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Post-op: What should I expect?
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Post-op: What should I expect?

I just underwent a right lobectomy.  I had a 2.36 cm follicular adenoma/lesion.  Half of my doctors said cancer and half said not.  The surgery went well and I am at home now (3 days post op).  I started low-dose Synthroid the day after the surgery.  Right now I feel worn out and have just a slight difficulty swallowing.  I feel a little "on edge" and sometimes my pulse races.  The doctor said that everything looks good (read:benign) but I am still waiting on tests from the Mayo clinic.  I really just want to know what to expect.  It is a little discouraging reading some of these posts to think I will spend so many years trying to feel normal.  What will I really be facing?  Also, is the generic form of Synthroid okay to take?  Will I continue to feel the lump in my throat when I swallow?  The tumor is gone but I still feel something.  As I said, I am only a few days post-op and still have some healing to do, but I like to be prepared.  Any information would be greatly appreciated.  I have already learned alot from this site.  Thanks to all!

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553113_tn?1236180811
What were the reasons that you had your surgery?  I am scheduled to have a left lobectomy in January due to my FNA showing possible follicular neoplasm.  I am afraid that I may be jumping into this.  My doctor had told me that we could wait and retest every 6 months to see if it has grown.  I just had my 2nd FNA (I had decided to wait after the 1st one) which showed the atypical follicular cells, but it didn't grow.  I told him I would prefer to just take it out to see if it was cancer,  but I got the feeling that he thought I was overreacting.  I have researched this a lot, and most research states that it should be removed due to a 20% chance of cancer.  Did you have any apprehensions about having the surgery?  My doctor said I wouldn't need to take meds because the other side would take over.  It is weird how different doctors recommend different things.
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687408_tn?1228843011
I discovered my "bump" in July.  I was having symptoms like: lightheadedness, pounding heartbeat, fatigue, etc.  My husband tried to take my pulse (at the neck) and found a hard bump.  I went to the doctor two days later.  He sent me for blood work (which came back normal) and then an ultrasound.  It showed a 2.36 cm nodule on the right side.  He told me that I could wait a year and recheck or he could refer to an Endo.  I chose to see an Endo.  The Endo required a FNA before he would see me.  The FNA showed a follicular adenoma.  The pathologists were split.  Two said it was cancer and two said it was not cancer (four doctors read the results because the first two couldn't agree).  So I turned to the Endo.  He was not the nicest guy but he gave me some good info.  My nodule was growing, had high vascular involvement (blood supply), and was hard so he feared cancer.  I was given the 20% statistics as well.  I chose the surgery because the average thyroid nodule has a 4% chance of being cancer and my chances just jumped x5.  My GP wasn't dismissive but he also encouraged the wait and see approach.  I am very proactive about my health and knew that the symptoms alone were affecting my life.  I next went to an ENT surgeon.  BEST MOVE!  He was very confident that we should remove at least the right side.  He told me that follicular cancer has a much higher chance of distant metastis (showing up somewhere else like lungs, kidneys, bones, etc.) than papillary cancer.  I was sold.  I scheduled my surgery for less than a month after the appointment.  I am now 5 days post op.  There is very little pain/discomfort with the surgery.  They only took the right side because he found no signs of cancer.  The tumor is being evaluated by the Mayo clinic for a second opinion.  I started taking synthroid 4 days ago.  It takes some time to get used to but I hope it is worth it.  My endo also told me I didn't need the meds but the ENT said that without them, the left side may get overworked or form a goiter so a low dose is recommended.  I found that the Endo had a lot of good knowledge about thyroid dysfunction but the ENT had much more current info.  I will follow up with the ENT next week and get levels checked.  If the nodule is, in fact cancer, I will see an oncologist.  If not, I will continue with my ENT.  I do not plan to return to the Endo or I will find another who listens to MY issues better.  Hope this helps.
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553113_tn?1236180811
Your feelings about this are very similar to mine.  It is very discouraging when you feel a certain way about something and the doctor dismisses you.  I tried his wait and see approach for 4 months.  When the 2nd biopsy came back with the diagnosis of possible follicular neoplasm I decided I would rather be safe than sorry.  The weird thing is that after the 1st FNA he gave me the option of surgery, but after the 2nd time he was trying to push me to wait.  I know that 20% isn't really high, but it is still a chance.  My doctor told me that if it would come back as cancer that most doctors are now saying that the other side wouldn't have to be removed.  He said it should be contained to the one side.  It seems as if most people on here have the other side out if it is cancerous.  Is my doctor just more up to date on this or is he just too laid back about thyroid cancer?  He told me that thyroid cancer shouldn't even really be categorized as cancer because it doen't act the same way.   I figure that it is my life and I need to do what I feel is right.
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687408_tn?1228843011
I'm not sure if your doctor is really current or too laid back.  My ENT (the doctor I trust) told me if I get a positive cancer result, he would take out the other side.  He has done 700 partial thyroidectomies in his career.  He's also done nearly twice as many total thyroidectomies.  When I was looking for a surgeon/ENT, I asked other doctors and medical professionals who they would use and they all agreed on my dr.  I even spoke to a doctor and nurse who both had full blown follicular cancer and they both used him.  I will definitely have the other side taken out if my results are cancerous.  My doctor also recommends radioactive iodine and body scan for distant metastis.  As for not categorizing it as cancer, that sounds rediculous to me.  Cancer is cancer because it causes mutation of certain genes that then multiplies very quickly (an elementary definition).  To say that because it doesn't "act" the same as other cancers is just a dumb statement.  It still causes growth/tumors.  It still metastasizes.  It still causes death if untreated.  The only thing it doesn't do is respond well to chemo.  Several cancers don't respond well to chemo.  It responds very well to radiation.  It seems to me to be a well-studied type of cancer since it has such a specific treatment and high remission rate.  I get a little passionate about patient advocacy issues.  I wish more doctors practiced empathy.  
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553113_tn?1236180811
Your statements make me feel a lot more positive about my decision.  He told me that he really doesn't think it is cancer.  I told him that there was still a 20% chance and I could be in that percentage.  If it isn't cancer that is good, but why take the chance.  I don't think my doctor has too much experience.  He is an ENT at the hospital I work at.  It is mainly a pediatric organization, but the ENT's see adult patients, also.  I asked him how experienced he was and he told me that he did the most from our hospital. I asked him how many and he said about 10 a year.  That doesn't sound like too many.  Maybe that is why he is hesitant to do this!  I have stuck with him mainly because this surgery and hospital stay is 100% covered if I use our hospital. I have also heard that he is a really good surgeon (just don't know about thyroids).  I have already decided that if it would be cancer I would get a second opinion.  He has really frustrated me and made me feel as if this wasn't something to worry about.  I did a lot of my own research and decided to do what I thought was the right thing.  At least he agreed to do it.  I guess I will see how this all turns out.  

So, how is your recovery going?  How much time did you take off of work?  How does your incision look?  Did you have to stay in the hospital and if so how was that?

Thanks so much for all of you info.

Jackie
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687408_tn?1228843011
Recovery is going okay.  I was tired the first couple days but not really sore.  I stopped the pain meds Monday because I was returning to work.  I took off Thursday and Friday because of the surgery.  I went in Thursday morning and left Friday morning (23 hours).  I thought that all in all this was the easiest surgery I've had (it's number 8 total - first for thyroid).  My incision has a butterfly closure strip on it but no external stitches.  It is only 3 cm long.  The nurse I talked to before the procedure had this same surgery 3 months ago and I couldn't find the scar when I was talking to her.  I can eat anything I want and have very little problem swallowing.  My only real concern is adjusting to the meds.  I sometimes feel a little edgy.  My dr. said it is a normal side effect of this medication because it trying to jump start my metabolism.  Even this has gotten better each new day so I cannot complain.  My last hurdle is the pathology results next Wednesday to say for sure if it is benign.  
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553113_tn?1236180811
Wow, you had a quick recovery.  My doctor said recovery was 1-2 weeks.  He said it would only be painful for the first couple of days and then it would be like stiff and sore.  I asked off for a week.  Now I feel like I may be milking it.  I have to admit that I am excited to have some time off, especially if I don't feel terrible the whole time.  I have only had one surgery before and I could hardly function the first week. It was just a surgery for my nasal septum and turbinates.  I am wondering if it was the anesthesia that made me so exhausted.  I could only stay awake for about 2 hours and then I would need another nap.  I don't even remember watching tv, I was so miserable.  I felt like I had the flu.  I really hope it isn't like that again.  So, your incision was the small?  Did you have the new surgery that isn't as invasive?  The pictures I have seen shows the incision as really long.  I hope mine is small.  I really don't want a huge scar across my neck.  That is one of the main things I am worried about.  So, I wonder how my doctor will do with monitoring labs since he wasn't putting me on meds after the surgery.  I wonder if I should just have my primary doctor monitor this.  He seems nicer.  Thanks so much for the info.  It really helps to have an idea what will happen.  By the way, I really hope that your results are benign.
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687408_tn?1228843011
My surgery was the "new" way from what I understand.  I saw the old way while at the hospital.  Another patient with a different doctor had the old way.  Her incision was quite a bit larger than mine.  It looked pretty good (small stitches, etc) but will definitely be more noticeable than mine.  The main reason I chose my doctor was that he does aesthetic surgery.  Part of his practice includes a woman who does facial peels, microdermabrasion, etc.  They actually asked if I wanted anything else done while I was under! :)  When I go on Wednesday, I'm going to ask about the monitoring thing.  I like my GP but I feel more comfortable with a specialist.  There is a second, very small nodule in the remaining lobe.  Currently, it is too small to even biopsy but the chances that it will grow/change are fairly good.  I think that I want to already have a specialist in place that knows all my issues before something else occurs.  After reading some of the posts in here, I anticipate at least a few bumps in the road.  I'm going to ask the ENT if he can continue my care or if he can refer me to a GOOD endo.  Thanks for all the posts, it has helped to talk about it.  Keep in touch.
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553113_tn?1236180811
So, how did you get so lucky to find your surgeon?  I want my surgery to be like yours.  I have a feeling that mine is the "old" way.  I really hope that my incision heals nicely. So, how are  you feeling today.  Do you still have a lump in your throat?  Is your neck still sore and stiff?  Did you ever lose your voice?  What day are you finding out your results?  You will have to let me know how that turns out.   Did you ever feel pressure in your throat? My nodule is only 1.2 cm, but it seems that occassionally I have a weird pressure.  It isn't always there, so I don't know if I am just thinking too much into it.  So, you have a nodule on the other side, too? I have one that is 1.4 cm on the right side, but the FNA came back benign on that side.  Do you think I was right in just leaving that one?  I feel better about leaving that one because the risk of cancer is pretty much 0%.  How often do you think I will have to monitor that side?  I didn't really ask my surgeon all of the questions I should of, because I was too worried that he thought I was overreacting to having the surgery.  I really wish that I had a different doctor.  I think if I had a doctor that was making me feel as if I was doing the right thing I wouldn't be so anxious about this.
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687408_tn?1228843011
I found my surgeon by accident - he did surgery for my mom several years ago (not a thyroid issue).  I still have a lump of sorts.  I can feel it slightly in my throat but more so from the outside.  My neck was sore on Saturday (2 days post op) but that went away by Sunday night.  I never lost my voice at all but I couldn't talk as loudly for a few days.  I find out the results next Wednesday.  The dr. said that based on the preliminary evaluation, if there is cancer it is VERY early.  I definitely felt pressure before the surgery.  It was almost like I couldn't swallow completely.  Near the end, I could feel the pressure pretty much constantly.  I wouldn't have a benign nodule removed unless it is causing other symptoms (like difficulty swallowing).  The doctor told me that he would not need to do much with the left side unless my levels changed or I started getting symptomatic again.  He said that I should have a blood test annually.  When is your surgery scheduled?  I will keep you in my prayers.
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553113_tn?1236180811
Thanks so much for all of your info.  You really helped me to prepare for this.  My surgery is set up for January 7th.  Hopefully my recovery is as good as yours.  You will have to let me know how your appointment on Wednesday goes.  I hope it all comes back benign.  Talk to you later. Jackie
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Avatar_f_tn
How did your surgery go? i'm having total on february 19th i;m nervous a bit I had pre op yesterday i really want to know how people feel after this surgery and what to exspect?
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553113_tn?1236180811
My surgery went very smoothly.  I stayed one night in the hospital.  I never had any really intense pain.  I tried telling the doctor that I would just take Tylenol, but he thought I should use something a little stronger.  I was a little tired for 2-3 days, but then was up and moving around pretty normal.  I took 10 days off from work, so I actually had a little vacation!  I had my bandage and steristrips on my neck for 1 week.  I had my surgery on January 7th and I feel pretty good.  I actually have to go to my primary care doctor to get lab drawn today.  I only had my left side removed, so hopefully the other side is functioning normally and I won't need medications.  My incision is still a little red and hard, but it is definately looking better.  I can tell it is a very fine line, so hopefully it will fade so much that you won't even see it.  By the way, my pathology came back benign.  Why are you having the surgery?  What did your doctor say?  I had so much anxiety about the surgery before hand.  I am really glad I had it done, because I have peace of mind now.  I will still have to monitor the right side of my thyroid, but since the FNA said the nodule was benign, I don't have too much anxiety about it.  Well, let me know how things go and good luck on your surgery.  I hope you have a speedy recovery!!
Jackie
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Avatar_n_tn
Im scheduled to go have a consultation in about 3 hours with a surgeon here in Sacramento, CA. Im subclinical hyperthyroid but my goiter has grown to 2.45 cm from about 2.2cm from about 6 months ago. The endo was concerned because it was still growing and said the biopsy may not have been correct. So im supposed to have surgery to remove the growth after I talk to the surgeon. The endo said he may not put me on meds since im hyperactive and maybe removing the growth will "level" out my body. But he told me for about 4-6 weeks I may swing to Hypo and feel like ****.

Hopefully they can get the surgery done sometime really soon and not push it out.
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Avatar_f_tn
I am 6 days post-op and I'm still a little sore. Stiff neck and hard to stretch.  I had a total thyroidectomy and will see my doctor 6/11 to find out if the nodules were cancerous. I have not been started on replacement until I get these results. How soon did anyone start replacement and at what dosage?
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Avatar_f_tn
I started the day after my total thyroidectomy (exactly 6 weeks ago) on 100mcg.  It was removed due to a suspicious FNA, but the final path report was benign.
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Avatar_n_tn
I have been reading all of those posts and would like to post my story.  I am a 30 year old female with the following symptoms that finally drove me to see an ENT:  hoarseness lasting six weeks, right neck and ear pain, feeling of fullness in my throat.  The ENT diagnosed me with a paralyzed right vocal cord and ordered some CT scans...neck CT showed thyromegaly.  Ultrasound was ordered which showed a 1.5cm hypoechoic nodule (this nodule is not palpable).  Long story short after several docs, I am having a right thyroidectomy with a frozen section in 4 weeks (although my doc does not feel it is cancer)...however my doctor does not feel this is the cause of my vocal cord paralysis.  Anyone with similar symptoms??  If so, did you vocal cord return to normal function after surgery.  Any input appreciated.
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Avatar_f_tn
I think sometimes I'm ok with the fact I had the right side of my thyroid took out but now 6 months later I wish they had never touched me. I had a follicular tumor that was 4.8 cm removed along with 9 lymph nodes. The tumor was benign but now I feel like absolute CRAP. They didn't give me any meds and they said I'd be fine because I still have my left side. Since the surgery I've had nothing but trouble my blood sugar is haywire, my heart skips beats, my heart rate is racing all the time, my blood pressure is low, I have constant infections, flu like symptoms, sinus problems,  dry skin, white hard bumps that itch like hell, acne that seems to pop up everywhere,  I'm tired and feel beat down all the time, my memory *****, my ears ring, I have red blotchy places all over, I feel like I'm losing my mind, I choke a lot at night and during the day, I've went from having an 8 day period to a 1 day with agonizing cramps, my feet and hands feel like I have millions of needles sticking through them, and then comes not sleeping. I go to sleep just to wake up in 2 hours and then not able to go back to sleep.  I've seen my primary care doctor 7 times since my surgery about all of this and she says I'm fine. I have choice words for her. My endocrine surgeon retired right after my recheck visit so I had to wait until they found a replacement doctor for his practice at the cancer center. I saw her and told her of all these things. She thinks I have menopause because even though my blood levels are high on my T3 T4 and my TSH they're still considered normal. I just love how doctors pass the bucks and use us as lab rats. So now I'm being sent to a regular endocrinoligist for supposedly menopause which I just got screened for 3 weeks ago and I was FINE! I'm getting tired of the typical BS I'm receiving from all these doctors. I never had any problems before my surgery and now I feel like a damn train wreck.
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Avatar_f_tn
I had the right side of my thyroid removed because of a nodule four weeks ago.  Op went well, no obvious side effects.  Could eat, drink, swallow, talk etc straight after op. Scar minimal.
Everything ok for the first three weeks.  Went back to work a week ago and haven't had a decent night's sleep since.  Feel tired but if I sleep at all, I am awake in about two hours and either don't sleep or cat nap for the remainder of the night.  Have put on a few pounds and skin/hair seems drier than normal.  Can cope with that, it is the insomnia that is getting me down.  But don't know if this could be related to the op or not.
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649848_tn?1357751184
Have you been put on medication to replace the hormones?  Insomnia is a symptom of being hypo.  Have your thyroid hormone levels been tested?  You should be getting TSH, Free T3 and Free T4, every 5-6 weeks until your levels stabilize and symptoms are gone.

If you have recent thyroid labs, please post them, with reference ranges, since ranges vary lab to lab and must come from your own report.

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Avatar_f_tn
Reason for the surgery was because my thyroid was over active, caused by the nodule I think.   Haven't had any blood tests since the surgery. Due to see consultant again next month (first time since the op).  Seeing my own GP next Thursday so will mention the insomnia.  I was originally advised that since only half my thyroid was being removed, there was a 95% change I wouldn't need any medication following the op.
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649848_tn?1357751184
Many people are told they don't need medication when only 1/2 the thyroid is removed, because it's hoped the other 1/2 will be able to produce enough hormones, but too often, it can't. Your doctor should have tested you by now to make sure.  

You have some of the classic symptoms that indicate the remaining 1/2 of your thyroid is not producing adequately.  Ask for testing, before things get worse.  Insist on TSH, Free T3 and Free T4; don't settle for just TSH.  
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Avatar_m_tn
I am scheduled to have my entire thyroid gland removed next month. I have a 5.2 cm nodule on the left and a smaller one on the right.
The specialist wants to remove the entire gland. I am a bit apprehensive about the procedure and subsequent effects. My job includes being on the phone a lot and I have gone through periods of being unable to speak at all, or very hoarse. I am concerned about damage to my vocal cords and my ability to perform my job after the surgery.
I have also read about the weight gains after surgery and after reading these posts - I am wondering whether there are alternatives to having this surgery performed.
Would appreciate your comments.
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649848_tn?1357751184
If your entire thyroid is being removed, you will be put on thyroid hormone replacement, probably synthroid or another, similar T4 medication.  If you are put on an adequate dosage, you should do fine, and should not gain weight, or it would be minimal.  Typically, it's best to start at a low dose and work up to a therapeutic level, in order to give your body time to adjust.  

Damage to vocal cords is very rare. I, actually, had surgery on my vocal cords and my voice is perfect.  It's probably the large nodule that's causing you to have the periods of hoarseness or no voice, now.  With it gone, you should have no trouble.

With a nodule that large, I'm sure there is no alternative. Try not stress about it and do let us know how you turn out.
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