Norah and I headed to Children’s today at 6:30 a.m., which turned out to be quite early for an 8 o’clock appointment since the traffic wasn’t bad at all.  We were inside the hospital by 7:15, and since Norah couldn’t eat for 2 hours before her test (she got up early and ate breakfast with Ben), we just hung around watching Max & Ruby until it was time for her to drink the iodine cocktail.

It was actually just a tiny oral syringe of iodine, not the kind your mom used to paint your cuts with.  She drank it with no problem, but I was surprised to find out that we had to wait 4 hours before she had the scan, rather than 2 hours.  The technician also told me that she would have to hold still for 15 minutes per scan, and that there were 3 scans.  I obsessed for most of the 4 hours about how I was going to keep Norah still for 45 minutes+.

We went to my office and I got a bit of work done while we waited, although Norah’s hyperactivity makes it hard to get much accomplished.  The high metabolism doesn’t help either because every car ride involves a stop to poop.  Any behavioral progress or boundries that may have existed before have been wiped clean by hyperthyroidism.  My old boss Reyn, now one of our vice presidents, came into the office and she immediately started feeling around in his pockets!

I shouldn’t have worried about how to keep Norah still during the scans because everyone at Children’s is a pro.  Diane and Joanne laid her out on the machine, took the initial scan which was just a few seconds, and then 3 scans at 60-90 seconds each.  Diane had her hands on Norah’s head just to remind her not to move, and Joanne moved the machine to take scans from the front and each side.  The were very impressed with Norah’s ability to stay still and quiet, and so was I.  A dozen stickers later (and a balloon), we left Children’s for the second time today.

Norah is headed back with Ben tomorrow morning for a 24-hour scan.  The scans measure how much iodine is in her thyroid gland, which will help the doctors decide whether Norah has Graves Disease or Thyroiditis.  If it’s Thyroiditis, her thyroid won’t absorb much iodine.  Once the diagnosis is made, they will work on the treatment plan.  We have an appointment next Monday but Dr. Fleisch just emailed me to say we should have some test results by Thursday at the latest.  I hope so.

P.S.  When I told Norah that we were going to the hospital she said, “I want to go see Dr. Fleisch.  She’s so nice.  And her husband is nice too.  Ben’s really cool.”  Ben’s either a med student or intern or some sort of doctor-ish guy.  I’m pretty sure they’re not married.  🙂

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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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