PDA

Просмотр полной версии : Status after a resection of a thyroid gland



Jack
01.09.2004, 19:30
Dear Galina Afanasevna!

I ask your advice or council here on what question:

To my wife 16.12.2004 operation on a subtotal resection of a thyroid gland has been made. Indications to operation - a hyperthyroidism which 2 years unsuccessfully treated tablets.

After operation the doctor has appointed or nominated replacing dose of a L-thyroxine of 50 mkg, with the reference to pass to 100 mkg in 2 weeks. The status was good, a dose have increased only in a month after visiting the doctor and its or his demand.

The first analyses have handed over 12.01.05 (TTG - 0,82 - the doctor very much was surprised, has told or said, what is it, probably, a mistake or an error; 8,2 - more should resemble the truth)

Following analyses 15.02.05: TTG - 8,53, 3 - 1,42; 4 - 0,79

21.03.05: TTG - 4,43

Since this moment the status has started to worsen - the general or common malaise, some signs of a former thyrotoxicosis (an intimate or a cardiac arrhythmia). Have decided to lower a dose up to 75 mkg as dynamics or changes of depression TTG has seemed sharp. There were first signs of depression, an agoraphobia, panic statuses which have now amplified up to critical statuses.

Last analysis have handed over 21.04.05: TTG - 15,0; 3 - 2,51; 4 - 0,74

The status has already compelled or forced to address to the expert to the psychiatrist and the alternative endocrinologist. And here we have received absolutely different two opinions:

1. The endocrinologist - typical gipotiroz, is probably connected with use of a counterfeit L-thyroxine or a low dose (though it is complex or difficult to explain such sharp change of the analysis). Has registered Eutiroks 100 and Thyreocombum (1/2 tablets), has told or said to not worry and wait - with an establishment of a normal level of hormones, the mental status itself will quickly return to the norm or rate, any antidepressants to not drink, money for the psychotherapist have spent in vain.

2. The psychotherapist - the typical alienation caused or called by hormonal problems. It is necessary to accept urgently medical preparations (has registered Paksil), to visit or attend the expert, simultaneously restoring a normal hormonal level.

Now we operate or work under the first script, has passed or has taken place 2 weeks, but the status has not improved, even on the contrary.



I ask your advice or council - whether there is a certain technique at treatment of such combination of signs, i.e. who from physicians of the rights? Now, in a boundary situation, on a joint of two areas of medicine, everyone pulls a blanket on itself(himself) and tries to treat in the ways, but result it is not so visible.

In advance I thank.

Melnichenko
01.09.2004, 19:30
Normal job of a gland reflects normal TTG (optimum-0, 5 2, 0) and for 2 months

Melnichenko
01.09.2004, 19:30
Rasschetnaja dose 4 - 1, 6 1, 8 mkg on kg of real mass of a body.

Depressions amplify and caused or cause gioptirozom (that does not prevent to be it or him without it or him), and serdtsebienija-not a prerogative only tirotoksikoza.

Melnichenko
01.09.2004, 19:30
T.e gipotiroz d.b. It is compensated, psihiatr-either it is trained. Or it is replaced. I think. Irina Gennadevna (aminazinka) and Bill (Vladimir) to us will help or assist.

Jack
01.09.2004, 19:30
Good afternoon, thanks for the answer.

- whether correctly I have understood unique specification, what up to indemnification gipotiroza treatment by psychotherapeutic methods should not be spent? At gradual deterioration of a mental status it will be complex or difficult for making. Whether probably simultaneous application of antidepressants and 4?

Melnichenko
01.09.2004, 19:30
Thanks for the important addition (the computer badly worked, and I have passed or missed the important thing). Certainly, treatment at the psychiatrist cannot be cancelled, but the person understanding a situation If you a muscovite is necessary, write or Morgunovoj, or on a site diabet ru discuss a situation) (referring to our conversation) with d.m.n. prof. Starostinoj-in both cases we msmozhem to discuss a situation with constantly working with our sick psychiatrists.

Once again I shall ask our colleagues Irina Genadevnu and Bill to look at our conversation.

Jack
01.09.2004, 19:30
Thanks for the contact information. I have made bold and too have sent Vladimir and Irina Gennadevne personal letters with the request to comment on a situation.

Aminazinka
01.09.2004, 19:30
I do not know, how much or as far as the agoraphobia can be caused by a status of the thyroid gland, here dear Galina Afanasevna, you should fill a blank in my education if such communication or connection exists. Affective frustration and uneasiness can quite accompany hormonal disturbances. How panic attacks proceed? How the agoraphobia is shown?

Up to answers to these two questions and if to accept for the fact, that diagnoses are put internally by the psychiatrist (psychotherapist), I shall agree with necessity of purpose or appointment of a sedative antidepressant. Paksil - not a unique variant. Certainly, observation of the endocrinologist should be obligatory and long, but is similar, only its or his help for normalization of a mental status will be a little... imho.

Melnichenko
01.09.2004, 19:30
Thanks, Irina Gennadevna. No, for phobias we do not carry the responsibility. Depressii-please, manii-too (other I shall not be), and here fobii-is not present.

bill
01.09.2004, 19:30
Jack!

I join both Galina Afanasevne and to Irina Gennadevne.

Jack
01.09.2004, 19:30
I thank experts for answers!

I shall describe displays of a problem for Irina Gennadevny's the best comprehension:

1. Phobia to leave on street, even in a window it is enough view for offensive or approach of an attack of pavor in the afternoon. Impossibility to remain in loneliness.

2. At the general or common constant status of depression sudden panic attacks (at present nearby 5 in day) are shown - I can not describe sensation of other person, but as she said signs - is lost chustvitelnost extremities, own voice and sensations as though keep away almost *quot; you look at yourself with ?OO?U*quot; - as consequence or investigation of tear and a hysterics.

Serious deterioration has occured or happened for last month. In April still it was possible to leave sometimes in shop, to take a walk with a dog. Now about it or this speech does not go at all.



I shall try to address on contacts in Moscow which were given by Galina Afanasevna and to organize departure of the qualified expert the house.

Aminazinka
01.09.2004, 19:30
In Moscow with departure the house, in my opinion, problems are not present. And the intervention of the expert is necessary, after reading the description of problems I in it or this have affirmed. SHCHitovidka here at anything.

Concerning to *quot; panic aOa*quot; - I can not be assured or confident in this qualification of an attack. But it is precisely connected with mentality. It is necessary to understand internally more precisely.