Missing Work due to Thyroidectomy

I have been very concerned with missing work due to the Thyroidectomy. There are doctor appointments, checkups, surgery, and I'll have a radiation treatment.  That adds up to be a lot of time off from work!

I am concerned for several reasons. First, my career is very fast paced and it is easy to fall behind. The competition for advancing skills and getting a "seat at the table" is very intense. If I don't demonstrate excellence, if I don't bring my "A Game" every day, there are five guys behind me that are younger, smarter, and faster that want my seat.

I am also concerned because I am the main bread winner. My wife works too, but, we really live off my earnings. I need to make sure my paycheck is preserved.

I didn't expect to get cancer this year, so, I carelessly used some of my sick and vacation time such that I am now down to 13 days off for the rest of the year. Any other year? That would be plenty! I probably wouldn't even need those remaining days off.

For the cancer surgery, I'm told I need 10 days off from work.
The radioactive iodine will be 5 days off from work.
And then I need another ultrasound, all the doctor appointments, etc.

Clearly 13 days isn't going to be enough! I devised a plan:

I work from home. So, I am going to try to recover from surgery in six days (four days off plus a weekend). That should give me nine days for the radioactive treatment and doctor appointments. In addition, I plan to work during the radioactive treatment. I just have to stay away from everyone, which shouldn't be a problem since I work from home. I'll just wall myself into my home office for 5 days.

It is a large concern for me that the math simply isn't going to work out and I'll come up short somewhere. What if I do need two weeks to recover from the surgery? What if they find bad lymph nodes - I might need as much as 8 weeks off from work. What if I can't work during the radiation treatments? What if 13 days isn't enough?

I did some research into Short Term Disability. I don't have a short term disability insurance like Aflac. I contacted my employer's Human Resource department today and learned I am covered for short term disability that will pay 80% of my current pay! And if short term turns into long term, I am covered for 66.6%.

Loosing 20% of my pay would suck. That's a lot of grocery money. But it isn't the end of the world and I have some savings that could see me through the gap. I am very fortunate to have a short term disability option. Learning about the short term disability has helped put my mind at ease. With this new knowledge, I feel I can take as long as I need to recover without needing to rush it. Of course... I will rush it because that is the kind of guy I am, and I need to get back to work before someone steals my seat at the table.

Thyroid Cancer Leads To Other Cancers

I have tried my best to stay away from negative stories about Thyroid Cancer and Thyroidectomy because I don't need to be extra worried. I am researching it though, and trying to learn as much as I can while I wait for my surgery in August. In my research, I came across a research paper published in 2006 that linked Thyroid Cancer with other cancers. Apparently, if you have Thyroid Cancer, you have a higher chance of developing another unrelated primary cancer.

According to the research, you have a higher than normal chance of developing the following cancers during the first year after surgery: non-melanoma skin cancer, prostate cancer, kidney cancer, adrenal gland cancer, and non-Hodgkin's lymphoma.

According to the research, in the years following a thyroidectomy, you will have a higher than normal chance of developing: salivary gland, pharynx, stomach, small intestine, colon, rectum, bone, soft tissue sarcoma, non-melanoma skin, female breast, prostate. kidney, brain, adrenal gland, non-Hodgkin's lymphoma, leukemia, parathyroid gland.

I read a story of someone, shortly after recovering from her thyroidectomy, was diagnosed with breast cancer. 

According to the research, the second cancer is completely unrelated to the first cancer. In other words, the thyroid cancer didn't spread causing the second caner. How is this possible? I have a theory.

My theory is that once you have been diagnosed with cancer, you become super sensitive to your body and start questioning everything. That funny looking mole? That odd lump? No more chances - you get it checked out! Because you have learned the importance of early detection.

My theory is that the rate of cancer isn't higher in thyroid cancer patients. It is simply detected at a higher rate. Perhaps the rate is high in the general population but it is going undetected.

For my theory to have any validity, it must be true for other cancers too. If I have a different cancer (something other then Thyroid cancer) then I should have a equally high chance of developing some other cancer. Well... unfortunately the 2006 study only looked at Thyroid Cancer. But it did say this: people who had other cancers had a higher chance of developing Thyroid Cancer as a second primary cancer. While the 2006 study didn't look at all cancers, it does provide evidence for my theory. It says, basically, people who have had other cancers might be more sensitive to cancer leading to detection of other cancers, in this case, detecting Thyroid cancer.

I am not a scientist. I am just applying common sense and a little wishful thinking. I am discouraged to know that I have a higher chance of developing some second cancer. But I am rest assured by my theory that I would have developed that second cancer anyways and it might have gone undetected.

It Is My Grandmother's Fault

"Did you have any radioactive treatments? Any Thyroid cancer in your family history?" the doctor asked, to which I answered "No" to each. My father's side of the family has had a lot of cancer. My mother's mother had a brain tumor. But no thyroid cancer. I haven't lived near power lines, taken radioactive treatments, talked at length on cell phones, or done any of the myriad of things that might lead to Thyroid cancer.

I kept thinking - I must have been exposed to something. I must have done something wrong. And as I racked my brain, I could think of nothing. I did have that radioactive test two years ago and I was convinced that must have caused this! However, the doctor and all my research said that was impossible.

Maybe I just drew the short straw? Shit happens. Maybe there was no explanation for why I was picked to get Thyroid cancer.

And then my mother recalled that her mother-in-law (my grandmother on my father's side) used to always complain about her goiter. A goiter is a growth on the Thyroid that can push on the esophagus. The goiters can grow due to cancer.

That is my best lead so far. Grandma had a goiter that might have been cancer and now so do I.

That means this is all my Grandma's fault! She caused this. She did this to me. It is easy for me to get angry at a woman I barely knew. I saw my Grandma once or twice per year growing up, but only saw her once or twice as a teenager. She was a recluse who never ventured from her home and relied on the care given by her daughter. She died when I was like 19 from pneumonia, although I recall my cousin saying it was cancer related. I attended her funeral as a representative of my family and got to be a pail bearer.

After a brief moment of anger that my cancer is my grandmother's fault, I quickly realized (other than biologically) she had nothing to do with it. She didn't give birth to my father knowing she was passing some mutated gene or whatever. My father, who died of cancer when I was just a child, didn't have me and my siblings believing he was passing on mutated genes. Equally, I didn't think I might be passing mutated genes to my children. You have to take the good with the bad. And honestly, there is far better good than bad.

So, it is my Grandmother's fault biologically in that she was likely the source. For me, the mystery is solved.

Other People's Stories on Thyroidectomy

I am three weeks away from my surgery and haven't thought much about it. I am on vacation and that helps keep my mind off the surgery. I did take some time this afternoon to watch several vLOGs on YouTube. I watched:

MsEllenMelon
Katty Delux 
Monica Sheirich
Marisa Iacobelli
LadyLeopard29https://www.youtube.com/watch?v=fiBrkzRJRY0

It is interesting to watch the reports because it tells me two things:

(1) Everyone's experience can be different. Just because one person experienced something, it doesn't mean I will

(2) It is reassuring that everyone believes the surgery was OK.

My list of concerns is very small: pain, weight gain, and being out of work for too long. It is always reassuring when I hear positive stories in these areas.

I know that this is something women are more likely to be diagnosed with than men, but I haven't found any vLOGs from men. I don't know if more women really have thyroid problems, or, if just more women are it detected. Perhaps a lot of guys have undiagnosed thyroid cancer or other problems. Or perhaps women are more likely to vLOG about it.

Hypothyroidism Caused My Weight Gain?

Recently, I learned by TSH level was 5.2, which, according to most measures, is Hypothyroidism. One of the symptoms of hypothyroidism is weight gain. I have a theory that I have had hypothyroidism since my first goiter was detected back in March 2014. I know I have put on around 45 pounds since that time period. I wanted to see if I could correlate my weight gain to Hypothyroidism and attempt to explain the weight gain by a high TSH level instead of eating too many cheeseburgers.

I have been overweight most of my life. I never knew I was overweight until, as a child of perhaps 6, a neighbor kid told me. I was never terribly overweight. I think back then they called it "husky". 

This changed in high school and college as I learned to workout. But then my children came along and the career took off, and so did my weight. When I focused on exercise and eating healthy - the weight came off. When I became busy? The weight returned. My adult life has been nothing but a yo-yo.

Around age 37 I decided to do something about this. I introduced exercise as a regular everyday activity. I like to exercise, but I usually feel like there are better ways to spend my time. Allowing myself to exercise daily guilt-free was perfect! I still had some ups and downs with weight, usually tied to getting too busy to work out, however, I was doing fairly well for seven years. I was even running five miles per day! And then my weight shot up. Immediately, as soon as I went on depression medicine (which I believe to have been hypothyroidism  related), my weight shot through the roof. A side effect of my depression medicine (as well as the hypothyroid) is weight gain because you crave food all day long and end up making horrible choices. It didn't matter how much I was working out, the needle on the scale simply moved in the wrong direction. My wife developed a slogan "You wouldn't have to go to the gym so much if you didn't eat so much." Even my doctor said "Stop eating so much". But the cravings were uncontrollable. 

I went back through my journals and logs and mapped out my weight for the past 23 years (half my life). 

Again, my hope was that I would find my weight was fairly average until two years ago at which time something terrible must have happened. What I found instead was a graph showing my weight was all over the place! High peaks and low valleys. While my average weight for the seven year period from age 37 to 44 was better than the rest, it too was filled with many struggles. 

In the end? It would be difficult for me to blame this latest weight gain on Hypothyroidism or Depression Medicine. I believe that caused it, but, a better explanation is that my life has been filled with many weight ups and downs, and this is just another one of them.

Hypothyroidism

When I met with the surgeon, he mentioned my blood work indicated a TSH of 5.2. He mentioned that if I weren't having the thyroid removed? This problem would have to be addressed. So, I did a little research. It turns out there are many scales for TSH, but, most agree that TSH should be 3.5 or lower. A high TSH means Hypothyroidism.

There are two: HypERthyroidism (low TSH) and HypOthyroidism (high TSH). I have Hypo.

According to some research, Hypothyroidism will result in feeling tired, depressed, dry skin, cool extremities, hair loss, and will result in weight gain - all symptoms I have had for the past two years.

Hypothyroidism can be the result of a previous treatment with radioactive iodine. Two years ago I had a nuclear scan of my thyroid that involved radioactive iodine.  I believe it was called a radioactive tracer test, or, a Radioactive Iodine Uptake Test. All my reading say the radiation used in the nuclear test is harmless. I just find it odd that all my Hypothyroidism symptoms appeared after that time period. It is probably just a coincidence?

Stress Screening

When I met with the surgeon on Monday, I had to fill out a Screening Tools For Measuring Distress form as part of the appointment admissions document. I can only imagine that this is a form that I will fill out every time I have an appointment.

The form seemed odd for my initial visit, however, I can imagine it would make more sense (perhaps?) for post-op visits.