Back from doctor / Back to SQUARE ONE.

[stella5349]

OK ready for this ---

Went to my MD -- My appointment fro 11:00 today was delayed to say the least b/c no US report was sent to him. Went back at 6:00 . and yes I got A COPY of the report. SAYS:

Left lobe measure 3.4x1.6x0.9 cm. In the lower pol of the left lobe there is a well circumscribed oval,

**isoechoic**

nodule, 11x10x8 mm.

**Mild increased vascularity**.

**The reminder of the left lobe has mildly heterogeneous echo texture. The isthmus appears quite atrophic. **

There does not appear to be mass effect by the thyroid or the left thyroid nodule upon adjacent structures. (then why am I gagging there when you touch it!!)

IMPRESSION: 1. Decreased size of the thyroid and mildly heterogeneous echo texture, likely secondary to previous RAI  and previous thyroidtis ( I take that as my thyroid is a pile of shriveled up junk. Right?)  2. Solitary 1 cm solid nodule in lower pole. Its isochoic texture suggests a benign lesion, but would be amenable to US- guided needle biopsy if desired. ( FNA!!)

THese little ****** i put by words or sentences  I need defination - not sure how to read properly.

The use of (    ) means what I am thinking while reading the report

So my doc says to me. after I suggested TT - no your problem is your lungs that is why you are coughing and so sore there. I said for 4 years? -- he didn't answer much. put me on a breathing treatment and basically sent me off with don't worry about your thyroid now for at least 3 weeks. GAve me an inhaler and sent me off.

February 27 though he, will be running a full hormone panel and antibodies. (I told him it was a good idea) whiskers on chin ect.

Here I am preparing myself all day to get a referral for an ENT surgeon and get the boot with an inhaler saying my lungs are the issue oh yeah got a Rx for predisone too. NOT!!


Any comments????

I lean toward seeking an ENT surgeon with thyroid experience myself and running this report past him.

Not happy - I mean no one wants surgery - but the RAD doc said the risk of thyroid cancer is high in these cases. She said that Friday night . Both Scott , my husband and I heard her. (No brain fog there)  No I take her rpeort she sent as no big deal.

What's up w/ that??

[AR-10]

:) You noticed!
If I could just get the hair under control...

I'm going to have to get Barb working on a real photo.

[stella5349]

yeah -

Great face lift from what I can see on your photo.

[AR-10]

Do NOT perform surgery on yourself!

Looking in the mirror makes everything too confusing.
Don't ask me how I know. :)
LOL!

[stella5349]

I no Tater.

Lungs now. What the he// ?? We are getting 20" snow tomorrow - I'll check back in this tread then.

Just disgusted. and crabby --- usually not me as you all know. Flipp'n sore throat - I am ready to preform that job my self like that commercial.  Right AR - you know.

[ChitChatNine]

Why didn't the jerk schedule an FNA at the very least for now? any nodule .. esp that large .. needs a biopsy ??  Where is his head?  Mine was only 1.9cm's and my primary sent me 1-2-3 for an FNA after my ultrasound even though nothing with red awful flags were in the report .........

I think you have two things going on here (lungs/thyroid) and an ENT can help you with both and/or find you a good pulmo guy/gal as he sorts thru the ultrasound report.

Also a 3rd party neutral opinion I find very helpful is an Endo bcz they don't slice and dice.

I had 4 opinions and 3 said surgery for me as my FNA was atypical and 25% of atypical growths turn into cancer .. that was enough for me to have it out.

C~

[stella5349]

Just read Xopenex side effects caution to use with hyperthryroidism

Well apparently he didn't look at my labs from 3 weeks ago. As a fresher he switched my meds for 120mcg to 60mcg because TSH was to low. *

HYPER -

Grrrrrrr    do I have to be the doctor here??

[stella5349]

Oh i forgot ......... suprise suprise.

I walked away with 3 Rx's yesterday too. Qvar 80 mcg inhaler - asthma med

Predisone and xopenex inhaler.

I see all steriod based. Not good as to what I read.

This should and will irragulate my TSH even more.

[utahmomma]

Clarification to everyone else:  Usually I wouldn't push someone to surgery but Stella had RAI for Hyper and her thyroid is supposed to be "dead" - the new nodule *shouldn't* be growing and, since she's had radiation, is concerning (even the radiologist was concerned).  Besides, she's gaging and choking.

All pretty good reasons to get that nasty thing out, ASAP, IMHO.

[katekos]

Sorry you seem to be getting the runaround!  Was this your PCP or Endo you saw today?  Are they going to do the FNA?  B/c it seems to state in the report that they should.  If it was your PCP that you saw today then I would push for a referal to an Endo.  If it was your Endo then I would head back to the PCP for a referal to a new Endo.  Of course I am assuming that you have the type of insurance that requires referals and such (such as mine).

[kitty9309]

My nodules are hypochoeic, but <1 cm. Hypochoeic is not always a problem. I have read that 1 nodule does raise suspicion, though.

Go with utah's suggestion.  Also AR's.

I'm sorry for you that we always have to fight the system.

You're tough- keep fighting!

[AR-10]

It sounds to me like your thyroid is HALF a pile of shriveled up junk, with a fair sized nodule/lesion that sounds more like a lump than a finger.

The definition of isoechoic that I read said "hard to distinguish from surrounding tissue".


http://www.ncbi.nlm.nih.gov/pubmed/1523294

This link says a isoechoic nodule, should be FNA'd, with 100% success of diagnosis and a 13% chance of being cancerous.

Hypoechoic seems to be the nasty one.

It doesn't recommend surgery if the FNA looks good.


I'd take utahmomma's advice and start looking for a good ENT.

I will say though, my PCP talked to three ENTs that wouldn't touch me because my Endo was 160 miles away, and didn't recommend surgery. Maybe things are different where you live, or maybe the ENT will hook you up with a new Endo the ENT is comfortable with.

Get the FNA somewhere along the way, and doctor shop until you find an ENT that does a lot of thyroids, that you trust and feel comfortable with. Then listen to him.

You don't have to pick the first one. You can always go back to that one if the next one or two don't seem as qualified.  

Sorry the day was such a let-down for you.
I was really hoping you would here good news.

[stella5349]

Utah -

On our way home even scott , who has no clue, said we need a second opinion.

I hate to dog my MD - he really has been good to me on basic thyroid issues and totally on top of blood work. I is doing a work up on me for all hormones finally. I have begged for that for decades. ( maybe those whishkers won't need plucking soon :)

- I do believe he is out of his realm here through.

The right path will come - It takes time as we all know. You just need to search for it.

[Jessi63]

Sorry things went so badly.  Hope things work out and I do agree with utah.  Jessi

[utahmomma]

Get to an ENT surgeon.  Take the report and all of your history you can gather.  

Your RAD doctor is correct - you are at increased risk because of the radiation.

Bypass the idiot you saw today and find an ENT on your own - you don't need a referral for an ENT.

Grrrr - stupid doctors who don't know how to deal with our stupid thyroids.  Grrrrrr

(the above is my opinion and only my opinion only so don't flame me people - my tinfoil hat is flameproof!  Ha!)