I am a new reader, and ordinarily would lurk longer but
my 20 year old daughter is scheduled to undergo a partial
thyroidectomy at the end of the month. She is also subscribed
but is busy with finals, so I will try and explain her story.

Last year the school nurse noticed she had some symptoms of
hypothyroidism. She went to her primary care doctor, but the
blood tests were fairly normal, and more indicative of hyper
than hypo thryoidism. My daughter Liz is a singer and was
about to leave on European tour, so we went to an older endo
rather than the one her doctor recommended. It was at that
time that they first noticed a goiter, altho that was not
why she had been referred in the first place. He did some
prelim tests, radioactive scan and biopsy before she left
for 3 weeks. While she was gone, the thing became at least
3 times bigger. However, her blood tests were all over the
place. The doctor basically could not figure out what was
wrong with her, and tried suppressing the growth with a
small amount of Synthyroid which seemed to work briefly.
Liz still was left with brittle nails, being cold and
tired, a 45 lb. weight gain and a constant pain in her
throat. This went on most of last year, while the guy
accused her of exaggerating her symptoms.
Finally, we decided to switch to the young endo who had
orginally been recommended. Liz and I saw him about a week
ago and he was very good at explaining things. Since the
nodule had been drained several times, hemorraged and
also had tissue breakdown he thought she should have
it removed as soon as possible. He wanted all of it
taken out. As soon as the nodule was drained it
almost immediately grew back to 1/3 its size. Liz
wanted to wait until June when finals were over.

We were referred to a surgeon and met with him. He
is a well qualified thoractic surgeon. He wanted to
take out only 1 lobe, esp. to avoid problems with
parathyroids and vocal chords. We asked his stats,
and he said he did about 50 per year, with appx.
5 per cent complications.

Liz's prof of anthropology has a brother who is an
endo in San Francisco. He strongly thought that Liz
should go to an endocrine surgeon and set up a 2nd
free consult with a dr. who is one of the big specialists
in the country which we have not as yet sat up.  His
complication rate is .5 or less, so it is very significant
since hoarseness would have big consequences for Liz.
He also mentioned several ways in which the vocal chords
can be damaged in a much clearer way than the PA surgeon.
He thought that when Liz had her first drainage an ultrasound
should have been done. Is this usually done before surgery?
It has not been mentioned by the surgeon.

The problem is how to we get the insurance company to
approve the need for this. I have been trying to locate
statistics regarding complication rates, etc. I am I
librarian, but certainly do not have experience using
Medline, etc.

This has all been a very frustrating experience, and Liz
is just tempted to get it over with, but we would like to
hear what experiences others may have had regarding surgery
and complications. It is funny that we live in Palo Alto
near Stanford Med Center but the first endo we went to
complained because I had looked treatment up on the net.
Sorry this is so long. I wish I had found this group sooner.
Margaret Snyder