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Case Study

Patient Background:
28-year-old, Allison Wallbreaker, was born on May 12, 1985 and is 147lbs. Her spouse is Josh
Wallbreaker. They have two children together, Jasmine and Brady Wallbreaker, and they all live
together at 9827 West Hollyberry Street. Her current occupation is a nurse.

Family History:
Her grandmother, Kaitlyn Chaplin survived thyroid cancer and is currently 51 years old. Her
mother Linda Thompson also had hyperthyroidism when she was younger but it is treated and
hasn't reoccurred since. Her father is deceased and had arthritis and she has two healthy
children who hasn't faced any medical problems yet.

Medical History:
Allison Wallbreaker was diagnosed with graves disease when she was younger but it has
reoccurred so she is back on atenolol and methimazole too treat it. She had phenomena when
she was younger and is facing high blood pressure due to the graves disease. She is taking
atenolol too treat the high blood pressure. She is also facing depression due to financial
problems. She has also had an acl replacement and a c-section.

Initially, the patient complained of neck pains and a lump in the neck. She also said that she had
a chronic cough, difficulty swallowing and hoarseness in her voice. Some general symptoms
she complained of was unexpected weight gain/loss, difficulty sleeping, fatigue/weakness and
change in appetite. We performed a biopsy of the lump on her neck and some blood tests (to
see if the thyroid was performing normally). We preformed thyroid-stimulating hormone tests on
the patient (TSH).

After all of the tests were completed, we staged her in stage one with papillary thyroid cancer.
We staged her in stage one because there isn't any signs of it spreading to the other parts of the
body yet. The tumor is also 2cm big on the thyroid gland. This type of cancer will often spread to
the lymph nodes.

Treatment: To treat Allison's case with stage one papillary thyroid cancer, she is going to have a
lobectomy which is the removal of half the lobe of the thyroid gland on which the tumor is on.
The patient will also go through radioactive iodine treatment to get rid of any access cancerous
spots. Since the thyroid makes half the hormones that it did before, the patient will then have to
take hormone replacement pills to help replace the hormones that the thyroid doesnt make
anymore. She will be first put on a normal dose but will have to come in and get her blood
drawn every month too make sure that the hormone levels are correct. Overtime we may have
to increase or decrease the dose of the hormone replacement.
The patient will have to get their blood drawn every now and then too make sure that the
hormone replacement pills are at the right dosage for your specific needs. Every 3-6 months the
patient will need to come in for a physical neck exam for the first two years. After that, she will
need to have it done every year. A neck ultrasound is also needed to see if there is disease in
the neck. All these tests are too make sure that there is no reoccurrence of the cancer. It would
probably be a good idea to eat better, too get exercise and get enough sleep.