# Appointment Today finally



## heath (May 2, 2013)

I have my endocrinologist appointment this afternoon that I've been waiting for! 
I know it's a little last minute - but anything I should remember to ask for or say? 
I'm going because of an enlarged thyroid that I've had about 20 years! and multiple nodules on the goiter. Been diagnosed with Fibro and just don't think that's accurate. 
Going with my recent blood work results and past ultrasounds too. 
Really hoping for answers!


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## Andros (Aug 26, 2009)

heath said:


> I have my endocrinologist appointment this afternoon that I've been waiting for!
> I know it's a little last minute - but anything I should remember to ask for or say?
> I'm going because of an enlarged thyroid that I've had about 20 years! and multiple nodules on the goiter. Been diagnosed with Fibro and just don't think that's accurate.
> Going with my recent blood work results and past ultrasounds too.
> Really hoping for answers!


Actually; the most important thing from my point of view would be an ultra-sound!

And some of these antibodies' tests would be good also.

TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin and Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/

Good luck today and let us know what transpired.


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## heath (May 2, 2013)

Thanks  
They almost tried to cancel my appointment! But were able to squeeze me in earlier thank goodness. Been waiting so long already and just want to get in there!


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## heath (May 2, 2013)

Well basically told my symptoms are not thryoid related. My TSH which were 3.68, 3.4 and 2.68 at last 3 checks were all within range and the fact my antibodies were too high meant my thyroid was just working overtime to keep an even balance. And it wasn't a concern.
My nodules were not big enough to warrant a biopsy or concern. (largest .9mm) 
She is sending me for more blood work and another ultrasound and go back with those results in August. 
The pain achy feeling I get in my neck and throat like a flu is coming on (whenever I'm tired or over stressed) is not typical with thyroid and something else must be going on. 
And if the large goiter is bothering me enough she can send me to a surgeon to have the right side removed but wouldn't be tested or anything. Just to have comfort in my throat. 
SIGH!

I actually almost got the feeling she was ticked with me because she tried to cancel my appointment to go home early. and I pushed to have it re-scheduled earlier so I didn't have to wait another 4 weeks! So she squeezed me in an hour before my actual appointment time.


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## Andros (Aug 26, 2009)

heath said:


> Well basically told my symptoms are not thryoid related. My TSH which were 3.68, 3.4 and 2.68 at last 3 checks were all within range and the fact my antibodies were too high meant my thyroid was just working overtime to keep an even balance. And it wasn't a concern.
> My nodules were not big enough to warrant a biopsy or concern. (largest .9mm)
> She is sending me for more blood work and another ultrasound and go back with those results in August.
> The pain achy feeling I get in my neck and throat like a flu is coming on (whenever I'm tired or over stressed) is not typical with thyroid and something else must be going on.
> ...


Eeeeeeeeeeeeer; excuse me?

This woman does not know what she is talking about and you have been fluffed off big time.

Please please find another doctor in your area. Many here are more than pleased w/their Naturopathic Doctors.

I give this woman a huge thump on the head! Let's see what others have to say.


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## bigfoot (May 13, 2011)

What-The-Frick. Andros is right, this endocrinologist totally gave you the run-around. Don't feel bad; most "specialists" are more concerned with lab values than a patient's signs & symptoms. But, in your case, you have both lab values and data to support your issues. How anyone could turn a blind eye to that is beyond me.

Enlarged thyroid for years. Check.
Multiple nodules. Check.
Goiter. Check.
High thyroid antibodies. Check.
Trouble swallowing. Check.
Multiple TSH labs above AACE recommendation of 3.0 for upper limit. Check.

Despite all of the above, the doctor has basically told you that most of what you are suffering from is not thyroid-related. Honestly, the only saving grace is that this doc ordered a follow-up ultrasound. Even so -- run, don't walk, to another doctor. You need answers and treatment, not BS.

You are right to suspect that there is more going on here than your previous diagnosis of fibromyalgia. Would you be so kind as to share any other thyroid or endocrine labs and ranges? Especially those antibodies.


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## heath (May 2, 2013)

Thanks for the feedback! I basically had to take a day and try to not think about it. So frustrated! Waited for this appointment for so long.

Here is my bloodwork and last ultrasound results she had with my referal to look at.

TSH 2.68 (0.35 - 5.00)
Free T4 10 ( 9 - 23 )
Free T3 4.6 (3.5-6.5)

Anti-TG 368 (HI) ( <40 )
Anti-TPO 8 ( < 35 )

Thyroglobulin 232.2 (HI) ( <60.0 )

Also got the last ultrasound results from July 2012
Right lobe is enlarged bot both lobes are heterogeneous. Right measures 6.9 x 3.1 x 3.1 cm and the left measures 4.9 x 1.2 x 1.6 cm. Well-defined echo poor nodules are again seen on the right side, the largest measuring 8 x 9 mm. No new suspicious microcalcifications. Multiple prominent lymph nodes are again seen bilaterally


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## bigfoot (May 13, 2011)

Lots of antibody action there. Something is *definitely* going on. I'd like to say Hashi's, but I'm not 100% sure of the distinction between Anti-TG and Thyroglobulin. Either way, your immune system is going nuts and your thyroid is absolutely involved. Hopefully somebody chimes in with more info, and especially someone who can interpret the ultrasound results. Since it's been a year, it would probably be a good idea to get a follow-up ultrasound to track progress.


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## Andros (Aug 26, 2009)

heath said:


> Thanks for the feedback! I basically had to take a day and try to not think about it. So frustrated! Waited for this appointment for so long.
> 
> Here is my bloodwork and last ultrasound results she had with my referal to look at.
> 
> ...


When they say this


> No new suspicious microcalcifications


; does that mean you do have some evidence of microcalcification from previous exam re ultra-sound?

You know what? Get in to see an ENT. Truly; your case sounds worrisome.


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## sjmjuly (Mar 23, 2012)

Your doctor sounds like the first "twit" I saw. I never went back to her again. Your free's are in the toilet just like mine are. There is something going on here. Find another doctor - try a naturopath. I love mine and I swear she has saved my life.


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## heath (May 2, 2013)

So I found my old post and thought I would offer an update on my "journey"

After the appointment with the endo despite feeling like I was brushed off, I was sent for yet another ultrasound. And I'm not sure if it was because I mentioned that I was seeing a new dr and she wanted a more through look at another ultrasound but I got this report back .....

Both lobes remain enlarged with heterogeneous parenchyma. The right measures 6.7 x 3.3 x 2.4 cm and left 4.1 x 0.9 x 1.4 cm

There is so much heterogeneity, it is difficult to detect discrete nodules but there is a more focal area of homogeneous echogenicity in the right isthmus which measures approximately 3.6 x 2.1 x 0.9 cm. There are no suspicious microcalcifications but there is moderate vascularity. This area was not discretely measured on the previous studies but upon review of the static images I favor that existed but blended in with the rest of the heterogeneous tissue. However, because it looks more discrete either close sonographic follow up or consideration of an FNA for cytology could be made.

So basically it looks like the larger nodule measuring 3.6 cm has been there in previous ultrasounds but not detected! Which bothers me because I recall going for an ultrasound about 5 years ago to a private clinic and there was a mass that was detected and the Endo I had then said to go to the hospital to re-do it and double check their findings. And that she trusted the hospital techs and that I should always have my ultrasounds done at the same place for a consistent reporting over time.

Well obviously the private clinic found it !! And when I went for the second opinion at the hospital they didn't see it! UGH Frustrated.

Once this Endo that brushed me off got this ultrasound she took me a bit more serious!

I was put on .05 mg of Eltroxin - her reasoning was to help the nodule to stop growing or possibly shrink it. But it has helped me feel a small bit better. I don't have to hit snooze 60 times in the morning. lol

And I have had 2 FNA now also.

BOTH came back undiagnostic.

My first FNA biopsy did have this comment that bothered me but the ENT surgeon didn't think it was worrisome at all.

Nondiagnostic: specimen consists predominantly of polymorphic population of lymphocytes and very rare, possible small groups of follicular cells.

With both biopsies undiagnostic and the larger nodule being almost 4cm my Endo assumed I would be looking at surgery and sent me to an ENT doctor.

Saw him yesterday and he offered to do a third Biopsy or just go to surgery.

I honestly just want this over with! so I told him not to bother with yet another FNA. Lets just do the surgery.

I have a choice. He said the larger nodule is basically in the middle so he would have to take the entire center and whole right lobe. Leaving only a small fraction of the left lobe. Or I can choose to remove the entire Thyroid.

I think I have decided I just want the entire thing out. have a fresh start with my levels and move on. Thoughts?

Looking at probably May for surgery but I have to decide before I go back to complete the paperwork in early March.


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## joplin1975 (Jul 21, 2011)

Yup, get the whole thing out. I can't see what you'd be gaining by keeping in a tiny bit.

I've been reading along and am glad you are finally getting treatment. Good for you.


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## jenny v (May 6, 2012)

I second just removing the whole thing--get a clean start without anything left in there to interfere with your medication down the road.


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## Andros (Aug 26, 2009)

I definitely go with your thinking. Get it all out. Why have to constantly worry? When FNA is indeterminate; this usually is the wise course.

This very heartening that at long last, someone has taken you seriously!! Please let us know when your surgery is scheduled.

Many hugs,


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## Madison Marie (Sep 3, 2013)

Your story is so similar to mine that I felt compelled to reply to this topic. My right thyroid lobe is about the same size as yours. My left is only slightly enlarged. My thyroid is also so heterogeneous that different ultrasound technicians can't seem to agree on what they are seeing. One place claimed I had one nodule in each lobe. When I was sent for biopsy of those nodules, the hospital tech insisted there were no discrete nodules, but rather tons of smaller nodules running together. Basically just a hot mess. I decided not to have them do the biopsy because I didn't see any point in them grabbing random samples when the tissue was consistently inconsistent throughout.

I am in the same boat as you, where I am leaning towards full removal. My ENT is working with me to rule out other causes for my problems first though. I am first having a neck MRI to determine if anything else in my neck could be the cause of my symptoms. I have multiple lymph nodes up around my head and neck so I am eager to see how this report comes back. If it comes back clear, he also wants to check for and treat any acid reflux I may be having. I am okay with this too. I would hate to have this thing removed only to find out it was something else causing my neck pain and discomfort. At the same time, this has been going on for a long time and I am over it.

Anyhow, I just wanted to wish you luck and let you know you are not alone. If you are a little unsure about surgery, maybe further imaging, such as an MRI will help you feel like you are making the right choice. Just a suggestion, I don't blame you one bit if you are just ready to be done.


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## heath (May 2, 2013)

Thanks everyone for replying 

I have decided to have it all removed. My antibodies have been so high for years with TSH within normal range.

Diagnosed with fibro and I'm sure it's thyroid related.

So I just want a fresh start.

March 7 I go back to the surgeon to get the process started and most likely surgery in May.

I'm sure I will be around much more with question and worries lol


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## heath (May 2, 2013)

Well latest update ...
Surgery is scheduled for June 13 - Friday the 13th LOL. I'm not superstitious though and just anxious to get it over and praying for no cancer.


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## bigfoot (May 13, 2011)

Excellent news! I think you made the right decision. Although I haven't been in those shoes (yet), I would have chosen the same path. Get it completely out, start fresh, titrate up on T4 (and potentially T3), get optimized levels, and get on with life.


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## CA-Lynn (Apr 29, 2010)

Agreed. Be done with the beast.

And if there IS cancer, this type of cancer is pretty easy to remove completely. [If you MUST have cancer, this is the kind you want.]


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## Octavia (Aug 1, 2011)

Agreed.


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## blackpoolbutterfly (Jun 2, 2014)

Will be following your journey. Non cancer thoughts ur way xx


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