Wednesday 26 November 2008
Pressure
Just received a letter from my doctor regarding making an appointment to have a 24 hour blood pressure monitor done. No idea what this involves, but we've arranged to do it on the 28th January 09
Tuesday 11 November 2008
First Endo Appointment
I'm not sure we've made the best first impression with each other.
Let me explain.
I turned up at 2 o'clock, 30 minutes before my scheduled appointment time, as requested in the letter I received. I checked in and all was breezy.
I sat and read my book for an hour, and then my name was called.
The nurses weighed me, took copies of my latest blood tests, and then sent me off with a sample pot to wee in. I'd drunk so much coffee by this time that this request was easy.
I then sat back in the waiting area for another 40 mins or so, and was called again. This time they wanted to send me for an ECG...routine for new patients apparently. And so I headed off to hunt for the elusive ECG room...I hunted high and low, I followed various sets of directions from all manner of hospital staff that I came across in my travels around the maze of corridors, and after getting increasingly frustrated and irrationally angry about the whole process, I finally found it...hidden near what appeared to be some laundry rooms...of course!
ECG results back in hand, I headed back to the outpatients department, and gave them into the nurse's station.
And than I sat back down and waited....and waited....and waited.
Around 5.30pm I realised that I was the only person left in the waiting room, and that the cleaning staff were starting to converge...emptying bins and sweeping the floor. The nurses were in their room, sitting around with coffee, presumably winding down after their shift. The receptionist looked as if she was doing her final tidy-up before heading home, and she looked at me puzzled, as if she'd only just noticed I was still sitting there.
I was tired, I was grumpy, I was snappy and I was starting to get upset. Then the consultant endocrinologist himself walked into the waiting area, with his brief case, looking for all the world as if he was clocked-out and heading home. He asked me why I was still sitting there...I looked him in the eye and replied that I was waiting for my 2.30pm appointment. He looked confused, asked me my name, conferred with the receptionist, called up one of the nurses, and then, with a sigh, he turned and invited me back into his consultation room.
I must confess, I was incredibly pissed off at this point, and I went to war on him....I told him I had better things to do than sit in his waiting room for 3+ hours, and told him inconsiderate it was to keep his patients waiting so long, how we do have lives, and why bother giving out specific appointment times if they weren't going to even bother trying to stick to them.
He then started back at me, saying that occasionally appointments take longer than expected, and would I want to have a strict, timed appointment, or would I prefer to have as much time with the doctor as my particular case required, and hence why appointments can start to run late.
I explained that I understood all that, and that yes, I would be very angry if my consultant was clock-watching throughout my appointment...but seriously, going in to his consultation room at 5.45pm, when my allotted appointment time was 2.30pm was more than a little excessive!
I suggested, that instead of giving out set times, why not just work on a first come-first served basis...we spent a good 5 minutes or so shouting at each other - we were going around in circles, and he stormed out a side door, where I overheard him giving the nurses a very hard time over it all....like it was their fault, apparently...
He came back in, looking more than a little sheepish - I guess one of the nurses threw some of that flack right back at him - and suggested we start again, and try to get back on the right foot with each other.
He spent a good while going over all my recent blood tests, mumbling into his Dictaphone, and then finally addressing me with the news that I was had a classic case of Grave's Disease....a momentous occasion for us all I might add!
We talked over what that meant, what my medication should do to help, he briefly mentioned Radio-Active Iodine treatment (RAI) and also thyroid surgery, but also added in quickly that it was very possible it wouldn't come down to that, and that hopefully the medication would be sufficient to cause my thyroid to comply and go into a state of remission.
He also expressed concern over my high blood pressure, and suggested I have a 24hr blood pressure monitor done. He said he would write to my GP about this. He also wrote me a prescription for Centyl-K to help with my blood pressure - but I don't think I'll be filling it - I'm too young to be on medication for hypertension FFS!
He made an appointment for me to return in February '09. My appointment time was given as 2.15pm this time, so I joked that I should probably turn up around 5.30pm then...he had the good grace to laugh, and said "No, we won't make that mistake with you again".
Let me explain.
I turned up at 2 o'clock, 30 minutes before my scheduled appointment time, as requested in the letter I received. I checked in and all was breezy.
I sat and read my book for an hour, and then my name was called.
The nurses weighed me, took copies of my latest blood tests, and then sent me off with a sample pot to wee in. I'd drunk so much coffee by this time that this request was easy.
I then sat back in the waiting area for another 40 mins or so, and was called again. This time they wanted to send me for an ECG...routine for new patients apparently. And so I headed off to hunt for the elusive ECG room...I hunted high and low, I followed various sets of directions from all manner of hospital staff that I came across in my travels around the maze of corridors, and after getting increasingly frustrated and irrationally angry about the whole process, I finally found it...hidden near what appeared to be some laundry rooms...of course!
ECG results back in hand, I headed back to the outpatients department, and gave them into the nurse's station.
And than I sat back down and waited....and waited....and waited.
Around 5.30pm I realised that I was the only person left in the waiting room, and that the cleaning staff were starting to converge...emptying bins and sweeping the floor. The nurses were in their room, sitting around with coffee, presumably winding down after their shift. The receptionist looked as if she was doing her final tidy-up before heading home, and she looked at me puzzled, as if she'd only just noticed I was still sitting there.
I was tired, I was grumpy, I was snappy and I was starting to get upset. Then the consultant endocrinologist himself walked into the waiting area, with his brief case, looking for all the world as if he was clocked-out and heading home. He asked me why I was still sitting there...I looked him in the eye and replied that I was waiting for my 2.30pm appointment. He looked confused, asked me my name, conferred with the receptionist, called up one of the nurses, and then, with a sigh, he turned and invited me back into his consultation room.
I must confess, I was incredibly pissed off at this point, and I went to war on him....I told him I had better things to do than sit in his waiting room for 3+ hours, and told him inconsiderate it was to keep his patients waiting so long, how we do have lives, and why bother giving out specific appointment times if they weren't going to even bother trying to stick to them.
He then started back at me, saying that occasionally appointments take longer than expected, and would I want to have a strict, timed appointment, or would I prefer to have as much time with the doctor as my particular case required, and hence why appointments can start to run late.
I explained that I understood all that, and that yes, I would be very angry if my consultant was clock-watching throughout my appointment...but seriously, going in to his consultation room at 5.45pm, when my allotted appointment time was 2.30pm was more than a little excessive!
I suggested, that instead of giving out set times, why not just work on a first come-first served basis...we spent a good 5 minutes or so shouting at each other - we were going around in circles, and he stormed out a side door, where I overheard him giving the nurses a very hard time over it all....like it was their fault, apparently...
He came back in, looking more than a little sheepish - I guess one of the nurses threw some of that flack right back at him - and suggested we start again, and try to get back on the right foot with each other.
He spent a good while going over all my recent blood tests, mumbling into his Dictaphone, and then finally addressing me with the news that I was had a classic case of Grave's Disease....a momentous occasion for us all I might add!
We talked over what that meant, what my medication should do to help, he briefly mentioned Radio-Active Iodine treatment (RAI) and also thyroid surgery, but also added in quickly that it was very possible it wouldn't come down to that, and that hopefully the medication would be sufficient to cause my thyroid to comply and go into a state of remission.
He also expressed concern over my high blood pressure, and suggested I have a 24hr blood pressure monitor done. He said he would write to my GP about this. He also wrote me a prescription for Centyl-K to help with my blood pressure - but I don't think I'll be filling it - I'm too young to be on medication for hypertension FFS!
He made an appointment for me to return in February '09. My appointment time was given as 2.15pm this time, so I joked that I should probably turn up around 5.30pm then...he had the good grace to laugh, and said "No, we won't make that mistake with you again".
Wednesday 10 September 2008
Quite possibly...
...the scariest day of my life!
Despite a positive diagnosis on my thyroid, my referral to an endocrinologist still hadn't come through. I had been avoiding my GP, and going back to my 'more familiar' Ostrich approach to it all, despite several missed calls and messages to my mobile phone from my GP.
I hadn't filled my prescription for Neomercazole, AKA Carbimazole (CBZ) as money was extremely tight, and I figured it was an unnecessary expense at this time.
I knew I was ill....but sure, hadn't I been ill for years with no medication, and nothing terrible had happened had it?
Well today, was the day I learned that lesson all well and good!
The day started as any other day....tea, cigarettes....more tea, more cigarettes.....some light housework, then onto the computer to see who was up to what in Internet-land...
I had a funny pain in my back, and felt a bit nauseous...but I mostly ignored it. I think I commented on it when J came home on his coffee break...but by the time lunchtime came around I was in a full panic. The back pain was spreadingto the front of my chest, I had pins and needles in my arms, going hot and cold, huge waves of nausea, but not able to actually be sick...but the time J came home for lunch I was in all out panic mode. At this point I had Googled the syptoms for a heart attack, and went into all out hysteria as I read the list and ticked off all the symptoms one by one. My pulse was all over the place, but mostly racing. And as it slowly dawned on me that perhaps this was it, I was finally going to die....I realised I was no where near ready to die...!
J wanted to take me to the GP...I knew that we didn't have the money for an appointment, and for the same reason we couldn't afford to call an ambulance either. I was imploring him to ring our landlord, who works as a paramedic, for some solid advice on what might be going on...but he refused, insisting we went to the GP first. The row over deciding what to do was making me feel worse by the second...and I realised that whatever we did we had to do it quickly, and so we headed to my GP.
She stuck me straight onto her ECG machine...and we were both mighty relieved to see that I hadn't had, nor was I currently having, a heart attack...phew! As far as my heart was concerned all was A-OK. She did various other tests on me, drew several vials of blood from me...and concluded, from the symptoms, that I was most likely duffering from an overdose of thyroid hormone, which may or may not have been dumped suddenly on my system. And if continued unchecked I would shortly go into a full blown thyroid storm, of which two symtpoms immediately jump out at you: coma & death. Either way, she insisted that I had to start to take this seriously, I was a very ill woman and the sooner I copped on to that and started following instructions the better...for me.
You know....we filled that CBZ prescription on the way home, I started my meds that night!
Despite a positive diagnosis on my thyroid, my referral to an endocrinologist still hadn't come through. I had been avoiding my GP, and going back to my 'more familiar' Ostrich approach to it all, despite several missed calls and messages to my mobile phone from my GP.
I hadn't filled my prescription for Neomercazole, AKA Carbimazole (CBZ) as money was extremely tight, and I figured it was an unnecessary expense at this time.
I knew I was ill....but sure, hadn't I been ill for years with no medication, and nothing terrible had happened had it?
Well today, was the day I learned that lesson all well and good!
The day started as any other day....tea, cigarettes....more tea, more cigarettes.....some light housework, then onto the computer to see who was up to what in Internet-land...
I had a funny pain in my back, and felt a bit nauseous...but I mostly ignored it. I think I commented on it when J came home on his coffee break...but by the time lunchtime came around I was in a full panic. The back pain was spreadingto the front of my chest, I had pins and needles in my arms, going hot and cold, huge waves of nausea, but not able to actually be sick...but the time J came home for lunch I was in all out panic mode. At this point I had Googled the syptoms for a heart attack, and went into all out hysteria as I read the list and ticked off all the symptoms one by one. My pulse was all over the place, but mostly racing. And as it slowly dawned on me that perhaps this was it, I was finally going to die....I realised I was no where near ready to die...!
J wanted to take me to the GP...I knew that we didn't have the money for an appointment, and for the same reason we couldn't afford to call an ambulance either. I was imploring him to ring our landlord, who works as a paramedic, for some solid advice on what might be going on...but he refused, insisting we went to the GP first. The row over deciding what to do was making me feel worse by the second...and I realised that whatever we did we had to do it quickly, and so we headed to my GP.
She stuck me straight onto her ECG machine...and we were both mighty relieved to see that I hadn't had, nor was I currently having, a heart attack...phew! As far as my heart was concerned all was A-OK. She did various other tests on me, drew several vials of blood from me...and concluded, from the symptoms, that I was most likely duffering from an overdose of thyroid hormone, which may or may not have been dumped suddenly on my system. And if continued unchecked I would shortly go into a full blown thyroid storm, of which two symtpoms immediately jump out at you: coma & death. Either way, she insisted that I had to start to take this seriously, I was a very ill woman and the sooner I copped on to that and started following instructions the better...for me.
You know....we filled that CBZ prescription on the way home, I started my meds that night!
Monday 25 February 2008
A definite diagnosis...at last!
The cellulitis still wasn't responding to anti-biotics as well as it should, so I was glad to be going back to see the doctor...but there was also a little trepidation as I realised that my blood test results would be available today as well.
I had an ultra painful injection in my bum....seriously, it continued to sting for several hours afterwards, as indeed my doctor warned me it would. But it did finally kick my cellulitis into submission and sent it on its merry way after just a few more days of hot, itchy ankle.
As suspected, my blood test results did show a thyroid abnormality....but surprisingly, despite me having obvious symptoms of weight gain, lethargy, lack of libido etc, the test results showed that I was in fact hypERthyroid, and not hypOthyroid as I had always assumed. We were both a little confused by that, but my doctor had done some research and explained that sometime hypERt patients gain weight inexplicably instead of lose it...I guess I was one of the unlucky ones. In hindsight, I seem to gain weight both when I'm hypo and also when I'm hyper...I just can't win in the weight game.
The tests also showed that my liver function was way out of whack....I was suddenly scared, after watching all the public health announcements and TV adverts regarding binge drinking, thinking that I'd overdone it during my student days, but my doctor immediately put me at ease and said that in the absence of any other symptoms for now we'd put my wonky liver down to my thyroid, and that if the liver function tests didn't improve in subsequent blood tests, THEN we'd look into it all a little more.
A few other test results were marginally out of range, but she reminded me that with my current case of cellulitis my body was presently fighting a huge battle with the incumbent infection. And that for now we should ignore those too.
She told me that she was going to refer me to an endocrinologist, and having previously explained to her the nightmare I'd had with a so-called 'specialist' at a local hospital, she asked me if I would mind travelling a little further, to a hospital in a neighbouring county, in order to see a proper endocrinologist. I jumped at the opportunity, and said I'd go anywhere, as long as she didn't send me back to the ignorant local 'specialist'.
She said she wouldn't initially put me on any anti-thyroid medication as she preferred that to be controlled by the endocrinologist...but if I was waiting too long for an appointment I should return to her and we would discuss starting on anti-thyroid drugs (ATDs). She informed me that when I had received the primary endo appointment to come in a week earlier and get some more blood tests done, so that the endocrinologist would have the most uptodate test results to work from during my initial consultation.
She gave me a copy of last week's blood test results and told me to keep them in a safe place, and to make sure I get copies of all future tests, so that I could contrast and compare as I headed down the thyroid highway. That was the single best piece of advice I've ever been given with regards to my thyroid. She also made sure I was able to read and understand the results sheets, so that in the future I could check my results myself and then phone her and/or my endo to tweak my medication if I felt it was required.
Here are my blood test results from 18-Feb-08
(when I've worked out how to set up a proper table I'll edit this and tidy it up!)
I had an ultra painful injection in my bum....seriously, it continued to sting for several hours afterwards, as indeed my doctor warned me it would. But it did finally kick my cellulitis into submission and sent it on its merry way after just a few more days of hot, itchy ankle.
As suspected, my blood test results did show a thyroid abnormality....but surprisingly, despite me having obvious symptoms of weight gain, lethargy, lack of libido etc, the test results showed that I was in fact hypERthyroid, and not hypOthyroid as I had always assumed. We were both a little confused by that, but my doctor had done some research and explained that sometime hypERt patients gain weight inexplicably instead of lose it...I guess I was one of the unlucky ones. In hindsight, I seem to gain weight both when I'm hypo and also when I'm hyper...I just can't win in the weight game.
The tests also showed that my liver function was way out of whack....I was suddenly scared, after watching all the public health announcements and TV adverts regarding binge drinking, thinking that I'd overdone it during my student days, but my doctor immediately put me at ease and said that in the absence of any other symptoms for now we'd put my wonky liver down to my thyroid, and that if the liver function tests didn't improve in subsequent blood tests, THEN we'd look into it all a little more.
A few other test results were marginally out of range, but she reminded me that with my current case of cellulitis my body was presently fighting a huge battle with the incumbent infection. And that for now we should ignore those too.
She told me that she was going to refer me to an endocrinologist, and having previously explained to her the nightmare I'd had with a so-called 'specialist' at a local hospital, she asked me if I would mind travelling a little further, to a hospital in a neighbouring county, in order to see a proper endocrinologist. I jumped at the opportunity, and said I'd go anywhere, as long as she didn't send me back to the ignorant local 'specialist'.
She said she wouldn't initially put me on any anti-thyroid medication as she preferred that to be controlled by the endocrinologist...but if I was waiting too long for an appointment I should return to her and we would discuss starting on anti-thyroid drugs (ATDs). She informed me that when I had received the primary endo appointment to come in a week earlier and get some more blood tests done, so that the endocrinologist would have the most uptodate test results to work from during my initial consultation.
She gave me a copy of last week's blood test results and told me to keep them in a safe place, and to make sure I get copies of all future tests, so that I could contrast and compare as I headed down the thyroid highway. That was the single best piece of advice I've ever been given with regards to my thyroid. She also made sure I was able to read and understand the results sheets, so that in the future I could check my results myself and then phone her and/or my endo to tweak my medication if I felt it was required.
Here are my blood test results from 18-Feb-08
| Test | Lab Range | Result |
| TSH | 0.15-3.2 | <0.05 |
| Free T3 | 2.7-7.0 | 11.6 |
| Free T4 | 10.3-24.5 | 29.7 |
| Thyroxine (T3) | 58-161 | 189 |
(when I've worked out how to set up a proper table I'll edit this and tidy it up!)
Monday 18 February 2008
A Simple Case of Cellulitis
It all started off so innocently. My husband and I went out for a rare night at the cinema. Whilst he stocked up on popcorn I headed off to use the toilet. Whilst sitting on the aforementioned convenience I scratched idly at an insect bite on my shin.
Fast forward to the following morning, and my whole shin was itchy, with no sign of what I had innocently assumed was a midge bite. We had a day of activities planned, and undeterred, we headed off with a quick pit stop at a local pharmacy to pick up some antihistamine cream.
By the end of the day my leg was causing a lot of pain, had swollen up enormously, and really starting to look quite nasty...and familiar!
I'd suffered with a bout of cellulitis following a crush injury during the 90's and my lower leg was looking and feeling just the same as it did then. We called the Out-Of-Hours Doctor Service and my guess was proved correct. The doctor confirmed that I had cellulitis, and I was promptly put on the corresponding course of hard-hitting antibiotics. During the consultation I really hit it off well with this doctor and I found her very approachable and easy to talk to. I mentioned the goitre on the left side of my neck and she immediately tapped several vials of blood from my arm and asked me to make an appointment with her at her own surgery in a week's time.
Thus commenced my present thyroid journey. I have had brief forays into the world of thyroidism in previous years, resulting in a very scary session with a so-called *specialist* 4 years previously, which had almost driven me to bury my head in the soil and totally ignore any further symptoms....but now I had seen the light, found a doctor I could work with and most importantly, a doctor I could *talk to* and discuss things with on an even keel...as opposed to be talked at and being told how I was feeling. I may discuss my previous experiences in trying to get diagnosed, at a later date, but for now we'll concentrate on the positive action we're currently taking....me, my husband and my doctor! A Team At Work!
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