We are seeing a pregnant woman who has a very large thyroid, large protruding eyes and elevated T7. She is about 35 weeks and is taking 16 tablets of PTU a day and her T7 is still elevated, but she started having other symptoms such as nervousness as her levels are coming down. She is not particularly thin and has gained weight during her pregnancy. She is very low income,non-English speaking, not eligible for Medicaid due to resident status, resources are limited in terms of referrals, she is being watched by an OB. There is concern about her having a thyroid storm during labor and also fears about use of any anesthesia in labor, she was seen by a doctor in another country several years ago for this "growth" and was reassured that it wasn't a problem- so it is long-standing. She would like to breastfeed, but is uncertain about who will be caring for her after delivery and also what medical treatment swill be done will be done. She doesn't like feeling so jittery and does not like taking so many pills. We are unsure of her pharmacologic options and their compatability with breastfeeding and also any threat to her health. We can probably find a physician who is willing to review any ideas, thoughts or suggestions you have to share. This is way outside my area of expertise, but I would like to provide resources for her. I would appreciate any help. Thanks, CAthy Liles