# Are all nodules palpable?



## mom9495 (Apr 14, 2010)

It may seem like a pretty simple question, but I'm not sure it is. I have a lump I can feel on the front of the right thyroid gland. During my first endo appointment, I mentioned the nodule. He did a quick feel of the sides of my thyroid from behind my back and announced that it didn't feel enlarged. He never once felt the part of my thryoid where *I* can feel the nodule. Also didn't mention an ultrasound even though my antibodies and TSH are high.

I don't know. I'm starting to second-guess myself. Maybe it's nothing out of the ordinary. Maybe it's just an enlarged lymph node -- do they feel the same? My voice has become very hoarse and scratchy too (my hubby calls it my "sexy voice", lol).

Am I worried about nothing? Maybe I've read too much about antibodies and higher TSH and thryoid cancer. Maybe I'm just paranoid. Maybe I'm crazy.

But the thought that something might be growing in there, undetected, scares me. Am I just a worry wart?


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## hillaryedrn (Dec 14, 2009)

Ok, first thing is first: If you are concerned, then it is an issue. Period. I don't give a [email protected] if the doctor thinks it is or not. I am living, walking, talking proof that MD's don't always have it right. If you are concerned, go BACK in there, literally POINT to where you feel it, and insist he take another look at it. An ultrasound is the LEAST he could do.

Ok, soapbox away for the moment! :tongue0015:

Can you feel all nodules? No, not all are palpable. NONE of mine were. However, since you feel something, it warrants inspection.

Raspy voice: HUGE CLUE! Hello?? This needs addressing more than the lump you feel! Classic sign that there is something going on. What is that something? Don't know, but it needs to be looked at!!

Keep me updated!! You've definitely got my attention!


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## Andros (Aug 26, 2009)

mom9495 said:


> It may seem like a pretty simple question, but I'm not sure it is. I have a lump I can feel on the front of the right thyroid gland. During my first endo appointment, I mentioned the nodule. He did a quick feel of the sides of my thyroid from behind my back and announced that it didn't feel enlarged. He never once felt the part of my thryoid where *I* can feel the nodule. Also didn't mention an ultrasound even though my antibodies and TSH are high.
> 
> I don't know. I'm starting to second-guess myself. Maybe it's nothing out of the ordinary. Maybe it's just an enlarged lymph node -- do they feel the same? My voice has become very hoarse and scratchy too (my hubby calls it my "sexy voice", lol).
> 
> ...


Oh, you have every reason in the world to demand an uptake scan to have a look at this nodule and perhaps others that may be there. I feel it is essential to either rule in or rule out cancer.

And they say a voice that is going hoarse is a great cause for concern.

Thyroid cancer symptoms
The symptoms of thyroid cancer can include a lump in your neck, sore throat, or a hoarse voice or difficulty swallowing that do not get better.

http://www.cancerhelp.org.uk/type/thyroid-cancer/about/thyroid-cancer-symptoms

Thyroid cancer typically doesn't cause any signs or symptoms early in the disease. As thyroid cancer grows, it may cause:

■A lump that can be felt through the skin on your neck
■Changes to your voice, including increasing hoarseness
■Difficulty swallowing
■Pain in your neck and throat
■Swollen lymph nodes in your neck

http://www.mayoclinic.com/health/thyroid-cancer/DS00492/DSECTION=risk-factors

Please call your doctor and make arrangements for a radioactive uptake scan. Sonograms do not always pick up everything.

Here is info to support that..........
http://www.radiologyinfo.org/en/info.cfm?pg=us-thyroid

By the way, your doctor should know this stuff. I believe you were fluffed off big time. He should have said, "You have a lump? We will schedule for a scan ASAP to find out what is going on!" At that point, even a sonogram would have been welcome in my mind. Good grief!!


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## mom9495 (Apr 14, 2010)

Thanks, ladies. As strange as it sounds, thanks for validating my fears. 
Andros, thanks for posting those links. I am now convinced I need at least an US (I'm not second-guessing this anymore) and hopefully a radioactive uptake scan. One particular sentence in your first link convinced me:

_"With medullary thyroid cancer, you may have unusual symptoms such as frequent loose bowel movements or becoming red in the face." _

I know that is a rare cancer, but I've got those symptoms and never though they might be related. About 2-3 years ago, I started having diarrhea (coincidentally coincided with my initial dx of hypothyroidism via high TSH test). Went thru a ton of tests and after colonoscopy, was given the dx of IBS (which I personally think is just a cop-out label when they can't "name" it).

And the red face? Ironically, that was one of the huge factors the reason I started all this testing to begin with (along with joint pain, extreme fatigue and my hair falling out). My friend, who has Lupus, said it looked like a malar rash. Since my ANA is negative, I don't think the rheumy thinks I have Lupus, but will hear her opinion at my return follow-up on May 6th. I seem to have a myriad of auto-immune diseases (Hashimoto's, Raynaud's, Sicca and one of my Anti Beta2 glycoprotein antibodies was flagged high).

So now, combined with the high thyroid antibodies (both Tg and TPO), a rising TSH, a hoarse voice and either a nodule/enlarged lymph node I can feel, I've convinced myself that cancer has to be ruled out. If my Endo, who is really old-school, doesn't order the tests, I will ask my PCP or Rheumy to order it. I've printed out the Mayo Clinic article for reference as necessary.

I just feel like I'm falling apart. Thanks for the support.


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## Andros (Aug 26, 2009)

mom9495 said:


> Thanks, ladies. As strange as it sounds, thanks for validating my fears.
> Andros, thanks for posting those links. I am now convinced I need at least an US (I'm not second-guessing this anymore) and hopefully a radioactive uptake scan. One particular sentence in your first link convinced me:
> 
> _"With medullary thyroid cancer, you may have unusual symptoms such as frequent loose bowel movements or becoming red in the face." _
> ...


Oh, wow!!!

ANA is not definitive for Lupus. It does not have to be present in Lupus. What has to be present for Lupus is Anti-DNA, C3 and C4. As you can see by my siggie, I have Lupus. So get the proper tests.

But yes, the medullary definitely needs to be ruled out.

Sending huge hugs,


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## mom9495 (Apr 14, 2010)

Andros said:


> Oh, wow!!!
> 
> ANA is not definitive for Lupus. It does not have to be present in Lupus. What has to be present for Lupus is Anti-DNA, C3 and C4. As you can see by my siggie, I have Lupus. So get the proper tests.
> 
> ...


I did see your lupus diagnosis in your siggie. Would it be okay if I pm'd you after I get back the rest of my lupus tests?


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## hillaryedrn (Dec 14, 2009)

A very simple test for medullary thyroid cancer is serum calcitonin. If that is normal, then you can pretty much write off medullary. Just thought I'd share that as that is what they thought my diagnosis would be!


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## Andros (Aug 26, 2009)

mom9495 said:


> I did see your lupus diagnosis in your siggie. Would it be okay if I pm'd you after I get back the rest of my lupus tests?


By all means; please do!! When did you get the tests run?

I meant to say that ANA, if present,is "suggestive" of a myriad of autoimmune diseases. For that reason, further in-depth tests should be run.

Here is a great place to look up "stuff" if you like.....

http://www.labtestsonline.org/understanding/conditions/thyroid.html


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## mom9495 (Apr 14, 2010)

Yeah! Just heard from the endo that he'd be "glad" to order an US and a calcitonin level! Finally, some good news. 
I've learned that I just need to listen to ya'll and advocate for myself. And he seems very willing to help. 
I hope ya'll get some good news today, too!


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## Andros (Aug 26, 2009)

mom9495 said:


> Yeah! Just heard from the endo that he'd be "glad" to order an US and a calcitonin level! Finally, some good news.
> I've learned that I just need to listen to ya'll and advocate for myself. And he seems very willing to help.
> I hope ya'll get some good news today, too!


There you go. Had you not educated yourself, he would never have done this. And that is a very scary thought!!

I am relieved and you must keep us in the loop!!


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