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@@Lawyersadvise1 that varies amongst patients. It depends on how abruptly they go into menopause or is it progressive. If they abruptly go to menopause, the hot flushes tend to be worse if they slowly go into menopause appeared the time that flushes are not so severe but overtime, they get better and go away. Every patient is different symptoms can last anywhere from six months to a few years

Thank you, David. Our goal is always to be on the cutting edge of medicine.

Glad you think so!

You're welcome!

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I would recommend you follow with a repeat ultrasound in about 3 to 4 months. Lymph nodes are not uncommon specially after infections or a viral illness. Lymph nodes are more suspicious, especially if there’s a history of thyroid cancer, which you do not have according to your description. Therefore follow-up repeat ultrasound in a few months would be recommended unless the ultrasound characteristics of the lymph node are suspicious, which I cannot tell based on the size.

Thanks Doc

Vaginal estrogen only helps with the vaginal dryness and does not typically help the insomnia . Insomnia is very much correlated with how much hot flashes lingers over time the less hot flashes, the less insomnia

@@Pezhman101Not true. Not every woman has hot flashes and those that don’t can still experience insomnia during perimenopause and menopause.

@@jt8142 exactly not every woman experiences hot flushes. Insomnia is mainly secondary to the hormone changes and overtime. It improves, but in some patients it takes a long time.

This procedure should not be painful if use the appropriate and neck, anesthetic approach and conscious sedation technique specially with large nodules. Our experience is completely the opposite. Our patients are very happy and satisfied with the procedure..

Radio frequency ablation can be a viable option if your tumor is 1 cm or less or larger as long are clear margins. One via late thyroid, tumors, specifically, papillary thyroid cancers we need to blade the margin of the tumor to ensure eradication. Therefore, the margin cannot be attached to vital structures. If it is close to a viable structure we will then use a technique called Hydro dissection to lift the tumor away from the structures temporarily while we ablate the margins.

@@Pezhman101 Thank-you so much for answering me it means a lot as I was totally confused between RFA and surgery. The nodule is 9×7mm on the junction of left thyroid and isthmus.

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Cyst has the lowest risk for cancer if it is a simple cyst

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It was completely cystic or mixed nodule?

If it is a simple cyst, it should fully collapse and hopefully not regain although the capsule, if there’s an active leak into the capsule, then it will regrow again. If it is a complex cyst, then it will have multiple septations within the system, and each compartment needs to be drained separately. I would recommend repeat reevaluation with an ultrasound in about 3 to 6 months, unless you feel compression again, and therefore, if so, I would repeat the ultrasound sooner

@Pezhman101 thank you for the reply. there were 3 compartments, first time liquid was taken from 2 compartments, the 3rd was too deep for the needle, so the doctor gave me antioxidant for a month, came back for the 2nd visit and the compartment moved up and the remaining liquid which was 12cc was able to be removed. Gave me antioxidant again for 2 months to see if there's more liquid or growth before my 3rd visit. So far so good, haven't seen or felt any growth in my throat.

On that case it's simply cyst because I can see small solid part on the right of the nodule? Sorry for asking but because I have the same case and my doctor recommended PEI and not aspiration

Your case description sounds like possibly subclinical Hashimoto’s thyroiditis. The positive thyroid antibodies indicate an active auto immune process, causing damage to the thyroid tissue the nodules that were found on the thyroid, ultrasound or incidental, and very small and therefore biopsy is not recommended just based on those size measurements I would encourage you to ask the radiologist to give those knowledge a TIRAD score. The scoring system allows to understand the characteristics of the nodule. Size is one component and based on the size that you give at 2 to 3 mm I don’t think a biopsies recommended although I would recommend repeating the autosound somewhere between six months to one year. Meanwhile, you need to follow your mother‘s TSH value and you want to keep the TSH less than 3. Also, I would encourage your mom to start taking a supplement known as a selenium at 200 MCG a day. Talk to your doctor to make sure there are no contraindications regarding this recommendation.

The dose of 200 mg per week or split doses is a very high dose when taking high dose like this you’re much higher propensity to develop thicken blood and high estrogen values. Testosterone is very important hormone, but too much of it can be counterproductive therefore, I would encourage you to consider to lower the dose slowly to the maximum of 100 mg subcutaneously once a week you need to use a higher dose then split that and give it twice a week subcutaneously to avoid the peaks, these peaks will lead to your PSA and thinking of your blood with elevation of estrogen which you do not want

@@Pezhman101 see saying that is assuming you know everything about or theeds I take. So I have an autoimmune disorder mixed connective tissue disorder and I family history of horrible bone issues example I'm 38. Have had 54 back injection, 12 epidurals in my tail bone, 8 in my base of my neck. Two back surgery's. On top of that my puberty started at age 9. Full blown looked older then 18 at that time My hormones stopped producing normally at age 27. That's why I'm on it. I also have to be on some type of pain med so I switched to Suboxone instead of oxy. Yes hormones can do all that to you but I would rather feel like a man and live a few years less then be alive as a shadow of aan I once knew

Are you referring to the thyroid or the colon? If a patient has colon cancer, there is no contraindications on doing a thyroid radio frequency ablation.

For the treatment and management of toxic knowledge, surgery is the last resort as a radio frequency. Ablation is quite very effective.

Yes, this patient’s case was extraordinary challenging. We partnered with the company to offer this. Patient several treatments at no cost as we wanted to help this. Very nice patient.

Thank you very much

Painless lymph nodes are always concerning. You need to have repeat ultrasound and possible biopsy.

This option was given to the patient. He did not want his parathyroid damaged. Je did not want to go the embolization procedure based on the possible complications.

It is unfortunate when patients do not get the appropriate response or treatment plan but that also depends the severity, the disease process, and the time when it presents regarding what treatments are available. The goal is always to offer the most minimally invasive approach to gain the maximum benefits with informed consent.

Newport Beach California www.seannikravanmd.com

Yes, it takes time for these procedures to become FD approved even though we have received FD approval in late 2018 now in 2024 still doctors are referring patients for surgery while this great procedure exist

Thank you very much her two year follow-up shows complete resolution of the mass/ thyroid cancer

When the first biopsy was nondiagnostic, she should’ve undergone a second biopsy surely, after. The characteristics of the ultrasound per your description was quite concerning therefore, not surprised it came back as thyroid cancer.

@@Pezhman101 mine hasn’t came back as cancer doctor. With those features and the first biopsy showing nondiagnostic, I went for a repeat ultrasound and the nodule was still 5mm irregular solid hypoechoic nodule with coarse calcification anterior calcification and posterior shadowing and nodule was wider than tall. It had not changed in size but was rebiopsied a second time and that biopsy came back as low cellularity specimen but showed as benign follicular nodule. It said that the specimen was demonstrating occasional fragments of follicular epithelium. I am still concerned that because it is low cellularity that something was missed due to all the cancerous features of the nodule that were described in this post and the post which you responded to from 5 months ago. Being that my sister had thyroid cancer and had a small nodule at the time of diagnosis, does that mean that since I had a non diagnostic biopsy the first time, and a low cellularity specimen with benign results this second time that this nodule could still be cancerous doctor? Please help? I am really interested in doing RFA and would like to know what type of nodule I am dealing with based on your knowledge from the results of my biopsies? Thank you in advance Doctor!

Yes, thyroid frequency ablation can be a possible option for your son based on the location and the size of the nodule

Yes, we have treated nodules that are bigger, but it depends on the size of the location. Nodules that are bigger may need to be treated more than one occasion.

@@Pezhman101great to hear. I have just been diagnosed with papillary thyroid carcinoma. The nodule measures 1.8cm. Would I be a possible candidate doctor,

If you have the opportunity travel to whichever country, this is offered. It is worth it save your thyroid.

Yes, radio frequency can be an option. Please contact us so we can evaluate your case.

Radio frequencies is designed for thyroid nodules. When the nodule becomes extremely large or it takes over the entire lobe, the reduction is lessened therefore it is important to treat early and sooner rather than waiting. This patient received substantial reduction and alleviation of the compressive symptoms, although his neck it is highly unlikely that his neck will go back to his original size

I am not sure I have many patients that travel from Canada to visit us for this procedure

One dimensional size does not tell the whole story. The thyroid nodule is a three-dimensional structure and when calculated yields of volume. A 6.6 cm is a large length dimension when we talk about our knowledge we always like to talk about volume instead of just centimeters

Maybe you want to consider applying for a visa for medical reasons, and come to us for treatment

Would recommend thyroid, frequency ablation. Do whatever it takes to save your thyroid!