my endo letter to my gp
I reviewed nichola today in surgical outpatients, as you know she has a right thyroid nodule which has been under surveillance for some years now, she has had a further ultrasound scan recently showing there is some increase in the size of the nodule, looking back over the three years, it is about double what it was but is still the maximum of 2cm, she declined to have a cytology done because she was feeling very anxious but unfortunately regretted this later.
she still has a lot of problems swallowing and we discussed whether a right thyroid lobectomy might help with these problems, I said that I think there is a good chance that the thyroid nodule may well be contributing but that it it difficult to tell for sure without actually removing it but this of course would mean a operation, an operation carries risks of having a scar and of having a hoarse voice which is rare but definite problem.
ms Watson is going to think about what she wants to do, she is quite anxious about having surgery in general, she will let me know.
she has a lot of other symptoms and I know she has had some investigation in the past. we talked about her thyroid as a cause for some of her problems but looking at several thyroid function tests that had been done, the tsh is always in normal range and t3 and t4 are aswell, I am not sure if you could defend putting her on thyroxeine with those levels and I have said to her today that I do not believe that her thyroid function is causing these problems and I thought it would be useful if she could be reviewed by my medical endocrine dr J, I believe she is going to arrange to see him privately.
Firstly id like to say my last tsh was 2.84 and he was only interested in my swallowing problem, also I wasn't told it had grown he told me it has been the same since day one, also he didn't seem to know that a trial of thyroxeine could at least shrink a nodule and he said he would refer me to this dr J not that id have to pay privately x
Edited slightly by Admin to remove Dr's name