Bride of Frankenstein

I am the Bride of Frankenstein. I know this because I can feel the awkward drain running from just below the surgical wound to an enclosed receptacle tied to the side of the bed. On my left hand is a patent vein, immediate open access should the need arise. Everyday, I am poked, prodded and pricked for blood tests and for the piece-de-resistance, a 3 inch wound on my neck. 

The 3 days I was in the hospital after surgery were very trying ones. Swallowing was hard and the only thing that was a pleasure to eat was boiled oatmeal. No swallowing required! Nobody also told me that it would be the most boring three days. Sure, stacked on my bedside table were unread books, overhead was a TV and I could also ask Adam to bring me my computer. All well and good, except that when you are in pain, with hardly any appetite and no prospect of closure until after final biopsy results were in sometime after discharge... reading, writing or watching TV were the last things that you want to do. Visits by family and friends interrupted the boredom but one disadvantage of this was that being the Filipino that I am, I was too polite to shoo people away when I would get too tired or sleepy.

What I have found out is that if you are going to have thyroid surgery there is no need to pack a weekend bag. A couple of books, bottles of soda water (preferably cold), maybe lemon drops or any sour candy, toothbrush and toothpaste are probably the only things you really need to bring. Anything else is really just unnecessary baggage.

You will feel pain, there are now two ways about it. I was always proud of my high pain tolerance, but that was just it...pride and arrogance. Ask for pain reliever when you need it. There is no purpose in tiring your body. It will just make it harder for your body to heal itself.

You have to expect:

1. Difficulty in swallowing. Your neck area was manipulated during surgery and you will have some swelling.

2. Dryness in your nose and throat. Most likely from the nasogastric

tube that was inserted during surgery.

3. Pain and stiffness in your neck. Mostly from the surgical wound.

4. Bleeding. A closed drain will be placed just under you

r surgical wound. For those scared of blood, just keep the receptacle out of sight :-)

5. Hoarse voice. This usually disappears after a few days although some may have this whispery, hoarse voice after a couple of months.

Usually, those in for thyroid surgery are sent home the day after. In my case, I was held 3 days more because of bleeding and low calcium levels. As patients, we see this as an attempt at curtailing our freedom, however, there are post-thyroidectomy indications that warrant extending your hospital stay.

Most common complication is hypocalcemia. The parathyroid glands (which process calcium) are right under the thyroid and could be jarred or damaged during surgery. Signs of hypocalcemia include:

1. numbness and tingling in your extremities

2. cramps and spasm

Another complication is bleeding which can cause:

1. Light-headedness because of low oxygen delivery to the brain

2. Choking sensation, and

3. Intense pressure.

Inform your caregiver right away if you have any of these.

Recovery from thyroid surgery can be as easy as three days discomfort or can extend to months of cramps and emotional changes. I have been lucky not to have had any of more severe complications but with new developments it will all come to light.

Surgery Day

IT´S BEEN days since my last post mainly because I did not want to bring the mac to the hospital. My blogging nerves were already shot with worry. But here it is, as much as I can remember. The last days went by like a blur.

September 8

Adam and I spent a cosy evening: cooked a nice meal, put on music (a flea market find from the day before, a CD of torch songs) and quietly talked about our plans. It was a feeble attempt at diverting our tension to more productive pursuits.

Eventually, Adam gave up and went in to rest, praying for sleep to claim his worries... at least for a few hours. Not me though. I could not sleep. Instead, I watched TV and read a book. Not one show or line I can even remember now. I was happy that the pre-op guidelines did not forbid me from eating anything after midnight, so at 3 am I rustled up a shrimp omelette and had it with rice. Went to bed afterwards.

Got woken up at 6:30 am and as Adam reviewed both pre and post-op guidelines, i gathered my thoughts and whispered a prayer. I must admit though that I even briefly entertained the idea of just skipping the surgery and taking my chances. Getting into the car was tough.

Walking into the waiting area, I saw 4 other patients. All of them elderly and apparently used to the pre-operative process. I saw a 70 year old man taking the arm of his sick wife. Really heartwarming. What really lifted

my flagging spirits was that a rainbow appeared. A rainbow is always a good sign.

My surgery was to happen right after lunch, so to relax while waiting we decided that it would be a good idea for me to proceed to the clean room and just read. It was tough seeing Adam go (since he cannot be in the clean room). Tried reading a book, which did not work since my mind was running 100 miles a minute. I was promptly given a sedative by the nurse. Three hours later, a team cam in to wheel me into the operating room. I found out that anesthesia is a sleep light switch, the next thing I knew I was being wheeled into the recovery room (RR). There, I was in a state of half-awareness. I was conscious but pain and medication blurred the concept of reality. I do remember being asked about where I work and if I have family here in Iceland. Also, that I tried to take off my oxygen cannula because oxygen made my nose and throat dry. When they kept putting it back on, I asked what my oxygen saturation was before I stopped taking it off. It was also strange to hear the recovery room nurse en

dorsing me to the post-surgery ward nurse and knowing that this is something that I would´ve normally done myself as a nurse. It was a surrealistic experience being on the other side of the fence. I was learning.

A lovely day for blood tests

WEATHER forecast: sunny with a slight chance of rainshowers. Perfect day for blood tests and interviews with the team who will do the surgery.

Yes, I was irritable and this landed squarely on the shoulders of my significant other. Adam has been really patient with my mood swings and pent-up stress that would come out once in a while as a smart-alecky comment. Sigh.

Walking into the hospital for the first time as a patient was a series of surrealistic incidents. I had been there the day before when Adam´s sister lost consciousness at a mall while on a shopping trip with her son. They found a mass right behind a major artery and she too will eventually have to have surgery. It was strange to know that someone close to you is somewhere else in the building and having follow-up tests. Then, as we neared the the surgical admissions department someone softly called out my name. Turned out another Filipino had injured himself at work and was there to have the wound sewn up. Iceland is so much like a small town.

I never thought about how much waiting was necessary before everything is over and done with. The process included:

waiting

1. Reading and signing the health history form (concise but in Icelandic). You can ask for one in English. Actually, you should definitely ask for a form in a language you fully understand. Write down everything that is pertinent and important TO YOU. Nothing is too silly or trivial.

waiting

2. Interview with the assisting surgeon (I already had one previous interview with the main surgeon). She was particularly helpful and clearly marked out what is going to and could happen. It turns out that my surgeon will try to take just half of the thyroid but if something seems off or a few more suspicious nodules are seen, he will most likely talk the whole thing off or even do a radical neck dissection. For me, it is important for surgeons to be aggressive. True, I asked him to be careful about saving my recurrent laryngeal nerve (that being important for karaoke hahaha), I would rather lose my voice than my life later on because of metastasis. It also comforted me to know that this particular doctor did 70% of thyroid surgeries in Iceland! He apparently is a very busy man.

waiting

3. Interview with the anesthesiologist. With her, I made sure to emphasize that the strongest medication I have taken was probably diclofenac for arthritic symptoms after that effing Atkins diet (which worked but I ate too much fatty pork). I did not want to be overmedicated and not wake up. I used to drink a lot (as some of you very well know) but in the last year or so, I have not gone to too many social events or dinner parties so wine consumption has definitely gone down. Now, one light beer gets me sleepy.

waiting

4. Interview with the shift nurse. That went well too. She was funny, kind and listened closely. Thumbs up to this woman. I was told to be back at the hospital at 8am and although I´d been scheduled for 1pm, it is likely that the surgery will be done a bit later than that. I can have something to eat up to the early hours of the morning and maybe something clear to drink at 7am. Nothing after that. Wondering how I will hold up with lunch and its appetizing smells just before surgery. Hopefully, I will be asleep and dreaming of beer and beach by them.

waiting

5. paying for the waiting....sorry, for the process. Was a bit disappointed there because the hospital has apparently stopped giving discounts to hospital employees. It seems to me though that receptionists all over the world seem to have a crotchety character. Adam pointed out that they are also the people who deal with really rude people on a daily basis. So, please be nice to them...and smile. It´s important that you smile with your face AND voice.

The whole process was done in Icelandic. I do recommend though that for those who have doubts with their command of the language, bring an interpreter. Sometimes, a friend who speaks better Icelandic (or any other language for that matter) than you may not be adequate. The working vocabulary you hold might just be confined to what you use for work and home. Health terms are slightly a bit more specialized. I was lucky because I work in a hospital and my working vocabulary was particularly useful this time.

All this waiting however, allowed me to calm my fears. I had been apprehensive that no one had previously asked me about my health history. I had to volunteer that information to the GP and surgeon. Please volunteer your health information! Make sure that from the get go, your health care provider should know the following:

1. Previous health problems (heart, respiratory most important)

2. Medications you are currently taking (even illegal substances, you don´t want to gamble with your life. This, I emphasize with my patients after someone denied having taken anything and promptly went into life-threatening withdrawal symptoms. Plus, for those who take strong medications, you could be undermedicated. Think slightly awake WHILE surgery is going on. No, no, no...that you definitely do not want to happen.)

3. Food and medication allergies. This bit of information I kept repeating to everyone who would hear me. My parents once brought me to an allergy specialist when I was around 6 years old.

4. Family history (family sicknesses and whether anyone in your family had problems when under anesthesia). The only

That´s it in a nutshell. If you think of anything else, let me know.

The nurse offered me Sobril. Leery of benzos, or any other strong medication for that matter, I promptly said "no" except that she saw how that monkey called Panic was trying to get out of the box in my head.

At home, Adam began coaxing me to take Sobril which I reluctantly did (he even asked me to open my mouth to be sure that I took it..LOL). Fell asleep 5 minutes into a movie and woke up because of nightmares. Returned to sleep and woke up after a couple of hours. Now, I am calm but cannot sleep.

Which reminds me...I gotta sleep. Only 4 hours between now and the time I have to be up and heading for the hospital. I don´t know when I can get back online again but will make sure to update this regularly.

Thanks for all the love. I know that heaven is going to be stormed with prayers...or is being stormed with prayers. n

*Picture taken right outside the house just before we headed for the hospital.

The elephant in the room

UP UNTIL the fourth grade, Mama would wrap my head in a towel before going to sleep. Doing this helped me avoid the effects of dawn temperature changes. On days when this ritual was forgotten, I would wake up sneezing, teary-eyed and runny-nosed until about 8am when the sun was high in the sky and the temperature stable. Allergic rhinitis is in fact is how Mama eventually declared me as her living barometer.

It was not surprising then that in moving to Iceland (where you could expect four seasons in one day) I encountered difficulties in adjusting to the weather. This peaked a few months ago when it became so bad that I had to sleep sitting up. It scared me enough to make an appointment with a doctor.

Two weeks later, there I was twiddling my thumbs and trying to compose in my head a litany of symptoms (half of them already gone in the two weeks waiting to see the doctor) in Icelandic. When I walked into the examination room, greeting me was a framed "American Academy of Physicians" certificate so off went the carefully researched Icelandic medical terms and I happily rattled off medicalese in English. So satisfying...but I digress.

My fifty-ish doctor ( age being a good thing otherwise I would´ve walked out) promptly scribbled off a prescription for a nasal corticosteroid spray. Everything all clear and well-diagnosed. Or so, we thought until on my way out I happened to mention if it would be alright if he checked this probable lump on my throat. I was half-embarrassed about it because it could just very well be an advancing second chin. Except that, with sonogram in hand he turns around and says, "Yes, there seems to be a well-defined mass."

Uh, okay.

Since then, I have been to blood tests, ultrasounds and biopsies which in summation arrived at an unsatisfactory conclusion: thyroid carcinoma. It is supposed to be papillary, the curable kind, but the biopsy report also mentioned undefined cellular mutations which can only be classified and identified by an actual specimen (and not through cells sucked out by a thin, abnormally long needle).

The Big C is a family thing and more than a few in every generation gets initiated into the club. I just never thought that I would be the first in my batch.

Well, there it is. The elephant in the room that I have never as yet publicly discussed except with the few who I thought ought to know directly from me. It could be that I cannot call everyone who matters seeing that overseas calls are expensive and everyone´s just spread out all over the world. So, I blog instead.

On September 8, I will for the first time go under the knife. After that auspicious date I will go on sick leave. Time on my hands and hopefully enough blogging hours will allow me to add to the meager first-person information on thyroid cancer in the internet. It will also be my self-purging, a therapeutic addition to my post-op recovery. Besides, writing has always been my life and allows me to connect from the old world, cold world.

I hope you keep me company in this new adventure, another fork in the path.