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Avatar universal

I need opinions/help please

I met with the surgeon today and I know I need to have at least 1/2 my thyroid removed, but he suggested taking the whole thing as I have a small nodule on the right side as well as the 3.8 cm one on the left. I had an Atypical FNA biopsy on the large nodule (small one not checked) and so now I dont know what I should do :( I thought I was only going to have half of it removed and hoped the other half would make enough hormone to keep me off meds ( all of my blood work is within normal limits). What would or did you do and what was your situation?  I dont have too long to decide as surgery is in a couple weeks.  Also if they take the whole thing, do they send you home with a prescription for thyroid meds?  Thanks!
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Avatar universal
Hi,
     First I want to thank everyone for posting their stories and the decisions that they made. It has been very helpful to me.  
     My Ent only biposied the 3.8 cm mass on the left lobe, he did not biposy the 9mm nodule on the right side.  All of my labs including antibodies are within normal limits. My left lobe measures 6.7 cm x 2.5cm x 2.1 cm , right lobe is 2.5cm x 2.1 cm and the isthmus is thickened at 5mm. The surgeon implied that if I only take half, the other side will have to work harder and the nodule could grow or eventually my remaining half would just stop working and I would end up on meds any way or have to have the other half out. I am naturally a worrier and I think having that other half in knowing what he suggested could be going on, would be really hard for me. I just hate to be on a medication that I need to take everyday to survivie if I dont have to.
     The other thing that worries me is that if I only take half out and then find out its cancer, thats two surgeries I will have to go through:( The surgeon said that normally the frozen sections in the OR do not give any more of a result than the FNA biopsy, so he is pretty sure I would still have to wait for the pathologist to review which would lead to two surgeries.
     I am scheduled for surgery on the 18th of August and from what I have been told it will be a same day surgery.
     Thank you every one :)  I will keep you all in my thoughts and prayers.
Helpful - 0
168348 tn?1379357075
Hi

2.5 yrs ago I was where you are now.

4.0 mm on intact side

Two nodules > 1.0 cm on right side that FNA were atypical

Frozen Biopsy showed NO cancer for two large rt. side nodules

So they left the left side intact

Then 48hr later the Final Biopsy showed two other incidental findings of Papillary Cancer elsewhere in the removed gland .. tiny, fully encapsulated, but two of them about 5.0 mm

The other side NEVER regained full function and I'm on Synthroid to live w/o a choice of using it for Cancer Suppression.  20% of surgeries damage the other side.  Yep. I'm one of them.

If you have the other side out, you don't have to go through wondering "if" and/or "when" the other nodule will grow or is it cancer or can it turn into cancer or waiting for your next ultrasound.  The fist 2 yrs I went ev. 6 mos for serial comparason ultrasounds of the "other side's nodule" which is totally stable and 4.0mm in size.

Now I go ev. year;

On the other hand, if you are fully benign like my large ones were (overgrowth of thy. tissue adeonomas), then why take the other side out.

It's a double edged sword and we've decided to keep my other side in unless the small nodule changes then I RUN (not walk) to have it out.

LIving with knowing I have another nodule has taken time to accept.  I have had around 5 opinions (my endo moved away) and 4 say keep the other side intact and 1 said to have it out with RAI and cited studies.

Tough call ..... but protocol usually is frozen biopsy and take other side out only if comes back cancerous.

Did you have the other side's biopsied?  WHAT did it say?

C~
partial 1/07
Synthorid 75mcgs
Helpful - 0
Avatar universal
I am recovering well, thanks! Everyone is so different in their reactions to anesthesia and the whole surgery. I had a great surgeon (skill level) however not so great bedside manner.
Here are some questions I would ask (that I didn't know/think to ask then):
1.What type of pain medication will you give me after surgery? If that does not work, what other medication can I have? (I say this because the only med my doc ordered for pain was morphine, which I have not had before. It gave me a TERRIBLE headache and bad nausea.) He ordered the morphine every 2 hours for pain but the anti-nausea medication only every 6 hours--what!? I went more than 6-7 hours without pain medication because he wouldn't give me anything else.

The next morning he came in all chipper and I still felt like ****. He said I should be walking around the hospital and moving around. I  just kept thinking "you gotta be kidding me!!" Luckily I had a fabulous nurse that day and things got much better.

2. If you need time off from work I would get VERY clear on expectations and how your doc will handle the paperwork for this. I won't go into detail, I just had a very bad experience with this part too.

3. What type of thyroid meds will I get after surgery and why?

I think the parathyroid and calcium stuff has already been addressed...

Honestly the first 24 hours were awful for me--headache, nausea, VERY sore throat...the next week was hard, very tired and I lost my voice for 6 weeks. Even though my surgeon said he didn't touch the vocal cord nerves my right vocal cord was paralyzed (possibly from the intubation-breathing tube).

Anyway, I know some people say it was a breeze for them, but not for me. However I'm doing great now and really happy I had the surgery.

Good luck and email me if you have any more questions.

Sandra
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Avatar universal
I'm having my surgery close to you, on 19th Aug - probably between Tracey415 and shellyme33.

I wish I had a choice about how much of the thyroid gets removed. I have an adenoma of 4,5cm x 3,5cm x 2,5c on the right and two little ones on the left of only 0,7cm x 0,7cm.

My surgeon said he'll remove the right side but that the left does not worry him at all, so its staying.  I would far rather have this "Thyroid worry" from my life as shellyme so aptly describes.  I would prefer the whole thing out, but on the other hand I think the lobectomy is a smaller surgery, so its also a bit of a comfort.

I'll keep you both in my prayers and hope it all goes well for you.
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Avatar universal
Hi Sandra,
                Thank you for your response:) It helps to hear what other people are going through and what they decide to do.  I think you are right, I definitely do not want to do this twice! Its just so scary... Are you recovering well? I will keep you in my thoughts :)
Helpful - 0
Avatar universal
Hi Tracey,

I had a total thyroidectomy at the end of May--about 10 weeks ago. Although my circumstances were different (lymphocytic thyroiditis w/compressive goiter--no cancer suspected, although pathology did show multiple benign nodules not detected on ultrasound) if it were me I would NOT  want to go through the surgery, risks, time off (work issues/finances!!), recovery, etc. twice. There's no guarantee either that you wouldn't need thyroid meds even if you did have a partial. I'd want it done all at once! You have to do what feels right for you. If there is cancer then you either won't get any thyroid meds after surgery and you will get really hypo (in prep for RAI) or they will put you on a T3 med only is what I've heard/read. There are many posts on this that you can search. If there's no cancer they can put you on thyroid meds right away. Be sure to ask your doctor about each scenario.

Take care and let us know what you decide.

Sandra
Helpful - 0
Avatar universal
I am worried also... but I think that since I have issues in both lobes, I would rather be done with the cancer worry. I think my cytology will be similar to yours. I will remember you in my prayers.

God Bless,

Shelly
Helpful - 0
Avatar universal
Thank you for responding to me. Good Luck to you :) I will have my surgery one week before you. The surgeon said I can wait until the morning of surgery to let him know what I want to do. I am leaning toward having the whole thing out, but it is scary to think about. I am so frightened right now :(  I hope you get good results back on your FNA. I was hoping for a more definite answer than atypical (nuclear grooves and prominent nucleoli) so the decision on how much to take would be easier :)
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Avatar universal
Wow! My story exactly... I agreed to have the surgeon remove the whole dang thing. I don't want two surgeries or the having to get blood work and ultrasounds for the rest of my life. I WANT THIS THYROID NIGHTMARE, DONE ONCE AND FOR ALL. I met with my surgeon today, and loved her. I was supposed to get the cytology report today, but it won't be ready until tomorrow. The left thyroid tumor has grown 2cm since April 24th, and the right has gotten a little smaller. I had the biopsy last Friday, and I have not felt well since. Friday night and saturday, my thyroid was swollen, and I talked real funny. Sunday I came down with a fever, of 99.0 and have had a fever ever since. I will most likely be having surgery the last week of August. I am in a very similar boat, and I say take it!
Helpful - 0
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