After years of various issues relating to throat infections, breathing and swallowing issues, I was diagnosed with Goitre by my local ENT Surgeon.
A series of ultrasound and ct scans revealed that my thyroid enlargement was benign however my trachea was compressed down to 20% along 4cm in my neck. In addition Pemberton's signs were also present which meant my blood flow was at times being restricted.
Following these tests I was wait listed as urgent for a Total Thyroidectomy. The surgeon advised that due to the compression on my trachea (which had most likely been present for a number of years) this had created additional significant risks for the planned surgery.
As well as the usual risks related to a Thyroidectomy, the other significant risk was tracheal collapse during and post surgery. It was agreed that the best way to manage these risks was to have me undergo awake intubation prior to full anesthesia, and awake extubation post surgery along with potential stay in ICU under sedation.
Both awake intubation / extubation required my active participation and the outcome of these procedures would define how long my ICU stay would be for and what state I would be in ICU.
As you can imagine during the weeks leading up to the surgery I went through a high degree of anxiety. Despite my symptoms and my anxiety I decided to be positive and I made sure that I went out for a walk every day and ate well in order to ensure I was as mentally and physically strong for the surgery and recovery as possible.
I had my surgery on the 13th July with following outcomes;
The awake intubation was a success thanks to use of the mix of relaxant / local anesthesia applied as part of the procedure in combination with the instructions given by the team. Overall this was not as bad as I though it was going to be, there was a couple of moment where I gagged (but that actually helped ) and also there was a 10 second period of breath holding where I felt as if I could panic, but knew not to. Next thing I knew was I could breath easily albeit with a tube down my trachea while awake.
I was then told I was going to be put under, and the next thing I will know will be my name being called and the process of extubation would be attempted. I felt my eyes get heavy and then I was out.....
.......6 and 1/2 hours later - I hear my name being called. I open my eyes and it's the anesthesia team and surgeon. I'm told not to panic and asked to nod if I know where I am. I quickly remember and nod. I'm told the surgery has been a success and my thyroid is now gone, I'm reminded I still have tube for breathing and that they need to try to extubate me. I try to smile and feel elated knowing my source of anguish has gone. A series of instructions and deep breathes and holding breaths and the breathing tube is out..... now came the crux point.... and I was soon breathing but with no stridor.
I was soon able to speak (and joke) and cough, which I was told were excellent signs. I was then given an oxygen mask and told I would still be going to ICU for 48 hours to ensure I was in the best place if any tracheal collapse were to occur.
In the end I was moved from ICU after 24 hours and put under observation in the ENT ward. I was soon eating, drinking and up and walking about, but I required a fair bit of pain relief. Tests for calcium were all good, so no calcium supplement was required. Following removal of drains tubes and other bit and pieces I was discharged from hospital after 5 days. The best part is I can now breath easily, and swallow food without coughing and choking as I had done prior to surgery. There are lots of other symptoms that I no longer have as well, including blocked hearing. I am now some what sound sensitive.
Two week later I'm making a decent recovery. My neck is still stiff and tight but my scar is healing well. I no longer need any pain relief. I have been put on 150mg of Levothyroxine and seem to be okay. I do feel quite sluggish and tired especially later in the day. I have been out for some walks but at a much slower pace than I did pre op. I have my first visit to docs for blood test next week so they can adjust my Levothyroxine as required. I'm not sure when I will return to work, as I think I need to get through the sluggish / tired feeling I'm getting before this happens. I'm also hoping to get back behind the wheel of my car next week as well.
For the record while in hospital I also sat with my surgeon and viewed photos taken during my surgery. Not for the squeemish but I just had to see what it was like. The surgeon made a joke about delivering two babies. Larger right and smaller left. These two large masses were like coconuts (no kidding). He explained that the normal adult thyroid weighs about 25 grams / 1 ounce. My thyroid weighed in at over 1 KG / 2.3 Ibs. He said he could not understand how I had managed to get by so long in the condition I was in. He said I had been very lucky indeed.
Denial plain and simple. I was in denial for years that I had a problem and now I realise how lucky I have been. I could have died in my sleep at any point due to the tracheal compression. Denial can be killer.
Onwards and upwards from here on in and glad to be through the worst. I hope by sharing this experience other people who require surgery gain confidence that all will be well, just make sure your have a good experienced surgeon and anesthesia team.
Total thyroidectomy, remnants and euthroyx. 
Advice for private blood test following total thyroidectomy please
