During a telephone consultation, the patient complains of pain around the thyroid area, an enlargement of the neck at the thyroid and her voice is raspy and husky. These changes have occurred often over the last 3 years though intermittently - ie they come and go. The patient currently has a sore, enlarged throat and a very husky voice.
Do you:
1. Arrange for a physical appointment to examine the patient
2. Make an appointment for an ultrasound on the thyroid area
3. Suggest that the patient is referred to ENT as this cannot be thyroid related
4. State that it could be related to the lymph nodes as you have never experienced anything similar in your career
5. Suggest a reduction in levo as you admit to not knowing what else to do and Ft3 is slightly over top of range
If you answered that you would do 3, 4 and 5 above, TOP SKILLS you are a top endo and could have a job with the NHS in the north of Scotland.
Written by
Lalatoot
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I feel lucky as actually saw my (private) endo in person today…. And he was ok about suppressed TSH 👍and he examined my neck area, took pulse & did eye & tremor checks. Wish there were more like him!
I’m very grateful to have an understanding endocrinologist who has supported a private trial of T3 & encouraged my GP to continue supply via NHS. I only wish training of all thyroid ‘specialists’ was comprehensive & that all with thyroid issues received the same care and could access T3 if Levothyroxine alone does not significantly improve symptoms.
That doesn’t sound like an unreasonable request but sadly is not the standard of practice. 😞 when it will change who knows. U gotta take the wins when they come and be thankful always in life. I say that to my children all the time. Be thankful for what u have because it can all be taken away in an instant.
If you have the name and some details of an endo you've seen that you thought was competent and worth passing on you can't mention them on the forum (there is always the risk that someone might slag a doctor off and the forum might get sued for libel.
What you can do is send the details you have to Thyroid UK (who run this forum).
They keep lists of private and NHS endos and doctors who have been good for at least one patient. They get taken off the list again if they are horrible to other patients!
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Update following 1st endocrinology appt
Endocrinology Scotland
Top 5 Reasons Doctors Fail To Diagnose Hypothyroidism
Self medicating?
Advice please - bit long, sorry
