Thyroid Surgical Diseases - An Accomplishment - A Legacy
I wrote "Thyroid Surgical Diseases" in 1996.
It was liked by consultants and residents from several different hospitals. I can recall Dr. Sammy Ang, the departments of surgery of Batangas Regional Hospital, Zamboanga City Medical Center, Philippine General Hospital liking it, among others.
See feedback below.
This is a legacy I leave behind for the surgical residents and in surgical education.
https://www.scribd.com/document/367323918/Thyroid-Surgical-Diseases-ROJOSON-1986
https://sites.google.com/site/thyroidsurgicaldiseasesroj1986/
https://www.facebook.com/media/set/?set=a.1049005138582877&type=1&l=d66c13c059
August 19, 2011
I received this note from Dr. Matic.
Hi Sir. I remember when I was a resident, I read a book about thyroid disorders which was handed to me by my consultants at that time that you authored. It was very useful for me. It made the topic of thyroid really simple to understand. I'm just wondering if your have any plans sir to coming up with a second edition. I can help you with it, if you want sir.
Marwin Emerson V. Matic, M.D.
Head and Neck Surgical Oncology
General Surgery
De La Salle University Medical Center
Dasmarinas, Cavite
August 18, 2011
Dr. Matic is NOT the first person who has given me positive feedback on the book that I wrote circa 1986. It was entitled "Thyroid Surgical Diseases." It was liked by consultants and residents from several different hospitals. I can recall Dr. Sammy Ang, the departments of surgery of Batangas Regional Hospital, Zamboanga City Medical Center, Philippine General Hospital liking it, among others.
Dr. Matic's note serves as the latest stimulus for me to come out with a 2nd edition or 2nd book on thyroid disorder.
First thing I have to do is to get hold of my 1986 book entitled: "Thyroid Surgical Diseases" and decide whether I will make a 2nd edition and come out with a completely new format.
I don't think I have a copy of this book anymore. However, I heard from Dr. Hazel Turingan that she saw a copy of this book in the office of the Division of Thoracocardiovascular Surgery in the Philippine General Hospital when she was rotating there 3 to 4 years ago. It was a copy of Dr. Jimmy Esquivel. I will inquire.
I gave Dr. Sammy Ang a copy more than 20 years ago. I don't know whether he still has the copy. Again, I will inquire.
NOTE: If anybody happens to have a copy of the book, I will appreciate lending it to me so that I can review and revise for a possible 2nd edition.
Good day sir. I already found the copy of your book I used during residency. It was hoarded by one of our residents in La Salle. However, it was a pirated version of your book pala. I hope you do not mind. It is a photocopied book of a copy you gave to Dr. Jess Villanueva. Nevertheless, sir, reading your book was a great help in my understanding of thyroid surgical diseases.
In the event you would like to author a newer edition, I would be very much honored to help you sir in any way I can. Since i have another copy, we can work on the book simultaneously, if you wish sir.
Marwin Emerson V. Matic, M.D.
Head and Neck Surgical Oncology
General Surgery
De La Salle University Medical Center
Dasmarinas, Cavite
September 5. 211
Sir Rey,
I have a copy. It's somewhere in the house. I will look for it. There have been a lot of changes in the management of thyroid diseases since you came up with that book. I'm not sure though that the controversies have lessened. Your book helped me in my practice when I was still a young consultant and a new edition will help in a great way even at this stage of my career. I am very thankful for it! Louis
From Louis Limjoco (August 19, 2011)
Sir Rey,
i still have a copy of your original book on thyroid surgical diseases which i require my residents to read and have it copied.i also have a copy of your book on neck dissection.i will have the thyroid book copied and send to your office. Sa ospital ng maynila ba sir? ALEX
From Alex Palines (August 9, 2011)
Yesterday, Sept 3, 2011, I got hold of a copy of my very own book entitled “Thyroid Surgical Diseases.” This was brought to my clinic in MDH by Dr. Alex Palines from Batangas City. Thanks, Alex. I was so happy to see the dedication or autograph I made to Alex in 1986. More so, I am happy to know that he has kept the book all these years, from the time of EDSA I revolution, and as he has said, used it for himself and for all his residents in Batangas City Regional Hospital. Having received the book, I am set to review it and come out with a 2nd edition or 2nd book on thyroid diseases.
ROJoson emailed to MCCCAR group
September 4, 2011 11:02 AM
Subject: [mcccars] Confusing Management of Patients with Thyroid Disorders (by Physicians)
September 3, 2011, in my Saturday clinic in MDH, I had a patient with a thyroid concern. He has a 4-cm nodule on the right lobe of his thyroid gland which was noted 5 months ago. He has seen other doctors before me and he came to me for another opinion.
As has been my practice, whenever a patient come to me for second or nth opinion, I don't usually ask right away what were the opinions of the previous doctors. As much as possible, I don't let the opinions of the previous doctors influence my evaluation and what I have to say to the patient and his relatives in terms of diagnosis and my recommendations. It is only after I have given my diagnosis and opinions on medical management that I ask for what the patient has been told by the previous doctors. This is more out of curiosity. Sometimes, I don't ask anymore and oftentimes, I don't ask for the names of his previous doctors and their respective advices to avoid any repercussion.
In this particular patient, I did what I usually do for patients coming for a second or nth opinion. After I did my focused interview and physical examination, aided by written explanation and analysis and with the use of drawings and illustrations, I told him chances are he has a colloid adenomatous nodule (a non-cancer thyroid disorder).
Before I took a look at all diagnostic tests that were done on him by the previous doctors, I told him the following:
"If you have thyroid function tests done, I expect them to be normal as you have a thyroid nodule and a normal pulse rate." [True enough, the results of his thyroid function tests were normal as I predicted.]
"If you have an ultrasound done on your thyroid gland, if the result shows cystic or complex mass, that will support my diagnosis of a colloid adenomatous nodule." [True enough, the result of the ultrasound showed the term "complex mass."]
Integrating the results of the diagnostic tests with my clinical evaluation (based on the symptom and sign data that I got from interview and physical examination respectively), I told him that I was 95% sure that his thyroid nodule is a colloid adenomatous nodule.
I then told him the options for further management, diagnosis-wise and treatment-wise. Diagnosis-wise, I recommended a needle evaluation and biopsy. If the result of the needle evaluation and biopsy supports the diagnosis of colloid adenomatous nodule, he has the options of surgical and non-surgical treatment (trial of medical treatment). If the result unfortunately shows something in favor of cancer, then the treatment is surgical or operation.
After hearing my explanations and recommendations, he was quite quick in consenting to a needle evaluation and biopsy which I did in my clinic. The main reason why he was quite quick in accepting my recommendation was because he was afraid of surgery and ALL the doctors he had previously seen, which included endocrinologists and surgeons), recommended SURGERY RIGHT AWAY. He was told by an endocrinologist that there is a high chance that the nodule is CANCER because he is a MALE.
Using a hypodermic needle, I was able to aspirate 3-cc of brown fluid. After aspiration, there was a marked decrease in the size of the thyroid nodule. With these findings and the appearance of the specimen that I smeared on a glass slide which was suggestive of colloid gel, I told the patient I would now increase my degree of certainty to 98% to 99% that the thyroid nodule is a colloid adenomatous nodule. I told him, though, we still have to await the result of the microscopic examination of the specimen (biopsy) for a definitive pretreatment diagnosis.
The patient left my clinic markedly relieved that he has a 98 to 99% chances of NOT having a thyroid cancer and that he has an option for a non-surgical treatment. He said he will be able to enjoy the Lion King play in Singapore on September 11, 2011.
However, before he left my clinic, he made a friendly comment to me: "You doctors are so confusing."
NOTE1: I am happy to help this patient based on what I think should be done . I am a surgeon but I don't operate left and right. I operate only when indicated and needed.
NOTE2: This incident, especially, the parting comment of the patient, serves to reinforce the requests of my former students to update my 1986 book on "Thyroid Surgical Diseases.'' (See my Facebook Wall: 2nd Edition or 2nd Book on Thyroid Diseases? - August 19, 2011) The main objective of this book was to attempt to clear up confusion in the management of patients with thyroid disorders. In this book, I have a chapter with the title: "Pitfalls in the Management of a Patient with Thyroid Problem." The circumstances in the management of the patient described above are reflective of what I included as pitfalls in this chapter.
From: Manuel Francisco Roxas <ramroxas_md@yahoo.com>;
To: mcccars@yahoogroups.com <mcccars@yahoogroups.com>; rjoson2001@yahoo.co <rjoson2001@yahoo.co>;
Subject: Re: [mcccars] Confusing Management of Patients with Thyroid Disorders (by Physicians)
Sent: Sun, Sep 4, 2011 4:25:18 AM
Very inspiring sir. I do believe you should update your booklet. There is certainly a crying need since the teaching of head and neck surgery across many GS programs has fallen along the wayside. Makes me think we should also come up with a colorectal text book because the management of colorectal diseases is advancing so rapidly we ourselves are constantly pushing to keep up. As they say for all academic surgeons: "We are only as good as our last publication".
ROJ@18dec23