# Nodule Newbie...long



## Dee_CT (Aug 7, 2011)

My first post  Mainly to vent, as I am not diagnosed at this time.

I'm 36, female (no kids), and had a palpable nodule during a physical at the end of May 2011 (~ 3 months ago), and had US and labs done. I was feeling really crummy then. (I am also a biologist, but that being said, am just getting into the nitty-gritty of the thyroid now.)

*Ultrasound report*:

Right lobe is 4.9 x 1.6 x 1.5 cm.
Left lobe is 5.0 x 1.4 x 1.4 cm.
In the inferior isthmus is a 1.7 x 1.6 x 0.9 cm hypoechoic complex solid and cystic nodule with vascularity but without calcification.
There is a 0.7 x 0.5 x 0.3 cm solid hypoechoic nodule in the lower pole right thyroid.
There is no focal lesion in the left thyroid lobe (I thought there might be something on the left side. I was wrong.)
Surrounding soft tissues and vascular structures are unremarkable.
Impression: Indeterminate small nodules in the right isthmus and lower pole right thyroid.
No suspicious microcalcifications.

I also had a CBC, metabolic panel, CRP, lipid panel, TSH, and Free T3 and Free T4 done (no data right now- long story), but Dr. said all was "normal" except anemia (iron deficient: low HG, low HCT, hypochromic, microcytic cells based on previous labs over many years) and high triglycerides (family history & have been high for a few years). 
I had NO antibody tests done, and also tested NEG for H. pylori (to rule out ulcer as cause of GI issues.) Started on daily omeprazole, and heartburn is gone, but still have the other symptoms.

He said to take fish oil and return in 6 months for follow-up (probably need to start Tricor for TG levels).

Nodules: OK, I was expecting this because of the tight feeling in my throat that periodically comes and goes, that I of course Googled and diagnosed myself with globus hystericus (PCP also immediately said that right before he palpated!). I was actually a little relieved it wasn't all in my head.

Symptoms that I have most days (but never know what to expect include: anxiety, depression, fatigue, feeling over-heated/head & face sweating when not exerting myself, serious insomnia, diarrhea (not responding well to Immodium and Pepto), crazy heartburn (higher up in esophagus than I normally would), nausea, dizzyness, stomach bloating, serious weight gain, and yes, the dreaded brain fog.

A month later, I went back to see my PCP because I just could NOT deal with the anxiety (Xanax 0.5 mg- I take it occasionally) and insomnia (Ambien-isn't doing anything, so I only took it a couple of times).

I asked him his opinion regarding a FNA and he referred me to a local Endo. That was 6 weeks ago. (I had to wait about a month for the endo to call to schedule an appt., which I sort of expected based on what I've read online.) My endo appt. is September 28, and I'm just HOPING she doesn't tell me to "wait & see"... I wanna know what's going on in there. Like yesterday.

I know two women who've had thyroid cancer and they eventually did just fine, so I'm not really afraid of it or of taking meds... I just want to feel healthy and get through this.:confused0024:


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## lainey (Aug 26, 2010)

If you haven't read up on it already, the general size needed for a good sample for a FNA is above 1 cm--so you have one nodule that would be a good candidate for an FNA.

If you want to move things along a little faster, you can try to find an endocrine surgeon to review your results--surgeons that specialize in breast cancer are also excellent at needle biopsies--and both have calendars that are slightly more open than most endocrinologists, so you might be able to get some action sooner.

Nodules that occur in multiples are the least suspicious. Nodules also occur at a fairly high rate in the general population (20-30%--increasing as people age), and approximately 95% of them are benign.

The anemia and low levels of certain vitamins such as D and B can be the source of your symptoms, as can hormone imbalances. We would really have to know your thyroid levels, and antibodies tests, if any, to see how that factors in.

Unfortunately, watch and wait is a very common approach with nodules of this size and appearance. A followup ultrasound at the six month mark (November) with corresponding blood work should be part of your doctor's plan, regardless of how it goes with the endo.


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## Dee_CT (Aug 7, 2011)

I do not like my Endo... I know my appointment was supposed to be for an hour, but only saw her for maybe 10 minutes. The only thing we agreed on was the biopsy for the larger nodule, using US. Her next available appt. for the biopsy isn't until November. By then it will be close to six months from when I saw my regular doctor. The Endo was not thorough; said that NO additional labs were needed because TSH was normal (in the middle of the range, but I don't know the numbers, yet). I asked about antibody testing, vitamin D, ferritin (I already know I'm still anemic), etc. She said No. Finally she said I could get TSH re-done, but they don't draw blood at her office and I'd have to go to another office done the road. I said no thanks, as my PCP can get that for me whenever I want. I saw the portable ultrasound behind the exam chair, and she said she will use it during the biopsy. I guess I expected the biopsy that day, and so I left very ticked off about how dismissive she was and wondering why my appt. was supposed to be for an hour when all she did was palpate my neck and listen to my chest... And I had to wait yet another month before getting an answer. She also said that none of my symptoms were at ALL related to any possible thyroid problem. And I also should've asked when I was given the referral to her in the first place if they had an on-staff pathologist; they fo not, naturally. As soon as the biopsy is done, I'm requesting a new referral to a better practice, even if its benign, because that visit did not make me feel comfortable. Hoping Endo doesn't add a few aggressive passes during the biopsy just to get back at me! In closing, she added this nugget of wisdom: hardly anyone ever dies bc of a thyroid problem. Said the biopsy is pretty painless, too... not sure I believe her just yet!


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## Octavia (Aug 1, 2011)

Dee_CT said:


> In closing, she added this nugget of wisdom: hardly anyone ever dies bc of a thyroid problem.


Wow...I'm just not sure how to interpret that, not having been in the room and all. But my first thought was "so, it's okay for the patient to feel like doo-doo for months or years, as long as he or she isn't dying?"


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## Tocra (Mar 25, 2011)

Good luck from someone going through this... Maybe I'll see some of you waiting for the TSH in the looney bin... Someone call my shrink.


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## Andros (Aug 26, 2009)

Dee_CT said:


> I do not like my Endo... I know my appointment was supposed to be for an hour, but only saw her for maybe 10 minutes. The only thing we agreed on was the biopsy for the larger nodule, using US. Her next available appt. for the biopsy isn't until November. By then it will be close to six months from when I saw my regular doctor. The Endo was not thorough; said that NO additional labs were needed because TSH was normal (in the middle of the range, but I don't know the numbers, yet). I asked about antibody testing, vitamin D, ferritin (I already know I'm still anemic), etc. She said No. Finally she said I could get TSH re-done, but they don't draw blood at her office and I'd have to go to another office done the road. I said no thanks, as my PCP can get that for me whenever I want. I saw the portable ultrasound behind the exam chair, and she said she will use it during the biopsy. I guess I expected the biopsy that day, and so I left very ticked off about how dismissive she was and wondering why my appt. was supposed to be for an hour when all she did was palpate my neck and listen to my chest... And I had to wait yet another month before getting an answer. She also said that none of my symptoms were at ALL related to any possible thyroid problem. And I also should've asked when I was given the referral to her in the first place if they had an on-staff pathologist; they fo not, naturally. As soon as the biopsy is done, I'm requesting a new referral to a better practice, even if its benign, because that visit did not make me feel comfortable. Hoping Endo doesn't add a few aggressive passes during the biopsy just to get back at me! In closing, she added this nugget of wisdom: hardly anyone ever dies bc of a thyroid problem. Said the biopsy is pretty painless, too... not sure I believe her just yet!


If it were me, I would not let that woman touch me.

May I recommend that you see an ENT? (Ear,Nose and Throat)

And people do die from undiagnosed and untreated thyroid disease. I think this doctor is a condescending sadist.

Sorry to be so blunt but I am putting it out there!


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## webster2 (May 19, 2011)

Goodness, what an awful doctor. An ENT is a very good choice. Best wishes to you, and I'll send a bit of kindness for your doctor,if that wouldn't kill her....what a beast.


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