I had a long conversation tonight with my surgeon and we have worked out an elaborate but sensible surgical game plan for my surgery which is Tuesday, July 14. Instead of a complete thyroidectomy, the pre-surgical game plan will be a hemithyroidectomy, in which the right thyroid lobe and isthmus (where the cancerous nodule is) will be removed, but most of the left thyroid lobe will be left in me (he will remove only about 1 cm left of the tumor). This game plan will change if suspicious lymph nodes are identified, removed, and found to be cancerous (which cancer detection my surgeon told me can be done in 20 minutes in the lab while I remain under anesthesia). If the latter is found, I will consent in advance to a complete thyroidectomy.
If no other suspicious tissue is located and the left thyroid lobe is left inside me, due to the small size of my tumor, radiation will not be indicated per ATA guidelines, but I will have lifetime monitoring of the left thyroid lobe, consisting of annual ultrasounds and biopsies of anything that looks suspicious. The pros of doing this procedure is less risk to the laryngeal nerve and my vocal chords, and by leaving that left thyroid lobe in, my body will likely produce enough thyroid hormone to be sufficient. I also will not be as at risk for low calcium. The only real con is that the left thyroid will need to be watched the rest of my life.
IF suspicious lymph nodes are identified and removed and determined to be cancerous, the entire thyroid will then be removed, and I will also need radiation.
My surgeon agreed to arrange the necessary informed consent paperwork to be prepared for my signature tomorrow and I will be consenting to the above game plan so that we do not need to delay sedating my body when I get to the hospital on Tuesday. Which will likely be a good idea for both me and the hospital staff.
If all goes well I will still have a little less than half a thyroid left when the smoke clears on this, which may produce enough hormone for me to get by and have the energy needed to do what I do. At most I might need a little booster- I am going to speak further to the endocrinologist about this because the surgeon doesn't think i will need any synthroid at all with the hemithyroidectomy.