[catstuart7]

#1058971

I’m curious why this seems to be a far second choice to RAI. While I don’t like the idea of surgery, I do like the idea of getting it all done in one go without waiting for the radiation to do its job. How many people on this board opted for surgery? Or if you didn’t, why didn’t you?

[adenure]

#1171279

Hi,

A friend of mine is a nurse (her dad and another family had RAI for Graves). She told me that she wouldn’t recommend the surgery only because the neck is such a sensitive area and too many things can go wrong. If, for some reason, the methimazole doesn’t work for me, I don’t know what I’d do. For some reason, the idea of RAI doesn’t appeal to me- so I’m hoping the meds. work.

Alexis

[PolishTym]

#1171280

There are some good threads on this issue. I haven’t posted much but I am an advocate for considering surgery.

Outside of the simplest surgeries, it seems that going to a specialist is serious option to consider. My surgeon only does endocrine surgeries, and I drove 90 minutes for it. It was well worth it. One of the moderators suggested, I think, at least 50 a year. Mine does around 300 each year. I’d ask your endo which surgeon she/he would go to if needed to be done. I didn’t even consider a local ENT. And I didn’t have to worry about the post-RAI contamination around my kids!

[snelsen]

#1171281

Hi catstuart,
I chose a thyroidectomy for the very reason you mentioned. Check out the search engine using that word, plus the word surgery. It has been a while, I think it was lch11 or lhc11 who did such a nice narration of her experience. I loved my experience.

Adenure, I don’t want to offend your friend, but her comment is unfounded and pretty silly. You could say that about every part of the body. As someone who has personally scrubbed for surgeries in general, cardiac and neurological surgery, I can assure you that all surgical sites are as complex as the people who have them. We all want optimal skills and abilities in a surgeon who is going to operat on us.

To respond to your question, catstuart, a decision on what treatment path to choose, it is a combination of geography, your doc’s presentation, what is available in your area, and your thoughts of pros and cons of one treatment over another for you. The surgeon who spoke at the San Diego conference said that we should find one who does at least 50 thyroidectomies a year.
Generally it is near a larger medical center. It is the same with any surgery. Not all eye surgeons do cataract surgery, most surgeons a usually known for the procedures they do and are known for. In my case RAI was fairly new at that time, but a much more compelling reason for me was that I wanted the fastest way possible away from the hell of Graves. It is my recommendation that you try to find one or two docs in your area who meeet the criteria I mentioned, talk with them about the surgical considerations, and incidence of any complications that could occur, how they would be treated if they did occur.

In conclusion, I think most people are the happiest with their choice when they participate in the process, and feel fully informed. The personal reasons are all over the map. Totally based on the person, their life. Several women on the forum did not choose or want RAI solely because they did not want to wait that long to get pregnant. A couple of the facilitators chose ATD’s. Others chose RAI.
Best wishes to you in your decision
Sirley

[Kimberly]

#1171282

@catstuart7 – The Foundation’s spring newsletter just came out, and the feature article was on thyroid surgery. If you’d like a copy, you can send your mailing address to info@gdatf.org, and we can get one out to you.

Take care!

[snelsen]

#1171283

Thank you, Kimberly, I intended to include that in my post last night.

[catstuart7]

#1171284

Thank you all for your thoughts about this. I am really torn about what to do because due to my life circumstances I really need the quickest route to return to full function. At the same time I have no support network so if anything goes wrong with surgery I am completely screwed. So this pushes me toward radiation but I keep reading it takes so long to get adjusted afterward. Then there’s medication but I have concerns that may not be viable long-term due to my long history of med reactions. Guess I’ll keep researching and thinking – thanks everybody.

[emmtee]

#1171285

When I was first diagnosed, surgery was my first choice for the same reason you’re favoring it – it seemed like it would be the quickest route to “normal.” I had read all about how it can take a really long time for your thyroid to die after RAI, and even longer for you to find the right dosage of replacement hormone. I wanted something that I knew would work faster than that. Before I made my decision, I asked all kinds of questions, but there were a couple of things that I didn’t know enough to ask about.

1. I didn’t know that I would have to initially go on methimizole in order to get my thyroid hormones in the normal range before surgery could even be done. If you undergo surgery when you’re hyperthyroid, you risk a thyroid storm.

2. I didn’t know that it would be so hard to find a surgeon who would even do a thyroidectomy on a Graves’ patient. (It’s not like I live in the middle of nowhere; I live in the 6th largest city in the country, and my endo works for the best hospital in the state.) In some areas it might be easy to find a surgeon, but in others, it just isn’t done.

I met with one surgeon who told me a thyroidectomy is harder on a patient whose thyroid is enlarged and he didn’t want to risk it. My endo doesn’t know of any other surgeons who would do a thyroidectomy for Graves. My GP referred me to another surgeon and I have an appointment on Wednesday, but I don’t have very high hopes. Kimberly actually asked around for me and found a surgeon who sounds qualified, but he doesn’t accept my insurance.

Of course, even if I had found a surgeon months ago, I still couldn’t have had the surgery until now because it’s taken 4 months and 2 dosage increases for my T-3 and T-4 to get into the normal range.

If I had known then what I know now, I would have just had the RAI back in November. At this point, I’ve pretty much given up on the idea of surgery. I’m doing okay on the methimazole, but I’m at the maximum dose now and I know it’s just a matter of time before I’ll have to choose a permanent treatment.

[snelsen]

#1171286

If you have not read the featured artucle Kimberly mentioned, catstuart, I encourage you to read it.
With any surgical procedure, a list of risks are presented, as I am sure you probably know. I chose the surgery, wanted it and was happy with my choice.

I imagine the surgeon emmtee mentioned, who told her it would would be “harder” (my quotes) was probably not comfortable doing thyroidectomies, or simply did not want to do it. Having a small gland is not the criteria for doing it, and having a larger gland does not mean you will have a harder time. If you talk to a surgeon, you will be discussing all that is involved, and you can ask that specific question. The preparation before surgery talking the potassium iodide drops, decreases all mucous drainage, and decreases the vascularity, thos the size, of the thyroid. Main thing is it find the surgeon who does a lot of them. They are not as common as appendectomies and hysterectomies, which are way more frequent.
Shirley

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