Learning to be brave

Moving to Germany hasn't been all fun for us. Shortly before moving to Germany, there was a nodule (bump) found in my(Kristin) thyroid during a routine doctor's appointment. I wasn't in any pain and had no idea that it was even there. I had a Ultra Sound of my thyroid at Portsmouth Naval Hospital just days before Tyler and I flew over here. The results confirmed that there was a indeed a nodule in my thyroid as well as many other small nodules on both sides.



Picture from:

(http://mariettasurgicalassociates.com/42)



After moving to Germany, I was referred to a German Endocrinologist (Thyroid Doctor). The Endocrinologist preformed several tests on me and concluded that the nodule is suspicious for cancer. Basically, he doesn't know for sure if it is cancer or not, but he suspects that it might be papillary carcinoma (cancer). Papillary thyroid cancer is the most common form of thyroid cancer. The name "papillary" refers to the way that its cells are arrayed in leaflike formations called papillae. Papillary thyroid cancer tends to be slow-growing, and often remains contained within the thyroid gland. (Taken from Johns-Hopkins website)



His course of treatment is to remove the left thyroid lobe (where the nodule is located) and possibly the entire thyroid. Once the left lobe is removed it will be immediately analyzed for cancer. A positive cancer identification will cause the rest of the thyroid and other tissues to be removed. All of this will most likely happen during one surgery, and will not result in a second.



Because of his recommendation, the Endocrinologist referred me to the Chief Endocrine Surgeon at a local hospital. The surgeon will make a small 3-5 inch incision about an inch above my collar bone and remove all or part of the thyroid. In general these types of incisions are very small and heal very well. Regardless, I have requested that Tyler buy me a giant diamond necklace to cover it! : ) My dad says that a spiked dog collar would look better! Ha! I talked with a lady who had this surgery and she says that the scar is hard to see and is covered by a t-shirt.



I will go to the hospital on July 10th and the hospital stay will last for 4-7 days. German hospital stays are extra long. Just to give you a frame of reference, if I were having this surgery in the US, it would be possible to have it as outpatient surgery or stay in the hospital for one to two days. I view the long hospital stay as a good thing though. I would rather be in the hospital where they can monitor me and check on me than at home.



Complications with the surgery include damage to the parathyroid glands, which regulate calcium in the blood. There are four tiny parathyroid glands located behind the thyroid. Because they are so small, they can be easy to damage, or simply may not work when removed from the thyroid. The body only needs 1/2 of one of the four glands to work, so chances of damaging all of them is relatively small, even if the entire thyroid is removed. One of the reasons I will stay in the hospital for several days is to ensure that these glands are working after surgery. The cure for damaged parathyroid glands is simply taking a calcium supplement. Another complication can be damage to the vocal chords. Any long term damage of this sort is very rare and highly unlikely.



So overall, everything should be ok. The doctors have reassured me that this is routine surgery for them as they do about 1,500 thyroid surgeries a year. The long-term implications for me are good. Having this surgery does not impact my life expectancy. At worst, if it is determined I need a full removal of the thyroid, I will have to regulate my energy and metabolism simply by taking a pill for the rest of my life. More than likely the surgery will be the only treatment. Also, Tyler's work has been very generous and has given him time off to take care of me. I know he is going to do a good job. : )



Kristin






More information:

NPR article about German Health Care
http://www.npr.org/templates/story/story.php?storyId=91971406
Drawings of the different types of operations:

http://www.endocrineweb.com/surthyroid.html

Questions about thyroids answered:

http://www.thyroid-cancer.net/

Stats on Thyroid Cancer from the American Cancer Society:

http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_are_the_key_statistics_for_thyroid_cancer_43.asp?sitearea=