Medical records

It must have been my lucky day today because the lady at the medical records department printed out almost all of my medical records that I was requesting. It normally takes 15 days to process the request, and there is a copy charge, whether or not I have hard or soft copies made, but she just handed them to me. Nice!

I had a few minutes to read about half of the pages in the packet she gave me before my ultrasound. I finished reading the packet when I got home, going over a few sections of interest a few times. Below are some of the those interesting sections:

NM Thyroid Cancer Survey Post Therapy (date 7/12/2010)
Reason for Exam:  Papillary Thyroid Cancer S/P Thyroidectomy

** I saw the "PTC" reference on some paper work I signed before my RAI dosage. Still confused as to why my HCC, which was a much bigger tumor and a more aggressive form of TC, is not mentioned.

FINDINGS: On the five day examination, there is very subtle low level activity within the chest with no focal areas of abnormality seen. In addition, there is activity in the liver corresponding to circulating endogenous thyroid hormone.
In the neck region, there are multifocal areas of uptake. Specifically, there are two foci with fairly intense uptake left of midline and two more faint foci of uptake right of midline. The possibility of lymphadenopathy is raised.  11-day posttherapy scans demonstrate decreased activity in the chest. The areas of uptake in the neck are redeomonstrated.

**Holy smokes! "Intense uptake left of midline", that was still present 6 days later? My ENDO never mentioned that, only that there was questionable uptake in my chest area, hence the CT scan in August. The only thing I can think of is that the uptake, intense and faint, in my neck region means that some thyroid cells, cancerous or not, were sucking up the radiation. Lymph node involvement? - I think that is what the 'lymphadenopathy' term might mean. From what I understand, RAI has no effect on ThyCa in the lymph nodes. Not sure what to think about this.

ECG done before first surgery:
Marked sinus bradycardia
Abnormal ECG when compared with ECG of 08-OCT-2009 8:10, PR Interval has decreased
Questionable change in QRS axis

Bloodwork done on 6/29/2010, day before RAI therapy dose:
TSH = 67.44 (it had to be at least 30 in order for me to have RAI the next day)
Thyroglobulin = 0.8f ng/mL (range 0.0-63.4)
Thyroglob Ab = 0.9f IU/mL (range 0.0-4.0)

Bloodwork done on 8/10/2010, first draw post RAI, and on 175mcg Levoxyl as of July 3:
TSH = .25 uIU/ml (.34-4.82 -- range for non-ThyCans)
FT4 = 1.63 ng/dl (.51-1.20)
Thyroglobulin = 0.2f ng/mL (range 0.0-63.4)
Thyroglob Ab = 0.9f IU/mL (range 0.0-4.0)

**So my Tg went down, but my TgAb stayed the same. For the most part, I guess both are considered to be undetectable.

Footnotes from the Tg/TgAb test say this: Tg results less than 0.2 ng/mL are consistent with the absence of thyroglobulin-producing thyroid tissue. This must be why my ENDO told me last month that my Tg and TgAb are undetectable.
Also, as of 11/15/2010, the lab changed its' Tg to the Beckman Access method.

US Neck Soft Tissue 12/13/2010
The left thyroid bed is unremarkable. Within the area of the right thyroid bed, there is a focal amount of echogenic tissue measuring 9mm x 6mm.
A single benign appearing lymph node is seen within the right aspect of the neck. Two benign appearing lyumph nodes are seen within the left aspect of the neck.
Impression:
1. Focal echogenic tissue within the right thyroid bed. Although this could represent scar tissue, residual thyroid tissue or recurrent cannot be excluded.