Questions...

[TonnaB]

TSH 1.91  (0.4-4.5)
T4    6.6  (5-12)
FreeT4 0.66 (0.8-1.5
Peroxidase <10 (0-40)
All normal, I know, but I knew you'd ask :-)

I'll try to make a long story short. Summer 2006-noticed a catching of my voice when I sang or spoke loudly. Bottom right, where my thyroid is. I could touch the exact spot it was. Just thought whatever, didn't go to the Dr. Didn't know anything about thyroid at that time. Winter 2006, wearing gloves & hats inside I was so cold, heartbeat down to 40 bpm, slept the whole winter, don't even remember Christmas. Mentally feeling very slow. Too tired to talk most days. Tongue swelling.I have a phobia of Dr's so I just thought I'd tough it out..lol

Spring 2007-catching voice progressively worse. Feeling like someone is holding their fingers around my neck. Sort of a suffocating feeling all the time. VERY itchy neck exactly where it is. Bursting outta my skin I was SO energetic. TSH was 1 which is perfect, I know. They wouldn't run any other tests, didn't think my symptoms warranted it(which is code for 'This woman has no insurance' :-)) Nurse said thyroid felt large. Ct scan said "Thyroid normal in size".Swollen gland on side of neck, had it biopsied, normal. He looked at vocal cords, normal.
He just sent me on my way without any help on the catching. Said to stop worrying, probably a muscle, so I just gave up.

Summer 2008- Catching happens with almost every sentence. Can't talk much anymore without getting a headache, when I speak it is so tight in my neck I get light headed, so I have nasty headaches a few times a week, totally tied into my throat, because I can feel the suffocation when I talk. Looking down makes me light headed almost, & feels as if it's hard to breathe. Sleep with neck extended, because of the choking feeling when my neck isn't just right. Granola & nuts get caught in my throat when I eat. Tongue still swollen. I've went from 110 to 158 since this all started. So much more but I'm trying to keep this short...Hahaa!

Went to diff Dr in July. He said it has to be thyroid with all my symptoms. Promised if my labs were normal he'd order an ultrasound. I called for my results & they said he wanted to send me to a G.I. I told them about the US and they said he wanted a GI to do an EGD. He said with the CT scan being normal a year & a half ago, an US wouldn't tell him anything different. Nobody has even touched or looked at my neck except for one nurse in spring 2007.

SOOO, my question is, what should I be looking at and asking for? The area the tightness is is from a little below my indentation on the base of my throat up to a little above my adams apple.
Sorry this is so long. I just want to know why this has gone on for 2 years & I'm still at square one.
Thanks in advance. And hello to everyone I knew the last time I was here :-)

[kitty9309]

A sub-sternal thyroid goiter can cause the symptoms you mentioned when 898 asked you to put your hands over your head.

Does your face get red when you do that?

http://www.annals.org/cgi/content/full/125/7/568

http://www.endocrineweb.com/sternal.html

[TonnaB]

Nope, no neck surgery. I had a small lymph node removed on the side, but nowhere near where all the action is...lol. So that shoots that theory down :-(...Don't go getting all scary on me talking about an obstruction behind the sternum either!! I'm getting paranoid enough as it is...if it isnt my thyroid then I don't wanna know...lol.

[898]

Sternum is the same as breastbone; I can speculate that if you had any neck surgery, then post-surgery connective tissue ["internal scar"] may form in that area.

[TonnaB]

I didn't mean my sternum...isn't that the breastbone? I meant where my collarbones would meet in the middle. The strangling goes from there to what feels like around my adams apple...feels like whatever it is is going inward instead of out?

[898]

Could be some type obstruction behind the sternum, in the upper chest.

[TonnaB]

I just did it, & it's not so much shortness of breath as it is feeling like I'm holding my breath or my throat is closing off at my sternum & my heads gonna pop. Not painful, just like I'm holding my breath. Lightheaded. Why?

[898]

One more question, do you have shorness of breath when you are lifting both arms above the shoulders?

[TonnaB]

Between 8 & 18 cubic centimeters? To me you just said blah, blah, blah...LOL ;-)  I have no idea what that is. It's been a thousand lifetimes ago that I had to use real math.
How bout in in mathematically challenged persons terms? You seem very knowledgeable, sorry for all the questions. Anyone else is welcome to join in also with thoughts...It's been a while since I've been here & I missed you guys.

[898]

If thyroid abnormality is suspected the ultrasound can give definite answers about thyroid, parathyroid and lymph node condition in the neck region.
According to the 10 years old article, 50 % of the people with  thyroid abnormalities have NORMAL hormonal level.
If thyroid inflammation took place in the past, the scar tissue may form in these areas, which can cause 'compressive effects'.
The volume of normal adult thyroid is between 8 and 18 cubic centimeters for females; one lobe can be larger then other.

[TonnaB]

Thanks so much for all your knowledge! It's visible when I swallow with neck in normal position & VERY visible when I swallow with my neck extended, which make me very lightheaded.  I'll try to take a decent pic of it & upload it later. What looks big to me may not be big to someone else. At the bottom where they are separate in pictures they are squished together. Almost feels as if something is growing where my collarbones meet when I look down.
So the advice would be what? Go to another Dr. & try to get an US? Because the one I have now said no, he will send me to a GI Dr. But no more neck testing because of normal labs.I hate to ask them, because it's been my experience that the ones I've been to don't like suggestions on what I think. Then they ask me about anxiety & try to prescribe me meds for it. Guess they think I'm crazy ;-P

I have one more question. In 2006 when this all started & I had the worst of the physical symotoms, could that have been some type of thyroid thing & then it evened out & now I'm stuck with the enlargement?

Guess I shouldn't have been such a chicken & went to the Dr then when it was bad. I don't have any other things now except for being crazy hot all the time, puffy face & hands, swollen tongue, exhaustion, and the whole not being able to talk without getting a headache...lol.
And do yo or anyone else have any dimensions for what's normal? I've googled it & have come up blank so far...Thank you!!

[898]

The normal thyroid gland is usually not visible and hardly palpable [unless you have really thin neck]; most masses are visible while patient swallowing with neck extended.
Side view may also be necessary
Less then 5 % of hashimotos patients have normal TPO AB level; if thyroid feels wooden-hard, rare type of " fibrous struma " is indicated [when thyroid forms a hard 'shell' around itself]

[TonnaB]

I have never had an ultrasound. Nobody will do one because my labs are normal. They did a CT scan in April? 2007 because of the swollen node & the tightness I felt. That wouldn't have shown a nodule on the voice box or thyroid?

  I've done a neck check a million times, I don't see any lumps, all I see is my thyroid gland...looks to be about even on both sides, right side a little bigger. It is very pronounced on the bottom...seems to be thick from the back towards the front...no real gap where the isthmus is, they just blend together almost. Just how visible is it supposed to be? I can't find any info on that. Dimensions, visibility...any info would be appreciated being as I can't even get anyone to look.

[898]

He looked insidethe throat to look on the vocal cords but the nerve that controls the voice is on the outside of voice box.
If solid nodule develops in that region it can cause loss of voice.
If ultrasound was not performed recently it is good idea to do so.
You also can do 'thyroid neck check' to catch any large lumps in thyroid area

[TonnaB]

The ent looked at my cords last year...said they were fine. And it is bad even when I'm not speaking. Always have to keep my neck extended to keep from feeling like I can't breathe.

[898]

The ultrasound will be most accurate to determine thyroid size; however the symptoms you are mentioning could be also vocal nerve inflammation related.