Re: Dr. Nader

[Guest guest]

Lynn,

Why are you thinking about removing your thyroid? What are your

symptoms? Why are you saying that your thyroid is functions fine? If you

remove all or part you will need thyroid replacement.

I know nothing about this doctor. But I would never remove my thyroid

unless it was cancer or was blocking a large amount of the wind pipe and

suppression therapy didn't work.

I have four nodules with no growth in two years. Four grains of Armour

thyroid and 20 mg of hydrocortisone.

Kate G

Hashi's

AS

At 10:20 PM 11/6/2008, you wrote:

>I posted a few weeks ago about needing surgery for my thyroid nodules. I'm

>torn about removing it all vs just removing half. I'll probably end up

>removing half but know that somewhere sometime I'll probably need the rest

>removed. I'm hopeful that I won't need much meds since my thyroid is

>functioning fine now. I'd prefer the potential of possibly no meds for a

>period of time than the certainty of all meds all the time. I appreciate

>all the responses, I've just been really bogged down at work (I'm trying

>to plan for a potential month or more of hormone hell, just in case).

>

>I have been seeing Dr. Shala Nader at UT Physicians Women's Center here in

>Houston. I was looking at the database and saw that someone posted a " NO

>NO NO " review of her. If that person is still out there, could you contact

>me so I can find out more why?

>

>I'm totally clueless on what I'll need/questions to ask/etc as far as meds

>go if I need them. Thus, I'm not sure what to look for in a good doc.

>

>I could not get into to see an endocrinologist after my initial nodule

>diagnosis from my GP. I was in getting my annual poke & prod from my

>OB/GYN who is in Dr. Nader's office and mentioned the nodule and that I

>was waiting 8 wks to see an endo. I had been a patient of Nader's partner

>Dr. Huang for Reproductive Endo and had good results (a baby!) and saw her

>once or twice during the process and liked her. Since I was already a

>patient I was able to get in right away, which is why I've been seeing

>her. Obviously this is something else and just because she's good at

>reproductive endo doesn't mean she's a great general endo. Anyway, if

>anyone has any info/opinons on her, please let me know.

>

>Lynn

>

>

>

>No virus found in this incoming message.

>Checked by AVG - http://www.avg.com

>Version: 8.0.175 / Virus Database: 270.9.0/1773 - Release Date: 11/7/2008

>9:08 AM

[Guest guest]

I can't comment on your doctor but I can tell you that I was told that by just removing half of my thyroid that I would do fine without any hormone replacement. Six weeks after surgery my family almost admitted me to the hospital psych ward. I was confused, depressed, suicidal, couldn't hold a fork, etc. My husband walked into the kitchen to find me holding a knife in front of a bunck of veggies. He asked what I was doing and I said that I just couldn't make my hand cut them...didn't know how to communicate that to my hand as my brain wasn't working. Scary! That was a lot point for me. I thank God that I don't have to work as I am just now getting my brains back...3 years later. This is just my story. My advice is to get the best thyroid doc and the best surgeon before you do anything.

I posted a few weeks ago about needing surgery for my thyroid nodules. I'm torn about removing it all vs just removing half. I'll probably end up removing half but know that somewhere sometime I'll probably need the rest removed. I'm hopeful that I won't need much meds since my thyroid is functioning fine now. I'd prefer the potential of possibly no meds for a period of time than the certainty of all meds all the time. I appreciate all the responses, I've just been really bogged down at work (I'm trying to plan for a potential month or more of hormone hell, just in case).

I have been seeing Dr. Shala Nader at UT Physicians Women's Center here in Houston. I was looking at the database and saw that someone posted a " NO NO NO " review of her. If that person is still out there, could you contact me so I can find out more why?

I'm totally clueless on what I'll need/questions to ask/etc as far as meds go if I need them. Thus, I'm not sure what to look for in a good doc.I could not get into to see an endocrinologist after my initial nodule diagnosis from my GP. I was in getting my annual poke & prod from my OB/GYN who is in Dr. Nader's office and mentioned the nodule and that I was waiting 8 wks to see an endo. I had been a patient of Nader's partner Dr. Huang for Reproductive Endo and had good results (a baby!) and saw her once or twice during the process and liked her. Since I was already a patient I was able to get in right away, which is why I've been seeing her. Obviously this is something else and just because she's good at reproductive endo doesn't mean she's a great general endo. Anyway, if anyone has any info/opinons on her, please let me know.

Lynn

-- Cauleywww.shaneandlauracauley.blogspot.com

Home Cell

[Guest guest]

Kate-

I'm having half of my thyroid removed due to a large nodule that has

come back indeterminate twice over the course of a year and is growing

somewhat rapidly (.5 cm in 6 mo). Over the last few weeks it has now

started to press on a nerve in my neck and giving me shoulder pain

(MRI from by GP). I know I may have to be on thyroid replacement but I

just can't risk possibly having cancer or the continued pain in my

right shoulder. I'm hoping the remainder of my thyroid kicks in and

takes up the job of the part that's been removed.

All my bloodwork over the past year has been normal (TSH, T4, T3,

free, etc) and I have no hypothyroid symptoms. But I don't think at

this point I have a lot of options to not have it removed. I'm just

thankful that the surgeon wants to take out half instead of all of it.

Lynn

> >I posted a few weeks ago about needing surgery for my thyroid

nodules. I'm

> >torn about removing it all vs just removing half. I'll probably

end up

> >removing half but know that somewhere sometime I'll probably need

the rest

> >removed. I'm hopeful that I won't need much meds since my thyroid is

> >functioning fine now. I'd prefer the potential of possibly no meds

for a

> >period of time than the certainty of all meds all the time. I

appreciate

> >all the responses, I've just been really bogged down at work (I'm

trying

> >to plan for a potential month or more of hormone hell, just in case).

> >

> >I have been seeing Dr. Shala Nader at UT Physicians Women's Center

here in

> >Houston. I was looking at the database and saw that someone posted

a " NO

> >NO NO " review of her. If that person is still out there, could you

contact

> >me so I can find out more why?

> >

> >I'm totally clueless on what I'll need/questions to ask/etc as far

as meds

> >go if I need them. Thus, I'm not sure what to look for in a good doc.

> >

> >I could not get into to see an endocrinologist after my initial nodule

> >diagnosis from my GP. I was in getting my annual poke & prod from my

> >OB/GYN who is in Dr. Nader's office and mentioned the nodule and

that I

> >was waiting 8 wks to see an endo. I had been a patient of Nader's

partner

> >Dr. Huang for Reproductive Endo and had good results (a baby!) and

saw her

> >once or twice during the process and liked her. Since I was already a

> >patient I was able to get in right away, which is why I've been seeing

> >her. Obviously this is something else and just because she's good at

> >reproductive endo doesn't mean she's a great general endo. Anyway, if

> >anyone has any info/opinons on her, please let me know.

> >

> >Lynn

> >

> >

> >

> >No virus found in this incoming message.

> >Checked by AVG - http://www.avg.com

> >Version: 8.0.175 / Virus Database: 270.9.0/1773 - Release Date:

11/7/2008

> >9:08 AM

>

[Guest guest]

Lynn,

Have they done a FNA? I find it odd, that you have that rapid of growth

and no symptoms. What were you labs results, if you don't mind

sharing? It the doctor using the correct range on the TSH? I have you

double checked a thyroid symptom check list?

I'm sorry you have had that rapid of a growth and dealing with shoulder pain.

Kate

At 10:00 AM 11/11/2008, you wrote:

>Kate-

>

>I'm having half of my thyroid removed due to a large nodule that has

>come back indeterminate twice over the course of a year and is growing

>somewhat rapidly (.5 cm in 6 mo). Over the last few weeks it has now

>started to press on a nerve in my neck and giving me shoulder pain

>(MRI from by GP). I know I may have to be on thyroid replacement but I

>just can't risk possibly having cancer or the continued pain in my

>right shoulder. I'm hoping the remainder of my thyroid kicks in and

>takes up the job of the part that's been removed.

>

>All my bloodwork over the past year has been normal (TSH, T4, T3,

>free, etc) and I have no hypothyroid symptoms. But I don't think at

>this point I have a lot of options to not have it removed. I'm just

>thankful that the surgeon wants to take out half instead of all of it.

>

>Lynn

>

>

> > >I posted a few weeks ago about needing surgery for my thyroid

>nodules. I'm

> > >torn about removing it all vs just removing half. I'll probably

>end up

> > >removing half but know that somewhere sometime I'll probably need

>the rest

> > >removed. I'm hopeful that I won't need much meds since my thyroid is

> > >functioning fine now. I'd prefer the potential of possibly no meds

>for a

> > >period of time than the certainty of all meds all the time. I

>appreciate

> > >all the responses, I've just been really bogged down at work (I'm

>trying

> > >to plan for a potential month or more of hormone hell, just in case).

> > >

> > >I have been seeing Dr. Shala Nader at UT Physicians Women's Center

>here in

> > >Houston. I was looking at the database and saw that someone posted

>a " NO

> > >NO NO " review of her. If that person is still out there, could you

>contact

> > >me so I can find out more why?

> > >

> > >I'm totally clueless on what I'll need/questions to ask/etc as far

>as meds

> > >go if I need them. Thus, I'm not sure what to look for in a good doc.

> > >

> > >I could not get into to see an endocrinologist after my initial nodule

> > >diagnosis from my GP. I was in getting my annual poke & prod from my

> > >OB/GYN who is in Dr. Nader's office and mentioned the nodule and

>that I

> > >was waiting 8 wks to see an endo. I had been a patient of Nader's

>partner

> > >Dr. Huang for Reproductive Endo and had good results (a baby!) and

>saw her

> > >once or twice during the process and liked her. Since I was already a

> > >patient I was able to get in right away, which is why I've been seeing

> > >her. Obviously this is something else and just because she's good at

> > >reproductive endo doesn't mean she's a great general endo. Anyway, if

> > >anyone has any info/opinons on her, please let me know.

> > >

> > >Lynn

> > >

> > >

> > >

> > >No virus found in this incoming message.

> > >Checked by AVG - http://www.avg.com

> > >Version: 8.0.175 / Virus Database: 270.9.0/1773 - Release Date:

>11/7/2008

> > >9:08 AM

> >

>

>

>

>------------------------------------

>

>

[Guest guest]

Kate-

Yes, I've had 2 FNAs about 6 months apart and both came back as

indeterminate, I think she referenced it as a follicular neoplasm, so

there's some chance there that it is cancer with that type of nodule

and no biopsy will ever be accurate. The uptake showed the nodules as

cold as well, which I guess is good. From what the endo, the doc doing

the FNA and my GP says (and a little research on the net), it isn't

that uncommon to have these stupid nodules and not cause any symptoms,

that's what makes treating them so troubling. (I think I was told that

70% of people have a nodule, they just don't know it because it isn't

large or growing). If it is indeterminate, you end up taking out an

organ that may not be cancerous and leaving the patient with the

lifelong need for meds, but there's not another way to ensure it isn't

cancer except to take it out. I'm not happy about it, but there's not

much I can do about it. Particularly now that it is messing with my

nerves.

The nodule is on the far, far right side of the thyroid and is clearly

visible on my neck. Again, I'm hoping that the half they leave in will

kick in and do the work of the rest of it. I have a good friend who

had 70% of hers removed due to cancer and she thankfully is not on any

meds. I'm keeping my fingers crossed.

I don't recall the numbers on my results as it was a year ago when

this whole thing started, but I'm not experiencing any symptoms so I

have no reason to dispute the test results. They are running more

bloodwork before surgery so I have a baseline as to what is " normal "

for me. That way if I do start to feel off, the doctors have some

target for levels for what works for me rather than just trying to

achieve some standardized normal that may not be quite right for me.

Lynn

>

> Lynn,

>

> Have they done a FNA? I find it odd, that you have that rapid of

growth

> and no symptoms. What were you labs results, if you don't mind

> sharing? It the doctor using the correct range on the TSH? I have you

> double checked a thyroid symptom check list?

>

> I'm sorry you have had that rapid of a growth and dealing with

shoulder pain.

>

> Kate

>

[Guest guest]

Follicular carcinoma cannot be diagnosed from an fna. It also cannot be detected in a frozen section while you are still on the table, as the paraffin embedding process takes three days.

If it comes back cancerous, then you will have to go back in for a completion thyroidectomy, which carries with it a much greater risk of complications than does an initial total thyroidectomy.

I would add that your friend who kept part of her thyroid gland after cancer and is not taking any meds is at great risk of a recurrence. The doc who let her do that should lose his license. Meds are given after thyroid cancer, not just as replacement for the missing hormone, but also to suppress the TSH and hopefully prevent any recurrence. TSH stands for Thyroid Stimulating Hormone. For the thyca survivor, it stands for Thyroid CANCER Stimulating Hormone.

> >> > Lynn,> > > > Have they done a FNA? I find it odd, that you have that rapid of> growth > > and no symptoms. What were you labs results, if you don't mind > > sharing? It the doctor using the correct range on the TSH? I have you > > double checked a thyroid symptom check list?> > > > I'm sorry you have had that rapid of a growth and dealing with> shoulder pain.> > > > Kate> >>

[Guest guest]

A cold nodule is the most questionable one, and a hot nodule is not. A cold

nodule needs to be biopsied, and yes, a fine needle aspiration can certainly

be inderminate.

Re: Dr. Nader

> Kate-

>

> Yes, I've had 2 FNAs about 6 months apart and both came back as

> indeterminate, I think she referenced it as a follicular neoplasm, so

> there's some chance there that it is cancer with that type of nodule

> and no biopsy will ever be accurate. The uptake showed the nodules as

> cold as well, which I guess is good. From what the endo, the doc doing

> the FNA and my GP says (and a little research on the net), it isn't

> that uncommon to have these stupid nodules and not cause any symptoms,

> that's what makes treating them so troubling. (I think I was told that

> 70% of people have a nodule, they just don't know it because it isn't

> large or growing). If it is indeterminate, you end up taking out an

> organ that may not be cancerous and leaving the patient with the

> lifelong need for meds, but there's not another way to ensure it isn't

> cancer except to take it out. I'm not happy about it, but there's not

> much I can do about it. Particularly now that it is messing with my

> nerves.

>

> The nodule is on the far, far right side of the thyroid and is clearly

> visible on my neck. Again, I'm hoping that the half they leave in will

> kick in and do the work of the rest of it. I have a good friend who

> had 70% of hers removed due to cancer and she thankfully is not on any

> meds. I'm keeping my fingers crossed.

>

> I don't recall the numbers on my results as it was a year ago when

> this whole thing started, but I'm not experiencing any symptoms so I

> have no reason to dispute the test results. They are running more

> bloodwork before surgery so I have a baseline as to what is " normal "

> for me. That way if I do start to feel off, the doctors have some

> target for levels for what works for me rather than just trying to

> achieve some standardized normal that may not be quite right for me.

>

> Lynn

[Guest guest]

My thought was its better to not be producing hormones than affecting

the hormone produciton--or I'm completely confused as to hot vs cold.

Lynn

>

> A cold nodule is the most questionable one, and a hot nodule is not.

A cold

> nodule needs to be biopsied, and yes, a fine needle aspiration can

certainly

> be inderminate.

>

>

[Guest guest]

Jan-

I've gone over all the various scenarios in my head. Maybe I'm just

rationalizing but I'd rather have to go back in than not. Thought

being that there's a slim chance its cancer and if they take it all

out I most certainly have to be on meds rather than just taking part

out, hoping its not cancer and maybe having to do meds. Its a hard

choice and I still struggle with it and probably will until they put

me under next week.

I had cervical cancer and they did have to go in a second time on that

one, so I know its a possibility.

As for my friend, the small cancer was in the center of a very large

fluid filled cyst. So the doctors felt that removing just the cyst

with the cancer inside would do fine and I think her situation was

probably an unusual one. She was treated at MD and is 5 years OK.

Lynn

>

>

> Follicular carcinoma cannot be diagnosed from an fna. It also cannot be

> detected in a frozen section while you are still on the table, as the

> paraffin embedding process takes three days.

>

> If it comes back cancerous, then you will have to go back in for a

> completion thyroidectomy, which carries with it a much greater risk of

> complications than does an initial total thyroidectomy.

>

> I would add that your friend who kept part of her thyroid gland after

> cancer and is not taking any meds is at great risk of a recurrence. The

> doc who let her do that should lose his license. Meds are given after

> thyroid cancer, not just as replacement for the missing hormone, but

> also to suppress the TSH and hopefully prevent any recurrence. TSH

> stands for Thyroid Stimulating Hormone. For the thyca survivor, it

> stands for Thyroid CANCER Stimulating Hormone.

>

>

>

>