Report from the appointment with my PCP

Sorry for the delay on getting this up- I’ve had some people ask how things went and I meant to get it up last week!

The appointment went well with my primary care physician on Thursday.  Remember, I haven’t seen this woman in 4 years so I wasn’t sure what to expect.  I got there and was the last appointment of the day, so I was pretty tired, which showed when she walked in the door.

As soon as I saw her, I was having hard time composing myself.  I love my PCP.  It’s just too bad I don’t have a reason to see her more often.  She took one look at me and was like, oh you look bad.  I know, I said.

So she asked me what was going on, how Kevin was, and the normal small talk.  Then, I unloaded on her.  Like really unloaded.

She listened and was generally irritated that I wasn’t getting a lot of people taking me seriously here, which she admitted has been a problem for a couple of her other “subclinical” patients.  At one point she said, I’m not sure when this happened but doctors stopped looking at a person and seeing illness- they wait for test results and then decide to treat.  She agreed to take all the blood work I asked for and wrote the recommendation for the doctor in Fredericksburg.

One interesting thing that I found out from meeting with her (over an hour appointment) was that all of the specialists that I have seen have only tested me for one of the Hashimoto’s antibodies.  There are two tests. I have always been given one, which never comes up positive.

That is good and bad.  It would be good if I didn’t have an autoimmune disorder because treatment wouldn’t be so complicated.  It would be bad if the other one comes up positive because Hashimotos basically attacks your thyroid so it would be exponentially harder to treat.  In addition, the likelihood of having another autoimmune disorder is higher.  She elected to do a full panel for other autoimmune disorders, including Lupus and all of that, just in case.  Sigh.

She also put in for the Celiac testing again.  Why not.

Then, she drops the big one on me.  Have I had my thyroid ultrasounded before?  No, I said, I haven’t.  She’s all like, WHAT?  You’ve been to six specialists and no one has done this or an iodine uptake on you before?  That’s inexcusable, if you have a patient suffering like you, she says.

So here is what it is: a small dose of radioactive iodine 123 is given in pill form. Several hours later, the amount of iodine in the bloodstream is measured, often accompanied by an x-ray that views how the iodine concentrates in the thyroid.

Decreased levels of activity can indicate subacute thyroiditis, which is what she says she thinks I have.  We even went back years ago and she had written that down in her notes from when we met in 2005.

I did the blood work this morning, since I had to do a 24 hour urine panel first, which tests the cortisol levels.  I’m hoping to hear from the hospital to do the ultrasound and uptake in the next week or so. 

She agreed that even if my labs come back all normal that there is definitely something wrong with me.  She said after 10 years, I should have had some relief. 



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