# Potential upcoming surgery...looking for insight



## aquabean (Apr 23, 2013)

New here, looking for some insight  To start this off at the end of December
I had my copper IUD removed, I had it for 6 years. I was afraid that I was
potentially suffering from copper toxicity as I found a forum with a bunch of
other women who had issues from the IUD. I got pregnant a month later but had a miscarriage a week after I found out (6 weeks along). It's been a little over 2 months since the miscarriage and 2 weeks ago I noticed a nice sized bump on my neck! After a couple doctor visits and some tests, they said my thyroid is working "fine" but I do have a 3cm nodule and the FNA came back as "follicular neoplasm" so 30% chance of cancer and they want to remove that whole side  Here are the full results:

"The slides are cellular and show follicular epithelium
predominantly arranged in trabecular and micro-acinar groups with
scant-to-absent colloid. The groups do not have smooth luminal
edges. There are no intranuclear inclusions although there are many
red blood cells overlying nuclei simulating inclusions.. The
findings are most consistent with a follicular neoplasm and the
differential diagnosis includes follicular adenoma, follicular
carcinoma, and papillary carcinoma. Clinical and radiographic
correlation is suggested. Consider clinical intervention. The
associated risk of malignancy as defined by Bethesda is 15-30%(Ali
SZ and Cibas ES ed.; The Bethesda System for Reporting Thyroid
Cytopathology. Springer 2010)."

"The left lobe measures 1.9 x 2.2 x 4.5 cm. There is a
1.7 x 2.1 x 3.0 cm fairly well marginated heterogeneously
isoechoic nodule with internal vascularity, but no calcifications,
in the left thyroid lobe. The echogenicity of the parenchyma in
the left lobe is otherwise normal. ** IMPRESSION **:
1.7 x 2.1 x 3.0 cm fairly well marginated isoechoic solid nodule
with internal vascularity, but no calcifications in the left
thyroid lobe."

My blood tests were:
TSH 1.26 (0.10-5.50) Total T3 87 (50-170) Free T4 1.0 (0.8-1.7). I don't know why but they didn't test for free T3 and I'v also been reading about testing for antibodies but not sure if that applies in my case. I'm 27 and there is no history of thyroid problems or even cancer in my family at this point. The whole time I was pregnant and the 2 months after the miscarriage I've felt like crap, always tired, no motivation. My hair was falling out like crazy
back in October and I tested very low in iron & ferritin so I took iron for a couple months and it helped my hair a bit. It's still incredibly thin. Also tested my B12 which was good but vitaman D was on the low side so I've been taking drops. I've also been having random muscle twitches in my arms/legs since then but my doctor blamed it on stress. Just recently I've started getting tingling/falling asleep feeling in my hands/feet if I elevate them the wrong way. Since October I've felt like something is off, but I thought it was from my IUD.

I met with a surgeon last week and scheduled surgery for the 17th though I'm still unsure if I want to go through with it. He said he does about 60 thyroid surgeries a year and hasn't had anyone lose their voice yet :\ I forgot to ask how many years he had been doing thyroid surgeries though. He's a general surgeon. He seemed confident in what he does, my husband liked him. After some searching around I found a another general surgeon who is about a hour 1 1/2 away who states "I have specialty training in Endocrine Surgery, and I am interested in surgical diseases of the thyroid, parathyroid, pancreas, and adrenal glands." and then I found a head & neck surgeon who is a little closer. Not sure if I can get a referral to them though...I have Kaiser and they're weird! Is 60 surgeries a year enough??

A friend recommended a good endo at a different Kaiser not too far away so I'm going to see about getting a referral to her just to see what she says too. Tomorrow I have an appointment with a ND...I talked to her for a bit and she will do a full thyroid panel and is aware of NDT and stuff. It's going to cost a bit but I'm curious to see what she says. I don't really know if I trust kaiser with my aftercare lol. I think I'm actually leaning toward surgery cause of the size, I hate the unknown about cancer and it scares me a little about how fast it grew. But then I go and read about potentially shrinking nodules with iodine. I'm just so over whelmed by all the information on the internet that I just don't know what to do. I kind of think I might have been having thyroid symptoms the past couple months despite testing "normal" I feel like my pregnancy/miscarriage might have set things off? My dad is freaking out a little and sending me all these web sites about natural ways to shrink nodules, foods not to eat, supplements to take, etc. He thinks I should maybe give it 6 months and see how it's progressing with iodine and supplements but I don't know. To make things worse, we're in escrow for a house right now and if all goes well we would be moving the first week of June. Right now I live only a couple miles from the hospital. After move, it would be over an hour away. I raise dogs and currently have 8 and the house we're moving to has dog boarding facility that I'm going to be taking over. I'm so worried about potentially having caner, losing my whole thyroid and not having the energy or will to handle all this after all  Anyway, I'd love some in site about this since thyroid issues are so new to me. I'm trying to learn everything I can. Thanks for reading!


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## joplin1975 (Jul 21, 2011)

Hi and welcome!

First off, we've had lots of people on this sites with lots of nodules of varying sizes and I think you'll be hard pressed to find anyone who has substantially shrunk a nodule with natural methods. Some people do get on hormone replacement therapy (for thyroids) and get general thyroid swelling down, but I really doubt you'll be able to shrink just the thyroid.

I had a very, very easy time with surgery and was hollering at my dog two days after with no issues. I also had a general surgeon. That said, he does about 8-12 per week. It sounds like the guy you saw is only doing about 1 per week? I'm not sure I'd be thrilled with at, based on numbers alone. I would advise that you go with you gut feeling...and also ask around. You'll be surprised at how many people have had thyroid surgery and most are very willing to share experiences.

Since you are concerned about after care (very valid), did your surgeon talk to you about how that works with his practice?


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## Octavia (Aug 1, 2011)

I agree with joplin about the surgeon...60 surgeries a year is not enough for my comfort level. You may wish to also speak with an ENT about surgery. Many ENTs do several thyroidectomies and/or partial thyroidectomies every week. Regardless, make sure your surgeon uses a nerve monitor to protect your laryngeal nerves (vocal cords).


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## Andros (Aug 26, 2009)

aquabean said:


> New here, looking for some insight  To start this off at the end of December
> I had my copper IUD removed, I had it for 6 years. I was afraid that I was
> potentially suffering from copper toxicity as I found a forum with a bunch of
> other women who had issues from the IUD. I got pregnant a month later but had a miscarriage a week after I found out (6 weeks along). It's been a little over 2 months since the miscarriage and 2 weeks ago I noticed a nice sized bump on my neck! After a couple doctor visits and some tests, they said my thyroid is working "fine" but I do have a 3cm nodule and the FNA came back as "follicular neoplasm" so 30% chance of cancer and they want to remove that whole side  Here are the full results:
> ...


I agree w/the others who have had a boat load of experience in these matters.

Fortunately, I did not have cancer nor did I have surgery but I do wish to welcome you and let you know you have come to a good place.


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## aquabean (Apr 23, 2013)

Yes, I am not too thrilled with the amount of thyroid surgeries he's done either but I have Kaiser so I can only "shop" around through their network and I have no idea how to get referrals for other surgeons. My PCP sent me to an endo and she sent me to the surgeon....I'm assuming she wouldn't just sent me to someone who doesn't know what they're doing but gosh who knows! He did say he will use a nerve monitor to protect my vocal cords and said he'll push the parathyroids aside and trys not to bother them. He said he probably does the most thyroid surgeries out of all the surgeons there. It's a very nice facility that is brand new.

I just e-mailed my endo and asked for a referral to a endo at a different kaiser that my friend recommended so that I can get a second opinion. I hope that doesn't offend her?? But maybe this other endo knows of different surgeons. My aftercare would be in the hands of the endo I believe.

Thanks for welcomes and replies!


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## next2normal (Apr 10, 2013)

I think it's important to shop around for both an endo and a surgeon that you are comfortable with. After all, it is YOUR body, organs, and hormones that they are messing with. Good luck! I am sure you'll find someone great!


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## Octavia (Aug 1, 2011)

aquabean said:


> I just e-mailed my endo and asked for a referral to a endo at a different kaiser that my friend recommended so that I can get a second opinion. I hope that doesn't offend her?? But maybe this other endo knows of different surgeons.


If a doctor is offended by a request for a second opinion, she needs to develop thicker skin. That's part of the business she's in.

If you do get to see another endo, you might be wise to ask for a referral to an ENT who does thyroid surgeries...that way, you'll have an opportunity to talk with both a general surgeon and an ENT and see how they might approach things differently or have different levels of experience.


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