The Smileys


Two years ago today, I was lying in a hospital bed, endoned up with an ice pack across my neck.

When I had this initial surgery, we didn’t know it was cancer.  There were just a couple of smallish nodules on the right side of my (enlarged) thyroid.  So the plan was to remove just the right wing of the butterfly-shaped thyroid, and ideally the left side would grow a little bit bigger to compensate, and life should continue on as normal.

Before the surgery, I looked online for photos of similar surgeries, and some of the images online were pretty bloody scary (literally).  I’m talking scars from ear to ear, with large stitches, almost looking like Hallowe’en makeup.  And so I was very nervous about what would happen, how I would heal, and how it would eventually look.

My surgeon explained he would use “minimally invasive” surgery techniques, and that I would be left with a small scar on the right side of my neck.  I work on-air in television, often subjected to extreme camera close ups, and so we both know that his work is going to be on show!  Mark said he would try to position it over one of my natural neck lines so that it would eventually blend in.   This was of some comfort, but of course the real test was when I woke from surgery.

I wanted to share my photo journal of the scar’s progress because there are a few horror stories out there, and I figure the more information you have, the empowered you are (and the less fearful).

• • •

30th January 2015 • Surgery #1: Right Hemithyroidectomy

31 January 2015 – Right hemi-thyroidectomy – 24 hours later

Immediately following surgery, I awake to an ice pack laid across my neck.  It’s a clever tube of sorts, filled with ice that the nurses replace with fresh ice for me every few hours.

I can see a small strip of tape across the incision, and the surrounding area feels largely numb.  What’s really weird is the white outline, following the shape of the right wing of my thyroid that no longer exists inside my body.

I’m endone-d up, and feel pretty good, no real pain.  I can’t see much of the incision, but the fact the surgical tape is so small is reassuring, and I follow the nurse’s instructions to ice it as much as possible.

They keep me in overnight to make sure that my calcium levels are stable and that first night’s sleep is a weird one – the endone has made me feel completely invincible – almost euphoric – and so it’s around 2am before I get any sleep.  I try to sleep with the ice pack lying against my neck, and with my head slightly raised which is awkward and difficult, but I want to minimise any swelling.

9 February 2015 – Right hemi-thyroidectomy – 10 days later

I can feel the muscles in my neck starting to stiffen overnight, and when I wake up the next day, I have restricted movement in my head and neck.

There’s a bit of a dull ache and tenderness, but no intense pain, and I don’t want to take any medication unless absolutely necessary, so icing it as much as possible works well.

I am discharged the second day.

Usually patients are advised they can go back to work in about a week, but because I have to talk so much in my job, my surgeon has advised two weeks for me.  No driving my car, no turning my head.  Sleeping with my head slightly elevated.

I spend most of my time at home, reading, meditating, sleeping.  It’s also summer here in Australia, so it’s really hot and humid.  I manage a couple of walks, but start to feel pretty woozy after 10 minutes or so.

• • •

12th February 2015 • Surgery #2: Completion Thyroidectomy

Five days later, when I receive the cancer diagnosis, we need to arrange a second surgery to remove the remainder of the thyroid (completion thyroidectomy).  My surgeon says it will be easier and neater to do this as soon as possible, before the scar tissue has time to heal and harden.  So we opt for the next available date, which means I’ll have two major surgeries in 13 days.

It also means I’ll need an additional two weeks off work to heal from the second surgery.  Plus another week following my radiation therapy.  At this point, the financial costs are starting to mount up: one month off work (I don’t get any annual or sick leave), plus the surgeon’s, anaesthetist’s and hospital’s fees – now doubled.

25 February – 26 days right side, 13 days left

This time when I wake up in recovery, the endone has sent me in the opposite direction, and I wake but then instantly feel physically exhausted and burst into tears.  I find it difficult to even communicate simple words, so I fall back into a deep sleep for a couple of hours.

My neck feels very stiff and sore, and I’m careful to keep it iced regularly again.  I’m now wearing micropore tape over the first incision, to keep the scar flat, and surgical tape over the new scar.  It looks like a small smile across my neck.

This time I’m in hospital for two nights: with the entire thryoid now removed they need to monitor for any adverse reactions: lowered calcium levels, disruption to the parathyroids, etc.

I feel like I’m climbing the walls in the hospital and I’m struggling to get any measure of good sleep.

The hospital has a healing garden so I spend as much time out there as I can, and on Friday afternoons they run a meditation class, so I tuck myself into one of their chairs and watch the soft warm lights flicker in the room for half an hour, feeling so grateful for these moments of peace.

Come Saturday morning (Valentine’s Day), I’ve made up my mind that I’m outta here!  I’ve got to wait for the final blood tests to come back, but I decide positive actions will yield positive results, so I shower, dress, pack my suitcase and am sitting on my bed for what feels like hours, but is probably only hours, until they finally discharge me!

Still no driving, turning neck quickly to the side, so I start walking to local cafes etc to keep my body moving and try to rid my body of the general anaesthetics.

Two weeks later, I’m back at work.  The scars are now quite red and puffy, most of the muscular stiffness in my neck has now receded.  At work I use foundation and concealer to cover some of the redness, but the puffiness and indentations make it sill quite noticeable.  It doesn’t bother me too much, so outside of work, I don’t bother trying to cover it with makeup, scarves, necklaces etc.

• • •

8 March 2015 • Post-Op: 5 weeks right side, 3 weeks left

8 March 2015 – 5 weeks right, 3 weeks left

I’ve been back at work for a few weeks now, and although the swelling is starting to recede, my voice feels very weak.

During both surgeries, my surgeon Mark attached a nerve monitor to make sure that he didn’t nick any nerves required for voice/speech.  It’s not always used in this surgery, but because of my work involving so much talking, we wanted to be safe.  So although there’s no damage to the nerves, the musculature has obviously been disrupted in a major way, and this takes time to repair.

The TV show I work on is live, unscripted and runs for 55 minutes without an ad break, so it’s vocally and physically demanding even in full physical health, but with the scar tissue starting to form, it makes it much more difficult to maintain my vocal projection for the full hour.

My surgeon has suggested to use my voice as much as possible, so that the muscles and surrounding area remain open and flexible – to prevent the scar tissue from adhering too much and tightening everything up.

16 March 2016 – 6 weeks right, 4 weeks left

 

 

But when I come off air after an hour of talking, I don’t want to use my voice at all.

I’m only wearing makeup to cover the scars when on air, as I want to minimise use of cosmetics (and the rubbing or wiping to remove the makeup at the end of my day).  Otherwise, I’m still wearing micropore tape most of the time to keep the scars flat, changing it every few days, keeping the scars clean and applying a little bit of Vitamin E here and there gently to help soothe and soften the skin.

I’m also heading back into hospital for my radiation treatment next week, so it’s important that the scars are healed well and sealed so that when I undergo my three day treatment isolated in the lead-lined room, the risk of complications is minimised.

• • •

4 May 2015: Post-Op: 13 weeks right, 11 weeks left

4 May 2015 – 13 weeks right, 11 weeks left

We’re about 3 months on now, so I head into see my surgeon, to check the scars’ healing.  I’m still struggling with vocal weakness, in part because of the surgeries, but also as part of the side effects of my radiation treatment.

There’s jaw tenderness, in and around my jaw, and swelling under my jawline, where my salivary glands are.  This is a side effect from the radioactive iodine (you have to swallow this type of radiation, and the salivary glands also use iodine, so they’ve absorbed a percentage of this radioactive iodine), and the swelling is gradually subsiding.  The radiation has also contributed to vocal weakness, and I continue gentle vocal warm ups as I

The scars are still quite vibrantly red, and Mark explains this happens more commonly in younger patients, where the vascularity is quite strong.

I’m back at Pilates and slowly doing work to stretch my neck and move the scar tissue around so it doesn’t create adhesions and hardening stiffness.  This is quite awkward and weird at times – I’ve certainly been unconsciously protecting my neck, and so the idea of opening my movement up again makes that area feel vulnerable.  Easy does it.

I go to a masseuse to gently massages the surrounding area, avoiding the scars themselves in order to reduce some of the tension that’s been building up protecting me.

• • •

3 August 2015: 6 months Post-Op

3 August 2015 – 6 months

The surrounding skin is really smooth, however there’s still a lot of redness, and noticeable indentations where my scars sit.

Again, the scars don’t faze me day to day (still difficult for me to ignore when I’m on a camera close-up on air), but it’s funny sometimes to see other people’s reactions to them.  Thinking maybe gives me a little more street cred … I’m tempted to say “you should see the other guy!”

In the coldness of the Australian winter (it’s cold for us, alright?!?) I can feel the desire to contract down and protect the muscles.

But I’ve started to notice that although the middle range of my voice is a bit stronger and thicker, the lower part of my register is completely inaccessible – as if my larynx literally cannot move low enough in my throat to access the lower notes of my voice.  I realise this is because of the scar tissue hardening, and so I do my best to keep my voice mobile – keep shooting for the lower notes – and regularly, gently massage the scars to help break up the scar tissue.  It doesn’t hurt, but it does feel weird – and again, vulnerable – and a couple of times I do this, there are even tears – it feels to me that I’m releasing collected fear, grief and trauma over all the changes and loss I’ve experienced in the past six months.

 

• • •

29 January 2016: 12 months Post-Op

29 January 2016 – 1 year on

Today marks my near-one year anniversary.  I’ve spent the day filming on set for a corporate job – 10 hour shoot days, early starts, constant walking and – for the first time in a long time – having to remember lines!

Memory has been a challenge for me over the past year.  It seems to have been a side effect of the radiation treatment – I’ve found myself forgetting things, unable to do simple maths at times, and – most frighteningly – unable to find the word for a certain object or idea or getting words mixed up. This is confusing and occasionally funny at the best of times, but when presenting on national live tv, actually quite frightening.

But the work today involves a different set of skills: remembering specific words and jargon, walking through locations, and having to hit physical marks.  Physical and mental stamina are required, especially when having to do and say the same things, word perfect, 20 takes in a row.

My voice feels strong and clear, and after a few wobbly first takes, I begin to relax and trust myself more and more.  I can see that my memory is serving me well, my words are coming relatively easily, and the bone-crushing fatigue I’ve experienced for the majority of the past 12 months seems to relinquishing its grip on me.

When I first arrive on set at 7am, I tell the hair and makeup girls about the scars as they will need to cover them, but after that initial application, I don’t think about them again throughout the day.

When I watch the footage back, I’m excited to realise that after checking out the scars at first, I really don’t notice them again in my work.

I feel grateful for my body’s ability to heal, and to have the opportunity to look back at how far I’ve come in one year.  It feels like a sweet gift from the universe to be doing this job, and tomorrow when I wrap shooting will mark one year from the day of my first surgery.

• • •

23 January 2017: 2 years Post-Op

23 January 2017 – nearly 2 years on

Just a week shy of my two year anniversary, and I don’t think about the scar most days.  Occasionally when I see myself on screen I will notice it, but no one else seems to say anything.  The majority of the redness has disappeared, and, as my surgeon predicted, the scars have healed themselves into the natural crease in my neckline.

There’s still some pinkness to the lines – I think eventually it’s supposed to fade to a thin white line, but it’s really not an issue for me day to day.  I’ve never felt ashamed of my scars, or worried about what people would think, but if I have an audition, I will do my best to cover them, as they may not be appropriate to the character!

Vocally, I am still very fatigued after a live show where I’ve been talking non-stop for 55 minutes.  I still lose my voice quickly if I’m in a loud place – like a bar – trying to be heard over the music.  I imagine if I was still teaching, I would struggle sometimes to be heard over a bunch of rowdy kids.  But those things were probably always an issue!

Although I have a lot of flexibility back in body, I still find that I have a tendency to nod my head forward – like I’m trying to protect my neck – and I’m slowly working on releasing that and becoming more open and upright.  It’s a work in progress 😉

Happily, I’ve got my lower vocal register back and it’s amazing to be able to sing along in the car and feel like I can enjoy my voice again.

I’ve since learned that some people who undergo surgery like mine call themselves “the smileys” – because their scars look like a little smile across their neck.

I like that.

I also like the idea that the thyroid is symbolised by a butterfly, which is also the symbol for Psyche, the soul.  I contemplate the story of Psyche, and all the trials and tribulations she underwent in order to be reunited with love.  It reminds me of this quote:

 

Just when the caterpillar thought the world was over… it became a butterfly

 

 

Life’s too short … wear the red shoes

Emma x

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