- Re:

[Guest guest]

HAHAHAHAHA - okay - sorry - short but full case report on .

7 years old - born 15 weeks premature in Feb 98 weighing 1 pound 6 ounces

(650 grams) - 81 days NICU - hernia surgery at 6 weeks - 1 year on home

oxygen - multiple pneumonias - dx'd with Bronchopulmonary Dysplasia /

Chronic Lung Disease & pinhole sized Atrial Septal Defect (hole in heart) &

grade 3 Retinopathy of Prematurity (reached grade 4 then self-resolved)

early 2001 - Sept 2004 was pretty good - basic colds, occasional ear

infection, cold sores, etc - dx'd with ADHD in early 2004 (after more than a

year of crying over being unable to deal with his bouncing off the walls) &

started on Adderall XR

Sept 04 - rt lung collapsed - 4 days in hospital w/ chest tube & water seal

Oct 04 - rt lung collapsed - 16 days in w/ chest tube & water seal -

required Pleurodesis to repair (surgery to make lung stick to chest wall) -

echo done prior to surgery revealed " pinhole " ASD was now 6mm X 8mm.

Dec 04 - visit to pediatric cardiologist to discuss repair of ASD -

cardiologists noticed 's thyroid was " fairly prominent " and sent us to

lab - called next day with news that he's hypoT - TSH 9.79 - fT4 1.33

Subsequent labs have been as follows:

1/20 - TSH 63.4 . . . fT4 0.94 (first endo appt on 1/27 - began 50mcg

levothyroxine on 1/28)

2/16 - TSH 16.4 . . . fT4 1.13

3/02 - TSH 9.08 . . . fT4 1.84

4/13 - TSH 9.50 . . . fT4 1.86 . . . fT3 3.3 (second endo appt on 4/20 -

upped to 75mcg)

Endo said at first appointment he possibly has Hashi's (antibodies test was

<1.5, but doc said that doesn't necessarily mean it's NOT - we have to watch

HIM, not just the numbers).

Second appointment he also said he may have Thyroid Hormone resistance, due

to the odd lab numbers. He had 3 patients (a father and his 2 sons) who had

the same type of odd numbers (high TSH & high fT4) and he called in another

endo from Chicago to help him w/ it and it turned out to be hormone

resistance. Ended up that in order to get their TSH's down to decent levels

AND clear up their symptoms, their fT4's had to be much higher than " normal

range " .

He's still tired, has very dry hair, runs a fever the next day if he puts in

a full day of school, has constipation, abdominal pain (past 2 months or

so), lower extremity muscle & joint pain, definite cold intolerance, low

body temp, irritability, goiter. (The doc yesterday noticed that there was

mention made in his record about his having narrowing of the trachea. I

want to mention this to his endo, as the only thing that makes ANY sense

there is the goiter, and gives credence to his complaining about his

Adderall getting stuck in his throat so he won't take it unless I force him

to.)

Meds: Adderall XR 10mg, Levothyroxine 75mcg, Advair 100/50 (twice daily),

Nasonex (once daily), Glycolax, Albuterol (as needed), Acyclovir (as

needed), Ex-Lax (as needed), Carnation Instant Breakfast daily, multivitamin

daily

DX's: Chronic Lung Disease/Asthma, ADHD, Recurrent Spontaneous

Pneumothorax, Atrial Septal Defect, Hypothyroidism with Goiter

And that's pretty close to as short as I can make it - LoL. I don't know if

I left anything out or not. If you have questions about anything, let me

know. I'll answer whatever.

Ami