Dr Patel Appointment - 12/28/15

Questions I had for Dr Patel on 12/28/15, based on the results from my most recent ultrasound on 12/15/15 which indicated 2 additional lymph nodes which were not discussed on previous ultrasounds:

1. It is one thing to have 1 or 2 enlarged lymph nodes, but 4 seems like a lot?  Is that true?  Do these worry you? - it did change things a little bit which is why he took the ultrasound himself so he can decide which course of action to take.
2. Are the 2 additional nodes new or do you think they already existed before? Does this matter? - they were not new and were stable
3. Does the quantity of nodes worry you or is the size more important?
4. Does the fact that my Tg is still undetectable supersede or lessen the worry of having 4 enlarged lymph nodes? - the bloodwork is a good sign but is not the only indicator which is why he wanted to check things out for himself.  
5. At what point is it time to worry (size of nodes, quantity of nodes, etc.)?  What would the course of action be - surgery or radioactive iodine? - didn't discuss, but the first step would be to do a biopsy of the node to see if it was cancerous but he did not see anything suspicious enough on his own ultrasound to warrant one. A biopsy was not conducted during today's visit
6. Should I get an ultrasound in 3 months as recommended? - get one in 4 months towards the end of April 2016 before I see Dr Patel

Saw Dr Patel on 12/28/15
Wants to see me in 4 months - 4/25/16 @ 9:15am (already scheduled)
Wants me to get follow up ultrasound in 4 months

Dr Patel took an ultrasound of my neck himself in his office.  He did see the nodes on both the left and right sides but did not see anything suspicious or concerning on either side.  The left side was not suspicious at all, and he looked closely on the right side nodes but was not concerned. He said that he would have taken a biopsy of one of the nodes on the right side to be safe but did not see anything suspicious enough to warrant one.  The nodes could just be regular reactive nodes and not cancerous at this point but doesn't know without biopsy.  Just in case, he wants me to get a follow up ultrasound in 4 mo instead of 6 mo, and then to come into see him for an appt a couple days later.

He read my ultrasound results from 12/15/15 before seeing me and did acknowledge right away that there seemed to be more nodes than in the past (4 instead of 2, including a node on the left side which wasn't indicated in the past).  The additional two nodes did exist before and were stable and were not new (one of which is on the left side; all prev ones were on the right).  They have changed the people who read the ultrasounds.  People in the past were good but not great (Dr. Patel's words), and they strive to now be great (ugh). Therefore, the ultrasound results will be more extensive than in the past as evidenced by my most recent ultrasound.

My bloodwork, as I expected, looked good to him given that my Tg is still undetectable.  This is a good sign given the fact that the lymph nodes show up.  If my cancer exists (it may not) and spread, my Tg would have spiked which has not occurred.

Next appt with Dr. Patel: 4/25/16 at 9:15am