Post-thyroid Munira

It is exactly two weeks since my thyroidectomy, and I just finished happily watching the two and only seasons of An Astrological Guide for Broken Hearts. Dil khush kar ditta, as an old crush from my college days would say, every romantic nerve in my body all a-tingle. Well, at least some things are still functioning like pre-thyroidectomy Munira.

Nights haven’t been the best over the last two weeks, firstly because of neck discomfort and an inability to find an optimal position conducive to restful sleep. But for the last couple of days, it’s been an inopportune bout of the flu. There’s something quite nice about the initial onset of a fever though that I can’t quite explain, that halka halka suroor before the headache, the bodyache, and general feeling of malaise set in. The worst though are the little spiky gremlins that show up without fail as I hit the sack, to take up seats in the mucosa of my upper trachea, creating a great longing to cough the most violent cough that could be coughed, and the gremlins get dislodged temporarily only to come back and resettle with fiercer determination. Even a tsp of ginger honey did nothing to soothe, and it was all I could do to maintain a cough-less state of equilibrium so I wouldn’t cause any more damage than had already been done.

I don’t want to dwell on anything regarding the situation I find myself in now, this weird thyroid-less limbo. The post-op biopsy report is a good one in the surgeon’s opinion and he doesn’t seem to think I need radioactive iodine (RAI) ablation. This procedure basically obliterates all remnants of thyroid tissue that may have been missed, thereby reducing the chances of errant thyroid cells making their way into other areas and creating potential problems. We were asked to get an opinion from a nuclear physician too though, just to get some clarity.

According to the nuclear physician, if my nodule had been 1 cm or less I wouldn’t need RAI. On the other hand, if it had been 2 cm or more I would definitely need RAI. Mine was 1.5 cm, which puts me in a gray area.

Being hyper aware of the kind of unpleasant effects RAI has on my salivary glands and heaven knows what other glands, I am extremely squeamish about this hurdle in my path. (Hurdles in the path ARE the path, says someone wise) I remind myself I’ve been through a lot worse by now, and my big girl panties are hitched up so high they’ll give me a wedgie if I pull them any further. One more blood test in about 8 days will determine not only my TSH and thyroglobulin levels, but also the necessity of RAI, therefore I have a little breathing space until ……I don’t know.

What should I expect as to the ways I can fall apart? It all remains to be seen, and I’ll be watching out for signs…

I’d much rather talk about the very palpable outpouring of love I experienced as soon as word got around about what I was going through. Loving, heartfelt messages from friends and family, so much kindness and concern and support from far off ones, the prayers and duas, the food that was cooked by some very unexpected mother hens with love and sent over, the soups and juices my sisters made, the daily check-ins by someone or the other…..all of these made me feel so loved, so like I belonged, that I meant something, and if this kind of love isn’t unconditional, what is? I was even the recipient of a whatsapp prayer chain for the first time ever in my life. I had the strongest feeling that it was the combined energy of the collective that lifted me up and out of harm’s way, that kept me safe and cared for at the most vulnerable moments of my life.

And much though as I reveled in this unfathomable sea of goodwill, a very strange feeling of unworthiness also crept in. What did I do to deserve such love?

I am aware of how good it feels to give, and I am also aware of how good it feels to be received. So now that I was on the receiving end, I had to learn to accept with grace all that I was receiving. I think at some point I began to feel overwhelmed and anxious about how I would ever repay all the kindness with my current energetic limitations.

I decided to let go of these useless burdens and just feel very very grateful instead. Gratitude is such a heart-based response, I figure that if I felt it then everyone felt it too, and that is all that is required. I am grateful too, for all who read my words and come along on the journey and feel my feelings and empathize. You are my tribe, and I love you and value your presence here. Thank you so much.

I just drew my curtain aside to look out the window at the sky and saw such a wondrous cloudscape, with iridescent spots of pink and swirly blue. Dragonflies are flying around everywhere…….how very symbolic.

Off with its head

It is day 12 post-surgery, and my vocal cords have gone into protest mode.

In the weeks before surgery , when I began to glean information about potential risks and complications of thyroidectomies, I half-joked with Amu that I might be forced into lifelong vipassana. The idea felt oddly delightful to me, though I obviously didn’t want my recurrent laryngeal nerve to suffer unnecessary damage at the hands of an unsuitable surgeon.

A friend who underwent a total thyroidectomy last year due to Hashimoto’s reported changes in her voice for some time, but it’s perfectly normal now, so I am not too worried. My ex-next door neighbour was advised to get rid of her entire thyroid upon discovery of multiple nodules in it many years ago after the birth of her first child. Her biggest worry back then was the separation anxiety her little daughter would experience with her surgery and hospitalization.

I consulted a senior and well-respected endocrinologist very soon after my dismal biopsy report, and she referred me to the same surgeon who operated on my friend last year. I took my own sweet time before making an appointment to go meet him though, but followed instructions to get a few baseline blood tests as well as another, more detailed ultrasound very efficiently the next day.

We marveled at the accelerated speed and ease at which things started to unfold once the uncertainty started to give way to action. There must be a reason why I felt such equanimity, and surely, I received my confirmation of angelic help when I happened to glance at the time on my phone while walking towards the ultrasound room from the waiting lounge. It was exactly 11:11 am, and I didn’t care if anyone saw my delighted grin, wishing I could high-five Huz and Amu. All repeating numbers stop me in my tracks and make me quickly come out of my mind and into the now. And in the now, I am well, I am safe and everything will be okay, no matter what.

This spirit connection is such a beautiful source of peace for me, as even when I am all alone, I never feel as if I’m alone. And the gratitude for having this understanding made me feel deeply emotional as I lay with my head tilted in a way to facilitate the movement of the ultrasound transducer over my neck and throat, tears trickling automatically out the sides of my eyes, hidden behind my mask. I was sure my lymph nodes would be perfectly okay, and the ultrasound doctor said it seemed they were!

There is a lot to be said about keeping an open heart while navigating your way through the medical world, finding joy in the positives while releasing anything negative as quickly as possible.

I know I may sound a bit too zen to be credible, but honestly, the peace I am able to access definitely does not preclude the feelings of confusion and anxiety that often assail me at night. I’m just getting a lot better at sitting with discomfort since I know all feelings are temporary…. as of course, is the very nature of Being.

What can I say, I’m in touch with my inner mystic.

Now that I was beginning to make peace with the loss of my thyroid, a new concern reared its head….what about the parathyroids? I definitely couldn’t bear the thought of losing them too. The endocrinologist made light of having to take copious amounts of calcium and vitamin D to make up for my body being unable to regulate them, but this was a huge red flag and even my inner mystic freaked out. I mean, I really didn’t want the system of calcium-release from my bones into my bloodstream to go out of whack. And why would I want the process of calcium-absorption from the food in my intestines to go awry? I love that my kidneys perform the vital function of conserving all my calcium without me even knowing. I took all this awesomeness so much for granted all my life….until now.

After a tentative online exploration of potential candidates for thyroid surgery, I felt more uncertain than ever. How was it possible to decide who would protect my parathyroids and who wouldn’t? It turns out the best indicator of the experience of a good surgeon is, quite simply, volume. I needed someone who did at least 25 thyroid surgeries a year.

The first endocrinologist put me at a little ease by saying he would put his blind trust in anyone recommended by the second endocrinologist. And since my friend had already given me glowing reviews about her experience with the recommended surgeon, it seemed wisest to go see him first.

If meeting the surgeon and discovering that he not only specializes in thyroid surgery but that he performed over three hundred surgeries last year wasn’t enough, the beautiful forest outside his consulting clinic had me sold. It was literally a no-brainer. His manner and presence exuded a patient confidence and after explaining lots of things about thyroid anatomy and physiology, he told us to go home, think about what to do next and get back to him if we chose.

And after three days of thinking, get back to him we surely did. A week was the time-frame I had in mind to prepare myself for surgery, but there were a few things I had to consider…..the monsoons, my menstrual cycle, and Muharram. The irony of having my neck dissected in this holy month wasn’t lost on me.

There were a few other idiotic things on my mind too, like buying new sheets for my bed. I didn’t know what my life would look like post-surgery, it seemed like some kind of looming debilitation that would stop me from living despite all assurances to the contrary.

When we met the surgeon three days later, he proposed to do the operation in two days and after a paralyzing few minutes of staring alternately at Huz and the surgeon, brain going from overdrive to numb, I found myself saying ….okay. Why not? And even though Huz was in favour of sooner rather than later I heard him pipe up with a ‘But what about the bedsheet….?’ I gave him a look and he trailed off.

And so it came to be that we drove the 30 seconds it takes to reach the hospital from my home, early on the 1st of August (armed with our Covid test results and an x-ray) and got me admitted into a nice little private room for a total thyroidectomy at 2 that afternoon.