One Week Post Op Round Two

About four weeks ago I went into hospital to have the right lobe of my thyroid gland taken out because there was a large lump inside it which doctors suspected of being a follicular cancer tumour.  You can find the details of that surgery in previous thyroid related entries.

When I woke up from that operation I had a painfully dry throat and mouth for a few hours.  A few times it felt like a burp was trapped behind my vocal chords which was also a bit painful while it lasted but that was the extent of the pain.  The rest I would describe as discomfort.  Slight discomfort when swallowing and a tenderness of the wound and surrounding tissues but nothing serious.  I didn’t even want to accept the pain killers they were offering me every four hours because I didn’t need them.

I had no problems moving my head or neck and felt quite capable of going back to work the next day.  A few days later some pain set in after a two hour shopping trip but a couple of panadol sorted it out and it passed after about two more days.

Two weeks later they told me the lump was follicular cancer and I would need to have the rest of the thyroid gland removed and things deteriorated.  I felt discomfort and some difficulty swallowing as well as a few twinges of pain which doctors said might have been caused by internal stitches.

Twenty days after the first surgery I was back having the second one.  Here’s how it went.  I’m putting in a lot of detail because details are what I was looking for when I went searching for information on what to expect.  It’s going to be boring for anyone not facing the same sort of operation so read on at your own risk lol.

Operation Day

I arrived for the surgery at seven in the morning, just like last time, but the admission procedure was a lot quicker this time.

My daughter and I were both surprised and pleased to hear that, once again, I was first on their operating list and would not have to wait long.

They gave me the pre-surgery pain killer, measured me for surgical support socks and gave me ones which were too big just like last time, supplied me with a gown, robe and paper booties.  Unlike last time the gown fitted and they told me I could keep my underpants on this time which I did.

They walked me to the recovery room, put me on a trolly, added a surgical cap to my outfit, inserted a needle into the back of my hand, put a hot blanket over me, then wheeled me into the operating theatre at about 8:45 am which is the same time they took me in there last time.

They got me to scoot over onto the operating table and put boards up for me to rest my arms on then they put cold sticky things on several places around my chest.  One of them was overlooked after surgery and I found it stuck to my ribcage after I got home.  Here’s a photo of it.

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I felt a coldness as they injected the anaesthetic into my hand and that was all I knew until I woke up feeling sore and sorry for myself with my daughter beside me.

This time I don’t recall having the same painful dry mouth although my mouth was dry but this time there was no “Nil By Mouth” sign over my bed.  I was hooked up to a drip, a drain, an oxygen mask, a heart monitor and a blood pressure cuff and I did not want to wake up.

I was determined to be a good patient this time so I deliberately stayed as drowsy as I could for as long as I could so I would not try to run off for a smoke.

I was so successful in this that, when I was still drowsy at 4pm, they began to get worried about me.  When the nurse said she was going to call a doctor because she thought there must be something wrong I said I am drowsy because I am trying to be drowsy so I won’t need a smoke.  When I saw she did not believe me I pulled myself together and proved it.  Within minutes I was arranging to go outside for a smoke.

I felt weak and dizzy so I took it slow and my first move was a long overdue visit to the rest room.  As I was getting ready to go downstairs and outside for a smoke the nurse came in and said to wait as she had gotten permission from her supervisor to take me out in a wheelchair.  She took me out and I had a smoke then came back to bed and did my best to behave myself.  The trip outside for a smoke took a lot more out of me than I expected, despite the wheelchair, so I am glad the nurse insisted.

I was pretty doped up on pain killers so pain wasn’t a big deal at that point but I did accept the pain killers they were offering where, last time, I didn’t as I was not feeling any need for them.

This time the pain was so bad I actually asked them for pain killers once or twice as the night wore on and I took the ones they offered me every four hours.  There was a sharp pain in the front of my throat and another at the back of my neck and these were the main reason I needed pain killers.  It felt as if a muscle had been strained and it lasted for about two or three days.

My neck was stiff and sore and it was hard to turn my head which didn’t happen last time.  It hurt to swallow this time where it was only uncomfortable last time.  It reminded me of when I had my tonsils out although not quite as painful as that was.

They took my blood pressure, heart rate, etc every four hours throughout the night and took blood in the late afternoon and again in the early hours the next morning.

They took me off the drip as soon as I got mobile and began drinking fluids but they left the needle in just in case something happened to make it useful again.  They also took me off the oxygen mask and wrapped a thin tube over one ear, down across my face and under my nose, then back up and over the other ear.  The tube had two tiny prongs in the middle that they inserted into my nose.  This device supplemented the air I was breathing with additional oxygen.  They did the same thing to me last time as well.  I think it was because I am a smoker.

I was out of bed and roaming the hospital having cigarettes and buying junk food and diet coke from the vending machines about four hours after going in for the removal of half my thyroid gland.  I felt fine apart from some tenderness when swallowing or moving my head around.

It took twice that long to get mobile after the second surgery and, even then, I was weak and shaky on my legs on and off.  There was more pain but it was kept managable by ordinary panadol so I still bought, and consumed, diet coke and junk food and I still went wandering off for a smoke every hour or so throughout the day and night but it wasn’t as easy as last time.  I got weak and tired quite quickly so the trips wore me out more causing me to spend more time in bed than I did last time.

At midnight they put a strip of tape from top to bottom of the drain and marked how much blood it had collected.

Day One

I was told they would be keeping me in for two days this time so I arrived with all the things I thought I’d need to cope with a longer stay.  I took music, books, and some nicotine gum and was determined to be a good patient and not leave until they were ready to let me go.  I didn’t push or nag or try to hurry them at all.  I even left the surgical socks on until I saw they were cutting off circulation and I was given permission to remove them!

Doctors arrived around breakfast time and told me “Everything was pretty well stuck down this time but we got it all and it all looked normal.”  The said they had found both of the left parathyroid glands and were able to leave one in place but that the other one “was looking a bit blue so we mushed it up and injected it into the strap muscle”.  They said “those things grow like weeds so it should establish itself in there and come good in time”.

They authorised the removal of the needle from my hand and, after they left, that was done which was a great relief as I kept knocking it and it had gotten quite red and sore by then.

Another set of doctors came by an hour later and told me I was doing well and might be able to go home that afternoon.  One of the staff members, I thought he was a doctor but he might not have been, told me he would check my drain at about noon and if no more blood had been collected he would remove the drain then.

I returned from a smoke break at about 10 am and yet another group of doctors was on their way through the wards.  As I passed them in the hall one of them told me the drain could be removed.  I said “Are you sure?  I was told it will be checked at 12 and could not be removed before then.”  The doctor said “Tell Luke Raj said to take out the drain now.”

It was music to my ears so I went straight to the nurses station and asked for Luke who turned out to be the same person who told me he was going to check the drain at noon.  He did not seem all that happy about being over ruled but he agreed to come and remove the drain when he finished filling out some forms for me to take home.

A little while later he came and gave me a referal form to get some blood tests done a week before my post operation appointment and a sick leave form for my bosses.

I waited patiently for him to come back and remove the drain which he did soon after and I even encouraged him to use me as a guinea pig for an intern to practise on.  I remembered the last time the drain was removed and they did it differently this time which made it a slightly more unpleasant experience.  Last time they cut the drain to release all suction and the drain slid silently and painlessly out but this time they just clamped the tube and it made an awful sucking sound as it was removed.  It still didn’t hurt but it sounded like it should be hurting and that was unpleasant.

Even though the drain had been removed and I had the all clear to leave from the doc I still stayed patient.  I was determined not to make a scene this time and force my release along.  I knew there was still the issue of medications and I would have to wait for the pharmacist to visit me.  About ten minutes later, she did, and said she would be back soon with my thyroid meds.

A nurse came in after she left and asked me how I was going to get home and I said I would call my son to come get me as soon as I was given the all clear to leave.  She wanted to know how long it would take my son to get there and I said not long but I didn’t want to call him until I had actually been released.  I said last time I was here I made a big fuss and rushed my release and I did not want to do that again and she said she remembered me from last time.  She said she had only asked how long my son would take because, if it was going to be three hours or something like that, I would have to be sent to another part of the hospital to wait.

After she left I got dressed and packed up my things.  Minutes later the pharmacist poked her head around the door and asked me if I wanted to wait for her to come back with my medication or come and pick it up on my way out of the hospital.  I said I’d pick it up on my way out.  She said OK and the nurse heard her.

I asked the nurse if there was anything else that needed to be done and she said no I was free to go.  I said are you sure?  I said I didn’t want to call my son until they were really ready to release me.  She said she just wanted to put a waterproof bandage over the wound before I went and I should call my son while she went to get the bandage.

I protested, I said I hate those bandages, she said she would prefer the wound to be protected so I gave in.  I called my son and arranged for him to come and pick me up then I let her put a waterproof bandage over the wound.

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After she was done I collected my belongings and headed down the passage thinking I had redeemed myself by being as patient as a patient should be this time.  Just as I finished congratulating myself for not making a scene the nurse came up behind me and asked me to wait.  I turned around and she said she thought there was something they had forgotten after all.  She said she was pretty sure I was supposed to wait four hours after the drain had been removed before leaving.

I felt like one of those cartoon characters racing off to do something and another character comes up behind with a walking stick or shepherds crook and catches you around the throat.  Yoink goes the soundtrack and you get carted off but I was in full flight mode, this was no cartoon, and I wasn’t about to let them yoink me back!

I said it was too late to tell me that now because I was leaving and she said just wait a second while she checked with her supervisor.  I said no need to check as I am not going to wait and I turned around and kept walking.

Seconds later I heard them call my name and a whole group surrounded me and began insisting I had to stay another four hours.  I refused and the nurse in charge asked me to go with her to another room so she could explain the risks.  I said if they wanted me to stay another four hours they should have told me that before I called my son and it was too late now.

She said it was the same procedure as last time so I should have known.  I said I know what you said the risks were last time so you don’t need to explain them and I don’t care what the risks are I am leaving.  She said there were other risks she had not told me about last time and I should come to another room with her so she could explain them.

I looked her in the eye and said I don’t care what the risks are, I’m leaving, thank you for your concern and goodbye.  She said well at least listen to the symptoms so you will know if you are in danger.  I said I know them, bleeding, swelling, fever, difficulty breathing.  I said I promise to go straight to emergency if I experience any of those things.

She said there is another condition that can be life threatening and the symptoms of that are numbness or tingling of the mouth, hands or feet, if you get any of those symptoms you need to come straight back too.  I nodded and kept walking.  I wasn’t about to get into an argument with her about those symptoms being common and easily dealt with by taking a dose of calcium supplement.  I knew they were only serious if they persist even after you have taken a calcium pill.

She moved in front of me to block my way and said she needed me to understand I was putting my life at risk by leaving.

I said I do understand but you need to understand that you can’t mess people around like this!  I said if you had told me I’d have to wait four hours before I called my son I would have waited four hours but you can’t change your mind about releasing me at the last minute like this.  I won’t accept it, I don’t accept it, and I am going but I will get my son to bring me back if there is any sign at all that something is going wrong over the next 24 hours.  The other nurse held up her hand showing four fingers and said I just needed to be alert for the next four hours.  I agreed and I left and I was absolutely certain the whole thing had been staged to punish me for the performance I put on last time.

My son picked me up and took me home then went back to bed because he was due to do a night shift that night.  He ordered me to wake him again if anything went wrong so he could run me back to hospital and I agreed but said I was going to bed too.  He said he would look in on me to be sure all was well before he went to work and that my daughter would probably be home from work soon after he left so she could help me if I needed it then.

I was tired and weak and ready to lie down so I went to bed and I wasn’t out of bed for very long at a time for the rest of the day.  I took panadol every four hours, propped myself up on pillows, and rested as much as I could.  I needed to because I kept being overcome by a weak, shaky, sensation whenever I was out of bed for any length of time.

For those who are interested, this weak and shaky sensation felt exactly like the very start of a fainting episode.  Unlike fainting, however, it didn’t progress up the body into the head and turn into dizziness and loss of consciousness.  It came very close to including dizziness but stopped a hairs breadth short.  It was a very strong incentive to go back to bed whenever it happened though.

Day Two

I woke up about four in the morning of day two and I was feeling pretty horrid.  My hands and fingers were numb and tingling, I felt weak and shaky, and I hurt so I had to think about medication.

I was supposed to take two calcium supplement tablets, a thyroid replacement pill, and a vitamin D pill every day and the nurses gave me all of those to take with my breakfast the day after surgery.

I knew that was the wrong way to do it because I researched the medications and knew thyroid medication is very sensitive and taking it with food or calcium pills would prevent my system from absorbing it properly.  The last thing I wanted was to get a lower dosage than I should so I resolved to take it alone and on an empty stomach as recommended.

The main problem was the numbness and tingling.  I knew that meant I did not have enough calcium in my system and should take the calcium pills to sort that out.  If taking the pills did not fix the symptoms I would have to go to the hospital but the weakness and shakiness were unpleasant symptoms that I believed the thyroid medicine would fix.  The pain I was experiencing meant I was pretty keen to take a couple of pain killers as soon as possible too but what to take first?

I decided the thyroid medication should be first because I had not eaten for more than 8 hours which was ideal.  According to the packet I could eat or take my other medication half an hour after taking it so I took the Eutroxsig tablet first with a few mouthfuls of diet coke and had a cigarette.  I still felt awful so I took my weak, shaky, numb, tingling, pain filled body back to bed where I surprised myself by falling asleep for about four hours.  When I woke up I didn’t feel weak or shaky any more but I still had all the other symptoms so I made some toast and took two large calcium pills, a small vitamin D pill, and two medium sized panadol capsules all at once then pushed them all down with toast and diet coke.

I rarely take pills so it probably shouldn’t have surprised me when my stomach made a protest about being bombarded with so many at once.  I had another smoke and tried to ignore the mild stomach pains but I felt awful so I went back to bed and was very quickly asleep again for another couple of hours.

The rest of the day passed alternating between brief periods of being awake followed by longer periods of sleep.  I ate but not much and mostly to have something in my stomach when I took the painkillers every four hours.  The pills had sorted out the worst of the weakness, shakiness, numbness and tingling but the pain persisted and I continued to have mild episodes of the other symptoms.  If I was up for too long I would get a little bit weak and shaky and if I left my hands and arms in the same position for any length of time they would get numb and go tingly.

The only bright spot was my ankle.  I broke it almost four years ago and it has not felt right ever since.  It has been swollen and puffy all the time lately but, after the surgery, the swelling went down and it was feeling almost as good as new.

Day Three

Once again I woke in the early hours of the morning and was confronted by the need to deal with the medication issue.  I was feeling exactly the same as the day before so I took the Eutroxsig pill even though it was a couple of hours earlier than the last time I took it and went back to bed.  Two hours later I woke and the weakness and shakiness was gone so I made a slice of toast and took one of the large calcium supplement tablets.  I thought if I took one in the morning and one later in the day I might not get the numbness and tingling again.

The pain was easing so I wasn’t needing painkillers every four hours but I did still have to take them a few times throughout the day.

The nurse had told me to leave the waterproof bandage on for two days and that time was up today so I had a shower in the afternoon then took the bandage off which gave me a lot of relief as I find they irritate my skin.

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Throughout the day I had mild episodes of the numbness and tingling if I got on the computer and rested my hand on the mouse for any length of time or left my arms or hands in one position for more than a few minutes.  I also had mild episodes of the weakness and shakiness which I treated by nipping back to bed for an hour or more.

I was definately on the mend though and I spent most of the day sitting outside in the shade reading a book, smoking, and drinking diet coke.

The ankle continued to be free of any swelling.

In the evening both my son and daughter were out and I had finished the books I had been lent so I headed for bed to listen to music when I started feeling weak and shaky again.  I propped myself up on pillows and listened to the man start singing about what he believed.

As he sang “I believe you don’t know what you’ve got until you say goodbye” I found myself overwhelmed with grief and the tears began to flow.  I sobbed and sobbed in the dark knowing nobody would hear me so nobody would be distressed by it but I was completely shocked and confused by the emotional storm.

After crying like a baby for about ten minutes my mind began to function again and I had thoughts like this.

“You aren’t supposed to bury yourself piece by piece like this.  What happened to my thyroid gland?  Did they dump it in a bin somewhere?  It wasn’t rubbish!  It worked hard for over 50 years.  I betrayed it by filling my body with toxins.  It doesn’t deserve to become junk in a rubbish bin somewhere.”

You really don’t know what you have until you say goodbye do you?  I said goodbye in tears.

“Goodbye thyroid gland.  Goodbye independence.  For the rest of my life my health will depend on a little white pill and I will be at the mercy of those who make and supply it to me.  I don’t want to rely on others.  It leads to let downs and abuse!”

The wave of grief passed after a while so I dried my tears and passed the night with music filling my ears.

Day Four

The early hours of day four found me, once again, grappling with medication issues but I took the Eutroxsig pill to ease the shaky, weak, feeling and waited as long as I could before taking the calcium to ease the numbness and tingling.  I was starting to think my stomach did not like the thyroxine as it had begun to respond to taking it with a mild case of heartburn.

I spent the day watching TV, playing computer games, and researching the internet on the best way to take the medicines.

I was still feeling a bit beat up but the pain wasn’t too bad and I wasn’t having as many episodes of the weak, shaky, feeling or the numbness and tingling so I guess I was gaining some strength back.

The main problem was a cough that caused a fair bit of pain.  Yawning, however, was even more painful so I tried real hard not to do it which only made me want to yawn even more.  I had, however, regained the ability to blow my nose which I lost for about two or three days after both of my surgeries.

By the afternoon of this day I was feeling strong enough to start getting a bit stir crazy.

Day Five

Things were looking up a bit by day five and I began to try and plan a medication routine that would be easy to stick to once I went back to work.  I didn’t have the weak, shaky, feeling this time so I didn’t feel forced to take the Eutroxsig as soon as I could which meant I could delay taking it with a view to moving the time from 2 in the morning, a time I am often at work, to a more convenient one.  I really don’t want to be carting pills to work with me as it’s just one more thing to remember and my memory has been pretty sucky lately.

Once I had taken the pills, however, the day unfolded without any drama and I felt even more stir crazy than ever.  I was also starting to want the steri-strips taken off the wound so I could see how it was healing.

There had been a little bit of seepage and they were looking gross by this day (See picture below).  I was worried that the wound had opened or infection was setting in but everything I could find on the internet said not to touch them for at least 7 days.

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I passed the time watching TV, playing computer games, and researching diet on the internet.  I learned I was doing a LOT of things wrong.  You are supposed to drink water with the thyroxine and I was drinking diet coke.  You are not supposed to take flouride with thyroxine but the water here contains flouride.

By 6pm I developed a strong craving for roast pumpkin which I knew was available at an all you can eat buffet my daughter took me to for the first time the day before surgery.  I texted her asking if we could go but she had just eaten.  She offered to take me there for lunch the next day and I agreed.

I pottered around and, through sheer boredom, eventually went to bed where I had my worst night ever.

Day Six

I’d been able to sleep without extra pillows as long as I had a pile of them beside me to rest my upper arm on but heartburn forced me to go back to propping myself up on a pile of pillows.  I listened to music but it felt like someone was pressing on the front of my windpipe so I couldn’t get comfortable.

The sensation of having my windpipe pressed on increased and I began to feel as if I might be having a sudden, lethal, bleed out like the ones they warned me about.  I knew the main symptom would be trouble breathing so I decided not to panic unless I began having trouble breathing.  It didn’t happen but I did start having all sorts of other problems including sharp pains, a lump in my throat that wouldn’t go away, problems swallowing etc.

About 4 am I took the Eutroxsig and my problems with heartburn took a turn for the worse but you shouldn’t take antacids with thyroxine so I just had to suffer through it.  Around 6 am I woke to discover my left hand was completely numb and I wondered if this was the other complication they had warned me about.  I took my calcium pill and decided to wait and see if that fixed it before panicking.  It helped but some numbness remained so I took the other calcium pill and decided I probably would not be up to going out for lunch.

By around ten am things had settled down but I was exhausted and thought I should wake my daughter and cancel our lunch date.  My body had other ideas, however, and I could not shake off the craving for roast pumpkin so I made an effort to wake up.

Around noon we went to the all you can eat place and ate.  My daughter wanted to try a new alcoholic drink but it came in a bottle that held more than she felt she could drink so I agreed to have a glass with her.

I rarely drink alcohol so she was surprised but she bought the cider and I had one small glass of it.  To pass the time while she drank the rest we went and played the pokies and, praise God, I won enough money to cover most of my expenses for the next fortnight.  I used up all my holiday and sick leave for the last operation so this time I am off work without pay and I was wondering how I was going to manage.

Winning the money was a bit of a natural pick-me-up so I was in good spirits as we made a quick supermarket visit before coming home and I stayed in good spirits for the rest of the evening.

During our visit to the supermarket I passed a major chemist so I popped in to ask about the state of the steristrips.  The chemist said he saw no cause for alarm and I should just let them stay on until they fell off.  He said they were most likely as yucky looking as they were because I had been keeping water off them.  He said I should only be concerned if swelling, soreness, or redness increased or if bleeding began.  He said as long as things got better, not worse, as time went by there was nothing to worry about.

Day Seven

As part of my plan to move the time I take my Eutroxsig to a time when I am always home and almost ready to go to bed I decided to delay it until 4 am this day but I had time to kill and plenty of it.  I decided to shower and see if the steristrips would come a bit cleaner.  They didn’t.  They just got wet and one end began to peel off.  I lost patience and peeled them off.  There was bloody spots (see the picture below) so I worried but there didn’t seem to be any fresh oozing or bleeding.

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I was feeling completely overwhelmed, helpless, and hopeless about diet and all the other considerations when 4 am arrived so I decided to take the thyroxine with a biscuit in hopes of avoiding the heartburn I had been getting after taking it.  The plan was to wait 4 hours, as recommended on the internet, before taking the calcium supplement but the serious numbness in my hand happened again so I took it about 7 am instead.

Once I had taken all the pills I settled down and had the best sleep I’ve had so far as I was able to really curl up and relax.  The only problem I still had was pain on yawning.  There was a specific, sharp, tearing pain as if the wound was opening in one particular spot but examining that spot showed no such thing was happening so I can only assume it’s something to do with the stitches.  Sadly, it was as if my body couldn’t accept it should not yawn, and the more it hurt the more I needed to yawn.

To resolve the struggle, I took two panadol, yawned to my hearts content with only minimal pain then slept like a log.

As I write this I am feeling almost back to my normal self.  I haven’t had the weak, trembly, sensation for a day or two now.  The numbness and tingling still happen now and then but I feel much better.  There is still tenderness at the site and when I’m swallowing and sharp pain when I yawn but even that is much better today.

The wound looks much better today than it did early this morning (see picture below) and there is just some swelling and bruising left to heal now.

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My voice is rough sounding, has been since the surgery, but I can talk which is the main thing.  I have decided to throw caution to the wind and take my pills as and when I feel like it without any concern for anything else apart from making sure I do take them.  I’m going to buy one of those weekly pill containers so I can see at a glance if I have taken that days pills but I will wait and see if my body copes and worry about taking them on an empty stomach and all the rest if I find I don’t feel good when all the dust has settled.

The wound looks neater this time.  It has been sewn shut instead of stapled which is what they did last time.  It has been slower to heal, 7 days as opposed to 3, but I am hoping it will heal neater as it looked a bit messy last time (see picture).

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