Thyroidectomy part 5

My Thyroidectomy, part 5: Meeting the Surgeon and Pre-Op

5/18/17 Justin’s mom watched Ryan and picked Tyler up from school while Justin and I went to my appointment to meet with the surgeon, Dr. Sampson. It took us about 45 minutes to get to his office, which is why we planned for Justin’s mom to pick Tyler up from school, we weren’t sure we would be back in time. We were both very impressed with him, and were comfortable with him as a surgeon. He explained the thyroidectomy further to me, what his plan of action is, and listened to my concerns. As he explained the actual procedure, we could tell that he was explaining from experience, not just from reading about it. I forgot to ask how many of these he has done, but we both got the impression that it’s a lot. His plan is to remove my entire left lobe, and send that to pathology. There is a test that can be done in about 20 minutes that gives a pretty good indication of whether this is follicular cell cancer or not. Basically, there is a baseline that the follicular cells should not be below, and if under examination they are, that’s indicative of cancer. As long as that test came back negative, he would leave as much of the right thyroid lobe as possible. And if it came back indicative of cancer, he would remove the right lobe. He also said that while they did that 20 minute test, he would take a look at the cyst on the right lobe and determine if he thinks that needs to come out as well. He said he wants to leave as much as possible in the hopes that it would pick up and make enough TSH so I don’t have to be on medication for it for the rest of my life, and he also didn’t want to touch the parathyroid glands as much as possible. The parathyroid glands control the calcium in your body. You are supposed to have 4 of them, one at the top and bottom of each lobe, but many people have only 2 or 3, some have 5 or 6. He said there’s no way to really know until you are in there, and even then it is risky to check. He said to check for a parathyroid gland on the part of the thyroid he leaves would mean he would have to lift the thyroid gland up and almost flip it over to check. Doing that is risky to the parathyroid gland because it is a very small blood vessel that connects it, and that can be damaged easily, which then means the parathyroid isn’t working anyways. Dr. Sampson set a tentative surgery date of May 31st. He operates on Wednesdays, and since I left for Florida the next day and wasn’t home until Tuesday, there wouldn’t be time for me to do my pre-op appointment before the following Wednesday. They said it also gave them time to get everything set up at the hospital and with my insurance. The office said they would call me as soon as they get everything set up with the hospital.

letter to surgeon
Letter from my endocrinologist to the surgeon with the diagnosis and his suggestions for surgery.
Conversation with my wonderful mommas group letting them know the tentative surgery date and all their support.

5/19/17 Dr. Sampson’s office called to let me know that I was definitely on the schedule for May 31, and the pre-op will be on May 25 at Kingwood Hospital. I asked if they knew the time of the surgery and she said no, I will get that information at the pre-op appointment.

5/24/17 My cousin, Kevin, had surgery on his shoulder yesterday and text me in the morning saying he was a little nervous about general anesthesia, but it wasn’t a big deal at all. He said they did a nerve block, gave him meds to calm his nerves, then he remembers a really bad smell then was out. He woke up feeling like he was waking from a deep sleep. I asked and he doesn’t have any pain from the trach tube, and it went in after he was out and was removed before he woke so he didn’t even know it was in there. It made me feel better to hear that and hear that he did fine with anesthesia with our family history. I also got a call about payment. They called my insurance for an estimate and said they thought my deductible was met. I said I have no idea because the EOB for the biopsy came back with my claim being processed as an emergency room visit, not an outpatient surgery like it was supposed to be. She said they will just assume that the hospital is going to resubmit and charge me now as if my deductible is met. If that’s the case, then the surgery will go towards my coinsurance which is 20%. The cost to me would be $536, but if I paid in full before the surgery, they do a prompt-payment discount of 20% which brought my payment down to $429. I don’t know that will happen with that other claim, but she said they will just collect this and submit to insurance and bill me if there is any other leftover amount due. This estimate did not include the anesthesia, because she said they won’t know how much they use until the surgery is over. Someone else from the hospital also called to confirm my pre-op appointment, and said to expect to be there for about 1.5-2 hours. The first thing they will do is registration and signing consents, then I would see the nurse for any physical exam and tests that they need done before surgery.

5/25/17 The pre-op appointment was much quicker than the time they estimated, about an hour total. The first thing we did was make sure that all of my demographics information was still the same, and since I was just there a few weeks ago for the biopsy, nothing had changed. Then they sent me over to the pre-op testing area where I had to fill out a few forms with personal and family medical history and last dates of certain tests. When that was done, a nurse called me back and took my vitals. She asked who was doing the surgery and when I told her Dr. Sampson, she went on and on about what a wonderful surgeon he is and if she had to have anything done she would be talking to him about it. She said I couldn’t be in better hands for this and that made me feel pretty good in my decision to have him perform the surgery. She went over my health history, and said she will get my recent EKG from my cardiologist so I wouldn’t have to do one there (which is probably what saved time at the hospital). She drew blood to test where some of my levels are pre-surgery to be able to compare to post-surgery. I was given an instructional booklet with information about having surgery there and what to expect. It also had my basic instructions, when to stop certain medications, what to do the night before and morning of, etc. The nurse showed me where to go when we get there for the surgery, and where Justin would be waiting during the surgery. He would be able to come back with me during prep, and stay until they brought me to the OR. Then I would see him again after the surgery. The waiting area has screens that would have my name and the surgeons name and let him know what steps they are on such as anesthesia started, first cut made, etc. She suggested leaving my overnight bag in the car during the surgery so he wouldn’t have to keep track of it, and said Dr. Sampson would be out to update him once the surgery was over. My surgery is scheduled for an arrival time of 6:30am on May 31, and he has the OR booked for 2 hours 15 minutes. Results of my blood work done that day: everything was within normal range on both a CBC and a BMP, with my Calcium at 9.7.

  • When do I get to the hospital? 6:30am
  • What are visiting hours? 9am-9pm but Justin could probably stay, there just isn’t anywhere comfortable for him to sleep
  • What should I make sure to bring? Glasses, my own pads if I don’t want to use theirs since I am expecting to be on my period
  • What do I do if I am on my period? Wear a pad, I can’t have a tampon in during surgery and recovery there

5/29/17 2 days. In less than 48 hours I should be in recovery. Justin was out of town all weekend, and I kept myself busy, and told myself I wasn’t allowed to think about the surgery until he got home. Well, that morning, while in the shower, I thought about it and all the emotions came flooding in. This would be the last night I tuck the boys in bed for at least a week. I’m scared of the anesthesia. I’m worried about my recovery. And I am very sensitive about things touching my neck so I am a little freaked out about the potential for having stitches or staples that have to be removed.

5/30/17 We dropped the boys off at Justin’s parents before dinner time, and ordered some pizza for us. Justin said I could pick whatever I wanted for dinner since I probably wouldn’t be able to eat much after the surgery for a few days. I took a shower after dinner, but was told not to shave. Sorry, but I can’t stand to not shave my underarms, so I still shaved that, but I did not do my legs like they asked. I was told that shaving can leave tiny nicks in the skin which could make you more susceptible to possible infection. An hour after I showered, I had to use some skin prep wipes and wipe myself down to try to prep my skin, again, to help prevent infection. Since I had to do my back as well, I had Justin help me with those. It took a few minutes to dry, then it wasn’t near as sticky as they made it sound like it would be. I got my bag packed for the hospital and since I couldn’t concentrate on anything that night, just laid on the couch and watched some Netflix until about 9:30 when I went to bed.

Items I packed that I actually used:

  • Phone and charger
  • Kindle
  • Hairtie
  • Glasses (they won’t want you to wear contacts if you do)
  • Chapstick/Lip Balm (your lips will be very dry after surgery)
  • Comfortable clothes to go home in
    • Low cut shirt that’s easy to get on from your legs rather than over your head (I brought a camisole shirt)
    • Comfortable bra and underwear
    • Comfy pants to wear home
  • Face cleansing wipes
Trying not to worry too much about surgery in the morning. You can really see the nodule in this image, but it should be one of my last photos with that there!
More love and support from my wonderful mommas group.
Post on my personal facebook page about surgery the next day.
Related Thyroidectomy Posts:

[archive tag=”thyroid” posts=”10000000″ orderby=”date” order=”ASC”][/archive]
Thyroidectomy part 5 Thyroidectomy part 5

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