i think it's super dangerous to take advice from forumers here...
Well, since there's no establish diagnosis for your condition, there's very little information here and all these while you've been managed by a GP...

To be on the safe side, go and see an endocrinologist first before any further decision.
You need further investigation on your thyroid ds.
Yes, you're definately hyperthyroid judging from your symptoms and presentation, but the underlying cause must be investigate before further management.

to the med students here...
I think it's important to establish a sets of differential diagnosis before you give advice to your patients in future practice.
Misleading information could lead to lots of stress and anxiety to our forumers...

example :
Hi, thanks for d info, really helpful b4 I make any decision. Seem like I gt no othrr choice than go for a surgery :-(

When a pt failed medical treatment, something to ponder in our mind :

1) what cause the treatment to fail ? incorrect diagnosis? non compliance to medication? drug drug interaction? or inadequate therapy.
Bear in mind that the treatment has been started by a GP...
plus, we don't even know the TSH/T3/T4 trending on treatment over the year.
How low is low?
So, you should ask her to provide these valuable information before further decide whether or not this is truly a failed medical treatment.
we don't even know whether pt's on maximum dose of carbimazole etc.
Maybe she's just on chicken dose started by GP...who knows?


2) You should also ask for associated symptoms and well known complications which is associated her thyroid problem.
eg: thyroid eye ds, AF...
should any of above present, she should immediately seek a specialist review.

Dear Karen,

I think u seriously need a specialist review, they are available in any general hospital/university hospital.
You may want to speak to your current doctor to provide a detail medical report/referral.
Bring your medical report/blood reports along and book an appointment.

You may not need to worry about surgical review for now as judging from your progress, you responded to the previous treatment, it just tat it rebound back quite fast.

There's pt who r on medical treatment for years before opted for surgical intervention.

---

Added on September 6, 2011, 8:33 pmi think it's super dangerous to take advice from forumers here...
Well, since there's no establish diagnosis for your condition, there's very little information here and all these while you've been managed by a GP...

To be on the safe side, go and see an endocrinologist first before any further decision.
You need further investigation on your thyroid ds.
Yes, you're definately hyperthyroid judging from your symptoms and presentation, but the underlying cause must be investigate before further management.

to the med students here...
I think it's important to establish a sets of differential diagnosis before you give advice to your patients in future practice.
Misleading information could lead to lots of stress and anxiety to our forumers...

example :
Hi, thanks for d info, really helpful b4 I make any decision. Seem like I gt no othrr choice than go for a surgery :-(

When a pt failed medical treatment, something to ponder in our mind :

1) what cause the treatment to fail ? incorrect diagnosis? non compliance to medication? drug drug interaction? or inadequate therapy.
Bear in mind that the treatment has been started by a GP...
plus, we don't even know the TSH/T3/T4 trending on treatment over the year.
How low is low?
So, you should ask her to provide these valuable information before further decide whether or not this is truly a failed medical treatment.
we don't even know whether pt's on maximum dose of carbimazole etc.
Maybe she's just on chicken dose started by GP...who knows?


2) You should also ask for associated symptoms and well known complications which is associated her thyroid problem.
eg: thyroid eye ds, AF...
should any of above present, she should immediately seek a specialist review.

Dear Karen,

I think u seriously need a specialist review, they are available in any general hospital/university hospital.
You may want to speak to your current doctor to provide a detail medical report/referral.
Bring your medical report/blood reports along and book an appointment.

You may not need to worry about surgical review for now as judging from your progress, you responded to the previous treatment, it just tat it rebound back quite fast.

There's pt who r on medical treatment for years before opted for surgical intervention.

This post has been edited by klifex: Sep 6 2011, 08:33 PM

not invisible.. just a more transparent ... some are colourful...