Guest guest Posted October 30, 2010 Report Share Posted October 30, 2010 Barb, before undertaking ANY types of tests for ANYTHING, I believe that it is important to get a complete explanation from the the doctor of what the test is for, exactly what will be done, what, if any drugs will be used on you, what the effects of those drugs and/or radiation might cause, and if there are any less invasive or dangerous tests available? Then I think you should be allowed at least one day to make up your mind as you how you feel about getting any particular test. When my cardio wanted to give me a nuclear stress test. I asked the questions. After I heard what would be done and what the alternative was I opted for the alternative and have had that test twice in the space of three years. I have not been sorry since a regular stress test on a tread mill was non invasive. I was not afraid of having a heart attack from the stress, because I never get an atrial fibrillation attack from exercise. It usually happens when I'm sitting down. We are all different, and we need to be proactive in our health care and protecting ourselves from undue substances being introduced into our bodies, from any source if possible. These are just my feelings, and I'm not telling anyone that they should or should not do what their doctor says. On the other hand, I do feel that a patient is entitled to informed consent about any type of diagnostic study or treatment. <>Roni Immortality exists! It's called knowledge! Just because something isn't seen doesn't mean it's not there<> " The biopsy will categorize the type of cells in the nodules. The scan is necessary to show whether any cells have spread beyond the nodules. It will also show the biochemical activity of the nodules, whether they take take up iodine and are actively producing hormones or not. " No one has suggested a biopsy yet. I guess you are referring to the needle biopsy I've read about. I was told I've been scheduled for a scan, but not told which type. I read there are two types. The reason I'm looking into this is because I was told to go to the cardiology department for the scan. That doesn't make sense to me, since I thought it would be done in radiology. It's not a hospital, but a large medical group with lab and testing facilities on site. They have a radiology department. I definitely want to avoid another CT scan, especially since I read that a person with thyroid nodules will often be found to have high thyroid hormone levels for the first time after being injected with dye for a CT scan. I had one last year, and posted my next blood test here, which showed TSH over 8. " Sometimes patients with toxic multinodular goiter will develop high thyroid levels for the first time after they receive a large amount of iodine through a vein (intravenously). The iodine may be contrast for a CT scan or heart catheterization. " http://www.nlm.nih.gov/medlineplus/ency/article/000317.htm You probably already know this, but here are the two types of scans: " There are two types of thyroid nuclear medicine tests. Both assess the health of your thyroid, a gland in your neck that controls metabolism. A thyroid scan produces a picture of the gland to help evaluate any lumps or inflammation, or to investigate the cause of an overactive thyroid. A radioactive iodine uptake test is performed to see if your thyroid is functioning normally and to determine why thyroid hormone levels may be elevated. For both types of test, a small amount of a weakly radioactive substance, known as a radionuclide, is either injected into a vein or given to you as a pill A thyroid scan is usually ordered when a physical examination or laboratory finding suggests that the thyroid is enlarged. If laboratory tests show an overactive thyroid, a radioactive iodine uptake test may be ordered at the same time. A radioactive iodine uptake test measures the amount of radioactivity in your thyroid after you've been given a relatively small dose of radioactive iodine in pill form. Your thyroid gland absorbs iodine and uses it to make hormones. Therefore, the amount of radioactive iodine detected in your thyroid gland corresponds with the amount of hormone your thyroid is producing. " http://www.health.harvard.edu/diagnostic-tests/thyroid-scan.htm It is my understanding that the above tests are done with a camera and a probe, not x-rays. Please correct me if I'm wrong. All I was told is that I am scheduled for a scan, I will go in briefly, leave for two hours, go back, and then leave again for four more hours. Then I'm to go back again. They didn't say why. I have not been told to avoid shell fish or thyroid medication, which I've read the doctor might suggest before a scan. I was told to fast for 12 hours before going. After leaving the first time there is no food allowed for those two hours. After leaving the second time, I am allowed to eat before going back again in four hours. Do you think this indicates they are doing both types of scans? I'm trying to avoid unnecessary tests and any expense associated with them. I'm sorry to be asking you this because I think my doctor should have given me more information. Which test do you think I need? Why do you think a needle biopsy has not been suggested? Thanks again, Barb Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2010 Report Share Posted October 30, 2010 Barb, You wrote: > > " The biopsy will categorize the type of cells in the nodules. The scan > is necessary to show whether any cells have spread beyond the nodules. > It will also show the biochemical activity of the nodules, whether they > take take up iodine and are actively producing hormones or not. " > > No one has suggested a biopsy yet.... I believe Roni was recommending alternatives to the iodine scan. > .... I was told I've been scheduled for a > scan, but not told which type.... The radioactive iodine scan does not use a dye, so it does not have the side effects you and Roni mentioned. It is a nuclear procedure, so the facility may well be in the cardiology lab outside a hospital. >...You probably already know this, but here are the two types of scans: > > " There are two types of thyroid nuclear medicine tests. Both assess the > health of your thyroid, a gland in your neck that controls metabolism. A > thyroid scan produces a picture of the gland to help evaluate any lumps > or inflammation, or to investigate the cause of an overactive thyroid. A > radioactive iodine uptake test is performed to see if your thyroid is > functioning normally and to determine why thyroid hormone levels may be > elevated. For both types of test, a small amount of a weakly radioactive > substance, known as a radionuclide, is either injected into a vein or > given to you as a pill... Neither of these is a CT scan, which uses a NON-radioactive form of iodine as a dye. I was definitely referring to the uptake scan, which uses minimal amounts of iodine. The imaging version uses a lot more, but I doubt they would go to that for an initial assessment. > ... It is my understanding that the above tests are done with a camera and a > probe, not x-rays. Please correct me if I'm wrong. The imaging version is done with a bank of gamma ray cameras. The uptake test can use a single detector that is moved around. In both cases, the radiation source is in your thyroid, while X-rays would come from an external source. Both will have similar procedures and food restrictions. Again, the imaging method would be more likely to be used after a biopsy showed it to be necessary. My son did the uptake test first, which indicated we needed to perform biopsies at regular six month intervals. However, since he requires blood thinners for a heart valve that was replaced, each biopsy would have required admission to the hospital for nearly a week, while they replace his Coumadin with heparin and then restored it. So, we opted to just remove the thyroid entirely, so he would only have to go through the heparin protocol once. This turned out to be a lucky decision, since the nodules removed turned out to be malignant. Afterwards, they used radioactive ablation to " mop up " any remaining cells. This allowed them to use the gamma camera scan to look for any hot spots. So, we have effectively done both nuclear procedures but not the biopsy. Chuck Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2010 Report Share Posted October 30, 2010 Thanks for sharing your feelings with me Roni. It sounds like you definitely did the right thing for you. I can't get in to see the endocronologist until 11-17, and my internist thought I should have this scan before going there, to make sure it's okay to wait that long for the appointment. That was after he told me he didn't think it was Cancer. Then he said it wasn't Cancer, I think so I wouldn't bother him. As Chuck has said, there is no way to know until the tests are done. The internist's office scheduled the test based on the results of the ultrasound. I'm not pleased with the fact that they don't seem to have time to talk with anyone. After I had the original bloodwork, and received the message when I got home that medication was being prescribed for Hypothyroidism, I asked a couple of questions when I returned the call. When I had more questions, it was suggested that I make another apointment with the doctor to discuss it, so I did. That's when he told me it was a common problem, he treats it all the time, and " There isn't going to be anything else, " when I suggested additional tests might be in order. I told him my Dad and my maternal Grandmother had needed surgery to have their thyroid removed, and he said that was because they were overactive. He has no idea, because I don't even know, and there's no one left to ask. I'm considering going to the Mayo Clinic in ville for a diagnosis. My Son only lives about an hour from there. I could drive up to his house, which takes about two hours, and I'm sure he would go with me. I appreciate your advice. Barb Re: Question About Scan Barb, before undertaking ANY types of tests for ANYTHING, I believe that it is important to get a complete explanation from the the doctor of what the test is for, exactly what will be done, what, if any drugs will be used on you, what the effects of those drugs and/or radiation might cause, and if there are any less invasive or dangerous tests available? Then I think you should be allowed at least one day to make up your mind as you how you feel about getting any particular test. When my cardio wanted to give me a nuclear stress test. I asked the questions. After I heard what would be done and what the alternative was I opted for the alternative and have had that test twice in the space of three years. I have not been sorry since a regular stress test on a tread mill was non invasive. I was not afraid of having a heart attack from the stress, because I never get an atrial fibrillation attack from exercise. It usually happens when I'm sitting down. We are all different, and we need to be proactive in our health care and protecting ourselves from undue substances being introduced into our bodies, from any source if possible. These are just my feelings, and I'm not telling anyone that they should or should not do what their doctor says. On the other hand, I do feel that a patient is entitled to informed consent about any type of diagnostic study or treatment. <>Roni Immortality exists! It's called knowledge! Just because something isn't seen doesn't mean it's not there<> " The biopsy will categorize the type of cells in the nodules. The scan is necessary to show whether any cells have spread beyond the nodules. It will also show the biochemical activity of the nodules, whether they take take up iodine and are actively producing hormones or not. " No one has suggested a biopsy yet. I guess you are referring to the needle biopsy I've read about. I was told I've been scheduled for a scan, but not told which type. I read there are two types. The reason I'm looking into this is because I was told to go to the cardiology department for the scan. That doesn't make sense to me, since I thought it would be done in radiology. It's not a hospital, but a large medical group with lab and testing facilities on site. They have a radiology department. I definitely want to avoid another CT scan, especially since I read that a person with thyroid nodules will often be found to have high thyroid hormone levels for the first time after being injected with dye for a CT scan. I had one last year, and posted my next blood test here, which showed TSH over 8. " Sometimes patients with toxic multinodular goiter will develop high thyroid levels for the first time after they receive a large amount of iodine through a vein (intravenously). The iodine may be contrast for a CT scan or heart catheterization. " http://www.nlm.nih.gov/medlineplus/ency/article/000317.htm You probably already know this, but here are the two types of scans: " There are two types of thyroid nuclear medicine tests. Both assess the health of your thyroid, a gland in your neck that controls metabolism. A thyroid scan produces a picture of the gland to help evaluate any lumps or inflammation, or to investigate the cause of an overactive thyroid. A radioactive iodine uptake test is performed to see if your thyroid is functioning normally and to determine why thyroid hormone levels may be elevated. For both types of test, a small amount of a weakly radioactive substance, known as a radionuclide, is either injected into a vein or given to you as a pill A thyroid scan is usually ordered when a physical examination or laboratory finding suggests that the thyroid is enlarged. If laboratory tests show an overactive thyroid, a radioactive iodine uptake test may be ordered at the same time. A radioactive iodine uptake test measures the amount of radioactivity in your thyroid after you've been given a relatively small dose of radioactive iodine in pill form. Your thyroid gland absorbs iodine and uses it to make hormones. Therefore, the amount of radioactive iodine detected in your thyroid gland corresponds with the amount of hormone your thyroid is producing. " http://www.health.harvard.edu/diagnostic-tests/thyroid-scan.htm It is my understanding that the above tests are done with a camera and a probe, not x-rays. Please correct me if I'm wrong. All I was told is that I am scheduled for a scan, I will go in briefly, leave for two hours, go back, and then leave again for four more hours. Then I'm to go back again. They didn't say why. I have not been told to avoid shell fish or thyroid medication, which I've read the doctor might suggest before a scan. I was told to fast for 12 hours before going. After leaving the first time there is no food allowed for those two hours. After leaving the second time, I am allowed to eat before going back again in four hours. Do you think this indicates they are doing both types of scans? I'm trying to avoid unnecessary tests and any expense associated with them. I'm sorry to be asking you this because I think my doctor should have given me more information. Which test do you think I need? Why do you think a needle biopsy has not been suggested? Thanks again, Barb Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2010 Report Share Posted October 30, 2010 Thanks for the information Chuck. How is your son now? It sounds like you have been through a lot with him. I sure hope he's doing well. " Neither of these is a CT scan, which uses a NON-radioactive form of iodine as a dye. I was definitely referring to the uptake scan, which uses minimal amounts of iodine. The imaging version uses a lot more, but I doubt they would go to that for an initial assessment. " This is all so confusing to me. I think what you're saying is that if I do need a scan, which I previously understood you to say was essential, it should be the uptake scan. Is that right? You said it's the one your son had first which determined he needed biopsies. So if they want to do both, I should refuse the imaging version? Barb Re: Question About Scan Barb, You wrote: " The biopsy will categorize the type of cells in the nodules. The scan is necessary to show whether any cells have spread beyond the nodules. It will also show the biochemical activity of the nodules, whether they take take up iodine and are actively producing hormones or not. " No one has suggested a biopsy yet.... I believe Roni was recommending alternatives to the iodine scan. > .... I was told I've been scheduled for a scan, but not told which type.... The radioactive iodine scan does not use a dye, so it does not have the ide effects you and Roni mentioned. It is a nuclear procedure, so the acility may well be in the cardiology lab outside a hospital. >...You probably already know this, but here are the two types of scans: " There are two types of thyroid nuclear medicine tests. Both assess the health of your thyroid, a gland in your neck that controls metabolism. A thyroid scan produces a picture of the gland to help evaluate any lumps or inflammation, or to investigate the cause of an overactive thyroid. A radioactive iodine uptake test is performed to see if your thyroid is functioning normally and to determine why thyroid hormone levels may be elevated. For both types of test, a small amount of a weakly radioactive substance, known as a radionuclide, is either injected into a vein or given to you as a pill... Neither of these is a CT scan, which uses a NON-radioactive form of odine as a dye. I was definitely referring to the uptake scan, which ses minimal amounts of iodine. The imaging version uses a lot more, but doubt they would go to that for an initial assessment. > ... It is my understanding that the above tests are done with a camera and a probe, not x-rays. Please correct me if I'm wrong. The imaging version is done with a bank of gamma ray cameras. The uptake est can use a single detector that is moved around. In both cases, the adiation source is in your thyroid, while X-rays would come from an xternal source. Both will have similar procedures and food estrictions. Again, the imaging method would be more likely to be used fter a biopsy showed it to be necessary. My son did the uptake test first, which indicated we needed to perform iopsies at regular six month intervals. However, since he requires lood thinners for a heart valve that was replaced, each biopsy would ave required admission to the hospital for nearly a week, while they eplace his Coumadin with heparin and then restored it. So, we opted to ust remove the thyroid entirely, so he would only have to go through he heparin protocol once. This turned out to be a lucky decision, since he nodules removed turned out to be malignant. Afterwards, they used radioactive ablation to " mop up " any remaining ells. This allowed them to use the gamma camera scan to look for any ot spots. So, we have effectively done both nuclear procedures but not he biopsy. Chuck ----------------------------------- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2010 Report Share Posted October 30, 2010 That sounds like a good idea. If you go there or where you are, please make sure to find out exactly what is in your throat, whether or not it is cancerous, get hard copies of all tests and finally ask what all the possible treatments are, including thyroid therapy. Even if they say it is cancerous, give yourself a day or two to digest the diagnosis and the other information so that you can make an informed and less panicked decision (I'd feel panicked, but I know by now to wait at least a day before making any decisions that are really important. <>Roni Immortality exists! It's called knowledge! Just because something isn't seen doesn't mean it's not there<> " The biopsy will categorize the type of cells in the nodules. The scan is necessary to show whether any cells have spread beyond the nodules. It will also show the biochemical activity of the nodules, whether they take take up iodine and are actively producing hormones or not. " No one has suggested a biopsy yet. I guess you are referring to the needle biopsy I've read about. I was told I've been scheduled for a scan, but not told which type. I read there are two types. The reason I'm looking into this is because I was told to go to the cardiology department for the scan. That doesn't make sense to me, since I thought it would be done in radiology. It's not a hospital, but a large medical group with lab and testing facilities on site. They have a radiology department. I definitely want to avoid another CT scan, especially since I read that a person with thyroid nodules will often be found to have high thyroid hormone levels for the first time after being injected with dye for a CT scan. I had one last year, and posted my next blood test here, which showed TSH over 8. " Sometimes patients with toxic multinodular goiter will develop high thyroid levels for the first time after they receive a large amount of iodine through a vein (intravenously). The iodine may be contrast for a CT scan or heart catheterization. " http://www.nlm.nih.gov/medlineplus/ency/article/000317.htm You probably already know this, but here are the two types of scans: " There are two types of thyroid nuclear medicine tests. Both assess the health of your thyroid, a gland in your neck that controls metabolism. A thyroid scan produces a picture of the gland to help evaluate any lumps or inflammation, or to investigate the cause of an overactive thyroid. A radioactive iodine uptake test is performed to see if your thyroid is functioning normally and to determine why thyroid hormone levels may be elevated. For both types of test, a small amount of a weakly radioactive substance, known as a radionuclide, is either injected into a vein or given to you as a pill A thyroid scan is usually ordered when a physical examination or laboratory finding suggests that the thyroid is enlarged. If laboratory tests show an overactive thyroid, a radioactive iodine uptake test may be ordered at the same time. A radioactive iodine uptake test measures the amount of radioactivity in your thyroid after you've been given a relatively small dose of radioactive iodine in pill form. Your thyroid gland absorbs iodine and uses it to make hormones. Therefore, the amount of radioactive iodine detected in your thyroid gland corresponds with the amount of hormone your thyroid is producing. " http://www.health.harvard.edu/diagnostic-tests/thyroid-scan.htm It is my understanding that the above tests are done with a camera and a probe, not x-rays. Please correct me if I'm wrong. All I was told is that I am scheduled for a scan, I will go in briefly, leave for two hours, go back, and then leave again for four more hours. Then I'm to go back again. They didn't say why. I have not been told to avoid shell fish or thyroid medication, which I've read the doctor might suggest before a scan. I was told to fast for 12 hours before going. After leaving the first time there is no food allowed for those two hours. After leaving the second time, I am allowed to eat before going back again in four hours. Do you think this indicates they are doing both types of scans? I'm trying to avoid unnecessary tests and any expense associated with them. I'm sorry to be asking you this because I think my doctor should have given me more information. Which test do you think I need? Why do you think a needle biopsy has not been suggested? Thanks again, Barb Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 31, 2010 Report Share Posted October 31, 2010 More great advice! Thank you Roni! It does take time to sort through all the information, think about the options, and make a good decision. Taking a day or two to decide makes sense to me. Barb Re: Question About Scan That sounds like a good idea. If you go there or where you are, please make sure to find out exactly what is in your throat, whether or not it is cancerous, get hard copies of all tests and finally ask what all the possible treatments are, including thyroid therapy. Even if they say it is cancerous, give yourself a day or two to digest the diagnosis and the other information so that you can make an informed and less panicked decision (I'd feel panicked, but I know by now to wait at least a day before making any decisions that are really important. <>Roni Immortality exists! It's called knowledge! Just because something isn't seen doesn't mean it's not there<> " The biopsy will categorize the type of cells in the nodules. The scan is necessary to show whether any cells have spread beyond the nodules. It will also show the biochemical activity of the nodules, whether they take take up iodine and are actively producing hormones or not. " No one has suggested a biopsy yet. I guess you are referring to the needle biopsy I've read about. I was told I've been scheduled for a scan, but not told which type. I read there are two types. The reason I'm looking into this is because I was told to go to the cardiology department for the scan. That doesn't make sense to me, since I thought it would be done in radiology. It's not a hospital, but a large medical group with lab and testing facilities on site. They have a radiology department. I definitely want to avoid another CT scan, especially since I read that a person with thyroid nodules will often be found to have high thyroid hormone levels for the first time after being injected with dye for a CT scan. I had one last year, and posted my next blood test here, which showed TSH over 8. " Sometimes patients with toxic multinodular goiter will develop high thyroid levels for the first time after they receive a large amount of iodine through a vein (intravenously). The iodine may be contrast for a CT scan or heart catheterization. " http://www.nlm.nih.gov/medlineplus/ency/article/000317.htm You probably already know this, but here are the two types of scans: " There are two types of thyroid nuclear medicine tests. Both assess the health of your thyroid, a gland in your neck that controls metabolism. A thyroid scan produces a picture of the gland to help evaluate any lumps or inflammation, or to investigate the cause of an overactive thyroid. A radioactive iodine uptake test is performed to see if your thyroid is functioning normally and to determine why thyroid hormone levels may be elevated. For both types of test, a small amount of a weakly radioactive substance, known as a radionuclide, is either injected into a vein or given to you as a pill A thyroid scan is usually ordered when a physical examination or laboratory finding suggests that the thyroid is enlarged. If laboratory tests show an overactive thyroid, a radioactive iodine uptake test may be ordered at the same time. A radioactive iodine uptake test measures the amount of radioactivity in your thyroid after you've been given a relatively small dose of radioactive iodine in pill form. Your thyroid gland absorbs iodine and uses it to make hormones. Therefore, the amount of radioactive iodine detected in your thyroid gland corresponds with the amount of hormone your thyroid is producing. " http://www.health.harvard.edu/diagnostic-tests/thyroid-scan.htm It is my understanding that the above tests are done with a camera and a probe, not x-rays. Please correct me if I'm wrong. All I was told is that I am scheduled for a scan, I will go in briefly, leave for two hours, go back, and then leave again for four more hours. Then I'm to go back again. They didn't say why. I have not been told to avoid shell fish or thyroid medication, which I've read the doctor might suggest before a scan. I was told to fast for 12 hours before going. After leaving the first time there is no food allowed for those two hours. After leaving the second time, I am allowed to eat before going back again in four hours. Do you think this indicates they are doing both types of scans? I'm trying to avoid unnecessary tests and any expense associated with them. I'm sorry to be asking you this because I think my doctor should have given me more information. Which test do you think I need? Why do you think a needle biopsy has not been suggested? Thanks again, Barb Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 1, 2010 Report Share Posted November 1, 2010 Hi again, After asking about the two types of thyroid scans, I received this response from you Chuck. " The imaging version is done with a bank of gamma ray cameras. The uptake test can use a single detector that is moved around. In both cases, the radiation source is in your thyroid, while X-rays would come from an external source. Both will have similar procedures and food restrictions. Again, the imaging method would be more likely to be used after a biopsy showed it to be necessary. " This morning the department where the test will be done said the same amount of iodine is required for both tests. According to them it wouldn't make any difference if it was for one test or two. I will take the iodine pill, leave for two hours, go back, and they will use the detector you mentioned to see how much iodine has been taken up. Then I leave for another four hours, go back, and they will use the detector again to see if more iodine has been taken up. After that they plan to do a scan with a camera, so it appears they want me to have both tests. You also mentioned that the radiation source is in the thyroid Chuck. Because the iodine is taken in pill form, it doesn't just go to the thyroid does it? You mentioned the second test would be " more likely to be used after a biopsy showed it to be necessary. " As you know I haven't had a biopsy Could they possibly be doing this instead of a biopsy? Or maybe they prefer to do both while I'm there, to prevent a trip back for a second test? Whatever the reason, do you see any harm in having both? No doubt it will cost a lot more, but I mean other than that. I thought I read here that the scan takes more iodine than the uptake test, so I specifically asked about that, and she insisted it was the same amount of iodine for one or both. My apologies for being so ignorant about all of this. Everyone's input is welcomed and appreciated. Thanks, Barb Re: Question About Scan Barb, You wrote: " The biopsy will categorize the type of cells in the nodules. The scan is necessary to show whether any cells have spread beyond the nodules. It will also show the biochemical activity of the nodules, whether they take take up iodine and are actively producing hormones or not. " No one has suggested a biopsy yet.... I believe Roni was recommending alternatives to the iodine scan. > .... I was told I've been scheduled for a scan, but not told which type.... The radioactive iodine scan does not use a dye, so it does not have the ide effects you and Roni mentioned. It is a nuclear procedure, so the acility may well be in the cardiology lab outside a hospital. >...You probably already know this, but here are the two types of scans: " There are two types of thyroid nuclear medicine tests. Both assess the health of your thyroid, a gland in your neck that controls metabolism. A thyroid scan produces a picture of the gland to help evaluate any lumps or inflammation, or to investigate the cause of an overactive thyroid. A radioactive iodine uptake test is performed to see if your thyroid is functioning normally and to determine why thyroid hormone levels may be elevated. For both types of test, a small amount of a weakly radioactive substance, known as a radionuclide, is either injected into a vein or given to you as a pill... Neither of these is a CT scan, which uses a NON-radioactive form of odine as a dye. I was definitely referring to the uptake scan, which ses minimal amounts of iodine. The imaging version uses a lot more, but doubt they would go to that for an initial assessment. > ... It is my understanding that the above tests are done with a camera and a probe, not x-rays. Please correct me if I'm wrong. The imaging version is done with a bank of gamma ray cameras. The uptake est can use a single detector that is moved around. In both cases, the adiation source is in your thyroid, while X-rays would come from an xternal source. Both will have similar procedures and food estrictions. Again, the imaging method would be more likely to be used fter a biopsy showed it to be necessary. My son did the uptake test first, which indicated we needed to perform iopsies at regular six month intervals. However, since he requires lood thinners for a heart valve that was replaced, each biopsy would ave required admission to the hospital for nearly a week, while they eplace his Coumadin with heparin and then restored it. So, we opted to ust remove the thyroid entirely, so he would only have to go through he heparin protocol once. This turned out to be a lucky decision, since he nodules removed turned out to be malignant. Afterwards, they used radioactive ablation to " mop up " any remaining ells. This allowed them to use the gamma camera scan to look for any ot spots. So, we have effectively done both nuclear procedures but not he biopsy. Chuck ----------------------------------- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 1, 2010 Report Share Posted November 1, 2010 Barb, You wrote: > > Thanks for the information Chuck. How is your son now? It sounds like > you have been through a lot with him. I sure hope he's doing well. Thanks, he is doing well. We still have concerns about his heart. In his life, he has had three open heart procedures. He still needs oxygen when he sleeps or takes a bath, but otherwise his life is pretty normal. > > This is all so confusing to me. I think what you're saying is that if I > do need a scan, which I previously understood you to say was essential, > it should be the uptake scan. Is that right? You said it's the one your > son had first which determined he needed biopsies. So if they want to do > both, I should refuse the imaging version? If that is what they want to do, I would ask for an explanation. They should compare the risks and benefits of any procedure for you. I would be surprised if they chose the imaging procedure first, since that is more of a preparation for surgery. Chuck Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 1, 2010 Report Share Posted November 1, 2010 Barb, You wrote: > > This morning the department where the test will be done said the same > amount of iodine is required for both tests.... That is a surprise to me. They may have made the imaging more efficient. The Am. College of Radiography guidelines I looked up said that the uptake test dose is 0.2 to 0.4 millicurie, while the scan requires about 5 millicuries. Both may be contrasted with ablation, which is typically 50-100 millicuries. Chuck Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 2, 2010 Report Share Posted November 2, 2010 That's two things you have mentioned that make me personally nervous about this facility. Barbara, is it possible for you to go to another imaging facility which might possibly be doing a more professional job? Also, I would ask the doctor why they want to do what they want to do? Are they prepping you for surgery even before all the tests are in? Unfortunately, some doctors think because they say something needs surgery, that's it. You are entitile to a second opinion. <>Roni Immortality exists! It's called knowledge! Just because something isn't seen doesn't mean it's not there<> > > This morning the department where the test will be done said the same > amount of iodine is required for both tests.... That is a surprise to me. They may have made the imaging more efficient. The Am. College of Radiography guidelines I looked up said that the uptake test dose is 0.2 to 0.4 millicurie, while the scan requires about 5 millicuries. Both may be contrasted with ablation, which is typically 50-100 millicuries. Chuck ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 2, 2010 Report Share Posted November 2, 2010 Chuck & Roni, Thanks for replying. I don't feel good about any of this. I think the reason I can't ask a doctor the questions I want to ask, is that I'm being scheduled for these tests before seeing the endocronologist. So, there is no one to ask, except the person I talked with in the cardiology department where the test is scheduled to be done. The Internest said the test is essential, but I thought it was just an iodine uptake scan, and from what you said Chuck, that does seem necessary. It seems to me like the thing to do first would be to see the endocronologist. Then when he suggests testing, I could ask questions to determine if I need or want the tests. I can't get in to see him until the 17th, and the tests are scheduled for this Thursday. Of course if there's a possibility I have Cancer, I need to find out ASAP. If I don't, then there is more time to make other appointments and get other opinions. Will the uptake test or the scan show if I have Cancer? Wouldn't a needle biopsy do the same? I thought the purpose of a needle biopsy was to test for Cancer, but it has not been mentioned by the internist. I definitely plan to get a second opinion, but would like to have a first opinion before too much more time passes. All I want to do is find out what's wrong with me, without having any unnecessary or risky tests that might cause more problems. I'm probably more upset over this than I should be, but I also have to go back an have my pap test done over also, since I'm being told the sample didn't have enough cells. They're saying this is not uncommon in women over 60, but it's just something else to be concerned about. Thanks so much for taking the time to read and answer my questions. Barb Re: Question About Scan That's two things you have mentioned that make me personally nervous about this facility. Barbara, is it possible for you to go to another imaging facility which might possibly be doing a more professional job? Also, I would ask the doctor why they want to do what they want to do? Are they prepping you for surgery even before all the tests are in? Unfortunately, some doctors think because they say something needs surgery, that's it. You are entitile to a second opinion. <>Roni Immortality exists! It's called knowledge! Just because something isn't seen doesn't mean it's not there<> > > This morning the department where the test will be done said the same > amount of iodine is required for both tests.... That is a surprise to me. They may have made the imaging more efficient. The Am. College of Radiography guidelines I looked up said that the uptake test dose is 0.2 to 0.4 millicurie, while the scan requires about 5 millicuries. Both may be contrasted with ablation, which is typically 50-100 millicuries. Chuck ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 2, 2010 Report Share Posted November 2, 2010 Wow Chuck! What you son has gone though doesn't sound anything like normal to me. Poor guy! How old is he? Three open heart procedures and oxygen to sleep or take a bath, indicates there is still much progress to be made. I hope and pray that things will turn around for him, and he will be able to live a more normal life, which isn't interrupted by surgeries and being hooked up to oxygen. I apologize for answering this e-mail second. I was reading my e-mail backwards (duh), so read it after Roni's. I would love to ask for an explanation and comparison of risks to benefits as you suggest, but as explained in my previous post, there is no one to ask. I doubt the endocronologist's office would take the time, since I haven't seen him yet, and he didn't order the tests. I don't want to talk to the internest about it because I don't trust him. Barb Re: Question About Scan Barb, You wrote: > > Thanks for the information Chuck. How is your son now? It sounds like > you have been through a lot with him. I sure hope he's doing well. Thanks, he is doing well. We still have concerns about his heart. In his life, he has had three open heart procedures. He still needs oxygen when he sleeps or takes a bath, but otherwise his life is pretty normal. > > This is all so confusing to me. I think what you're saying is that if I > do need a scan, which I previously understood you to say was essential, > it should be the uptake scan. Is that right? You said it's the one your > son had first which determined he needed biopsies. So if they want to do > both, I should refuse the imaging version? If that is what they want to do, I would ask for an explanation. They should compare the risks and benefits of any procedure for you. I would be surprised if they chose the imaging procedure first, since that is more of a preparation for surgery. Chuck Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 2, 2010 Report Share Posted November 2, 2010 Barb, I hope you don't think I'm being impertinent, but I think you need in person support. Do you have a daughter or neice or good friend that could go with you to these doctors and be there when you ask questions and hear their answers? Maybe you have a son who could do this for you. These things can get very overpowering and speaking as a senior who also is alone, I can relate to that. I wouldn't think the needle biopsy should be the first test. Perhaps you could call the facility and ask for the chief radiologist and ask him/her your questions. I'd have them written down in order first so you don't forget anything. I know if I don't write them down I always manage to forget something. <>Roni Immortality exists! It's called knowledge! Just because something isn't seen doesn't mean it's not there<> > > This morning the department where the test will be done said the same > amount of iodine is required for both tests.... That is a surprise to me. They may have made the imaging more efficient. The Am. College of Radiography guidelines I looked up said that the uptake test dose is 0.2 to 0.4 millicurie, while the scan requires about 5 millicuries. Both may be contrasted with ablation, which is typically 50-100 millicuries. Chuck ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 2, 2010 Report Share Posted November 2, 2010 Barb, You wrote: > > ... It seems to me like the thing to do first would be to see the > endocronologist... Not necessarily. The specialist could be called in just to evaluate the testing. > > Will the uptake test or the scan show if I have Cancer? ... No, it shows whether the nodules are actively producing hormones or not. Since the biopsy carries some risk of opening an otherwise enclosed nodule, logic requires they rule out benign conditions before the biopsy. Chuck Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 2, 2010 Report Share Posted November 2, 2010 Barb, You wrote: > > Wow Chuck! What you son has gone though doesn't sound anything like > normal to me. Poor guy! How old is he?... Mike is 36. His first procedure was a pulmonary valvulotomy at 10 days. He weighed five pounds after the procedure. His last heart surgery replaced both his mitral and pulmonary valves. Last spring he had the thyroidectomy followed by radioactive iodine ablation. He now seems to be back to normal, although we still have to monitor his blood thinners and potassium carefully. He also had a spinal fusion for scoliosis when he was 12. That took over nine hours. Chuck Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 2, 2010 Report Share Posted November 2, 2010 I feel so bad for your son. He's gone through so much, and of course, you and your wife, as his parents went through it all with him. I pray that he will be healthy now and not need any more procedures. He's a brave kid. I have a question, how do you monitor the potassium? <>Roni Immortality exists! It's called knowledge! Just because something isn't seen doesn't mean it's not there<> > > Wow Chuck! What you son has gone though doesn't sound anything like > normal to me. Poor guy! How old is he?... Mike is 36. His first procedure was a pulmonary valvulotomy at 10 days. He weighed five pounds after the procedure. His last heart surgery replaced both his mitral and pulmonary valves. Last spring he had the thyroidectomy followed by radioactive iodine ablation. He now seems to be back to normal, although we still have to monitor his blood thinners and potassium carefully. He also had a spinal fusion for scoliosis when he was 12. That took over nine hours. Chuck ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 2, 2010 Report Share Posted November 2, 2010 Thanks Roni. I don't think you're being impertinent, and appreciate your input. I do have someone to go with me, if I just had a place to go, sit down, and talk with a doctor. I already have a list of questions, and would love to ask them and hear answers. I'm sure this is something I will be able to do when going for a second opinion, but don't know how it's possible now. They are all so busy, and it takes weeks or months to even get an appointment. Your idea about calling and asking to speak with the chief radiologist is a good one, and I'll give it a try. What I've experienced so far though, is that doctor's don't return calls. It's either a nurse, a secretary telling me what the doctor said, or someone else who isn't a doctor who calls back. Barb Re: Question About Scan Barb, I hope you don't think I'm being impertinent, but I think you need in person support. Do you have a daughter or neice or good friend that could go with you to these doctors and be there when you ask questions and hear their answers? Maybe you have a son who could do this for you. These things can get very overpowering and speaking as a senior who also is alone, I can relate to that. I wouldn't think the needle biopsy should be the first test. Perhaps you could call the facility and ask for the chief radiologist and ask him/her your questions. I'd have them written down in order first so you don't forget anything. I know if I don't write them down I always manage to forget something. <>Roni Immortality exists! It's called knowledge! Just because something isn't seen doesn't mean it's not there<> > > This morning the department where the test will be done said the same > amount of iodine is required for both tests.... That is a surprise to me. They may have made the imaging more efficient. The Am. College of Radiography guidelines I looked up said that the uptake test dose is 0.2 to 0.4 millicurie, while the scan requires about 5 millicuries. Both may be contrasted with ablation, which is typically 50-100 millicuries. Chuck ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 2, 2010 Report Share Posted November 2, 2010 > Will the uptake test or the scan show if I have Cancer? ... No, it shows whether the nodules are actively producing hormones or not. Since the biopsy carries some risk of opening an otherwise enclosed nodule, logic requires they rule out benign conditions before the biopsy. Thanks Chuck. I understand the reason for the uptake test, but not the scan. Barb Re: Question About Scan Barb, You wrote: > > ... It seems to me like the thing to do first would be to see the > endocronologist... Not necessarily. The specialist could be called in just to evaluate the testing. > > Will the uptake test or the scan show if I have Cancer? ... No, it shows whether the nodules are actively producing hormones or not. Since the biopsy carries some risk of opening an otherwise enclosed nodule, logic requires they rule out benign conditions before the biopsy. Chuck Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 2, 2010 Report Share Posted November 2, 2010 Chuck, Your son sounds like a living miracle! I can't imagine how difficult it must have been for you and your family to go through all those procedures. It's good news that he seems to be " back to normal. " I pray he will continue to improve, and be able to put all of this behind him. Barb Re: Question About Scan Barb, You wrote: > > Wow Chuck! What you son has gone though doesn't sound anything like > normal to me. Poor guy! How old is he?... Mike is 36. His first procedure was a pulmonary valvulotomy at 10 days. He weighed five pounds after the procedure. His last heart surgery replaced both his mitral and pulmonary valves. Last spring he had the thyroidectomy followed by radioactive iodine ablation. He now seems to be back to normal, although we still have to monitor his blood thinners and potassium carefully. He also had a spinal fusion for scoliosis when he was 12. That took over nine hours. Chuck Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 2, 2010 Report Share Posted November 2, 2010 Try telling whoever tells you that that it's very important and you'll hold on. This sometimes works. <>Roni Immortality exists! It's called knowledge! Just because something isn't seen doesn't mean it's not there<> > > This morning the department where the test will be done said the same > amount of iodine is required for both tests.... That is a surprise to me. They may have made the imaging more efficient. The Am. College of Radiography guidelines I looked up said that the uptake test dose is 0.2 to 0.4 millicurie, while the scan requires about 5 millicuries. Both may be contrasted with ablation, which is typically 50-100 millicuries. Chuck ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 2, 2010 Report Share Posted November 2, 2010 I agree, unless they are already planning the surgery. Barb email me direftly please. <>Roni Immortality exists! It's called knowledge! Just because something isn't seen doesn't mean it's not there<> > > ... It seems to me like the thing to do first would be to see the > endocronologist... Not necessarily. The specialist could be called in just to evaluate the testing. > > Will the uptake test or the scan show if I have Cancer? ... No, it shows whether the nodules are actively producing hormones or not. Since the biopsy carries some risk of opening an otherwise enclosed nodule, logic requires they rule out benign conditions before the biopsy. Chuck Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 2, 2010 Report Share Posted November 2, 2010 Try telling whoever tells you that that it's very important and you'll hold on. This sometimes works. That's a good suggestion. Thanks Roni. Barb Re: Question About Scan Try telling whoever tells you that that it's very important and you'll hold on. This sometimes works. <>Roni Immortality exists! It's called knowledge! Just because something isn't seen doesn't mean it's not there<> > > This morning the department where the test will be done said the same > amount of iodine is required for both tests.... That is a surprise to me. They may have made the imaging more efficient. The Am. College of Radiography guidelines I looked up said that the uptake test dose is 0.2 to 0.4 millicurie, while the scan requires about 5 millicuries. Both may be contrasted with ablation, which is typically 50-100 millicuries. Chuck ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 3, 2010 Report Share Posted November 3, 2010 Roni, You wrote: > I feel so bad for your son. He's gone through so much, and of course, > you and your wife, as his parents went through it all with him. I pray > that he will be healthy now and not need any more procedures. He's a > brave kid. > > I have a question, how do you monitor the potassium? He was getting a blood draw every other week for INR (thinner) and potassium. His endo wants to look at another panel that includes potassium every week for awhile. I'm not sure what he is fishing for, at least not exactly. One of his cardiac issues force us to give him whopping diuretics, so we have to work to keep the electrolytes up. Normally, they take weeks between checks on the thinner, but his current situation requires all of these to be monitored more frequently. Chuck Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 3, 2010 Report Share Posted November 3, 2010 Well I think I mentioned that diuretics give me atrial fibrillation attacks the next morning. Draining out that fluid so fast probably adversely affects the heart, so it does make sense to me that the doctor is checking that. He sounds like a good doctor. <>Roni Immortality exists! It's called knowledge! Just because something isn't seen doesn't mean it's not there<> > I feel so bad for your son. He's gone through so much, and of course, > you and your wife, as his parents went through it all with him. I pray > that he will be healthy now and not need any more procedures. He's a > brave kid. > > I have a question, how do you monitor the potassium? He was getting a blood draw every other week for INR (thinner) and potassium. His endo wants to look at another panel that includes potassium every week for awhile. I'm not sure what he is fishing for, at least not exactly. One of his cardiac issues force us to give him whopping diuretics, so we have to work to keep the electrolytes up. Normally, they take weeks between checks on the thinner, but his current situation requires all of these to be monitored more frequently. Chuck ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 3, 2010 Report Share Posted November 3, 2010 On 11/2/2010 9:25 AM, H wrote: > > > > Will the uptake test or the scan show if I have Cancer? ... > > No, it shows whether the nodules are actively producing hormones or not. > Since the biopsy carries some risk of opening an otherwise enclosed > nodule, logic requires they rule out benign conditions before the biopsy. > > Thanks Chuck. I understand the reason for the uptake test, but not the scan. > One of the key indicators is how rapidly something is changing or growing. They may be wanting a baseline image for that. However, the ultrasound can also measure size, and it does not use ionizing radiation. Also, if they can get two tests off one dose of iodine, then they might as well get all the information they can get. My sources said the uptake test required much less activity than the scan, so this possible explanation would not have made sense before. Chuck Quote Link to comment Share on other sites More sharing options...
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