Sarika N. Rao, DO

24 posts

Sarika N. Rao, DO

Sarika N. Rao, DO

@SarikaRao

Oncologic Endocrinologist at Mayo Clinic

Katılım Aralık 2019
10 Takip Edilen85 Takipçiler
Sarika N. Rao, DO
Sarika N. Rao, DO@SarikaRao·
@chase @ChaseSupport A delayed bag forced me to stay overnight and rebook my ferry. Chase denied my hotel and ferry claim but would reimburse toiletries. Was I supposed to sleep at the airport? Disappointing for a $795 Sapphire Reserve card.
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Sarika N. Rao, DO
Sarika N. Rao, DO@SarikaRao·
Thank you for the great questions and discussion!! Enjoyed being here 😀 #ahnschat
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Sarika N. Rao, DO
Sarika N. Rao, DO@SarikaRao·
@AHNSEndo I pts closely for the first 5 years (frequency varies between every 3-12 months w/in first 5 yrs). If no recurrence will space out visits. “Variability” is my theme tonight! but it’s true, one size does not fit all. A personalized approach is key!! #AHNSChat
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ThyCa Inc.
ThyCa Inc.@ThyCaInc·
Q5: Docs, what does the follow-up look like for a typical patient? #AHNSchat
ThyCa Inc. tweet media
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Sarika N. Rao, DO
Sarika N. Rao, DO@SarikaRao·
@ThyCaInc I often will see my patients at minimum 6 months after RAI for an ultrasound and to check labs. Then based on their original pathology and RAI outcome, I may chose to see them anywhere from 6 to 12 months thereafter, ongoing. But each case is different and will vary. #AHNSChat
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ThyCa Inc.
ThyCa Inc.@ThyCaInc·
@SarikaRao We do hear from folks in other countries that they sometimes don't have access to Thyrogen. :-( #AHNSchat
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Sarika N. Rao, DO
Sarika N. Rao, DO@SarikaRao·
@allenhomd Most of the studies have shown thyrogen vs hormone withdrawal has fairly similar outcomes. But sometimes with very widespread disease, some providers may elect withdrawal. Generally I still favor thyrogen, if accessible ! #AHNSChat
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Allen S. Ho MD
Allen S. Ho MD@allenhomd·
Sarika - do some endocrinologists feel that the withdrawal approach leads to greater RAI efficacy, compared to Thyrogen? Or is it considered more or less the same #ahnschat
Sarika N. Rao, DO@SarikaRao

@ThyCaInc Thyrogen=artificial TSH to stimulate thyroid cells to take up iodine. It does require stopping timed. Withdrawal= stop levothyroxine or brand for at least 2 weeks prior to “naturally” raise the TSH for the same effect, but patients don’t feel great with this approach. #AHNSChat

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Sarika N. Rao, DO
Sarika N. Rao, DO@SarikaRao·
@ThyCaInc Low iodine diet is needed to “starve” the remaining thyroid cells of iodine, so when we give the radioactive form, the cells will be “hungry” and more likely take it up. #AHNSChat
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Sarika N. Rao, DO
Sarika N. Rao, DO@SarikaRao·
#AHNSChat
Sarika N. Rao, DO@SarikaRao

@ThyCaInc A3: radioactive iodine (RAI) is not always needed. After surgery, the first step is to determine the risk of disease recurrence. If low risk of recurrence, then radioactive iodine may not be needed. High risk, we usually recommend RAI. Intermediate risk varies but ? lower dose

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Sarika N. Rao, DO
Sarika N. Rao, DO@SarikaRao·
@ThyCaInc A3: radioactive iodine (RAI) is not always needed. After surgery, the first step is to determine the risk of disease recurrence. If low risk of recurrence, then radioactive iodine may not be needed. High risk, we usually recommend RAI. Intermediate risk varies but ? lower dose
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ThyCa Inc.
ThyCa Inc.@ThyCaInc·
Q3: Docs, "To RAI or not RAI, that is the question" - this can be so confusing for many of us, and we worry about the risks from RAI. Many ask about secondary cancers later in life...and dry mouth. Are these things to be worried about? #AHNSchat
ThyCa Inc. tweet media
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Sarika N. Rao, DO
Sarika N. Rao, DO@SarikaRao·
@ThyCaInc Thyroid cancer often involves other parts of the thyroid, and bc the gland is very small it may be harder to re-operate in that region #AHNSChat
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ThyCa Inc.
ThyCa Inc.@ThyCaInc·
Q2: For our Docs. This is a great question...why can't you just take out the cancerous nodule(s)? Please tell us more about total vs. hemi (partial) thyroidectomies. Remember to answer with A2 and use our #AHNSchat hashtag! 😎
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Sarika N. Rao, DO
Sarika N. Rao, DO@SarikaRao·
Q2 Compliance with meds with known graves is the greatest preventative measure against thyroid storm, though there are always unforeseen changes which makes reg f/u with your provider equally as important #thyroidchat
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Sarika N. Rao, DO
Sarika N. Rao, DO@SarikaRao·
On an aside, although some thyroid surgeries are becoming minimally invasive, ex transoral, transaxillary, etc, for Graves this may not be the best approach (more technically difficult vs thyca) and must always be performed by a skilled surgeon #thyroidchat
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Sarika N. Rao, DO
Sarika N. Rao, DO@SarikaRao·
In addition to the responses below including needing more urgent and rapid control of their thyroid hormone levels due to acute life threatening complications from their high hormone. #thyroidchat
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Keşfet

@thepointsguy @FrequentMiler @chase @ChaseSupport @AHNSEndo @ThyCaInc @allenhomd @elonmusk