Thyroid Storm and Surgery

[dianejk]

Does anyone know at what point during or after surgery one is no longer susceptible to Thyroid storm? I read on About.com that surgery and anesthesia can precipitate Thyroid Storm. This sounds pretty risky to me. My hyperhtyroidism has not been labled by any doctor. The only diagnosis they give is that I have a subacute hot nodule and slightly elevated levels of T3 and T4 and very low TSH. I've had this situation for 8 years and take no meds. Just lots of kale and cruceferous vegetables. I'm thinking of just putting off getting the lobectomy. Not sure.
And thank you to Sally and Deb for commenting on my last question.
Dianejk

[Smilerdeb]

Sorry but just re-read yr posting and noticed you are on Kale.
Kale is bad for the thyroid...you shouldnt be on it.

Also forgot to mention that I was on anti-thyroid meds right up until day of RAI (whereas most are disconitinued) and my Endo said RAI wouldnt work because of this.She was totally against it but it was MY request as my levels were so high and couldnt be controlled.
I think the silly c@w wiped her hands of me lol.

I demanded the dosage, I demanded the proceedure to be done MY way or NO way.
This is something that you are able to do
'It is your body.

[Smilerdeb]

If its any consolation to you diannek...my levels were 3 times higher than reference ranges when RAI was done and I didnt experience thyroid storm after RAI (which I thought I would).
But I was also given a beta blocker via IV an hour before RAI (this was requested by me and was not refused. I basically asked for it for my own personal peace of mind).
I had been on beta blockers prior to RAI that did help.
I also had TT (keyhole -under the armpit) 3 months after and felt no different.
I also had the TT proceedure whilst awake (at my request too) via Epidural.

Was I scared? You bet I was but the fear was unfounded.
If at any stage while under anaestic, it shows yr heartrate going into 'overdrive'....IV by beta blocker is used straight away.
If you proceed with the surgery....ask for a beta blocker to be given before you go under the anaesetic.
As long as your BP isnt drastically low, they will comply with it.

[laura1967]

I agree with Stella, and would also like to comment that I wouldn't worry about storming.
A couple of days of surge from extra hormone, from surgery is well worth the long term benefits of controlled levels with meds.  :)
Thyroid storms are rare and mostly caused by Graves and requires VERY high levels of hormone.
There are meds to help control high levels as well.  :)

[stella5349]

With a hot nodule most likely there is leekage of hormone and that could be causing some of the hyper symptoms. The hard call for doctors is the actual producing of the hormone and what the nodule is doing to you internally.

In many cases - its easier to control the problem removing the nodule and then seeing actual hypo levels after surgery to medicate.

Wondering if you had autoimmune testing for both Graves and Hashimoto? That could help understand more too. How could a non-labeling happen if your levels indicate hyperthyroidism?

In the big picture of storming, it is uncommon to storm in many cases. With a hot nodule however the secretion of hormone during removal could spike a surge of hormone. Whether you storm or not - is only a guess for anyone.