Hi again! We had a great second day in Boston at the annual patient and family conference, "A Bridge to Wellness." Here are a few highlights from the day:
Dr. Lawrence Wood, Associate Physician at Massachusetts General Hospital (retired) and Board Member, Graves' Disease and Thyroid Foundation
1) Thyroid surgery is a tricky surgery. Two important questions to ask your surgeon are how many surgeries they do in a year and how many of those caused vocal nerve damage if any.
Dr. Scott Rivkees, M.D. Chair, Department of Pediatrics at the University of Florida College of Medicine
1) Graves' Disease affects 1 in 1000 individuals, or about 1 in 100 women; it affects 1 in 10,000 children, and more girls than boys; 2) children have lower remission rates; 3) 15-30% remission rate for young children; 4) the younger the child, the less likely it will ever go completely away; 5) there are risks with PTU in children (be sure to discuss with your child's doctor); 6) we have had no new anti-thyroid drugs in the past 60 years; 7) increased anti-thyroid drug treatment lengths do not equate to increased remission rates; 8) thyroid surgery is more challenging in children than adults.
Dr. Barbra Miller, Assistant Professor, Division of Endocrine Surgery, University of Michigan
1) complications after total thyroidectomy in children are not significantly higher than in adults; 2) thyroidectomy should be performed by high-volume thyroid surgeon; 3) click this link for information on University of Michigan's Division of Endocrine Surgery; 4) click this link for the American Association of Endocrine Surgeons Patient Education Site; 5) thyroid nodules > 1 centimeter should be biopsied; 6) an uptake scan of the thyroid can determine which thyroid nodules are "hot" and "cold" which helps to determine which ones should be biopsied; 6) It's important to follow thyroid nodules over time; 7) questions to ask you thyroid sugeron should includ how many thyroid operations have you performed, what is your recurrant laryngeal nerve injury rate and if zero, ask for volume of surgeries performed; what is your rate of permanent hypoparathyroidism/hypocalcemia; do you routinely use intraoperative nerve monitoring; 8) Recurrant laryngeal nerve injury is very important to understand, therefore need to find an experienced surgeon.
Dr.Alon Kahana, MD, PhD. Helmut F Stern Professor, Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan
1) 80-90% of Graves' Eye Disease occur within 18 months of Graves' Disease diagnosis; 2) 20% of Graves' Eye Disease patients have normal thyroid levels; 3) there is no magic bullet, each person's case of Graves' Disease is unique; 4) common symptoms of eye pain include pressure around the eyes, pain with eye movement, eye scratchiness with irritation or itching, and eye pressure; 5) there are natural lubricants that can help with eye pain issues including a warm compress to improve oil gland function; a cold compress to reduce eye swelling; lubricating ointment to reduce evaporation.
Dr. Scott Rivkees: Chair, Department of Pediatrics, University of Florida College of Medicine
1) treatment of pediatric Graves' Disease is associated with excessive weight gain
Dr. Ray Douglas M.D., PhD, Assistant Professor, Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan
1) there are two phases to Graves' Eye Disease, the active and stable phase; in the active phase there is active inflamation and passive congestion; 2) every patient should have a customized treatment plan; 3) eye swelling restrics blood flow in the eye area which causes the swelling, which can also cause scarring of tissue; 4) scarring can cause eyelid retraction; 5) there are 2 types of Graves' Eye Disease, fat disease and muscle disease; 6) there are treatment options available to patients with Graves' Eye Disease, including fat decompression, bone decompression and eyelid repositioning (surgery).
It was truly a great day and it ended with a lovely dinner as a group where numerous awards were presented to the medical professionals and volunteers.
What are foods to avoid with Grave's Disease? Dr. Jeff Koff: foods with iodine including kelp, seafood
Is there anything that can help with early Thyroid Eye Disease? Dr. Ray Douglas: A European study has shown that selenium may help in the early stages