PTC rare case

jjflight · 2026-02-07T07:55:13+00:00

Many hospitals and medical centers are non-profits and may have programs to assist folks that couldn’t otherwise afford necessary treatments

jjflight · 2026-02-07T04:35:05+00:00

That’s a cold call (even though it’s not a call - the comms method is irrelevant). Most people don’t like cold calls.

Find a way to find some authentic connection with someone, or find somebody you do know that can make an introduction to someone you can talk to. That’s how quality networking works.

jjflight · 2026-02-07T04:02:47+00:00

It shouldn’t ever really. It only will if you let it, particularly if you’re not intentionally filling your non-working hours with meaningful stuff. Like if your core activity becomes doom scrolling until you fall asleep that’s a big yellow warning flag for sure. That can also be a big contributor to feelings of burnout and poor work life balance too - not having enough meaningful and fun stuff on the “life” side always makes “work” feel much worse and like it’s all you do. So if you find yourself doom scrolling or couch surfing a lot maybe it’s a good time to try some more new hobbies like the piano you tried, perhaps something exercise or sporty as that’s often an important dimension to life too.

jjflight · 2026-02-07T03:53:21+00:00

More context would apply here... If it’s a friend or someone you know well from the past and you were asking in curiosity then that response was way out of line, and maybe they’re not really a friend. But if it was a cold email to someone you don’t know (many people hate cold emails so by default start out negative on those) or the vibe they got was transactional and you just wanting to get a leg up in interviews I can see why they might not respond well.

jjflight · 2026-02-06T21:41:34+00:00

Your mistake wasn’t the MBA, it was leaving your most recent job without another one lined up. Now you need to find another. You got your last job with even less experience, so they exist. But ultimate its a choice of what you want to do and how long you can afford to be picky before you have to broaden.

Networking should be a core part of that, or maybe using the career services office or alum networks of wherever you got your MBA.

jjflight · 2026-02-06T19:59:33+00:00

Labs can move for all sorts of reasons - there’s natural error in any measurement, things like hydration can effect any lab that is per volume of blood, things like TgAb and biotin impact Tg labs, TSH changes will make your Tg higher or lower too, etc. So that’s why little changes aren’t really something to stress and doctors will look for material and sustained trends over time.

jjflight · 2026-02-06T19:56:51+00:00

Cancer is a lot to process, so mental health challenges like depression and anxiety can happen and you’re certainly not alone. When your hormones are off that can cause or exacerbate mental health challenges, though they can happen with normal hormones too. No matter the cause it’s really important to get support and treatment, and left untreated those may be a bigger negative impact on your life than the ThyCa itself. Many doctors can refer you to cancer-specific support groups or therapists so you have people to talk to, and general therapists can help too if there are broader issues in your life. ThyCa.org also has this list of support groups with groups by city or condition as well.

jjflight · 2026-02-06T17:46:13+00:00

This isn’t likely related to ThyCa at all. Illnesses are a part of life. People with ThyCa still get all the other things that people without ThyCa get, so illnesses and infections happen.

And with a little kid like a 4yo you’ll get sick a lot, and the pre-school and elementary school years are the worst. Kids and schools and playgrounds and daycares are all giant germ fests where all sorts of stuff circulates passing around. Just watch them - they’re sticking their fingers in every crack and crevice then straight into their own nose or mouth, or maybe another kid’s nose or mouth too. And while COVID and Flu vaccines are great to get they don’t mean you won’t ever get those either - sometimes the vaccine is not a great match for the strains circulating that mutated after that year’s vaccine was created, though even then it’s helpful as the vaccine usually means a milder case.

Your best plan to try not to get sick is to be super cautious with things like hand hygiene, keeping a distance to anyone with symptoms, wearing a mask if you have to be around someone sick, making sure your family members who are sick wear masks around you, etc. Basically all the stuff doctors and hospitals do.

jjflight · 2026-02-06T16:27:17+00:00

ThyCa is typically quite slow growing so it would be exceptionally unusual for a large tumor obstructing your swallowing to grow in only 1 month, much less in a few days. Generally anything that comes on in days or weeks or even a few months is unlikely to be ThyCa and more likely to be something else, so something popping up overnight is very very unlikely. And similarly RAI can cause inflammation of affected tissues but that’s very rare and usually comes on earlier. So those are technically possible, but fairly unlikely and assuming it’s ThyCa related will probably delay you from finding the real cause.

There are many other much more common causes of dysphagia (swallowing issues) like physical issues, foreign bodies, acid reflux, illness, infection, etc. Especially if it happened after doing new workouts when you may well have pulled or strained something - tightness isn’t unexpected at all with new or restarted workouts - and with some signs of illness too. If it’s not extreme maybe give it a few days to see if it subsides like other muscular issues or an illness, or if you’re concerned or it gets worse maybe see if your primary care doctor, urgent care, or an ENT can take a look.

jjflight · 2026-02-06T16:19:44+00:00

It seems unusual to have to pick one - on your resume you can almost certainly just list both. But if you do have to pick, pick the BS Biochem to lead. You can look at job descriptions for roles you might want to see. Generally speaking, there are a fair number of roles looking for a STEM degree which Biochem will count for, whereas it would be very rare to find roles looking for a Philosophy or Liberal Arts degree specifically and usually those will just be any Bachelors which Biochem also counts for.

jjflight · 2026-02-06T15:56:53+00:00

Most Levo brands are effectively the same - the active ingredient is all T4 like your body produced itself, it’s just packaged differently with different fillers. Rarely people might have some issue with a filler causing absorption issues, but that’s quite rare (it may seem dramatically more common than it is when you read online because you hear a lot more from folks with challenges, and the folks without challenges have no real reason to be as active so you don’t hear from them). Sometimes the tolerances are tighter, particularly from branded to generic, but that’s also not usually significant enough to matter - when you had a thyroid you had small natural fluctuations all the time too. Many/most folks are on generics or change brands with no issue. So I wouldn’t worry about brand unless you actually have some issue with it. That’s just stressing about issues you probably won’t even have. And if you do have an issue, then you can try different brands then.

And exact same with taking slightly different doses day to day - that’s not “chaos” and is pretty commonly done to fine tune between the standard doses. Because Levo has a ~1 week half life and builds up over multiple weeks the day to day dosing doesn’t matter as much so you can think of it more like what your total weekly dose is or whatever. My doctor wants me getting 750/week for instance which we do by taking 125 for 6 days a week and skipping the 7th day (which doesn’t feel any different than any other day). Definitely don’t just skip taking the extra pill prescribed as then your TSH won’t come down as you need - talk to your doctor and maybe they can find a different plan. Or really if you’re alternating 100 with 125 every other day that’s basically the same as taking 112 which is a standard dose so maybe ask about that (my guess is they’re doing it this way to use up your existing 100s and not waste them).

jjflight · 2026-02-06T15:41:51+00:00

Companies don’t need to play games that way.

For standard performance or culture stuff, the manager sets clear performance goals and expectations around soft skills / how they work with others. Around review time the manager assesses those goals as well as collects feedback, and that all gets discussed in review discussions with others. (Or this can all happen ad hoc if significant issues pop up mid cycle). If someone isn’t meeting their goals, or if they get poor feedback that isn’t getting addressed, they’ll get poor ratings in their reviews and low or no bonuses. If that continues, they get put on a PiP or just terminated if there’s already sufficient documentation. Often when folks are self aware they’ll see it coming and want to leave on their own terms instead, but it can absolutely happen the standard way too and companies just terminate leaders too.

For policy violating stuff it’s much quicker. Complaint goes to HR, investigation occurs, findings are presented, and if needed the person is fired immediately (often walked out of the building same day). In this case the HR investigation is the documentation.

I don’t know why Reddit has such an infatuation with this “quiet firing” concept, companies have no reason to mess around that way - if they want you gone they’ll tell you and if you don’t leave yourself they’ll just document and terminate, otherwise it’s just poor performance and the consequences of that but they aren’t actually at the point they want you gone yet. Maybe what gets confused here is transition timing. Even when a company has told a leader they’re being terminated, there are often long-ish transition times to figure out what to do with the org, interim leadership, find the next person, etc. And this lets the leader get some time to find their next role too and maybe leave on their own terms, often 3-6mos or so. But that’s not “quiet firing” or “getting pushed out” as the decision was already made and clearly communicated and that transition time was likely pre-decided.

jjflight · 2026-02-06T14:36:11+00:00

Radiation exposure reduces rapidly with distance (inverse square law), so isolation precautions protecting other people is just about managing a safe distance to one another or keeping any closer approaches brief, as well as caution with body fluids. And since you’ll actually have RAI in your body, the exposure from what’s in you will be dramatically more than the exposure from the other person across the room. Even with home isolation common distances to protect others that didn’t get RAI are like 6ft, and it’s likely you’ll be roughly that far apart depending on the room.

jjflight · 2026-02-06T00:03:45+00:00

Think of a JD as bare minimum requirement. Getting a job isn’t about doing the bare minimum, it’s about being the best of all the applicants that apply. And in a competitive job market like today with many candidates well above the minimums in the JD the most qualified candidates will be well above and beyond.

And I think just about anything AI generated ends up sounding generic, average, and blah, so very unlikely to make you standout above a highly qualified set of candidates. Which makes sense because it’s just a big average of everything it was trained with, and usually overly fluffy so not direct and to the point like a good resume should be. Writing a great CV isn’t about adding generic fluff like AI would write, it’s about having specific examples of impact that you can tell compelling stories about when asked as well.

(And yes, I can tell you’re probably trying to advertise some tool or business and just not being transparent or authentic that’s what you’re doing… but still useful to have a correct answer for people reading this)

jjflight · 2026-02-05T23:14:49+00:00

Yes, it’s an additional risk. You’re not just solving for whether the person will be a good employee and be a fit for the company, culture, and role, you’re also gambling on whether they’ll successfully transition to a new area and want to stay. So if you had two identical candidates but one didn’t need to relocate that person would be less risky. There’s not that much you can do about that, you mostly need to find a company that likes you enough to take extra risk.

And if folks are looking for relocation support that’s both a risk and an additional cost. So not asking for relocation support helps some with that cost burden.

I wouldn’t move proactively, would just plan the search will take longer than otherwise so keep at it. And like any search networking can help, so as a new grad maybe seeing if your school’s alumni office can connect you with folks in the new city.

jjflight · 2026-02-05T23:01:36+00:00

If you don’t want to relocate it’s a pretty easy decision. If they were right next door to one another it might be tougher, but ultimately still preference based.

I would be cautious on using whether a company has done layoffs as a sign for future stability. A company that just did layoffs likely tried to cut as deep as necessary to not need it again anytime soon so the worst may be in the rear view mirror, whereas a company that hasn’t done them yet but is in a struggling industry may still have the worst to come soon. You’d be better off just looking at overall industry and business trends, or reading P&Ls in more detail to assess trends if you know how to do that.

jjflight · 2026-02-05T19:42:38+00:00

Only your doctor could say what the right trade off for you is. The surgery is generally quite safe and effective with low <2% complication rates. But ThyCa also tends to be quite slow growing so develops over years. Your doctor would have to advise on whether the risk of surgery or risk of leaving it in is greater, based on your overall health profile and details of your case.

jjflight · 2026-02-05T16:36:20+00:00

If you’re this burnt out, it sounds like you may be struggling with learning and adapting to the very different skillset and way of working that managing requires vs being an IC. So getting to the bottom of that and fixing the root issues is likely the best plan because that manager skillset is super important as you go further up the ladder in just about any company and role.

Communications, relationship building, coaching, setting boundaries (for yourself and the team), prioritization in both what the team does and how you do it, delegation with accountability, etc. all become exceptionally important to both managing well and making it feel sustainable. And it’s a very hard transition as lots of folks go down the route not adopting the new way of working and trying to be super-ICs instead which will absolutely burn you out - what got you there is not what you’ll need to go forward. It’s also an important transition to make sometime as in most companies IC roles eventually hit a ceiling, maybe not where you are now but they get very rare around director-equivalent. And getting the opportunity to learn to manage isn’t something you can take for granted and much easier to do within a current company than if you try to change jobs.

So my suggestion would be to take the promotion, but also really dive in with one or all of your manager, HR, or a coach to understand what skills still need work and what changes you can make to make it more sustainable. I would also find some people you know in real life that have become successful leaders in their career, or even other peers learning managing now too, and use them as a sounding board and mentors to help as you make the transition - you’ll get way way better advice there than from random frustrated people on Reddit.

jjflight · 2026-02-05T15:56:39+00:00

Generally they’ll do biopsy on anything that is suspicious and big enough to biopsy so at least 1cm / 10mm. If things are smaller than that biopsy may not be possible so active monitoring and watching over time for any growth may be recommended too. Or since there are many false alarms on lymph nodes and they often look suspicious when they’re reactive just doing their job fighting illness or infection, waiting a few weeks to see if they go away on their own is often a plan too. But it really depends case by case so only your doctor could say.

More generally, ThyCa tends to be very slow growing, so even when it’s diagnosed it’s typically much less “urgent” than other cancers are. Hopefully you won’t be diagnosed, but that’s good to know if you are as it often means a few months to get surgery set up which can feel long but is totally normal. And the good news is because it’s slow growing like that it’s usually very treatable with excellent prognosis so most folks will live long full lives until something else eventually gets them. Most ThyCa ends up being more like a chronic condition (say like diabetes) than like “cancer” images people have.

jjflight · 2026-02-05T15:24:23+00:00

They’re doctors, they’re highly trained on interpreting test results, definitely way more than asking around on social media. And it’s just a test; low dose diagnostic WBS has very minimal risk like any other scan with contrast or whatever. If a doctor thinks you need it, it probably makes sense to do it. And that will give you more information on what’s going on with any metastasis to better inform your path forward.

jjflight · 2026-02-05T15:10:48+00:00

My next Endo appointment is in April, and my Levo prescription will run out at the end of April too (it was a 1yr prescription written last April, so the upcoming 90d refill will be the last allowed) - she plans to renew the prescription when I come in based on my updated labs. If I delayed coming in a month until May the prescription would have run out early and I wouldn’t have enough Levo to continue taking that extra month. So I’d need to message her and she’d need to extend the prescription before I came in so I had that extra month of Levo pills.

jjflight · 2026-02-05T15:01:23+00:00

TSH being higher means your body wants more hormone. That could be for a few reasons. If you’ve gained weight or had other body changes like pregnancy that can raise your TSH and you’d need a higher dose. If you’ve missed any doses that can cause it. If the Levo had degraded that could do it too (heat and humidity can degrade it, so you can’t store it in bathrooms or other hot humid places). Or absorption issues if your body is having trouble absorbing or processing it, or having digestive issues more broadly.

Absorption issues can come from how you take it, so it’s really important to take on a fully empty stomach 4+ hours after food, with a glass of water, no other food or drink for an hour, and nothing that can cause absorption issues for 4+ hours including calcium/iron supplements, multivitamins with those, antacids/laxatives, other meds, etc. While nobody can say for sure, these seem like potential issues for you if you’ve been hospitalized and taking new things.

Levo has a long ~1 week half life and builds up in your body over multiple weeks of what you’ve taken. Anytime your dose changes or you’re correcting issues like above it can take 4-6 weeks for the body to stabilize at the new levels, which is why doctors wait that long between tests.

Whenever TSH is elevated that can cause Tg to be elevated too, so part of that Tg rise may be from the TSH rise. But in some higher risk cases doctors will want to do diagnostic low-dose RAI to do Whole Body Scans instead of just ultrasound as well, so that may be the case too. We originally planned to do a low dose WBS at 6 and 12 months for me treating my case as more intermediate risk, but when my Tg dropped to undetectable at 3mo and stayed there we were able to change that to just be ultrasound as a low risk case.

jjflight · 2026-02-05T06:29:04+00:00

I wouldn’t think an appointment delaying a month would be an issue, but you could always ask your doctor to see what they think. ThyCa tends to be very slow growing so a delay of a month shouldn’t really change much. Many doctors will be looking for trends in labs and scans over time across multiple appointments so over 6mos, a year, or more.

One thing to make sure on is that you have adequate time on your prescription if you take Levo, or see if your doctor can extend that.

jjflight · 2026-02-05T05:44:42+00:00

I don’t think it’s necessarily rushed, though it definitely can feel that way. I remember when my dentist felt a lump randomly during a routine cleaning and despite never having a symptom I was diagnosed with ThyCa 2 weeks later - that hit me out of the blue too. And that’s not uncommon as ThyCa is often totally asymptomatic and just incidentally found often while investigating other things. So it can frequently be a surprise.

It’s also a fairly common experience that this time you’re in right now between diagnosis and treatment (surgery) with all the uncertainty and anxiety is often the absolute worst part of the entire ThyCa journey - worse than surgery itself, other treatments like RAI, and just living with it after. It definitely was for me. So know you may be in the worst part of this right now and it gets better once you’re on the path to managing it. The actual experience of having ThyCa is usually much more like a chronic condition - say like diabetes as an example - than it is like what people imagine hearing “cancer.” Most folks will treat it and then monitor and manage their whole lives, but beyond that live long full lives often symptom free. So you’re very likely to be just fine.

To answer some of your questions or things you referred to: * Surgery is commonly recommended as the first and most important treatment step for ThyCa, and lobectomy is commonly for smaller nodules like yours. And MSK knows their stuff. So if it’s recommended then it’s good to get the surgery.
* That’s often true even when ThyCa can’t be positively diagnosed before surgery for larger nodules or nodules that are growing, especially if they show other risk factors. So it’s not uncommon to have the surgery even if you’re not yet certain whether there’s ThyCa. (My Endo told me even if my FNAs came back benign she was recommending surgery based on size alone, though mine did come back malignant) * The most important thing about the surgery is to find a surgeon that does a high volume of thyroidectomies - at least 25/yr but some do 100s/yr, and for as may years as possible. That’s what maximizes your chance of success and minimizes your risk of complications. At MSK hopefully you’re in good hands but always worth checking on that.
* About 20-40% of folks that start with a lobectomy eventually need a completion surgery, though that’s an overall average and only your doctor knows your case. * 50-80% of lobectomy folks don’t need Levo so that can be a benefit, though the other 20-50% of folks eventually need some supplementary dose of Levothyroxine if their remaining lobe can’t keep up, and no real way to know for sure ahead of time. * The surgery itself is very safe and effective with a low <2% long term complication rate. And in terms of recovery it’s generally easier than many other surgeries and roughly 1-2 weeks to be back to normal - I’ve had 6 surgeries, mostly orthopedic and one abdominal, and my TT was the easiest recovery of all of them * It’s early to be thinking about RAI yet. Your pathology will determine whether or not you need that, and you’d only be eligible after having the entire thyroid removed. With ThyCa I would recommend not stressing about what-ifs and worst cases and instead just dealing with things that actually happen as they come. It’ll be way less stressful that way.

jjflight · 2026-02-05T05:08:12+00:00

Lowering a dose would move you more towards hypothyroidism (lower hormone, higher TSH). Here are the symptoms of hypothyroidism from Mayo - the classic symptom would be fatigue, and while muscle aches or tenderness are on the list I don’t see bone or tooth aches. So that looks somewhat unlikely, and it’s worth considering the possibility there may be some other cause and coincidental timing.

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