Wednesday, October 24, 2012

Thyroidectomy, before and after

Our 5AM drive down to Yale-New Haven hospital was dark and peaceful.  My nerves were ablaze with worry and to settle me as much as possible Sean kept quiet and turned on Jackson Browne.  I made statements of should I die, be sure to... and Sean held my hand and reassured me that I would be just fine.  But just in case, I said.

Half of me wanted to get this surgery over with as soon as possible and the other half wanted to drive in the other direction. But there is no denying cancer and so we pressed on until I found myself getting IVs placed in my hand and wearing a not-so-flattering XXL hospital gown.  After checking the baby's heartbeat--the nurses gathered around and ooh'd and aah'd at her strong 146 ba-bump ba-bump--it was time to go.  I kissed Sean goodbye twice in the hallway.  My young anesthesiologist placed a warm blanket over my shoulders and hugged me as we began the walk to the operating room.  He asked about Dylan and told me that he and his wife were trying to have a baby.  "You'll never sleep again," I told him, "but having a child is the best thing in the entire world."  He replied, "I don't sleep much now with this job anyway" and smiled as he pushed open the door to the operating room.

The room was bright and filled with people in masks.  One of the nurses, a sweet woman named Mimi, knows one of my aunt's friends and had been advised to take extra special care of me.  When I walked in the room she introduced herself and talked about the mutual friend and said, "We were friends, you and me, but now we're family!"  She held my hand in those last seconds as my wonderful surgeon Doctor Udlesman instructed me off to sleep with a promise to take great care of me and the little girl in my belly.  My mind wandered before I drifted asleep from the anesthesia and I thought about how the lighting in this operating room would be perfect for a photo shoot.

I woke up groggy in a small room with nurses floating in and out.  After a few minutes they asked me if I'd like to have them get my husband from the waiting room and as soon as he came into the room the nurse made a comment about how my blood pressure immediately dropped upon seeing him.  I remember being wheeled into an elevator and up to my hospital room next, and the excruciating pain which shot through my neck as the nurses rolled me from my temporary bed.  This is what it feels like to have your neck sliced open.  The nurses had given me Reglan in recovery for the nausea and were now offering Tylenol with codeine for the pain.  The rest of those first hours in my new hospital room are a bit foggy.

I was scheduled to go home Friday morning until it was determined through blood tests that I was becoming severely hypocalcemic.  My calcium levels were a low 7.5.  They gave me six calcium pills and checked my levels an hour later.  They were dropping to 7.3.  My room was a carousel of doctors and nurses coming in to check on me, flicking my face with their fingers to monitor the twitching resulting from my decreasing calcium.  One doctor came in and advised that they were going to put me on a calcium IV drip, my levels were dropping too fast and my body couldn't catch up even with extra calcium supplements and so I would have to receive a constant dose of calcium until my body could regain control.  I was placed on a heart monitor as well and told that there was no way I would be going home in the morning.

My heart broke.  Literally.  I went tachycardic.  The heart monitor continued to pulse from a safe 96 bpm one moment to a sudden 149 bpm in an instant.  More doctors.  More nurses.  I was given an EKG.  More calcium pills, some magnesium, potassium.  I felt my body failing.

By morning I was feeling a bit better.  My heart continued to stress and the monitors continued to rise and fall, sending out shrill alarms and sending in nurse after nurse.  The doctors came in and told me that I would be staying at least until Saturday night, maybe Sunday morning.  Part of me was relieved that I would be safe in the hospital and most of me was sad that I wasn't going to be able to see Dylan who had come down with the world's worst cold.  So we took full advantage of video chatting.

Having dinner with my boys via video chat
I could write for days about all of the experiences I had in the hospital, but mostly my stay involved lots of pills, lots of monitors and nurses, plenty of nausea and sickness, having to pee in a plastic "hat", getting blood drawn so often that even the nurses were shocked at how bruised I was, and watching terrible television programs.  The free room service was pretty great though, and our family pulled together to watch our poor sick Dylan for a few hours each day so that Sean could come sit with me.

A very sore arm after having blood draws every three hours for four days
My calcium levels slowly improved on the IV drip 7.3 to 8.0 to 8.5 to 8.8.  They stopped the drip for an hour to give me a magnesium IV, my levels went from 8.8 to 8.0.  Apparently my body still wasn't able to regulate calcium.  I was having pretty frequent braxton hicks contractions so an OB was called in to give me a vaginal ultrasound.  This involved me laying spread eagle naked in my hospital bed propped up on a bed pan.  Pregnancy really knows no shame.  Katie seemed fine and I was not at risk for preterm labor.

On Sunday morning, after three horrid vomit-filled nights in the hospital, the doctors felt confident that my 9.5 calcium was stable enough to cut the IV dose in half to see how I managed.  Hours later I was down to 9.1.  They stopped the drip.  I was told I needed to maintain an 8.8 or higher before I could be discharged.  Sean was hopeful, I was not.  But at 3PM on Sunday my levels were exactly 8.8 and I was allowed to go home.

I haven't felt much throat pain, although I do have minor muscle discomfort.  Yawning still stinks and I can't stand up for very long.  I photographed my neck today when I gained an inch of energy.  Here it is six days post op.

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I started my synthroid hormones yesterday and am feeling less anxious than I have in years. My fabulous surgeon called this morning and gave me my pathology results. The tumor was 3cm--as expected--and the cancer had spread into the surrounding muscles and into 3 or 4 lymph nodes, all of which were removed. So the doctor says everything is looking good and aside from my radioiodine therapy after Katie is born, I should have this cancer thing behind me. And I'm going to live a long and healthy life. The doctor had one request, that I send him a picture of the baby when she is born. I really could not have had a better surgical team.

And now to continue on with my life.