Found thyroid nodule, is CNB the correct method to determine if benign or malignant?

I am a 33 y/o Caucasian female with no family medical history of thyroid issues or thyroid cancer (family medical history: my father has diabetes and bipolar disorder, my sister and I myself have bipolar disorder, and there are no other significant medical issues in the family). In May 2016, my GP suggested I get an ultrasound for a thyroid nodule on the right side of my thyroid that she discovered during a routine physical exam. I had the US in June. According to the US report, “The right thyroid lobe measures 5.1 x 2.1 x1.9 cm. The left thyroid lobe measures 3.3 x 1.1 x 1.6 cm. There is a 4 mm nodule in the right mid gland. There is a 2 cm nodule in the lower pole of the right thyroid lobe. Impression: A 2cm nodule in the lower pole of the right thyroid lobe. Ultrasound guided fine needle aspiration suggests an established diagnosis.”

I then had a fine-needle aspiration biopsy (FNA) in July. The results came back “atypical” (I don’t have them on hand right now, but I can send them to you). I then consulted with a thyroid specialist, who recommended a partial lobectomy to establish a diagnosis. I have been doing some research into the medical literature (via PubMed, etc) and it sounds like perhaps a core-needle biopsy (CNB) may provide a more definitive diagnosis and help me determine if I should go the surgical route or not (if the nodule turns out to be cancerous or precancerous, I will of course go with surgery, but since it’s atypical and it could turn out to be malignant or benign, I would like to exhaust any other options available in determining the diagnosis before electing to have surgery). I also had blood work done in May. TSH and (TPO) Ab and T4, Free (Direct) were in normal ranges (TSH was 1.420 and (TPO) Ab was 9 IU/mL and T4 was 1.36) and TgAb was a little high (2.1 IU/mL). Everything else (CBC w/diff, CMP, lipid panel) came back normal. Can you help, please? Happy to send you the US and FNA results. My question is: Would you recommend CNB or some other method to determine if the nodule is benign or malignant besides surgery? I just want to exhaust all my options if I can.


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IV inserted in jugular vein is causing vision problems and pain in back of head?

i am a 32 year old female and last week i was taken to hospital and admitted and kidney stone got stuck in my urethra and infection started backing up , they had to put a stent in there to get the infection out …so now im out of the hospital and i am having problems from the site of IV the ambulance put a IV in my juggler vein and now a lot of pain is coming from there all the way up to the back of my head , my ear hurts muffled sounds in that ear black floating dots in my vision and my head hurts and i cant think straight. please tell me what you think is going on?


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I suffer from digestive issues, doctor has no answers?

I am 23 y/o male and suffer from digestive issues for around 2 years. Here are the symptoms: yellowish stool, very smelly and floating. Tiredness and inability to sleep past 2-3 am. Acne and skin issues. Brain fog. Occasional 1-2 times a month stabbing dull pain in liver area, especially after meals containing lots of fat(think bacon, eggs, avocados).

So far, I went to do tests and I have elevated ALP at 150(upper limit 125). ALP is always raised, I had 4-5 liver tests in 5 months period and it is always above 140. Other liver enzymes and bilirubin are normal. Doctor ruled out bone issues connected to ALP. Vitamin D level is well above normal. Ultrasound shown no abnormalities in hepatic region. Doctor said he hit the wall with testing and I suggested to inspect hepatic region with more details. Is it wise to go for CT or MRI? Raised ALP can be either due to bones(ruled out) issues or liver.

Can I get advice regarding this? I feel constantly tired, have bad sleep and skin issues in addition to digestive problems I mentioned.


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I have burning sensations on my chest and whole body, had false diagnosis, need second opinion?

I am a lady of 34 years of age, i have no medical history nor taking any chronic condition. i have been consulting with different doctors for same symptoms for 6 months now and till to date i still have not found a solution. i have burning sensations on my chest and whole body at times, i get dizzy and my body itchy, shortness of breath, tight and stiff tight muscles on my chest in the morning and night. i was diagnosed with bronchpneomonia but it was false diagnosis said two doctors, they suspected Gastro and send me for G-scope which came out fine. no trace of ulcer just that my body is producing too much acid, hence i am burning. My body is in so much pain at night and in the morning, i did different tests and all came out good.


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Lost 30 pounds in three months nausea every time, they still can’t diagnose me?

Been to 2 GI docs & internist had blood tests, HIDA, ultrasound CT abdominal scan CT angiogram of the abdomen colonoscopy… He could not get all the way past the first curve even with pediatric instruments so had G.I. bariatric enema, stomach emptying test and they still can’t tell me anything the CT showed right kidney atrophy …atelectasis of lower right lung. Symptoms are lost 30 pounds in three months nausea every time I eat quickly full cannot eat barely anything anymore get sick every time i Eat, heightened sense of smell extreme exhaustion hiccups belching, changes recently… I have severe thyroid hormone resistant disease . They still can’t diagnose me and I’ll getting sicker and I’m sick all the time it’s debilitating


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My mother in law is bedridden, shaking, incontinent and virtually sleeps all day, no one seems to care?

My 76 year old mother in law was put on Abilify last December due to bi polar disorder, paranoria, psychotic episodes. Afterward she seemed to develop shaking in her hands, that progressed to her head, literally severe tremors, along with muscle weakness. It then developed into a complete inability to walk or function. She is now bedridden, incontinent and virtually sleeps all day. At the beginning of her diagnosis she had white matter degradation, diabetes, high cholesterol, thyroid disorder, high blood pressure and irregular heartbeat but other than the psychotic episodes which became more frequent, she was functional, mobile and able to hold a conversation. She has had 2 ER visits to the local hospital in PA, where they ran a battery of tests, could find nothing wrong and discharged her. Her physician does not care, and told us she is of sound mind and body (completely laughable.) The hospital psychiatrist who placed her on the Abilify only treats those patients in the hospital mental health ward. He will not see or consult on outside patients even if he saw them while they were previously in the hospital. We have attempted to transfer her to another physician but zero anywhere nearby are taking new patients. Its a catch 22. Her physician recently took her off the Abilify cold turkey which seems to be counter indicated, but there is zero improvement. She was placed in assisted living by her psychiatrist last December, one of the conditions of discharge, as she was attempting to injure my father in law. The nursing staff is baffled and frustrated. We, as her family, are equally so. Any ideas or advice? She is also on Glipizine 10mg 2x per day, Metropolol Tartrate 25mg daily, Lisinopril 10mg daily, Levothyroxine sodium 100mcg daily, Coumadin 5mg daily, Divalproex 500mg 2x daily, Atorvastin Calcium 10mg daily. It as if no one cares, and she is not up for travel. I am wondering if we should try to check her into a larger hospital 60+ miles away?


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Pain behind right eye, blurriness, headache, sinus pain?

47/f
asthma 38 yrs Albuteral inhaler taken 1x/week average
Cervical disk disease w/ arthritis
Lumbar stenosis, sciatica, osteoarthritis ibprofren 4 X/mo average

dull ache behind right eye started 8 days ago. Level 4 pain when light pressure is applied started 4 days ago. Sometimes sudden sharp pain in right eye with movement to left and downward and sometimes without movement started 4 days ago becoming more frequent. Dull ache always present. White flashed seen twice. Some blurriness right eye. Constant headache level 3 pain. No relief with ibprofren 800mg/dosage

I’ve had what feels like sinus pain on right side for over a month. No drainage but level 6 pain inside nose when pushed on slightly. Pain shoots to ear, teeth, jaw, neck level 4-7 pain. No fever but sometimes low temp 96 my normal is 98.6

My doctor left the practice. I was not notified. Urgent care does not have proper DX support.


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In hospital now for 3 weeks for bacterial infection, hematoma, antibiotics not working, can you help?

Age 64, Male, In hospital now for 3 weeks for bacterial infection. Was given Heparin for clots in right leg that I had surgery on last year for bypass surgery. While on heparin, now have a hematoma that is bleeding. Was on Ventilator for 3 days, then was breathing on own. Today on CPAP. Kidney functions stopped. On Dialysis. Rectal tube in, bed sores. Can’t move. Prior to hospital was in terrible back pain. Found a mass in pelvic area that was drained. Have been on antibiotics and not seeming to help. I don’t want to die yet. Can you help?


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I have chronic lumbar back pain, would surgery make me regain a healthy life?

I am 57 year old male residing in the upper midwest. I’ve had chronic lumbar back pain since 1995 approximately and carpal tunnel, in both hands, since 1993. In 2004 I was hit from behind by a speeding truck, adding chronic cervical pain to my cocktail of chronic pain conditions.
Two years ago I was informed by a neurologist I saw at the time that I might need lower back surgery. However, he proposed an initial treatment regimen consisting only of epidural steroid injections for both lumbar and cervical infractions as well as streoid injections for both hands.
Then he suddenly resigned and I have not had access to a neurologist since then.
You can see from my age that I’m about past what I consider child-rearing age in that I badly want to start a family but my condition makes that impossible because I can only lie comfortably on my back and stomach for approximately 10 minutes, at times a bit longer or shorter.
My point is that sexual intercourse is and has been out of the question for me for two decades.
QUESTION: What are the chances that surgery and/or any other medical procedure will make it possible for me to enjoy sexual intercourse in the immediate future?
I am currently taking: Nabumetone, Gabapentin, Amitriptyline, Tramadol, Flexiril, and Citalopram


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Arthrosis of the hip joint (coxarthrosis), are my running days over?

Arthrosis of the hip joint (coxarthrosis) and running?
I am a 32 years old male, and my diagnosis is arthrosis of the (right) hip joint – coxarthrosis. I am a marathon runner, and I also swim and bike. My orthopedist told me that this condition is not caused by running, but genetic (hereditary factor).

I have a “simple” question: Is my running over?

arthrosis-of-the-hip


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I have pain, discomfort, almost non-stop frequent urination, my life has become miserable?

I’m at my wits end. My quality of life has become miserable. Pain, discomfort, almost non-stop frequent urination, that also triggers the urge to defecate regularly, ultra sensitivity in my penis , especially the head, blood and matter that come often after the normal urine flow, and a great degree of difficulty to sleep from the accompanying symptoms – even sitting can trigger the urge to urinate. I can get a short term relief from a hot bath, but that seems to be losing its effect as time goes by. I live with a urinal always close at hand and when I use the toilet my stream is erratic and unpredictable.

The second urologist I’ve seen since July, has treated it with meds and did a green light laser trimming of the prostate, to rule out that it was not a prostate blockage, and the colonoscopy shows my bladder holds such little fluid, but does always empty. It just got worse and he then looked at it as a bladder irritation, and did two other courses of meds including Vesicare and it just got worse.The colonoscopy showed my bladder holds virtually no urine – less than one fifth a normal male. I also was treated for yeast twice in this period. The first urologist I saw back in April this year had a CAT scan that revealed a large kidney stone and only wanted to treat that, so it made no sense and hence I saw the second doctor who also concurred with me. Also, defecating has become strained and accompanies irritation to the penis, and I see blood and bloody matter in the urine, like clots or something and I’ve addressed this matter, but the doctor still sluffs it off as from the laser surgery which was done almost five months back, and is now more frequently occurring.

After many visits and med treatments this urologist agreed we should try an InterStim trial, and I was prepped to do that Dec. 5th, but because they did a phone pre-op rather than at the hospital they overlooked that I was a candidate for MRSA and VRE. They confirmed no VRE at the time, but since they’d swabbed my nostrils already they postponed the surgery till I came back to get checked for that, and it was positive , so surgery was postponed. That aggravation caused me to write a detailed letter to the management of the urology clinic, and after conferring with her we agreed to try another urologist at their clinic, who I’ve seen once now.

To put it mildly , since my first visit with this this urologist in July the urination frequency, has increased and is always uncomfortable to pee, and and the stream is eradicate. I live with varying degrees of pain and discomfort , from mild to breathtaking, and I am a constant captive of the bathroom and a urinal by my bedside . The doctor informed me the prostate surgery trimming went well, but has ruled that out as the basis of my problem. My quality of life now is zilch.

Don’t get me wrong, because I believe the doctor has acted quite professionally. He’s been quite aware that my primary concern is the lack of quality of life I’m now experiencing, and he acted conservatively, trying every pharmacy treatment available, unfortunately none doing the job. Which led him to the next option of the InterStim trial.
One thing that I think the doctor failed was not paying as much attention as I possibly felt needed to be addressed is the severity of pain and frequency which has only gotten worse over the time in his care. Every urination is uncomfortable and I’ve told him that when I really push hard to empty my my bladder is when I get serious nerve and pain aggravation that largely emanates as stings in my penis and privates, and almost always there is some blood and matter that follows. The pain becomes harder and harder to subside as the days go by. Also, I see many of these refuse-like bloody looking pieces along with this, and r occurrence that many times it causes a response to have to defecate. My sleep has been seriously disrupted, and I get up and down and pee into a bedside urinal throughout the night, not to mention the day as well. I can pee as many as 3-4-5, even more, times per hour. One visit I directly asked the doctor if it might be some kind of bladder cancer and at first he said I don’t think so, then matter of factly stated it wasn’t, but as far as I know there has been no testing to verify this. It scares me to see more blood and refuse now than even shortly after the laser surgery of the prostate, although he more or less wrote this off to the healing from that prostate trimming.

To have heard I still carried MRSA was another emotional setback being I barely survived a septic shock in 2013 that had me hospitalized for months and shut my kidneys down. I was on dialysis at the hospital and a year on home peritoneal dialysis at home, but fortunately my kidneys recovered enough to be taken off and am considered chronic renal rather than end stage renal.

So my question is how would you proceed from here given this information. Thank you.

Trying to conceive but no success, need solution?

We are married for approx 4.5 years and trying to conceive since then but no success. We started treatment for same around 1 year ago. My sperm count are 15 mill/ml. My wife’s AMH level is 0.68 ng/ml and FSH is 13.35 mIu/ml We tried two failed IUIs. Due to my low sperm count and her low AMH levels our doctor is suggesting for OD IVF for successful IVF. I do not want to go with donor egg IVF at this stage. I see it as a last resort only. What option do we have? Can we do IVF with my wife’s egg? I did some research on internet and found AMH test is relatively new and it only predicts about overian reserve not about the egg quality. Even, women having 0.1 AMH have conceived naturally. I found if she takes following contents for 3 months her egg quality and hormone levels can be improved. DHEA, 25mg thrice a day. CoQ 10, 100 mg daily Folic Acid 1mg/day Greens: wheat grass 2 shots/day, or, spirulina 3000mg/day Omega-3 2000mg/day Vitamin D 1000 IU/day Can you please prescribe for above contents and also for improving my sperm count? I plan to do AMH test again after taking medicines for 3 months. Regards


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I am concerned about my aortic valve and pulmonary valve peak gradient, need second opinion?

40yo female born with a congenital heart defect. Had a Ross Procedure in 2000 to replace a bicuspid aortic valve with my own pulmonary valve. In 2007 the surgery had failed and I had a pulmonary valve replacement, tricuspid repair and a right ventricle patch. I experience shortness of breath upon exercising and when laying down. My ECHO, according to my cardiologist, says everything is fine and my shortness of breath has been diagnosed to be allergies. I do have a concern about the my aortic valve peak gradient and my pulmonic valve’s peak gradient. My ECHO in 2014 showed that my aortic valves peak gradient was 12.3mmHg, peak velocity was 1.8m/s and mean gradient was 7.8mmHg. Last month my aortic valve’s peak gradient was 5mmHg, peak velocity was 1.1m/s and mean gradient is 2mmHg. My pulmonic valve’s peak gradient in 2014 was 33.6mmHg, peak velocity was 2.9m/s, and mean gradient was 19.7mmHg. This year my peak gradient is 26mmHg, peak velocity 2.5m/s, and mean gradient 13mmHg.

My cardiologist says everything looks great, but come of those numbers have changed a lot. Why are they not concerned with some of those numbers? Also, my EF was 61-65% in 2015 and is now 50-55%. Did the numbers improve or get worse?


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Bleeding from anus, blood in urine, pain in lower back

i am 51 years of age reason for contacting you is i am pretty worried because i am bleeding from my anus i have to put toilet paper or something there as it seeps out and when i go to the toilet there is a lot of blood in the toilet there are clots in it to the color of it looks like beetroot and i have been passing blood in my urine but it is not as dark as what i have coming from my bowels ,i have had pain in my lower back around my kidneys i know i don’t have a urine infection as i don’t need to wee all the time ,i have been getting jolts of sharp pain on my appendix side of my abdominal area i but i had my appendix out along time ago .about six to eight months ago i was passing blood but it started happening again about 4 maybe 5 days ago i don’t have any pain whilst using my bowels or when i am passing urine i have been feeling very tired and lethargic i have not felt sick like vomiting or anything like that i have been getting a lot of head aches i know its not piles there are no lumps or anything like that at the entrance of my anus when i get the sharp pain on my lower right hand side its a real sudden sharp jolting grabbing pain i haven’t seen a doctor for a very longtime its been years and years till a week or two ago as i hurt my right hand pretty badly its on the mend now though i am not on any medications my only allergy is to horses


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