>The PTU has not worked as well as they had
>hoped, and she still has erratic thyroid levels, and has recently been
>hypothyroid.

If she is hypothyroid the meds are working "too" well.

Are they just saying she needs the surgery so that it is eaier for them
as she would likely become hypothryroid and need thyroid replacement
then. Easier than dealing with fluctuating levels of hormones.

If she is not floridly hyperthyroid I don't understand why they need to
do surgery right now. If floridly hyperthyroid this can cause weight
loss, tremours, high heart rate. I have a patient who did not treat her
hyperthyroidism at all and then had a tiny stroke which she recovered
from completely. This is  very rare, and not likely if she is on PTU.

I do not know much about premedication before surgery but think they want
to shrink the gland and make it less vascular which will make the surgery
technically easier and less risky. They usually want to be able to see
and save nerves and parathyroid glands and this is more difficult the
more vascular the gland is.

Karen Cunningham MD CCFP

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