Tuesday, March 17, 2015

My Throid Story: Surgery (Part Two of Four)

March 25th marks the one-year anniversary of my being diagnosed with Graves' Disease. In the months that followed, I learned I had thyroid cancer as well. But through all of the repetitive testing and unexpected procedures I found there were few sources which documented events specifically. I would have anticipated, in this enormous blogosphere of ours, at least two or three personal experiences with Graves' -- not so. Of course, I couldn't resist taking a crack at changing all that. This is Part Two of that effort:

A complete thyroidectomy was scheduled for June 5th, 2014. It was a routine procedure, scheduled to take about an hour to ninety minutes, with an overnight stay in the hospital simply for the sake of caution. My entire thyroid would be removed, thereby eliminating the current target of the Graves' Disease which had rendered me "hyperthyroid" for the past several months. After the surgery, with no thyroid to absorb iodine and control cell metabolism throughout my body, I would become "hypothyroid;" it would then be necessary for me to take a synthetic thyroid hormone each day for the rest of my life.

In the weeks before my surgery I scheduled my time off with my employer, filed my paperwork for my short-term disability, snapped up a couple of library books for the post-surgery period, made sure the pantry and freezer were well-stocked, and even emailed account information and passwords to a close friend "should anything happen." Scott and I had dinner with good friends, reassured our twelve-year old repeatedly, and spent a little extra time together -- for as much reassuring as we did, we could have used some ourselves. I did not have warm fuzzies about this going in, but what else was there?

The day of, we arrived at the hospital even before the surgery center staff; I was anxious to get this over with. I knew I'd be much happier once I was recup-ing in bed at home, surrounded by books and dogs. (I'd even made sure I'd bathed them the day before -- the dogs, not the books.)

I believe prepping for surgery took longer than the surgery itself. Now is a good time to say, I am always intrigued by the way anesthesia works. By the time you realize it has gone to work, your friends are already posting your ridiculous antics on Youtube. I vaguely remember showing the nurses who were prepping me, one of my tattoos. Ugh!

When I awakened in Recovery, like Custer at Little Bighorn, I was surrounded, and it was surreal. A man I'd never seen before was almost nose-to-nose with me (he ought to know better than that) telling me I couldn't breathe. Yeah, seriously. You wouldn't think someone would have to tell you that kind of thing, but there he was. Worst part if it? I was pretty sure I could. Sniff. Sniff. Yep. Breathing.

He explained I was not getting enough oxygen to my brain. (I think some of the folks who know me would agree I probably checked-in that way.) They were going to intubate me.

"Nooo," I whined. Just then, I looked over his left shoulder, through the half-dozen other faces gathered, and saw my husband -- blanched, wide-eyed and fearful. "Ok. Ok. Just do what you have to do," I told the stranger. The "room" emptied out, the curtain was closed, and I drifted back to sleep praying Scott would be alright.

I have no idea what time it was when I woke up in ICU. Nurses were everywhere, and I just wanted them out. Everyone was telling me something. "Your husband is right here." "Do you know where you are? You had to be intubated." "Are you ok? The tube is going to be very uncomfortable." "My name is ___. I'm going to be taking care of you for a bit." E-nuff!! Eventually the room did clear out and I was able to visit with my husband and the Lovely Katie. Lovely Katie, my cousin, had stayed with Scott throughout my surgery, and her smile lights up the grimmest of circumstances. Although our visit required me to write my every word, it made me forget just how horrible a thing being sick when you don't feel sick really is.

So what, exactly, had happened? Well, in my visits with the surgeon we had discussed possible complications. I had also visited fairly reputable sites like WebMD and MayoClinic to do some of my own fact finding. The long and the short of it is this:
  • An average adult female's thyroid weighs approximately 14 grams; mine weighed 56 grams.
  • Damage to the vocal nerve which controls the opening and closing of the vocal cords as we breathe and eat, is a risk associated with thyroid surgery and prolonged thyroid issues.
  • For some inexplicable reason, my throat swelled shut immediately upon removing the thyroid.
Turns out, the stranger who told me I couldn't breathe was an ear, nose and throat specialist -- an Otolaryngologist. Yeah, really. He appeared in my room some time after our first unpleasant introduction and explained I would be intubated until noon the following day, at which point he would remove the tube, examine my vocal cords and determine whether they were functioning enough to maintain a sufficient airway. It seems the vocal nerve had indeed been damaged and my cords were now paralyzed in a semi-open/ semi-closed position: insufficiently clear for proper breathing, and insufficiently closed for safe eating or drinking without aspirating solids or liquids into my lungs. I couldn't talk, but I could surely text and status: it was time to get all my prayer warriors praying for noon the next day.

Nighttime turned out to be much worse. I had no concept of time, still I was trying to text people and explain what had happened -- and get them praying! I wound up texting my one friend at 3AM (It's a good thing she loves me). The tube in my throat was making me feel as if I couldn't breathe. They gave me a sedative to relieve my anxiety over suffocating to death, but it was causing drowsiness; as I slept, I would crimp the tube, setting off the alarm that monitored my breathing and bringing my poor nurse running. It was an endless cycle. I knew I was getting worked up, but waking up from a dead sleep (no pun intended) because you can't seem to fill your lungs is terrifying. Plus, it was causing me to sweat, making my incision sting; I was sure it was going to be infected. The tube irritated the back of my throat in addition to whatever pain or irritation the surgery had caused. It was going to be a very long night.

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