Dr. Kathleen Hands: At the forefront of thyroid care

Dr. Kathleen Hands’ Practice Focuses on Thyroid Disorders. One of the first things you notice upon entering Dr. Kathleen Hands’ office is a long hand-written chart posted on an inside door. It contains the record of her patients’ weight loss progress over a period of a year, with the collective sum of pounds lost, 2517, prominently underlined. “A lot of people come in here complaining of fatigue, daytime drowsiness and weight gain, and they blame their thyroid,” says the doctor, who is an endocrinologist specializing in thyroid disorders. “Many are on thyroid medication, and they shouldn’t be. Eighty percent of the time their thyroid function is perfectly normal. So I explain to them that their thyroid has nothing to do with the weight.” The real culprit in these cases is insulin. The more insulin you have in the body, the more fat you retain, she tells them, while drawing little diagrams on the white board of the examining room to illustrate the lesson. Then she proceeds to teach them how to eat to lower their weight through insulin control. The gist of it is few carbs, lean protein, vegetables, adequate water intake and no processed foods. Internists and family physicians are often too busy to do more than suggest weight loss to overweight patients, but as a consultant whom the patient is likely to see only a few times, she takes the time necessary to guide them through the process.

Profile-Hands3Some patients are disappointed because she won’t prescribe a pill remedy, but once the facts are clearly spelled out for them and a reasonable time frame established for the new diet to work, most are willing to change, and she is there to support them. Though Dr. Hands has become passionate about helping people reduce insulin resistance, she also deals with real thyroid disorders, which range from the quite common hypothyroidism (insufficient production of thyroid hormones) and Graves Disease (excessive production of the same hormones) to thyroid nodules, pregnancy-related disorders and cancer. Ninety percent of the patients are women. Most of these conditions are treatable, however. Though cancer incidence “is going up exponentially,” largely thanks to new scanning methods, the mortality rate is flat, with 98 percent of those affected surviving after 20 years. Knowing how to examine suspicious nodules to avoid unnecessary surgery or to map out lymph nodes for the surgeon, should an operation become necessary, is what she specializes in. She was the first endocrinologist in the country to obtain the Endocrine Certification in Neck Ultrasound (ECNU), a training that prepared her to use the technology to accurately perform ultrasound-guided biopsies on thyroid nodules, which may or may not be cancerous. Many surgeons won’t even operate without getting these data.

“I wanted to be a surgeon,” says the doctor, explaining how she got interested in ultrasound. “I like doing procedures. The biopsies are the closest I get to surgical procedures.” While many physicians use post-operative radioactive iodine – I 131 – to destroy whatever cancerous tissue may be left behind, Dr. Hands believes that such treatment should be avoided in most cases of low-risk thyroid cancer patients.

Determined to be a doctor

Born and reared in New Jersey, Dr. Hands has always known that she wanted to be a doctor. But life interfered in different ways, including illness in the family. For 18 years she worked as a physician assistant in diabetes care, but that desire to be a doctor never left her. Finally, at 40, she enrolled in medical school, and this time, she wasn’t going to let anything divert her from her intended life path. The Hands family moved to San Antonio 11 years ago when her husband, Michael, was transferred here by his company. Already an internal medicine physician, Kathleen decided to pursue a fellowship in endocrinology at the UT Health Science Center at San Antonio, where she developed the University Hospitals’ “insulin protocol” and a thyroid nodule clinic. After several years at UTHSC, the mother of three took a risk by opening her own practice in 2010, with Michael serving as her first office manager. “Being a Jersey girl, I don’t play well in the sandbox with others,” she offers as the reason for striking out on her own. “I am too much of a perfectionist. It’s difficult for me to work in a laissez-faire practice that doesn’t optimize patient care. I have to have the freedom to do it right, and I love what I do.”

Today, the doctor relies on her three grown children to help run her Thyroid & Endocrine Center of South Texas, the only thyroid-focused clinic in the area. While the practice is now established, she remembers how nervous her husband was about the solo venture in the beginning. Other naysayers were also trying to dissuade her. She forged ahead anyway. “If you are passionate about something, you can’t fail,” she asserts. “Believe in yourself, do the right thing, and trust in God to help guide you, and you’ll be OK. As long as you are doing something to help others, it’s very gratifying.” Dr. Hands attributes her present success to her old-fashioned doctoring, meaning listening to and carefully examining the patient, and to her children, who make sure that patients have a good experience while in her office. In fact, the latter often convey their appreciation for the staff’s dedication without being aware of the familial connection.

After seeing patients Monday through Wednesday, she spends every Thursday and Friday on the road, traveling all over the country to teach other endocrinologists and health care providers about thyroid cancer, neck ultrasound and diabetes treatment. In fact, she had just returned from such a trip to Chicago the day before our interview. Other commitments involve traveling as a national speaker to professional organizations and conferences, including the American Association of Clinical Endocrinologists’ upcoming meeting in Nashville, where Dr. Hands intends to present her research results about post-operative treatment of cancer patients. Asked about her interests outside of the office, she says her hobbies include sailing and playing flute but admits she has found little time for either since moving to Texas. Her greatest inspiration came from her father, who taught her to always do the right thing, no matter how difficult or unpopular. On our way out after our conversation, we pass again through the clinic’s cozy waiting room, where paintings by San Antonio artists are displayed and available for sale – a rather unique setup. I notice a couple of artists’ names I recognize, like Marcus Cerda and Jared DuCote. Do they sell? “Oh, yes,” says the doctor. “We do it as a favor to the artists.”

Photography by MARIE LANGMORE

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