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  • Blood and Sono - Need help deciphering

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    Old 11-11-2008, 10:22 AM   #1
    PandaBear777
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    Question Blood and Sono - Need help deciphering

    I went to the doctor a couple weeks ago complaining of migraine headaches. I have a history of allergies and sinus issues and he headed exactly that direction. Gave me a narcotic pain reliever and muscle relaxer. But he also checked the glands in my throat and found an enlargement on my thyroid. From there he checked my TSH and Free Thyroine. He also sent me to have an ultrasound.

    The TSH was 6.33 and the Free Thyroxine was 0.80 - Doc put me on a starter dose of Synthroid.

    Got the Songram results yesterday - Doc explained but left me wondering...
    Results: Echotexture is heterogeneous bilaterally and both loabes appear hypervascular by color Doppler. 1 cm hypoechoic nodule noted along the posterior aspect inferior pole. IMPRESSION: Heterogeneous, hypervascular thyroid gland. In the setting of hypothyroidism, this finding might represent evidence of thyroiditis. 1 cm hypoechoic nodule lower pole left lobe.

    What I got from what the doctor said is that they believe I have a virus in my thyroid (thyroiditis), which may clear up on its own. They believe this because of the texture of the thyroid. What I didn't get was what makes a nodule hypoechoic and what does that mean?

    What bothers me is....mom died of lung cancer metastatic to the bone, paternal grandfather died of thyroid cancer, neice died last year from brain tumors....and many other cancers in the family all rapid progression.

    Yep - freakin' out a little here...especially after asking to see a specialist and being told I probably won't hear for two weeks about an appointment and then it will be 3 or more months off.

    Oddly. the migraine has gotten better since taking the Synthroid - but the doctor says one has nothing to do with the other....?.....

    A 1 cm nodule....hypoechoic??? - does that mean the echo had trouble penetrating it?

    Anybody think I should push the time issue or find an endocrinologist that can see me sooner?

    Some advice please!

     
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    Old 11-11-2008, 10:51 AM   #2
    mkgb
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    Re: Blood and Sono - Need help deciphering

    Get into an ENT for a biopsy of the nodules. This will take car of your structural worries and identify if it is hashimoto's thyroiditis. Your MD should have tested your TSH, Ft3, Ft4 and TPOAb and TGAb. I am betting Hashimoto's. Given the cancer history consulting with an Endo and ENT is a safe bet. Thyroid cancers are SLOW. You should be safe to wait a little bit. An ENT that is thyroid savvy will be better versed at structural anomalies that may hint at cancer. I trust my ENT to follow my thyroid nodule. I haven't found a good Endo to follow me yet. They have all been suboptimal in thyroid treatment. You will get the joke if you read enough here.

    Check out some of my threads I think they will help you:
    Week 7 - TT and RAI concerns with a discussion on the facts of thyroid cancer.
    [url]http://www.healthboards.com/boards/showthread.php?t=610550[/url]

    Threads Summary:
    Week 5
    [url]http://www.healthboards.com/boards/showthread.php?t=601986[/url]
    Humm.. this was a rambler. We went over a few things old and new. Peruse at your leisure, if you so desire. More on physical and pulmonolgy effects.. as well as medicine and adrenal questions and my opinions.

    Week 3 and 4 of my Thyroid care and concerns thread series:
    [url]http://www.healthboards.com/boards/showthread.php?t=599141[/url]
    This thread has a lot of discussion on the mental(cognitive), genetic probabilities, and physical effects (cardiological and pulmonary to name a few) of thyroid disorders. Look into it if you are interested.

    Week 2 of my Thyroid care and concerns thread series:
    [url]http://www.healthboards.com/boards/showthread.php?t=597479[/url]
    This thread is jam packed with information on my ideas and opinion of what optimal and basic thyroid care should be.. accuracy of testing.. necessity of testing.. TSH suppression.. TPOAb and TSI effects and mechanisms.. Latest TSH range.. change in 2006 to 0.3-2.5! It is a lot of good stuff. It is a must read for all you getting started and questioning, “Am I getting the care I deserve?” For most the answer is “NO, I am not!”

    Week 1 of my thyroid care and concerns series..
    [url]http://www.healthboards.com/boards/showthread.php?t=595898[/url]
    you can read a bit about me and my story.. it continues on in the following weeks.. as well as others. It also goes into why I feel and will keep up with these weekly threads as long as I am permitted.
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    Old 11-11-2008, 11:34 AM   #3
    PandaBear777
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    Re: Blood and Sono - Need help deciphering

    Thanks! Finding and Endo that here is a bit ....ooky. I've not heard too much good about the dr.s here and haven't had any good experiences with any either. I used to better.

    I've been reading the boards at many sites but liked what I was seeing here best. Was actually hoping for an answer from you. Sounds like you've learned a lot.

    I don't know anyone in this area well either....I work too much and my job brought me here. So, getting people to tell me the good and bad of their doctors is limited and tough.

    I'll look at the threads you suggested!

    Thanks again!

     
    Old 11-11-2008, 11:50 AM   #4
    mkgb
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    Re: Blood and Sono - Need help deciphering

    I will see if I can get some good hits on top thyroid MDs in your area. I was going to recommend my Im too you but that would be one heck of a haul. I know one Endo in Birmingham, but she is not accepting new patients right now. Not even on a waiting list. *sigh* A good Endo is like teeth on a chicken.. one in a lifetime. I have a large family of dysfunction and I fell apart on the endocrine side of things. I am just lucky to have the chemistry and teaching background to brow beat my MDs. This is a great set of boards. You get the occasionaly nut, but with thyroid issues that is to be expected.

    MG
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    Old 11-11-2008, 12:12 PM   #5
    mkgb
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    Re: Blood and Sono - Need help deciphering

    Alabama is sparse top thyroid MD territory from what i can tell after a quick search.

    I tried to get Birmingham and below.

    Mark Reese, MD, Mobile Alabama
    Review:
    "I have had hypothyroidism my entire life. Because my exhusband was in the military, I have moved around and went to numerous endocrinologist.Thebest endocrinologist I've ever gone to is, Dr Mark Reese, in Mobile Alabama. He educated me on various topics related to my pituitary tumor and hypothyroidism. He was kind and I felt that he really cared about me and all his patients. My thyroid levels have been difficult to regulate since I developed a pituitary tumor. The tumor on my pituitary gland secretes too much prolactin (hyperprolactin) He checked my thyroid level and prolactin level more frequently than I hadchecked in the past.I've alwaystaken my medication everyday. He listened to me and discussed my concerns. I use to be really over weight and my blood pressure was high. I felt that he understood how I felt. Now that I live in another state, I can't seem to find a doctor like him. He definately deserves to be on a list for giving high quality service on hypothyroidism." (July 2008)

    Montgomery, AL
    Scott A. Bell, Internal Medicine, Montgomery, AL
    Review: "I found Dr. Bell through the ACAM website; Dr. Bell tests frees along with TSH, but his treatment relies strongly on how you feel. He also diagnosed me with Insulin Resistance after trying to get other dr's to look at this for two years; accepts insurance, which was also a huge plus for me. He prescribes T3 in combination with T4." (June 2006)

    NOTE: This doctor has reportedly instituted an mandatory annual "membership" fee of more than $1000 per year for anyone who wants to be his patient. (October 2007)
    Not sure about this.. but it might be worth a call. But I do not know if I would pay an annual fee like that unless my insurance covered it. Yikes!

    David DeAtkine, Endocrinology, Birmingham, AL. “Thorough, compassionate, and not pushed for time. I felt a sense of relief after my visit with him. He does do FT3 & FT4 testing and is not opposed at all to T3 addition in the form of Cytomel. He IS NOT an Armour prescriber but realizes the significance of adding T3 meds.”

    THIS GUY IS IFFY. HE SEEMS TO HAVE IMPLEMENTED A 600 PATIENT LIMIT AND A 1500 ANNUAL FEE FOR THOSE PATIENTS. HUMM. I GUESS IF YOU ARE GOOD YOU CAN ASK AN EXTRA FEE.


    Dr. Robert C. Doekel, Jr. Birmingham, AL.
    REVIEW: He treats thyroid patients according to Broda Barnes principles, does a thorough interview and exam, explains things well, uses up-to-date testing, and answers his calls himself when you call back with questions. My preliminary thyroid screens from a family physician showed no abnormalities but he began treatment on the strength of my symptoms, history, and a basal temperature chart. He also sent away an Adrenal Stress Index Test that showed adrenal problems.

    IF THIS MD TREATS BY TEMPERATURE ALONE I WOULD SAY NO GO. HENCE AN IFFY ONE AS WELL.

    Sorry I couldn't dig up a good one for you.

    MG
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    Old 11-11-2008, 12:39 PM   #6
    PandaBear777
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    Re: Blood and Sono - Need help deciphering

    There's one here in Dothan. Can't find him listed on sites for a patient recommendation. Did find that he did his Graduate studies at the Mayo Clinic. Good education - don't know about bedside manner or his position on thyroid treatment. He's the one I've asked to be referred to...his office called a little while ago. Appointment set for February 3, but he doesn't accept my insurance and I'm not done looking. But I took the appointment for now. Don't know if listing his name here would violate the sites rules....

     
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