Unholy Sinner [R-18]

7 : Hyperthyroidism

Hyperthyroidism

✔️ ⬆️thyroxine, inc. metabolic rate
✔️tumor
✔️autoimmune

ASSESSMENT
1. HEAT INTOLERANCE
2. Sweating : warm skin"feverish", red moist skin
3. Tachycardia, palpitations
4. Inc peristalsis-diarrhea ( fluid and electrolyte imbalance)
5. Weight loss
6. Exopthalmus (periorbital edema)
-incomplete closure of eyelids - risk for injury
7. Amenorrhea

DIET :
High calorie, low fiber (diarrhea)

MANAGEMENT
1. Thiomide
- prophythiarucil (PTU)
-Methinazole (tapazole)
S/e : sore throat (agranulocytosis)
2. Thyroidectomy - lifetime medications
*Lugol's solution - before surgery to prevent bleeding and dec. thyroid hormones.

*laryngeal nerve damage - persistent hoarseness of voice 1 week post surgery

*laryngospasms - calcium gluconate

*THYROID STORM - exaggerated symptoms dues to stress, infection/illness, surgery

* Grave's disease- autoimmune hyperthyroidism

⚜️🔱⚜️

Aviona

Iniwasan ko si Luke. As much as possible, hindi ko na siya pinapatuloy pa sa apartment ko.

I also often meet up with my sister and she has a lot of stories to tell me everytime.

" Alam mo ate, napapansin ko na palaging focus si Luke sa studies niya and everything." She said. Tumango ako

" He might be doing his best because it's his last year. Shempre dapat maganda ang record niya diba?" I just told my sister.

" Ate I'm gonna tell you a secret" She started. I acted out like I am very willing to listen to her.

" Last night, kinausap ako ni Dad. Pinagkasundo niya kami ni Luke. He told me that Luke is a good man and that I should marry him. May family dinner tonight tapos ininvite nila mama iyung pamilya ni Luke so that we could talk about our engagement after graduation." Parang bombang sumabog sa harapan ko ang sinabi ng aking kapatid. It was as if my world moved upside down.

" Alam mo ate, I'm so happy dahil narinig ko kay mama na pumayag daw si Luke" She giggled. Ako naman ay parang nawalan ako sa sarili. My face must have paled in front of her. She's a year younger than me. Kaya hindi nagkakalayo ang edad nila ni Luke. Luke is just a year older than me.

" Ate okay ka lang ba?" Concern was evident in her voice.

Dun ko lang namalayang natulala pala ako.

" Ahh yes, I'm okay. May naisip lang ako. Nakalimutan ko pala iyung sinampay ko." I reasoned out. Buti na lang at biglaan din ang pagbuhos ng ulan sa labas para sang-ayunan ang pagdadahilan ko.

We talked about other things. I tried to avert my thoughts to what we are talking as of the moment and forget about Luke.

Hanggang sa dumating iyung sundo ni Cassy saka lang natigil ang pag-uusap namin.

" Oh bye ate. I think I need to go. I better get ready for my meet up with Luke's family. Shempre dapat maganda ako diba?" She said. I smiled trying to hide the jealousy that I am feeling.

" Bye Cassy. Enjoy your dinner tonight. Kahit wala ako, you know that I am always happy for you" I said sincerely.

Bago namatay si mama, sinabi niya sa akin na mahalin ko ang kapatid ko. Dahil siya nalang ang naiiwang pamilya ko. And if giving up this feelings I have for Luke will make my sister happy then I won't think twice on doing it.

——