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thyroid nodule, goitre , left lobectomy scheduled for july 27th + sleep apnea?

nodule surgery goitre sleep apnea

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#1 cascais

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Posted 16 June 2017 - 03:26 PM

Hi all,

 

i am a newbie, this is my first post.

i am not usually part of forums, but i have been researching thyroid issues and thyroid surgery and i have arrived here !

 

my story really started in january last when my parents were over for a visit. (my parents live in a different country , i don t see them very often).  My mother how had her thyroid removed about 15 years ago (aged 58 or so because of a  benign nodule) noticed that i had a very big neck and told me "you should really have it checked out". i thought nothing of it, and went on my daily life .

 

about a month later , i started having issues with sleep, not able to sleep, waking up at night ,with a pressure feeling in my neck, i also woke up one night with pain on the bottom of my neck. especially lying down the pressure was terrible and on one side the pressure seemed to be worse . i also had issues with nightime palpitations and thirst first thing in the morning .So i eventually decided to go to a GP.

the doctor felt my neck and said i had a "goitre", ran some bloods  and asked me to have a xray and an ultrasound. i went privately for those as i did not want to wait in the public system.

 the xray came back clear but the ultrasound came back with a category U5 nodule ( see more about nodule categories here ( https://radiopaedia....thyroid-nodules) on the left and a couple of category U2 on the other side . i was then referred on to a private endocrinologist.

 

the endocrinologist said my bloods were normal, although i still have my doubts in that regard ( see results below), but said the nodule on the left was U5 and because of this we needed to have a FNA on it.

the result of the FNA returned "undetermined" .

  i was then refered on to an ENT for thyroid surgery, who has scheduled a left lobectomy on july 27th but has pretty much told me if you want to have it all removed left me know , but that he would not make the decision for me or  the decision would not be made on the day/table. he did mention my thyroid was swollen on both sides . he seems to have a very good reputation .( but not much of a talker )

 

 

in the meantime, another of the Gps in the surgery seemed to think i may also have sleep apnea. given my problem going to sleep and staying asleep and general tiredness i feel/ somnolence during the day ( i do work in front of the computer all day that won t help, and i have 2 toddlers who wake up at night also). My father has sleep apnea , so he thinks  i may have it also. so i was reffered to a breathing consultant. i am seeing him on monday for results of sleep studies .

however, i have looked into this and although rare, thyroid can cause sleep apnea i think.. so i wonder , is this all related after all ?

 

i am quite confused  at the moment, i do not should i go ahead with left lobectomy or request it all gone ? i also had an ovary removed a few years ago, and already have balancing issues for hormones, i have night sweats ad hot flushes like i was  menopausal, but i shouldn t be yet , i m 38, the bloods say i am not menopausal, is that again due to the thyroid..? would hormones be easier to balance with all the thyroid gone ?

what bugs me the most is that the ent surgeon leaves the choice to me? how do i know what to do ?

if i am honest,. the pressure has eased a bit since i went to the gp originally, but i am concerned about leaving half of it in there ? i wonder if i should do the whole shabang and be done with it!

 

i have asked the gp for an opinion, she is to ring me back next week.

 

my bloods are :

13.05.2014 tsh 0.26 fT4 14.0

05.02.2016 tsh 0.63 fT4  11.7

15.04.2016 tsh 0.98 fT4  12.7

28.02.2017 tsh 0.66 fT4 15.43

 

The range for tsh is 0.27-4.20

The range for free T4 is 12.00 to 22.00

 

what would you do ?

 

thanks

cascais

ps:i have also had issues  with low iron post pregnancy in 2014 and post natal depression, although i am not sure if there any relation...



#2 joplin1975

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Posted 16 June 2017 - 10:51 PM

Could you please edit your post and include the reference ranges for your blood work?

Did they test thyroid antibodies?
Papillary cancer with lymph node involvement
Total Thyroidectomy 8/29/11
TSH 71.17 on 9/14/11
RAI 100mci 9/23/11
Starting point for replacement meds: 50 mcgs of Synthroid, TSH 121.88 on 11/8/11; 100 mcgs of Synthroid, TSH 43.21 on 12/9/11; 137 mcgs of Synthroid, TSH 7.88 on 1/11/12; TSH 8.38 on 2/9/12, 150 mcgs of Synthroid, TSH 2.81 on 3/27/12, TSH 0.54 on 5/8/12, TSH 0.78 on 8/8/12, TSH 0.39 on 12/20/12, TSH 0.24 on 3/5/13, TSH 0.33 on 4/15/14, TSH .12 on 3/10/15, TSH 0.21 on 9/15/2016, TSH .12 on 2/17/17.

#3 cascais

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Posted 17 June 2017 - 07:46 PM

Hi joplin1975
Thanks for your reply
I am not too sure if I can edit this right now i am on an iPhone at the moment . I ll have to try from work on Monday
As far as I can see on the blood work antibodies we're not tested
The range for tsh is 0.27-4.20
The range for free T4 is 12.00 to 22.00

Kind regards
Cascais

#4 joplin1975

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Posted 18 June 2017 - 11:21 PM

So your free t4 looks hypo but you TSH looks good, perhaps borderline hyper. I think you've got antibodies fiddling with your results.

If I were you, I'd ask to have the following tested: TPO, TSI, and Tg/TgAb.

If any come back elevated, I'd get the whole thyroid out. The other half will likely always cause antibodies and that makes dosing difficult,
  • Lovlkn likes this
Papillary cancer with lymph node involvement
Total Thyroidectomy 8/29/11
TSH 71.17 on 9/14/11
RAI 100mci 9/23/11
Starting point for replacement meds: 50 mcgs of Synthroid, TSH 121.88 on 11/8/11; 100 mcgs of Synthroid, TSH 43.21 on 12/9/11; 137 mcgs of Synthroid, TSH 7.88 on 1/11/12; TSH 8.38 on 2/9/12, 150 mcgs of Synthroid, TSH 2.81 on 3/27/12, TSH 0.54 on 5/8/12, TSH 0.78 on 8/8/12, TSH 0.39 on 12/20/12, TSH 0.24 on 3/5/13, TSH 0.33 on 4/15/14, TSH .12 on 3/10/15, TSH 0.21 on 9/15/2016, TSH .12 on 2/17/17.

#5 cascais

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Posted 19 June 2017 - 08:39 AM

Thanks joplin1975
I was actually thinking the same - having the bloods redone . They are basing this on bloods from the end of February - surely this should be based on recent bloods.
There is a thing in the blood work called triglyceride I am not sure if that's the same as tg/tgab . The triglycerides come back as 1.16 in April 2016 and 0.78 in February 2017 (range 0.50 to 1.70) . Other ones not in the list at all, but I think you are right they should have checked. Surprised the endo didn't order his own blood work...
I am due to this the sleep consultant today so I ll ask him what he thinks too.
Kind regards
Cascais

#6 joplin1975

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Posted 19 June 2017 - 11:11 AM

That's related to cholesterol, not your thyroid.

Just gather as much information as you can so you can make an informed decision.
Papillary cancer with lymph node involvement
Total Thyroidectomy 8/29/11
TSH 71.17 on 9/14/11
RAI 100mci 9/23/11
Starting point for replacement meds: 50 mcgs of Synthroid, TSH 121.88 on 11/8/11; 100 mcgs of Synthroid, TSH 43.21 on 12/9/11; 137 mcgs of Synthroid, TSH 7.88 on 1/11/12; TSH 8.38 on 2/9/12, 150 mcgs of Synthroid, TSH 2.81 on 3/27/12, TSH 0.54 on 5/8/12, TSH 0.78 on 8/8/12, TSH 0.39 on 12/20/12, TSH 0.24 on 3/5/13, TSH 0.33 on 4/15/14, TSH .12 on 3/10/15, TSH 0.21 on 9/15/2016, TSH .12 on 2/17/17.

#7 cascais

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Posted 19 June 2017 - 02:50 PM

Thanks joplin1975 I am going to wait until I talk to the gp later this week. I am planning to ask her to redo bloods and test the antibodies also so I can make a more informed decision.
On another note the sleep consultant does not think I have apnea he says I have mild snoring and has recommended some devices to help with breathing at night time but I am going to wait until the thyroid is done before looking into that any further

#8 cascais

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Posted 19 June 2017 - 02:58 PM

if anyone wants more information , it can be here :

https://www.thyroid....apnea-symptoms/

cascais







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