[SueAndHerZoo]

#1060100

Hi Guys.
Tomorrow’s the big day and I am very excited and SO READY. I’ve been running around the house like a lunatic today cleaning and organizing so I’m guessing it’s nervous energy. At least I’ll be coming home to a clean house, right?

So I have taken the SSKI drops, 5 at a time, three times a day, for seven days. Tonight about 11:00 p.m. will be the final dose. Soon I will send my husband to the pharmacy to pick up a few more things (soft cold packs, Cepacol lozenges, Extra-Strength Tums (suggested by my surgeon), etc.) and I have purchased and laundered a large supply of soft, v-neck tshirts. I bought one of those airplane neck pillows in case I have a hard time getting comfortable, and soon I’ll pack an overnight bag for the hospital. Then, time to plan my “Last Supper”. LOL I’m trying to think of something that will stay with me a long time but yet I don’t think a high-fat meal would be a good idea before surgery. As you know, no food or drink after midnight tonight, and the automated message I received said my surgery will be at 12:40. That’s a long time without food and water but what I’m really worried about is a caffeine withdrawal headache. I’m actually thinking of having a small cup of coffee at 11:00 p.m. tonight to avoid a withdrawal headache because, heck… I probably won’t sleep much tonight anyway!

Sorry, I’m rambling… nervous energy. I told my co-workers I would be out between 2-3 weeks and my husband has taken the next 4 days off to be at my beckon call so I think I’ve got it covered.

Please let me know if there’s anything else I should do or buy or prepare that I may have forgotten.

Thanks for being here guys… this place is the best!
Sue

[snelsen]

#1180325

Hi Sue!! Caffeine withdrawal is REAL! I’m very very surprised they have you fasting that long, since your scheduled time is in the afternoon. The new guidelines have been implemented for quite a while now. But the health care industry moves slowly, and change is HARD! Sometimes institutions continue to say the same thing, nothing to eat or drink after 12 midnight, even though guidelines and rationale have changed.

I think it will help you in your planning, if you reflect on the fact that the reflexive pre op order has historically been “no food or drink after midnight”
If you think about that, people scheduled for 6am start time for their surgeries, are really in good shape from a fluid volume point of view. And they have been NPO (Latin phrase, meaning “nothing per os” which means nothing in your mouth! So they have fasted of both food and water for @ 6 hours, when you will be fasting more than 12 hours! Big difference.

Check this out, asking if you can have coffee, and a glass of water too, so you are as dehydrated. It might not even be too late today for you to call the contact number you may have, to ask if you can have clear liquids up until six hours before your arrival time. I’d ask for the anesthesiologist on call. Ask if you can have clear liquids up until six hours before your arrival time. He/she can look up your OR time. You might be told that it is fine to have clear liquids up until six hours before your arrival time.
So these folks have been NPO for only six hours. That should give a bit of a perspective on your situation.

You are going to a good place, and all will be very fine for you. The reason I am giving you a reference, plus telling you what I know, having worked in the pre op/post op area recently for many years, is to support you in having that cup of coffee, and telling you what the new guidelines are, so you don’t worry about it. Of course we all know I am not a doctor. But my medical center changed their protocol some time ago, and there are several evidenced based studies that prompted to have a later NPO time for people who go to the OR later in the day. For liquids, not meals.

Hope you can find someone to get this checked out with your people. I’m just handing you some information. Good luck in getting that cup of coffee!
This a portion of a long article from the American Society of Anesthesiologists.
http://www.theapms.com/topicpages/pre-postop-care/preop.htm#anchor3

Preoperative Fasting Status

[Talley]

#1180326

Sounds like you have what you will need:)

I agree with previous post about liquids – I would call and clarify if you can have liquid in the early AM. My surgeon said nothing 8 hours prior to surgery – I had surgery scheduled at 1:00. I did get up at 4 AM and had some tea and a cookie! I get nauseous when I get hungry and couldn’t stand the thought of a caffeine withdraw headache!

I also had a small amount of water in the morning to take my propranolol, and I would put water in my mouth and “swish” it around to help with the dry mouth…

You’re going to do great!

[Gabe]

#1180327

Good luck tomorrow Sue. I’ll be thinking about you! You’ll do fine. Hopefully you can get permission to drink water past midnight. Being hydrated is important and helps you with the anesthesia (and the needles to start the IVs!). Sounds like you have a solid plan.

You will probably feel like super woman a few hours after the op. Trust me…it’s a fake feeling…it’s the remains of the anesthesia. Just take it easy, try not to overdo it, and in no time, you’ll be finding your new normal!

Hugs,

Karen

[SueAndHerZoo]

#1180328

You guys are the best…. truly you are! When I mention my fear of caffeine withdrawal to co-workers or friends they just laugh or criticize, saying I’m worrying about something insignificant or petty. But I (and all of you) know it’s NOT petty! My body is going to be stressed enough tomorrow… it shouldn’t have to deal with withdrawal at the same time.

I’ve done a really good job of weaning myself off of coffee over the past two months. I’ve gotten myself down to about 2 cups a day and know that I can go at least 15 hours without getting a headache. So the way I see it, if I have a cup of coffee at midnight tonight and if I can have one as soon as I’m out of recovery, that will only be about 15 or 16 hours. I don’t remember exactly what hour is the “witching hour” when the headache starts, but I don’t want to find out!

Thanks for the article and the protocol updates. I’m not going to worry about it so much anymore – thank you for that. I do need to take a bunch of pills when I get up in the morning so that will be with water, maybe I’ll swallow an extra sip or two. I’m sure that the doc would agree that 8 hours before would be fine for clear fluids but I don’t think I’ll be up that late so it’s a moot point.

I do worry about being dehydrated by the time I get to surgery but I’m guessing they will hook me up to an IV in pre-op?

OK, just made another decision (thanks to the wisdom of my wonderful support system on this forum): I think I’ll set my alarm for like 4:30 a.m., take my daily pills, and go back to sleep. My plan was to sleep till 9:00, take my pills, and head to the hospital, but that means the pills and water will only be 3.5 hours before surgery.

Thanks everyone……I’m sure I’m worrying about these details too much but, hey, if I can’t worry twelve hours before surgery, when can I?
Sue

[Raspberry]

#1180329

Good luck Sue!!!! May you have a smooth and uneventful, even boring, TT!

[Boomer]

#1180330

Aw darn it I missed your send-off by one day. Drat…

I hope things have gone well for you and that you’re recovering nicely already. You’re a tough cookie but you have my expresss permission to as big a baby as you want to be. You’ve got a full license to whine, to cry, to stomp your feet, and to throw Jello. In fact you are hereby ordered to throw Jello. More people should- it’s great for lifting the spirits and cleanup is delicious.

I’m sure that you’re in no mood for my nonsense so i’m gonna tiptoe out of here, turn off the nightlight, and close the door all the way unlike the nurses who never seem to close the darn thing all the way. Drop us a line when you feel up to it and let us know how things are going.

In the meantime rest, heal, think positive, and remember that when it comes to you and your thyroid: YOU WON!

Love and health to you and yours,

Boomer

[barbra]

#1180331

Hi Sue,

I hope you’re doing OK, everything went well and the pampering has begun.

Hugs.
Barbra.

[SueAndHerZoo]

#1180332

Hi Guys, I’m home. Since I tend to ramble I’ll try to break this into three or four different sections so you can just read what you want and leave the rest.

The Bad:
I was to be at the hospital at 10:30 a.m. Tuesday for a 12:30 surgery, and I was there on time and VERY ready. They got me into my pre-op room pretty quickly, went over last minute details and paperwork, and was told that the anesthesiologist would soon be down to introduce herself, answer questions, and then take me to the OR. Ummmmm….. not really. One hour went by, no sign of her. Two hours…. nothing. A nurse came by to tell me it shouldn’t be much longer. Another hour goes by. At this point I have gone through an attack of nerves (was ready and calm when I got there but when you have nothing else to do but sit and stare at the wall you start to get antsy and nervous). But mostly, I was dehydrated, starving, and got a headache. My husband was a wreck about surgery anyway so for both of us to sit there and stare at each other while we both got more agitated and nervous was no picnic. It’s not like we could go down and get lunch or anything! Another nurse came in to explain that the two parathyroid surgeries scheduled before me had both taken longer than planned and my surgeon was still working on the second patient. It’s now about 4:00 p.m. and I’m feeling awful, physically and emotionally. I was seriously considering saying “Let’s get out of here, they can reschedule me another day.” but with all the prep work, SSKI drops, fasting, etc. I would have been only hurting myself. At 4:45 an anesthesiologist came down to chat with me but I could barely understand her and I was seeing double by then with frustration, fear, hunger and thirst. She went over some of the things that could go wrong with anesthesia and scared the crap out of me even more. It’s nothing I hadn’t already heard but to hear it on the way into surgery after sitting for over 6 hours was not the best time.

So I say goodbye to my husband and walk to the OR. The surgeon is there and profusely apologizing and I kept asking her if she wanted to reschedule since she must be so tired (honestly I wasn’t sure I wanted her operating on me after being on her feet over 8 hours on other patients. She assured me she had a slight break and was fed and hydrated and ready to go.) They got an iv in me quickly and put in some sugar water (?) I think because I hadn’t eaten in so long, then gave me a “cocktail” of relaxants, then put the mask on my face and I was out.

The Good:
I didn’t hear or feel anything during surgery (one of my fears) and it took about three hours…I think it was 8:00 p.m. when they closed, but the surgeon told me it went perfectly, no complications, that my thyroid was “jumping out at her” and was very easy to work with. All the calcium tests I had while in the hospital showed no problems, but we’re supplementing anyway as a precaution.

More Bad:
I don’t remember a thing about the recovery room … the first thing I remember is someone asking if I wanted to be lifted onto my bed or if I wanted to skootch over myself. I skootched. They asked what they could get me and I of course asked for COFFEE (hoping it would help my headache). It went down nicely and then I started to doze but then the “every 15 minute” check ups began. It’s true that you really don’t get any rest or sleep in a hospital. I’m glad they are thorough, but geez! A nurse came in to give me some liquid Tylenol for pain and within a minute I was throwing up. Once that subsided, we tried again with Tylenol tablets and water. Threw it up. They brought me some ginger ale…..threw it up.
They had given me three different anti-nauseau meds in the OR but apparently it didn’t work? They brought me a dissolving tablet and that seemed to help but I certainly wasn’t up to eating or drinking even though I badly needed something. About midnight I asked to try a dry cracker but I threw it up. I have no idea what that was all about but I guess it’s somewhat normal to be sick from anesthesia?

It was a rough night. I was in pain, (neck and headache)and exhausted but couldn’t rest. And they would come in to do vitals and ask questions every 15 minutes. Yes, at that point, I was second-guessing my decision to have surgery. I was the epitome of miserable.

The checking and prodding and vitals continued through the night and I kept getting up to use the ladies room, dragging the nurse and the IV stand with me. I guess they were keeping me well hydrated through IV because I had to go several times.

This morning about 7:00 they asked what I wanted for breakfast and I was scared to try anything but they insisted I should try. I ordered a cheese omelette, and surprisingly it stayed down – hurray! I was dead tired at this point but there is no rest for the weary. I am not exaggerating when I say there was a constant parade coming through, perhaps because Yale is a teaching hospital? Regular nurses, regular doctors, and then “teams” would come by to check on me. They were all wonderful, but ENOUGH! During the night I figured there was no way I’d be going home since I couldn’t keep food down and could barely walk but at that point with all the interruptions I just wanted to get out of there and deal with it in my own house. They cooperated…. they told me right after I ate that my discharge papers would be presented as soon as my surgeon came to chat with me again. Pages and pages of paperwork that we had to go through together, but do you have any idea how incoherent you are at this point????? I was out of there at 11:00 a.m., less than 15 hours after surgery. Not sure if that’s good or bad.

More Good:

I’m home and in my own bed, couch, husband waiting on me, dogs glad to have me home, etc. I don’t feel terrible… I am able to eat and keep it down and the pain isn’t terrible. Headache is gone – yippee! I’m tired, but can’t sleep really well but that’s to be expected. I think the worst is over but I remind myself that I will still have some bad days, emotionally and physically, but the surgery is over and it’s time to head towards feeling better.

Questions for those who had TT:
Were you afraid to clear your throat or cough? I feel phlegm that I need to get up but I’m afraid to cough or clear my throat too hard.

My surgeon told me not to use ice on my neck. I told her we purchased the soft, pliable ice packs and she said it was up to me but she preferred I not use them…. the condensation and moisture would cause the strips and wound to become damp.

They sent me home with anti-nausea meds (if needed), Tylenol with codeine (if needed) Vitamin D tablets (not the kind you can get over the counter) mega doses of Tums, and Levothyroixine (to be started Sunday). Do you all have the “D” tablets, too, or just the Tums? I think the D is for one week while the Tums get weaned off of in 2 weeks.

Thank you.
OK, if you’ve read this far you have a lot of patience and a high tolerance for boredom. Sorry for the ramble. Feel free to ask anything I may have missed.

As always, thanks for being here and for your support!
Sue

[Gabe]

#1180333

Welcome home! Holy cow what an experience. I feel bad telling you mine was such a breeze. I’m not sure how I would have handled that long of a delay. I’m sure that added to your anxiety.

I did use ice, however, the hospital sent me home with a cloth covered packet that can be refilled and kept the area dry. I agree with your doc that you don’t want to use anything that melts or gets damp because you want those steri strips to stay as long as possible. Surprised they didn’t send you home with something since they are standard hospital issue.

Yes, was nervous to cough or clear throat and that was the only thing that sort of hurt,,,but still did it only when necessary.

No Vitamin D for me. Just told me to take calcium, which I still do as a precaution. I take a calcium supplement that also includes Vit D. But was not told to do this by doc. I was sent home with Vicoden, which I only used once.

My hospital experience as so very different from yours. I had zero disruptions during the night. Was able to go to bathroom across hall on my own. I loved the leg stimulators they had hooked up to message my legs as a precaution to blood clots. I didn’t have to walk to OR, they wheeled me from pre op since that’s where they set up my IV. So sorry you had to go thru all that at Yale nonetheless!

Get some rest and eat whatever you can. You can’t hurt anything by swallowing or coughing or clearing your throat.

Hugs, Karen

[Robboford]

#1180334

Hi Sue,
Thank you for effort it would have taken to write about your experience. Sorry to hear you had to go through the waiting game, I am sure I wouldn’t have handled it as well as you did. Wishing you a full and speedy recovery and hopefully you can drag out the husband waiting on you for a few more days, cause it’s probably not going to happen again for a while (if ever – lol). I look forward to reading more about your recovery over the coming days, but for now relax and take it easy.
Cheers, hugs and kisses
Deb

[Raspberry]

#1180335

HUGS Sue! I’m so glad the most critical part went well – the actual surgery but sorry so much misery came with the before and after parts. Now it’s time to recuperate and know that you won’t ever have to take methimazole again!

[Talley]

#1180336

Wow! I probably would have walked out after waiting an hour…my TT ended up being an hour earlier than scheduled – which was good since I was a puke of nerves…

Clear your throat and cough! Did they have you using the “breathing thing” in the hospital? You need to cough out any phlegm that could be in your lungs from surgery – I think – I know I had a lot of gunk (for lack of a better word) after surgery and was coughing for days…still seem to be clearing my throat more than usual. I would say all the throwing up you did in the hospital is worse than coughing;)

Try to sleep as much as you can…I think those that do recover quicker. I’m typing on my iPhone – at the beach with the kids (yay), and surprised the surgery seems a distant memory…other than the silicone scar sheet plastered on my neck…

So glad to hear you are home and the surgery, if not pleasant, was a success!

Talley

[Talley]

#1180337

Oh, no ice for me, no calcium and no D…

Didn’t touch incision – went back at one week for doc to change steri strip, then four weeks to remove, now using silicone scar sheets and told I can massage incision 3-4xday.

[snelsen]

#1180338

WOW.
THE BAD
Sue, I am so sorry about the long wait. When you are able to, please tell me when they started the IV!!!! I think I understand from your post, that they did not start it right away! That is very weird. In all my experience as a preop nurse, that is the first thing we do. Then, when patients have to wait a long time (and usually afternoon people do…) they are fully hydrated, and we can “give stuff” through the IV to help calm anxious nerves for having to wait.
Unfortunately, your experience of going in way beyond your “start” time is pretty common. I am SO SORRY.

MORE BAD AND MORE GOOD
I am glad this is behind you, that is all I can say to that! So glad you are home.

1. I was hesitant to cough, because it hurt to do so. But it does not hurt the surgery that was done. ALL the muscles in our neck are VERY sore, cause they were in very unusual positions for the surgery.
2. In my experience, there was little or no swelling. I think the surgeon is the boss on this one. It’s her handiwork. So I suggest going with cool, not cold, for 10-15 minutes, then OFF for the ice packs.
3. No, Vitamin D was not prescribed for me, not have I heard of it. Guess it won’t hurt you? Tums, yes, but only 2-3day.

When do you go for your first post op check from surgeon and labs? I am guessing she will order labs at that time, and she will be most interested in the calcium. When you see her, ask about Vitamin D. Maybe you had that in a lab, and your Vitamin D level was low. That is a possibility.

**remember, if you take many narcotics AT ALL, you WILL be constipated, so if you take the T3’s, at a stool softener each time, maybe take one a day.

Sue! you are absolutely right!!!!!
More Good:

“I’m home and in my own bed, couch, husband waiting on me, dogs glad to have me home, etc. I don’t feel terrible… I am able to eat and keep it down and the pain isn’t terrible. Headache is gone – yippee! I’m tired, but can’t sleep really well but that’s to be expected. I think the worst is over but I remind myself that I will still have some bad days, emotionally and physically, but the surgery is over and it’s time to head towards feeling better. “

* you will surprise yourself at how tired you get in a big hurry, when you think you feel great. Respect that!
Shirley

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