Three Weeks Thyroid Free
Hi everyone,
I hope you are all having a wonderful summer, even if it is still in a pandemic. Firstly, I wanted to say I cannot even begin to thank everyone who has messaged me since my last blog post. I have been so overwhelmed with support, and I am so grateful for all of your kind words.
As I am writing this three weeks after my operation, I thought I would give you an update on what has happened and what is in store for the future. Since my previous blog, I have pretty much spent my life at hospital for blood tests, pre-op assessments and Covid-19 tests. I was told to isolate for fourteen days before my surgery on the 21st July. On the actual day, I had to be in for 7am. I was quite relieved it was so early as my FitBit sleep stat said I had an incredible three hours twenty five minute sleep that night. Once I arrived I was told to say goodbye to my mum and my sister (which was painful), and I had my temperature taken. I then got taken to a ward for day-patients and had to sign a few consent forms which just powered my anxiety even more. I was extremely lucky to be one of the first patients taken in for surgery, but the twenty minute wait felt like a lifetime.
However, my surgeon came to see me and throughout this process he has been amazing. He has always listened to my worries- especially regarding my voice, so I have always felt reassured. I was able to meet the rest of the team that morning and they were also lovely. My anaesthetist Hannah made me feel very comfortable, even when I had to lie straight on the operating table (thanks Covid), rather than go into a room next door to be given the general anaesthetic. This was certainly a different kind of theatre than what I was used to. It was also quite difficult being connected to an ECG to hear my heart beat echoing around the room. Despite this though, the team made me feel really at ease and I am very grateful for the work that they did.
My operation took six hours in total. This is probably one thing that I still cannot believe three weeks on. I am no doctor, but I have been told that thyroidectomy’s tend to take between one to three hours, so it felt a bit of a shock to know that I was lying on an operating table for that long. My case was slightly different to a normal thyroid surgery as I had cancer and metastases disease, meaning I needed a lymph node dissection to remove all of the infected lymph nodes.
Now I will give you a biology lesson, Odette style. The actual tumour had grown not only around my windpipe (terrifying) but also into my recurrent laryngeal nerve that controls your vocal function. Although the operation was successful, and most of the cancer was removed, a part of the tumour was tangled in my left RL vocal nerve. We have two of these either side of the neck, as well as an SL nerve higher up that helps you hit the higher notes and sing. One of the risks of this surgery is vocal damage and my case (I am pretty sure but again no doctor) had a high risk for two reasons. As my lymph nodes were near the SL nerve and the tumour was on my RL nerve, it meant I had double the risk of damage. My largest fear as a twenty-two year old performer was permanent vocal damage, so my anxiety levels leading up to this had been through the roof. It got to the point at any given opportunity I would tell my surgeon or any nurse how much my voice meant to me. As my surgeon wanted to protect my vocal function, after the first three hours he actually phoned my mum on his break to discuss my RL nerve. In some surgeries the RLN can be removed, however it isn’t certain that it will grow back and if not that will leave the voice hoarse. My surgeon wanted to leave the nerve in and to eliminate as much of the cancer as possible around it, but he wanted to check that that would be okay. My mum said to me she knew if I had been awake I would have also wanted that decision, and I am incredibly relieved that she made that decision.
Therefore, he left a tiny tumour margin that will be treated with radioactive iodine and possibly radiation in the future. Although my lymph nodes were large, this was actually a result of a reaction to the cancer and not the cancer spreading. Therefore, there is a high chance that the cancer hasn’t spread, which is reassuring. As with most cancer cases, cancer can never normally be surgically removed completely. This is due to the fact that as human beings are all made up of so many cells that unless the tumour was tiny, there is always going to be a tiny amount of cells leftover. This is where the radio-iodine comes into play; this will destroy all the remaining cancerous cells. The process for taking radio-iodine is quite complicated as I will need an injection to stimulate any thyroid cells left over to swell up, before having a radio-nuclear scan. Once they see how much thyroid tissue is leftover, they can see how much they need to eliminate with the radio-iodine. It will then involve me staying in hospital for a few days as the pill will make me radioactive, and so I will initially be highly dangerous to humans! After this they will do blood tests and another scan to see how much cancer was destroyed. If any is left over they may need to give me some targeted radiation. As I no longer have a thyroid, the doctors have to manage my thyroglobulin levels through blood tests, and as long as they remain low I will remain in the clear.
After the surgery I spent two nights in hospital. As my surgery went on for so long, and I had to chill in the HDU (high dependency unit), I didn’t actually get to my ward until about six pm. The first night was tough as I had more blood tests taken, and had to be monitored with a blood pressure unit every twenty minutes. I also suffered from what I can only describe as a bladder paralysis; I was told by my doctor sometimes your body can seize up after the general anaesthetic and I would arguably say this was more painful than my neck! Luckily the next day I was told I could move around and then my body started to go back to normal. I also had two drains attached to my neck to stop any bleeding in my neck. I’m lucky I’m not very squeamish because it did look a bit grim walking around with my new medical necklace. My first mealtime was a day and a half after fasting for the surgery, and I had to be so careful not to devour it with my fragile throat! On the second day I felt a lot more active (walking around the ward, look at her go), and my surgeon checked me over and said I was good to go. I was relieved because some people on my ward seemed so much worse than me, and I find hospitals incredibly traumatic. Even though it was only half full because of Covid-19, I felt the other three people needed the assistance more than me.
Moreover, the pain I can only describe as being punched in the jaw, combined with screaming at a concert and carrying a really heavy bag on one side. It wasn’t unbearable for me, but I think because I’ve had a spinal fusion nothing can compare. It was just uncomfortable as my neck felt incredibly tight and lying down stretched the scar out. However, since being at home I’ve found the general anaesthetic wearing off to be the worst. A lot of my back had seized up, and my head had taken a lot of manipulating so I had a constant pressure headache. I also found nerve sensation starting to take place, which caused a bit of pain in both my neck and back. The reality also hit me which made me very emotional, and my new medication made me initially feel quite sick. As the thyroid controls your metabolism and your energy levels, although it isn’t an essential gland I needed a large amount of thyroxine (the hormone it releases) to compensate for my lack of thyroid. The good news is, I’m starting to readjust and three weeks on feel so much better already.
As my journey continues, I think I will focus on regular blog updates and also a couple of health blogs to keep you all posted. Equally if anyone wants to know more or has any questions I am more than happy to answer them. As I’ve said before thank you for all of the support; trust me it never goes unnoticed.
All my love,
Odette
Xo
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