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Old 04-15-2008, 07:53 AM   #1
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Thyroid surgery? Nodules and hashimotos.

I have been diagnosed with Hashimotos and also have thyroid nodules. I started out with 2 nodules, then 4 and now 5. I have had two FNA's both undiagnostic. My doctor is now suggesting surgery to remove the thyroid. There is no way to tell 100% that there is no cancer without checking the nodules and since the FNA came back inconclusive, is this the next step.

I am very nervous about having the surgery, esp if there is something else that can be done. I am taking synthroid to try and reduce the nodules, but that has not worked.

If anyone has been in the same situation, I would appreciate any feedback.
I feel I should just have the surgery and be done with it, esp since I don't know if there is any cancer involved.

 
Old 04-15-2008, 08:05 AM   #2
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Re: Thyroid surgery? Nodules and hashimotos.

Yes at least a partial thyroidectomy is in order. Are the nodules on one side or both sides? My mom lucked out with only one lumpy side.. it was precancerous. The biopsy came back questionable.. so out it came. She is doing great and surgery went well.

My Aunt B1 had her 6 small nodulee thyroid cut out after they tried killing it twice with RAis. She is loving life. Aunt B2.. I have four aunts all with issues. She is scheduled for TT soon as well. Some times it is better after the bugger is gone. I had one nodule visible on my first US. It has been over 3 months and I am having issues swallowing now and can not stay balanced on my thyroid meds. I am going to push for mine to be removed every chance I get.

MG
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Old 04-15-2008, 08:08 AM   #3
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Re: Thyroid surgery? Nodules and hashimotos.

MG, thanks for the quick response. The nodules are on both sides, so it would have to be a total.

I have been having problems swallowing also. Not all the times, but on and off it feels like there is something stuck in my throat.

 
Old 04-15-2008, 08:12 AM   #4
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Re: Thyroid surgery? Nodules and hashimotos.

Sounds like your thyroid is still being hammered by antibodies then. How is your medication situation? Have they been able to optimize you and shrink any of the nodules? Are you getting a second opinion and evaluation by an ENT in addition to your Endo. The swallowing difficulties are a sign that the thyroid is constricting your esphogus. I bet you have issues with voice strain and singing. If you sing a long song does your voice break and your thyroid throb like a stubbed toe? Mine does.. ugh! Hashi's is a real pain in the neck.

MG
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Old 04-15-2008, 08:17 AM   #5
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Re: Thyroid surgery? Nodules and hashimotos.

So far the meds have not done anything for the nodules, they were hoping it would shrink them, but nothing yet. I have been going for blood work and ultrasounds every 6 months for the last 2 years and the only thing that is happening is I am getting more nodules.

I am seeing an endocronogist next month, so that will be my second opinion. If he agrees with surgery, I think that will be the way to go. I guess the not knowing for sure if it is cancer or not is the main reason to have it done. But if I am just continuing to get more nodules each time I get an US, pretty soon my whole thyoid will be nothing but nodules.

 
Old 04-15-2008, 08:23 AM   #6
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Re: Thyroid surgery? Nodules and hashimotos.

I personally would trust and ENT over an Endo for the diagnosis of the thyroid and nodules. You are looking at a physical throat phenomena over a hormonal and function issue. A good ENT that performs thyroid surgeries and biopsies weekly would have more experience in this regard. I am not saying don't go to the Endo.. I am just saying adding an ENT to the mix would be a good idea.

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Old 04-15-2008, 08:59 AM   #7
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Re: Thyroid surgery? Nodules and hashimotos.

The ENT is the one who is leaning toward surgery. My primary dr wants me to see an endo and get another opinion.

 
Old 04-15-2008, 09:17 AM   #8
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Re: Thyroid surgery? Nodules and hashimotos.

Sumar -I too have hashi's and nodules on each side-a total of 7. The nodules are 2-8mm. I have not had a fna yet. I was scheduled for one when they found a 3cm mass in my neck on thyroid us-but 4 days later it was no longer there-it is speculated it was a lymph node. The dr. at the hosp who was going to do the biopsy said , there is nothing here that warrants a biopsy now-???So, a biopsy was not done.What I am wondering is could you list the sizes of your nodules?
I have not yet noticed trouble swallowing though there is a tightness in my neck. My thyroid has gotten much smaller , like 47% on one side, the other side has gotten smaller but more like 20%-. On my first u/s it was said normal size, this last one said small size. I read that hashi's due to scar tisssue developing where thyroid has been attacked will tend to shrink/constrict and could involve the esoph. and windpipe.
So, I am wondering if our situations are roughly similar. If you could write down the size of your nodules and maybe whether your thyroid has decreased in size I would be very interested to compare our situations. It just took a little math to calculate the change in size of the thyroid. If you want to just put the measurements of your thyroid from earliest to current us- I could do the math for you,if you want. I am going to see the endo in approx. 3 wks and thyroidectomy is at the top of my list of questions .And, I am going to get an appt with the ent scheduled.

 
Old 04-15-2008, 09:31 AM   #9
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Re: Thyroid surgery? Nodules and hashimotos.

Quote:
Originally Posted by sumar203 View Post
MG, thanks for the quick response. The nodules are on both sides, so it would have to be a total.

I have been having problems swallowing also. Not all the times, but on and off it feels like there is something stuck in my throat.
I have nodules on both sides, but did not test positive for Hashimotos. I had one nodule and one lymph node biopsied and they were benign. The radiologist said the other nodules could be followed by ultrasound. I'm still waiting for the doctor's report. We've been watching these things for over 3 years now.

 
Old 04-15-2008, 09:41 AM   #10
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Re: Thyroid surgery? Nodules and hashimotos.

Oseteo....My nodules are between 1 mm and 8 mm. They have not said anything about any change in the size of my actual thyroid. I have had ultrasounds and blood work every 6 months for the past 2+ years and the only change they have said is one of the nodules has gotten slightly larger and I went from 2 nodules to 4 and now 5 total. I have only seen an ENT so far and he is recommending removing the thyroid since the FNA came back inconclusive. My primary wants me to see an endo and see what he says, that appt isn't until the beginning of June. We;ll have to compare notes on our dr appts and see what they say...

 
Old 04-15-2008, 09:42 AM   #11
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Re: Thyroid surgery? Nodules and hashimotos.

Curious, do they just recommend to keep watching. I have been doing the "watching game" for 2 1/2 years and this is actually the first time my ENT recommended surgery.

 
Old 04-15-2008, 12:26 PM   #12
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Re: Thyroid surgery? Nodules and hashimotos.

Sumar-our situations seem so similar. Please update when you find out if you will have surgery. Do you want surgery? I am getting to the point where I need relief from my unstable tsh levels.Have your levels been real unstable and hard to manage? Mine have been very hard to manage.I have thought the fluctuation may have been the cause of so many nodules.

Last edited by osteoblast; 04-15-2008 at 12:27 PM.

 
Old 04-15-2008, 12:58 PM   #13
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Re: Thyroid surgery? Nodules and hashimotos.

Quote:
Originally Posted by sumar203 View Post
Curious, do they just recommend to keep watching. I have been doing the "watching game" for 2 1/2 years and this is actually the first time my ENT recommended surgery.
I'm not sure what they will say. I went to an ENT who looked at my thyroid, looked at the scan and said take the whole thing out before the end of the year. I then went to a major cancer center and saw a general surgeon who specializes in thyroids. He said I had a multinodular goiter and on the basis of their new more detailed ultrasound said I needed a FNA of a lymph node and a very vascular dense nodule. That was done and the preliminary results were benign. They seemed very sure about that!

That was a week ago. The doctor was supposed to call me in 3-5 days. If I don't hear from him by the end of today (he has clinic today) I will call and leave a voice mail message asking what if anything he thinks I should do. The radiologist did note that she thought the nodules on the left side of my thyroid could just be monitored by ultrasound. She didn't say at what interval.

This whole thing was complicated by discovering that my blood pressure wasn't under control near as much as we thought it was and that I had a lot of PVCs on my EKG.

The doctor did tell me that having a LOT of nodules does not make it less likely that any one of them could be cancer. It does not make it any MORE likely either.

 
Old 04-15-2008, 01:10 PM   #14
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Re: Thyroid surgery? Nodules and hashimotos.

Curious -congratulations on the news that the nodules are benign. How many do you have and what are the sizes? Do you have hashi's as well? As I indicated above, I am babysitting 7 nodules, from2-8mm.I have hashi's. My endo says u/s again in 6 months but I am not comfortable with this situation.

 
Old 04-15-2008, 01:52 PM   #15
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Re: Thyroid surgery? Nodules and hashimotos.

I know how you feel. I had multi- nodules, hashimoto, and my levels were all over the place. My Endo treated me for about 6 months, then sent me to a surgeon. The surgeon said best option for me was total thyroidectomy. I had the surgery a little over a year ago. I dont regret it at all. I had very little pain. I think I took 1 or 2 pain pills total. I had a totally hysterectomy 4 months after the thyroid surgery. Recovery was so much easier with thyroid surgery. I wish you the best with your decision. I cant tell you if this is right for you, but in my situation it was the right decision for me. Many prayers.

 
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