January 22, 2014

The Battle with Graves' Disease Part IV: Chickening Out....

The waiting area for all my endocrine specialist appointment at Changi General Hospital
After deciding to go for a total thyroidectomy to deal with my troublesome thyroid gland once and for all, I made an appointment to see my Surgeon, who will explain the surgical risks to me. If you have missed out on the previous postings, here are the links:

  Even though I have decided to go for the surgery, I did not inform my family, as I am not quite sure whether I want to go through with the procedure yet. Intensive research ensued.

First, let's find out more about the Surgeon.

There are many horror stories on the internet how a thyroidectomy procedure went terribly wrong and all of them agreed on one common thing. An experience surgeon will lower the risks of any complications. Armed with the my Surgeon's name, I Googled.

Hmmm, He is an adjunct assistant professor with an established medical school.

Aha! Facebook! 

Hmmm. Married, with 3 kids. Looks like a serious man in his late 40s. Good good, not a young chap who will accidentally slit my throat.

Looks like my Surgeon has all the makings of a good Doctor!

On appointment day, the Surgeon looks exactly like the person I googled online. That sets my heart at ease a bit. 

Than we got down to the business of examining all the possible implications:

1) I will be on Hypothyroidism and has to be on hormone replacement medication for the rest of my life. I was well aware of that even before the surgery.

2) 1% chance of Laryngeal nerve injury. Might be higher since my thyroid gland is so big. This will lead to a change in voice, and I might not be able to speak in a loud manner. This is a pretty big concern to me since I give talks and workshop, and is insanely proud of my loud voice.

3) 1-4% chance of Hypoparathyroidism .There are another 4 glands that are attached to the thyroid gland that regulate  the calcium in the blood. Side effects of this conditions include cramping of muscles or tingling sensations in the toes and fingers. Long side effects include increased risk of kidney problems. Calcium replacement hormones may be needed on top of the thyroid hormone. This is the biggest risk my both my doctors are concerned about.

4) The usual general anesthesia, excessive bleeding risks that comes along with any major surgery.

Estimated hospitalization days: 3 days. With complications: 7 days

After explaining all the risks and potential complications, I have to decide whether to move forward with the surgery date. So as usual, the Doc assure me that I can cancel my surgery anytime as long as it is one week before the surgery. He is also going for a month long leave during December. 

Oh well, might as well plan the date and I can back out later if I want to. After considering, I decided on 20th Jan 2014. Why? Because a it is one week before Chinese New Year and in case there is any complications, I will have more time to recover. Most people don't work or want to meet me during CNY anyway and the stock market shouldn't bother me too much as it has been going up during Capricorn/CNY period for the past 5 years (I was wrong on this. The stock market crashed during CNY)

So all the wheels were set in motion for the surgery and I will have to meet my endocrine specialist, decide in my hospitalization ward class and do a pre ops checkup. 

It's time to break the news of the surgery to my family and friends.

And I was rewarded with a storm of conflicting information, advice and stories of friend of friends/ aunt/ distance relatives who were cured of thyroid through a myriad of means without needing to go through the major surgery. 

After 8 years of battling with Graves', I think I am a semi expert on this topic by now, but I must still thank my friends and relatives who took the effort and  tried to find out other alternatives to cure my condition, even though I know deep down, that many of the suggestions most probably will not work. 

In any case, the advice that made me wavier came from my sister, whom spent a longer period of time battling Graves' disease, but abate a much milder form of the condition. She had her own struggles as her pregnancies were made complicated by Graves

She said," If you were feeling great and healthy now, why do you want to take this unecessary risk? Perhaps with a healthy lifestyle, and the right kind if diet over a long period of time, might reduce the problem?" 

Her solution was indeed tempting. However, I know that her advice was based on her own condition which is not as genetically advance and mutated (anti-drug/anti-radioactive) as mine, but still, the idea was tempting for me to give it a try for a few more years.

During my next appt with my endocrine doctor, I told him.

"Doc, I feel like pulling out from the ops and observe another year or two. What do you think?"

Than I told him my idea.

He replied, "Yes, you can continue in this condition, perhaps for life, but you have had this condition for many many years, way longer than most average patients with thyroid conditions. I am sure that you have already tried many methods to try to cure yourself of this condition. If you do not do anything about it when you are younger and healthier, you will have much more problems dealing with it when you are older. On top of that, you will have a much higher chance of getting a heart condition or stroke when you are older. Having heart disease is not too bad, but stroke! That's the worst way to die! I have seen people dying due to different conditions, but trust me, I will rather die due to other disease than due to stroke. Think about it!"

After a few minutes of thinking how miserable it is to die of stroke, and having a similar experience when I was paralyzed for 3 days prior to this discuss, I can understand what he meant. 

 Steeling a my heart, I told my Doc

"Heck! Let's go ahead with the surgery. Get this over and done with!"

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