Tuesday, July 25, 2006
Benign neglect
Ok. I'm not, apparently, dying. Sorry for any suspense. Although there is that fat false negative rate to worry about (3-21% depending on various, mostly operator dependent, factors). The cytologist seemed to be covering his bases..."sample scanty but adequate"...consistent with a degenerating benign colloid nodule.
Recently I went down to The Medical College of Georgia to see super thryoid man of the universe, David Terris, MD,
who has pioneered minimally invasive thyroid surgery in the states...and on me, will do an even newer " Miccoli" endoscopic procedure that reduces the scar by half again (although scar size is variable), reduces bleeding with a magical ultrasonic scalpel enough that I should be able to go back to the hotel afterward and leave town the following day, and uses tools so slender it is possible to avoid transection of the strap muscles (other minimally invasive procedures have required cutting these)
There is no external visible sign of my thyroid trouble, but it causes a good deal of discomfort. I'm currently sceduled for a hemithyroidectomy at the end of August. If my nodule gets even a little larger it would not be possible to do the minimally invasive endoscopic surgery.
I am very vain and don't want ANY scar, but a little one is far better than a five inch "OJ was my boyfriend" scar sometime down the road. And I'm tired of the choking , hoarseness and difficulty swallowing. And I would like the question of thyroid cancer answered definitively.
Still, I'm wondering if its the right thing to do. I'm clinically euthyroid, which means my thryoid function is completely normal. Messing with that is risky to my future well-being. Removing even the replaced/compressed thyroid tissue on the left could leave me hypothyroid. This causes far more misery and health side-effects for people than doctors like to admit..and it isn't as easy to treat as is often claimed. First, doctors may be slow to pick up on a subclinical hypothyroidism caused by the surgery. Thyroxine replacement is tricky and can require constant adjustment... and feeling good might be an elusive goal if my thyroid struggles to produce enough hormone. I could get nodules on the other side, as well. And even the minimally invasive surgery, performed by one of the most talented and experienced surgeons in the country, could have complications. And if I have an undiagnosed thyroiditis (I won't go into it now, but there is a t least a little reason to worry about this) bleeding and oozing could require him to convert to a conventional procedure and I'd wake up with the big scar after all my trouble to avoid it.
I have just learned of a cutting-edge procedure using a laser to thermocoagulate solid benign nodules. It doesn't completely eliminate them, but it makes them shrink dramatically. No scar. No hypothyroidism. NO COMPRESSION SYMPTOMS....sounds good to me. I could have it done....if I fricking flew to Italy.
I wonder if Terris would have any interest in attempting something along those lines with me...they do have one of the top thyroid programs in the nation there at Medical College of Georgia...I'm a willing ginuea pig, to be sure.
Recently I went down to The Medical College of Georgia to see super thryoid man of the universe, David Terris, MD,
who has pioneered minimally invasive thyroid surgery in the states...and on me, will do an even newer " Miccoli" endoscopic procedure that reduces the scar by half again (although scar size is variable), reduces bleeding with a magical ultrasonic scalpel enough that I should be able to go back to the hotel afterward and leave town the following day, and uses tools so slender it is possible to avoid transection of the strap muscles (other minimally invasive procedures have required cutting these)
There is no external visible sign of my thyroid trouble, but it causes a good deal of discomfort. I'm currently sceduled for a hemithyroidectomy at the end of August. If my nodule gets even a little larger it would not be possible to do the minimally invasive endoscopic surgery.
I am very vain and don't want ANY scar, but a little one is far better than a five inch "OJ was my boyfriend" scar sometime down the road. And I'm tired of the choking , hoarseness and difficulty swallowing. And I would like the question of thyroid cancer answered definitively.
Still, I'm wondering if its the right thing to do. I'm clinically euthyroid, which means my thryoid function is completely normal. Messing with that is risky to my future well-being. Removing even the replaced/compressed thyroid tissue on the left could leave me hypothyroid. This causes far more misery and health side-effects for people than doctors like to admit..and it isn't as easy to treat as is often claimed. First, doctors may be slow to pick up on a subclinical hypothyroidism caused by the surgery. Thyroxine replacement is tricky and can require constant adjustment... and feeling good might be an elusive goal if my thyroid struggles to produce enough hormone. I could get nodules on the other side, as well. And even the minimally invasive surgery, performed by one of the most talented and experienced surgeons in the country, could have complications. And if I have an undiagnosed thyroiditis (I won't go into it now, but there is a t least a little reason to worry about this) bleeding and oozing could require him to convert to a conventional procedure and I'd wake up with the big scar after all my trouble to avoid it.
I have just learned of a cutting-edge procedure using a laser to thermocoagulate solid benign nodules. It doesn't completely eliminate them, but it makes them shrink dramatically. No scar. No hypothyroidism. NO COMPRESSION SYMPTOMS....sounds good to me. I could have it done....if I fricking flew to Italy.
I wonder if Terris would have any interest in attempting something along those lines with me...they do have one of the top thyroid programs in the nation there at Medical College of Georgia...I'm a willing ginuea pig, to be sure.
