43 yowf,smoker 28 yrs. I was diagnosed with RA and ALE at 23. Took plaquenil 6 months til affected vision. and last 20 yrs I manage with occasional steroids for flares and I exercise and I'm very active. I have raynauds and antiphospholipid syndrome and osteoarthritis for sure, but rheumatologist disagree over lupus and RA diagnosis. Sometimes Ana andRF is pos but not in 15 yrs so I don't risk taking biologic. Also have autoimmune thrombophilia (mthfr+,pai-1+ )diagnosed in last pregnancy after recurrent miscarriage. My father died at age 51 from rare bronchogenic carcinoid. He had lupus, raynauds(had multiple digits amputated). I had a cough 3/2017and had a chest BY that showed minimal lingular right middle and hope we love scarring with mild bilateral dependent atelectasis. Now, yesterday after persistent SOB cxr reveals 13mm calcified nodule right middle-upper lobe. Exact location of previous abnormalities. I've been a critical care RN for going on 20 years and buried both parents from lung Ca. Dad with the rare carcinoid and mom with NSCLA. Both progressed RAPIDLY and was stage IVs at diagnosis. I have a 4 no thyroid complex nodule seen uS 6 months ago that my primary care Dr said not to worry about. Btw, it's on right side of thyroid and my T4 had been low for over 3 yrs. I've experienced 30#weight loss in last year. Shoot straight , I can handle it. In my mind, I want to have immediate thyroid ectomy and r lung lobe removed ASAP. I know I'm jumping the gun and haven't even had CT. But what I've seen, my fears are warranted. How do I convey the severity of being aggressive with surgical options, when I know logic will be imaging, pet scans, bone scans, etc. I watched my parents spend their retirement funds at MD .Anderson's hoping for a miracle to be told it was too rare and they didn't know enough to treat it. I know those cancers have a high ;90%) 5 yr survival rate if diagnosed early, but are often misdiagnosed due to sometimes presenting as a calcified nodule. Seeking professional advise...am I off base ?