Suggest Remedy For Bad Sensation In Throat After Thyroidectomy
I'm suffering from constant bad feeling in throat for months, and not feeling any better. The feeling is strong and very much inside the throat, feeling mass/lump/twisted… I can't lead normal life due to it, and desperately need help!
I've had surgery of thyroidectomy in May 29 2014 due to papilary thyroid cancer. I didn't take thyroxine during Jun 4 - July 18 due to herbal medicine treatment and therefore fell into severe hypothyroidism. Since I started taking thyroxine from July 19 and gradually increased the dosage, my various hypo symptoms disappeared while the bad throat feeling remains untill now. The recent physical tests doesn't show structure problem (including neck ultrasound, gastroscopy and laryngendoscope), but the feeling in throat is very true and strong. My current medication includes thyroxine(112.5mg), dexilant and remeron.
XXXX
Thyroid
Detailed Answer:
I am very sorry to learn about your neck symptoms.
I have reviewed your attached summary. It is quite clear you have been thoroughly investigated for potential causes of your neck complaints and unfortunately nothing has come to light.
When I see someone like you in my practice, I tend to typically order the following blood tests, obviously in addition to a thorough physical examination:
CBC
CMP
TSH
Free T4
Quantitative Thyroglobulin
Anti thyroglobulin antibodies
Some of the tests above are markers to see if there is any residual thyroid tissue in the neck.
It would be most advisable for you to be under the care of an endocrinologist experienced in the management of thyroid cancer. A comprehensive academic center with expertise in dealing with thyroid cancer, would perhaps be an even better choice.
There are specific TSH and free T4 targets that need to be adhered to, in order to prevent the cancer from coming back. However, these decisions require application of latest guidelines that have undergone changes as recently as few months ago.
Thanks a lot for your prompt reply.
My most recent blood test results are as followings:
Oct 21 2014
Reference
TT3 0.77 ng/ml 0.6-1.8
TT4 11.50 ug/dl 4.5-10.9
TSH 0.08 uIU/ml 0.35-5.5
TGAb 21.60 U/ml 0-70
TP0Ab 57.80 U/ml 0-70
TG <0.20 ng/ml 1.7-56
I also attach another blood test report for your review. I'm wondering that if these blood test results are related to my current neck/throat symptoms.
Great thanks!
XXXX
Follow up
Detailed Answer:
Your thyroid blood test results seem to be on target. It is important to follow up regularly with an endocrinologist to ensure the values remain at goal for the intended period of time.
I have seen the other laboratory test result that you have attached. It is a CBC. It is more or less ok.
It would be helpful to review the CMP which stands for Complete metabolic Panel. It includes the following blood tests:
Electrolytes
Glucose
Calcium
Creatinine
SGOT
SGPT
Albumin
Globulin
Bilirubin
bicarbonate
Alkaline phosphatase
Thanks for your futher explanation. I had a CMP test in July and the result was OK then. But I'll redo a blood test for all the index you mentioned.
Upon your suggestion, do you know any appropriate doctor/institution in Toronto that I can go to for monitoring and analyzing my situation, especially to help sovle my neck/throat feeling problem? I've found "UHN XXXXXXX XXXXXXX Cancer Center" on internet, and they have a team of Head & Neck Clinic and Endocrine Clinic. Have you heard of them and should I go to see them?
Thanks a lot.
Second follow up
Detailed Answer:
There is Dr XXXXXXX Drucker at University of Toronto. You can check with either center if they have the expertise and experience dealing with your condition.