My follow-up visits with the Nurse Practitioner at endocrinology following my thyroid surgery were unremarkable, which is a good thing. She’d look at my lab work, palpate my neck, ask me about symptoms, and declare me good to go until the next follow-up.
My most recent visit was with the actual endocrinologist. My most recent lab work showed a significant spike in my Thyroid Stimulating Hormone (TSH), while my T4 levels remained on the low end of normal. Since I’d already gotten an education in how hormones work when I went through menopause, I suspected that the higher levels of TSH were a sure sign that I’d be put on thyroid medication — if not now, then eventually.
As suspected, he prescribed a low dose of levothyroxine. Now that I’m already on Hormone Replacement Therapy (HRT) for estrogen, adding another hormone to the regime doesn’t seem as daunting as it once did. In fact, I’m looking forward to seeing if it lessens any of the symptoms that could be attributable to my thyroid.
Last night, the edges of the steri-strips began curling up and peeling away from my incision site. It didn’t take much help from me for them to come off entirely, revealing my new surgery scar.
I’m beyond satisfied with the cosmetic look of the scar, even freshly-healed. I even turned on my camera in a Teams meeting this afternoon, sans scarf, and didn’t get even a second glance. Except from N, who told me privately that it didn’t even look like I’d just had surgery.
Like the ubergeek that I am, I studied the surgery notes as soon as they were made available to me online. One thing I noted was that the “incision was made along one of the natural creases in the neck.” Never have I been so pleased to have neck creases! I’ve seen photos and videos of patients with a straight horizontal scar right across the front of the neck, and that’s definitely not ideal. My scar looks like it’s going to be No Big Deal.
One week after surgery, the pathology results came through. As expected, my lobe was NOT cancerous (and neither was the lymph node they also removed). I did a double-take at this gem, though:
For context, that would be a kiwi fruit shoved into the space behind my left collarbone. No wonder I felt so strange.
As for how I’m feeling now… the swelling has gone down considerably. Now there’s just a little spot in the vicinity of my trachea that’s still tender to the touch. My neck seems to have full range of motion side to side, but I can’t tilt my head to look up very far yet. Per the surgery notes, they did have to separate and reflect some muscles to get to the thyroid, so it’s not surprising to me that they’re still healing.
At my initial consultation with the surgeon, he told me that I most likely would not need to take thyroid hormones after my lobectomy. It had honestly never occurred to me to wonder exactly what my thyroid was responsible for and how it did it, beyond knowing that my bloodwork has been coming back in the normal range for the past decade. So, I did a little research, making sure to check the veracity of my sources before putting too much stock in what they had to say.
Since the thyroid plays a major role in regulating body temperature, one way to monitor thyroid health is basal body temperature, My normal body temp has always been about a degree below the typical 98.6F, so I decided to start taking my temperature every morning and logging it when I log my weight. (Again, being an ubergeek, I have an iOS Shortcut on my Apple Watch for entering my data into Apple Health.) Hoping that I don’t see any downward trends in my body temp — although it wouldn’t be the end of the world if I did have to take thyroid hormones.
I meet with my surgeon on Monday for my post-op follow-up. I’m not expecting any new info, although I am hoping for clearance to return to my Krav Maga classes.
Not everyone is OK with seeing incision sites, so I censored my steri-strip sutures for the good of the order. If you’re curious about what my incision looks like three days post-op, click the image for the uncensored version.
The strips on my incision actually look quite a bit less gnarly now that I’ve taken a proper shower (and ever-so-carefully patted them dry afterward). I feel less gnarly in general, too, with the remainder of the adhesives and whatnot finally scrubbed off of my skin.
I’m feeling closer to normal overall. My throat no longer hurts when I swallow, although the surgical strips still pull on the skin of my neck, and the swelling and tenderness is starting to subside. It’s hard to tell through the swelling, but I think my trachea might be moving closer to its normal position, now that there’s not a goiter in the way. The base of my skull still hurts like the worst cramp ever whenever I have my neck muscles engaged, though, and I developed a mild rash on parts of my face and neck last night after taking a dose of Oxycodone. Dealing with histamine reactions is old hat for me, thanks to my ultra-severe sensitivity to urushiol (poison ivy, et al.), so I just popped a Benadryl. Medications don’t seem to touch the muscle tension, though — only relaxing my neck and applying ice seems to do anything for it.
On the subject of my neck: I was a little surprised to find nothing in my discharge instructions about neck mobility exercises. Maybe my surgeon is planning to give me those at my two-week follow-up? At any rate, I’ve researched it myself, and have been doing some simple neck rotation exercises: up and down, left to right, ear to shoulder, and chin tucks (which my chiropractor has been having me do, anyway). Some internal tightness is keeping me from looking upward, but I’m only kept from looking farther left or right by the surgical strips pulling on my skin.
Yesterday, I did my best to get laundry done (with help) and make dinner, but I definitely overdid it a little — even with the two naps I took. I’m taking today and tomorrow off of work to rest and recuperate. I did have to get up at the usual time to get Connor out the door this morning, but then I went straight back to bed and slept for another few hours. Once I rolled out of bed and showered, the rest of the day has been spent researching, stretching, blogging, eating, and scheduling follow-up appointments.
And nerding out on the details of the surgery as found in my chart online… but that’s a post for another day.
Two days before my surgery, I felt the telltale signs of an impending cold: dry eyes, slightly irritated throat, and the occasional sniffle. During my pre-op call two weeks prior, I had received instructions to call my doctor if I felt sick in the days leading up to the surgery — so that’s what I did. The scheduler asked about my symptoms, and then explained that the biggest concern would be from the anesthesiologist — for example, a moderate to severe cough would get me sent home and rescheduled, but if my symptoms didn’t worsen by the day of surgery, I’d be fine.
This was confirmed on the day of surgery, when I kept letting all my care team know that I had the very beginnings of a cold, including the anesthesiologist. His only comment was that the residual dry throat from being intubated would be made worse by my cold symptoms, but it was nothing that would stop things from going forward.
So, now I’m on Day Two post-op, and Day Four of an impending cold, and colds always start out as a sore throat for me, anyway. I had trouble clearing my throat in bed last night, too, so I’m pretty sure I ended up snoring.
I’ve also got a wicked headache at the base of my skull, which is apparently a common thing after general anesthesia. At first, I assumed that the ache was because I’ve been experimenting with different ways to position my head, and maybe that’s still part of it. My pain relief options are limited to Oxycodone or Tylenol, since NSAIDS can increase the likelihood of bleeding. Current status: attempting to balance an ice pack on my neck and a laptop on my knee.
One other thing worth noting is that I woke up hella sore this morning. Abs, lats, core in general. Not sure if I just slept so hardcore that everything got extra stiff, or if I was using my core more yesterday to avoid using my neck muscles, but things seem to have worked themselves out now that I’ve been up and around for a couple of hours.
I suspect that this is going to be one of those recoveries where I just wish it would be over with already. Isn’t that always the case, though?
I slept the sleep of the recently-anesthetized last night, with the help of Oxycodone and a large amount of pillows. Luckily, I’ve been sleeping propped-up for a while now, due to my enlarged thyroid making my snoring worse, so the position wasn’t awkward for sleeping.
What did make things interesting was the painful swallowing. Every time I had to swallow, I’d wake up. Normally, I figure it would be a reflex thing that I’d sleep right through. Not last night. I eventually found a position where I could swallow without much pain, but it still woke me up.
My cat, Baxter, was so confused last night. Usually, at some point during the night, he climbs up on my shoulder and drapes himself over my neck to snuggle with me. Last night, though, he could tell something was wrong, and found a different place to snuggle up after sniffing my neck and licking my hands where the IVs had been.
I’ve been looking forward to having this massive nodule removed for months. Even with the swelling in my neck and the pain as everything heals up from surgery, I can feel a difference. I can tuck my chin without feeling something pressing on the blood vessels in my neck, or impeding my airway. I no longer feel constant pressure on the inside of my left collarbone. I can tell that the back of my tongue has gotten used to being shifted to the side, from lack of room in my neck. Also, I’m not totally positive yet, but I think the numbness in my left arm may have been exacerbated (if not caused) by my thyroid pressing on a nerve that runs under the collarbone.
I asked Aaron to take this photo after the surgeon marked the site of the goiter and before I was fully prepped for surgery.
The discharge instructions I was given seemed very general: Regular texture diet (I call shenanigans after trying to swallow a bite of my son’s cheesy toast this morning), pat the incision area dry after showering and keep the dressing intact until my two-week follow-up with the surgeon, and “activity as tolerated,” which is clarified later on in my 16-page document as “light to normal activity… as you feel you can.”
Since I’m the kind of person/patient who wants to know as much as possible going into a situation, I did some research beforehand on recovery from thyroid surgery. (Yes, I know that Google results are not necessarily valid references in and of themselves, but I use them to find legit references, like the Cleveland Clinic, Penn Medicine, and the University of Maryland Medical Center.) I’m planning to take at least a two-week break from Krav Maga — after that, I will have had a follow-up with my surgeon and can get his take on when I can return. I also intend to do some daily neck movements to keep things from getting stiff, and to ensure I can move my head well enough to drive Connor to his Krav Maga class.
My surgeon did tell me at our initial consult that I most likely will not have to take supplemental thyroid hormones, but that remains to be seen. I may need to take supplemental calcium if the parathyroid glands were damaged, but I never did get to see the surgeon during my recovery to get the details straight from him. He debriefed Aaron while I was in recovery, but that’s always kind of like a game of telephone.
I’m surprisingly optimistic about how having had this procedure will improve my quality of life. As I told the surgeon last month, 2024 is the year of reclaiming my health, and I see this procedure as the first step.
