This is the follow-up to what happened on February 8.
I had an appointment with an internal medicine doctor on Friday. This is a doctor that my OB recommended I talk to before we move on to an endocrinologist and I happily agreed for two reasons:
1. My OB knows this doctor personally and spoke highly of her. I trust her opinion.
2. This doctor is cheaper than an endo – my co-pay is half the price.
Seeing an internal medicine specialist benefits me beyond just assessing my thyroid problem. She is not only extremely knowledgeable about the thyroid and how it functions, she is knowledgeable about pretty much everything and she proved it with the extensive notes (pages, as in multiple) and diagrams that she wrote/drew on in front of me and sent me home with.
We talked for a long time. This appointment was well worth my time. When I left, she sent me to a lab for more bloodwork. I should have the results this week and then we’re going to move forward with a course of action. In a nutshell, this is what she said:
1. Hypothyroidism. She confirmed a diagnosis for this and plans to start me on Synthroid once we get the other bloodwork back. She has an idea of what dose I need (100mcg), but plans to start me on 88mcg to see how I do and wean me into a higher dose. Then she’ll check me again and once we get my TSH level down to the 1-2 range (it is currently 8.23), then I’ll be considered stable and we won’t have to check it but once a year. Until she gets me stable, we’re looking at every 8 weeks for labs.
2. Hypoglycemic. She is convinced that this is what caused me to faint and while I knew this was a possibility with having PCOS, I never really considered it official because usually women with PCOS end up on the diabetic side of things. She agreed with my OB’s decision to pull me off the Metformin immediately because she is afraid it is keeping my levels too low. She sent me home with a free glucose monitor and a chart with orders to check my levels before breakfast and after dinner, as well as any time I feel “off” so she can see if there is a pattern between my fasting levels and my non-fasting levels. The thing is, when my blood sugar drops, it isn’t a slow decline. It plunges so rapidly, I don’t think I’d even have time to check my levels before needing to bring them up. She also agreed with the ER’s diagnosis that my body’s defense just kicked in when I was in a moment of stress and it decided to check out. She isn’t concerned about it, especially since there literally isn’t a pattern to when I have just experienced a low and when I have completely blacked out.
Finally, she has ordered an echocardiogram just to check the structure of my heart to make 100% sure that there isn’t something going on there, but we both feel pretty confident that it’ll turn out just fine. The way she explained it is since I am a more petite-framed person, my heart might just be more squished in my chest and it’s possible that when I have a moment of anxiety, the heart is what is telling my blood sugar to drop and causing me to feel faint. The rapidness of these episodes is what leads her to think that’s a possibility. She doesn’t suspect anything is wrong at all. It’s just a precaution and I respect her decision. We’ll see how much it costs though… they’re waiting for insurance to approve or deny the claim before scheduling the test. I may have met my deductible with the ER visit so it depends on that. Zoey just had tubes so I have that to pay for as well… the echo may wait while we focus on the hypo twins.
So that’s it, friends. This doctor is pretty awesome and she told me that she can refer me to an endo if I’d prefer, but I told her I prefer less doctors to deal with so if she is knowledgeable (and she is) on the thyroid, I’ll just stick with her. She suffers from hypothyroidism herself so she has first-hand experience living with Synthroid. That alone helps! We did talk about my struggles with PCOS + infertility and she feels pretty confident that fixing my thyroid will help us out a lot.
Oh, how I hope she is right.