Sunday, July 31, 2016

And now for something completely different: Thyroid Surgery Preparation

Yes, I paid someone a lot of money to
cut my own throat, thank you very much.
I haven't been posting much recently for a variety of reasons, but the big one is that I was diagnosed with papillary thyroid cancer in late June and had my thyroid removed on July 8th. The surgery took 12 hours and my energy levels dropped like a rock post-surgery, which means I haven't been awake enough to play any RPGs since then.

Anyway, I'm fine now, or at least, as fine as I can be without my thyroid. But I'm hijacking my own blog because I want to make some notes on a patient's experience with a total thyroidectomy and I found the existing material to be rather sparse.

Preparing for a Total Thyroidectomy

  1. Get some bloodwork done. Ideally, you should have bloodwork going back a couple of years with your TSH, free T3, and free T4 levels, but even a bloodwork taken the moment you got the ultrasound of a suspicious tumor in your neck is going to be useful. Basically, after a total thyroidectomy, you and your endocrinologist are going to be experimenting with synthetic T4 and synthetic T3 tablets to determine how much you need to feel healthy and well and not be hypothyroid or hyperthyroid. If you have some numbers personal to yourself to aim for, that's going to be better than just aiming for "within the normal range" which is apparently pretty broad and doesn't suit a lot of people.
  2. Find out if you're going to have drains. Drains are flexible plastic tubes that pierce your skin and then hang outside your body and feed into little plastic collection bottles and let various gross fluids drain from the inside of your neck into the bottles. Drains are also a huge pain in the ass. The piercings are painful in and of themselves and the bottles have to be carried around, and you have to sleep with your head elevated as long as the drains are in. If you're going to have drains, bring a fanny pack to the hospital so you can carry the drains hands-free and get a wedge pillow or two so it's easy to sleep with your head elevated when you get home.
  3. Do all the prep work recommended by your hospital. You'll be under general anesthesia so go in with an empty stomach and don't drink any fluids for at least 8 hours before the surgery, etc. The hospital will give you a list of things to do. Read it, do it.
  4. Bring a pair of shorts to the hospital. After the surgery, you'll be in a stupid hospital gown but you'll be expected to get up and walk around some. Wear some shorts under the gown so you can walk around without having to worry about flashing everyone. I didn't remember to bring a fanny pack but I did bring shorts and it simplified walking around so much.
  5. Bring comfortable blankets and pillows from home. Hospital blankets are awful and hospital pillows aren't much better. Bring a comfortable blanket from home to minimize discomfort. If you've spent any time optimizing your pillows at home, bring them too so you benefit from that optimization.
  6. Bring reading material. You will be bored at some points, so have books or a tablet/smartphone with the Kindle reader on it, whatever you prefer. A laptop is probably overkill and hospitals don't make it easy to plug them in.
  7. Contact friends and family and invite them to visit you in the hospital. Human contact will cheer you up.

The experience of a total thyroidectomy

My experience went something like this:
  1. Home: Got up stupid early, even for me, and showered and went to the hospital.
  2. Hospital Reception: Paperwork and waiting.
  3. Surgery prep: changed into a hospital gown, got an IV tube in my arm, met some nurses.
  4. Surgery room: Got transferred to the OR. Anesthesiologist gave me some anesthesia. Went to sleep.
  5. Recovery room: Woke up 14 hours later after an abnormally and stupidly long surgery. Got told everything was fine. Didn't feel any pain because of morphine.
  6. Hospital Room: Went back to a sleep for two hours before the morphine wore off. Started feeling a lot of pain. More morphine. I couldn't sit up because trying made my neck hurt too much. Eventually I discovered that if I forced my way past the pain, could sit up normally or at angle without pain. Adjusted hospital bed so I could sit up properly. Recovery begins.
A lot of people with a diagnosis of thyroid cancer have a lot of anxiety about the surgery, but in practice, it's fairly boring until the doctors put you under, and then you're asleep and don't notice anything. There's really not much to be anxious about. There's stuff to prepare, but the actual procedure, from a patient's point of view, is over pretty quickly.

Next Posting

I'll write up the most recent session of After the End soon, and then this blog will probably alternate gaming stuff and thyroid cancer posts for a bit.