Decisions, decisions…
Feb. 26th, 2010 01:33 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
shapeofthingsYesterday’s endocrinologist’s appointment was, shall we say, not good. The appointment itself was fine, with my counsellor coming along for support and to ensure all my questions got answered (the boy had classes). The answers, on the other hand, were depressing.
I’m mildly hyper-thyric again. Nearly eight months after radio-iodine treatment, some thyroid tissue has been destroyed, but any reduction in gland mass is being countered by an increase in anti-body production. My immune system is currently producing the most anti-body it ever has.
Nearly eight months after radio-iodine treatment, I’m on a higher dose of thyroid inhibiter than I was before they nuked me. I have had no net improvement.
At least that explains why I’m feeling so ridiculously tired and run down.
Clearly, further treatment is needed. So now it comes down to a decision between proceeding with the nuclear option, or getting all knifey on the damn gland. I’m arranging to talk to a surgeon next week to find out more about the bleedy option.
In the mean time, this is where things stand:
Option 1 - additional radio-iodine treatment
Note: may require 2 further doses (3 in total)
Pros:
• does not involve hospital stays, anaesthetics or being cut open
• non-invasive, an go straight back to life-as-usual
• largely covered by Medicare
• quick to organise – can happen a week after decision
• chance of being medication-free for several years before needing thyroxin
Cons:
• will take 6 to 18 months to fully resolve: will continue to feel like crap for this time, with associated problems with work
• thyroid levels will still fluctuate and be difficult to manage in the interim
• will require ongoing close monitoring and management
• cannot get pregnant until 12 months after final treatment (not that I’m trying)
• slight increase in risk of some cancers (minor)
• may not actually work at all (I may be radio-iodine resistant)
Option 2 – thyroidectomy
Pros:
• instant resolution of hyper-thyroidism
• no influence on pregnancy
• certain to work
• quick return to something approximating “normal” life
Cons:
• involves a hospital stay, anaesthesia and being cut open
• long waiting time if done through public system, expensive if done through private (I don’t have insurance)
• ~1 % chance of damage to the vocal nerves
• ~ 5 % risk of permanent damage to the parathyroid glands, leading to complicated, life-long problems
• ~ 30 % risk of temporary damage to the parathyroid glands
…and this is why I drink.
I’m mildly hyper-thyric again. Nearly eight months after radio-iodine treatment, some thyroid tissue has been destroyed, but any reduction in gland mass is being countered by an increase in anti-body production. My immune system is currently producing the most anti-body it ever has.
Nearly eight months after radio-iodine treatment, I’m on a higher dose of thyroid inhibiter than I was before they nuked me. I have had no net improvement.
At least that explains why I’m feeling so ridiculously tired and run down.
Clearly, further treatment is needed. So now it comes down to a decision between proceeding with the nuclear option, or getting all knifey on the damn gland. I’m arranging to talk to a surgeon next week to find out more about the bleedy option.
In the mean time, this is where things stand:
Option 1 - additional radio-iodine treatment
Note: may require 2 further doses (3 in total)
Pros:
• does not involve hospital stays, anaesthetics or being cut open
• non-invasive, an go straight back to life-as-usual
• largely covered by Medicare
• quick to organise – can happen a week after decision
• chance of being medication-free for several years before needing thyroxin
Cons:
• will take 6 to 18 months to fully resolve: will continue to feel like crap for this time, with associated problems with work
• thyroid levels will still fluctuate and be difficult to manage in the interim
• will require ongoing close monitoring and management
• cannot get pregnant until 12 months after final treatment (not that I’m trying)
• slight increase in risk of some cancers (minor)
• may not actually work at all (I may be radio-iodine resistant)
Option 2 – thyroidectomy
Pros:
• instant resolution of hyper-thyroidism
• no influence on pregnancy
• certain to work
• quick return to something approximating “normal” life
Cons:
• involves a hospital stay, anaesthesia and being cut open
• long waiting time if done through public system, expensive if done through private (I don’t have insurance)
• ~1 % chance of damage to the vocal nerves
• ~ 5 % risk of permanent damage to the parathyroid glands, leading to complicated, life-long problems
• ~ 30 % risk of temporary damage to the parathyroid glands
…and this is why I drink.