After getting my ultrasound results from Dr Fenichel on Wednesday, I went to see Dr Heller today so he can further investigate the calcification found in my lymph node - found on the upper part of neck, just below my right jawline. This is where I figured it was because that was the location in which the technician spent the most time going back and forth throughout my ultrasound.
When Dr Heller came into my examination room, he was looking at my results and reiterated what the radiologist found. He felt my neck and said that he was able to feel something slight in my neck. He said that he was a little concerned because thyroid cancer cells can cause calcification in the lymph nodes. It could be benign but it can also be a possible sign of microscopic cancer cells that metastasized into my lymph node. He said that they would usually be able to tell the presence of thyroid cancer cells in my body based on my Tg blood test, but since I still have anti Tg antibodies present in my body, my Tg levels are not reliable even though they are currently undetectable. On that note, Dr Heller mentioned that he was also concerned a little bit that not only were the anti thyroglobulin antibodies still present, but their levels have been going up over the past few blood tests that I had. That could also me a sign of microscopic cells in the body. This threw me a little bit because Dr Fenichel always has said that the level of antibodies are not really important, but rather if they are present or not. Dr Heller said that the RAI scans are not always very sensitive and can miss certain things (he doesn't seem too happy with them). In order to investigate further, Dr. Heller performed an ultrasound in his office and planned to take a biopsy of the node.
It took him a little while to find the spot in my lymph node but eventually found what was originally seen on my ultrasound from last week. The calcification measured just under 9 mm. After seeing the size of the spot, Dr. Heller said that it was so small that it did not warrant him taking a biopsy (good sign). While he couldn't say for sure, he felt that the spot was probably benign and too small to carry cancer cells right now. He preferred to monitor the calcification, rather than do a biopsy. He wanted me to come and see him in 6 months and take another ultrasound. I told him I already had an appointment scheduled in October and he said to keep it.
It was a little bit of a relief that Dr Heller didn't seem too worried about my calcification for the time being. However, without a biopsy there is no way to know for sure whether or not the spot was benign or cancerous. After two years of clean scans and ultrasound, I guess I am back to the waiting game again. Hopefully it is nothing. I mentioned to the doctor about whether or not a PET/CT is something that would be helpful for me since it is also used to detect thyroid cancer. He said that he would think it over and discuss it with Dr Fenichel.
My next appointment with Dr Heller is scheduled for October 14th at 5PM.
Thursday, July 8, 2010
Wednesday, July 7, 2010
Ultrasound Results - 7/7/10 - Slight Abnormality
Well, I had an instinct after my ultrasound last Friday that something was a little off. The procedure took longer than usual. The technician kept on going back to certain areas for more images (more than just being thorough). Her meeting with the radiologist took slightly longer than expected. She looked to confirm that I had papillary carcinoma before speaking with the radiologist. Something just didn't seem right.
I called Dr Fenichel's office on Tuesday afternoon to see if she got my results yet. The receptionist told me that the results were in and that a doctor would be calling me to discuss the results. I asked if Dr Fenichel was still in the office and they said no. I thought that they meant that she left for maternity leave already and that I would be speaking with her replacement. I was a little bummed since I have formed a good relationship with her and I trust her, and therefore was hoping to speak with her about the results and not another doctor. I was planning on calling again on Wednesday, when I realized last night that there was a message on my cell phone. It was a call from Dr Fenichel telling me that she wanted to touch base with me about my results and that there was one thing that she wanted to talk about with me. Then I got worried. She wouldn't have said that if everything was fine. She knew that I would know what her statement meant and that I was probably getting nervous about what the results of the ultrasound were telling her. She knows me pretty well by now. Did I have a recurrence? Did they find a nodule?
Me and Dr. F spoke this morning and she told me that there were calcifications found on one (or two?) of my lymph nodes which should not be there. There weren't any contained in my thyroid bed. Given the fact that many of my lymph nodes were removed during my surgery due to the cancer metastasizing outside of my thyroid area, she wanted me to get checked out further. The calcification could be benign but she wants to explore things further. She discussed my results with Dr Heller and she said that he wants me to come into his office and do further tests. He will read the results of my ultrasound from last week and either do an ultrasound of his own and/or a biopsy of the lymph node. At this point, they don't know quite what is happening and they need to delve further. Without the ability to track my Tg levels because of the presence of the Tg antibodies, there is no way of knowing what the calcification indicates without probably a biopsy or possible surgery to remove the lymph know. Hopefully I will have a clearer picture after tomorrow.
I made an appointment to see Dr Heller tomorrow at 5PM. I am glad that he is getting involved. I trust his opinion a great deal and he knows what he is talking about. I will not to worry too much until I speak with Dr. Heller tomorrow but that is a bit hard to do.
I called Dr Fenichel's office on Tuesday afternoon to see if she got my results yet. The receptionist told me that the results were in and that a doctor would be calling me to discuss the results. I asked if Dr Fenichel was still in the office and they said no. I thought that they meant that she left for maternity leave already and that I would be speaking with her replacement. I was a little bummed since I have formed a good relationship with her and I trust her, and therefore was hoping to speak with her about the results and not another doctor. I was planning on calling again on Wednesday, when I realized last night that there was a message on my cell phone. It was a call from Dr Fenichel telling me that she wanted to touch base with me about my results and that there was one thing that she wanted to talk about with me. Then I got worried. She wouldn't have said that if everything was fine. She knew that I would know what her statement meant and that I was probably getting nervous about what the results of the ultrasound were telling her. She knows me pretty well by now. Did I have a recurrence? Did they find a nodule?
Me and Dr. F spoke this morning and she told me that there were calcifications found on one (or two?) of my lymph nodes which should not be there. There weren't any contained in my thyroid bed. Given the fact that many of my lymph nodes were removed during my surgery due to the cancer metastasizing outside of my thyroid area, she wanted me to get checked out further. The calcification could be benign but she wants to explore things further. She discussed my results with Dr Heller and she said that he wants me to come into his office and do further tests. He will read the results of my ultrasound from last week and either do an ultrasound of his own and/or a biopsy of the lymph node. At this point, they don't know quite what is happening and they need to delve further. Without the ability to track my Tg levels because of the presence of the Tg antibodies, there is no way of knowing what the calcification indicates without probably a biopsy or possible surgery to remove the lymph know. Hopefully I will have a clearer picture after tomorrow.
I made an appointment to see Dr Heller tomorrow at 5PM. I am glad that he is getting involved. I trust his opinion a great deal and he knows what he is talking about. I will not to worry too much until I speak with Dr. Heller tomorrow but that is a bit hard to do.
Saturday, July 3, 2010
Thyroid and Neck Ultrasound - 7/2/10
I went in for my latest thyroid and neck ultrasound. My last one was back in October 2009, but Dr F wanted me to get it in July in advance of my possible scan at the end of the year. I will call Dr F on Tuesday to find out my results. Hopefully she has not left for maternity leave yet.
Thursday, June 3, 2010
No Change in Synthroid Dosage
I went for my follow up blood test yesterday after switching my Synthroid dosage to 137 on April 13th. I got a call from Dr Fenichel's office that my test came back fine and to stay on the dosage that I currently am on - 137.
Tuesday, April 13, 2010
Monday, April 12, 2010
Blood Test Results - 4/12/2010
I spoke with Dr. Fenichel regarding my blood test results after seeing her last week.
She said that the Tg antibodies are still present. There is nothing to do right now. We will check them again in October when I have my ultrasound and blood tests.
She also said that my Thyroid levels were normal, which is good for most people but I need to be slightly hyperthyroid. Therefore, she is changing my Synthroid level from 125 to 137.
According to her scale, my weight has increased in the last year. Could be muscle, could be to the lowered Synthroid dose. My lowest weight in her office was 142, and it was up to 150 when I saw her on Thursday. To me, the weight of 150 is normal and the 142 was quite low for me and I noticed that I looked pretty skinny. The 142 weight was probably after the low iodine diet in which I usually lose 5-7 pounds. I have been training for a marathon for the past 4 months - although I tend to eat more during training, it would not make sense to me that I gained weight overall during my training cycle. I usually lose weight. I have been feeling fine while on the Synthroid 125 level and my running has being doing great as well.
She said that the Tg antibodies are still present. There is nothing to do right now. We will check them again in October when I have my ultrasound and blood tests.
She also said that my Thyroid levels were normal, which is good for most people but I need to be slightly hyperthyroid. Therefore, she is changing my Synthroid level from 125 to 137.
According to her scale, my weight has increased in the last year. Could be muscle, could be to the lowered Synthroid dose. My lowest weight in her office was 142, and it was up to 150 when I saw her on Thursday. To me, the weight of 150 is normal and the 142 was quite low for me and I noticed that I looked pretty skinny. The 142 weight was probably after the low iodine diet in which I usually lose 5-7 pounds. I have been training for a marathon for the past 4 months - although I tend to eat more during training, it would not make sense to me that I gained weight overall during my training cycle. I usually lose weight. I have been feeling fine while on the Synthroid 125 level and my running has being doing great as well.
Friday, April 9, 2010
Doctor Visits - 4/8/10
I went for my six month checkups with both Dr H and Dr F.
Dr. H - He felt my neck and lymph nodes, really digging around, and said that everything felt great and to come back into the office in another six months. When I asked about whether or not I needed to get a total body scan this year, he said that he didn't think I needed one but he would check with Dr. F. He said that I would still need an ultrasound. He didn't have me get a blood test since I was going to get one for Dr F anyway. The main thing that we need to do is track my Tg antibody levels, which still exist.
Dr F - First, she felt my neck as well and said that everything was normal. Then we discussed what needed to be done for me for the rest of the year. When I asked her about the need for a scan this year (which was done in June the past 2 years), she said that I did not need one right now. Although my Tg antibodies were still present last year, she said that she will track my blood results when I get a test in April 2010 and October 2010, and that there is no need for a scan just yet. She wants to track my blood progress over the next 6 months and decide in October if there is a need for a scan. If the antibodies are still present in October, then I may need a scan in the future. She will discuss this with Dr. H.
Therefore, the plan is to get a blood test tomorrow, and then get a blood test and neck ultrasound in October 2010 and see where we stand then. Dr F said that the ultrasound is more sensitive than the scan and will be able to tell us what we need to know and would pick up activity before the scan would.
Schedule:
April 2010 - Blood Test
October 2010 - Blood Test (Dr F gave me the prescription)
October 2010 - Neck Ultrasound (call NYU Radiology - Dr F already gave me the prescription)
Dr. H - He felt my neck and lymph nodes, really digging around, and said that everything felt great and to come back into the office in another six months. When I asked about whether or not I needed to get a total body scan this year, he said that he didn't think I needed one but he would check with Dr. F. He said that I would still need an ultrasound. He didn't have me get a blood test since I was going to get one for Dr F anyway. The main thing that we need to do is track my Tg antibody levels, which still exist.
Dr F - First, she felt my neck as well and said that everything was normal. Then we discussed what needed to be done for me for the rest of the year. When I asked her about the need for a scan this year (which was done in June the past 2 years), she said that I did not need one right now. Although my Tg antibodies were still present last year, she said that she will track my blood results when I get a test in April 2010 and October 2010, and that there is no need for a scan just yet. She wants to track my blood progress over the next 6 months and decide in October if there is a need for a scan. If the antibodies are still present in October, then I may need a scan in the future. She will discuss this with Dr. H.
Therefore, the plan is to get a blood test tomorrow, and then get a blood test and neck ultrasound in October 2010 and see where we stand then. Dr F said that the ultrasound is more sensitive than the scan and will be able to tell us what we need to know and would pick up activity before the scan would.
Schedule:
April 2010 - Blood Test
October 2010 - Blood Test (Dr F gave me the prescription)
October 2010 - Neck Ultrasound (call NYU Radiology - Dr F already gave me the prescription)
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