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Post Thyroid Lobectomy Hematoma
Hi,

Eight days ago, I had a thyroid lobectomy to remove a benign follicular adenoma (5 cm) that reached below my collar bone and my left thyroid gland.  Immediately, in the hospital I began to swell and bruise, and after going home, I bruised all the way to the center of my breasts.  That bruising is gone, but the lump and bruise on my throat remain.  (My husband says I look like a toad.)

I went to the surgeon today for a follow-up visit and she attempted to aspirate it.  It is too thick, and won't come out.  She says it should dissolve and be reabsorbed into the body within the next 4 weeks.  Does this seem reasonable?  Will it go away on its own?  Should she have planned some type of surgical removal of it since it is so thick?  It is uncomfortable, and sometimes I have trouble swallowing, but breathing seems to be ok so far.  Also, it swells more as the day goes on, and usually by the end of the day my voice is “horsey”.  I think this is because it is swelling and putting pressure on my voice box, but of course I’m not a medical professional.

She did say that she will not attempt another aspiration, especially not in the office, as I basically passed out without loosing total consciousness immediately after her attempt.  I felt faint, the room went black, I could hardly move, I felt sick etc.  Basically I felt like you do when you come out of surgery and they are talking to you—you know someone is there, but you can't yet respond – even my words were kind of slurred.  My husband said I turned blue from the nose to the chin before beginning to regain color.  They didn’t have oxygen in the office, but I think it would have helped me come around quicker.  It took about 45 minutes for me to feel ready to leave.  By then, the doc had gone to surgery, but her nurse was still there.  Is this type of response often seen after an unsuccessful aspiration attempt?  My BP has been relatively low (as low as 85/52, but averaging around 104/75 – my normal BP is around 136/88).  Should I be concerned about this?  I see a cardiologist about my possible BP problems (I’m not sure they aren’t related to the thyroid).  Should I contact her about the episode?

The surgeon says she plans to do blood work in two months to determine if the right side of my thyroid is taking up the load of the left side or if synthetic medications are needed.  Is it normal to wait this long after surgery?  I was told by a friend who had thyroid cancer to expect them to tap on my face.  They never did.  Should they have?

My surgeon specializes in thyroid, parathyroid and breast surgeries/cancers.  So, I feel she is qualified; it's just that I haven't seen these symptoms posted anywhere on the web, and I haven't had tests, I thought would be performed by now, so I need a little reassurance.  I need to know that playing the "wait and see" game is the best for my health.

Thank you for your advice.
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158939 tn?1274918797
Holy surgical mess!   Okay, I haven't had post-surgery bleeding from my thyroid surgeries but I did from an ovarian surgery and I swelled up like I was 8 months pregnant and turned black and blue.  At the time my neighbor was a doctor and I called to ask him his opinion.  He told me to get to the ER *now* and when I did they checked my blood work and my levels were very, very low from internal bleeding.  I spend three days in the ICU.  They were debating re-opening me to repair the bleeding.  My body *did* eventually reabsorb the blood and stopped bleeding.  

Is your surgeon *sure* YOU have stopped bleeding?  If you have, your body will reabsorb the blood *but* with your low BP, I'm concerned that you are *still* bleeding.

I'm also VERY upset that the surgeon left you in her office and went off to surgery.  You should have been transported to the hospital - especially since there was no oxygen or other emergency equipment there, not left with a nurse.

Contact your cardiologist and explain everything that is going on.  If you feel faint or have difficulty breathing or chest pain (which may indicate blood in the chest cavity) GET TO THE ER!

Wow - I'm so sorry for all you have been through!
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158939 tn?1274918797
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Thank you for your thoughtfulness.  Actually, the nurse was in the other room.  I guess since my husband was there, they felt I would be ok...Although both of them did come into the room repeatedly to check on me.

What about the followup blood work to see if the other side of my thyroid is working?  Is is normal to take so long before it's done?
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158939 tn?1274918797
It will take about 6-8 weeks for your thyroid levels to "normalize".  After thyroid surgery there is often a dump of thyroid hormones and it takes that long to see what the real picture is.  Sometimes though, and ChitChatNIne is an example of this, the other half of the thyroid will slowly stop working so you will need to have your labs checked every few months until they figure out what level of meds (if any) you will need to be on.

Do you have a good endocrinologist?
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158939 tn?1274918797
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Not yet, but I there are 5 hospitals in the area, one the only teaching hospital in the state, so I feel certain I'll be able to find a good one.
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362809 tn?1233510154
I had surgery recently for recurrent thyroid cancer where they took out a mass and 5 lymph nodes.  I swelled up like a balloon as well and they thought it coud be a hematoma.  It took about 2 weeks for it to go down completely, but it did.  It was at it's worst about a week after my surgery.  Maybe give it another week and if it doesn't start going down, go see the doctor again.  Of course, if it continues to get bigger and bigger, you may want to go to the doctor sooner.
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362809 tn?1233510154
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Anyone have any suggestions on how to stop the itching at the incision site?  I know that is part of the healing process, but it is driving me nuts.  The doctor replaced the surgical tape after yesterday's incident, and I'm wondering if the feeling is back enough for the adhesive to be causing some of the problem.

Is the adhesive on the surgical tape they put on the incision the same kind of adhesive that goes on the leads of a heart halter monitor?  If so, I might need to call her.  I once wore a halter monitor for 24 hours, but had the "smiley face" burned into my skin for 3 weeks.  It seems I'm alergic to some adhesives.

Thanks for your continued help.
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