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Old 08-09-2008, 01:02 PM   #1
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Confused, nodule not there now?

Saw new Endo yesterday and a whole new situation now. He did another ultrasound: no nodule! (back in April had biopsy on a 1cm hurthle cell/follicular nodule) He agrees the biopsy was done reviewing the path report but thinks it was on my thyroid lobe only? Now, either the nodule just vanished or the other endo lied? Could a nodule vanish in just a few months? I'm set for a surgical consult next week and I'm thinking of forgetting it!!! This new dr is stuck on TSH only, but agrees to treat by "symptoms" and the lower the better. He doesn't like cytomel due to the "peaks and valleys" of short life. He sd its better to surpress with t4 and be on the very low side of level to help with the flucuations of Hashi's. He did do the adrenal blood work and we'll see? This guy is with a top notch teaching hospital so I'm feeling better about things. Just confused on the"nodule" thing? how can a 1cm nodule disappear? and kinda worried about hurthle cells in my thyroid w/o a nodule? he sd many hashi people get this, its when there are prominent hurthle cells without the other cells you take it out. Anyway glad I got rid of the previous endo.
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Old 08-09-2008, 03:12 PM   #2
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Re: Confused, nodule not there now?

Kindspirit-What did your new endo at the teaching instit. have to say about you seeing a surgeon???? Did you ask the endo if he thought surgery was called for? Your current endo should send over the u/s report and your chart notes and give the surgeon his recommendation on whether surgery is in his opinion called for. And the surgeon should have your biopsy results as well as your previous endo's chart notes. I too have conflicting reports and will see a thyroid cancer endo specialist at the end of the month to try to put the variousct scans and u/s and biopsy results together. Like yours, my biopsy also said hurthle and follicular cells and said see comment--comment said consistent with hashimoto's and it said not malignant. Though apparently I do still havea 3cm mass. When they did my biopsy the dr. said it would be six needles--but he took 120 tissue samples--that means the needle went in and he poked it around inside 20 times ea. needle--OMG did that hurt like #%**. But, I was told by a person that had thyroid cancer that it was excellent that the dr. took so many samples--that he did a good job for me. So I am thankful for that , though the pain was something else.
Let us know what happens--I do think second opinions are helpful and actually critically impt. But to make the best use of going to the doctor, you need to be sure that he would have the film and notes from the prior and latest ultra sound, the pathology report on the biopsy and both endo's chart notes--that is current and previous endo.
Best of luck!!

 
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Old 08-09-2008, 03:57 PM   #3
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Re: Confused, nodule not there now?

Hi Osteo, yes, he advised me NOT to have surgery. The new endo had the biopsy report, but no u/s report, had notes from the other guy. I'll be calling the old endo Mon. to "inform" him of the new report... The other dumb endo also advised no surgery. The only reason I got all caught up in "surgery" was reading so much about hurthle cells. But...if there is no nodule now, it doesn't make sense? I'm afraid if I go to the surgeon he will want surgery, as that's his expertise??? My dilema is : if I in fact had a nodule and its gone, well, that's a good sign!! But, if maybe when he did the biopsy it could have drained it? like you said they took so many slides! will it come back? It just appears with no big masses showing things are going in the right direction? I have a bit of a concern on a "limp node" higher up my neck. He ultrasounded that and sd yes its enlarged, but showed blood flow. He sd it could be from sinus issues. I had 2 areas that hurt during the u/s. I dunno, so confused right now. I'd like to keep with this recent opinion, seeing as its the least invasive. I'm trying to be optimistic and put this whole thyroid thing behind me. Atleast he did the adrenal test, as I have always felt something was off with that, now all is covered. The high "estradiol" levels had me concerned, with no female parts left, he was baffled too. If the adrenal test comes back with flags that will end that case, if not, well, where the heck is the estrogen coming from? He insisted the thyroid does not make estrogen, but I showed him documents proving estrogen is a thryoid cancer tumor producer. So, hmm. But then again, it still would have to come from another source to make the t tumor. Oh, well, one step at a time. For now, I think after I get the test results Monday I'll make my decision on if I'm going to pursue surgery? He's upped my Synthroid and dropped the cytomel, another 6 wk wait, been at the dose he's upped me to and my tsh went very low, he wasn't concerned. I just want to stick with ONE dr and stop dwelling on this, reading too much is not good. I think we must go with our "gut" feelings. It appears there are a lot of us with similar readings and don't require surgery. I'll let you know what the adrenal test showed? but not leaning toward surgery at this point.
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Old 08-09-2008, 06:38 PM   #4
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Re: Confused, nodule not there now?

Kindspirit, good news that the nodule disappeared! For what it's worth, I have a small complex nodule on my left lobe it's 1.3cm. The first FNA showed rare atypical Hurthle and follicular cells. Like you, I read a bunch online and got really worried. The FNA was repeated at a different hospital and came back benign. That nodule is still there and they are just watching it, no surgery recommended. The new endo you're seeing sounds good. Is he at MGH as well? By the way, I decided to pursue an opinion with the same surgeon you have an appt with after all I hope things continue to go well for you and surgery is taken off the table--that would be a relief.

 
Old 08-10-2008, 07:35 AM   #5
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Re: Confused, nodule not there now?

Hi Sienna, no, the new endo is with Dartmouth-Hitch. He's very young but tac smart. After I get my lab results, I hope tomorrow, I'll decide if I am canceling the MGH appt? I wasn't looking forward to the commute into Boston, plus, if I don't even have a nodule now what's the point? Does your nodule bother you? the new endo sd if it gets to a point of pain and pressure then surgery might help? He truly feels with the correct dose of Synthroid, with a consistant dosing, not like the other endo did to me: he had me altering days with 50's and 75's , no wonder I was all over the place. If we don't do surgery we just need to keep up on ultrasounds. The people that have cancer seem not to be Hashi's and found their lumps by accident. Atleast we are being monitored regularly. I just feel so--much better, having a doctor you like makes a world of difference! When you don't trust your doctor that's when one starts "studying"... I'll always do my research, but now a bit of the load is off. When do you go to MGH? you can have my appt on the 19th if I cancel?
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Old 08-10-2008, 07:52 AM   #6
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Re: Confused, nodule not there now?

Dartmouth is a great facility. My daughter has a specialist at their Manchester branch. I'm so glad you found a good endo! I'm still looking for one and it's a frustrating search to say the least! I have two nodules, the complex one that had some hurthle cells I can't even feel, but the cyst is big and really does bother me. Someone was just telling me that you can have it drained and have ethanol injected into it to prevent it from coming back, but I don't know if anyone around here does that. The person was from California. I've never heard of that before. My appt in Boston is October 21st, I imagine that, like you said, since he's a surgeon he'll recommend a lobectomy. I think it would be absolutely wonderful if you can completely avoid surgery! Watching it via ultrasound with a good endo sounds really managable. Plus if he gets your levels right you'll feel great! I hope your labs come back great!

 
Old 08-10-2008, 11:16 AM   #7
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Re: Confused, nodule not there now?

Kindspirit-I just wanted to say I hear you when you talked about how having a good doc can put you at your ease. You still will do your research but you don't feel hanging out all alone with what might be a very serious situation.
Having said that it is soooo hard to find someone who will take an interest in your case--in my experience. The way the medical system is set up , the docs have hardly a minute to look at your file before they come in the exam room. Then they seem to be so on the fly.
It seems so many on this board, chew through docs ....and keep searching. Some few have found dr. right and others think they have found dr. right and then with time it doesn't work out.
I think thyroid cases are very difficult and not easily resolved with the new"quickie" medicine delivery methods.
I have always thought that how a dr. treats you is so impt. to your healing even if what they do is identical to the uncaring , unkind dr.---do you know what I mean??
Dr. shopping just gets sooo tiring. But, maintaining with a dr. who you think/know is not taking the time to treat you correctly is a waste of time and can be damaging to our health.
So, the challenge to find a caring, kind dr. who is also top notch. Now some people luck into this situation and others of us have to keep working at it.

 
Old 08-10-2008, 12:41 PM   #8
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Re: Confused, nodule not there now?

Osteo, so true. I never felt "cared for" by my 2nd endo, no return calls, staff very rude and blah responses to my questions. This new guy, is young and probably not "burnt out" yet...so he seems up to the challenge and my questions to boot. I put things right at him and he was right back at me. I questioned his suggestions and he made some sense. Atleast he was responsive to the lab request on adrenals, the other guy ignored me on that. It is so---true, one can heal faster with "faith and trust". Being treated by a rude, uncaring so called professional is detrimental to anyones health. We all need to be treated with respect! these guys are getting paid big bucks at our healths' expense! There are some good doc's out there, it takes "weeding" thru them. This guy might not be a keeper but having a bit more peace of mind right now is good enough for me. Yes, I'll still study and question, and as long as I get a response that will appease me. I can't wait to see what the adrenal test looks like? I'm hoping it is the issue and I can stop worrying about the high estrogen levels. He retested my estrogen, he questioned the accuracy of the lab? so off of nodule stress and on to estrogen worry, lol. I hope we all get our issues resolved, take care. Sienna: yes Dartmouth is great, I went to the one in Conocord NH. I hope you get a good response in Boston!!!!
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Last edited by kindspirit; 08-10-2008 at 12:44 PM.

 
Old 08-11-2008, 06:48 AM   #9
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kilgore52 HB User
Re: Confused, nodule not there now?

my doctor says they come and go. I had one also and after 2 years of fine needle biopsys, the nodule is now drained completely and very small. so no surgery needed. I still go have it looked at for any changes once a year.

 
Old 08-11-2008, 07:04 AM   #10
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Re: Confused, nodule not there now?

Hi, I have a small nodule of 0.7*0.4cm. Is it too small to ignore? Or I should have it observed with ultrasound periodically? thanks.

 
Old 08-11-2008, 08:05 AM   #11
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Re: Confused, nodule not there now?

Urgh...just called my old endo to get copies of the so called nodule ultrasound. Well---the nurse was very very RUDE. I sd I want the films of the actual ultrasound sent to my new endo, she sd they've never done that. Well, I say: how would a 1cm nodule disappear? she acted dumb, and your new endo has the report: you had a biopsy of the thyroid. Hmmm.., not what the report says I got that same day!!! it says 1cm nodule, solid, with goiter and multinodulas. She refused to continue our conversation and I jumped in and said make sure my next appt on the 29th is canceled, she sd I already did that! So, looks like I was biopsied for no reason!!! granted it shows hurthle and follicular cells but the thyroid produces those. This doctor crap is really getting me so upset!!! No wonder we all "study" so much, dr's hate that, but given the injust treatment we're left to fend for ourselves!
My new endo is not in til Friday, he goes to Concord only 1# and spends the rest in Dartmouth. So unless he peeps in for my lab results I've gotta wait til Friday now, urgh. I'm so---glad I left that old endo!!!! going to cancel the surgical consult, seeing as I don't have a nodule? and if those hurthle cells were cancer and had the whole thyroid to "play" with I would think malignant would have shown up in that biopsy? what do you think?
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Hashi's / Hypo Jan 2008
C 5-6-7 fusion
L-5 s1, discectomy, ddd, o/a, scoliosis
Hysterectomy

 
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