New Surprise - Enlarged Thyroid with multiple Nodules (goiter)

[BoerieNZ]

Never ever underestimate the power of Prayer!!

I just came from a specialist surgeon who wrote a report on my thyroid findings. Literally quoting each and every test. Discussing each point as being within normal limits for an incidental case like mine. He wrote me a letter in the format required by INZ with the end summary clearly stating:

NO FUTURE TREATMENT REQUIRED AND IS HIGHLY UNLIKELY TO INCUR ANY FUTURE MEDICAL COSTS!!!

This was from a surgeon who specializes in endocrine surgery. My panel physician also stated that a "normal" endocrinologist would not have had any bearing on the matter since my hormone levels are perfectly normal and the concerns of the thyroid were physical in nature, hence the report from a surgeon was advised rather than an endocrinologist.

My medicals were sent off today with the echocardiograph report (to explain my functional murmur) and the report from the surgeon explaining VERY clearly that I have a simple multi-nodule thyroid, which was proven via biopsy to be benign and I have no clinical signs of a goiter (because it's simply not visible) or any impingement in my breathing (so that clears the concerns of "pressure on trachea" that was mentioned in my ultrasound report).

I honestly do not believe that the medical assessor will have any issues with the letter. Even my panel physician said he'd be very surprised if they came back looking for more.

[BoerieNZ]

For anyone who ever comes across this in future, this is what I had to submit with my eMedical:

1. Chest X-Ray and Report (abnormal finding: thyroid enlarged)
2. Urine Sample Report
3. Panel Physician Report
4. Full Blood Count
5. Another Iron Profile Blood Test (because my iron was ever so slightly off during the first test. I scored 78.8, I needed to get 79 or higher to be within reference)
6. Another blood test showing my thyroid hormone levels and thyroid antibody levels - all normal.
7. The ultrasound and report for my thyroid (which lead to a biopsy to check for cancer on a suspect node)
8. The FNA biopsy showing no malignancy on the thyroid nodule in question (Thank You God!!!)
9. The letter from a specialist surgeon stating that my thyroid finding will not cost any more money than it already has and will not be a burden on the medical system.
10. An echocardiograph report stating no heart abnormalities and confirming a functional (innocent) murmur.

Dear New Zealand Medical Assessor, you have some work to do

[JandM]

I'm so pleased for you that the biopsy showed no malignancy.

All the very best for the processing.

[BoerieNZ]

Thanks so much JandM!

My wife's visa JUST got approved. My medicals were only submitted today including those two specialist reports, so it will be referred to the MA panel now.

I see my wife's visa states she must be in the country for 01/03/2019. So it gives us 3 months to get there from today. The kids' visas are pending my visa's approval because that was a group application.

Is it common for the medical assessor's to refute the report of specialist surgeons / doctors on a finding when the report clearly states that the finding/condition will pose no future costs for the INZ medical system?

We are just afraid that the MA panel will insist on additional "tests" even though all the relevant tests and results have been done WITH a report from a specialist surgeon stating that there is NO further treatment required for the finding and that it poses no risk to me OR anyone else.

[BoerieNZ]

To be honest, the surgeon that wrote the letter stating that my finding will require no treatment now or in future is a Senior Specialist in the Department of Surgery in one of the top academic institutions for medicine and surgery in the country. I am guessing that a medical assessor will respect the opinion of someone like that and not question it too much.

[JandM]

You are bound to be anxious, which is perfectly natural in your situation.

Everything you say is perfectly reasonable and one would think that it OUGHT to be the case. In fairness to you, I will mention that it has been known for an MA in a few individual cases to be awkward - I remember one where the applicant's particular specialist ended up writing to the effect, 'There IS no specialist in the UK who has more knowledge of this condition than me, so will you kindly stop asking this woman to give other opinions than mine,' and it did go through. But that is EXTREMELY rare. If it happened, you'd have good grounds for arguing your case very robustly, and it most likely WON'T.

Here's hoping this is the beginning of the end of your troubles.

[BoerieNZ]

You're 100% right, JandM

We are literally just nervous. We've gone through so many tests and had a huge cancer scare, we just want it to be over.

My chest xray, lead to an ultrasound, lead to an fna biopsy proving that i don't have cancer, lead to a thyroid function blood test which showed normal thyroid function, and ultimately culminated in a letter from a surgeon stating that there is no treatment required now or later.

In my case there literally are no more tests or reports which can be submitted. I'll update the thread as soon as I have an update

[JandM]

All the very best.

[Lon]

I had a Thyroidectomy 12 years ago due to Multiple Toxic Nodules and have been on Levoxyl daily since then.

[BoerieNZ]

I had a Thyroidectomy 12 years ago due to Multiple Toxic Nodules and have been on Levoxyl daily since then.

Hi Lon, was this before you emigrated to NZ? Where you referred to the medical panel?

My thyroid isn't toxic at all. Perfectly normal TSH levels, completely benign and not even thyroid antibodies, so it isn't some underlying thing. My prognosis is no treatment or surgery. Worse case scenario is maybe an ultrasound every 2 years to monitor.