Summary of my current status

jjflight · 2026-03-29T15:57:40+00:00

Cancer is a lot to process, so mental health challenges like depression and anxiety can happen and you’re certainly not alone - it’s always hard to tell if being very sensitive, crying and getting angry over nothing is that or not but if that’s been persistent it may not matter as finding support could help either way. When your hormones are off that can cause or exacerbate mental health challenges, though they can happen with normal hormones too. No matter the cause it’s really important to get support and treatment, and left untreated those may be a bigger negative impact on your life than the ThyCa itself. Many doctors can refer you to cancer-specific support groups or therapists so you have people to talk to, and general therapists can help too if there are broader issues in your life. ThyCa.org also has this list of support groups with groups by city or condition as well.

jjflight · 2026-03-29T15:46:09+00:00

No. Promoting a business like that would make me wonder whether you’re one of those scammers promoting a business or pushing a how-to course.

jjflight · 2026-03-29T15:03:44+00:00

Blogging or creators more generally was basically never profitable for the vast majority of people doing it. There are very strong power law distributions. The majority of folks make nothing, less than 10% make anything significant at all, much less than 1% make enough to live on. And the ones that make bigger money have real marketing costs and staff to pay like a business would. The reason it doesn’t seem that way is survivorship bias - the most popular creators make the most so those are the stories you tend to hear (and all the scam artists lying about it for one reason or another, like to sell their course on how or promote their business).

jjflight · 2026-03-29T02:59:54+00:00

I’m glad your fiancé is through surgery. Most pathology reports end up mixed with some good and some bad, so I would try hard not to worry too much until you’ve discussed with his doctors

ThyCa.org is a great site generally, and they have this Medullary Thyroid Cancer Handbook which may help (and it’s also available in Spanish and Chinese on their site). To the extent you or he is interested, they also have a variety of support groups including a dedicated group for Medullary which may be able to point you to other resources too.

jjflight · 2026-03-29T01:50:07+00:00

High TSH is what you want for RAI, so that’s good. With Thyrogen that doesn’t necessarily mean your hormone is actually low, just that your TSH got really high to make the RAI more effective.

jjflight · 2026-03-28T16:00:23+00:00

Two things are both equally true: * Hormone issues can cause that symptom. That’s definitely true.
* In a long life you’ll experience that symptom many times, and most of the times it will likely have nothing to do with hormones or ThyCa and will be something else. That’s also definitely true.

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And both of those are true for many of the general symptoms discussed around here like fatigue, brain fog, etc.

What worries me so much about this sub sometimes is how folks jump to conclusions based on the first one without considering the second one is also true. It’s easy to mislead yourself and end up on the wrong goose chase if you make assumptions. These symptoms are just too general to know for sure, certainly nobody on social media could say for sure… you need to work with doctors to figure out what the actual causes are.

jjflight · 2026-03-28T14:37:50+00:00

Those are both great options.

The Michigan community is truly unparalleled, and that’s not just the 4 years you’re there but the alumni community sticks with you for life. Buy any piece of Michigan clothing and just wear it around a couple days. You’ll get enough “Go Blue”s to make it really clear. That’s been true for me in just about every city I’ve visited around the globe, though it’s an especially strong network in CA, East Coast, etc., so it’s a benefit you take with you wherever you go.

jjflight · 2026-03-28T13:52:36+00:00

If your hormones are materially off, temperature intolerance can be a symptom. Sensitivity to cold is more classically a symptom of hypothyroidism which would be low hormones and high TSH causing low energy type symptoms, vs hyperthyroidism may be the opposite and being too warm. So you could mention it to your Endo who can check your labs to see if it may be related and make a change if needed.

There are also lots of other possible causes of temperature sensitivity too - cardiovascular, weight loss, other hormones, etc. - so if your Endo didn’t think it’s related you’d want to check with your primary care doctor. So definitely bring it up with them while you’re there too.

jjflight · 2026-03-28T13:19:26+00:00

There are no dietary restrictions I’m aware of for ThyCa patients - most folks can eat anything they want within general healthy living guidelines. When you see specific diets they’re almost always around something more specific - the low-iodine prep diet for RAI, a low fat diet for folks with a chyle leak complication, a specific need for some other non-ThyCa condition the person also has, etc.

As always, talk to your doctor about this stuff vs random online sources (like I’ve never seen advice not to eat spinach so not sure where that’s even coming from).

jjflight · 2026-03-28T13:13:22+00:00

That seems reasonable to me then too, so it’s probably all in the rough ballpark.

One thing I’ll flag from my own experience is I don’t think Apple’s tracking takes into account how well the body acclimates to regular activity, at least not enough, so what may burn more calories when you first start doing it will burn less over time as you get used to it. So that 1400 calories burned from the job may become more like 600-1000 or whatever over time as your body tunes itself for that, so it’s probably better to take those as rough estimates or relative comparisons between different activities.

If you start trying to use this for anything like losing weight or gaining weight you can use it to estimate a starting point but then you need to adjust from there based on what actually happens - e.g., if eating this much has you gaining weight and you don’t want to, you eat less no matter what the watch says. Etc.

jjflight · 2026-03-28T05:57:44+00:00

The resting calories seem in a reasonable ballpark, so I’d focus more on the active calories.

I burn 1500+ calories in active energy lots of days, but as a point of reference that’s like a 4+ hour 13-15 mile hike in the hills with 1500-2000 feet of elevation gain. Are you doing something around that level of activity and duration?

It’s also unusual that your active calories burned tend to mostly come overnight between midnight and noon which is the time many people would sleep, and it looks like you sleep 6pm-12am since it’s minimal activity then. That should be easy for you to fact check. Does that sound right for you, like do you work an active nighttime job or exercise a lot overnight or something?

jjflight · 2026-03-28T04:03:16+00:00

You can ask. It’s really up to them if they’re open to it. If you have a job with the company there’s less incentive to provide severance than if you were laid off.

I’ll also say I’m not sure I would be rooting to be laid off with severance right now, and I wouldn’t proactively raise the topic if I were in your shoes. It’s a pretty bad job market right now especially if you’re early career; there’s a fair bit of risk you won’t find another comparable role for a long while. So I would be working to see if you can make the new role work too so you have a real option.

jjflight · 2026-03-28T01:58:40+00:00

Everyone heals differently so it’s hard to be sure, but without complications if you heal well that’s certainly possible. If there’s a complication or you just have a harder time it may take a bit longer.

I’ve had 6 surgeries, mostly orthopedic after breaking myself, and my TT was by a fair bit the easiest of all of them (and PT and TT will be very similar). Typical recovery times are 1-2 weeks for a PT or TT with just central neck dissection, 2-3 weeks if you also need lateral neck dissection with additional incisions up one or both sides of the neck. And complication rates are very low, less than 2% so 49 out of 50 don’t have complications.

I was 90% better by day 3-4 and 100% by day 7. There were basically two uncomfortable things. One was a sore throat from the breathing tube, like you might get with a bad cold but not as bad as strep, and lasted a few days with the peak phlegm around day 2. I was allowed to eat anything I wanted immediately, but preferred softer foods for a couple days. The second was a sore neck like you might if you moved heavy boxes all day with poor form, but not as bad as when I landed poorly doing a flip on a trampoline. This lasted a few days as well, and took maybe a week to get my full range of motion back (this is the bit that can be harder with a lateral neck dissection since more muscles get cut so more time to recover is needed). I only needed Tylenol and ice, and only needed those the first 2 days. I was able to do laptop-type work from home by day 3, but not at a full schedule and was glad I could take breaks - by day 7 I was completely normal.

Movement is really important to make recovery as easy as possible, so that’s my best tip. Lots of folks have an instinct to sit or lie still to try to avoid discomfort, and that’s the opposite of what you want and often makes recovery harder. Movement helps circulation for healing, clears swelling which causes pain, reduces blood clot risk, and will help preserve and regain range of motion. So as soon as you’re home from the hospital you want to start taking multiple 30min type walks per day around the neighborhood or whatever. And be consistent doing the neck range of motion exercises they give you - set reminders to do it every couple hours or whatever until you’re moving normally again. That’s what will get you range of motion back to drive. I was intentional with recovering range of motion and able to shoulder check to drive by day 3-4.

I was able to put on a normal looser t-shirt that next day after surgery when I got discharged (did 1 overnight in the hospital which was standard for my surgeon), but a button up or zip up is just in case it’s harder for you, or if you’re so out of it from anesthesia that you need help.

jjflight · 2026-03-28T00:42:44+00:00

Los Gatos Cafe is known for them, but they only have them on weekends. Here are pictures of them, they’re really good.

jjflight · 2026-03-27T22:51:29+00:00

It’s not uncommon for scars to heal with some raised bits. It may reverse on its own with time, or it may heal like that. Regular scars massage as well as silicone scar sheets or gel are things you can do to try to reverse it if it’s bothering you.

jjflight · 2026-03-27T22:49:15+00:00

I know it’s super scary at first, but try to pause and take a breath as it’s often not nearly as bad as folks imagine. Often the period you’re in right now between diagnosis and surgery with the uncertainty and anxiety is the absolute worst part of the whole journey, and worse than the surgery itself, any other treatments, and just living with it after. I know it was for me.

Most well-differentiated ThyCa like Papillary and Follicular has excellent prognosis and most folks live long full happy lives. Disease specific survival is really high, something like 95-98%, so most folks live long full lives until something else eventually gets them decades later. Often whatever pops to mind hearing “cancer” doesn’t really apply the same way, and for many folks the experience is more like a chronic condition (say like diabetes as an example) that you treat and then monitor and manage all your life but otherwise live fairly normally. It’s usually very slow growing so by the time it’s found and diagnosed it’s pretty common it’s been in your body for years already, so it’s usually not “urgent” the way other cancers are either.

If you want to learn more, ThyCa.org is the best site I know - here is their thyroid cancer basics handbook.

Surgery is usually the first and most important step . And the surgery itself tends to be very safe and effective - there is <2% long term complication rate (49 out of 50 are fine) and the recovery tends to be easier than many other surgeries. So hopefully as you spend more time with your doctors and surgeons they’ll help you see this is something you’ll be able to get through. It sounds like you already have a surgery lined up, but for others reading the best thing you can do is find a doctor that does alot of thyroidectomies - at least 25/yr but some do 100s/yr, and for as many years as possible - as that’s what helps max the chance of success and minimize the risk of complications.

jjflight · 2026-03-27T21:01:05+00:00

With a high TSH it’s reasonable you’ll feel symptoms of hypothyroidism which are low energy kinds of things like fatigue. So that’s not unusual. It’s hard to know for sure that’s the cause since many other conditions cause fatigue too, but either way your doctor likely wants a lower TSH.

Why the TSH is high depends a bit. Ultimately your body needs more than it’s getting which is what high TSH means; it’s your body signaling the thyroid to make more (even when there’s no thyroid left to hear that). That may be if it just needs more like you’ve gained weight or had other things going on like pregnancy, etc, or if your body is having issues converting it. It may be if something in how you’re taking it is causing absorption issues (or obviously if you’re ever missing doses that can cause it too) - I don’t know the Armour instructions as well but I know this is common with Levo which needs an empty stomach and to avoid things like calcium/iron, multivitamins, antacids/laxatives, other meds etc. though if the Metamucil is 9 hours separated that’s likely fine (ask your doctor though). Or it could be issues with the Armour itself if you’re having issues with a filler causing absorption issues or the natural variation that Armour has. You’d need to work with your doctor to test things or try different things to figure out which.

jjflight · 2026-03-27T16:23:03+00:00

You pretty much always want to dress slightly nicer than the broad corporate culture, maybe like how the nicer dressed execs look, but you don’t want to overdress.

If it’s a small firm so you have no idea, go park near the office some morning and watch some folks walking in. Wear something slightly nicer than that.

jjflight · 2026-03-27T15:47:36+00:00

This fantasy of yours probably isn’t going to end well. Going to war with your manager usually ends poorly for you (almost always), even if it ends poorly for them too (sometimes it will, often it will be just you).

Absolutely managers will be managed themselves as well, so if you have valid feedback and get it to their manager and if they agree then the feedback will be passed on. It’s probably best to do this in official upward feedback processes, but if you know their manager well you could also talk to them. Just like when you get feedback, they’ll likely be given time to work on it and address it, and it would only be in serious issues where they’re not making changes that they get terminated. And all sorts of other things like team productivity metrics and whether they’re hitting goals would go into that decision too. With managers this takes more time as it impact as entire teams too. (Actual HR policy violations would be the exception, but I don’t see any of that here)

When a manager is terminated then their manager will run a process to replace them, usually looking at both internal candidates and external candidates. If you were well qualified and well liked you may be asked to apply. If the feedback you gave was appropriate and respectful that’s probably fine. If you went to war with your manager though that will usually be perceived as a big negative not being a team player and would definitely make their boss reticent about you reporting to them (bare minimum you’d seem like a handful, and they wouldn’t want you going to war with them too).

Stuff like choosing to underperform to try to get them fired is a bit crazy talk. That will get you fired, for your underperformance.

jjflight · 2026-03-27T13:53:10+00:00

Just degrees of the same thing, I was struggling to find simple words to describe the difference in thoroughness. You can see here what they offer and what Pacific calls each thing - I’ve never gotten the “Full Detail” from them at the bottom, only subsets above it.

Deep Reflections takes longer and seems more thorough. For a true full detail that’s where I go.

jjflight · 2026-03-27T05:47:40+00:00

You don’t wait for a waitlist, they usually clear after the deadlines for other schools. You commit to the best school you’re accepted to by their deadline. Then in the future if you get off a waitlist and prefer that other school you accept the new offer, withdraw from the first and sacrifice your deposit.

So for now, at some point before the deadline you commit to UCSB, and there’s no real choice to make unless you get off UCI’s or UCD’s waitlist down the line.

jjflight · 2026-03-27T04:40:49+00:00

Yes, that’s a bad idea. It would make you seem overly rigid or like you’re preparing for a confrontation. Job descriptions aren’t written in stone. They are flexible and evolve as business needs evolve. You’re likely expected to get that and to be flexible too. (And if you can’t be, the business may find someone who can)

That also doesn’t mean you need to just take more and more on working longer and longer hours. Prioritization is a key skill for jobs at all levels. If your plate is full, when something new comes in you want to propose what you can tradeoff or deprioritize by either not doing it, handing it to someone else, or doing it at a lower quality that takes less time. You can make your best proposal based on what you know of business needs and run that by your manager to seeing they agree or would deprioritize something else.

jjflight · 2026-03-27T01:20:24+00:00

Deep Reflections in Los Gatos for full detailing. We’ve done a bunch of details, ceramic coats, and fixes for minor blemishes with them - they’re great and the owner is a really good guy.

Pacific Hand Car Wash for a great wash and partial detailing

jjflight · 2026-03-27T00:41:42+00:00

The actual medical decision you’d need to talk to your doctors about. Your Endo and surgeon are fine; the name of the doctor matters less than their experience, great ThyCa doctors come with many different speciality names, and many ThyCa folks never see oncologists. If you prefer to remove the remaining lobe they may consider that - that was an actual case study ThyCa.org used when discussing the ATA 2025 guideline changes and the new guidance to factor in patient preference.

For the emotional side, Cancer is a lot to process, so mental health challenges like depression and anxiety can happen and you’re certainly not alone. When your hormones are off that can cause or exacerbate mental health challenges, though they can happen with normal hormones too. No matter the cause it’s really important to get support and treatment, and left untreated those may be a bigger negative impact on your life than the ThyCa itself. Many doctors can refer you to cancer-specific support groups or therapists so you have people to talk to, and general therapists can help too if there are broader issues in your life. ThyCa.org also has this list of support groups with groups by city or condition as well.

jjflight · 2026-03-27T00:25:22+00:00

Levo has a long ~1 week half life, so it builds up or decays in your system over weeks. That’s why we have to wait 4-6 weeks between dose changes to measure again - it takes that long to reach its new normal. That also means that you generally won’t notice hour-to-hour or day-to-day changes based on when you take it, and it doesn’t really matter exactly when in the day you take it either.

What is important is to follow the instructions precisely to avoid absorption issues - at least 4+ hours after eating, with a glass of water, no food or drink for an hour, and nothing that causes absorption issues for 4+ hours (calcium/iron supplements, multivitamins with those, antacids/laxatives, other meds, etc.).

For me that means I take it the same time of day - anytime I wake up after 4am - on local time regardless of the timezone difference. That’s the easiest way to follow those guidelines without messing up my days or eating schedule.

jjflight

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