Is surgery necessary?

[bamamom2]

I would very much appreciate your opinion:

As of October 2008:
Levels:
TSH 2.33 (0.34-4.8)
FT4 .82 (0.77-1.61)

sonogram:

Findings:  The right lobe is 4.6 X 2.2  X 1.9cm.  The left lobe is 4.4 X 1.4 X 1.1 c.m  Multinodular thyroid appearance is seen with 4 mm nodule in the upper pole on the right and 2.8 cm nodule in the mid aspect of the right lobe noted.  7 mm nodule in the right side of the isthumus is seen.

Impressions:  Multinodular thyroid disease with a 2.8 cm dominant nodule in the mid right lobe of the thyroid.  This has a complex appearance.  Nuclear medicine I-123 scan to exclude a dominant cold nodule here is suggested to exclude malignancy.

Nuclear Med I-123:

"Cold nodule on the right-Neoplastic nodule cannot be excluded"

FNB:

Diagnosis:
Right thyroid gland, FNA, smears/autocyte prep. negative for malignant cells.  Benign follicular cells with a moderate amount of colloid, Hurthle cells and blood.  Consistent with nodular goiter.

Present meds:

premarin 0.623 mg
nexium 40 mg
simvastatin 40 mg (take l/2)
glycopyrrolate 2mg (take l/2)

5l year old female, 5'l",  approx. 166 lbs.
VAP study:  LDL 136 with homocystine elevated at 21 and highly sensitive CRP elevated at 6.9

What would you recommend at this point?

My concerns with surgery:

weight gain (really can't afford to be any heavier at my height)
Hair thinning/loss
emotional problems (anxiety, depression, etc.)
not being able to function physically or mentally.

If I have surgery (removal of the right lobe), would you recomment hormone replacement?  If so, which one and what dose?

Also, if I have surgery, what is the best treatment to minimize scarring?

Thank you so much

[bamamom2]

Thanks, you are both very kind,

Bamamom2

[redheadaussie]

If you have the one lobe removed it is unlikely you will need any medication. The other side, will, after some time pick up the slack.
These days the scarring is very minimal. Some on this forum have had keyhole surgery. Meaning a tiny scar. I have had two surgeries, a left lobe removed and then the right 6 months later..and I am very fair skinned, and my scar is fading nicely. These days they don't use yards of stitches, but a kind of super glue... so you'll be fine!

[AJWS6]

I understand.  

Surgery is scheduled, to help you feel better.  

I'm sure someone will be by, that maybe able to answer your questions & provide support.  

Good luck to you !!  

[bamamom2]

Yes, I'm actually scheduled for surgery.  I'm just having doubts.

Thanks, I'll try to get through on the "ask the doctor section".

[AJWS6]

Have you spoke with a general surgeon ??  You can also post your question to Dr. Lupo here at the forum, in the ask the doctor section.  He can answer complex questions and explain your lab results.  

Sorry, couldn't be more help.  

Good luck to you !