After excision of share SHCHZH

[Scully]

Hello dear!



One month ago have removed left share SHCHZH (oksifilnaja an adenoma).



1. Simply in a bewilderment about what preparations should be accepted after operation. One doctor speaks only a L-thyroxine (25 mg.), another to it or him;them adds jodomarin, the third speaks - a L-thyroxine (50.), vitamins Tri_Vi and in no event jodomarin because he will provoke a new struma.??? At itself in a card has found following analyses before operation: (TSH = 1.88, FT4 = 15.76, FT3 = 4,56, TG = 45,6, A-TPO = 11.1) Can they are important at purpose or appointment of treatment.



Whether 2. There Is somewhere an approximate statistics of patients at which have removed only one half SHCHZH, and then it was necessary to delete the second?



3. This summer I completely should avoid hit of solar beams in area of a neck or not? Whether It is possible to float? The south - in general now the closed subject?



4. How soon after operation it is possible to be engaged in various physical exercises?



In advance I thank you. Very much I hope for your consultation. Excuse, that it is a lot of questions. But simply for me this operation was the most awful stage in my life. I am afraid up to horror of any consequences. And very strongly frightens, that different doctors appoint or nominate absolutely opposite.



Yours faithfully.

[Melnichenko]

Dear Skalli!

Oksifilnaja alenoma - the good-quality monoclonal tumour, and, unlike a nodal colloid struma, after its or her excision is not required obligatory reception of preparations of an iodine - iodomarina and so forth as body height of this adenoma is not provoked by shortage of an iodine.



At the same time it would be a pity, if the remained share was exposed to the problems connected with shortage of an iodine (as well as any inhabitant of Belarus, you do not receive with nutrition enough iodine), therefore, as well as to any other inhabitant Belorusssii, you it is necessary to cook food on iodirovannoj salts.



Reception of a thyroxine (I shall notice in brackets, that this preparation is dosed out in mikrogrammah-mkg, instead of in milligrammah-mg), is obligatory, if the remained share does not cope with job - over 4 below norm or rate in 2 weeks or TTG above norm or rate in 2 months after operation.

TSl treatments in such sluchae-maintenance TTG in normal limits.

Theoretically oksifilnaja the adenoma cannot and should not recur, and reception of a thyroxine with the purpose of prophylaxis of relapse is not necessary, at the same time there is small, but well constructed research which has shown expediency of reception of a thyroxine and with the purpose of prophylaxis of education of adenomas (adenomas voobshche-not their concrete kind).

If your doctor will have still questions, shall be glad to respond. The reasons of various references in your situation have a subjective basis if you are more senior than 20 years.

Interdictions on reasonable physical activity are not present.

[Scully]

Dear Galina Afansevna! Many thanks for consultation. As it actually is healthy, when it is possible to receive explanatory or sensible answers to exciting questions from the expert.



It still more some voprosikov?:



1.

As body height of this adenoma is not provoked by shortage of an iodine.





I am now simple a lot of literature I search on this subject. And nevertheless I can not find, and than education of such adenoma is provoked? And how quickly she grows?



2. At me it or her have found casually, I did not pay attention that sometimes seemed that is any *quot; not Oa*quot; a lump in a neck? Is more often she develops into a cancer or can *quot; ??Oy*quot; all life? Now doubts and why so have urgently directed on operation simply come?



3.



Reception of a thyroxine, is obligatory, if the remained share does not cope with job - over 4 below norm or rate in 2 weeks or TTG above norm or rate in 2 months after operation.





Whether instead of it will be strong to be checked late in 3 months? Through such time to me have told or said to come on reception and to hand over analyses?





The reasons of various references in your situation have a subjective basis if you are more senior than 20 years.





To me it is just equal 20;)



4. Galina Afanasevna, resolve still, please, our dispute with mum in occasion of the sun and the south. We find absolutely opposite information on it or this in occasion of.



5. I am am confused a little with that after operation I began to get tired more somehow. Often by the evening I feel low, it would be desirable to sleep, after study the head often hurts. Earlier especially such did not observe. Whether it is normal?



Still time of many thanks from me and my mum. Yours faithfully.

[Melnichenko]

. The output or exit knocks in and-is not present, therefore otchechu is fragmentary.

*quot; our dispute with mum in occasion of the sun and the south. And quot;

Unlike people which knows, that the sun and shchitovidka are incompatible, at medicine is not present the slightest data about a harmful role of the sun at faces with various zabolenvanijami zhelezy-and anything distinct from idei-plentiful zagra is fraught with problems for everything, and hozhlenie in a heat under a umbrella or parasol typically for nevrotizirovannyh young women we shall not tell or say.

*quot; I am am confused a little with that after operation I began to get tired more somehow. Often by the evening I feel low, it would be desirable to sleep, after study the head often hurts. Earlier especially such did not observe. Whether it is normal? *quot; - we shall discuss after data acquisition TTG.

[Melnichenko]

*quot; And nevertheless I can not find, and than education of such adenoma is provoked? And how quickly she grows? *quot; is a random error at division of a cell, a mutation. You do not have sense to search for the answer for the decision individaulnogo voprosa-it not Chernobyl.

Rates of body height are not prognosticated.





*quot; At me it or her have found casually, I did not pay attention that sometimes seemed that is any *quot; not Oa*quot; a lump in a neck? Is more often she develops into a cancer or can *quot; ??Oy*quot; all life? Now doubts and why so have urgently directed on operation simply come? *quot;

Adenoma deletes objazatelno-for only on opreratsii it is visible, what is it actually an adenoma (there is no germination in a capsule and vessels), instead of the initial stage raka-is germination. In the far future we shall learn to distinguish these processes on biopsies and the approach can become another.

[Scully]

Many thanks from me and my mum for answers, Galina Afansevna.



It would be desirable to learn or find out still: and how define or determine a dose of a L-thyroxine after operation if I, for example, did not hand over any analyses on hormones after excision of share SHCHZH?

[Melnichenko]

TTG a pituitary body reflects a status of a thyroid gland for the expired two months. T.e I in two months shall ask TTG - and how there the gland at Skalli works?

Answers - yes not so (TTG it is more 4), nazhdo urgently to fill a stock of a thyroxine.

Like normal, but it would be desirable is better (from 2, 0 4, 0) - especially. Brazilians like have shown, that.. (I already wrote it). And the Brazilian. It is shown, with such our surname - Nepomnjachy...

Bleks as it is good (0.5), well it or him. The Brazilian...



Here mum and govorit-well we 2 months shall wait - and more quickly it is possible?

In 2 weeks it is possible to look or see over 4.

[Scully]

Thanks for answers, Galina Afansevna.:)



I shall soon hand over analyses and then, probably, there will be new questions.



Was recently on reception at the endocrinologist, she up to mors has frightened me: feels my right not removed share and speaks: *quot; Oh, and what is it at you for the site such huge??? *quot; I speak: and quot; Generally the left share Ona????*quot;. She looks in a card and speaks: and quot; And, precisely... *quot;



And at me nervous failure.: (Sorry for offtopic.



Yours faithfully Scully.

[Scully]

I welcome you, Galina Afansevna, again!

So, two months after excision of share SHCHZH has passed or has taken place. Wished to learn or find out, that it is necessary to hand over now. As I understand: the analysis on 4, TTG and US? It or this will be enough?

Yours faithfully Scully.

[Melnichenko]

Izbytochno-US what for?