# Surgery in a week, though it still makes no sense



## redroks2 (Feb 23, 2014)

Hi all! I am going to start here in the surgery forum because, well, I am not entirely sure where to start! The basics are that I am a 36 year old mom of two boys (6 &10) and have been in good health until all this chaos started.

It has been a looooong and arduous six month battle trying figure out what in the #ell is wrong with my body. I have good insurance and a good PCP but the major issue has been conflicting symptoms and/or rare symptoms that make virtually no sense. Six doctors and a mass of scans later they found a 3.5cm mass in the left lobe of my thyroid. All TSH tests were normal and the biopsy came back "inconclusive", yet highly suspicious. Due to the size, re-biopsying was pointless because it had to come out no matter what. Thyroidectomy is in 8 days!

A few days ago I had my H&P, CBC, and Chem Panel. My last round of blood work, four months ago, was the picture of perfection...despite my many fairly significant symptoms. The results on the new round of blood work came as a bit of a surprise. Everything was normal except all the WBC values which were ALL high. WBC, neutrophils, lymphocytes, monocytes, basophil, and eosinophils...all high or damn close. The current results would very likely not look as concerning if not for having the previous results to compare to and see the size of the jump in each value.

Now, to rewind a little...this all started six months ago with a lump in my breast about the size of a grape. Within 10 days the lump was the size of a grapefruit. A subsequent biopsy ended up doing nothing more than puncturing an abscess...BARF!! To this day, the abscess is totally unexplained and seeing has how there are only a few ways something like that can happen, it becomes all that more mysterious! From that point on, I have had pain in/on/under my ribs on the right side. The pain is there 24/7 but does vary in intensity from day to day. Some days it basically feels like my liver is trying to escape from my body Aliens-style, and other days it feels like a broken rib or a strained muscle.

And MRI showed 3 breast masses, all biopsied and benign however, a 4th has shown up since then (3 on the right, 1 on the left). Also during this whole process, I have swollen lymph nodes all up and down the right side of my body...and ONLY the right side. Two rounds of antibiotics did nothing. A chest CT is what revealed the thyroid mass...ON THE LEFT! The endocrinologist told me that it would be extremely uncommon for a there to be lymph swelling on the opposite side of the mass unless it was swelling on both sides. The lymph swelling isn't consistent either. It is constant, but not consistent in location. Some days my arm pit is ginormous and other days the pressure in my neck causes earaches and headaches. I have lymph swelling around my elbow, my armpit, the back of my knee, my groin, and all over my neck and clavicle...but only on the right side! The Rheumatologist only did a PE but was fairly quick to say that she has no indication to believe that any of this is auto-immune.

The surgeon and the endocrinologist have brought up Lymphoma several times in the last few weeks but the new blood results could almost look like leukemia. This has been one hell of a roller coaster ride and I would appreciate ANY input. Like I said, my symptoms have been abnormal, inconsistent, severe at times, and very unspecific to any one condition. I pray with every fiber of my soul that the pathology will show SOMETHING but I've heard "I don't know" for the past six months so I figure going to the people who have been through it is probably the best idea I've had so far!

Much appreciated!!


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## joplin1975 (Jul 21, 2011)

Hi there...and welcome!

I have some random thoughts - in no particular order:

Do you have thyroid related blood work that you could share (with reference ranges, please)?

When they do the surgery, I would ask for a prophylactic neck dissection. That will take some of the lymph nodes most proximate to your thyroid out for pathology. If they are already in there, why not get the full path done?

Also, I would ask if they could test to see if you are BRAF positive. It's not only related to breast cancer, but also thyroid cancer. It informs treatment protocols as BRAF positive patients usually opt for a slightly more aggressive treatment plan.

Finally, autoimmune thyroid disease and fatty livers are related. Mine was fatty and caused a lot of pain. I cleaned up my, ER, drinking habits but also once my thyroid numbers god under control, things got better. Make sure those liver function tests are done regularly.

Good luck!


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## Andros (Aug 26, 2009)

Welcome to the board. Oh, boy! This came on fast; didn't it? I will comment that it is not unusual to have swollen lymph nodes and infections/boil/abscesses during the untreated phase of thyroid disease.

That said, it probably would be best to take it one step at a time here. Get the thyroidectomy in a week (what day exactly so we can be thinking of you) and see what pathology has to say.

The reason your basic thyroid tests probably always came in normal range could be because to the binding, blocking and stimulating antibodies to the receptor sites. Their job is to make things look good.....................or not; as the case may be sometimes.


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## redroks2 (Feb 23, 2014)

My Labs...

TSH = 1.81 [0.40-4.50]

T3 Free = 2.9 [2.3-4.2]

T4 Free = 1.1 [0.8-1.8]

Thyroglobulin Antibodies = <20 [<20]

Thyroid Peroxidase Antibodies = <10 [<35]

I had a thyroid panel done 2 years ago and my values have not changed despite the large mass.

All the docs have said that the breast abscess isn't related to the thyroid mass but have offered no other alternatives. I have a hard time believing it is not somehow connected because it was started this whole long process. I do intend to ask the surgeon that he sample every last lymph node he can possibly reach. I would rather have a larger incision and some answers.

I have been trying to find information correlating the high WBC to a thyroid mass and I am not coming up with much. Anyone else have a WBC prior to thyroidectomy??


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## Andros (Aug 26, 2009)

Infection can raise WBC; as you know, I am sure!


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## redroks2 (Feb 23, 2014)

And lord do I wish I had an infection somewhere so I could stop worrying about it! It's driving me batty that I can't find any shred of information about a connection between a normally functioning thyroid and a high WBC. The same way I can find no correlation between a functioning thyroid and a breast abscess. *sigh* I am so tired of nothing making sense


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## Aimee0907 (Feb 17, 2014)

Im new to this board but hoping your surgery goes well and update us soon


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