Saturday, June 7, 2014

Thyroid Battery Part 5 - A Day at the Endocrinologist Office



Throughout the summer of 2013, I was bounced from one test to another by my "primary care" physician. Finally in August, I called my dad who lives North of me in Florida to ask who he sees for his Endocrinology needs.

"I'm sorry, honey. I had no idea. You need to tell me about these things.....and YES! You MUST go see my doctor! He is world-renowned and has a GREAT reputation. Let me give you his number. Tell him I sent you."

"Um, okay dad. I will."

From the research I did, he was a very long-established endocrinologist in the area with a great following. Unfortunately, the age and demographics were not disclosed in this research, but I did not know anybody down here in SW Florida well enough to personally ask. Dad was still alive, so I gave it a go.


The doctor I was greeted with at my first appointment was very, very old. It was evident he was trying to appear "younger" by the very thin, combed-over, dyed "do" in an awful shade of bronze-brown. He stiffly waddled into the room like a hunched-over character from South park. He went to take a look in my ears and eyes, like every old-time doc I remember. The power for the contraption was unplugged. Took us both a minute to figure out the problem, but I saw the dangling cord and fixed it to get this thing over with.

Now, don't get me wrong. I have a very deep respect for our elders. I would not know half the stuff I do now, or have been challenged to learn MORE by their encouragement. But this...just made me uneasy. Call it intuition, fate to spring-board to a higher understanding...whatever. This did not feel right.

 He later concluded that he thinks I definitely "have an enlarged portion of my thyroid", "need to get that checked out", "might have some hormone imbalances" and proceeded to write a long list of tests from ANOTHER Ultra-sound to labs to a pituitary MRI that I had to schedule, in tandem, "before I saw him next." With my schedule (I actually WORK), and the way medical offices schedule things down here with all the elderly retirees in Florida, I was sincerely concerned this man would be dead "before I saw him next."

"Just do what he says!" my father scolded me after expressing my concerns. Ugh. So I did.

After the battery of tests I was prescribed to do: a.) my NEW (3rd) Ultrasound indicated I now had 4 nodules in my Thyroid remnant, my brain MRI to check my pituitary was "inconclusive" (because of clerical error in the orders, I later discovered) and my labs were "relatively normal". I then got the lecture about how I seemed to be a "very stressed-out lady" from this "renowned endocrinologist".

"Um, pardon me, sir...but with all things considered, DO YOU BLAME ME???"

"No, no, no sweetheart. It's perfectly understandable. You are getting to that age when "things" can start changing."

"I'm 45. Nothing has changed "that way." I am having the same troubles I had 10 years ago when I had my thyroid operation, but the heart palps are getting worse. And my dad, who had pituitary issues, started having them about the same age I am now. He's YOUR patient.  BUT, you told me the MRI was "inconclusive because it wasn't ordered "properly"."

The radiology firm that did the MRI confirmed with me by visual proof that: a.) IF a scan of the pituitary was mandated, a completely DIFFERENT set of sequences would have been done, AND b.) the orders given by the assigning doctor's front office did NOT indicate this was the order. After mentioning this to the doctor, I was told that he had a "specialist" who would be able to review the scans that WERE done and give a conclusive reading. This made NO sense to me, but just documented it as I had been doing all along. (Imagine my "surprise" when the mentioned "specialist" concluded a few weeks later that the $1,000 botched test I was paying for in deductible showed "normal" results. No further observation notes were available.)

"Well, the good news is, judging from your lab work, I think I may be able to help you."

My cynical brow framed my piercing glare.

"I think you need to have your progestrone level raised. Your levels were very low. It should help balance you out, and reduce your anxiety, too. It comes in a creme. It is made by a local pharmacy here from real USP sources which circumvents the risks posed by synthetic progesterone sources."

I also took this opportunity to ask about a brown splotch on my nose, and a brown line that had prominently appeared on my left thumb-nail in the past month. Upon examination, I was also written a referral to see a dermatologist he knows.

I closed my eyes. I already knew how to get USP grade progesterone cream. Researched it. Never needed it. As my anger started to quietly smolder, I considered that perhaps this old codger knew something I didn't. It was supposed to last 3 months into 2014. We didn't get that far.

More to come.



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