Doctor frustration

[jessmarimba]

A little late to the discussion, but I know here it's pretty easy to get a second opinion on things since referrals are not required in Colorado (as long as your insurance is ok with it. And when I called my insurance, they said it's up to the state). I'm eventually going to be paying a big chunk for my recent back appointment because they took all new x-rays, which I hadn't budgeted for (deductible just reset Feb 1) but they won't question the appointment itself. Balance billing is also illegal here.

[redrhodie]

Have you had any luck with this, Indy? Been wondering how you're feeling.

[indysteel]

Thanks for asking, Red. I have an appointment with my endo in a few weeks. It was originally at the end of this month, but she had to reshedule. Depending on how the appointments goes, I may decide to get a second opinion. She did agree to cut my dose of anti-thyroid meds. While I feel okay (I'm still mildly sluggish) I tend to think it's time to ween off of them. I'm not sure I should have ever been on them in the first place. I have a better understanding of that now.

[redrhodie]

Is the sluggishness the main symptom? Was that the original reason you thought there was something wrong? Did anything improve with the meds?

Maybe you should keep a journal to see if you can find patterns or triggers.

[indysteel]

Is the sluggishness the main symptom? Was that the original reason you thought there was something wrong? Did anything improve with the meds?

Maybe you should keep a journal to see if you can find patterns or triggers.

Long story short: My annual bloodwork last summer showed a suppressed TSH--which is consistent with hyperthyroidism. I had some additional tests done and was ultimately referred to an endocrinologist. My sister has Graves' Disease (an autoimmune issue that causes hyperthyroidism), so I wasn't surprised when the endo told me that I, too, had GD, albeit in a mild form. At that point, I didn't know a ton about what the various blood tests reveal about the severity of a particular case or what type of values warrant what type of treatment, so I wasn't able to ask the right questions.

At the time, my hyper symptoms were relatively minor but noticeable all the same. I was mostly concerned about an elevated heart rate and what the meant in terms of exercise. Often they treat mild or subclinical cases of Graves' with beta blockers rather than anti-thyroid meds. I remember my doc saying that she didn't want to use those with me because I typcially have low/low normal blood pressure. Instead, she put me on a relatively low dose of anti-thyroid meds. That seemed like a decent decision at the time but, in retrospect, I'm not so sure.

From the start, the meds oversuppressed my thyroid, so I went from mildly hyper to mildly hypo. I started reading up on what to look for in blood values and, in so doing, realized that my doc wasn't necessarily interpretting my blood work correctly or focusing on the right numbers. So, she's allowed me to persist in a hypo state far longer than she arguably should have. I've had to push her a couple different types to lower my dose of the anti-thyroid meds. I've complained to her assistant (because I rarely talk to my doc directly) about some hypo symptoms (heart palps, hives, constipation, hair loss, weight gain, dry eyes, fatigue and sluggishness) and was told "not every problem you have is necessarily thyroid related." It's been hard to find my voice with this doc's office.

That said, I think we are likely headed in the right direction in that I have been able to cut my meds and will likely stop taking them altogether at some point down the line. I'm just irritated that I've been the one to push for that. I've even had to push to get the right blood tests in the first place. We're just not on the same page. Ultimately, whatever errors in judgment my doc made (or didn't make) have not lead to grievous injury. It would just be nice to feel like she truly understands the disease and how to monitor it. Some of the conversations I've had, via her assistant, suggest to me that she perhaps doesn't fully understand it. Unfortunately, the vast majority of endos out there, only dabble in GD. They spend more type dealing with diabetes or non-immune related hypothyroidism.

[Catrin]

(((Indy))) I do hope you are feeling better soon. Can you find another Endo?

[indysteel]

(((Indy))) I do hope you are feeling better soon. Can you find another Endo?

Not yet. I have a name of somebody else, but his office is in Fishers and I'd really prefer somebody a little closer. Part of the challenge is finding endos in this city and, then, getting an appointment. It's not easy.

[redrhodie]

Well, it does seem like you're getting closer, at least. I've been spoiled by great doctors, so I notice when one isn't up to par. My oncologist is just okay. Her personality and bedside manner are good, but I felt like she's lacking some info. Of course, with the Internet as my medical training, I know everything. Like when I asked about med interactions, she said there were none. I don't believe that's true.

[shootingstar]

I think I found a family doctor that I like...whew. That was just yesterday. I am relieved. In a city where there is demand because the population is growing fast.

I try to provide to useful info. that the doctor asks. It doesn't help any doctor to be too vague and careless in one's own memory of symptoms. A doctor cannot read your mind.

Being at the doctor's appointment, it is important that a lay person, remains alert and sharp to think of and ask questions as the doctor provides information. You are paying for this professional...through whatever health care insurance system you use. That's how I treat the whole visit....glean as much information as I can out of the doctor that's relevant to me. It is precious valuable time.

Be sharp, ask and think (rather quickly) of the right questions right there on the spot with whatever information you may have learned yourself prior to the appointment. This way of thinking has helped me alot in my doctor interactions. Don't allow yourself to be intimidated by any doctor specialist...but you must think of good questions...on the fly within that 15-25 min. visit.

Then I might go home and phone up a sister who is a doctor...and ask for a 2nd casual opinion. I just want to reaction out of another professional on the recommended treatment. I usually do get abit more information from sis.

But even with all that, some doctors just aren't expert/knowledgeable in certain areas.

[redrhodie]

Good points, shootingstar. For my major doctor visit, I actually brought a friend, and she took notes. She and I had also written down a bunch of questions, because I'm notorious for forgetting the things I want to ask. Even with two of us listening, there were some things we missed. It would have been overwhelming alone.

[shootingstar]

You know, at times, listening to the doctor is hard enough....my doctor-sister was trying to explain to my mother that really there is no cure, not much prolonging of life (beyond 18 months to 2-3 yrs.) for my father with cancer.

[WindingRoad]

Indy you doing OK?