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Monday, March 14, 2011

Diagnostics and Decisions

The next day I see the surgeon at the hospital.  Again I am waiting for some time until it is my turn.  I have a love/hate relationship with hospitals.  I am in awe of what happens there but they instinctually make me nervous.  As I wait I can hear the consultations with the other patients.  This always makes me wonder about the truth in patient confidentiality.  When the surgeon finally comes to my side of the curtain, he is surprised to see me.  He says that the appointment should have been at his office, not the hospital.  Still he proceeds to discuss the details of the surgery, the possible complications and risks of pursuing the surgery, and of not pursuing the surgery.  He tells me that he strongly recommends the surgery but gives me the option to decline.  Now I am even more confused.  Should I proceed with the surgery, or shouldn’t I? 

If I don’t there is a risk that my goiter will continue to grow and could cause damage to other organs in my neck.  There is also still a slight risk of cancer.  If I do proceed with the surgery I will need to be on medication to replace my thyroid hormones for the rest of my life.  There is a risk that I will become hypothyroid and I have read accounts of people who have not responded well to synthetic hormone replacement.  What if that is me?  What if I can’t function normally after the surgery?  Not to mention the possible complications of the surgery itself:  hypoparathyroidism, hypocalcemia and laryngeal nerve damage.  These things can be permanent or transient but permanent changes are very rare.  I have had anesthetic procedures in the past and I don’t do well with them.  The drugs seem to hit me harder than the average person and I am out of sorts for days.  This with the addition of hypothyroidism and possible hypocalcemia, how long will I take to recover? 

The surgeon tells me that I need to see him at his office for another test so I book the appointment when I leave the hospital. I show up at his office in two days and again he is surprised to see me.  I assumed that I had to make this appointment regardless of if I was to have the surgery or not but he assumed that I should only come if I was booking the surgery.  Again, I left confused.  I did sign to book the surgery.  The next available dates weren’t for 7 months.  I figured that I had lots of time to think about it and change my mind if I wanted. 

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