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Psy name: scholar
Age: 80s
Gender: female
City: Hangzhou
Hosts: Drink coffee, read books
and thyroid : In November 2020, a thyroid nodule was found. In March 2021, ultrasound was found to have slightly enlarged. In June 2021, ultrasound discovery continued to increase. In July 2021, a complete laparoscopic thyroid semisection surgery was performed at Zhejiang Provincial People's Hospital without inflatable
physical examination was found in nodules
At the end of November 2020, when the unit was undergoing a neck ultrasound, I heard the doctor muttering to himself: "There is a small nodule, it's okay, it doesn't matter if it is cut off." I didn't take it seriously at that time. There were too many people with nodules on the neck and I became accustomed to it.
After a few weeks, the Second Municipal Hospital called and suggested that I have an puncture biopsy when I started paying attention to it. So, at the end of December, I had another ultrasound at Zhejiang Provincial People's Hospital. The ultrasound results were of category 5, which means that it is a high probability of a malignant tumor, commonly known as thyroid cancer . The doctor recommended surgery in the near future.
After getting the examination results and doctor's advice, I went to another Grade A hospital to to confirm again. At the same time, the family mobilized their connections and took the ultrasound results to seek advice from doctors everywhere. Soon, I received feedback from 9 doctors from 5 hospitals. Although all doctors judge that it is a malignant tumor, some doctors recommend that you observe it for a while. These feedbacks made me fall into a two-choice entanglement. Should I have surgery immediately?
I made my own idea
In my communication with my colleagues and friends, I was surprised to find that many people around me were hesitating whether to have surgery. Most of them were like me, and they had no symptoms in normal times and were diagnosed with physical examination.
also heard someone say that he regretted it after the operation and felt it was unnecessary. Because thyroid nodules develop slowly and are usually not in a hurry, doctors usually don’t have a very firm attitude on whether to have surgery immediately. Only the person knows the situation best. Doctors usually give plans to let the patient decide for themselves.
When multiple doctors’ suggestions are inconsistent and they need to make their own ideas, the inner struggle is very painful. So, I want to write such an experience post for reference by friends who are struggling.
Do I need surgery immediately?
For doctors, this kind of minor surgery is not risky, and it is recommended to have surgery when you see the indication. But for patients, there are many concerns: the regret of missing an organ, the psychological preparation for taking medicine for life, the scars in the neck after surgery, the cost of surgery and the impact of taking care of the baby. Compared to getting, people will be more concerned about losing.
As a bystander, he may feel that it is ridiculous to hesitate whether to undergo surgery for these seemingly insignificant factors. But as the party involved, you will be influenced by these thoughts and feel your head full of blur.
In order to help everyone think about this issue calmly, I drew a decision tree. Friend A who is hesitating whether to have surgery immediately may walk around this tree to help make decisions. After all, this is the only time you can make your own decisions. After I got on the operating table, we were fine.
Good luck!
An incomplete thyroid surgery decision tree
1. Identify thyroid nodules
With the continuous improvement of examination technology, more and more people are suffering from thyroid nodules around them. It can be said that 2 out of every 3 Chinese people have nodules. But most of them are benign, without pain or itch, and do not affect life. Therefore, you don’t have to worry about seeing thyroid nodules on the physical examination report.
Of course, it is still necessary to have regular physical examinations.My physical examination was interrupted for 5 years, which made it impossible to determine the time of the nodule when it was found this time. Maybe it happened a few years ago and has not changed much over the years; it may have just appeared and has grown relatively fast. If there is historical data, it can be used as a reference for judgment.
When I was sure that short-term observation would not be risky, I chose to observe for 3 months first, and then continued to observe for 3 months. In the past few months, I continued to do whatever I should do, go to work, go on business trips, and even climbed Huangshan. On the surface, the wind is calm and the family is not worried, but in fact, I still think about it all the time.
2. Ultrasound judged malignant nodules
thyroid nodules are graded. It can be simply understood as being divided into multiple levels according to the possibility of its malignancy. The grade is level 3 or below, so there is no need to worry. Just adjust your diet and improve your daily routine. A grade of level 4 or level 5 means that there is a high possibility of malignancy, so you should pay attention.
Here I remind everyone that different hospitals may use different grading standards. My first hospital had a 5-category. Later, when the examination result was 4b in another hospital, I thought the possibility of malignancy had decreased, and I was excited. Later I learned that the standards were different, and the 4b of the second hospital was equivalent to the 5 categories of the first hospital, and the judgment was the same.
different ratings give a malignant probability, for example, 5 categories indicate that 85% are malignant. This probability is for everyone, and for a single patient, that is, for you, the possibility of malignancy and benignity is half and half.
Some cases of ultrasound examinations are malignant, but they are found to be benign after surgery; some cases of during surgery are benign, but they are found to be malignant after surgery. This is like Schrödinger's cat , there is no way to know without opening the box. In fact, most things in life are like this. If you figure it out, you don’t have to worry about the probability issue.
3. The size of the nodules is very small
Ultrasound examination is likely to be malignant, and it does not mean that surgery must be performed immediately. The size of thyroid nodules is also a consideration. The size of the thyroid nodules is measured in millimeters, and those below 10 mm are called micro-nodules. If it is below 5 mm, doctors in the United States and Japan will likely recommend against any tests and interventions.
Regarding whether thyroid microcarcinoma should undergo surgery, there are different opinions in the medical community. Some doctors believe that some thyroid microcancerous cancers can be considered for the time being without surgery. The reason is that many micro-thyroid cancers have been found clinically to progress very slowly and even do not progress.
After more than ten years of follow-up research, some Japanese scholars found that some tiny thyroid cancers have almost no changes. Some doctors advocate early surgery, because although thyroid cancer is small, lymph node metastasis or distal metastasis may occur.
Therefore, if it is a micro cancer, should the surgery be performed immediately or the observation should be continued depending on whether the cancer cells are "Buddhist". Unfortunately, current medical examination methods cannot accurately identify which micro-thyroid cancers are high-risk. At this time, we can only rely on the doctor's experience, so choosing a good doctor is very important. A good doctor not only has rich clinical experience, but also has a careful understanding of your personal situation.
My thyroid nodules, one 4 mm and one 1 mm, are all small nodules. It is usually invisible and intangible, it does not affect the function of the trachea and does not have any discomfort. Fortunately, I met a good doctor who is kind and kind, and arranged the most suitable plan for me. After 6 months of mental preparation, I decided to make up for the operation.
4. Assess your psychological endurance
In addition to whether the cancer cells are "Buddhist", whether you are "Buddhist" may also become the decisive factor.If you suspect that you are going to have a cold or cough during the observation period, or you are worried that you will get worse, you should take the surgery as soon as possible. Anyway, this kind of mature surgery has relatively little risk. But the opportunity cost is that it may not require surgery on it in your entire life, or if the technology is more advanced in the future, there can be a treatment plan for inactivity surgery.
Of course, it is not that the choice of immediate surgery is that the psychological endurance is weak, and it also depends on the personal situation. Hollywood actress Angelina Julie (the heroine of Tomb Raider ), found that in gene test, she was 87% at risk of breast cancer, so she immediately took action and underwent bilateral mastectomy. I admire her psychological quality very much.
5. Puncture biopsy technology
Finally, if you go to this branch of the decision tree, you are still hesitating. I personally recommend a puncture biopsy. This name sounds terrible, but in fact the process is not terrible. Use a very thin needle under local anesthesia, with almost no pain and no bleeding. Although I have never had eyebrow tattoos, I believe it will not hurt more than eyebrow tattoos.
Ultrasound results of my nodules on both sides are all 5 categories. I originally thought that the puncture could only be made of a slightly larger one, after all, puncture of a size of 0.4cm has been a test of technology. I only found out that the doctor had issued a order for both sides to make. OK, since you come, you can rest assured. Since you have done one side, the other side will be the same.
After the operation, it did not affect eating
Thanks for the courageous thought at that time. In the end, the puncture result of both sides was 0.4cm, which was malignant and the other was 0.1cm, which was benign. Thanks to this result, otherwise the surgical plan would have been to remove both sides. I have always hoped to keep one side of the thyroid gland and finally got what I wanted. How about
? Have you passed this thyroid surgery decision tree? If you "passed the level", then congratulations, at least I think you have thought rationally about thyroid surgery. But this is just an [incomplete] decision tree that I drew myself, and there are some factors that I omitted when writing this post, which vary from person to person.
written at the end
This article is not a chicken soup article, nor is it a medical guide. I am just a thyroid cancer patient, sharing my personal experiences and observations. I hope that patients who are as entangled with whether to undergo surgery will know that they are not alone and try to provide you with reference to my experience.
There is no need to panic when you check the thyroid nodule. You can calm down even if you accidentally encounter thyroid cancer. After all, life is facing uncertainty anytime and anywhere, and we are ready to prevent soldiers from being blocked by water and soil.
actively seeks relevant information and medical experts to help you overcome this level in your life. Try to make your own decision after fully understanding the information. If you can't do it, go to a large hospital to find a reliable doctor. With full trust, let your brain rest and listen to the military doctors and students!
Want to tell Friend A: There are indeed some changes in life after the operation, such as missing organs and more scars, and having to get up early every day to take medicine, but these changes are not as terrible as imagined. After all, the only thing that remains unchanged in life is that it is constantly changing. This small hurdle, step over! Habits can be changed, but the pursuit of beautiful life will not change. ——Scholar
Message Interactive Topic
Life is so wonderful, unexpected stories will happen, it doesn’t matter, only by stepping over bravely can you see the gorgeous rainbow! After seeing this friend A’s sharing, I don’t know if I have any insights. What do you want to share? Leave a message below to tell us!
