What is Endocrinology?
Endocrinology is a subspecialty that focuses on disorders of various hormones. Common problems include diabetes and disorders of the thyroid, pituitary and adrenal glands. Testosterone deficiency and osteoporosis are also treated by an Endocrinologist.
What to expect at your visit?
The first visit will begin with a brief discussion about why you are being seen and your medical history. All the tests already done along with the notes from the referring physician will be reviewed. A physical exam will be done with special attention to the problem in mind. A plan will then be formulated which may include blood/laboratory tests, imaging tests, prescription medication to treat your disorder, and appropriate followup visit to monitor your progress. Where appropriate, each patient will be offered education in nutrition and exercise as necessary. Our goal is to create the most well-rounded personalized experience for each patient in order to optimize their health and well being.
Will I need a follow up visit?
Most patients with hormone disorders need follow up, although the frequency of such visits will vary by the condition and patient. Labs and other results are not discussed over the phone unless specified otherwise. Once the endocrinology problem has been treated successfully and no longer requires active monitoring, the patient is typically discharged to the care of his or her primary provider and can make a follow up appointment with the Endocrinologist as the need arises.
Diabetes is a disease usually in which there is either too little insulin or too much insulin resistance. Complications of diabetes can include problems with vision (retinopathy), kidney function (nephropathy), nerves (neuropathy) and atherosclerosis.
We offer initial consultation and follow up, insulin starts and pen teaching, comprehensive patient education, insulin pump starts and management, continuous glucose monitoring, and glucometer downloads.
The thyroid gland produces a hormone called thyroxine which controls the body’s conversion of food into energy (metabolism). An ultrasound can determine the size and shape of the thyroid gland. Changes in size, shape and the appearance of lumps on the thyroid gland can be assessed using the ultrasound images. Lumps in the thyroid are common and are easily treated in most cases. Ultrasounds are performed by the medical providers in the office and usually take around 30 minutes to perform.
Thyroid FNA (Fine Needle Aspirations)
The thyroid gland is found in the neck just below the “Adam’s apple.” This gland is responsible for producing thyroid hormone, which is an important hormone that stimulates the metabolism of the body. Between 4% and 7% of people in the United States have lumps (or nodules) in their thyroid gland that can be felt on examination. The doctors at the Clinic always holds a degree of concern whenever a new growth is detected on the body, regardless of the tissue involved. The concern is whether or not the growth or nodule is cancer (malignant). Fortunately, fewer than 5% of thyroid nodules are malignant. The majority of thyroid nodules are harmless growths, known as adenomas, and are contained within a capsule.
A biopsy to obtain tissue for analysis is the best technique for detecting or ruling out the presence of cancer. For many years, a core biopsy of the thyroid was the procedure of choice. This method involved a large biopsy, which was often more difficult for patients. A fine needle aspiration biopsy has now become the method of choice for obtaining samples of thyroid tissue. The procedure is technically quite simple. When performed properly, the testing has a false negative rate of less than 5%. This means that a positive finding, such as cancer, will be missed fewer than five times out of 100.
In most cases, if the nodule can be felt, a biopsy can be performed in the doctor’s office. In some cases, an ultrasound may be needed to help guide the biopsy. For example, if the nodule cannot be felt without difficulty or if the nodule has areas within it that specifically should be biopsied.
Insulin pumps are small, portable devices that deliver fast-acting insulin 24 hours a day. About the size of a small cell phone or MP3 player, insulin pumps deliver insulin through a small tube and cannula (known as the infusion set) placed under your skin.
The amount of insulin delivered can be changed by the user. When you eat, you use buttons on the insulin pump to give yourself more insulin. This is called a “bolus”. You can determine the size of the bolus using calculations based on the amount of carbohydrates you eat. When you use an insulin pump, you must still monitor your glucose levels during the course of a day. You set the doses of your insulin and adjust the doses based on your food intake and exercise program.