Completion thyroidectomy

Just got home after my completion thyroidectomy on 4 October 2015.  This time the left side was removed.  I continue to praise God for the second operation was uneventful and of course successful except for the sudden calcium level drop that lead to upper and lower extremity numbness and muscle twitching. The sudden drop in calcium level was corrected with 600 mg two tablets of calcium carbonate.  All went well and I am now home recuperating.

Thank you for all your prayers.

  

And the fight goes on...

Tomorrow, 4 October 2015, Sunday, I will be once again going under the knife for left hemithyroidectomt to complete the surgical excision of total thyroidectomy.

My dear readers, if you pass by this blog, please utter a prayer for me as I continue to fight this battle.

For the victory!

God bless us all!

What is papillary thyroid carcinoma?

My histopatholoy read:  Well-differentiated pattern lesion with papillary cytology.  Part B shows papillary carcinoma.....

When the "bomb" was thrown to me three days ago, i read and re-read the test results, the laboratory tests, medical reports and operative report.  It says carcinoma...papillary thyroid carcinoma.  What in the world is papillary thyroid carcinoma?

 the final pathology report

According to Thyroid Cancer Survivor's Association, 

• Papillary and follicular thyroid cancers are referred to as differentiated thyroid cancer, which means that the cancer cells look and act in some respects like normal thyroid cells.
• Papillary and follicular thyroid cancers account for more than 90% of all thyroid cancers. They tend to grow very slowly.
• Their variants include columnar, diffuse sclerosing, follicular variant of papillary, Hürthle cell, and tall cell. Two other variants (insular andsolid/trabecular) are considered to be intermediate between differentiated thyroid cancer and poorly differentiated thyroid cancer. The variants tend to grow and spread more than typical papillary cancer.
• If detected early, most papillary and follicular thyroid cancers can be treated successfully. Their treatment and management are similar and are based on staging and individual risk levels.
• Papillary thyroid cancer is the most common type of thyroid cancer. It accounts for about 80% of all thyroid cancers. Papillary thyroid cancer generally grows very slowly, but can often spread to lymph nodes in the neck. It also can spread elsewhere in the body.
• The most common variant of papillary is the follicular variant (not to be confused with follicular thyroid cancer). It also usually grows very slowly. Other variants of papillary thyroid cancer (columnar, diffuse sclerosing, and tall cell) are not as common and tend to grow and spread more quickly.
• Follicular thyroid cancer accounts for about 10-15% of all thyroid cancers. Treatment will be discussed later in this booklet. Hürthle cell thyroid cancer is a variant of follicular.
• Follicular thyroid cancers usually do not spread to the lymph nodes, but in some cases can spread to other parts of the body, such as the lungs or bones.
• Treatment for follicular thyroid cancer is similar to treatment for papillary. Hürthle cell cancer (also known as oncocytic or oxyphilic) is less likely than other differentiated thyroid cancer to absorb radioactive iodine, which is often used for the treatment of differentiated thyroid cancer.
• A protein called thyroglobulin (abbreviated Tg) is used as a marker for whether all of the differentiated thyroid cancer has been successfully removed. Determining the Tg level in your blood by periodic testing will help your doctors determine how well you are doing with your treatment. Some patients produce anti-thyroglobulin antibodies (TgAb), which are not harmful but which mask the reliability of the Tg value.

Cancer of any type is still cancer - scary and dreadful.  A lot of doctors say, even my doctor, that thyroid carcinoma is the simpliest and the easiest to treat.  Well, it is still cancer, right?

It's cancer!!

The doctor asked me, "You want the good news or the bad news first?"  Being a strong-willed woman myself, i boldly told him, "bad news!".  The doctor then said unfortunately the result of your biopsy is not good.  It shows papillary thyroid carcinoma.  The good news is that this type of cancer is easy to treat.  He further said, God forbids if he asks me what type of cancer I want, I will say thyroid cancer.  Cases of thyroid cancer have been increasing worldwide.  The cause is believed to be from radiation, like if you have lived in Japan during the Hiroshima atomic bomb explosion or in Russia in Chernobyl.

What?  I was not even born during the Hiroshima atomic bomb explosion and not in my life have i travelled to Russia.  Where could have i gotten this when in fact cancer is not in my family history?  I had a lot of questions in mind but since i just got operated on my right thyroid, i still have hoarse and low voice, i did not have the energy to say something.

That was September 14, 2015.

My ENT surgeon removing the drain a day after right hemithyroidectomy

My initial reaction:

The doctor told me that the other half of my thyroid needs to be removed, which means another dreaded trip to the operating room.  After six weeks of healing, then i will undergo radioactive iodine therapy.  The first thing i said was, "When?".  He said, that is a good question.  Then, he wrote on the consent and all the needed documents for me to sign and for insurance to approve.  I needed to get the other half removed as soon as possible.  I did not cry in front of the doctor.  My friend, Yolly, was with me who have been comforting me since the day before.  Apparently, she and other two of my friends have known the results before me.  Now i know why they have been delaying and why they have been hiding from me.  Anyway, after i left the doctor's office, i sat down at the patient's waiting area where my tears started to fall.  Then, i suddenly felt like urinating, so i told Yolly, "Naiihi ako (i want to urinate)."  I went to the public toilet outside the clinic without even waiting for Yolly.  She found me crying inside one of the cubicles.  All i asked her was, how can i get this?  I have never been to Russia or Japan.

The day before:

The day before my checkup, on 13 September, I asked my friend Yolly who is a nurse in our hospital to check on my results because I am also a patient in their clinic.  Before asking Yolly, I asked Harold, another friend of mine who works with me in the Medical Records.  I told him that i have signed a consent and if he can email me the results.  It was taking him a long time to get back to me, so i asked another friend to remind him.  To make the story short, the three of them tried to avoid me.  I became suspicious.  I became nervous that something was wrong with my biopsy.

Harold and Nova

Two of my friends who wouldn't pass for an acting job!!

 The best actress award goes to, Yolly!

The night before the checkup, i was feeling weird of these friends of mine who kept on ignoring me.  So, i told Yolly to check with Harold in Medical Records.  Unknowingly, Nova was sent by Yolly to follow up with Harold.  The next thing, Harold went up to the clinic and showed Yolly the result of the biopsy.   Apparently, they cried.  What Yolly just told me was the results cannot be discussed by a nurse because the doctor won't allow it.  She told me to just wait for tomorrow, anyway it is just few hours away.  Apparently, the three of them had a pact not to  tell me the result until i see my doctor.

The "bomb" day:

My appointment was at 3:00 p.m.   As early as 9:00 a.m., Yolly messaged me that she wanted to go with me in the clinic during my checkup.  I told her i can manage as i am feeling well now but she insisted and she said that she is my mother here in Dubai as i leave far from them.  This is very unusual for her.  I know she tried to hide what she knows and feels but then again as i have told her, she cannot be an actress.  At the same time, Nova also told me that she will go to the clinic when i come because she can just come and go in that clinic.  I also remember Tintin, our coordinator volunteered to accompany me during the checkup but told he i can manage.  This made me really suspicious.

I was prescribed B complex for my hoarse voice hoping that it will normalize soon.  After buying the medicine from Pharmacy, Yolly fetched me and brought me to her office.  When i sat, she told me, okay now, cry!  Tell me what you really feel.  Tell me what is on your mind.  I cried.  I cried big time.

Yolly called Tita Lydia to bring me home.  I was crying inside the car but it was so sweet of Tita Lydia  to sit beside me at the back and left her husband, Tito Phil drive.  It made me feel good that they are here for me and to comfort me.

I had headache because of too much crying.  I cried the whole afternoon.  I cried, in my mind saying I have cancer I want my mother!

How to survive hemithyroidectomy - Week One

Today marks the first week of my right hemithyroidectomy.  I have been confined to my room the whole week.  I tried to walk a little further away from the entrance door or our building to the nearest grocery store in the same building but i was lightheaded and felt dizzy, so I went back to my flat immediately fearing that i might fall.  I have now less choking with clear fluids but still have some few incidences of choking.  It is hard when i cough or sneeze.  I still have hoarse voice.  But with all of these, I am optimistic that i am on my way to healing.

my patient ID during the surgery and confinement

How to survive the first week of post hemithyroidectomy:

1.  Relax.  All wounds heal in time.

2.  Take the time to totally rest.  Do not force yourself to do certain activities that can cause dizziness.  This is the first week.  Activity is as tolerated only.

3.  Take pain medications as necessary.  I took only take pain medication at night so i can have a good night sleep.

4.  Spray lavender mist, so you can have a good night's sleep.

5.  Sleep as long as you can to get back your lost energy.

6.  Change position slowly.  One time when i was kneeling while praying, i suddenly stood up but my knees and legs won't let me as if i am paralyzed.  Good thing somebody was at my back to support.  So, i knelt back and slowly stood up while holding on to something.

7.  Eat really nutritious foods for healing especially avocado.  Avocado gives extra energy. 

8.  Adult coloring book.  Colors helped me relax and felt the pain less.

9. Drink lots of water to help heal the hoarseness of voice.

10.  Pray.  As you stay confined, do not stop praying but keep on talking and listening to God.

Onwards to healing!  Tomorrow is my first follow-up checkup.  Claiming for negative biopsy result.

After hemithyroidectomy

I was brought to my room after the recovery.  I was awake but really groggy.  It made me feel at home when I saw the people i know after i woke up.  I am living alone in Dubai without any family, but the feeling of familiarity made me feel home.  I am so blessed and thankful to have my friends around me.  When i reached my room, i told the nurse that i wanted to urinate.  She was surprised that among all the patients they handled with the same surgery, I had the fastest recovery, that is getting back the kidney function immediately after recovery.  I went  back to bed and slept for awhile.  After a few hours, the nurse told me to try to sip water.  I reclined and tried sipping water.  Unfortunately, I choked.  Clear fluids made me choke.  They said it was because of the dryness caused by the endotracheal intubation to protect the airway during a general anesthesia.  After every few hours, I kept taking liquids but to no avail.  I never wanted to eat or take anything because i was afraid it might choke me again.  At night, i tried with hot tea with the suggestion of the nurse, which helped a lot.  I was able to ingest hot tea, jello and soup.  I did have some choking events but it was lesser then.

 With Marvin and Dhes, the first two people I saw when i was brought to the room after recovery

 Tita Yolly, more than a nurse, more than a friend

 Dhes and Marvin

Me with my JP drain ha ha ha

Top 5 discomforts I had after my hemithyroidectomy

1.  Choking on fluids

2.  Hoarse voice

3.  Discomfort sleeping on flat

4.  Pain

5.  Unsightly wound

Currently, i am still recuperating.  A little bit of hoarse voice.  A little bit of discomforts.  In God's time i will be well, will be stronger and healthier to know, love and serve God....