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Thyroidectomy
Thank you for responding to my question on March 11 with regard to the FNA findings. The total thyroidectomy was done on Friday, Apr 14 (3 days ago). The surgery was expected to be 1 to 2 hours but lasted over 5 hours. We were told that the entire thyroid was as "hard as a rock" and had wrapped around the carotid, trachea and esophagus. It was very enlarged and inflamed. The surgeon said he removed 4 lymph nodes and a quick glance under the microscope indicated they looked "okay." We're now awaiting the final pathology report which will be another 3 to 4 days.
The surgeon said he didn't "see any cancer" which is a great relief. He mentioned that it "could be" Hashimoto's thyroiditis. This is perplexing to me because the thyroid antibody tests have all been normal. Also, all TSH tests have reflect euthyroid.
The solitary nodules (one on each lobe) were between 1.0 and 1.5 cm. The left lobe was over 8 cm and the right lobe was about 6 cm.
My understanding is that cancer can only be ruled out microscopically by proving there's no vascular or capsular invasion. When I asked the surgeon about this, he said the nodules were inside the thyroid gland. I was still a bit groggy from the pain meds and wasn't communicating as effectively as I would have liked. His reply didn't align with my question but I was getting frustrated trying to put cohesive thoughts together.
Based on the limited info here (and my previous 3/11 post), can you shed some light on what you think this "monster" was?
Thank you!
The surgeon said he didn't "see any cancer" which is a great relief. He mentioned that it "could be" Hashimoto's thyroiditis. This is perplexing to me because the thyroid antibody tests have all been normal. Also, all TSH tests have reflect euthyroid.
The solitary nodules (one on each lobe) were between 1.0 and 1.5 cm. The left lobe was over 8 cm and the right lobe was about 6 cm.
My understanding is that cancer can only be ruled out microscopically by proving there's no vascular or capsular invasion. When I asked the surgeon about this, he said the nodules were inside the thyroid gland. I was still a bit groggy from the pain meds and wasn't communicating as effectively as I would have liked. His reply didn't align with my question but I was getting frustrated trying to put cohesive thoughts together.
Based on the limited info here (and my previous 3/11 post), can you shed some light on what you think this "monster" was?
Thank you!
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A related discussion, LIfe after total thyroidectomy was started.
I am glad to hear that yours is ok and your back to "normal" I just had mine out 1wk and 1 day ago... sad to say I did not bounce back to "normal" quite as fast (although getting tonsils out was still a lot worse)- and I am finding adapting to my syn thyroid meds a little intrestring... I find myself saying "half baked" things. Not to mention that my boyfriend is asking me if I am going to have to be put in the looney bin- My thyroid was 5.0 x 3.5 x 2.9 cm on the left and was purple gray (what ever that means) and 4.8 x 2.9 x 2.8 cm on the right and a combined weight of 30 grams... my doc said it had grown into one large mass! So I understand the weiryness of path reports- enough about that... does any one know where to find some good information about life after the surgery. There is tons about the proceedure and what to look for and nothing about the life after
The pathology report stated "Chronic Thyroiditis." While it was a welcome relief, these findings were quite surprising since I've always been euthyroid and have tested negative for both thyroid antibodies (anti-thyroglobulin and anti-peridoxase). I've read that 95 to 97% of people with Hashimoto's test positive for these antibodies. The possibility of such a diagnosis (chronic thyroiditis) had never even mentioned to me prior to the surgery...
The pathology report also stated that the entire gland was "very firm and friable" and "beefy red and black" but no mention was made as to the content of the bilateral nodules that were removed. There were four lymph nodes removed, which the report stated were "negative for tumor."
There WAS verbal mention of the possibility of Riedel's. The slides are being sent out to a thyroid expert for further study.
In the meantime, I'm back to 100% (although I was at 100% before the surgery, never having had any thyroid problems). So, I guess that I'm not really any worse off (or better) other than the 2" scar and $35,000 in medical bills. (Thank God we have great insurance.)
The pathology report also stated that the entire gland was "very firm and friable" and "beefy red and black" but no mention was made as to the content of the bilateral nodules that were removed. There were four lymph nodes removed, which the report stated were "negative for tumor."
There WAS verbal mention of the possibility of Riedel's. The slides are being sent out to a thyroid expert for further study.
In the meantime, I'm back to 100% (although I was at 100% before the surgery, never having had any thyroid problems). So, I guess that I'm not really any worse off (or better) other than the 2" scar and $35,000 in medical bills. (Thank God we have great insurance.)
MEDICAL PROFESSIONAL
Many times cancer can only be evaluated after proving that on "permanent section" pathology there is no vascular or capsular invasion -- this is not typically the case however with papillary cancer that can be diagnosed during "frozen section" at the time of surgery.
Reidels is a possibility but this is rare and is a fibrosing disease of the thyroid. Thyroid antibodies are negative in about 15% of Hashi patients.
You should know by the end of the week what they think it is -- if there is a question, ask it to be sent for second opinion at a university (like Johns Hopkins or U Penn for example)....
Reidels is a possibility but this is rare and is a fibrosing disease of the thyroid. Thyroid antibodies are negative in about 15% of Hashi patients.
You should know by the end of the week what they think it is -- if there is a question, ask it to be sent for second opinion at a university (like Johns Hopkins or U Penn for example)....
I bounced back very quickly after the thyroidectomy. The surgery was 5.5 hours and I went home 18 hours later.
The recovery was/is without problems. Just a little tired and some minor pain. Happily, I didn't need any pain med after the first 24 hours. Considering the extent of the surgery, I've been pleasantly surprised at how great I feel.
With regard to your question about the parathyroid, two are gone. One was inadvertantly destroyed and another was inflamed so it was removed and biopsied. I have two left (but I think you can get by with only one). The 18 hour post-op calcium level was 1.0 so I'm taking calcium supplements 3 times a day for 1 week. The calcium level will be checked again this Friday. Hopefully, the remaining parathyroids will have found their new equilibrium by then.
I wish you well on your upcoming surgery.
The recovery was/is without problems. Just a little tired and some minor pain. Happily, I didn't need any pain med after the first 24 hours. Considering the extent of the surgery, I've been pleasantly surprised at how great I feel.
With regard to your question about the parathyroid, two are gone. One was inadvertantly destroyed and another was inflamed so it was removed and biopsied. I have two left (but I think you can get by with only one). The 18 hour post-op calcium level was 1.0 so I'm taking calcium supplements 3 times a day for 1 week. The calcium level will be checked again this Friday. Hopefully, the remaining parathyroids will have found their new equilibrium by then.
I wish you well on your upcoming surgery.
Wow!! That's amazing! I'm so glad you're feeling well and considering the length of the surgery I'm surprised too. I have heard that this surgery is "ok" to recover from. Thank you for responding and for the good wishes. I have to admit I'm pretty scared, even knowing what I know. Hearing from people who have been through helps me to have some courage...so thank you. Continue feeling well. =)
To Doglover,
Has anyone mentioned Riedel's Thyroiditis to you? I tried to go back to your March 11th question re: your FNA but could not find it. What were your symptoms to begin with to have a FNA?
What was the results of your FNA test? Riedels has the effect that you just described as it hardens the Thyroid
and attaches to surroundings structures. Please let us know what your pathology report states. I have been doing alot of research on Riedel's. Good Luck to you and hope your post op is healing well. Not sure what state you are in but hope you seek out a good endocrinologist for future thyroid care.
Has anyone mentioned Riedel's Thyroiditis to you? I tried to go back to your March 11th question re: your FNA but could not find it. What were your symptoms to begin with to have a FNA?
What was the results of your FNA test? Riedels has the effect that you just described as it hardens the Thyroid
and attaches to surroundings structures. Please let us know what your pathology report states. I have been doing alot of research on Riedel's. Good Luck to you and hope your post op is healing well. Not sure what state you are in but hope you seek out a good endocrinologist for future thyroid care.
I can't answer your question...but I do have one. =)
How are you feeling now? I'm due for the same surgery in a month and my thyroid sounds a lot like yours...very enlarged and hard. I do have Hashi's. They set aside a five hour block of time for my surgery...but I didn't realize it actually could take that long. I'm glad you posted that so I can warn my family not to worry. I'm sorry I couldn't answer any of your questions...but if you're feeling up to it could you just fill me in a little on how you're recovery is going? Any issues with the para thyroid? Thank you and I hope you're feeling well.
How are you feeling now? I'm due for the same surgery in a month and my thyroid sounds a lot like yours...very enlarged and hard. I do have Hashi's. They set aside a five hour block of time for my surgery...but I didn't realize it actually could take that long. I'm glad you posted that so I can warn my family not to worry. I'm sorry I couldn't answer any of your questions...but if you're feeling up to it could you just fill me in a little on how you're recovery is going? Any issues with the para thyroid? Thank you and I hope you're feeling well.
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