1 fee or nr Tt BROOKHAVEN NATIONAL LABORATORY NAME UNIT NO. HOSPITAL of the MEDICAL RESEARCH CENTER UPTON, NEW YORK DISCHARGE SUMMARY 8-18-89 R PAVILION 1 -2- . OPD | . range of normal. Following TSH administration (10 units daily for 3 days) the thyroid uptake of 131 | had showed a good increase. However the serum thyroxin level did not show any increase over the pre TSH atimulation level. X-ray of the chest showed extrinsic pressure on the trachea, probably from thyroid enlargement. The basal metabolic rate was -§. The remainder of the laboratory findings were essentially negative. HOSPITAL COURSE: His hospical course was uneventful, The following thyroid experts were consulted: Dr. J.E, Rail and Dr. J. R,bbins of NIH, and Dr. B. Colcock of Lahey Clinic, Boston, The consensus was that surgical removal of diseased thyroid tissue was indicated, The patient was transferred to the New England Baptist Hospital in Boston on August 18, 1968 and under general anesthesia the thyroid gland was explored on August 20th. The gland was found to be grosaly multinodular with many cystic areas and a subtotal thyroidectomy was performed, Microscopic examination by Dr. W.A. Meissner of the New England Deaconess Hospital resulted in a diagnosis of "adenomatous goiter". Recovery from surgery was uneventful and the patient was transferred back to this hospital on August 25th. The surgical wound healed nicely and the patient was placed on L-Thyroxin (Synthroid, 0.3 mg. daily). He was discharged from the hospital on August 30, 1968 to travel back to his home in the Marshall Islands, £ 3 a 2 . e = 3 2 oa FINAL DIAGNOSIS: Adenomatous goiter. DISCHARGE MEDICATION: To continue thyroid medication for life. The patient was given ample hormone supply to last him for approximately a month. A note was sent to the Marshallese practitioner who will be in charge of the patient stressing the importance of continued thyroid medication. Robert A. Conard, M.D. RAC imam Dict: 9-13-68 Typed: 9-16-68 =m =} wy fm on “ Cc) BNL 720A C4 ; &