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Hi all, I really need advice. I am very conflicted over whether or not to have the surgery. Here's all my info:

Two nodules, one on each side. The 3.1 x 2.4 x 2.5 cm one on my left came back as benign from the FNA. It's soft and palpable.

The right nodule is 2.8 x 1.4 x 1.6 cm (as of October when I had the ultrasound) solid and heterogeneous and has calcification. It's hard and deep and hard to feel. The FNA came back indeterminate showing focal Hurthle cells.

I am having a little uncomfortable feeling when I swallow. I don't think I'm having any other symptoms.

My blood work came back as "normal" but I'll include it just for extra info:

Collected late December: T3, total=117 with reference range 76-181; T4, free=1.2 with reference range 0.8-1.8; TSH, 3rd generation=3.36 with reference range 0.4-4.5; thyroglobulin antibodies= <1 with reference range < or =1; and thyroglobulin=128.6 with reference range 2.8-40.9

Collected in October: TSH=2.33 with reference range 0.4-4.80; and thyroperoxidase Ab=0.5 with reference range <9.0

My endo dr recommended a total thyroidectomy. My second opinion endo dr said I could get an Afirma test, but I've looked into that and decided against it. He also recommended surgery but said it was up to me. The surgeon said I could wait three months and have another ultrasound. I feel if I'm going to have the surgery at some point anyway, I'd rather do it now. I could also wait and have another biopsy, but my dr and I think I also read that the only way to tell if Hurthle cells are cancerous is to take it out. Although the surgeon said my chance of cancer is low.

My issue is, what if it's benign and I have the surgery unnecessarily? My first endo dr said even if it is benign it could likely continue to grow and may cause problems in the future. But also, if it's benign it may not cause any trouble. Is not having the surgery worth the risk? Or is having the surgery worth it, even if it comes out benign. Any advice would be very much appreciated!!
 

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First, can you edit your post and include reference ranges, please? Thnakd!

Secondly, I think it's short sighted to think surgery is only appropriate for cancerous nodules. If you are having trouble swallowing, it mean the size of the nodule is impacting other structures in your neck.

Once nodules get to be that size, they tend not to be stable. While some small cystic nodules can and do grow, shrink, or even disappear, your larger nodules - especially the solid one - do not shrink. More often than not, the grow and surgery is required.

Surgery is relatively easy, but it's that much easier when the thyroid is closer to normal size and doesn't involve other structures in the neck.
 
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I just had a lobectomy for a suspicious nodule: Hurtle cell and it came back benign, but I am so glad I had it removed. Nodules can be benign now, but they certainly do run the risk of growing and/or having molecular changes, which can lead to cancer. I'm not suggesting surgery, as that is for you to decide, but think about what your doctors have told you and what will be the best disunion for you in the long run. Best wishes to you!
 

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Discussion Starter · #4 ·
First, can you edit your post and include reference ranges, please? Thnakd!

Secondly, I think it's short sighted to think surgery is only appropriate for cancerous nodules. If you are having trouble swallowing, it mean the size of the nodule is impacting other structures in your neck.

Once nodules get to be that size, they tend not to be stable. While some small cystic nodules can and do grow, shrink, or even disappear, your larger nodules - especially the solid one - do not shrink. More often than not, the grow and surgery is required.

Surgery is relatively easy, but it's that much easier when the thyroid is closer to normal size and doesn't involve other structures in the neck.
Thank you Joplin1975 for your reply. I edited my original post to include reference ranges.

I'm glad you said that because I was worried I might be doing just that. That I'm only thinking about the possibility of cancer and not taking the other possible issues that could arise into consideration. And I definitely would rather do it sooner than let them grow and do it later.

I think I'm also hesitant because I'm worried about the issues I've read that people have had regulating their dosage of the hormone pill after the surgery and getting used to life without a thyroid.
 

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Discussion Starter · #5 ·
I just had a lobectomy for a suspicious nodule: Hurtle cell and it came back benign, but I am so glad I had it removed. Nodules can be benign now, but they certainly do run the risk of growing and/or having molecular changes, which can lead to cancer. I'm not suggesting surgery, as that is for you to decide, but think about what your doctors have told you and what will be the best disunion for you in the long run. Best wishes to you!
Thank you Aspaige79 for your reply. That's good to know that you're happy with your decision. That's exactly what I've been thinking about. I think I would rather do it now than let them grow and worry and end up doing it later anyway. I have decided to go ahead with the surgery. I'm scared and worried about what it will be like afterwards, but I think it's the right decision. Thanks so much!
 

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There can absolutely be a period of adjustment after surgery.

I think the thing to keep in mind is that the vast majority of people have a very mild adjustment. Those people are out there living their lives, so you aren't hearing from them. It's the people who have trouble that makes up a lot of online/personal stories that you might read. And, to be clear, I'm not minimizing their struggles. I'm just saying it's not the average experience.
 

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Thank you Aspaige79 for your reply. That's good to know that you're happy with your decision. That's exactly what I've been thinking about. I think I would rather do it now than let them grow and worry and end up doing it later anyway. I have decided to go ahead with the surgery. I'm scared and worried about what it will be like afterwards, but I think it's the right decision. Thanks so much!
Strawberrey,

Of course! Sending lots of positive thoughts your way! I think you've made the right decision to get it over and done with now versus waiting and having a potentially worse situation later on. Let me know if I can answer any questions about recovery, too. I'm happy to help.
 

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Discussion Starter · #8 ·
Joplin- That's a good point about not hearing from the people who had a mild adjustment. It makes sense that most people share their struggles, so that's mostly what I've read. Knowing that most don't go through all that definitely eases my mind a bit.

Aspaige- Thank you for the positive thoughts! I am curious if your docs have told you anything more about the Hurthle cells? And I hope you are recovering well from your lobectomy. As far as the actual surgery goes, I'm actually concerned about throwing up and that causing a problem. I've had surgeries on both my knees and was very nauseous and threw up a lot. So I plan on telling my surgeon, anesthesiologist and anyone else in the room who will listen to give me anti-nausea medicine before I wake up. Was this a problem for you?

Thank you to both of you for all your help!!
 

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As far as the actual surgery goes, I'm actually concerned about throwing up and that causing a problem. I've had surgeries on both my knees and was very nauseous and threw up a lot.
Tell everybody - the anesthesiologist is responsible to take care of anti nausea med's. I have the same issue and had absolutely no issue. I also ask for a small breathing tube as one surgery on my female parts left me with a horrible sore throat and I found out it was the breathing tube they used.
 

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Joplin- That's a good point about not hearing from the people who had a mild adjustment. It makes sense that most people share their struggles, so that's mostly what I've read. Knowing that most don't go through all that definitely eases my mind a bit.

Aspaige- Thank you for the positive thoughts! I am curious if your docs have told you anything more about the Hurthle cells? And I hope you are recovering well from your lobectomy. As far as the actual surgery goes, I'm actually concerned about throwing up and that causing a problem. I've had surgeries on both my knees and was very nauseous and threw up a lot. So I plan on telling my surgeon, anesthesiologist and anyone else in the room who will listen to give me anti-nausea medicine before I wake up. Was this a problem for you?

Thank you to both of you for all your help!!
Strawberrey,

So, The Hurtle cells present in my nodule were typical H cells found in the body and totally benign. As for recovery, I am fully healed from surgery and have no voice issues or any neck pain. I felt good at about 4-5 days, great about 10-12 days post-surgery. I am back to exercising and have no limitations what so ever. My post-surgery labs are Thursday, so I'll see how that goes. I think I will need medication for a bit, as I get waves of exhaustion and I've had iodine deficiency problems in the past, but overall I would say I feel better now than I did prior to surgery.

I always get very nauseous after surgery and informed the entire team. Woke up with patch behind my ear that stays on for 2-3 days. It worked like a charm!

How are you doing? Have you made up your mid yet on whether or not you will get the surgery?
 

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I went through something similar last year. One solid nodule per side, plus a cyst, biopsies indicated possible hurtle cell...if I remember correctly. I was advised VERY low chance of cancer, like 10%. Three months from the day they discovered my thyroid was enlarged it was removed by total thyroidectomy. Post surgical biopsies revealed no cancer.

I had constant sore throats and pressure on my throat when lying down on one side. I knew my chance for cancer was low but they also said the nodules were not going to get any smaller.

On one hand, I feel MUCH better than I did pre surgery. I wish I had all tests done before my surgery for reference (did you do free T3?). However, I am still struggling with getting my hormones balanced to lead a more active lifestyle like I did before I started having thyroid issues.
 
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