Thursday, June 11, 2009

Decisions, decisions....

A few months back I went for an annual physical. It turns out that the age of 40 is magical is the medical world. All sorts of new and exciting tests to be performed to make sure you aren't falling apart. My personal favorite is the stool sample by mail. I know. TMI. I am just preparing those of you out there who might be approaching the magic age. Well, I was given the kit anyhow. The test, well, let's just say I can't remember where the kit is right now...

All my stats are beyond great. I keep up with them like some sort of prized report card. I pride myself on how low my numbers are and compare them from year to year like some star pupil in school. Yes, a little odd I am sure but at least I "know my numbers" as the ad says.

Part of the exam was feeling my thyroid, or actually I am not sure what they feel for when they grab your throat (I assume it was not same lame attempt to choke me...) but anyhow, it turns out I had a lump on my thyroid. "Did you know you had a node on your thryoid?" "Yes, you had me get an ultrasound last year when you told me about the node". Doctor scurrying over to the chart... "Oh, yes, we were going to re-check it in 6 months". "oh." The short version is I was sent for another ultrasound to check it out.

We got the ultrasound back and I was sent to a endocrinologist to look at it. The initial thought being it was a cyst. It was slightly larger than last year and now there are 2 smaller ones. I guess it was a buddy plan. Anyhow... The Endo did a biopsy two weeks ago. The biopsy was quite interesting. They did a series of five needles into the nodule and kind of dug around with each one. There was some amount of anesthetic but not completely numb. On a pain scale of cotton balls rubbing on your skin to hair being ripped out by the root, I give it a bee stinging you in the nexk five times while someone presses down on your throat. Yeah, that kind of captures the feeling I suppose. :)

So... I went back today for the results. They were only able to biopsy one of the three nodules. The other two were too small. The main one did not show cancer. A relief to be sure although the chances of cancer were very minor. It is rare. I went into it thinking that if it was cancer obviously there would be treatment, etc. If it was not, I would be on my merry way. Apparently, not so. I was given two options. One being we could do ultrasounds and biopsies every six months to monitor the issue OR surgically remove the thyroid gland since the other two nodules were not tested and there is a history of thryoid issues in the family. I was given the number to a surgeon they use quite frequently and they suggested I go talk to him to see what is involved. I have reservations about the surgery mostly because i know so many people who have horror stories about being on synthetic thyroid. Hmmmmm, what to do, what to do.... This is my dilemma of the day!

In other news, I have gone to boot camp faithfully all week. Still need to work in a run. Somewhere. I have been freakishly tired all week and have had the hardest time getting up. Must be from staying up so late Monday night at Finals. I am such a whimp. I had a tennis match tonight. I won - 6-0, 6-0. I was glad it was an easy match since I was so tired! Not much else going on. Lots of tennis this weekend. Have a great Friday!


Anonymous said...

The third option is the treatment for benign cysts called PEI. After the cyst is aspirated , it is injected with alcohol; this cause cyst to shrink. The nodules less then 1 cm in size are not usually needed FNA.
The PEI is performed on outpatient bases in the office.
Have a great day!

lindsay said...

as lovely as a bee sting & smushed neck might feel, i think i would personally opt for the every-6-months testing right now. thyroid issues run in my family too, and my mom recently had some radiation done on hers and it has taken her awhile to get back to feeling normal. thyroids certainly aren't something you want to mess with! i know there are lots of side effects that can come about.

good luck deciding what you will do! i'm glad the results came back negative for cancer. i feel like if it's not causing your trouble (other than having the lumps) why mess with it just yet. i don't know a whole lot about cysts though. go with what you will be comfortable with obviously!

Anonymous said...

Thyroid cyst is a blood or colloid filled "blister"; unless cyst is complex it is benign.

Karen said...

Thanks for the info... all good to know. I am leaning towards watching it for now and seeing what happens. So many thryoid horror stories that I have heard. I don't want to make a decision I would regret. Right now, there are 3 nodules - a multinodular something or another - one large, 2 so small they can't even biopsy. I am having no other issues. My thyroid levels are normal. My Mom is on synthroid so going down that road is not particularly appealing.

Anonymous said...

No prob.
You may also request blood test for TPO/TG antibodies ; elevated results suggesting the autoimmune thyroiditis which can explain the formation of the nodules [even with normal TSH and T4 levels]. Cysts are aspirated when they about 1.5 cm or larger.
Some doctors are calling the normal size thyroid as "multinodular goiter", if nodules are found within it.
Have a nice weekend