/December with a large goiter (8.5cm) on my thyroid. The Nuclear Medicine scan showed that it was not cancer but I am still concerned.  I have had ultra-sound, nuclear scan and CT scan.  My thyroid levels are normal, however I have gained an unexplained 30 kilos over the past couple of years, I am tired, short of breathe, dizzy and over the past month and a half I have experienced fainting.  My GP has informed me a cannot drive until after surgery, I have been kept in hospital after the first few fainting spells, but now takle them at home.  I see the surgeon on January 10th, but need surgery to stop the symptoms and I need to drive for work.  After surgery could a bi-opsy show cancer regardless of the nuclear scan? Will I go back to normal after surgery, I have a husband and 6 year old son that want me back to normal.  What are the chances I can loose the weight?
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14 Comments Post a Comment
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Avatar_n_tn
Hang in there, we are all here for you. There is a possibiliy you might have cancer, but most types are curable. We know its not easy, but try not to worry too much.

I had two fine-needle biopsies (Aug 05) done on a 3.5 c.m. node which came up inconclusive. My surgeon said it was nothing to worry about--so I didn't. After surgery the pathology came up as hurthle cell carcinoma. I have been through treatment and have had no recurrence.

Yes, you can lose the weight. With thyroid problems, it is not going to be easy. I lost 75 pounds and have kept most of it off.

Two things to consider though: first, wait until you get through your surgery, give your body the time it needs to heal afterwards and to adapt to any required medications? Try your best to be patient, in time you will get better. We all know this is not easy to do, so lean on us as we will help you through!

Second, when you are ready, I recommend the book "The Thyroid Diet" (2004, Harper Resource publisher) by Mary J. Shomon. It is geared towards those who live with hypothyroidism, works well for lots of people, and contains various lifestyle eating plans that suit individual needs. I used it as the foundation for my weightloss and found it very helpful.

Take care and let us know how you are doing.



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Avatar_n_tn
Thanks for the information.  Do you have to have a biopsy before surgery? I dont think I could face it.
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Avatar_n_tn
You're welcome!  

Having a biopsy is dependent on what your doctor/surgeon wants.  

A fine-needle biopsy is most often used and is a simple procedure. In my experience, it is not much worse than getting your blood work done. I had no anethesia. My surgeon inserted a fine (thin) needle into the lump to aspirate (remove) some of the tissues. I had little pain and was a little dizzy afterwards but that was it. I think the worrying part leading up to it was worse. Once through it, I found it quite easy.

Hang in there!
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Avatar_n_tn
Thanks again - the needle biopsy scares me more than the surgery (which I am dying to have).  My throat feels like it is more obstructed some days more than others.  Today I am flat, tired and sore and I am having more difficulty lying down etc.  Not sure if that's normal?
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Avatar_n_tn
Thanks everyone - I am scared as is everyone, more frustrated want my life back :-) will let you know how I go tomorrow.
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11852_tn?1216845043
Nimrod,

Like you the thought of people coming at me to stick needles into my throat was petrifying!!  However, the procedure was quite simple and relatively painless.  They squabbed my neck with lidacaine to deaden it.  Then they draped my neck and I couldn't see what they were doing. I had planned on closing my eyes anyway!!!! The first needle I felt a little stinging and pressure.  The other 3 times just a little pressure, but no pain.  The worst part of the procedure is waiting for it to get here!!!  So if you're doctor wants to do a FNA, go ahead.  You'll do great!!!
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158939_tn?1274918797
Please do let us know how it goes!

I'm guessing that you aren't allowed to drive because the (large) mass is impeding nerve and vascular functions which lead to the fainting.  It sounds like it is so large that it may become life threatening NOT to have it removed.  There isn't a heck of a lot of room in the neck and there are a ton of vital things going through there - no room for an 8.5cm roadblock!

If you've been reading the board there are six in my family alone who have had thyroids removed.  Four of us found out we had thyroid cancer AFTER the surgery (and two of them had FNAs that were "normal").  Honestly, surgery and pathology is the only definitive way to tell you WHAT that thing growing in your thyroid is made of.  Some get lucky on the FNA results but there are plenty of others who are surprised after surgery.

Regardless of what your mass consists of, it sounds like you really have no choice but to have it removed.

So many of us here have been through the surgery.  Some of our surgeries were relatively simple, others not but we all made it though.  We all would love to help you through whatever you may face.

You have tons of support here!
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168348_tn?1379360675
My FNA wasn't bad at all .. = to amniocentesis I had while pregnant .. actually, Novacaine shot @ dentist is WORSE~!

Good luck with your appt at surgeon, etc.  I will ck. on you after I return from my surgery scheduled for the 9th.

8+ cm's is large!  My friend had one size of grapefruit removed and that was 10yrs ago and she is doing great.  It was not cancer.

Keep us posted~ Cheryl
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Avatar_n_tn
Hi all, I met the surgeon yesterday who took one look at the scans etc and heard my symptoms and said yes that needs to come out! He has said they have to take the whole thyroid out as the goiter has wrapped itself all the way around both sides. Surgery was explained and has been booked for Februaury 27th 2007, a 7 week weight but I understand they are busy and he doesnt want anyone with less experience to operate due to the extense they need to remove and as you all know the risks of surgery.  I became a little frustrated as the surgeon did not believe some of my symptoms were related, but I figure he is a surgeon and I just have to wait and see.  He did give me the clearance to drive for work (thank god) as long as I continue to be cautious and if I am feeling like I will faint or cant work then continue not to or take days off.  
He also said that the Nuclear Medicine test showed the hot nodules so this meant there would be no cancer.  Still having read other stories I will wait for the biopsy after surgery to put my mind at ease.  Thanks everyone and I will continue to give you updates and ask questions as they arise.
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173351_tn?1201217657
Hi Nimrod78

As you might have read I am in Australia too.  You may be aware that any general surgeon can perform thyroidectomies.  
You must have a lot of compression going on in your neck from the goitre to be having fainting/dizzy spells.  I also had dizzy spells but only when lifting my hands above my head.

Due to the size of my goitre (more than 3x bigger than it should have been) I opted to use a head and neck surgeon - called an Otolaryngologist.  I did this because they should have more expertise in this area as they only work in this area.  I had alot of confidence in my surgeon and was ultimately happy with the end result.

I have only a 7.5 scar after my total thyroidectomy - I have seen bigger scars for a partial thyroidectomy.  While my parathyroids were bruised and I was hypocalacemic (low calcium)for a few days, there was no damage to vocal cords.  My goitre was wrapping around my trachea and eosophagus as well as beginning to grow substernally.

My surgeon also told me that some of my syptoms (symptoms) probably were not due to thyroid (Grr frustration shared).  He also told me a story of two patients who had the same type of surgery and one recovered within a few days and another took months - the surgeon put this all down to attitude, in your mind etc...  I have been very positive and proactive about my recovery but at 6 weeks on am not running on all cylinders.  I am learning ss positive as you can be you still can't rush your body.

My point is surgeons are experts in the Operating Room but after you leave hospital and have your 1 week follow up appointment they never see you again.  

You have a date for your surgery and a surgeon, who hopefully you are happy with.  If not their are other options.  I'd be happy to pass on the details of my surgeon (in Geelong Victoria-not where I live) if you're in that area.

Happy to share if you have any questions... Keep yourself occupied, waiting is the worst.  Thinking of you

PS. Is there any family history, if so have you had antibodies checked?  In my experience Dr's seem very slack at testing them over here so you have to ask.       SORRY TO HAVE GONE ON & ON..
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Avatar_n_tn
Thanks heaps for your comments, I am being operated on by a breast and endocrine surgeon so he is very speacilised and after meeting him I feel very confident.  I have high antibodies I believe you should have <50 and I have 586.  But yes frustrated, the phone rang today to tell me when my pre-admission session is 2 hours WOW! and then they told me my time of admission for surgery, although 7 weeks away I think it will go quickly.  I have taken 1 week off work from the day of surgery so I believe I will be well and truly on the road to recovery in that time.
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173351_tn?1201217657

Just another thought about the one week thing - it was one whole week after the op that I was started on thyroxine.  This was because we were waiting on the biopsy results.

I had a thyroid function test to check my levels at the end of that week and my TSH had risen to 15.5 - which is totally hypo.  As you would expect after having no thyroid for 1 week.  But it explained how low I felt. There is no way I could have gone back to work at this stage.

I'm sorry, I don't mean to bring you down - I hope you are better in one week. I was told that it would be only 1 week too but it wasn't the case.  

I'm not sure if these surgeon(s) think that it will be the same recovery time for someone who has a partial thyroidectomy and someone who has a total.  Because they are actually quite different recoveries.  If while you're waiting for biopsy results you are getting some thyroid hormone from remaining gland then you will feel better and have a quicker recovery rather than going hypo, won't you?  

Food for thought anyway...
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173351_tn?1201217657

One week off work only?  If you get to the end of that week and need to take another week or longer off will your employer be okay with that?  Please be kind to yourself and don't rush back too fast before your body is ready.

Did your surgeon recommend that amount of time too? I ask because before my surgery my surgeon told me to take off 2 weeks and then ended up writing a certificate for 3 weeks because I had hypocalacemia (and slight hypokalacemia-low potassium).  He said if I needed longer I'd have to see my GP.

By the way you'll be glad to know that there was hardly any pain! 2nd day and I was only taking panadol! I had my tonsils out a year earlier (at 26) and that was far far worse, I'd go through this surgery again if I had to pick out of the two.

I'm so glad you have a surgeon that you are confident in.  When feeling nervous remembering how reassuring your surgeon is helps.
Best wishes again
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Avatar_n_tn
Wow I didnt ask about recovery time, I just assumed.  I guess as I am having the full thyroid out which will require me to go on medication it will cause a problem until the levels even out.  I guess I am just going to have to do what I am doing now, take each day as it comes.  Financially I really need to return to work, but I will have to work it out hmmmm! Probably means I cant take any time off between now and surgery and given my current state, 7 weeks will be a long time to push through.  BUT THANKS TO EVERYONE for their comments
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