High T3, surgery cancelled

[sdlane]

So my surgeon at UCSF just called an said she's canceling my thyroid removal for next week due to my T3 still being too high.  Something about thyroid storm or cardiac issues during surgery.  I have Graves and started Methimazole about a month ago.  I'm at 30mg/day and have been at that for the past 3 weeks. TSH is >.01, T4 is low and T3 is high at 6.9 or 7.0.  My thyroid is huge, and now I have a noticeable lump (it moves around like a cyst) on the right side of my neck.  I'm really disappointed that she canceled it, but better to be safe than sorry.  Any chance that this might be thyroid cancer?  Or maybe just an enlarged lymph node that is irritated because of the inflamed thyroid?  Thanks in advance.  :)  By the way, an ultrasound in July showed strangely shaped neck lymph nodes that she said could be pre-cancer, but if they were, they would be really early stage 1.  She told me then that she was going to take them out when she took out the thyroid and send them to the lab.

[Mark Lupo, M.D.]

It's best to stabilize thyroid levels with methimazole before surgery.  We sometimes also use SSKI (potassium iodide drops) 10 days pre-op to decrease thyroid levels and blood flow to the thyroid.
You are in great hands at UCSF - I know some of the surgeons there - follow their advice....

[Mark Lupo, M.D.]

If you are already on methimazole, the SSKI can be used to further lower T4 and T3 as well as prepare you for surgery, but it may be necessary to take for a few weeks...

[sdlane]

My surgeon at UCSF is amazing....and I completely trust her.  I guess my T4 and T3 are still above the acceptable range and she won't operate until I'm back in range.  I was supposed tos tart the SSKI on Monday, but she said to hold off until the T4 and T3 are acceptable.  I'm on 30mg of Methimazole right now and stopped taking the beta blocker (Atenolol) because the Methimazole pretty much took my blood pressure and heart rate down to where I'm not as symptomatic as I had been.  My question, however, is what medicine will reduce the T4 and T3 low enough to be in the reference range?  My T3 has actually increased, and my T4 slightly decreased, on the Methimazole over the past 45 days that I've been on it.  Thanks.  :)