Lumpy

Norah and I left for Children’s Hospital at 11:30 this morning and arrived home at 6:30 tonight.  It was a long, tiring day, but the doctors and the rest of the staff were great.  Norah’s ultrasound showed that her thyroid is indeed enlarged, but it didn’t show a separate nodule or anything unusual beyond the fact that her whole thyroid is BIG.

After the ultrasound we met with a fellow and a resident in the endocrinology department.  I wasn’t sure what a “fellow” was (Dr. Abby Fleisch is definitely NOT a fellow in the gender-related sense of the word), so she explained that she had gone to college, gone to med school, completed her 3-year residency in pediatrics, and is now doing a fellowship in endocrinology.  She works with an attending physician who we also met with.

During our time in endo, there were at least 10 people who came in to check out the lump because it’s so unusual to see on a 4-year-old or really any kid younger than an adolescent.  Norah was so cute, lifting her head to show off her lump.  We had talked a lot about what she should expect at the hospital, and that she would be seeing new doctors there, so when we were sitting at Au Bon Pain surrounded by medical staff on their lunch breaks, Norah threw her arms open and said, “Are THESE my new doctors??”

There are basically two possibilities since the ultrasound didn’t show anything definitive.  One possibility is Thyroiditis, which would go away on its own.  If that’s what she has, she’ll take medicine for her high blood pressure until the thyroid issue resolves itself, at which point the rest of the symptoms would resolve themselves too.  The other possibility is Graves Disease, which is an autoimmune disorder.  Graves Disease would be treated with medicine to reduce the amount of thyroid hormone, which would resolve the other symptoms.

The trick is figuring out which of these is the cause.  More blood work was done today to look for specific antibodies.  On Monday Norah will have to drink some iodine and 2 hours later will have a scan to see how much iodine has been absorbed by her thyroid.  The next day she’ll have another scan to check the iodine in her thyroid again.  These test results should confirm one cause or the other, which will determine the treatment.  Meanwhile, she will be on a low dose of high blood pressure meds.  Her blood pressure is not high enough to be an emergency, but it’s pretty high.

I probably won’t have more to report until the middle of next week.  Thank you to everyone who called, emailed, and texted to ask for news.  Everything’s fine.

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