# New with questions



## 2boysmom (Feb 2, 2010)

Hi, I don't have any diagnosis yet but worried by what my GP said. First I will catch you up last Wednesday at the dentist for cleaning and she said my right side thyroid is twice as big as left. Did I know this? of course not. Go to GP on Friday and he orders blood work, ultrasound and a chest x-ray because I feel I am getting pneumonia. Fast forward to Monday (yesterday) go give blood, do x-ray, and ultrasound. radiologist calls my doctor and says that there is no need to do an uptake test? (dr ordered it if thyroid showed enlarged with ultra) they want to go straight to biopsy. The radiologist told my doctor that it was a solid mass and he is sure it is cold. and said these usually point to being malignant. I go for needle biopsy Thursday. 
Probably premature to be asking things but just scared I have cancer.

Trish


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## Andros (Aug 26, 2009)

2boysmom said:


> Hi, I don't have any diagnosis yet but worried by what my GP said. First I will catch you up last Wednesday at the dentist for cleaning and she said my right side thyroid is twice as big as left. Did I know this? of course not. Go to GP on Friday and he orders blood work, ultrasound and a chest x-ray because I feel I am getting pneumonia. Fast forward to Monday (yesterday) go give blood, do x-ray, and ultrasound. radiologist calls my doctor and says that there is no need to do an uptake test? (dr ordered it if thyroid showed enlarged with ultra) they want to go straight to biopsy. The radiologist told my doctor that it was a solid mass and he is sure it is cold. and said these usually point to being malignant. I go for needle biopsy Thursday.
> Probably premature to be asking things but just scared I have cancer.
> 
> Trish


Hi Trish! Holy cats! Well, the good news is that your hygenist is certainly on top of things. The second piece of good news is that if it is cancer, it is "usually" confined and easy to eradicate.

The third piece of good news is below.

85% of thyroid nodules are cold, 10% are warm, and 5% are hot. Remember that 85% of cold nodules are benign, 90% of warm nodules are benign, and 95% of hot nodules are benign.

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

Thursday seems a long way away but I want you to know that I care about this even though we have just met and will keep you in my thoughts and prayers.

And, if you are able, get back to us after you get the biopsy (want to know how you feel) and definitely when you get the results.


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## 2boysmom (Feb 2, 2010)

Biopsy went well last Thursday. Still haven't gotten results from it but I did get a copy of the ultrasound reports and a copy of all my blood test. I will post what I think would be helpful for anyone to give their opinion of what is going on with my thyroid. There was tons of blood work so if there is more info maybe I have it.

from Ultrasound report:

Real-time examination fo the thyroid gland demonstrating the right lobe to measure 5.0 x 3.2 x 2.9 cm in size. It contains a mass that is 4.0 x 3.1 x 2.3 cm. This is a hyperechoic heterogeneous mass with internal blood flow. This mass shoudl be evaluated further with a fna for evaluation of malignancy. There is a small 4.2 x 5.6 x 3.9 mm irregular bordered hypoechoic nodule also present on the right in the inferior pole below the level of the large mass. this appears as a benign predominantly colloid cystic density.
The isthmus measures 4.4 mm and appears normal. The left lobe inferiorly contains a benign appearing tiny nodule that measures 4.2 x 3.2 x 1.2 mm and it is hypoechoic and probably represents a small colloid nodule. The left ovary measures 5.2 x 1.5 x 1.5 cm in size and has a normal echogenic pattern and blood flow with the exception of the tiny inferior pole nodule as described.

then blood work:

cholesterol, total 205 125-200 mg/dl
hdl cholesterol 33 > OR = 46 mg/dl
triglycerides 252 <150 mg/dl
ldl cholesterol 122 <130 mg/dl (calc)
chol/hdlc ration 6.2 < OR = 5.0 (calc)

TSH 3rd generation 1.43 > OR = 20 years 0.40-4.50
T4 (thyroxine), total 9.1 4.5-12.5 mcg/dl
T3, free 240 230-420 pg/dl
T3, total 85 76-181 ng/dl
thyroid peroxidase and thyroglobulin antibodies
* thyroglobulin antibodies <20 <20 IU/ml
* thyroid peroxidase antibodies <10 <35 IU/dl

there are more blood work numbers if needed.

I hope all this will mean something to you and be able to give me a clue. I didn't know what the thyroid was until a couple weeks ago.

thanks


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## Andros (Aug 26, 2009)

2boysmom said:


> Biopsy went well last Thursday. Still haven't gotten results from it but I did get a copy of the ultrasound reports and a copy of all my blood test. I will post what I think would be helpful for anyone to give their opinion of what is going on with my thyroid. There was tons of blood work so if there is more info maybe I have it.
> 
> from Ultrasound report:
> 
> ...


While below range, you do have a smattering of antibodies (Antimicrosomal and Thyroglobulin) which means you do have them and that suggests autoimmune.

Your TSH and other labs are in range but to be noted that your Free T3 is in the basement as they say even w/TSH in normal range. We we look at the scan, we can see why. We often see unusual labs when a thyroid is as unwell as yours is.

Don't delay on that FNA (fine needle aspiration) as there is a chance that you have a maligancy. You already know this, of course.

Let us just be glad that it is caught in time. I believe that it has been. Fate intervened and you had your teeth cleaned. You are very very lucky in that sense.

It appears confined according to the scan so not to worry. Sending hugs and prayers.

Keep us up to date if you will. And thank you bunches for posting all of this.


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## 2boysmom (Feb 2, 2010)

Well I don't know what to think. I went to get a copy of my path report from the fna and all it says is "consisten with nodular goiter"

I did get to talk to the doctor and he said its good news, not cancer. He said his sugestion would be to start me on Synthroid 25 mcg and get more labs in a month and see if we need to increase the dose.

He acted like my putitary gland is producing too much and causing the thyroid on that side to enlarge and if I take this pill it will trick the pituitary gland into now producing as much and should shrink the thyroid. He said that other than having a enlarged thyroid this would cause nothing else to go on with my body or anything with the things a out of whack thryoid can cause.

I don't know what to think of all of it. should I go see an endocron. to get a second opinion? or does this all sound right?


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## thatbrian (Dec 11, 2009)

Glad to hear that it's not cancer, and also glad that your biopsy was definitive. At least you know what you are dealing with, and you didn't need surgery.

Did your doc want an MRI of the pituitary to see if there was something causing it to over produce? I'm no doctor, but I think you you should try to get the the root cause before you settle for just treating symptoms. Also, IMO, you should seek out a GOOD endocrinologist.



2boysmom said:


> Well I don't know what to think. I went to get a copy of my path report from the fna and all it says is "consisten with nodular goiter"
> 
> I did get to talk to the doctor and he said its good news, not cancer. He said his sugestion would be to start me on Synthroid 25 mcg and get more labs in a month and see if we need to increase the dose.
> 
> ...


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## Andros (Aug 26, 2009)

2boysmom said:


> Well I don't know what to think. I went to get a copy of my path report from the fna and all it says is "consisten with nodular goiter"
> 
> I did get to talk to the doctor and he said its good news, not cancer. He said his sugestion would be to start me on Synthroid 25 mcg and get more labs in a month and see if we need to increase the dose.
> 
> ...


I sure am glad that this FNA came back benign. Given the noted irregularities within your thyroid, I would make sure that I found a doctor who is going to stay on top of this. Indeed, I would.

It is true, if the patient has non-toxic nodular goiter, taking thyroxine replacement should help to shrink it.

Are you symptomatic besides the goiter?


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## hillaryedrn (Dec 14, 2009)

I am curious as to what your biopsy "actually" said. My Endo said that mine was benign, but then my surgeon said it was indeterminate and could only be a difinitive answer after surgery. I'm not trying to stir up trouble, I'm just sharing my own experience.


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## Andros (Aug 26, 2009)

hillaryedrn said:


> I am curious as to what your biopsy "actually" said. My Endo said that mine was benign, but then my surgeon said it was indeterminate and could only be a difinitive answer after surgery. I'm not trying to stir up trouble, I'm just sharing my own experience.


And I agree 100%. There is nothing ever better than the voice of experience.

Maybe a second opinion would be most wise. I did not like what I read on the scan results, that is for sure!

"It takes a village!"


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## hillaryedrn (Dec 14, 2009)

You know, I just think that some Endo's say it's benign when it doesn't specifically say "carcinoma" on the biopsy. I've had to be proactive to an extent I never imagined in the past. I say it's always a good idea to get copies of everything, just to be informed.


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## 2boysmom (Feb 2, 2010)

Thank you all for your help (sofar) all the test and suggestions have been through my general doctor. I usually only go see him when I am sick or something, which may only be once a year.

Hillaryedrn - all my report says is : Cytology Report 
Clinical History/Impression: 4.0 x 3.1 x 2.3 cm nodule containing blood flow.
Microscopic Interpretation: thyroid, right, fine needle aspiraton biopsy:\ Consistant with nodular goiter.

Microscopic Description: Received for evaluation are one H&E cell block, one ThinPrep smear, three Papanicolaou stained smears and three Wright stained smears from fine needle aspiration biopsy of right thyroid nodule. The smears and cell block reveal abundant background watery colloid, numerous macrophages and numerous sheets of follicle epithelial cells with evenly spaced nuclei. No nuclear enlargement or overlap is present.

thatbrian - you have a very good point I had not thought of. why has my pituitary gland started doing this?

So I have decided to not get the prescription filled for the Synthroid and I have made an appointment with an endocronoligist that a couple people recommended to me. I will see her March 8th.

Andros- Its hard for me to day if I am symptomatic. I have kind of felt a little lazy this winter so is it from thyroid or just a cold snowy winter? and I guess its hard for me to compare symptoms to info on the internet because I don't know whats wrong. At this point I guess you cant say that I am hypo or hyper so I don't know what symptons to look at. I have so much to learn but don't know what to learn about, if that makes sense.

Thanks again!
Trish


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## Andros (Aug 26, 2009)

2boysmom said:


> Thank you all for your help (sofar) all the test and suggestions have been through my general doctor. I usually only go see him when I am sick or something, which may only be once a year.
> 
> Hillaryedrn - all my report says is : Cytology Report
> Clinical History/Impression: 4.0 x 3.1 x 2.3 cm nodule containing blood flow.
> ...


You make a lot of sense given the fact that thyroid disease is sort of insidious. We just slowly grow into it and adjust.

I am glad you are seeing an endo. I hope you take the path report. Another opinion would not hurt.


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## hillaryedrn (Dec 14, 2009)

That path report sounds great!! Colloid is awesome! That's what "normal" thyroid nodules are made of. That's great news!!


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## 2boysmom (Feb 2, 2010)

Well I finally had my appointment with an endo. She came recommended from a couple people I know. She said my right thyroid needs to come out. she said that the mass is as big as the thyroid is supposed to be and its basically laying across that whole side of the thyroid. And she said with the size of the mass when they biopsy they are only taking a sample from one part of it and it doesn't tell about the rest. She said if it was only a 1cm mass your three biopsy samples would be a little more accutate but with the size of mine you are only hitting a small area of it. I hope that makes sense. she said the only way to know forsure its not cancer is take it out. she said I shouldnt need any hormone because the left side should take over (unless of course they find cancer and then they will go back and take the whole thing) she said my levels are fine and I wouldn't be having any thyroid disease symptoms. I had really hoped they would have been causing the fatigue and overall soreness I have had this winter. So now I will blame that on my uterine fibroids that seem to be getting worse. I will probably have a hysterectomy in my future also. So basically taking it out will be the only way to ensure its not cancer and she said it will continue to grow and can cause swallowing and breathing trouble if too big. She said I have probably had this growing for a while. She referred me to a surgeon she highly recommended but I called and can't see him until the 25th of March.

How does this sound to all you experts?

Thanks
Trish


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## Andros (Aug 26, 2009)

2boysmom said:


> Well I finally had my appointment with an endo. She came recommended from a couple people I know. She said my right thyroid needs to come out. she said that the mass is as big as the thyroid is supposed to be and its basically laying across that whole side of the thyroid. And she said with the size of the mass when they biopsy they are only taking a sample from one part of it and it doesn't tell about the rest. She said if it was only a 1cm mass your three biopsy samples would be a little more accutate but with the size of mine you are only hitting a small area of it. I hope that makes sense. she said the only way to know forsure its not cancer is take it out. she said I shouldnt need any hormone because the left side should take over (unless of course they find cancer and then they will go back and take the whole thing) she said my levels are fine and I wouldn't be having any thyroid disease symptoms. I had really hoped they would have been causing the fatigue and overall soreness I have had this winter. So now I will blame that on my uterine fibroids that seem to be getting worse. I will probably have a hysterectomy in my future also. So basically taking it out will be the only way to ensure its not cancer and she said it will continue to grow and can cause swallowing and breathing trouble if too big. She said I have probably had this growing for a while. She referred me to a surgeon she highly recommended but I called and can't see him until the 25th of March.
> 
> How does this sound to all you experts?
> 
> ...


Trish..................this all makes a lot of sense to me and I think you have a terrific endo. And I sure will pray you do not have cancer but it sounds suspicious. So, the good news here is that we are going to find out. All will be well; thyroid cancer is usually always confined to a small area and out it comes. You will be fine; I am confident of that.

Since you have fibroids (and boy does that go w/ thyroid disease), you may wish to get a Ferritin test for if your ferritin is low (should be 50 to100), that can make you exhausted. CBC can come back fine but meanwhile Ferritin(iron stores)are in the basement.

Good to hear from you and please keep us posted so we can hang though with you through your surgery.


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## 2boysmom (Feb 2, 2010)

Well I had quite the surprise today. The surgeons office called and asked me if I could come in tomorrow. She said they were going to squeeze me in. This of course makes me happy I don't have to wait until the 25th to get started with the surgeon but VERY nervous that they are going to "squeeze" me in so fast.

I called on Monday after the endo appt and I told them she (endo)said thyroid needs to come out, thats when they set me up the 25th and said with spring break it was longer than usual (didn't know drs. took spring break) 
then they call today with moved up date. I wonder if the endo office sent over my paper work and someone decided they don't want to wait that long?

Guess I will see what they say Thursday. Now I have to get to the imaging place today and pick up my ultrasound disk. I thought I had plenty of time.

Let you know


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## Andros (Aug 26, 2009)

2boysmom said:


> Well I had quite the surprise today. The surgeons office called and asked me if I could come in tomorrow. She said they were going to squeeze me in. This of course makes me happy I don't have to wait until the 25th to get started with the surgeon but VERY nervous that they are going to "squeeze" me in so fast.
> 
> I called on Monday after the endo appt and I told them she (endo)said thyroid needs to come out, thats when they set me up the 25th and said with spring break it was longer than usual (didn't know drs. took spring break)
> then they call today with moved up date. I wonder if the endo office sent over my paper work and someone decided they don't want to wait that long?
> ...


I was reading through from your "original" post. I think you are now glad you pursued this futher? I know I am.

Yes; I want to know.........................we all want to know.


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## 2boysmom (Feb 2, 2010)

I want to thank everyone on this board that brought up alot of good points when I was first going through this and made me think alot more about getting a second opinion. It didn't feel right in my gut to just take a pill and the responses reassured me of my feelings. And from reading stories here it seems that a thyroid is a weird little part of our body that gets mis*diagnosed/mis*understood alot.

I almost forgot. when the endo asked if I wanted her to notify my general doctor about what was going on I told her sure. I said especially since what needs to be done is alot different that what he said to do. she asked so I told her about he wanted to put me on 25m of synthroid and work up from there. and it would shrink the thyroid. she chuckled a little bit and said well it wouldn't shrink it down its a mass. she said "not to be mean, but we will send him a little education about the thyroid" I really like her, she reminds me of my "woman" gyno.

Trish


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## Andros (Aug 26, 2009)

2boysmom said:


> I want to thank everyone on this board that brought up alot of good points when I was first going through this and made me think alot more about getting a second opinion. It didn't feel right in my gut to just take a pill and the responses reassured me of my feelings. And from reading stories here it seems that a thyroid is a weird little part of our body that gets mis*diagnosed/mis*understood alot.
> 
> I almost forgot. when the endo asked if I wanted her to notify my general doctor about what was going on I told her sure. I said especially since what needs to be done is alot different that what he said to do. she asked so I told her about he wanted to put me on 25m of synthroid and work up from there. and it would shrink the thyroid. she chuckled a little bit and said well it wouldn't shrink it down its a mass. she said "not to be mean, but we will send him a little education about the thyroid" I really like her, she reminds me of my "woman" gyno.
> 
> Trish


Your endo kicks butt and a thump on the head to the GP. Shame on him!!

You are welcome for anything we may have done to help and you are the perfect example of a job well done.

Sorry you are having these issues but it is better to know than not to know. We are here for you throughout.


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## 2boysmom (Feb 2, 2010)

meeting with surgeon went good. He pretty much went through all the reasons to remove the right thyroid and reasons not too. The reason too outweighed of course. He is very nice and explained everything right in line with what the endo said and all the things I have read on the internet. He said he does 6*8 thyroid surgeries a week so I feel I will be in great hands. He feels fairly confident by what the fna biopsy said it will not be cancer but there is only one way to find out.

He had said they use cosmetic type closures to help with the scaring but I told him I have had some allergic tape reactions so he said they could use dermabond instead.
Has anyone been closed up with dermabond? how is the scar compared to typical stiches with steri strips?
surgery is set for the 26th of March. I got nervous when its so soon but I guess to get it over with.

Trish


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## Andros (Aug 26, 2009)

2boysmom said:


> meeting with surgeon went good. He pretty much went through all the reasons to remove the right thyroid and reasons not too. The reason too outweighed of course. He is very nice and explained everything right in line with what the endo said and all the things I have read on the internet. He said he does 6*8 thyroid surgeries a week so I feel I will be in great hands. He feels fairly confident by what the fna biopsy said it will not be cancer but there is only one way to find out.
> 
> He had said they use cosmetic type closures to help with the scaring but I told him I have had some allergic tape reactions so he said they could use dermabond instead.
> Has anyone been closed up with dermabond? how is the scar compared to typical stiches with steri strips?
> ...


Good news, Trish. Maybe someone will come along w/ the Dermabond experience. But not to worry; they would not use it if it wasn't working.

Glad the surgeon is also in line w/ the popular opinion here.

Hey, the sooner, the better. Less time for you to fret. Just git 'er dun!arty0006:


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## Lovlkn (Dec 20, 2009)

It sounds like your surgeon has alot of experience * did he mention how big the incision will be?

I had internal stitches (I assume dermabond) then seri strips for my neck and you cannot even see it although when I heal I tend to have darker skin at the incision sites, my incision is 1".

With an umbilical hernia I had repaired they used dermabond and I developed a raised red scar, had the scar removed and closed again with derma bond and developed the exact type raised scar. I don't know if the scar is from the dermabond or if it's just a part of the body that scars differently.

Your surgeon should be able to give you a better idea of what to expect.


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## 2boysmom (Feb 2, 2010)

I actually forgot to ask him the size of the incision. I figure it will be typical to what I have seen on the internet. I know my son has had dermabond used twice on him (1 surgery side to side across his belly at 10 weeks and at 20 months a liver transplant) and his scars look pretty good. But of course baby skin probably heals nicer than our skin that has been damaged through the years.

But if I can avoid an allergic reaction I will deal with the scar. About a year ago I had a pencil eraser size spot removed from my leg and the tape caused a terrible rash. my leg was hot, swollen, hard and at that time I would have just assumed someone cut it off it itched soooooo bad.


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## Andros (Aug 26, 2009)

2boysmom said:


> I actually forgot to ask him the size of the incision. I figure it will be typical to what I have seen on the internet. I know my son has had dermabond used twice on him (1 surgery side to side across his belly at 10 weeks and at 20 months a liver transplant) and his scars look pretty good. But of course baby skin probably heals nicer than our skin that has been damaged through the years.
> 
> But if I can avoid an allergic reaction I will deal with the scar. About a year ago I had a pencil eraser size spot removed from my leg and the tape caused a terrible rash. my leg was hot, swollen, hard and at that time I would have just assumed someone cut it off it itched soooooo bad.


Whoa; your family is not stranger to serious medical issues for sure! God bless and how old is your son now?


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## 2boysmom (Feb 2, 2010)

He is 3 1/2. He had his transplant in August of 2008 and has done wonderfully since. We are just so thankful for the family that had to deal with a tragedy and during that had the kindness to donate organs. Without a transplant he probably would not be with us now.

Be sure to sign your license or register as a donor and let your family know of your wishes. One donor can save 8 lives and make vast improvement to many others.

Trish


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## Andros (Aug 26, 2009)

2boysmom said:


> He is 3 1/2. He had his transplant in August of 2008 and has done wonderfully since. We are just so thankful for the family that had to deal with a tragedy and during that had the kindness to donate organs. Without a transplant he probably would not be with us now.
> 
> Be sure to sign your license or register as a donor and let your family know of your wishes. One donor can save 8 lives and make vast improvement to many others.
> 
> Trish


Oh, I am a donor; you can bet your bippy on that! Especially for the children and I do mean that from the bottom of my heart.

I am so so glad your son is doing well. He probably will end up on the Varsity Football Team when he is old enough.


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