Diagnosis

This past week I had my doctor's appointment to follow-up on my thyroid tests.  The diagnosis:  postpartum thyroiditis, an irritation of the thyroid due to pregnancy and childbirth.  In my case, first the thyroid was releasing too much thyroid hormone because antibodies damaged the thyroid follicles, and now, because of that damage, I'm slightly hypothyroid; the cells aren't making enough thyroid hormone (but they're coming close, I'm happy to know.  But I still need a lot of extra sleep--that's my main symptom.).  (Previously I was thought to have hyperthyroidism because at that time, my blood work indicated too-high levels of  thyroid hormones.)  So a couple days ago I started taking synthetic thyroid hormone.  I've read that many people with this type of thyroiditis fully recover.

But I also have this thyroid nodule to deal with.  I'll have a biopsy of it in a couple of weeks and if it looks suspicious, out will come all or half of my thyroid.  They seem to think this is likely because they already had me schedule an pre-surgery evaluation with an ENT who would do the surgery.  Seemed like jumping the gun a little bit since I hadn't even had the biopsy, so I made the appointment for two days AFTER the biopsy, just to keep the order of things as I understand them.

So far the course of testing and treatment I've received agrees with literature I've read.  But how experienced are the pathologists at the military hospital that will analyze my biospy? and how well will my internist be able to monitor my thyroid in the long term?  I'm reading a good book about the diagnosis and treatment of thyroid disorders* that is  helping me form specific questions, particularly about my test results.  I really wanted my doctor to explain everything he could that was revealed by my radioactive iodine uptake and test.  I was dying to analyze it all with him, and I wish I had read this book before my appointment so I knew what to ask.

So, come tomorrow morning (Monday), I'm going to work on getting a copy of my medical record and finding an endocrinologist off-base that specializes in thyroid disorders (hopefully one that speaks good English).  There's an excellent university hospital off base that I have in mind.  Perhaps it would be better to get the biopsy done there.  Anyway, I'll keep you posted.

[Update:  10/3/11 I got my medical records and that gave me a little more information.  Mostly it made me feel more confident that my case was in good hands.  I did call some other hospitals to look for a specialist, but hit some thick language barriers that I probably will not try to cross.]


This book also explained how to check for thyroid nodules. I already knew I had one, of course, but it was a little hard to locate and impossible to show anyone, but with a little tip of the head and a swallow, it pops right out.  I was in the middle of a swallow in this picture.  Can you see the nodule?   (It's on my right.)  When I'm not swallowing it doesn't stick out at all.

*A Simple Guide to Thyroid Disorders: From Diagnosis to Treatment by Paul Ruggieri, M.D. and Scott Isaacs, M.D., 2004.