Wednesday, January 18, 2012

An Update

Today would have been Beth's 39th birthday. We started our day with her parents, having lunch in Salem.

It was a great time of soup, salad, cheeseburger sliders and lots of messy crackers and cheese for Cayden (which ended up all over the Applebee's floor). Cayden had a great time playing with Vic's iPhone (she likes to see herself on the camera), and making scrunchy smiles at us. We spent about and hour and a half telling stories about Beth, and wishing she could be here with us. Vic and Carolyn are so special to us, and it was a good time together. After lunch, Carolyn was off to a hair appointment and I drove over to church to visit with my dad because we had a few extra minutes. Bryan's mom stopped by to see us too, and Cayden lit up and crawled right to her. Then we had to hurry home for Cayden's doctor's appointment....I thought she might have an ear infection, but it turned out to be nothing.

In other medical news, I went to the endocrinologist again yesterday, to find out if my blood work is normal yet. I had blood taken a couple of weeks ago, and the doctor gave me the results yesterday. Some of my hormones are back to normal, my liver is healthy and my blood count is good, but my TSH is still low, which means that I can't have surgery or take the radioactive iodine pill yet. They are going to switch my medication to help the TSH come back up, and I have to have blood taken again in early March. My endo told me I need to make a decision about what I want to do by the time I go back to see her in mid-March.

Since my last post about my Graves' Disease, I've learned a few things.  I actually have three options.

Option #1: Take medication.

There are two types of medication to combat hyerthyroidism (Graves' Disease), Methimazole (what I'm currently taking) and Propylthiouracil, or PTU, (what I will soon be taking). Methimazole limited my tremor, got control of my metabolism, and helped me gain back 10 pounds, but it's not doing the trick to increase my TSH. PTU is a different drug that helps more with the TSH so I will be starting that. It's more pills per day (12 compared to 3), and has a black box warning, which means it can cause liver failure. My doctor said there is a 5-7% chance of liver failure. In six weeks, I will need to check my liver and kidney functions, to make sure everything is ok. The cool thing about PTU, is you can use it during pregnancy, unlike Methimazole. So I could just take PTU during my next pregnancy, and then deal with the surgery/RAI pill decision after the baby is weaned. You can also breastfeed on PTU. Both medications are basically band-aids for Graves'. The only definitive treatment is removal or destruction of my thyroid.

Option #2: Radioactive Iodine (RAI)

New things I have learned about this include:

Before taking the pill of radioactive iodine, the doctors have to figure out how much radioactivity I need to kill my thyroid. They figure this out by giving me a bunch of iodine and then scanning my neck to see how much iodine is retained by my thyroid. This isn't really a big deal, just something that adds another couple of weeks onto the 1 year+ that I have to wait to be pregnant again.

I cannot travel on a plane right after taking the pill. I have to wait at lease 1 month. This is significant because I might possibly be boarding a plane March 24 to fly to Peru on a mission trip, so I would have to wait until April (when we get back) to take the pill.

I would take the pill at Salem Hospital. (Not significant)

3-6 months after taking the RAI pill, I would get checked to see if it worked (if my thyroid is destroyed). If it didn't work (which can happen), I will have to take another pill (meaning another year to wait for pregnancy).

Right after I take the pill, I have to be completely isolated from everyone for 1-2 days. Then 7 days from babies under 2 and pregnant women.

Option #3: Surgery to remove my thyroid

New things I have learned about this include:

Recovery is 1-2 DAYS.

A couple of weeks after the surgery, my levels would be tested, and if they are fine, doctors will have no problem with me getting pregnant.

So those are my options. I've asked multiple doctors multiple times, whether or not this might just go away with a change of diet, or after being on meds for a while, but they were all very adamant that it is here to stay. I did the math.

RAI best case scenario:
IF my levels are fine by my March 20 appointment, I would have to schedule a scan and uptake maybe the first week of April, then another 2-3 weeks to get the pill taking scheduled, we are looking at the last week of April.
IF the pill works, then one year from that date (April 24, 2013), Cayden will have already turned 2. Add a year for conception and pregnancy (April 2014), and Cayden will be past 3 years old when baby #2 is born, and I will be 29.

RAI worst case scenario: (not really the WORST, but relatively the worst timing)
My levels are NOT fine in March, so we wait another 2 months, and check my blood work in May. IF my levels are fine then, I would take the pill 3 weeks later (June 10, 2012 - ironically our 6th wedding anniversary). If the pill doesn't completely work, I would find that out 6 months after (October 24, 2012) and then probably take another 2-3 weeks to schedule another pill taking at the hospital (December 7, 2012). One year after that (December 7, 2013), Cayden would be nearly 3 years old. Add a year for conception and pregnancy (December 2014) and Cayden will be nearly 4 when baby #2 is born, and I will be 30 in a few months.

This whole thing makes me feel old.

And indecisive.

1 comment:

Jessica Brammer said...

I will be praying for you to have the wisdom to make the best decision. It must be hard to try to decide on so many options, not knowing which will work.

God will provide the answer needed, though most likely not in the time frame we like. :)