Pre-op Preparations for My Total Thyroidectomy

 What to Expect Before Your Total Thyroidectomy

6.8.11

Two equally awful questions entered my mind when I learned I was to have surgery: what if I wake up and what if I don’t? The first being during surgery and the second being ever.

As the appointed day got closer I began to panic. I don’t think this was apparent to anyone other than my husband, especially since it manifested as a kind of morbid preoccupation with preparing my end-of-life services. As previously mentioned, I wrote a will. This was especially depressing because I do not have anything of fiscal value to leave behind. Just emotional value. I wonder how many other people have written wills bequeathing stuffed animals and favorite books and photo albums. But I figured this would make things easier on my loved ones in a small way and serve as one last gesture of love to the people I am closest to. I asked a few friends what they wanted, but even I felt creepy doing this. I went to the bank and arranged a POD (payment on death). I told my husband some final wishes. I read a last book. Wrote a last poem.

But none of it brought any relief from the fear. I’m just not ready to die at this point in my life. It is far too unfinished.

All of this probably sounds over-the-top dramatic to some. And it certainly proved to be unnecessary. But I want to be completely honest, no matter how much of a fool I seem. If there is anyone out there who is about to undergo surgery and scared shitless and constantly preoccupied with the possibility of dying on that operating table, you are not alone. Fear is not to be desired or encouraged, but in my opinion it is also not anything to feel ashamed of.

Other than fear, the emotion I have felt most intensely during this ordeal is shame. Shame for being so afraid and for making such a big deal out of this little disease that so many doctors and friends and family members have waved their hand at in dismissal. I won’t go into another diatribe on my frustrations for how this disease is perceived just now, but I know, from reading what other thyca patients have written, that this is a problem for many.

I felt shame prior to being diagnosed. I felt shame for spending so much money when I didn’t have any, for wasting everybody’s time just so I could get a little peace of mind. Then when it turned out it wasn’t all in my head, the shame grew. What had I done? What had I eaten or not eaten? I once smoked half a pack of cigarettes on my twenty-first birthday (and proceeded to vomit profusely). I microwaved food in tupperware despite all the warnings my mother had given me. I lived off microwavable foods for most of my life when I could have been careful like my no-artificial-preservatives friends. I certainly didn’t exercise as much as I should.

The doctors blame my genes. They said there were no other risk factors but family, something I could have no control over. But the thought is still there. That if I had just tried to live a healthier lifestyle, I might have avoided all this.

And why didn’t I know about my family? Did they too feel ashamed? So ashamed of the stigmas associated with cancer, with being Diseased, that they didn’t even warn their own family members about it? I don’t blame them. It probably never occurred to them that this would be something other women in the family should look out for. But maybe in their efforts to forget that they had once been cancer-patients, they lost an important opportunity to raise awareness.

The shame is ongoing. I feel shame about what is happening to my body. About my hormones and cold spells and weight gain and scar. About becoming drug-dependent to live. About costing so much money, feeling weak, and still being afraid, even after I survived the surgery.

The surgery is again something that I feel the need to document in potentially irritating detail so that, if another thyca patient reads this, they will know a little more about what to expect. So here is my pre-op experience of the total thyroidectomy:

I was told not to eat or drink anything after midnight the night before. This is easy enough, but the instructions about trying not to chew or swallow made me nervous. I’m a tooth-grinder in my sleep, especially when stressed, and was told that these movements could cause the gastric juices in my stomach to start-up, which is apparently bad. I also had to clean my throat with Hibiclens the night before and the morning of surgery. This worried me too, because I had always thought that hospitals do the sterilizing and hygiene practices. I was worried when, just before bed, I read the directions on the box and realized that I needed sterile swabs to apply the solution. We ended up getting by with clean washcloths, but it certainly felt like a risk.

I arrived at the hospital a little after 5am with my mother and husband. My father met us there. I cannot express how much of a difference it makes to go through this with loved ones. Do not go through this alone if you can avoid it. We went through the main doors and into the Patient Registration area. I told the nurse behind the counter my name and she had me sign a sticker and placed one of those ever so fashionable wristbands on my arm. I expected more quizzes and was not disappointed. Only, they added a question: what are you here for? Things felt very surreal around the fourth or fifth time I said “My name is Mary, I was born in 1984, and I am here for a total thyroidectomy plus lymph node dissection,” like an automaton.

Before the quizzes was a brief wait period. The hospital is alarmingly busy at the crack of dawn and so my family and I chose to sit outside the waiting room in a ring of comfy green sofa chairs. We were given a brochure that explained how my family would be able to monitor my progress through the procedure on a TV. I would be given a code and the display would say when the procedure began, how many minutes were left, and when I had moved to the recovery room. Though the chairs were placed in a social circle, the distance between them and enormity of their size actually made it quite difficult to have a conversation. I gave my mother a synopsis of the last book I had read, Life of Pi, which I highly recommend. Next to The Book Thief, it is the best book I have read this year.

After maybe fifteen minutes, we were moved in a group (four patients and their accompanying families) to private waiting rooms. There, we had just enough time to start a card game, when a nurse came in and gave me a hospital gown and pair of socks. This ended the game because nobody wants to play cards with their ass exposed, even with family. The gowns were in an appropriately hideous pattern of green and white stripes with blue targets. I can’t imagine any other use for this fabric. That it was ever created in the first place is a mystery. If it were made into prison uniforms, there would surely be some kind of “cruel and unusual punishment” protest. But by the time patients are deprived of their clothing, they have very little privacy or dignity to protect. Seriously, look at this fine gentleman to the right. Even he can't make a hospital gown look dignified. I would be very interested in a sociological study on hospital gowns that compared the pre-op contentment of patients in these eyesores and that of patients who were given, say, soft-blue terry-cloth gowns. Surely the operations themselves cost enough to cover the difference in expense. The socks were nice though. Thick, gray and grippy.

I spent the next fifteen minutes talking to my family, trying to distract and be distracted, and constantly pulling at the gown and checking to see that I was not in any way exposing myself. Then a nurse came in and began reviewing my medical history and medications aloud. She asked a few questions and attached an IV to me. Despite the larger needle, it was not at all painful and only felt strange when a cool liquid began flowing up my arm. Then two other nurses came in and wrapped my legs in large white compression sleeves. This actually freaked me out much more than the IV, because I was now attached to the gurney with no chance of walking. A heavy machine was no appended to the end of the bed, which alternately pumped up one leg and released it, then the other, all while making Darth Vader hissing noises.

The nurse came back and gave me morphine, comparing it to a “shot of tequila.” Not to discredit her, but her analogy was a bit off. It felt like cold liquid shooting up my arm, a bit of numbness, and then nothing. Maybe I’ve been drinking the wrong brand of tequila, but I don’t think I’ve ever had a margarita that knocked me over the head like a baseball bat. There wasn’t any pain, but there also was no fuzzy warm buzz or giddiness or really, anything. I don’t even remember saying goodbye to my family. They say I did it, that I gave them hugs and kisses and waved and even spoke, but I don’t recall a second of it.

The next moment I remember was in the operating room. I was being moved from the gurney to a long flat metal operating table. This was incredibly frightening because I felt that I had no control over my body, my sight was limited by the large insect-eye lamps glaring above me, and I couldn’t entirely understand the voices and faces around me. I had just enough time to panic about being awake before drifting out of consciousness again.