When It Isn’t Tonsillitis

Dr. Karni with Shelby Boatwright

Repeated bouts of strep throat and suspected tonsillitis led Shelby Boatwright’s primary care physician to refer her to William C. Yao, MD, an assistant professor in the Department of Otorhinolaryngology-Head and Neck Surgery in McGovern Medical School at UTHealth. Boatwright’s tonsils appeared normal, but during his examination, Dr. Yao found a nodule on her thyroid.   “It was strange that I had so many exams for strep without anyone noticing it,” she says. “When Dr. Yao said he was going to order an ultrasound, I started to panic, but he was calming and reassuring.”

With ultrasound results showing that the nodule was large enough to biopsy, Dr. Yao referred Boatwright to Ron Karni, MD, chief of the division of Head and Neck Surgical Oncology the Department. “Dr. Karni is our thyroid specialist,” he told her. “You’re in great hands.”

Dr. Yao saw Boatwright on a Thursday in February; she was in Dr. Karni’s office the following Monday for an ultrasound-guided fine needle aspiration thyroid biopsy. “By the nodule’s appearance on the scan, I had a sense that it would turn out to be thyroid cancer,” Dr. Karni, who is an associate professor of otorhinolaryngology and medical oncology, says. “We got the final pathology report two days later on February 14.”

Boatwright and her twin sister, Tatum Boatwright, had gone to a Chinese restaurant for dinner. As she left the restaurant, she checked her phone and found a message from Dr. Karni telling her he had the results of her biopsy. She had stage 1 papillary thyroid cancer.

She was in Dr. Karni’s office the following morning at 7:45 a.m. to discuss treatment. “I work in health care and hear stories like mine all the time,” says Boatwright, who is a marketing representative at Children’s Memorial Hermann Hospital at Memorial Hermann-TMC. “We’re all guilty of this – thinking it’s never going to happen to me, especially at the age of 25. It’s my job to promote Memorial Hermann, and I do it every day but now I’ve had a personal experience of the quality of care we deliver. Everything went like clockwork, and everyone worked in sync. They were all amazing.”

Dr. Karni took Boatwright to the OR on February 20 and removed the right lobe of her thyroid, including a 2-centimeter tumor, with clear margins. “We caught it early, and she has an excellent prognosis,” he says. “She made a good recovery after surgery, with no voice problems.”
After one night in the hospital, she was discharged. “My throat was sore from the surgery, but I was never in pain. It was like I’d done a hard neck workout,” she says. “I had a pain prescription, but I never even filled it.”

Dr. Karni referred her to Philip Orlander, MD, an endocrinologist affiliated with Memorial Hermann-TMC and a professor in the Department of Internal Medicine at McGovern Medical School. “Our endocrine tumor programs consists of surgeons, endocrinologists, radiologists, pathologists and nuclear medicine physicians,” Dr. Karni says. “Our goal is to deliver the highest quality of care in a patient-centered manner.

“It’s a credit to Dr. Yao that he did such a thorough physical examination,” Dr. Karni adds. “A good exam leads to an accurate diagnosis and quick action, which is always important, and especially so in the case of cancer.”