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Enlarged thyroid. Sore throat, difficulty swallowing and breathing. MRI, US done. Help?

Hi I have an enlarged thyroid. It was found through a MRI back in July 2012, the MRI was for my back and neck, which they found some issues, but it was the Thyroid that had the Dr. concerned. I went for an Ultrasound and they found multiple nodes, 2 with concerning size. My Dr. set up an appointment with an Endocrinologist but that wasn't for another 3 months. During that time my throat got worse and more sore, I went back to my Dr. he set me up for another Ultra Sound, my nodes were smaller (good) my) My Thyroid (Goiter) twice the size from original US. He put an urgent on my visit to the Endo. and I was in within 2 weeks. The Endo says we will do another US in 3 1/2 months to see if it has grown more or shrunk. I am in my 4th week and my throat is getting worse I feel, I am having difficulty swallowing, talking, and breathing. I can still breath but I feel out of breath doing it. This can't good. At times I feel like there are small razor blades rubbing my insides. It also feel as though there is a small clamp on my asophogus (sp) I have requested a second opinion for help, but I am still waiting for that. When do I seek Emergency Hospital vist to get help needed? I hope this makes sense. Thanks Tee
Asked On : Tue, 16 Apr 2013
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Internal Medicine Specialist 's  Response
The onset may be sudden or gradual and may be preceded by an upper respiratory infection. The pain may be limited to the region of the thyroid or radiate to the upper neck, jaw, throat, upper chest, or ears. Pain can be exacerbated by coughing or turning the head. Fever, fatigue, malaise, anorexia, and myalgia are common .

The thyroid gland is typically slightly or moderately diffusely or asymmetrically enlarged, and nearly always tender. In some cases, the pain is so severe that the patient cannot tolerate palpation of the neck. Both thyroid lobes are involved from the beginning in most patients, but the pain, tenderness, and enlargement can be unilateral or start on one side and later spread to the other side days or even weeks (so called “creeping thyroiditis”) later . Approximately one-half of patients have symptoms and signs of hyperthyroidism, but the neck pain and tenderness usually dominate the illness, and the diagnosis should not routinely be made in their absence. Temperature elevations also can occur .

The thyroid inflammation and hyperthyroidism are transient, usually subsiding in two to eight weeks, even if the patient is not treated. It may be followed by a period of transient, usually asymptomatic hypothyroidism lasting from two to eight weeks or longer, but recovery is nearly always complete.
In the majority of patientS are treated with either a nonsteroidal antiinflammatory drug or prednisone is indicated . A reasonable approach is to start with acetylsalicylic acid (aspirin, 2600 mg daily) or a nonsteroidal antiinflammatory drug (eg, ibuprofen 1200 to 3200 mg daily) in divided doses. If there is no improvement in two or three days, the nonsteroidal antiinflammatory drug should be discontinued and prednisone (40 mg daily) initiated. Prednisone therapy should result in pain relief in one to two days; if not, the diagnosis should be questioned. In patients with severe pain, prednisone is a reasonable first-line therapy.

Answered: Wed, 17 Apr 2013
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