Thyroglossal Cyst and Sistrunk Procedure - Post-Op DAY 1 and DAY 2

WARNING:  This is a very long post with lots of little details . . . it is intended for other Sistrunk procedure patients to read, but if you want to know more of the nitty-gritty about my surgery, here it is . . . and if you dare or care to look at my post-op photos, click on the tab near the top of my blog title, called "Surgery Photos".  I'm tracking my incision site's progress for one year post-surgery.

I don't have a very informative surgeon.  Maybe that's a good thing.  Prior to my surgery, I didn't know what the type of cyst was that I had, nor did I know the exact term for the type of procedure I was about to undergo.  I know my surgeon did tell me the name of the cyst . . . a thyroglossal cyst . . . at my initial appointment with him, but I didn't get him to write it down and so I left his office without remembering the correct name of the cyst.  I just knew that it was a cyst that I had since birth, it was located in my neck, and it needed to be removed.

Perhaps it is a good thing that I didn't know all the terminology before heading to the hospital.  Knowing the terminology would have resulted in my investigation of the surgery on the Internet,prior to my surgery, and I might have backed-out of the procedure after finding out everything I now know.  However, in my post-surgery research on a thyroglossal cyst and Sistrunk procedure, I have discovered that there aren't too many personal accounts of this surgery, and that is why I am going to document my personal experience here on my blog.  So, if you are one of those people who is trying to find out more about the surgery and the follow-up, you've come to the right place.  Of course, this is just my own personal experience, and obviously, results will vary.

I first discovered a hard lump in my throat at the end of January 2013.  This lump literally appeared overnight.  It didn't cause me any discomfort or pain, just some concern about what it was.  Because it was going to take over a month to see my regular doctor about this lump, I opted to book an appointment with another doctor in the same clinic that my regular doctor practices in.  Dr. R. ordered an ultrasound to investigate the lump further, which I had about 2 days later.  The ultrasound tech advised me immediately that it was a fluid-filled benign cyst, not attached to anything major, and that it would drain and fill periodically.  She said it would be up to my doctor about whether or not it would be removed or just drained . . . or possibly left alone.

Dr. R. decided to leave it be.  That was back at the beginning of February, and I didn't think much about it after that, although I did take notice of its size--whether it was shrinking or growing, over the next several months.  In August of 2013, I had my yearly check-up with my regular doctor, Dr. L.  She knew that I had been to see Dr. R. several months earlier, so we discussed my reason for that appointment and she immediately advised that I see a specialist about the lump.  She thought it would be best to have a second opinion.

Moving ahead to October 11, 2013, I was seen by the surgeon, Dr. G.  He immediately made a diagnosis and likely it is then that he told me the actual name for the cyst, and said that a minor day surgery would take care of the problem.  It was ultimately my choice to have the surgery done, but he strongly recommended it.  He also advised that these cysts have less than a 1% chance of being malignant, so that was good to hear.  He also told me that this is something I was born with, and in half of the cases he's seen, they appear in children.  The other half are in adults in their 20's.  Apparently a 41-year-old with this condition isn't as common.  Or maybe it's that it took 40 years to make itself known which makes it an oddity.  In any case, I agreed to the surgery and was told it would be at least 3 months before the surgery would take place, taking me to January 2014 as the earliest possible time frame for the removal of my cyst.

I was surprised to get a phone call on November 21st to advise that a cancellation in the surgery schedule had opened up an opportunity for me to have the procedure on November 26th.  After some quick consultation with my boss and family, I took the appointment and five days later I found myself at the hospital in the Day-Surgery Ward.  I am very grateful for an employer who is adaptable to change and made this work for me.  Initially I planned to return to work 2 days after (which would be today), even though the surgeon's booking personnel advised me to take the rest of the week off from work.  I thought to myself . . . "How bad could this be?  They're just making a small incision to remove this little cyst, sewing me back up and sending me on my way . . . I should be fine in two days."  Well, I should have listened to the lady who booked my appointment.  I am needing the extra time to recover, and wont' be returning to work until Monday the 2nd of December.  'Day surgery' can be a misleading term.  I've come to the realization that what is now considered a 'day surgery' was likely a 2 or 3 day stay in the hospital, 20 - 30 years ago.

So this now brings me to the day of the surgery and the actual surgery.  I had to be at the hospital by 7:00 a.m., but I arrived at 6:30 a.m.  I had been up since 5:00 a.m., which is the last possible moment I was allowed to drink any water.  I had been fasting since midnight.  My husband dropped me off at the admitting desk and he went to work for the day.  I was given my wrist band and signed some papers.  It was now about 7:15 a.m. and I was sent to Day Surgery to wait again, for about 30 minutes.  Around 7:45 a.m. I was taken to my "room" for the day, which was actually a huge room with one wall dividing it into two parts.  Each part had space for about 10 day-surgery patients, with only a curtain to separate me from the other patients.  So, for the morning, there were approximately 20 people waiting for some sort of minor surgery.

Since I had short-notice for my surgery, I was unable to have a pre-op examination by my family doctor prior to the surgery.  That meant a nurse did the pre-op, which was actually a good time-killer, because I found out that I wasn't scheduled for the actual surgery until 10 a.m.  I spent the next 2 hours chatting with the patient beside me, answering the nurse's questions, having my blood pressure, temperature, etc. taken, and basically just waiting.  I was also given some information about my surgery, at which time I found out the correct terminology for my cyst and procedure, was told about the possibility of a drain to deal with after surgery, and was advised of how the rest of my day would unfold.  My two-hour surgery was to begin at 10:00 a.m. and I would be in the recovery room from noon until 1:00 p.m.  At 1:00 p.m I would return to my Day Surgery bed for an hour, get some food, change into my regular clothes, and go home around 2:00 p.m.

Due to a fire alarm in the hospital around 9:20 a.m., everything was delayed and I didn't get taken to the surgical waiting area until 10:30 a.m.  Then I waited there for about 20 minutes, while the gurney, doctor, resident, anaesthesiologist and nurse came to ask me questions and get me to sign more forms.  Throughout the course of the day, I was asked about 6 or 7 times about whether or not I had any metal in my mouth, metal in my body, loose teeth, etc.  Other questions were asked as well, but for some reason I just remember that they were really concerned about metal being in my body.

I was wheeled to the operating room, and the nurse asked me if I was able to walk into the operating room myself, or if I needed to be lifted.  I assured him that I could walk.  I entered a very bright, white, sterile-looking room and laid down on the operating table.  After several failed attempts by a paramedic student to start an I.V. on me in the normal top-of-the-hand location, the anaesthesiologist took over and had to go in through an area on my wrist bone.  An oxygen mask was placed over me, I went to sleep, they put a tube down my throat, cut me open, performed the surgery, and the next thing I knew, I was struggling to wake up in the recovery room.

Apparently I was having breathing difficulties when I arrived there, and as I was trying to wake up and focus, the nurse kept telling me to take long deep breaths into the mask.  Eventually I woke-up more fully and my breathing returned to normal.  At 12:10 p.m. I was given 2 regular-strength Tylenol as well as 2 mg. of Dilaudid (another name for it is Hydromorphone) to help with the pain.  Taking medication in pill form immediately following a surgery that affects your throat is somewhat challenging.  My oral cavity and throat must have been swollen, because I could hardly get those pills down.  They felt like they were about 10 times their normal size, and that was probably the most uncomfortable part of my day.  At around 1:15 p.m. I returned to my day-surgery bed and had some water, orange juice and ice cream.  It felt good to drink, because I was SO dry.  The pain at this point was totally bearable, and all it really felt like was a sore throat.

I continued to rest for a bit and then the nurse came to review my continued care plan, which included the removal of my dressing at home the next day or the following day.  I was advised to avoid constipation, although I was told I could eat a regular diet, and to resume regular activity as I felt able.  Signs of infection and fever were to be reported to a doctor immediately, and Tylenol and the narcotic painkiller prescribed (listed above) were to be taken for pain as needed.  My sutures are to be removed in seven days following the surgery by my family doctor, and I was advised to book an appointment with the actual surgeon approximately 6 weeks post-surgery, or sooner, if needed.

That's all the information they provided me with, aside from advising not to drive for 24 hours, not to sign any legal documents for 24 hours, and to not care for children for 24 hours.  At approximately 2:30 p.m., I left the hospital under the care of my parents.  They took me to get my prescription filled, and while that was  happening, I began to feel very dizzy, light-headed and nauseous.  My mouth was also extremely dry . . . the driest my mouth has ever been in my life.  Painfully dry is the only way to describe it.  Thankfully, I was sitting and waiting while the prescription was being filled, so I had enough time to regain my composure and walk to the vehicle for my 45-minute trip home.  The ride home was bearable aside from the fact that my mouth was so incredibly dry, I could hardly stand it.  Apparently this is one side-effect from the painkillers.  I chewed some gum to help relieve the dryness, but that was only a temporary remedy.  I guzzled a lot of water when I got home, and that made me feel so much better.

My appetite did not return at all for the rest of the afternoon/evening, and it wasn't until 11:00 p.m. that night that I really even desired to eat.  Chewing was difficult, as it was tricky to open my mouth.  My neck/chin area was very swollen, and with the bandages on my neck, eating was a bit of a challenge.

After reading a bit more about the side-effects of the drugs the doctor prescribed for pain, I decided that my feelings of fatigue, dry mouth, dizziness, and general wooziness were not worth the pain reduction the pills were giving me, so I chose to only use extra-strength Tylenol and that seemed to work just fine.

My first night of sleep was spent on my couch, with my head propped up, lying straight on my back.  This was an easier position to be in, rather than my normal on-the-side sleep position, which is how I sleep in my bed.  I took Tylenol before I went to bed, and didn't  wake up until 6:00 a.m. the next morning.  The pain was manageable when I awoke, but I took 2 extra-strength Tylenol to remove all pain whatsoever.  It did the trick just fine.

Eating continued to be somewhat challenging 24 hours after the surgery, but thankfully, my appetite returned by noon Wednesday, which would have been about 24 hours after the dose of Dilaudid that I had been given in the hospital.  I actually attribute most of my feeling horrible the following day to the side-effects of the pain meds.

From about mid-morning until I went to bed Wednesday night, I was in quite a bit of discomfort and pain.  Since I had been resting after returning home, I was frustrated by what seemed like a lack-of-recovery.  I know I needed to rest, but that's hard to do when you're a person who is normally very active.  I've had some minions helping me out since returning home from the hospital, namely my husband (when he's not at work) and my two teenage sons.  They do their school from home on-line, so it's been fantastic to have so much assistance readily available to me.

So, if I call Day 1 of the surgery from Tuesday noon to Wednesday noon, then Day 2 is from Wednesday, November 27 noon to Thursday November 28 noon.  The latter part of Day 1 (Wednesday morning) and the beginning of Day 2 (Wednesday afternoon) were the worst for me so far.  There was quite a bit of pain and general discomfort during that time.  My second night of sleep was almost non-existent, even though I remained in my upright position on the couch.  My best sleep came between the hours of 6:00 a.m. and 10:30 a.m. Thursday morning.  I continue to take regular doses of extra-strength Tylenol to help with pain relief, although I am now down to 1 pill instead of 2.

My initial dressing is now off and I was able to see the incision.  It looks pretty ugly, but I don't have as much bruising as I thought I would.  My chin and neck are very swollen and were initially numb.  The numbness has been reduced slightly, and the swelling has gone down somewhat, about 5 hours after removing the dressing.  In place of the dressing that the hospital put on me, I am now sporting a lovely over-sized band aid, about 6 inches long, which seems to barely cover the incision site.  This over-sized band-aid is much more comfortable than the dressing bandage that I came home with from the hospital, and perhaps the next time I change this band aid, I'll get my son to take a picture of my incision and I'll post a picture so you can all see it.

I was planning to return to work on Thursday the 28th.  However, after the way I was feeling Wednesday afternoon, I opted to make the decision to not return until Monday, December 2nd.  I think in the long run, this is going to be better for my body.  It will provide more opportunity to rest and relax before returning to my classroom of students.  I feel okay to be up and around, but committing to a 7-hour day of work (including travel time) seems daunting right now.  My voice is quite weak and I'm not sure how long it is going to take for it to return to its normal volume.

One concern I have since having the surgery is a cough that was pretty-much gone the day of the surgery . . . it has now returned.  I can only imagine the impact/force my coughing is having on the incision-site, and I pray that no damage has been done as a result of my coughing.

Until next time . . . **Please note--there is more . . . follow these links to read more about the days following my Sistrunk procedure. In order to view these pages, search the dates or title of my post in the search engine on my sidebar . . . 

(I also have a page tab just below my blog title, called "Surgery Photos".  This will give you a photo synopsis of my scar from two days after surgery until 1 year post-surgery.)

Post-op Day 3 - November 29, 2013

Post-op Day 4 - November 30, 2013

Post-op Day 8 - December 4, 2013

6 Weeks Post-Op "Thin White Line" - January 9, 2014

2 Month Post-Op - January 26, 2014