Friday, April 30, 2010

Sunday - Radioactive Girl Day 5-6

We had a little bit of a thunderstorm last night. I've never been this close to the roof before during a storm. Sitting on the end of the bed my head is but four to six inches from being outside. I was cool until my head started tingling heavily. Yeah, I broke the isolation rule, I went downstairs and sat in the big chair across the room from Jeff. There was a good distance between us the only issue was the dogs at my feet but I kept my feet in the chair with me to help maximize the space. Once the major part of the storm passed I went back to my room. I'm sure I was just being a big baby but I've had a lightening experience before, I really don't want to have another.

So this morning Jeff needed to go meet a gentleman in Austin for some stuff. When he left the dogs were still sleeping so I got to play mom for the morning. Made the pups very happy. When they got up I put them out and then made camp in the big green chair as I had done briefly the night before. OMG...TV!!!! What a wonderful invention!!!!!!!!!

After a few hours of Mythbusters, the History channel, and the Travel channel my brain had been over stimulated and I was rendered unconscious for about four to five hours. I was out HARD! It really would have been nice to know just how many Mac trucks hit me but Jeff lost count after the first couple of dozen. LOL!

Once I recovered from my long nap (and it did take some recovery time) Jeff went and picked up some dinner from Jardin Corona. A little more TV, some actual in real life chatting time with Jeff (even if it was from across the room) and then back off to bed. Tomorrow is the big scan. Cross fingers, if this goes well it could mean no more treatments and only scans every six months or yearly. There should be a large butterfly shaped uptake of the iodine in the throat area where the thyroid used to be and ideally no where else. Tomorrow will tell!


Thursday - Radioactive Day 1.2

So it's been a full 24 plus hours since I took my iodine (I-131) pills. Today I get to start my Synthroid. Yea!

My new best friend or you could say my new thyroid in a sense. Synthroid 150mcg. Every day for the rest of my life this will be the first thing that enters my body.

















Oh and don't think that "little blue pill" jokes weren't buzzing about. Cause they were.

So another great thing to this radioactiveness is I have to carry a card with me until sometime in July stating that I've had this radioactive treatment because basically until the date the card expires I'm still considered active. I will set off sensors in airports and other "secured" areas (like government building...good thing I'm a State employee :) ) I have even read of multiple cases where people have set of fire sensors in restrooms. They advised not to panic and just flush a few times (which you are suppose to do any way) and the sensor should stop. THAT could be interesting! {note to self: locate fire sensor and select stall farthest from it!}


Radioactive Girl!

Thankfully since I had an ultrasound done a few weeks ago I don't have to do all the normal paperwork all over again.

We get called back and start going over everything. So for the next seven days I have to:

  • stay at home, isolated from the general public
  • maintain a distance of at least six feet from others in the house (impossible with my old dogs so it's total isolation for their welfare)
  • sleep alone
  • no travel with others by automobile for longer than 2 hours and must sit as far away as possible
  • drink plenty of fluid. This helps move the radioactive iodine through the body.
  • no strenuous activity that may result in excessive perspiration
  • shower one to three times a day
  • prepare food only for myself
  • no kissing
  • no sex
  • limit visitors, for short periods of time (15 minutes) and maintain distance of at least six feet
  • avoid contact with kids and women of childbearing age
  • to help avoid damage to the salivary glands take sour candies (I have a butt ton of these!)
After all was reviewed and all questions answered the time has come. Stephanie instructs me on how she is going to give me my capsules and what I am to do with the vial and taking the capsules. She then, using tongs, hands me my clear vial with two long, blue capsules in it. I wasn't sure I was going to get the cap off the vial. I finally get the cap off, I forgot to take a sip of water first (like any sane person knows they should do before taking a capsule) so the capsules stuck to my tongue...blah! Done! They are down!

After paperwork is sorted we are escorted from the building and we head home. Once home, I head up to my room where I will be for the next seven days.

In the whole grand scheme of things cancer wise, as hard as total isolation may be it's not like daily visits for radiation or spending 4-8 hours a day at a cancer center having chemo infusions.

So, here I am. Alone in my room. My only contact is the occasional delivery of food and/or beverage and video chats with Jeff. This will be life for the next seven days.

Wednesday, April 28, 2010

Countdown to Radiation Girl

April 20, 2010...Well today is it.

A few things left to do on the room this morning and then we'll head over to Round Rock for my pill. I hope it's not a honkin' horse pill!

Dressed the bed, moved my clothes and stuff in, set up my candy station. I think I'm about as ready as I can be.

Here's what will be my view for the next seven to 14 days.



I hope with two quilts I'll be warm enough. Probably won't though.



The East window will get lots of nice light in the mornings.



Isn't my beautiful golden harvest wing-back chair just lovely?











And here is the unfinished window box. Unfortunately, the snoozing Licorice Whips will not be allowed to stay with me. I'm sure that will be met with much protest from her and her brother Flipper.

I can't decide how I want to finish it. I have fabric for the top. I've had it for YEARS. But the front, no clue. It has a really nice grain pattern. I can't decide if I want to just stain it, do maybe a white wash, paint it just white or what? I had thought of stencils but are stencils so like over and done? No clue. Eh, I don't have to decide now. That's for another day.




This is the night stand I was able to pick up. $15 not bad I think. And other than one spot that has a little water ring type damage it's in really good shape. It's just like my mom's and Jeff said his folks had them too. LOL too funny!

And in case you are wondering the bottle has Murphy's Oil Soap in it for the cleaning the antique furniture.

Time to start getting ready to head over to Round Rock. I probably should grab a little something to eat. Haven't eaten all day and taking that iodine on a empty stomach is probably not a great idea. More later!








Monday, April 26, 2010

T - 1 Day - Let the Countdown to Radioactive Girl Begin!

Today I focused on getting the last of the stuff moved out of the red room and it somewhat organized. Jeff helps where he can but for the most part this is all stuff I have to sort through. My stuff, Rich's stuff, mine and Rich's stuff. And the fact that I can only go a few hours and then have to take a break is what seems like keeps this dragging on forever. But I can actually see an end to it.

I tackled the the closet and then reclaimed the bed. Other than a few little touch ups tomorrow and sheets and stuff back on the bed I'm calling it done! For the purpose of isolation that is!

At least some good will come of this. We've reclaimed this room for actual usableness (is that a word? Is now! LOL) and I put together 3 boxes to go to charity. Two over stuff boxes of clothing and one of "stuff."

This tired girl is going to bed. Tomorrow is a big day.

Day 16-21

So now we wait. Hopefully the lab results will come back to day and everything will be where they want it.

Sure enough the nurse calls later in the afternoon saying that my TSH levels are within range of where Dr. Blevins wants them so he has ordered my radioactive iodine treatment. The orders have been sent over to radiology guys and they will be contacting me to arrange the treatment.

Well, I guess we are doing this! And I need an isolation room. Hmmmmmm....the only other room with a bed is the red room and well, it's been used as a ransacked storage room (as has blue room) for........ 11 years??? Guess I better go check it out and start formulating a plan of attack.

I decide to be brutal. Do I really need it? Rich's items are really the hardest. Were they things he loved or things he'd picked up that someone had left behind in an apartment when he lived in Baytown? A lot of things we had already moved out of the boxes and into every day life so boxes just needed to be consolidated. Oh this is tiring.

A lot goes to trash. Bag after bag after bag goes to the trash bin and box after box gets tossed out the window.

Finally the radiology scheduler calls! She has two appointment options for my treatment, Friday, April 16, or Tuesday, April 20. Since Jeff has a meeting he HAS to attend and a recording session with the band on Friday looks like Tuesday is the better option. So I schedule for Tuesday to receive my radiation pills and setup to have my follow up scans on the following Monday (April 26).

Well, this pushes my return to work back. I feel bad. It's tough on the team when they are a person down. But this will get the treatment done and over with so that it will make life easier down the road. The good thing is at least I'm not having to stop meds, having to wait for my levels to rise then doing the treatment.

Okay, back to the room. I have a bed and a dresser in there that belong to my great-aunt Sallie. It's the same bed I slept in when we lived on Pine Street in Georgetown, my grandparents old house. We lived there after we moved off the dairy before we moved to where Mom and Dad are now. That bedroom set is at least 60-65 years old if not older.

Anyway, a night stand and a chair would be nice. Something more to sit on than just the bed. It would be nice to finish off the window box. Rich built the frame work and never made a lid for it. But I'm not going to push it. Just getting this room cleared out is going to be chore enough.

Whoohooo! Chair found! A beautiful 70's harvest gold floral print wingback chair! It's an awesome chair but clashes hideously with...EVERYTHING! But then, that's what slipcovers are for! LOL!!!!

More bags and boxes gone from the room. Wow...there's a floor in there!

Sweet! Night stand found! OMG it's the same style that my mom had and Jeff's parent's had them too! LOL!!!

Goodwill has def paid off. I paid way more for the chair then I should have but it is in really good condition.

Huh...I have way too many unfinished crafts. And apparently I was big on decorating for Christmas at one time. I have a ton of Christmas stuff I've never used and a ton of stuff I haven't used in...huh? When did Tony spend Christmas with us? '98? '99?

This is tiring. I get tired easily. I'm usually good for a few hours and then I have to rest for a while. I just have to hold out for a little bit longer and then I can start my meds and eat. The room is starting to come together nicely.

Friday, April 23, 2010

Day 15 - Lab Day

Well today I have to have blood work done to see where my TSH is at. TSH stands for Thyroid Stimulating Hormone. If my levels are high enough they will push forward with my radioactive iodine (I-131/RAI) treatment. Since it is believed that the cancer was still well contained within the thyroid and had not spread they want to move forward with the treatment before I start any thyroid replacement meds. If I start the meds before the treatment I'd have to stop them and be off of them until my they cleared out of my body and my TSH levels were able to rise. Plus since they are so certain this was caught early get the treatment done and get one with LIFE! I like that idea. A lot.

So we head into Austin. Jeff needs to spend a little time at the office checking in and seeing how his team is doing. So I drop him off and head over to the doctors office to see the vampiress. Man, I have not driven in SO long. It was kind of weird. I get over to the office and get the blood draw all done. But this time it's late mid-morning and I am starving! I went in fasting because I didn't know if I needed to be or not so I figured better safe than sorry. I knew there was a grocery store near by so I went over there. Turns out it was a Randall's. Smallest store I have been in in a LONG time. And they didn't have crap. Well let's just say at least nothing I could quickly and easily fit into the "low-iodine" plan. So I ended up getting some to-go peanut butter cups and some apple slices and a peach. I spent OVER $8. Insane! But I was really needing something badly so I slide my card. Randall's has always been higher than anywhere else and this just proved it. And let me tell you that peach was HORRID! All bruised and nasty. It looked great but it was far from it....far from it! So I ate about an apples worth of the slices and a whole little thing of the peanut butter. I wanted some milk something bad, and would have normally be what I went for...but couldn't.

So I started winding my way over to Burnet road and back up to Jeff's office. We headed down to the HAM store to pick up a couple of items and then headed home. But being the awesome hubby that he is he could tell I was either hungry, tired or both. Despite how much I said I wasn't. Everything I said was followed by "I don't know." We head over to Opal Divine's. I know I can get a salad there that will fit well within the guidelines I have to follow.

Afterwards we run a couple of errands and head home. I'm one tired girl and ready for a nap.

Thursday, April 22, 2010

The Shopping List

So what WAS on that list? Well here it is. This was stuff that focused on just me, not the family as a whole. Those items were on a different list. All items purchased were reviewed for whether or not they would/could fit in the guidelines of the low-iodine diet.

Almond milk

Ezekiel bread

Fresh chicken

Almonds - unsalted

Cashews - unsalted

Walnuts - unsalted

Pistachios - unsalted - good luck finding these easily

Hazelnuts - unsalted

Nut butters - unsalted

fresh veggies - no spinach

fresh fruits

Pasta with no salt or eggs

potatoes

Cereal -

cream of wheat

Oatmeal

Sorbet - natural, not colors or salt added

7-Up

Honey

Apple sauce

Unsalted Matzo crackers

“Butter” - if made with olive oil and no salt

salad vinegar

salad oils

Orzo

garlic

Avacado



Wednesday, April 21, 2010

DAY 10-14

So I got a shopping list together and we went shopping. We really hadn't done a full grocery shopping trip in a while so it took a little while. By the time we got done, home, and unloaded I was a tired girl. So we put away the things that needed to be refrigerated right away and the rest could wait until tomorrow.

I made the portobello mushrooms and chicken recipe from the low iodine cookbook. I added some extra veggies to it and it was REALLY yummy.

I've kind of spent these days learning to read myself again. Senses are not my norm. My lungs are pretty much cleared and opened back up. I still work on my deep breathing. It really sucks in the beginning but it is a very important necessary thing. Americans and westerners in general tend to be very shallow breathers. With every surgery or hospitalization I've had as an adult I've always tried to put deep breathing first. Not only do you get more oxygen to your cells but you help keep your lungs open and able to clear themselves better after being on machines, whether you were tubed and breathing on your own for airway management or were tube and the machines were breathing for you. The sooner you can get your lung happy, the sooner you'll be back to happy. Anyway...

I'm having to relearn myself. What am I feeling? Am I tired? Am I hungry? If I don't feel hungry, when was the last time I ate? What did I eat? What was I doing? Hey look, a bunny....
Every thing is a new feeling. And Jeff tends to get it right about half an hour before I do. By the time I figure it out I seem to be standing in the doorway of the study saying "I don't know, I don't know...I danna no." I either need to eat, rest, or take a nap or a combo of all three.

I have found that it takes me a few hours to get going in the morning. But once I do I feel pretty great for about 2-3 hours. And even if I don't do anything more than shuffle through some stuff, go let the chickens out or watch the deer in the yard, after a few hours I need to chill.

I still have to remember that I am just a week out from having surgery. My body is still healing an settling into the fact that I no longer have a thyroid running things. It's looking for hormones that are no longer present. Let's cross our fingers that the blood work next week comes out favorably.

Day 9 - Low Iodine Diet

Okay so, Dr. Blevins said I needed to start the low iodine diet so that when I do get to my radioactive iodine (I-131) treatment if there are any thyroid cells in my body they will be "starved" of iodine and will gobble up the radioactive stuff. That's basically the gist of it anyway. Now, this is a LOW iodine diet, not NO iodine so a little is okay. Iodine is naturally found in foods. Some have more than others but is not something that is labeled so it's not really a easy thing to measure. I have a feeling this will become a major pain in the buttocks!

So just what does this involve? Well, let's take a look shall we...this is taken from ThyCa.org (with commentary from me). This is not to be considered the complete list and is listed to give an idea of what is involved with this diet. For the complete list, with the removed iodine info counts please visit www.thyca.org and review the low iodine diet.

Things to AVOID

  • Iodized salt and sea salt and any foods containing iodized salt or sea salt. Non-iodized salt may be used. For example, Kosher salt is okay unless the label says that it is iodized or sea salt.The reason to avoid sea salt is that all products from the ocean tend to be high in iodine. One teaspoon of iodized salt has 400 mcg of iodine.
  • Seafood and sea products (fish, shellfish, seaweed, seaweed tablets, kelp). These are all very high in iodine and should be avoided.
  • Foods or products that contain these sea-based additives: carrageenan, agar-agar, algin, alginate, nori (these food additives are seaweed by-products). Carregeenan I ran into in my non-dairy coffee creamer...meh
  • Dairy products (milk, cheese, cream, yogurt, butter, ice cream, powdered dairy creamers, whey, casein, other dairy products). Note: Nondairy creamers often have iodine-containing ingredients, too. A study published in 2004 in the Journal of Clinical Endocrinology and Metabolism reported on tests of 18 brands of milk in the Boston, Massachusetts area. It reported that 250 ml of milk (about 8 ounces, or 1 cup, or 16 Tablespoons) contained from 88 to 168 micrograms of iodine and averaged 115 mcg. It noted that sources of iodine in milk include iodine in cattle feed, the products containing iodine used to clean teats and udders, and a small amount from equipment cleaning products. (Some low-iodine diets allow very small amounts of milk or other dairy, if not listed in the first three ingredients on a label. There is no dairy in any of the recipes in they thyca cookbook.) Growing up with a ranching and dairy family yeah I know exactly what's involved so...yeah...I may just kill someone without my Moo juice man!
  • Egg yolks or whole eggs or foods containing whole eggs. Egg whites are acceptable, because they contain little or no iodine. (Some low- iodine diets allow foods with very small amounts of eggs, if not listed in the first three ingredients on a label.) Okay this one I draw the line at, I tend to have allergic reactions to JUST egg whites, this is going to be a long enough ordeal without having to deal with the nauseousness of JUST egg whites. Plus my eggs come from my hens so...if I want eggs, I'm eaten me MY eggs! I'll be good else where!
  • Commercial bakery products. Avoid bread products that contain iodine/iodate dough conditioners (usually small bakery breads are safe; it’s best to bake it yourself or substitute with Matzos). If you read labels closely, you may also be able to find crackers made only with flour and water. Matzos...so I can have communion crackers? Awesome!
  • Red Dye #3. However, Red Dye #40 is OK. We suggest that you avoid red, orange, or brown processed food, pills, and capsules. Many red, red-orange, and brown food dyes contain iodine and should be avoided. The problem with food colors is specific to Red Dye FD&C #3 (erythrosine) ONLY. However, the problem is that some food labels do not specify which red dyes are used. Better safe than sorry. Please always check with your physician.
  • Most Chocolate (for its milk content). Cocoa powder and some dark chocolates are permitted. Check the label for other ingredients not allowed on the low-iodine diet. The ThyCa cookbook has recipes with permitted chocolate. NOOOOOO! Not my chocolate!!!!!!!!!!!!! Okay, I'm a really dark chocolate girl, but I will give it up to have an egg if I need/want it.
  • Some Molasses. Avoid if sulfured or blackstrap, which is concentrated and has a bitter taste. It's okay to use the milder, fairly sweet unsulfured molasses usually used in cooking and that is the type most often available in grocery stores in the USA. Sulfur is not related to iodine.
  • Soybeans and most soy products (soy sauce, soy milk, tofu). However, soy oil and soy lecithin are both okay. All this time "health experts" and the like have been pushing soy and for someone with a thyroid condition it's one food that should be avoided. Buggers
  • Some beans besides soybeans.The National Institutes of Health diet says to avoid these beans: red kidney beans, lima beans, navy beans, pinto beans, and cowpeas. So that leaves me black beans and anasazis and lentils...okay I'll survive.
  • Some diets diets say to avoid rhubarb and potato skins. The inside of the potato is fine. Wish I had some of Rich's mom's green rhubarb!
  • Iodine-Containing Vitamins, and Food Supplements. Also products containing iodate or iodide. Check the label and ingredients and discontinue completely if iodine is included. Most vitamins with minerals contain iodine. I gave up trying to find one that didn't have it
  • If you are taking a Medication that contains iodine, check with your physician.

These items should be "LIMITED"

  • Fresh meats. Up to 5 ounces per day of fresh meats such as chicken, beef, pork, lamb, and veal are fine. Whole cuts tend to contain less iodine than do ground meats. Also, check the package label on meats, including whole turkeys, turkey breasts, turkey cutlets, chicken, and all pork products. Many food makers inject broths into turkey or chicken or pork. The label may not indicate whether the broth contains iodized salt. If you are not sure, go to your local butcher for fresh turkey, pork, or chicken. Well I have fresh beef from our ranch so I KNOW where that meat came from. The pork is from wild hogs at the ranch so I'm pretty sure I know what they've been eating too, so other than poultry I'm good to go!
  • Grains, cereals. Up to 4 servings per day of grains, cereals, pasta, and breads without iodine-containing ingredients are fine on this diet. The iodine content depends on the iodine content of the region where the grain was grown. Homemade baked goods and cereals are best on this diet. If you use processed foods, read the labels carefully to avoid iodine-containing ingredients. Also, remember that labels are not always accurate or up to date. GREAT
  • Rices. Like grains, rices vary in the amount of iodine depending on the region where grown, so rice should be eaten only in limited amounts. Some low-iodine diets recommend avoiding rice. Basmati rice has been mentioned as the best for the diet. So...no sushi

Also...Although restaurants generally use non-iodized salt, it is not possible to know whether a particular restaurant is using iodized salt or sea salt. The manager or serving staff may not know what product is being used, or whether butter or other dairy products are present in foods. The ingredients that chain and fast-food restaurants use may change.
Therefore, we suggest that you avoid restaurant foods other than plain juices or soft drinks, or the inside of a plain baked potato. For most restaurant foods, there is no reasonable way to determine which restaurants use iodized salt. Avoid if in doubt. So...I can have an undressed baked potato and tea. What about a salad menu? Oh wait...let's not jump ahead.
So, what can I have?

Mostly fresh, low-fat, low-calorie foods. Because of this, following this diet greatly reduces the tendency to gain weight while hypothyroid. That is a plus.

The following foods and ingredients are fine to eat. You do not need to limit the quantity, except as noted.
  • Fresh fruits and fruit juices, except rhubarb, maraschino cherries (if they contain Red Dye #3), and fruit cocktail with maraschino cherries.
  • Vegetables, preferably raw and fresh-cooked or frozen without salt. (But not skins of potatoes, soybeans, and, according to the NIH diet, some other beans like pinto, lima, navy, red kidney, cowpeas).
  • Unsalted nuts and unsalted nut butters.
  • Grain/cereal products in moderate amounts (see above).
  • Fresh chicken, beef, and other meats in moderate amounts (see above).
  • Sugar, jelly, honey, maple syrup, and unsulfured molasses.
  • Black pepper and fresh or dried herbs.
  • All vegetable oils. Salad dressings provided they contain only allowed ingredients.
  • Homemade foods (see the free Low-Iodine Cookbook from the ThyCa web site.) The Chicken and portabella mushroom dish I fixed was nummmy!
  • Cola, diet cola, lemonade, sodas (except those with Red Dye #3), non-instant coffee and tea, beer, wine, other alcohol.
Food prepared from fresh meats, fresh poultry, fresh or frozen vegetables, and fresh fruits should be fine for this diet, provided that you do not add any of the iodine-containing ingredients listed above. The cookbook also has a handy snack list.

A Final Note
The key to coping well with this diet is being prepared ahead of time, especially if you are preparing for RAI by stopping your levothyroxine pills and becoming hypothyroid. Before you start becoming hypothyroid, prepare the basics and freeze. You do not want to be making chicken stock while you are hypothyroid.
Remember also the handy snack list. We suggest that you stock up on snack items from the list for times when you do not feel like cooking.
Let me tell you they ain't kidding. You may think you are doing great and get into something and then..BOOM!...you turn into a sloth and EVERYTHING takes a million times longer to do.
So I guess it's time to make a shopping list and get going!

Thursday, April 8, 2010

Day 8 - Doctor Day

So today is one week post surgical follow-ups.

Saw Dr. Blevins first, the endocrinologist. He hadn't gotten a copy of the pathology report yet, but because my nodule on the left side that we know for sure had cancer is right at the deciding size for whether or not radioactive iodine (I-131) is done I'll have to take it. There was a small chance that I might now have to but because it is right at that line, I have to. He said I was looking good and wrote me my first script for Synthroid. Which will now function as my thyroid for the rest of my life. I'm not to take it yet, but I take it the day after I take my radiation pill.

Because of my ER visit the other night we know what my TSH level was on Thursday, but he wants me back in a week to do blood work again to check my TSH and other stuff. Depending on how those come out he may push my I-131 treatment up. Could be a whole month and a half sooner than expected. ooooh I am no where near ready for that! But we will face that when we know more. He also gives me a lab slip for blood work for my next appt in a couple of months.

In preparation for the I-131 treatment he wants me to follow the low iodine diet starting...now and directs me to www.thyca.org. Been there, I glanced over it but didn't really read in depth. Guess I know what I'm doing tomorrow.

We check out and since we didn't grab anything for breakfast we are both starving we decide to head over to Mighty Fine for some tasty burgers. I know I'm suppose to start that diet now, but um....yeah no clue on what the guidelines are so it will have to wait until tomorrow till I can research it.

We get to Might Fine and luckily beat the lunch crowd. We get yellow cheese burgers, split a fry ( there is no small, medium or large it's just fries and lots of them!) get a couple of drinks and split a chocolate shake.

Because I'm only one week post surgery it's still a bit difficult to swallow. I have to be careful as to not take to large a bite and have to have plenty of liquids to help make sure things move down. The cold, thick, shake not only feels really good on my throat but helps in making sure things don't get "hung up."

I was so hungry, other than part of the bun I ate the whole thing. AND IT WAS GOOOOOOOOOD!

Time for the next doctor appointment. We gather up and head over to Dr. Kriesel's office. He too agreed I was looking well. The pathology report was in and there was cancer in BOTH lobes. So as much as I didn't want to do it it was good that I didn't fight too hard in taking the whole gland. Had I, I'd be finding myself back in the hospital going back into surgery to take the other side. Both lobes shows Hashimoto's thyroiditis/disease (which we just learned of in December/January...I'll get more into that later) and one side had a parathyroid or let's say a small piece of one. He said that my thyroid was very firm and fibrous which ties back to the Hashimoto's. It was very much a gland that had been under attack for a very long time, probably the majority, if not all, of my life.

But in the end the margins were very clean and they did take 1 lymph node which came back as clean also so they feel very sure that it was caught early and should only have to do one round of the I-131. But the full body scan that is done after the treatment will be the deciding factor on that. So stay tuned!

He removes my steri-strips. Which I am so happy about because they starting to come off on their own and are itching and driving me crazy (which isn't a long drive mind you). He laughed because when they start getting to that the body is ready for them to be gone. He gives care instructions and instructs to keep it slathered (his word) in Neosporin or the like. We're done, he wants to see me back in a month, but if anything changes or happens to call. We set the next appointment and head out.

Jeff is very good at monitoring how I'm doing. He can tell, even better than I can I think, how my energy levels are. But still, he let's me weigh in on it. LOL! He asks if I'm up for a few errands, and I am. If I do run down I can always take a nap in the Jeep.

So we pop over to the Apple so store so that he can check on an issue with is iphone, which turned out not to be a real issue so that was fast. Jeff asks if I'm up for a drive. By that time the sun is starting to come out a bit so a drive would be nice. Getting out of the house is really a nice change and I can always take a nap if I need too. So we head off to boundaries unbeknownst to me.

Along the way a sunbeam catches me and I do nap off and on as we drive south. I awake to find a large mountain covered in animals with a bright yellow piper cub hovering over it...for as long as I'm up to it. Ah Cabela's!

I find me a new 12 gauge shotgun I would LOVE to have but at $1500 is a wee bit out of my price range. But OMG it was the lightest 12 gauge I have ever laid hands on. It's an Italian made Fausti and beautiful. Jeff gets some ammo for the Mosin, which they had like a dozen or more Mosin's on the rack for $149. Ours is priceless but hey if someone wanted an old Russian firearm there's the real deal man...and cheap! We wander around for a bit, then I hit my wall and am done. We check out and head for home.

We stopped for dinner in Round Rock that way we didn't have to worry about anything once we got home and I could just snuggle up on the couch with my Bou and watch TV or snooze.

About 10 minutes of TV time and I was out like a light.

Day 7

And on the seventh day...even I rested. We didn't do much of anything. Jeff made breakfast, and we vegged on the couch watching rugby and football games.

Have doctor appointments tomorrow...big day.

Day 6

Saturday was a very busy day. My arm was feeling a bit better. It was such a pretty day, and there were errands that needed to be run, and I could use the sunshine...gotta get my vitamin D for that calcium!

I decided to get some Viactiv calcium chews last night at the pharmacy. It is getting hard to even think of putting another Tums into my mouth. So I got the little chocolate chews and while they aren't the tastiest they are better than the peppermint chalk. Plus they have vitamin D and K and while my issue isn't absorption the absorption help can't hurt.

So what's the deal with the calcium? Well the parathyroids sit behind the thyroid and they are the glands that control the amount of calcium in the blood, in the bones, tell the bones to release it or not. The little paras are sometimes in the thyroid so they have to be taken out, cleaned off and reconnected. Even them getting moved around can cause them to be a bit persnickety.

We decide to head out and get our what-nots done until I call it quits. My hands are still tingling off and on but for the most part, I'm a bit tired but over all feel okay. Our first mission is to get some new chairs for the yard. We head into town and decide to stop by Mom and Dad's since they are just a mile or so from Home Depot. We head over and get a few new chairs and then decide a nice drive would be in order since I was still feeling okay. So we drive over to Taylor to the Taylor Meat Market. We needed some bacon. Now you might think that's an awfully long way to go to get some bacon, but it is about the freshest bacon you can get. But unfortunately, being it was the end/first of the month they had been cleaned out. There wasn't even any in the back they could slice up or anything, but they did still have a little of the smoked black pepper bacon so we got some, a few weenies and a bit of summer sausage. Aaaahhh childhood happiness all wrapped up in butcher paper. Num-num!

We head back to the hill. I was still feeling pretty good so we decide to hit half price books in Cedar Park. And it hit me. I suddenly drained and worse, my fathers statement of how as my TSH levels rise people will irritate the living day lights out of me. Boy was he right. By the second little episode of...let's just call it stupidness, I found a chair a few rows over from the books I was interested in...thank you stupid couple for making the air in the area I wanted to be UNBREATHABLE! I sat and kind of chilled, after a while Jeff came and found me and we checked out and headed home. I was so ready.

I was so done. Jeff set up the new chairs in the yard and we sat out there for a little bit then went in and I crashed on the couch. I was one tired girl.

Monday, April 5, 2010

Day 5

Friday we slept late. Once we did get up, my arm was still in so much pain. I got a little breakfast and just curled up in big chair for a while. I called the ENT's office and talked with his nurse for a while. Then I called the Endo's office as I still did not have a post-op appt with him.

With in a few hours I was totally exhausted. I curled up in the big chair with my quilt and teddy bear and napped for a while. When I woke, we decided that we'd go into town and have my pain med script filled. Maybe it would help the pain in my arm.

It was my first trip out of the house since surgery so we hit the pharmacy, ran over across the road to Target for a few items, then grabbed some dinner before heading back out to the house. I took a pill and we watched tv for a bit then went to bed. After last nights' late hours and adventures we were both pretty exhausted.

Saturday, April 3, 2010

Day 4 - ER from Hell

Thursday found me basking in the glow of the morning sun yet again. Other than the one little spell during the night I felt pretty good. I kind of think that I'm becoming addicted to my ice pack. Is that a bad thing? I'm only suppose to use it for 20 minutes every hour but it really does make my neck feel so much better that I find myself leaving it on for much longer. Even sleeping with it. I know the whole deal with ice packs for too long but it feels good. See I told you I was addicted.

The internals of my throat are off and on still pretty sore. I have to be sure that if and when I eat something that I have plenty of fluids to wash it down with. I had a little piece of lemon pound cake and didn't have enough milk or water with me and it really scratched things up. I'm not sure if the cake was made out of sand paper and wood shavings or it was me just still being raw. Either way, the cake was nummy but my throat is super raw now.

I have to eat Tums several times a day to ensure that my calcium intake is up enough to ensure that the parathryoid still have enough there to work with in case they continue to be finicky with their best fried being gone now. A Tums at the end of a rock night was like a bedtime treat. Right now, just the thought of one of those peppermint buggers just makes me taste bluk.

I spent most of the day snoosing and lounging about the house. I washed a few dishes but that was about it. Flipper, my old lab, does not let me go far without him.

The hospital nurse called to check-up on me to make sure that things were going well. I told her of my little leg spasm spell from the night before and agreed that it could have been a calcium drop that caused it and agreed that I had done the right thing by taking more Tums. And the fact that I was able to fall back to sleep was a good thing. But if it happened again and didn't resolve or got worse or I had the tingling/numbness in my hands, arms and/or legs or feet and/or my face and around the lips that I needed to go to the ER. The low calcium signs were a big part of my discharge "review" so I was pretty aware of them and had been instructed by the nurse that going to Brack would be the best but since we live in Liberty Hill that the closest ER would be best. Just tell them that I had my thyroid out and the symptoms I was having. They'd know what to do.

We ordered pizza for dinner and I actually managed to eat a whole piece. It took forever but I did it, but I was exhausted from all the chewing too. Eating should not be an exhausting venture. The fat kid in me is very confused by this. It's one thing if you are having to hang out in a tree with a knife in your mouth and attack a passing critter. But taking a slice of pie out of a box from the local pizza shop and eating it should not wear one out. Ya know?

We spent the night watching tv and just chilling. Shortly before 10:00 pm I noticed that I was having spasms in my right leg. I stretched a bit but noticed that it was not going away so Jeff went and got me more Tums. Bluk. I figured it would do the same as it did the night before. Over the next hour my right hands started tingling, then my elbow. Let me tell you, that was the freakiest thing. My hand was tinging and my elbow, but everything in between was normal. Weird. Then my left temple started the tingle before long my left hand and elbow started the tingle thing. But the good was, my leg had stopped spasming. Yea! But after over an hour, it was decided time to head out to the ER. Better to be safe than sorry. Plus those had been the instructions more than once.

We load up and head out, debating which ER to go too. The two closest ERs are Georgetown and the new Cedar Park. We decide that because when I went to Georgetown in May due to a 105 degree temp and they focused more on an elevated blood sugar level than what may have been causing a 105 temp. Being told, "Eh, fevers are fevers." I kind you not, that is what the PA told me. I may hold the lowest of medic certifications but when you start getting to the 104-105 degree level that's NOT normal! But I digress...

We decide to go to the new Cedar Park hospital. They shouldn't be busy, like Brack would be, so we should be able to get in quickly and get good attentive care. Plus we could be there in minutes, as to almost an hour for downtown Austin. When we get to the hospital we began wondering if we'd made the right decision as there was a huge multi vehicle accident at the main intersections in front of the hospital. We get around to the ER and as we have figured it's pretty deserted. If you didn't know the hospital was open you'd be hard to tell that it was.

We check in and it wasn't long before we get called back to triage. That was pretty standard and we get a room. I'm not really thrilled with having to totally undress but I know the drill and don my lovely gown. It was just a few minutes and the doc was in. I thought to myself that this is awesome and we'd be getting down to business and hopefully getting this irritating tingling to stop. He comes in and asked so what do you want tonight? Wow...I was a little taken back I don't know anyone that would start a patient assessment like that. So I start in that I had a total thyroidectomy on Monday and I started having....."Why'd you do that for?" (Cause I thought it'd be a cool thing to do to rip my thyroid out for no reason....keep smart-assed comments to self....) had thyroid cancer....so I started having...."what kind?" papillary thyroid, so I started having spas..."What made you think that?"

Seriously!?! Am I not going to be able to get through a single sentence as to what has brought me in here? I was always taught to find out what brings your patient to you, then get a history to build on it from there. Have I been doing it wrong all these years? Was every speaker I picked for a patient assessment class for the EMS conference wrong too? This dude really sucks....

I, in a way, give up. I gave a short little answer that an unexplained weight gain lead to the find of an enlarged thyroid, had an ultrasound, lead to biopsy, cancer, surgery. And yes that's about exactly how I put it. The doctor left the room to got do something. By that point I really wanted to have nothing to do with him. As we sat there, I debated hard of just getting dress and leaving. Jeff mentioned that we could have been at Brack by now. But we both decided that if we could get to why were are here then maybe we can get somewhere this doc. So the doctor comes back in, sits down and starts talking about how I was hypothyroid and blah blah blah...um no. I never said anything about having a history of being hypo. In fact, I have NEVER been hypo. They highest TSH level I have ever had was 2.6. By this point Jeff and I are both ready to just walk out. Is he not believing that I actually h thyroidectomy ad a? Yeah my incision is not in the traditional place but let me lift my neck you can easily see the steri strips and oh hey would he like to see all my admission and discharge papers? I told the guy that my discharge instructions were if I had tingling in my hands, arms, feet, legs or face that I was to go to the ER and have my calcium levels checked so that's what I was there for. He leaves and the RN comes in.

And the circus continues. Now I'm sure she's a great person and from our little bits of conversations I can easily see the older rural paramedic turn RN for the money. But where did she get that I'd had my thyroid out because it had stopped working? She explains that doctor dude has ordered blood work and that they like to go ahead and put an IV cath in so that in case they end up having to run an IV or something then there was only one stick involved. In the grand scheme of things that sounds great.

So while she spends her time gathering the necessary items to put in the line we chat about my surgery and why and all the what-nots. I'm thinking we'll get the levels checked and things will get better. BOY WAS I WRONG! She sits down and takes my right hand and starts tapping around. I strongly advice again using that had has it was not very cooperative just a couple of nights before and it had to be aborted and that was with a MUCH smaller needle. Apparently I was talking but no words were coming out. She repeats a few times that she can see where the vein starts and stops and feels confident about it. I again express that it was not going to be a good location. So in she goes...

Now you have to understand I have a very high pain tolerance. I have had MANY sticks in my 40 years. I have not screamed for it to be stopped since my very first blood draw was done at the age of 4 or 5 with a bent needle. I have had numerous surgeries, blood transfusions, donated blood, donated plasma, blood draws, IV fluids and what-nots so sticks are not new nor something that general scare or bother me. But after a few minutes of this woman digging around on my hand the pain got to be too much. I told her if she didn't have it by then she needed to stop...she kept going. I sucked it up a bit longer, but then the hot flashes started and I knew if hadn't gotten by that point ENOUGH. I again asked her to stop. She didn't. I expressed repeatedly that the pain was getting to be too much and that once again, that hand was not a good place to attempt a line. She kept trying to get it. THANK GOD someone stepped in and told her that they needed her for the crisis team. That made her pull out. I was done. My head was spinning, I was sweating profusely, the room was fuzzy and the dark tunnel was starting to close in. But as she headed out, she asked the other chick to put in the line. Maybe she'll get it first try. But first, I have to lay down.

She gathers her stuff and sits down at my left arm. She starts taping around. I've had IVs, transfusion lines, blood draws from the forearm, sucks but is generally tolerable. Okay...big pinch. Good gawd this hurts. Breathe, breathe, this will be over soon. The more I try to block it out, the longer she keeps digging. Relax..relax....relax....oh my gawd how long is she going to keep digging at this? Okay chick, this is getting to the point that I can not take this pain any longer. Yet she keeps going. The room becomes hotter than hell, oh here comes that tunnel again. I begin begging her to stop. But she doesn't. Finally after much begging and pleading she pulls the needle out of my arm.

I have Jeff pull my socks off because I am dying from the heat. I know I'm the only one feeling it but good gawd, I'm sweating buckets. She decides to "inspect" my veins. Just as the first RN comes back she decides to go for the old stand-by, the crook of the elbow. The tunnel is closing, I'm thinking okay, I know the veins there are very good, this will be over quickly. OMG I was SO wrong!!!!!! Holy cow I thought the first two attempts were bad. The pain was 20 times worse! I'm trying to relax, I'm trying to stay calm, I'm trying so hard not to scream, I'm trying not to shake, I'm fighting the tears back, I'm trying not to curl up into the fetal position. I've expressed over and over how badly. I can feel Jeff beginning to boil. I finally plead that if they don't have it yet to please stop. Almost they say. Almost? You've been digging on my arm (this round) for five minutes. Gawd, PLEASE tell me you are in. The pain radiating through my arm was immense. She goes to tape and tie it off, tugging at it with every move and has the gall to question why I wince in pain. It felt like she was ripping the vein out of my arm. Jeff made it know just how he felt about the whole ordeal.

Finally they were able to draw the blood. I won't even go into the archaic method they used. No, I've ranted on how bad, I might as well finish the nightmarish tale. They opened the line, let you bleed out on to some gauze for a while, then used a syringe to collect the sample, then transfer that into a tube. Finally they left the room. I lay there traumatized. My arm was in excruciating pain, shaking, tears rolling down my face. So regretting not following my gut and leaving for Brack. After a few minutes in bopped Ms. Perky RN. They needed more blood, they'd not taken enough the first time. I know the line is taped off but it felt like she completely spun the line in my arm when she opened it to let it start bleeding out for a while. Once she got what she need, right before she bopped out of the room again she did promise to take it out just as soon as she got word that she could. The labs usually take about 20 minutes so it would hopefully be soon.

As I laid there, the pain radiating up and down my arm, I felt so vulnerable. Suddenly it all came back. I knew this pain. The pain in my arm, the pain in my heart, that gut wrenching pain. That was exactly the same pain I had when I was getting transfusions and the nurse strapped me to arm boards, on BOTH arms, then no one would come check on me when I started having pains. It wasn't until we got them to understand that there was a HUGE bubble forming that they bothered to come check it. Yep, the vein had blown. The pain I had now was the exact same. I had Jeff check to make sure nothing was wrong with my arm. I laid there for the next hour and a half breathing through the pain. Finally the doctor comes in. Calcium is fine, magnesium was low, TSH was high (for normal testing purposes - and um duh, I no longer have a thyroid) and my glucose was high. Well, had you done an intake assessment you'd know why it was what it was but you didn't so, that is not a factor to the issue for which I am here. Soooooooo...nothing you can do to stop the tingling. Although, you have managed to distract me from the tingling in my right hand by the pain in my left arm. I was to follow up with my primary. Um...he meant my ENT but I wasn't going to go into that for the seventh time. I just wanted out of there.

After a while the nurse bought my discharge papers and finally took the line out of my arm. I got dressed and we left. I believe as we walk out the doors I spoke the same words that I did 35 years ago. Don't EVER take me back there!

It was well after 2:30am by the time we got home. I curled up in the big chair for about an hour before I'd come down enough to even begin to get any sleep.

Day 3

Wednesday found me awake with the sun. The day found me snoozing in the big recliner downstairs. My tummy wasn't the happiest for not having eaten more than a little pudding and apple sauce in two days. My lungs weren't so happy either, but I kept working on my deep breathing. That caused lots of coughing. Not the most pleasant thing, but necessary.

Despite sleeping most of the day I was so ready when it was bedtime. I was awaken in the middle of the night with leg cramps. I had Jeff get me
another Tums for the calcium and soon I was fast asleep again.







Thursday, April 1, 2010

Day 2

After a pretty sleepless I started stirring around 6:30am. I was tired of watching the clock spin round. Jeff was sleeping so soundly and I hated having to wake him. But it was a good thing because it wasn't long before a 3rd year medical student, who said he was part of my surgical team, showed up to "check on me." It was your standard "med student" assessment. If he was part of my surgical team I was clueless.

There was yet another blood draw, and vitals but the best part was the IV was disconnected. The line wasn't removed, but I finally wasn't having to be constantly thinking about the position of my hand. Yea no more beeping pump!

It wasn't long before Dr. Kriesel showed up. We discussed how well the surgery went, future plans, appointments, meds, and the realization that radioactive iodine will happen much sooner than we...I expected. He took my drain tube out. That hurt like a bugger! But the best part, even though my calcium levels have steadily dropped they were still at good levels and I could go home!!! Yea!!!

It took about an hour for my nurse to get all my discharge papers in order. Once all my orders were reviewed, my IV cath removed, Jeff loaded the Jeep and my chariot arrived to take me downstairs. We were finally one our way home.

It was so nice to be home. Wasn't long before my mom showed up with lots of soft yummies for me and baked chicken, turkey and other nummies for Jeff. My brother showed up for a while. It sure was nice to be home.

Before long, it was just me, my wonderful husband, and the dogs. It was so nice to sleep in my old crappy bed. Home sweet home!

Der Tag - Surgery Day

We woke at 4:20am. Actually got out of the house sooner than expected. With almost no traffic on IH-35 we actually got from Liberty Hill to Brackenridge in 45 minutes. We didn't have to even be there until 6:30am. So technically we had 45 minutes to wait. And thus, the hurry up and wait began.

Once the money was exchanged and the last of the paperwork given to the nurses I was given a room, went through the pre-op rigmarole, got my sexy green, 4 sizes too big hospital gown, grippy socks and oh so sexy blue net cap. After
what seemed to be forever Jeff and I finally get moved to what they call "holding." There we met member after member of the anesthesiology team. They had some issues with other patients so it took some time, but they finally put in an IV line. Lactated ringers always taste nasty first off. If you've had them, you know what I mean. Once again, we wait. We were waiting for Dr. Kriesel. Like Dr. Solomon, he comes and checks on you. It's probably to get a sense of where you are before hand, but gives him the opportunity to put you at ease a bit before hand. We went over what was going to go down. I asked if he could do a bit of lipo around the neck since he was going to be in there, he chuckled and said no. Made the anesthesiology crew laugh. Next thing I knew I was getting whisked away. I didn't get to get a kiss from Jeff first but I got an I love you and that would have to do.

We rolled down hall ways, through doors. I remember sliding over onto the operating room table. It was soft and cushy and cool. Unlike that gurney bed I'd been on for what seemed like forever. I think I even commented on how comfy it was. I remember looking at the two big, silver, saucer lights over head. A lady said she was going to put my seat belt on and that was it until recovery.

I woke up in recovery hot. My nurse checked my pain levels, gave me Demerol. At least I'm pretty sure she said it was Demerol. Since I was so hot she took my compression boots off and one of my socks as I asked. I remember the eye goop stuff being extra gloppy on one eye, she gently wiped my eyes. I had a bed next to the window. I drifted in and out, I remember saying thank you a lot, any time my nurse would interact with me. She was very attentive. I listened to the conversations of the things that took place during my surgery. I could feel the sun on my face so I knew I was okay. I got more Demerol. Did I need it? I really don't know. Was the "pain" I was feeling really from the surgery itself or the intubation and O2? I could here my nurse giving a report on me again, and someone else saying, well she is a redhead so that makes sense. LOL

Talk soon shifted to that I'd been in recovery over 3 hrs and there was some one else who'd been there for four and a half hours. They brought in another lady who was very talkative. She kept saying it was so hot in there, and I kept agreeing. Remember the nurse had taken the one sock off, I was working on trying to slide the other one off with my toe. At some point I heard Starflight start up. I watched out my window to in hopes of getting to see it. Yes it's true, I may not be working in the EMS office anymore, but I still love helicopters. It wasn't much longer they said they had me a room finally. The hospital was apparently pretty packed and rooms were a high commodity.

So a chick wheels me up to my room. She and my room nurse get me settled. I kind of relax knowing I'd made it through the surgery, I still have a voice, soft as it may be, but where was my Jeff? It wasn't long before Jeff, Justin, Mom and Dad show up.
So how's I do? Well they said every thing went well. They didn't have to take any lymph
h nodes. So that means it was all (ideally) still contained to the thyroid. Yea! My incision is not in the "normal" spot. It's in the crease of my neck. Which is cool because I won't have the standard thyroid scar, and with my fat neck...the way it is now at least...you'd never see it.

So I spent the rest of the day resting, having vitals taken, getting blood draws and trying to not be too much of a pain in the ass of my loving family.

The evening and night was spent pretty much the same way. But it was just Jeff and I to ourselves. The nurse said she ordered a liquid dinner but a "soft" showed up. Turkey, a huge pile of green beans, mashed potatoes, apple sauce and vanilla pudding. My throat was cut open earlier in the day, and during that I had a tube with a balloon on it shoved down it. I was hungry but that was not what I was interested in. So I thought the pudding wouldn't be bad...boy was I wrong. Bluk is all I'm gonna say. I spent the rest of the night working on that little half cup dish of apple sauce. I finally finished it about 6:00am.