Kickin' Thyroid Cancer Phase 1: Surgery

View from the waiting room.

Yesterday at about 7:30 am I got a call from the hospital.  They were running way ahead of schedule so they wanted me to come in at 9 am instead of 12:45 pm.  We'd stayed up a little late to visit with friends who had come to bring us food and keep me distracted so we were both tired, but determined to get there and have the surgery as soon as possible.  I rushed through a shower and then packed while my boyfriend, Sean, got his shower and ate some breakfast (no food or water for me).

We pulled into the parking garage below the hospital at 9:03 am and rushed to the check in desk.  By 9:30 I'd been arm banded (Sean joked that I'd been tagged but it's not far from the truth, they ) and we got to sit in the waiting room for a few minutes.  The hospital is actually a series of buildings in downtown Seattle that are connected by sky bridges so most of the waiting rooms have great views.

About 15 minutes later, just as Sean was getting comfortable, they called my name and took us into the maze that is the inner, hidden portion of a hospital: Narrow, winding corridors packed with people and equipment.  If we hadn't had a guide I'm not sure I could have found my way.  This being my 4th surgery, I was prepared for what followed.  I always braid my hair in pigtails using hair ties with no metal because it keeps my hair out of the way.  I put my street clothes in a garment bag and put on my hospital socks with the rubberized soles, gown, robe, and hair net (another reason to braid my hair since it's easy to tuck in).

Each of the people who would be in the surgery stopped by for a few minutes.  Some to ask questions, but others just to introduce themselves (In my case, 3 doctors, 2 nurses, and the anesthesiologist).  I love that they do this.  It makes it a little less scary to walk into a surgery suite when you've already met the crowd of people waiting for you.  I also got the results of the CT they'd done a couple weeks ago; the cancer hadn't spread to the lymph nodes.

Because they were removing my thyroid they had to do a blood test before hand to check my glucose levels and they also inserted an IV.  I can usually handle all other needles but I hate IV needles because they are usually huge and for surgery they put it in the back of the hand.  She did a great job, though.  I barely felt anything and I could still move my wrist comfortably.

After they finished prepping me they walked me into surgery.  They let me keep my glasses on until they I got in the room so this is the first time I've really seen an operating room.  They are surprisingly large with a single bed in the middle of a room that's maybe 20 x 20 and huge lights hanging over the table.  It looks surprisingly similar to a lot of alien abduction movie scenes where the aliens are about to start experimenting on the human.  The room needs to be that big so there is room for all of the people and their equipment.  They got me situated on the table with a rubber donut under my head to stabilize it and a pillow under my knees.

They put a mask over my nose and mouth, first with oxygen and then with the anesthetic.  I always try to let them know that it's working so right before I fell asleep I said, "I'm going down!"  They said after they knocked me out, they would regulate my unconscious state through the IV and intubated me so they could paralyze all the muscles during surgery.  There are two large muscles (called the sternocleidomastoid) that go from the sternum out to the collar bones and then up to the mastoid bone (just behind the hinges of the jaw) that cover the sides of the neck and below that are two sets (one on each side) of three muscles called the strap muscles. All of these had to be pulled to the sides to get to the thyroid which is where a lot of the pain comes from afterward.

A couple of hours later I woke up in recovery.  It seemed like an instant to me, but I know from experience that I was probably in recovery for 10-15 minutes before I came to.  They gave me a nasal cannula (a tube that goes in your nose with oxygen) and some warm blankets. During surgery they had strapped compression devices around both my legs to keep the blood from pooling and forming clots and I could feel them alternating squeezing my calves.

Due to the surgery on my neck and the intubation it was difficult to speak at first.  It was really frustrating because the nurse (who was otherwise a very nice man) kept asking me questions like "Do you want your glasses on or off?"  I kept saying "Yes" because it was all I could eek out.  One of the surgeons stopped by and gave me a quick talk on taking care of the scar and a giant tube of antibacterial gel to put on it.

After I was conscious enough and breathing well they took off the oxygen and a transporter came to take me to my room.  I don't remember much of the trip but I was happy to see I had a small room to myself and wouldn't have to share with someone who might want to chat me up.  They wheeled the stretcher right next to the hospital bed and then had me sit up and alternately slide my hips and move my legs until I was all the way on the bed.  A lab tech came in to draw some blood so they could test my calcium levels since the tiny parathyroid glands that regulate blood calcium are located right behind the thyroid and sometimes can get damaged in surgery.

I was so happy to see my boyfriend was right behind them in the room.  I was also more happy than is reasonable to see a cup of water and a little plastic tub of red jello because I hadn't had anything since the night before.  I had him take a picture of my neck so I could see the incision.  The little tube was to drain went to a rubber bulb that would help drain the wound for the first day.  Other than a strange tugging sensation every once in awhile, it didn't really bother me.

He helped spoon feed me the jello which took about fifteen minutes because I could only eat a third of it at a time before getting tired.  Once I finished eating I sent him home to get some food and sleep himself.  By this time it was about one in the afternoon and he'd been up since 7:30 am with just a bowl of cereal and a few hours of sleep to go on.

I dozed on and off for about an hour when I noticed my right hand had started swelling.  I lifted it to see what was going on and the alarm on the IV drip machine started going off.  The nurse assistant came to check on  it and we tried to see if we could get my arm in a position where it would keep flowing, but after the third time the machine went off my nurse, Susan, decided it was time to get it repositioned.  The IV tech came in and moved it into my upper arm which ended up being more comfortable. Then Susan helped me order some clear broth, some peppermints and some bottled water from room service.  I wasn't being allowed anything solid until I could prove it would all stay down.  She also gave me a shot of heparin in my belly to help prevent blood clots from forming which is a big risk following surgery/hospitalization.

I dozed again until they arrived with my "lunch".  Since Sean was still home resting it took me even longer to eat the broth than it did the jello, but I was happy to have anything going into my stomach.  After that I rested some more while I waited for Sean to get back.  Up until about 6:30 pm I had felt fine.  I'd been up to the bathroom twice -- being in a hospital is one of the few time that people get excited about you peeing -- and hadn't needed any extra pain medication.  Then about ten minutes before Sean arrived I started having excruciating pain in my bladder.  By the time he got from the parking garage to the room tears were streaming down my face.

The hospital staff changes every 12 hours at 7 p.m. and 7 a.m. so in the midst of all the pain my new nurse (Lee) and his tech came into see me with Susan so she could hand me off.  They gave me my first dose of percocet but it didn't help at all so the tech helped me into the bathroom.  They make you pee in a measuring cup that is set inside the brim of the toilet (they call it a "hat") and I nearly overflowed the cup.  I'd been to the bathroom only 45 minutes before but between the broth and the IV fluids I guess I'd gone from empty bladder to excruciatingly full bladder before I could tell my bladder was even filling up.  Thankfully this was the only significant pain I've had.

After this it was time to eat dinner.  I begged Lee to bump me up from clear liquids to the all liquids menu so I could have some pudding with my broth, but he said he thought I was doing well enough that I could have some soft food, so along with the pudding I got some mac and cheese and a mug of chamomile tea.  Sean helped me eat my dinner then sat with me for about an hour while I read a bit of a book I'd brought. Then the tech who had helped me to the bathroom got me up for my first walk since the surgery.  We went down the hallway to a nice area with floor to ceiling windows and a great view of the city, then back to my room.

A little after 9 pm I sent Sean off home again.  In the weeks leading up to the surgery I'd been worried about staying in the hospital overnight by myself, but between having a room to myself and the staff making me feel so comfortable I decided it would be mean to ask him to stay in the tiny uncomfortable recliner with the staff coming in every hour or two to check on me.  He got me situated and then left for the evening.

Overnight they came check my vitals every couple of hours so between that, more pain meds, bathroom breaks and another shot of heparin I didn't get much sleep.  In the middle of the night one of the compression cuffs got twisted around and was causing my foot to flex every time it inflated so I had to call the nurse in for that as well.  The compression cuffs were a mixed blessing.  They help prevent blood clots and also work like a massager so I wouldn't have been able to lay there that long without them, but by the next morning the friction had made my skin so irritated I still itch from my knees to my ankles.  If not for the drugs, I don't think I would have gotten any rest at all.

By about 4:30 a.m. I was feeling incredibly exhausted so I refused when they asked if I wanted to get up again and slept from then to about 6:30 a.m. when the sun started coming up over Seattle through my hospital room window.