Ucirik 2212
MOWITAL OF Tet mEOICAL RESTARCH CENTER,
BLQOKHAYVIN NATIONAL LASORATORY
Wiamll
8-45-3R
UTOM, Nw YORK 1197)
Aves Code 31¢ YAghant 4-4267
wnt NO)
DISCHARGE SUMMARY
-2in the urine, she was placed on {5 unlts NPH Insulin dally which controlled her
diabetes. With the diabetes controlled, the slightly impaired kidney function was
nut considered serlous enough co peeclude surgery and she was discharged June i0ch
for transfer to Cleveland,
At Cleveland Metropolitan General Hospital,
thyroid surgery vas performed by Dr.
Brown Dobyns, The day before surgery she was given 25 pCh t ty in order to da
autoradiographic studies on the removed thyroid tissues. At Surgery, a left
lobectomy was performed removing several cystic nodules From that lobe, A diagnosis
of Hurthle cell adenomata on frozen section prompted the complete removal of that
lobe. A further adenoma was removed from the isthmus and several tiny nodules were
removed from the right lobe, The patient withstood surgery well and her convalescence
was uneventful, She was continued on insulin and dietary treatment,
FINAL DIACNOSIS:
Mixed follicular cell and Hurthle cell
adenomata of the thyroid.
Borderline hypertenston with slightly
reduced kidney function.
DISCHARGE MEDICATION:
Under normal circumstances with a lefe
thyroid lobectomy and subtotal on the
right, somewhat depressed metabolism might be expected and 0.1 to 0.2 mg of Lthyroxin would be given daily. However, since this lady is older, has diabetes and
a tendency to hypertension, tt was deemed advisable to observe her for a few months
before making the final decision on treatment, She was advised to attend the diabetic
clinte at the Majuro hospital and maintain her diet. The practitioner accompanying
the patients was advised to continue
the
insulin therapy.
If the patient
later was
muved back to her isolated home at Utirik Leland, the treatment would have to be
re-evaluated.
-, “ene Chron ta
RAC: bwa
Dice: 6/27/73
Typed: 6/29/73
Om 720A
obert A, Conard, KD.