Post Surgery Update (may be TMI for some people)

So surgery was Tuesday morning at 7:30am..had to be at the hospital at the lovely hour of 5:30am... But they have valet (no i didn't drive) and I didn't have to do my hair or pick out an outfit so it really wasn't all that bad. Plus I got to go back to sleep! ;o)

Anywho, I apaprently shared too much during my pre-encounter call (nurse calls, gets your history and current stats before surgery) because everyone (nurses, doctors, interns) thought that it was hilarous that my nodule/mass thingy had the lovely nickname of "Bob." A bit of a backstory there...my lovely brother-in-law said i had a baby in my neck and my lovely sister decided to name it Bob... well i told the pre-encounter nurse that i was looking forward to "Bob" coming out! Hey, she caught me on my last day of work (Friday no less) and in the middle of an intensive audit prep/clinical documentation training session! It was a moment of slap-happy weakness.

So back to the details... I was prepped for surgery which included getting into my new, cool hospital style dress/shirt and an IV in my hand and talked with my surgeon, anesthesiologist, senior resident and the med student assigned to my case. Just after 7:30am i was rolled into the surgical suite, had a mask put on my face and some "calming meds" put into my IV and thats the last I remember until about 11:30am.

I woke up in the recovery room freezing to death (I was shaking) with a nurse that wanted me to tell her the number of my pain...yeah my throat felt like it was on fire except for the ice pack on my neck and I just wanted to go back to sleep! I got some morphine shots and warm blankets and then I remember my mom coming in to help wake me up. Then i was wheeled past my dad and A.Pam and maybe another person or two (?) and into my lovely private room overlooking the new children's hospital and downtown GR (I had 2 windows- Thanks A.Pat!). The next few hours are a bit blurry - I had several visitors including mom, dad, A.Pam, Pastor Rick, Gpa, A.Pat, Mayme, KT, Brian, doctors, interns, nurses, techs... At this point they were giving me dilaudid and ice packs so I was just out for the count. I had a few ice chips, and by the time evening rolled around I was upgraded to Jello and chicken broth. I was also unhooking myself of the leg circulation machine and BP machine to get up to the restroom so I could rid myself of the betadine beard I had aquired.

I had also learned that once they got in there to look around, they found my nodule/mass thingy had ruptured at some point which made it stick to other essential items in the neck. (fantastic) They had to scrape it from the other structures including my laryngeal nerve (the one that controls the voice) so basically things were very inflamed and angry in there. Good news is that the frozen section biopsy looked good and they only ended up doing a partial thyroidectomy.

The next morning I was visited by the med student at 5am - she asked me a lot of really dumb questions for that time in the morning. Then the resident visited at about 6:30am to rip off the bandage over my incision and she wrote orders that I could try real food (YAY!). I was promptly given a menu that I could order my "room service" from LOL - totally not lying on that one! I ordered a fruit and yogurt parfait which was very yummy and was working on some apple juice and cream of wheat when my surgeon came in and wrote the order that I could go home! (another YAY!) So i said goodbye to my absolutely fabulous nurses and was wheeled to the parking structure while my mom got the car.

While waiting there in all my dirty hair/no makeup/bandaged glory, I see some of the big-wigs from the hospital pass me and hope they don't recognize me... then the president of the 2 hospitals I manage for came strolling by and said hello. I think he only had a vauge recognition... at least i hope!?

So home I was and feeling pretty good overall. I made it up the 2 flights of stairs into my apartment, was continuing on some solid foods, was taking my vicodin and putting the ice packs on my incision... was still a bit in and out of things and fell asleep while my mom was trying to talk to me about a movie we were watching (sorry!). Grandpa and dad came over for dinner and I was feeling pretty good so I took my pain meds, put an ice pack on my neck and decided to turn in for the night. Well about 3:30 am I woke up and had that horrible feeling that I was going to be sick. I ran to the bathroom and was immediately and violently sick... this was my worst nightmare come to life! My mom came running from the guest room saying things like "oh no!" and "take a deep breath!" I felt like i was going to die as I tried to hold my head on my neck in a stationary position so I would not rip out my stitches. Seriously - I have a gash across the front of my neck and now i'm so sick that I feel like my head is going to detach from my body - it was horrible!! And then it was over and I felt remarkably better (well in loads of pain but not like i was going to be sick again) and I crawled back into bed where Moses Jean put her paw on my arm and I drifted back to sleep... only to wake up about a half hour later to repeat the whole thing! This continued every 15-30mins or so until my mom called my dad to bring some Phenergan from their house... when he arrived at oh maybe 7:30ish I was in a down time but waited to take the meds until i was sick again so it would stay down and work for a bit. I took the meds and drifted to sleep hoping to not wake up for quite a while but I woke up again about a half hour later, sick once again. By this time my mom was calling her work to say she wouldn't be in and calling the surgeon's office and was (I think - i was a bit delerious) making plans to get me in the car to ER. Well thankfully after that last bout I drifted to sleep and stayed that way until about 2pm...

Of course when i woke up I felt like heck and was back on liquids and jello once again. I gradually took some tea and toast and then actually had real food for dinner... but avoided the vicodin completely because that's what was deemed the cause by my surgeon. Vicodin is EVIL!! So I went to bed Thursday night with some dread but ended up sleeping fairly well with no repeat of the previous night's nightmare. (YAY!)

Today I was feeling better but still a bit weak... just a bit bored because I only got 1 phone call of the millions promised (my mom had enlisted a bunch of people to check up..apparently they aren't good babysitters!). I did get caught up on my Gilmore Girls episodes and a couple movies and read an entire book (chick lit but still over 500 pages) and now i'm on the internet for the first time in a couple days :) Aren't you so lucky?

I really appreciate all the thoughts and prayers...keep em coming as the surgeon says it will be months before i'm able to raise my voice or attempt to sing even one note. My neck is still swollen and I have a nasty looking incision (ala Sweeny Todd) but if you can stand it, visitors are welcome. Otherwise keep sending your love via internet so i have something to do for the next week of recovery! :)

Surgeon's Hands...

Just got back from Surgeon's office...

Started out with a general exam where he explained that I would most likely need surgery because of the size of the nodule and then a detailed explanation of thyroid cancer and its survival rates for people like me (under 50yrs and in good health and a woman - generally live longer than the normal population after treatment!). Yikes - uhm could this really be a possibility?!

Then we moved into the ultrasound suite where he did the u/s himself - said whoa a couple times then said I have "good news and bad news" and then showed mom and I what he was looking at... a massive nodule (over 3cms) on my left thyroid lobe that is compressing my carotid artery, my trachea (windpipe), and my esophagus (food tube) as well as the nerve that controls my vocal cords.

Good news: its most likely benign because it is mostly cystic and calcified parts
Bad news: it requires surgery

Because of its size it will most likely not respond to just taking synthroid (thyroid hormone pill) to shrink it and like i said its pressing on some pretty vital parts! Then he said he wanted to do the biopsy to be sure of things because if it is malignant then they will do a thyroidectomy instead of a lobectomy (take the whole thyroid out instead of just the left lobe of it) when they do surgery.

So had the biopsy - long tiny needle was stuck into my neck a few times after they numbed it with lido. It only hurt a little and still hurts only a little but that's kinda been my norm for a week or so. They are sending it out for pathology and cytology results and we should know benign/malignant by mid next week.

My surgery is scheduled for May 26th (day after memorial day) and I have to be in the hospital overnight. They do that because they want to make sure the airway wasn't compromised and I don't develop any complications. I will be off work the rest of that week and the following week to recover because apparently the thyroid is an extremely vascular structure in the body. I won't be able to talk much at first and will have some voice problems for a while because they have to inject a nerve stimulating substance into the nerve that controls my vocal cords to make sure they can see it during surgery and not cut it - he said it usually affects the singing voice more than the speaking voice so i'm off singing for quite a while too...

So that's as much as I know at this point... going to take it easy for a couple days sporting my new fashion accessory (small round neck band aid) and then try to sort things out and prep for surgery.

And so it begins...

It was moving day! I was so exhausted i couldn't haul another box up the 3 flights of stairs to my door. Chalk it up to a whirlwind week of packing, stressful meetings at work, terribly little sleep and an even worse diet - right? As i hauled my booty out of bed to unpack the maze of boxes, i brushed off the exhaustion and the aching muscles and got to work. By the end of the weekend I had unpacked nearly everything and the place was starting to feel like home!

On Monday i was back to work shrugging off the muscle pains and popping motrin here and there to keep moving. During a lull in the action i decided a mini neck massage would work wonders... wait...what was that?! There was a painful bulge in my neck just above my collar bone...this is totally not normal! Could i have pulled a muscle in my neck somehow causing it to want to shoot out of my neck?! I called my mom [and my own personal nurse] with a mini freak-out. She assured me that i was over reacting and that she was sure i was fine... maybe i had caught a 'bug' and my lymph nodes were swollen... ok sure, she would stop by tonight and check it out only to prove i was a nutjob.

So she came over and her reaction was more of the 'what the heck IS that?' than 'yup, you just got a bug' variety. After some discussion it was decided that if it didn't go down/stop hurting/stop half choking me when i ate by Tuesday, I would call the doctor.

Now my doctor is fabulous, he is super funny, laid back, super smart, and doesn't mess around...which is why he is always so stinkin busy! I was told he was booked but that I could head over to Urgent Care to be checked if i thought it was necessary. Well by this point i had looked up my symptoms on WebMD and decided that i had some extremely rare disorder so of course i headed to the UC. In the waiting room i watched the swine flu epidemic unfold while anxiously awaiting my name. I was called back, my vitals were taken and soon a lovely MD was in to see me. He took a look and had me swallow while pressing on the lump [not comfortable at ALL mind you!] and quickly ordered me an EKG, xray and lab tests. Apparently my heart rate was over 100 resting which is not good and is ridiculously high for me, hence the EKG. The xray and lab work covered everything else. Oh yeah and at that point he also said 'You most likely need a biopsy of your thyroid and should follow-up with your doctor in 1-2 days.' Uhm....

In my world, biopsy = not good. My grandparents, dad, aunt... all had biopsies...all had cancer.

So i called my most wonderful doctor again and was able to squeeze an appointment into his day off [i wasn't the only patient he saw that day..i told you he is fabulous!]. He took a look and had me do the swallow while pressing thing too - again not fun - and said i needed to talk to Surgeon and he will most likely do a biopsy of my thyroid nodule. Ok so it now has an official name i could Google! Dangerous.