Arms stretched out in front of me, I focused on raising my arms to the heavens as the doctor pushed down. “Keep pushing up,” he advised.
“I AM,” I said through gritted teeth, as my heavenward reaching arms plummeted south for the umpteenth time.
“I think you’re anemic,” my chiropractor mused.
“My blood tests aren’t reflecting anemia,” I answered.
“Blood tests are piss poor diagnostic tests. Eat a cheeseburger. If you feel better, my theory is right.”
I scowled for a moment and then instantly smoothed my face, not wanting to add unnecessary wrinkles to my battered body, still scarred from surgery. Since my thyroid surgery, I had been doing a little better, but lately I’d been headed downhill. Although I’d tried to hide it from everyone around me, I could no longer hide it from myself. The little bit of resistance from the doctor pressing down gently on my arms shouldn’t have sent them straight towards hell. Going up a flight of subway stairs shouldn’t give me muscle cramps. Warrior II shouldn’t make me lose feeling in my hands. None of that should be happening. I was supposed to be “good” and healthy now. The half of my thyroid that had the tumor had been removed, my blood tests were normal and the right side of my thyroid that remained had a very small shadow on it, but it was most likely cyst and nothing major…
Or so I thought.
I rolled my eyes as I recounted my medical history to the confused medical student once more, so that she could present it to the doctor again, as three of her peers watched on. I knew the order in which the doctor wanted the information presented, and it was all I could do to keep from blurting it out to put the poor girl out of her misery and get the show on the road. I kept my mouth shut and stared at the ceiling as the endocrinologist quizzed the student a few more times before she turned her attention to me.
“Your calcium is low,” she remarked.
This was news to me, as I’d been told by the surgeon’s PA that everything was “fine”. “What’s that mean?” I asked.
“You’re not eating enough dairy products,” the doctor said absentmindedly, as she scrawled some things in my chart.
Slightly taken aback by her answer, I tried not to react defensively. “My eating habits have not changed since my surgery. I don’t understand why my calcium would be low when I haven’t changed my calcium intake,” I replied. She was all ready halfway out the door.
“Eat Tums and I want to see you in a month.”
The door closed and she was gone.
I rose from the exam table, slowly and deliberately putting one foot on the ground at a time. “Allow the Earth to support you,” I murmured to myself, feeling the ground beneath my feet, solid and steady. I took a few deep breaths and exited the exam room; as I reached the door to the lobby, a nurse called out to me about my next appointment. “Mami! You need to come back in a month!”
I glanced over my shoulder, calling out that I was switching doctors and I’d follow up at the new clinic. Then I hightailed it home.
A few hours later, after consulting with Google, research articles, my surgical pathology report and a childhood friend who’s now a doctor, I had the situation figured out. And it had nothing to do with eating more dairy, but everything to do with vision…20/20 vision, the kind hindsight offers.
For all intents and purposes, my surgeon sucked. He had inadvertently removed or damaged my parathyroid glands; the tiny glands by your thyroid that make parathyroid hormone (PTH), which controls your body’s calcium. We have four of them and they have variable anatomy, so even an experienced surgeon can mess up and remove them during a thyroidectomy. I didn’t have a thyroidectomy, though. I had a hemithyroidectomy, which means only part of my thyroid was removed….which means that the likelihood of a complication like hypoparathyroidism should be substantially lower. Worse yet was that no one had ever told me this was a possible complication, even though the surgeon was aware that my parathyroid glands had been removed, as it states clearly on my pathology report that parathyroid tissue was present in the sample submitted after surgery.
The anxiety, depression, fatigue, bruising, muscle cramps and tingling I was experiencing all made sense now. I wasn’t anemic, but I wasn’t losing my mind either. (Having never experienced anxiety attacks before, the first time I had one, I was very concerned I was losing my sanity.) I was hypocalcemic. Because of human error.
And because I’m human, I’m still a little bit upset over this latest development. I’m upset with the surgeon, but more importantly, I’m upset with myself for not being more vigilant. Why didn’t I ask about complications? I’d never even asked my surgeon how many of these operations he’d done.
I was so attached to the outcome (getting the tumor out) that I never really considered the risks, because I didn’t see myself as having any other options.
Research I read about thyroidectomies after the fact suggests:
- The acceptable rate for hypoparathyroidism is 1%, but studies show that this is only the case when a surgeon has performed 150 or more thyroidectomies per year; yet the same studies show that 85% of surgeons performed this operation less than every two weeks!
- 60% of surgeons never mentioned this as a complication.
- If surgeons were asked how often they performed this surgery, 55% of them overestimated by twofold or more.
- Surgeons who perform this surgery one time per month or less are 1000 times more likely to inflict hypoparathyroidism on their patients.
- Patients whose surgery was done by an otolaryngologist (an ENT) were 6 times more likely to be affected as opposed to those whose surgery was done by a general surgeon
Had I known this, I would have asked my doctor all of the above questions, and I most likely would have elected to have another surgeon do the operation. But I unwittingly let fear run the show.
Fear is the voice that tells you that you don’t have any other options, and fear is a f***ing liar.
Any time there is an attachment, there is a fear. I was attached to the idea of surgery sooner than later because I was fearful of allowing the tiny tumor to continue its tyranny on the beautiful butterfly shaped gland in my neck.
The good news is that the hypocalcemia and hypoparathyroidism may be transient, meaning they may not be permanent. Until we figure out whether or not this is the case, I’m on calcium and vitamin D supplements.
And lots of vitamin F: Forgiveness. Although I fancy myself an extra terrestrial, I’m human. That means I will not be perfect and I will make mistakes. I messed up.
It’s like that old saying says- Just when the caterpillar thinks the world is over, it becomes a butterfly. I’m not blaming myself at all. I’m taking accountability and empowering myself- my self, not my fear. I will not feed fear. That jerk job can starve to death.
Speaking of food, today when I came home from Zumba class, I had a cookies & cream milkshake and was able to consider it medically necessary.
That’s kind of sort of a little bit awesome. I could get used to that if I absolutely had to.
I think. Maybe. Ask me in a month or so, because I don’t want fear to delude me into thinking I don’t have any other options. In the meantime, I shall have no shame about having that extra scoop of ice cream with a cherry on top.