|Status of My Brain
||[Nov. 26th, 2008|04:23 am]
Kelly J. Cooper
Saw my primary care physician today and had blood drawn. (Nurse did it very gently; I was deeply relieved and there's no bruising.)
I have a follow-up next Wednesday to discuss the results and for me to get a complete physical; so in addition to the regular work-up, she's checking my thyroid levels, my cortisol levels, and looking for Epstein-Barr (which I think I've had checked before, but, whatever).
And we're going to talk about more in depth work on my sleepiness/depression.
I learned that there are a LOT of different generic thyroid medications and people tend to be very sensitive as to which one they take. So, dosages can be the same, but effects vary. We're going to look at my levels and discuss options. I'm considering asking to be switched to Armour, which is derived from piggies rather than synthetically generated, but we'll see.
I also learned that Paxil is a soporific and that people with low energy are generally recommended to take an SSNI (selective norepinephrine reuptake inhibitor) type of SSRI (selective serotonin reuptake inhibitor) to increase energy.
Damn. Didn't know that. Emailed my Psychiatric Nurse about it.
My PC also recommended a full-on Psychiatrist. Later in the day I got a return phone call from a friend's therapist recommending other psych folks who take my health insurance.
I'll know more next week, and then I'll take the next step in this CHOOSE YER OWN ADVENTURE quest I'm on.
I envy your level of interaction with your caregivers. I'm on both thyroid medication and an SSRI, and I've never had anyone sit down with me and explain all the ramifications of different meds. How did you pull this off?
2008-11-27 06:46 am (UTC)
Seriously. I went off on my doctor a little bit about how she never talks to me for more than 5 minutes and how I sleep constantly and I feel like crap.
I've been with her for about 10 years (her practice takes all types of insurance, so despite being with 5 carriers in the past 10 years, I've been able to consistently stay with her), so she knows I'm not the overreacting type. And she knows my case is pretty complicated. She was honestly shocked about how much I was sleeping. We discussed a few things, and then she scheduled me for the last appointment of the day next Wednesday so we can talk more at length about my options once we have the results of my blood tests.
I have a notebook in which I track the dates of when things have happened to me. I keep relatively detailed notes about visits, tests, and results. When a doctor tells me that something I'm experiencing is impossible, I provide details about how it IS possible. I've been keeping this notebook since around 1996. It doesn't have everything it should, and I've learned a lot, over the years, about how to take notes and how to write out my questions before I visit her office.
And don't get me wrong, my doctor isn't the greatest. She's good and she's caring, but she's not perfect and we've had problems. Being my own patient advocate has been one of the hardest jobs I've ever had.
There are groups that do patient advocacy. Maybe you could have one of them help you. You've also got the right to ask for copies of all of your blood tests and the results of your physicals - your "file" as they call it - so you can get a second opinion. You can use that data to track your progress - if you match up test results with diary entries, you can see whether your low periods match times of low/high thyroid levels.
You should be getting your thyroid levels tested regularly, at least every 6 months; every 3 months might even be better.
I'm on Armour Thyroid as an alternative to the synthetic because the synthetic combined T3/T4 pills have to be refrigerated. I put up with that for a few years but it was SO FRUSTRATING to have to take a cooler pack every time I left home overnight (with a syndrome where fuzziness, flakiness, and forgetfulness are symptoms) that I will never go back.
I note that cats desperately want to eat the pills. :)
Best of luck. Medical hoops suck.