First Endocrine Appointment

As expected, my appointment with the Endocrine doctor occurred 3 weeks post-op.

I arrived and checked in at the receptionist. Shortly thereafter, a nurse took my vitals (blood pressure, weight, ect). The nurse then took my back to one of the examination rooms.

After a short wait, my doctor arrived with a student doctor. She listened to my lungs, heard, stomach, checked for swelling, checked my reflexes, and shined a light into my eyes. They then left and said they would return with the resident doctor to have discuss my treatment.

A short while later, the first two doctors plus a third came into the room. She explained several things that were already on my list of questions and then asked if I had any further questions. I sure did! And I will get into those answers in a moment.

Apparently my condition is very good. They are waiting for one more blood test (hemoglobin?) to return and if that looks good? They won't see me for another 6 months, at which time they will do blood work and an ultrasound. If it doesn't look good? They'll do a radioactive scan to see what is going on. As a last resort, they might do RAI. However, they explained that aggressive treatments using RAI have not proven to improve outcomes, so, the direction any more is to avoid the RAI unless there is a reason for it. I was told there will be one more blood test at the end of this month so they can compare the results.

OK, now my questions:

MEDS

At what point do we cut back on calcium? Immediatly

Move my scripts from Hospital Pharmacy to my pharmacy? done

Same manufacturer for thyroid meds? They didn't really understand this question. I was saying that if I get generic, I want the same generic manufacturer. They said the way the guaranty that is by going with a name brand.

Are name brands more stable? Yes. But they haven't had problems with generics

All the vitamins I take OK? Yes

What are the different kinds of thyroid replacement medicines? She said there is one that comes from a pig and they don't recommend that because the contents of live free hormone can very.

How to request prescription refills? Contact the doctor

How will this impact my depression & depression meds? It won't

Long term effects of Thyroid Replacement medicines? None. Just don't miss a dose

RAI - Cross that bridge when we get to it. It is unlikely I will need it.

BLOOD WORK

Stop the calcium blood work? Yes, stop it now

When will the parathyroids kick in? Pth test says they already have

Will my calcium sky rocket when it kicks in? It did not

How often will I have blood work? Every six months unless there is a problem

What will the blood work check for? Can I get everything checked? Just TSH and T4free unless there is a problem

Damage from thyroid levels being too high or too low? Long term or short term? Long term. Could lead to growths which could lead to more cancer.

If I feel great but my levels are off, is that OK? Levels must be within range

TEST RESULTS

What symptoms should I watch for that would tell me I need a medicine adjustment? They will know because they are monitoring my blood test results.

What does the Intact Pth test tell us? Pyrathyroid test. Tells if the pyrathyroids are active

RECURRENCE

What are the chances it will recur? 1-3 %

What are the symptoms of recurrence? They will know because they are monitoring my blood levels

In what body parts do recurrences appear? Neck

Is there anything that can be done to reduce the chance of recurrence? Keep levels in ranges

WEIGHT LOSS

Is weight loss different for me now than before? No, it is the same

Do I have to be careful about eating too much calcium unexpectantly? I will just pee it out, but, I could end up getting kidney stones.

Could I have a tums overdose? No. I will just pee it out.

NEXT STEPS

How often will I see you? Depends on the results of the hemo-globin test. If the test is good? Every 6 months for 1 year. 

What role does my primary physician play? He will do everything except the thyroid

Follow up activities and timelines: rai & body scans? Next test is a 6 month ultrasound if the hemo-globin comes back OK

GENERAL

Where do I call if I have a serious problem? Call the Endocrine doctor

How has thyroid treatment changed in the recent years? They have become less aggressive

Alcohol consumption? OK

Books or websites to learn more? If I have questions I should contact the Endocrine doctor