Solid food?

[scaredandconfused84]

When is it ok to start normal and solid food again like pizza and steak and what not? I don't want the stitches on the inside to open. Will be a week since surgery tomorrow.

[Barb135]

At 37.9, your TSH should be high enough for anything that needs to be done.  You're going to be very hypo and will begin having symptoms very soon. I don't understand why they are dragging this out so long.

[scaredandconfused84]

After I'm on the low iodine diet for 2 weeks and my tsh is high enough. I will star rait after that.

[Barb135]

Here's a link that will give you information about it.

http://www.endocrineweb.com/conditions/thyroid-cancer/radioactive-iodine-papillary-thyroid-cancer

[Barb135]

I can't find a specific measurement for TSH to begin the low iodine diet, but I'd certainly think 37.9 should be high enough.  Always call your doctor when in doubt.  Do you know when you'll be having the RAI?  

[scaredandconfused84]

I was wondering if you could tell me if my TSH lvl is high enough to start the radioactive iodine diet. it is at 37.9. Or do you know someone who would be able to tell me?

[scaredandconfused84]

I am pretty sure my Endo knows what to test. I get it tomorrow. I just really hope the cancer stayed in one spot and didn't spread anywhere else. I want to done with surgery. Do the treatment and start to live life again.

[Barb135]

It's out now and you won't have to worry about it any more...

When they do your blood work, make sure they are doing Free T3 and Free T4, not Total T3 and Total T4.  

[scaredandconfused84]

Here is the report from the TT:
SPECIMEN(S): A. NECK DISSECTION, RIGHT LATERAL NECK CONTENTS; B.
THYROID TOTAL RESECTION, WITH CENTRAL NECK CONTENTS

A. NECK CONTENTS (RIGHT LATERAL), NECK DISSECTION
--- METASTATIC PAPILLARY THYROID CARCINOMA INVOLVING FIVE OF TWELVE
LYMPH NODES, UP TO 10 MM METASTASIS (5/12)
--- NO EXTRANODAL EXTENSION IDENTIFIED

B. THYROID WITH NECK CONTENTS (CENTRAL), TOTAL THYROIDECTOMY AND NECK
DISSECTION
--- PAPILLARY THYROID CARCINOMA, 2.5 CM, INVOLVING THE RIGHT LOBE,
LIMITED TO THE THYROID
--- METASTATIC PAPILLARY THYROID CARCINOMA INVOLVING EIGHT OF FOURTEEN
LYMPH NODES, UP TO 10 MM METASTASIS (8/14)
--- NO EXTRANODAL EXTENSION IDENTIFIED
--- MILD CHRONIC LYMPHOCYTIC THYROIDITIS
--- TWO UNREMARKABLE PARATHYROID GLANDS
--- FOCAL UNREMARKABLE THYMIC TISSUE
--- SEE SUMMARY OF FINDINGS

SUMMARY OF FINDINGS

Specimen Identification
Specimen, laterality, procedure: Thyroid, total thyroidectomy with
central neck and right lateral neck dissections
Specimen integrity: Intact
Specimen size: See gross description

Tumor focality: Unifocal

Dominant Tumor
Tumor laterality: Right lobe
Tumor size: 2.5 cm
Histologic type: Papillary thyroid carcinoma
---Variant: Classical (usual)
Tumor capsule: Partially encapsulated
Tumor capsular invasion: Not identified
Extrathyroidal extension: Not identified
Lymph-vascular invasion: Absent

Final Margins: Negative

Lymph Nodes
Regional lymph nodes (involved/examined): 13/26

Pathologic stage: pT2 N1b M(Not applicable)

NOTE: Final report will be faxed to the office of Dr. Peter Czako on
January 8, 2015.


cal/cr


GROSS DESCRIPTION:
A. Received in formalin labeled "right lateral neck contents" is a 4.5
x 3.5 x 1.5 cm unoriented aggregate of yellow adipose tissue. No
discrete skeletal muscle or internal jugular vein are identified
grossly. The specimen cannot be oriented due to the fragmented nature
of the specimen and absence of the normal anatomic landmarks. Upon
dissection, thirteen possible lymph nodes are identified ranging from
0.2 x 0.2 x 0.1 cm to 1.3 x 0.8 x 0.4 cm. The cut surfaces of the
larger lymph nodes are pink-red, smooth and glistening. Two of the
largest lymph nodes are grossly papillary and cystic, consistent with
involvement by tumor.

The possible lymph nodes are submitted entirely as follows:
1 - three possible lymph nodes
2 - two possible lymph nodes
3 - three possible lymph nodes
4 - two possible lymph nodes
5 - one possibly involved lymph node bisected
6 - one possibly involved lymph node bisected
7 - one lymph node bisected
Multiple/7, + G.

B. Received in formalin labeled "total thyroid with central neck
contents" is a 24 g total thyroidectomy specimen consisting of right
lobe (4.0 x 2.8 x 1.5 cm), left lobe (3.8 x 2.5 x 1.4 cm), isthmus (2.4
x 2.0 x 0.8 cm), and central neck contents extending from the inferior
aspect (5.0 x 3.0 x 1.0 cm). The capsule is dark red and slightly
ragged on the posterior aspect. The specimen is inked as follows:
anterior right lobe - red, anterior left lobe - blue, anterior isthmus
- green, posterior - black. Sectioning from superior to inferior
reveals a 2.5 x 1.7 x 1.6 cm well demarcated, pink, possibly partially
encapsulated, firm mass within the inferior pole of the right lobe at
the junction of the right lobe and isthmus. The mass abuts both the
anterior and posterior thyroid capsule. The remainder of the thyroid
parenchyma is dark red, glistening, and unremarkable.

Upon dissection of the central neck contents, twenty-two possible lymph
nodes are identified ranging from 0.2 x 0.2 x 0.1 cm to 1.5 x 1.0 x 0.8
cm. The cut surfaces of the larger lymph nodes are pink, soft,
papillary, and partially cystic. consistent with involvement by tumor.

Representative sections are submitted as follows:
1-8 - entire mass within right lobe to isthmus in sequential order
from superior to inferior
9 - representative unremarkable sections from superior right
lobe and superior left lobe
10 - representative sections of unremarkable inferior left lobe
11 - three possible lymph nodes
12-13 - four possible lymph nodes in each
14-15 - three possible lymph nodes in each
16-19 - one lymph node, bisected in each
20 - largest lymph node trisected
Multiple/20, + G. hg/cal/kh

[scaredandconfused84]

And no I don't feel sluggish or anything yet, its only been 11 days since I had the TT so I don't really feel bad or anything right now.

[scaredandconfused84]

I found out that the surgeon had to take 13 out of 26 lymph nodes. And I see the surgeon tomorrow, I have a blood test done for t3 and t4 tomorrow to see if my levels are what they should be to do a thyroid scan for RAIT and then if they are I start the diet. If not we figure out when my levels will be good enough. I get the scan on Monday.

[Barb135]

Oh wow, I thought they'd prescribed you 25 mcg levo... aren't you starting to feel kind of hypo?  When will they do they RAI?

Be careful with the diet then, because weight gain is a major thing with hypothyroidism and if you aren't on thyroid replacement, you could start gaining quickly... pizza would be off limits...

[scaredandconfused84]

I dont have any thyroid hormone pills yet. They aren't giving me anything until the radioactive iodine therapy is scheduled and completed.

[Barb135]

Let me know how it goes.

What are the strength of the vitamin D pills?  

You aren't taking those calcium pills at the same time as your thyroid hormone pills are you?  Calcium prevents thyroid hormones from being absorbed properly.  Make sure you separate the 2 by at least 4 hours.  Take your thyroid hormone first thing in the morning and the calcium pills after lunch, over the course of the afternoon/evening. Take the vitamin D with the calcium.  Magnesium is also necessary to absorb calcium.  Talk to your doctor about that.

[scaredandconfused84]

I go in today at 7:10, last appointment of the day. And yes she has me taking 8 500 calcium and vitamin d pills a day.

[Barb135]

Sorry, I wasn't online much yesterday.  Wow - you're doing good with the burger and fries; I can imagine it did really taste good...

Are you taking calcium supplements to get your level back up?  Have you heard anything?  

Keep me posted, okay?  

I'm here whenever you need to talk.

[scaredandconfused84]

Was able to have a burger and fries tonight. And let me tell you, it tasted soo good. Still waiting on Pizza for about another week or two. See my Endocrinologist for a follow up since my TT. My calcium was a touch low so I had to get another blood test done. Hopefully it is back up to normal. I believe it was at 7.6 and should be 8 to 10 or something like that. We will find out tomorrow. Thank you all for the support and advice. Means a lot.

[Barb135]

Ah... mac and cheese is a comfort food for most of us... good choice to wait for some of the other stuff.  Don't forget chicken noodle soup and things like that - more comfort food... lol

Hang in there and we're here... just keep posting on this thread, whenever you need to talk to somebody.

[scaredandconfused84]

I had Mac and cheese tonight and it was awesome. Still gonna wait on other stuff. Today was exactly a week.

[scaredandconfused84]

Opps typo. 5 weeks to go.

[scaredandconfused84]

Lol chewing is not the problem. I guess I will just wait the time I should. That way when I do have it, it will taste amazing.m5 weeks to go.

[898_1]

BTW I like pizza too:)

[898_1]

Cook lean boneless pork or beef and then grind it in meat grinder and mix it with pasta. I have had this diet after not so successful dental work resulted in perforated sinus and cracked jaw:)

[scaredandconfused84]

They said as tolerated. But I am not sure if I will open the stitching inside my throat. He said it will take 6 weeks for the stitches to devolve on the inside. And I usually just get cheese only. About 1 time a week. It's little things like food you take for granted when you can't have it.