Dr Bergman 7/10/14
BP- 118/70
Recommends that I get a total body scan since I haven't had one in 4 years. This will help guide future treatment.
Check my schedule and then call Josie in Dr Bergman's office to start the preauthorization process of the total body scan. UPDATE: I already did this and she called me back to tell me that she spoke to my insurance company and no preauthorization is needed for the scan.
Dr Bergman says nuclear medicine takes care of all the administrative aspects of ordering the Thyrogen but I will believe it when I see it.
Preauthorization is usually good for 90 days. I may want to get this done before Eoin leaves. NOT NEEDED.
Next appt with Dr Bergman Oct 10th at 9am
Friday, August 15, 2014
Monday, June 2, 2014
Saw Dr Patel on 6/2/14
Saw Dr Patel on 6/2/14. See him again in 6 months on 12/1/14.
We went over my ultrasound. There is a slightly enlarged lymph node on the lower right side of my neck. It had been present for 3 years but hasn't changed in size. Based on my past history, it is likely that it has been there all along. Dr P's instinct is that it is probably malignant but it is so small in size that there is really nothing much to do about it right now. If it is was cancerous and taken out, it wouldn't change my prognosis at all. He wants to continue to monitor it and will take an in office ultrasound next time when I see him in December 2014.
He examined my neck but didn't feel anything abnormal. He didn't feel anything on the lower right side of my neck where the slightly enlarged lymph node is.
Might be tough to biopsy since near my carotid artery and jugular. If we were to do anything, we would have surgery to take it out rather than biopsy.
Enlarged lymph node tells us that there is something in it causing it to be enlarged - can be malignant or benign. His gut is malignant but I could be fine with it for years. Before ultrasounds, people have cancerous cells in their lymph nodes for years with no ill effects. Taking it out won't change my prognosis.
If Dr. Patel does do surgery to take out lymph node, no RAI would be needed, just remove node and tissue and that is it.
BP was 130/80 after running to the office from the bus.
We went over my ultrasound. There is a slightly enlarged lymph node on the lower right side of my neck. It had been present for 3 years but hasn't changed in size. Based on my past history, it is likely that it has been there all along. Dr P's instinct is that it is probably malignant but it is so small in size that there is really nothing much to do about it right now. If it is was cancerous and taken out, it wouldn't change my prognosis at all. He wants to continue to monitor it and will take an in office ultrasound next time when I see him in December 2014.
He examined my neck but didn't feel anything abnormal. He didn't feel anything on the lower right side of my neck where the slightly enlarged lymph node is.
Might be tough to biopsy since near my carotid artery and jugular. If we were to do anything, we would have surgery to take it out rather than biopsy.
Enlarged lymph node tells us that there is something in it causing it to be enlarged - can be malignant or benign. His gut is malignant but I could be fine with it for years. Before ultrasounds, people have cancerous cells in their lymph nodes for years with no ill effects. Taking it out won't change my prognosis.
If Dr. Patel does do surgery to take out lymph node, no RAI would be needed, just remove node and tissue and that is it.
BP was 130/80 after running to the office from the bus.
Wednesday, May 28, 2014
Thyroid Ultrasound at NYU - 5/28/14
I had my neck and thyroid ultrasound at NYU on 5/28/14 at 8AM.
I heard back from Dr. Bergman's receptionist regarding the results:
Spoke to Dr Bergman's receptionist regarding my neck Ultrasound from 5/28 - saw small lymph node but no change in size. Everything looks stable but wanted Dr Patel to give his opinion on the results just in case. I am seeing him anyway on June 2nd.
Note to self - Make sure to ask Dr Patel's opinion when I see him on June 2nd. While I am there, ask about need for scan in the future.
I heard back from Dr. Bergman's receptionist regarding the results:
Spoke to Dr Bergman's receptionist regarding my neck Ultrasound from 5/28 - saw small lymph node but no change in size. Everything looks stable but wanted Dr Patel to give his opinion on the results just in case. I am seeing him anyway on June 2nd.
Note to self - Make sure to ask Dr Patel's opinion when I see him on June 2nd. While I am there, ask about need for scan in the future.
Tuesday, January 21, 2014
Dr. Bergman Appointment and Blood Tests: 1/10/14
I went into see Dr. Bergman on 1/10/14 for my routine 6 month appointment.
My blood pressure was 128/70 at his office which was taken before seeing Dr. Bergman.
We talked in his office first to go over my ultrasound from Dec 2013 and past bloodwork.
My current TSH level has been around 0.01 to 0.05 for the past year (I had one reading at 0.08, but overall my levels are low) and Dr. Bergman eventually wants my TSH level to get up to 0.1. Over time, it is now good to have such low levels and can lead to a bunch of undesired symptoms (rapid heart rate, loss of weight, bone issues, etc.). Since I have been over suppressed for 5 years now, he will look to gradually raise my dosage over time
For now, he still wants me to get a neck ultrasound twice per year, but will probably lower that down to once per year soon.
I read my blood test results last week, but finally spoke to someone at Dr. Bergman's office on 1/21/14 to discuss my results:
My blood pressure was 128/70 at his office which was taken before seeing Dr. Bergman.
We talked in his office first to go over my ultrasound from Dec 2013 and past bloodwork.
My current TSH level has been around 0.01 to 0.05 for the past year (I had one reading at 0.08, but overall my levels are low) and Dr. Bergman eventually wants my TSH level to get up to 0.1. Over time, it is now good to have such low levels and can lead to a bunch of undesired symptoms (rapid heart rate, loss of weight, bone issues, etc.). Since I have been over suppressed for 5 years now, he will look to gradually raise my dosage over time
For now, he still wants me to get a neck ultrasound twice per year, but will probably lower that down to once per year soon.
I read my blood test results last week, but finally spoke to someone at Dr. Bergman's office on 1/21/14 to discuss my results:
- My TSH level was 0.016. I need to revise my Synthroid regimen to 137 everyday, instead of switching off between 137 and 150.
- My Vitamin D levels were low (20.2 in Jan 2014 and 28 in Nov 2013; the low end of the normal range is 30). He recommended that I take 2000 units of Vitamin D each day. I started taking them on my own approximately 1/18 (but have only been taking 1,600 units)
- Thyroid protein was once again undetectable
- Platelets were slightly low but I have always had that
- Receptionist on the phone said that I may need another total body scan eventually since my last one was back in 2010. This seems a bit weird since I have asked Dr. Bergman about this before and he said that the neck ultrasounds should be fine and that I probably would not need another scan.
- Start taking 2,000 units of Vitamin D
- Change Synthroid intake to 137 micrograms every day
- Repeat blood tests in 2 months - approximately the end of March 2014
- Get a thyroid and neck ultrasound in either April/May 2014
- See Dr Bergman 7/10/14 at 9am
Thursday, December 5, 2013
Visit with Dr. Patel - 12/2/13 and Thryorid Bloodwork on 11/12/13
Since Dr. Heller is retiring, I had my first visit with Dr Patel, who will now be following me from now on. We had a brief conversation and he told me that he read through my file and past history.
He felt my neck and nodes and he said everything felt fine.
When I asked about a total body scan, he didn't think I would need one again since the other two have come back clean. When I asked about the continued presence of my antibodies, he said that the most important thing was that the levels remain the same and don't increase at all. While he hopes that they go away, he has seen them hang around for many years. However, as long as the levels do not fluctuate, there isn't anything to be alarmed about right now.
I told him I will have an ultrasound at the end of Dec 2013 (I need to call NYU Radiology to make an appointment) and will see Dr Bergman in Jan 9, 2014 at 9AM.
Next appt with Dr Patel is on 6/2/14 at 9am
==========================================================
I had bloodwork done on 11/12/2013 at the request of Dr. Bergman to check on my Thyroid levels. I got a call from his office a couple days later that my "thyroid levels were fine." I asked if my Synthroid levels should stay the same and she said yes. Therefore, my levels continue to stay at 137 five days per week and 150 two days per week. Dr. Bergman wants me to get blood tests again in 4 months which would bring me to mid March 2014.
He felt my neck and nodes and he said everything felt fine.
When I asked about a total body scan, he didn't think I would need one again since the other two have come back clean. When I asked about the continued presence of my antibodies, he said that the most important thing was that the levels remain the same and don't increase at all. While he hopes that they go away, he has seen them hang around for many years. However, as long as the levels do not fluctuate, there isn't anything to be alarmed about right now.
I told him I will have an ultrasound at the end of Dec 2013 (I need to call NYU Radiology to make an appointment) and will see Dr Bergman in Jan 9, 2014 at 9AM.
Next appt with Dr Patel is on 6/2/14 at 9am
==========================================================
I had bloodwork done on 11/12/2013 at the request of Dr. Bergman to check on my Thyroid levels. I got a call from his office a couple days later that my "thyroid levels were fine." I asked if my Synthroid levels should stay the same and she said yes. Therefore, my levels continue to stay at 137 five days per week and 150 two days per week. Dr. Bergman wants me to get blood tests again in 4 months which would bring me to mid March 2014.
Wednesday, July 10, 2013
Visit With Dr. Bergman - 7/10/13
Since Dr. Fenichel has left the practice and Dr. Marguiles is on maternity leave, I made an appointment with Dr. Bergman for my usual 6 month endocrinology appointment.
We spent a few minutes in the examination room where he introduced himself and then gave me a thorough exam which was understandable since he never met me before. He listened to my lungs and heart, felt my neck, tested my reflexes and leg and hand strength, etc. I was glad to see this. Since he never examined me before and probably has very little knowledge of my case or history, I was happy to see that he wanted to check me out for himself and not rely and past charts or other doctors' notes.
Afterwards, we went into his office to talk. I brought my ultrasound report from 6/27 as well as my bloodwork results from my visit with Dr. Heller just in case Dr Bergman needed them, but he was able to access all of my records on his computer. He asked me about the medication and dosage I was taking, the history of my condition, family history of thyroid issues, the last time I had a whole body scan, the last time I had my ultrasound, etc. He was very thorough, which was very good to see, and he wanted to get as well rounded a history of my case as possible.
He did not see any problems at all based on my results and his examination, and he said that he was very happy with the management of my treatment so far. Based on my last TSH reading of 0.05, he does believe that after 5 years that I might be oversurpressed and that he would like to see my TSH level between 0.1-0.5, but closer to 0.5 if possible, but it will take some monitoring of my Synthroid dosage.
He said that he would like me to get labs done within the next month to 6 weeks (around mid August 2013), which would be approximately 2 months after I switched my Synthroid dosage regimen to 137 for 5 days and 150 for two days. Also, since I am still oversurpressed and my dosage keeps changing, he would like me to get another neck ultrasound before I come back to their office in January 2014. Therefore, I should look to schedule my next neck ultrasound during the end of December 2013 or the beginning of January 2014.
Key upcoming dates:
Get bloodwork done at NYU - mid August 2013, Dr. Bergman gave me a hard copy of the script
Schedule a neck ultrasound at NYU - end of December 2013 or beginning of January 2014
My next endocrinology appointment is with Dr. Marguiles on 1/10/14 at 9AM
We spent a few minutes in the examination room where he introduced himself and then gave me a thorough exam which was understandable since he never met me before. He listened to my lungs and heart, felt my neck, tested my reflexes and leg and hand strength, etc. I was glad to see this. Since he never examined me before and probably has very little knowledge of my case or history, I was happy to see that he wanted to check me out for himself and not rely and past charts or other doctors' notes.
Afterwards, we went into his office to talk. I brought my ultrasound report from 6/27 as well as my bloodwork results from my visit with Dr. Heller just in case Dr Bergman needed them, but he was able to access all of my records on his computer. He asked me about the medication and dosage I was taking, the history of my condition, family history of thyroid issues, the last time I had a whole body scan, the last time I had my ultrasound, etc. He was very thorough, which was very good to see, and he wanted to get as well rounded a history of my case as possible.
He did not see any problems at all based on my results and his examination, and he said that he was very happy with the management of my treatment so far. Based on my last TSH reading of 0.05, he does believe that after 5 years that I might be oversurpressed and that he would like to see my TSH level between 0.1-0.5, but closer to 0.5 if possible, but it will take some monitoring of my Synthroid dosage.
He said that he would like me to get labs done within the next month to 6 weeks (around mid August 2013), which would be approximately 2 months after I switched my Synthroid dosage regimen to 137 for 5 days and 150 for two days. Also, since I am still oversurpressed and my dosage keeps changing, he would like me to get another neck ultrasound before I come back to their office in January 2014. Therefore, I should look to schedule my next neck ultrasound during the end of December 2013 or the beginning of January 2014.
Key upcoming dates:
Get bloodwork done at NYU - mid August 2013, Dr. Bergman gave me a hard copy of the script
Schedule a neck ultrasound at NYU - end of December 2013 or beginning of January 2014
My next endocrinology appointment is with Dr. Marguiles on 1/10/14 at 9AM
Thursday, June 13, 2013
Dr Heller Visit and Dr. Fenichel Phone Conversation
5/30/13 - I went to visit Dr. Heller and he did his usual digging around and told me that everything felt fine and looked good. He was supposed to be retiring at the end of May 2013 but he will be staying on until the end of the year 2013. I will be seeing him one more time before he retires, with my next scheduled appointment with him being on 12/5/13 at 5:30PM. With Dr. Heller retiring, I asked him who in his practice he recommended that I go see and he said Dr. Patel, which is the one I would have chosen based on the information on their website. I took blood tests in Dr. Heller's office and he told me to call for the results on Monday or Tuesday and speak with his PA, Liz.
6/2/13 - I read the blood test results online and saw that my TSH level was at around 0.05, which seemed a bit low to me since Dr. Fenichel usually wants me to be at around 0.1. I spoke with Liz in Dr. Heller's office and she agreed that they would want me to be at around 0.1, however the 0.05 level was close enough and I should stay on my current dosage of 137 for 4 days and 150 for 3 days, however I could be lowered to 137 all days but I would have to be monitored to make sure that I don't get hypothyroid. Liz in Dr. Heller's office said that doctors usually like patients to be oversupressed for up to 10 years after thyroid cancer surgery.
6/13/13- I spoke with Dr. Fenichel today on her final day before leaving the practice. She concurred that my 0.05 TSH level was a bit low and ideally she would lower my dosage to 137, but she did not know how I would react due to my weight fluctuations overs the years and the constant tinkering with my dosage.
Dr. Fenichel gave several options but said that I could switch my dosage to 137 for 5 days and 150 for 2 days per week, and that I should get follow up blood tests in 2-3 months to see how my body is adjusting to the change in dosage and to make sure that I am not becoming slightly hypothyroid. I do not need to go for blood tests before I see Dr. Bergman, but I need to schedule follow up blood tests 2-3 months after I see him. I told her that I if I knew that she was still at the practice through mid June, I would have switched my ultrasound and office appt up a few weeks so I could see her. Her staff told me that she already left the practice which is why I never made any attempts to switch my appt. Dr. Fenichel acknowledged that the transition was not organized or handled well - big shocker.
My next thyroid ultrasound is scheduled for 6/27/13 and my appointment with Dr. Bergman is scheduled for July 10th at 4:15PM.
6/2/13 - I read the blood test results online and saw that my TSH level was at around 0.05, which seemed a bit low to me since Dr. Fenichel usually wants me to be at around 0.1. I spoke with Liz in Dr. Heller's office and she agreed that they would want me to be at around 0.1, however the 0.05 level was close enough and I should stay on my current dosage of 137 for 4 days and 150 for 3 days, however I could be lowered to 137 all days but I would have to be monitored to make sure that I don't get hypothyroid. Liz in Dr. Heller's office said that doctors usually like patients to be oversupressed for up to 10 years after thyroid cancer surgery.
6/13/13- I spoke with Dr. Fenichel today on her final day before leaving the practice. She concurred that my 0.05 TSH level was a bit low and ideally she would lower my dosage to 137, but she did not know how I would react due to my weight fluctuations overs the years and the constant tinkering with my dosage.
Dr. Fenichel gave several options but said that I could switch my dosage to 137 for 5 days and 150 for 2 days per week, and that I should get follow up blood tests in 2-3 months to see how my body is adjusting to the change in dosage and to make sure that I am not becoming slightly hypothyroid. I do not need to go for blood tests before I see Dr. Bergman, but I need to schedule follow up blood tests 2-3 months after I see him. I told her that I if I knew that she was still at the practice through mid June, I would have switched my ultrasound and office appt up a few weeks so I could see her. Her staff told me that she already left the practice which is why I never made any attempts to switch my appt. Dr. Fenichel acknowledged that the transition was not organized or handled well - big shocker.
My next thyroid ultrasound is scheduled for 6/27/13 and my appointment with Dr. Bergman is scheduled for July 10th at 4:15PM.
Subscribe to:
Posts (Atom)