Read What Doctors And Other Thyroid Patients From Around The World Say About Their Thyroid Disease And Their Experiences With Dr Gary Clayman And The Clayman Thyroid Center Our Mission Is A Patient Centered Approach To Premier Thyroid Surgery See Our Reviews And 5 Star Ratings On Healthgrades As Well As Our Many Excellent Reviews On Google
Patient: BW, 40 y.o. male, Dallas, Texas, Thyroid Cancer Surgeon
Patient: Steven G Rothrock MD, FACEP, FAAP, 55 y.o. male, Professor of Emergency Medicine University of Florida College of Medicine,
Steven G Rothrock MD, FACEP, FAAP Professor of Emergency Medicine
Patient: N. E., 34 y.o. female, Austin, Texas, Entrepreneur business owner and mother – Total thyroidectomy and bilateral central compartment surgery for papillary thyroid cancer
Dr. Clayman did a great job on my thyroid cancer surgery, finding the perfect balance between removing as much as he could without effecting other delicate things nearby. I truly appreciate the time he took to answer my questions, as well as my familys concerns. Dr. Clayman has the most current knowledge on thyroid cancer surgery and did a great job explaining how treatment plans have changed throughout the years. Although not so important, my incision site is hardly noticeable and I had minimal discomfort after my total thyroidectomy and lymph node surgery. Most of all, I appreciate Dr. Clayman being accessible to me and going above and beyond just the surgery. He is truly a caring individual and doctor.
My highest recommendations!
Patient: P. B., 48 y. o. female, Shreveport, LA, Practicing nursePatient: PL, 59 y.o. male, Thyroid Cancer Surgeon, Corpus Christi, TexasPatient: D. M. Naples, Florida, Artist age 77Patient: retired Palm Beach County civilian employee of 22+ years
After 4 months there is no visible scar!
What Is Thyroid Cancer
There are about 53,000 new cases of thyroid cancer diagnosed in the US annually. This represents 2.9% of all new cancer cases in the United States. The incidence of thyroid cancer is increasing. There are four major histopathologic types of thyroid cancer:
- Papillary carcinoma-including follicular variant of papillary carcinoma represents 75-80% of thyroid cancers.
- Follicular carcinoma-including Hürthle cell carcinoma represents about 15% of thyroid cancers.
- Medullary carcinoma-represents about 1-2% of thyroid cancers.
- Undifferentiated-anaplastic carcinoma represents about 1% of thyroid cancers.
There are other rare types of cancers that may be found in the thyroid including lymphomas , and metastases .
A Safe Less Invasive Way
The procedure, which has been used for years to treat benign thyroid tumors in Korea, Italy, Brazil and a handful of other countries, involves inserting a thin, needle-like probe through the skin of the neck into the troublesome nodule, said , MD, assistant professor of otolaryngology at Stanford. The probe is activated via a foot pedal, triggering radio waves that send an electrical current through the probe the heat then destroys tissue of the nodule.
Its based on radio-wave technology that has already been used in the U.S. to treat bone, lung, liver and kidney tumors, Noel said. It allows us a safe, less invasive way to intervene on a benign thyroid nodule thats causing problems without the risks of surgery and the need for hormone therapy caused by its removal.
Thyroid nodules are lumps in or on the thyroid gland. They are relatively common, and, in most cases, their cause is unknown, Noel said. About 50% of people in the U.S. over the age of 60 have at least one nodule. The vast majority of nodules more than 90% are benign.
Still, benign nodules can wreak havoc, she said. They need to be watched in case they grow and start pushing on important structures. They can also become unsightly goiters, which are groupings of several nodules that bulge from the neck. Some nodules can become toxic, like OBriens, secreting unwanted hormones that can cause a variety of symptoms, including a racing heart, difficulty sleeping, anxiety and irritability.
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Thyroid Cancer: My Story
In the fall of 2011, three months after my wedding, I began to experience some strange health issues including an irregular heartbeat and panic attacks. I was just 31 at the time, and I have always exercised regularly, eaten a well balanced diet, and have been very healthy. Since we had just recently moved to New York from Maine, my husband and I had not yet found a new doctor, so it was not until January 2012 that I saw my new primary care provider. He could not find anything via physical examination or testing to cause my symptoms. Fortunately, he did not give up looking. Although the results of my thyroid blood test had been normal, he observed that my thyroid felt perhaps a little bit swollen, so he sent me for an ultrasound of my neck. To my great surprise, my thyroid was enlarged and had multiple nodules growing on both sides of it. Soon after, a biopsy confirmed that I had thyroid cancer.
My initial reaction to the C word was panic and fear. But once I met with Dr. Lee, I was reassured that this was just going to be a bump in the road of life. I underwent a complete thyroidectomy in March 2012, and the only required treatment afterwards was a radioactive iodine pill. My symptoms completely disappeared, and a few months after surgery, my tiny 1-inch incision faded away.
My fingers are crossed that this will be the end of it, and the only reminders of this life event I will hopefully have are my faded scar and the pill I take each morning.
What Is Your Complication Rate
The answer you want to hear is the surgeons own complication rate for the procedurenot the average 1% reported in the medical literature. If the surgeon only does two thyroid surgeries a year and one patient had a problem, that makes it a 50% risk, said Roman. Dont be shy about asking for this information. Said Sosa, Its the ethical responsibility of the surgeon to report the truth and to know their own data.
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‘i Don’t Want To Die’: Surprising Fears About Thyroid Surgery
Interviewer: Angela M. Leung, MD, MSc Interviewees: David C. Lieb, MD Lilah F. Morris-Wiseman, MD
A young patient in a thyroid cancer chat room discussed his surgery that was planned for the next day: “I’m very scared. I don’t want my life to really end tomorrow.”
As endocrinologists, we frequently talk to patients who need thyroid surgery. We talk about how thyroid cancer is slow-growing and how most cases are successfully treated with surgery. We discuss surgical risks like voice changes and the need to take pills every day to replace the thyroid’s function and/or to supplement calcium. We tell them that they will quickly be able to resume normal activities. We ask them if they understand and tell them not to worry. But are we asking the right questions? Do we know what’s really worrying patients?
One study found that patients having thyroid surgery were most worried about voice changes, complications from surgery, and pain far more than they worried about returning to daily activities. Although deaths related to thyroid surgery are uncommon , patients may feel like their lives may be permanently altered from a surgery that we perceive as routine. So how do we best address these concerns?
What are some common concerns that patients have when they need thyroid surgery?
David C. Lieb, MD
Lilah F. Morris-Wiseman, MD
What about patients’ worry regarding their thyroid cancer? What is our understanding in this area?
Chronic Neck Back Hip Or Spine Pain
Common back problems such as sprains, strains and aches may not interfere with a bone marrow donation. However, you are not able to join if you have on-going, chronic, significant pain areas of the neck, back, hip, or spine that:
- Interferes with your daily activities AND
- Requires daily prescription pain medication OR
- Requires regular physical therapy OR
- Requires regular chiropractor treatments
If you have significant back problems and/or any questions regarding your medical condition, contact your local donor center.
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Kidney Transplant Patient Support
I am 2 yes 9 months post kidney transplant. Has anyone had issues with immense sweating that your hair is sopping wet? I thought it could be my thyroid but thats not it. Apparently my blood work is stable. Ive asked the transplant team, nephrologist and an Endochronogist.. no answers. I am wondering if it has anything to do if I have a UTI infection?
Hi there! Yes I have had intense flushing and sweating I was told that they cant prove its Tac but it seems to get better the longer you have the kidney .Dare I say it could your age be a factor?
It is for me.
Hi, yes sadly had it for quite some time after my transplant. Most embarrassing and uncomfortable but it did ease over the first few years had my thyroid etc checked but nothing showed up.Im now 32 years post transplant and am now enjoying the other hot flushes ladies get to enjoy!! Xx
Hi Dara. You may want to submit your medications for review by your transplant pharmacist. My husband had intense flushing/perspiration as well as itching from the drug Dapsone which was prescribed as a preventative for pneumonia. His doctors thought it was nothing, but the pharmacist figured it out quickly. While these symptoms are “lesser known” symptoms, they do happen with this drug and perhaps others. It’s worth checking out. I truly hope you find a solution!
Characterization Of Clear Cells
EM analysis showed that cells with clear cytoplasm had little cytoplasmic components, such as rough endoplasmic reticulum and fewer numbers of Golgi apparatus . Some clear cells had dispersed chromatin and a few dense neuroendocrine-like granules , reminiscent of immature C cells, and were surrounded by follicular cells . Another class of clear cells retained characteristics of follicular cells, such as those facing the lumen and having microvilli at their apical side . Capillary blood or lymphoid vessels were arranged next to follicular or clear cells. Some cells with follicular characteristics appeared to undergo cell death through autophagy . EM further demonstrated that dead cells were occasionally seen in the colloid lumens of many microfollicles, which were about to form a follicle . This appeared to be a way to generate a follicle in vivo.
Immunohistochemical analysis demonstrated that the expression of C cell-specific calcitonin was mainly localized in the proliferative area of the thyroid lobe regardless of PTx . Most of C cells are surrounding microfollicles, whereas some C cells intermingle within small epithelial cell nests . No calcitonin expression was found in cells with clear cytoplasm . In contrast, thyroglobulin was expressed in almost all cells of the thyroid gland with and without PTx . Interestingly, low amounts of thyroglobulin were noted in some of clear cells in partially thyroidectomized glands .
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How Will You Partner With The Rest Of My Medical Team
After surgery, youll likely need monitoring of your thyroid hormone levels and, in the case of thyroid cancer, follow-up treatment and testing. You want to know that the people taking care of different aspects of your thyroid disease or thyroid cancer are working together and communicating as a team, said Sosa. At Duke, weve created a clinic where you, your surgeon and your endocrinologist can meet at the same time, in the same place.
Who Is At Risk For Atrial Fibrillation
More than 2 million people in the United States have atrial fibrillation . It affects both men and women.
The risk of AF increases as you age. This is mostly because as you get older, your risk for heart disease and other conditions that can cause AF also increases. However, about half of the people who have AF are younger than 75.
AF is uncommon in children.
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What The Thyroid Gland Does
To understand why some types of goiter develop, it is first important to know what the normal function of the thyroid gland is and how it is regulated. The thyroid gland makes and releases into blood two small chemicals, called thyroid hormones: thyroxine and triiodothyronine . Each of them is comprised of a pair of connected tyrosine amino acids to which four or three iodine molecules, respectively, are attached.
The iodine needed for thyroid hormone production comes from our diet in seafood, dairy products, store bought bread, and iodized salt. Once absorbed, iodine in blood is trapped by a special pump in thyroid cells, called the sodium-iodide symporter. The thyroid also has several specialized biochemical ‘fastening machines,’ called enzymes, that then carry out the steps needed to attach iodine to particular parts of a very big protein called thyroglobulin, which is made only by thyroid cells.
Some of this thyroglobulin with iodine molecules attached is stored in the gland in the form of a gooey paste called colloid, which is normally located in the center of follicles, which are balls of thyroid cells with a hollow center.
How Is Thyroid Cancer Treated
The treatment of thyroid cancer depends on the type of thyroid cancer that is identified. It can involve multiple types of treatment including surgery, radioactive iodine, radiation therapy, chemotherapy/targeted therapy, and/or thyroid suppressive therapy.
Surgery plays a central role in the treatment of thyroid cancer. The goal of surgery is the removal of the tumor. There are several options for surgical procedures to treat thyroid cancer including:
- Total thyroidectomy-the removal of the entire thyroid gland.
- Near-total thyroidectomy-leaving only a small remnant of thyroid tissue with parathyroid glands, which are attached to the thyroid.
- Lobectomy-the removal of a single lobe of the thyroid gland in patients with small papillary thyroid cancers, a lobectomy may be appropriate.
If the thyroid gland is not completely removed during the first surgical procedure, the patient is always at risk for recurrence in the portion of the thyroid left behind. Additional surgery to remove the remaining portion of the thyroid gland can also be performed.
Supplemental Thyroid Hormone Therapy
Radioactive Iodine Therapy
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Russian Scientists Use First
Last March, we wrote about Professor Vladimir Mironovs 3D printed medical breakthrough: the worlds first 3D printed transplantable organ, to be used on a mouse. This week, it was reported that not only did the mouse thyroid transplant surgery go relatively smoothly, but that the 3D printed thyroid gland is completely functional. The news has exciting implications for the future of medicine, Russian scientists, along with the rest of the world, set their sights on 3D printing functional human organs next.
The Bioprinter they use consists of a robot that can move in three directions. It is equipped with an automatic syringe that drips fabric layers consisting of living cells. The mouses thyroid glad was 3D printed using stem-cells from its own fat tissue, which ensured that the new organ wouldnt be rejected by the mouse. We had some difficulties during the study, but in the end the thyroid glad turned out to be functional, said Dmitri Fadin, Development Director at 3D BioPrinting Solutions. They have already announced that given the great success of this surgery, they will be experimenting with 3D printing human thyroids as early as possible.
Appearance Of Krt14 Expression After Ptx
To obtain a further insight into the possible altered condition of cells other than epithelial cells of microfollicles and/or follicles after PTx, genes whose expression is not restricted to thyroid follicular cells, such as cytokeratins, were examined. Several cytokeratins are expressed in the thyroid gland . Among them, Krt19 is known to be highly expressed in human papillary thyroid carcinomas . In our immunohistochemical study, Krt19 expression did not differ between intact thyroid glands and those after PTx, although the expression pattern after PTx appeared slightly diffused . Krt14 is known as a liver progenitor marker and is expressed in immature and/or stem/progenitor cells, such as taste buds and prostate . Immunohistochemistry demonstrated that Krt14 expression was barely detected in normal thyroid tissue , whereas after PTx, intense staining for Krt14 was identified in a restricted area within the proliferative area of the thyroid lobe . Krt14-positive cells presented both mesenchymal and epithelial cell features some had trabecular and/or nested patterns, whereas others showed a basal cell pattern with spindle shapes . In addition, they had narrow cytoplasm and a high N/C ratio, features distinct from those of thyroid follicular and/or clear cells.
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Alteration Of T4 And Tsh Levels After Ptx
It is well known that hypothyroidism after thyroidectomy is due to the sudden loss of thyroid tissue. Accordingly, T4 and TSH levels were determined in mice at various time points after PTx . T4 levels were markedly reduced 2 d after PTx but returned to baseline levels after 7 d . In contrast, serum TSH levels tended to increase at 2 d and were clearly high at 7 d after PTx . At 2 wk after PTx, TSH levels declined but did not reach baseline levels, whereas T4 levels were slightly, but not significantly, lower.
Serum T4 and TSH levels measured at various time points after PTx. Cont means serum obtained from nonoperated normal mouse. Each dot indicates a mouse. Statistical analysis was carried out by ANOVA, and P< 0.05 was considered as statistically significant. NS, Not significant.
Holter And Event Monitors
A Holter monitor records the heart’s electrical activity for a full 24- or 48-hour period. You wear small patches called electrodes on your chest. These patches are connected by wires to a small, portable recorder. The recorder can be clipped to a belt, kept in a pocket, or hung around your neck.
You wear the Holter monitor while you do your normal daily activities. This allows the monitor to record your heart for a longer time than a standard EKG.
An event monitor is similar to a Holter monitor. You wear an event monitor while doing your normal activities. However, an event monitor only records your heart’s electrical activity at certain times while you’re wearing it.
For many event monitors, you push a button to start the monitor when you feel symptoms. Other event monitors start automatically when they sense abnormal heart rhythms.
You might wear an event monitor for 1 to 2 months, or as long as it takes to get a recording of your heart during symptoms.
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