whats the flying status after thyroidectomy?

[old747man]

had to get my thyroid removed as they suspected carcinoma ? have done radio iodine therapy and its all clear after the scan ? whats happens to flying status ?

[old747man]

had to get it removed as it was cancer.....
any one who flying with the same condition ?

[gingernut]

I guess it will depend on the staging of the disease.

[Broomstick]

Hello,
I am really sorry to hear about your news and hope that you have made a good recovery following your operation. As a doctor, and aspiring pilot, but not an AME, I hope I can give you some insight. There are several issues with this.

1. You will need to have normal thyroid function to fly. As you have had (I am assuming a total) thyroidectomy, with Radio-iodine ablation you will require thyroxine replacement therapy. It may take some time before your thyroid function is biochemically normal. There are some who advocate a slightly "supra-therapeutic" dose of thyroxine in order to supress Thyroid stimulating hormone and therefore thyroid growth.

2. Further ablation or surgery may be required in the future. Occasionally radiotherapy is required if ablation has not been 100% effective. Follow-up imaging is required in all cases.

3. You may be required to demonstrate normal calcium levels due to the potential for damage to the parathyroid glands during thyroid surgery.

Prognosis is very much dependent upon the histology of the tumour, and the most common types of thyroid carcinoma are associated with very good prognosis and response to treatment.

Not being an AME, I cannot be absolutely sure about the procedures required, but from a purely medical point of view these are the issues I would anticipate.

Wishing you a full and speedy recovery.

[gingernut]

Hi again 747, Broomstick's advice looks sound.

I've just re-read my last post, sorry if it looked a bit brutal.

As Broomstick state's, the prognosis is generally good, please keep us informed of your progress, and the impact on your medical.

[old747man]

my calcium levels are ok as para thyroid was not touched on the right side...RAI was clear and the scan too was ok.
the doctors want to maintain the TSH to .1, so any more advice, thanks for the advice.

[Rory Dixon]

Just two little practical things (but they are in fact of importance).
If you start taking thyroxine, get used to really taking that 30 minutes before breakfast, e.g. directly after getting up, before entering the bathroom.
Thyroxine is one of the very few drugs where blood levels are heavily influenced by a combination with food. And in your case, achieving a stable steady state is the goal.
The second one: if a contrast enhanced computed tomography is ordered, do have a thorough conversation with your endocrincologist about that, and don't ever let your GP or radiologist decide that. The amount of iodine given for that exam blocks any further radio-iodine treatment for a couple of weeks, if not months. So in generally thyroid cancer is seen as a contraindication for i.v. contrast in X-ray or CT.
Wishing you a fast recovery.

[Koezy]

had the same deal and went for class one for commercial licence in aust. a bit of a drama to get it at first but now ok. i have to each year at the medical show stable over a number of tests - the last two if i recall. doing the radioactive iodine (with attendant massive fatigue state), is the worse of thyroid cancer treatment over with. though having to tick the 'have you had cancer' box from now on is a bit distressing to start with.

i cannot emphasise enough the good advice given in the previous post about being religious about taking thyroxine at the same time and religious about 30 min before breakfast. personally, i find i get the best sleep in the hour after taking it. alarm at 6, take thyroxine, sleep deeply for another hour.

i also found i got cramping and odd twitching muscles regularly for the first time in my life and eventually found that daily magnesium at breakfast fixes it for the most part. (yes, parathyoid not touched, Ca level fine like you). it is also a dose of concentrated calcium so maybe it is upping the calcium that fixes the cramping. who knows.

you will find that your ability to 'push through tiredness' late night is non existant now... manage it! it only takes 5-10 mins nap to fix. if you ignore this tiredness you make poor decisions - the brain packs it in. doctors will tell you that taking thyx is fine and you will be just the same as someone not taking / needing thyx . bull dust. miss it for two days and see if you feel fine - huh. doctors will tell you you can go for two weeks before t4 t3 blood level low enough to affect you -this is so not true.

from talking to others in our situation and my experience - try to keep steady even exercise, waking, sleeping, eating routine. beware trying to fix the low energy parts of the day with a sugar hit or chocolate.... you just get into a really bad habit and fat, which makes the situation worse. find a good book on Low GI eating. it all helps keep the not very far away fatigue state at bay.

if you are female your chance of getting breast cancer increases dramatically. only very recent USA evidence for this but plenty of speculation abou the link. (but personal experience here unfortunately... yup survived that too).

keep flying and doing everything you want to do in life. happy to answer questions. K

[old747man]

Thankk you for the info...just wanted to know how long should i wait before I ask for my medical date

[old747man]

hey can u check yr pm koezy, thanks

[PkF15]

Thanks for the great info out there, I do have some questions to add. I just had a complete thyroidectomy and diagnosed with papillary carcinoma. I had my entire thyroid removed and next is the iodine treatment.

1. What was the timeline between the thyroidectomy and getting you FAA class 1 med back?

2. Did you use a service to help deal with the FAA or did you just use your AME?

Thanks