The Move Part 2: Health and Pregnancy

Two days later we were off to Vegas for Scott’s great-aunt’s 100th birthday party. This meant we had to board the dogs ($450!!) because, God forbid, my parents actually be helpful –beyond letting us stay with them, which seems to mean we should just be eternally grateful to them.

First night in Vegas I have a nice, big margarita. It should have been yummy, but it wasn’t great. It got me super-drunk, though. Scott and his sister take the kids to a movie and I go to bed to sleep off this buzz that I’m not enjoying. It is in the quiet, dark hotel room where I realize that I did not start my period on Monday (it is Friday). Hmmm, stress could explain it. But I did start my pill pack 5 days late and I did have sex when I had signs of ovulation. Oh yeah, and the night before my garage sale, I had those horrible stomach painsthat reminded me of the implantation pain I experienced when pregnant with Macy.  If I hadn’t been so buzzed and sleepy, I would have headed off to the drug store right then and there. But alas, it would have to wait till the morning.

I knew I was pregnant, but I still bought the 2 pack of tests because “just in case.” Of what, I don’t know. I knew it would be positive. It was positive and it wasn’t even my “first morning pee.” Scott came to the hotel room with the kids from the pool right after I tested. I didn’t know what to say. I knew he would not be happy. I didn’t want to say anything in front of the kids, so I just threw the positive stick onto his lap. He was silent. I took a nap.

It is hard to say how I felt about being pregnant, besides tired. On one hand, I REALLY wanted another baby. On the other hand, this was horrible timing. We were in the process of purchasing a 3 bedroom house. On top of that, Scott was never on board with having a third. He’s always said he’d agree to it if certain conditions were met on my part, none of which had been met. I thought I’d be excited when it finally happened again, but I was not. I found myself very concerned about miscarriage. I vividly remember Jan 2005 and losing that pregnancy. I didn’t want to go through that again.

The interesting part was returning home from Vegas and trying to find a doctor. Our medical benefits didn’t transfer with us to California. Not really. We had emergency care, if needed, but not primary care and certainly not OB. It took over 2 weeks to finally get it straightened out with Scott’s former district and the health insurance HMO. During those 2 weeks, I didn’t know if I’d have any benefits until September 1, when Scott’s new district benefits kicked in. It was unacceptable to wait that long to find out if this pregnancy was going to be OK. I ended up going to a “free clinic.” Good times. I, of course, qualified because we had no income.

I requested a blood test to confirm a strong pregnancy. That wasn’t covered by my new, State of California free medical coverage. I said, “I’ll pay for it.” I don’t think they’ve ever heard those words at the clinic. It ended up being $30 for 2 blood tests for the HCG pregnancy hormone. Which ended up being 3 blood tests because the first one got lost. Good times. My numbers were excellent. The first one, done at 5weeks was 8000. The second one done at 6 weeks was 32,900. Very promising.

I was still not feeling good about the pregnancy yet. Both my other pregnancies involved first trimester nausea, and I wasn’t having any. I was exhausted beyond belief, but not nauseous. In fact, I was so exhausted I began to think it was not the pregnancy, but my thyroid levels. I felt very similar to how I felt last summer when my TSHwas off the charts. I didn’t feel very confident about going back to the clinic. So I waited until our benefits fully-transferred to California HMO. I went to see the doctor and told him, “I’m pregnant and I know my Thyroid levels are off.” I get the song and dance about how pregnancy comes with a certain amount of exhaustion early-on and that it is probably just that. I smiled politely and agreed, but would like my thyroid levels to be checked too. He reluctantly agrees, saying the doctorly thing of that “the results will undoubtedly come back normal, but it is good to have a base-line levels at the start of pregnancy.” He also referred me to a real OB doc.

Before my TSH results came back 4 days later, I realized that not only am I VERY tired, but I’ve been losing noticable amounts of hair AND I’m cold all the time– which for me is the sure sign of messed up thyroid because I normally run very hot.

Guess what my results were? My TSH was 12.04. That, ladies and gentlemen, is a sign of VERY messed up thyroid hormones. My endocrinologist in Denver liked to keep my TSHunder 1.7 because it helps with the cancer suppression. I’m sensitive to my TSH being elevated. It was 3.25 in February and I knew it, even thought my endo said I shouldn’t be able to tell anything unless it fell out of the range of normal, which is 4.5. So to hear the number 12.04 was shocking and concerning to me. First, there was some relief that it was thyroid-related and not just pregnancy. However, I knew it shouldn’t be that high.

I called my Denver endo and told him my levels and that I was pregnant and concerned. He called me back and was so nice and reassuring. He said thyroid demands during pregnancy can increase up to 30% and since I required a lot of thyroid replacement in the first place he was not concerned. He told me my new dose of Synthroid and told me to repeat the blood work in 6 weeks and call him back to confer. This truly makes up for all the waiting I had to do to get into see him the past 2 years. I love the man.

Except my new doc still wants me to see a endo specialist here. In fact, he didn’t want to change my Rx to what Denver endo ordered unless I promised to see his SoCal endo. Whatever, it’s not like I wanted to spend the $40 copay on anything else right now. 

The worst part about all of this is how long it takes for the medication to change how poorly I feel. From past experience, it will be a minimum of 4 weeks before I start to feel slightlybetter. Another bad part about this is that it now makes me even more concerned about the pregnancy. Elevated TSHalong with my other condition: Hashimoto’s thyroiditis, is a recipe for miscarriage.

Thankfully, I saw the OB –actually before my TSH levels came back, which btw, she too was confident would be normal because fatigue is common to pregnancy. Goes to show that I know my body better than any MD!!– and she ordered an ultrasound. Because of my prior miscarriage she just wanted to be sure everything was ok. So that will be this Friday. Fingers crossed for heartbeat!!

The only other thing I should mention about this pregnancy news is that my mom is not at all happy. In fact, she’s kind of mad. She keeps saying things like, “I don’t know why you want another when you barely take care of the two you have.” Yeah… OUCH. The best thing she said was, “I’ve been thinking, I don’t think this pregnancy is a very good thing right now.” Um, like she wants me to get rid of it. Not a chance. She’s just so negative and mean. You’d think most grandmothers would express at least some happiness at being a grandma again– at least after the initial shock wears off. But no, nothing. Not a thing.

I really don’t know why I care so much. I wish I could stop. But she is my mother.

To be continued: The Move Part 3: House Drama

 

Weight and Tonsil Update

As of this morning, my total weight-loss has reached 15.3 pounds!! Yeah me!! I’m very proud of myself. I didn’t lose any in California, but I maintained my 10 pound loss. And trust me, the way my mom cooks, that is a miracle!! Plus, I had gone off the Alli when I went on the antibiotic before Christmas (could not handle taking 2 pills that affected the last part of the digestive process in such profound ways- way too gross!) And then I didn’t want to start the Alli up again on vacation, because I was worried about having “treatment effects” on the plane. So I started that back up when I got home, but did it differently. Did it slower, waaaaaay slower. I took 1 pill every  other day for 5 days, then I increased it to 1 pill every day for a few days, and then added a second pill every other day for a few days, and now I’m at 2 pills each day. What a difference!! I haven’t had ANY treatment issues. So there’s my Alli update, too.

My tonsil biopsy last week was HORRIBLE! Not as bad as my thyroid biopsy last year, but still bad enough that I never want to do it again. I of course began my body’s “passing out” process after he cut and YANKED the majority of the growth out. I think my vasovagal reaction is weirder than most people who have it because I almost always pass out AFTER the trauma has happened and I think I’m going to be fine. In fact, my famous last words before passing out many, many times were, “That wasn’t bad at all!” Only to completely pass out when I try to get up or move. Practically all my life that I have had such episodes and sadly it is too many to count, but it began when I was very, very young, with my first splinter, continued with each tooth I lost, and progressed to any  shots or blood draws I had up until I was pregnant the first time, at which time it improved dramatically and now only occasionally presents itself with these type of weird procedures and occasional blood draws.  But, true to my form, I almost completely passed out when it was over. Scott thinks I did go out completely because I didn’t respond to him, but I think I only went very close because the doc did recline the chair right away and I remember everything. It truly couldn’t be a medical procedure with me unless I faint!

So, faintly aside, what was very weird about the tonsil biopsy is that I felt most of my pain after the local in my throat began to wear-off in my right ear, the side biopsied. Truthfully, the pain in my throat was no more than a VERY bad sore throat/strep infection. What made it close to unbearable was the pain and ringing in my ear. It was just so odd and unexpected to me, that I called my doc’s office twice to make sure it was normal because it was so much more painful than my actual throat that I couldn’t believe it was normal. It was.

The good news is that I went back to the doc for a follow-up this morning and the biopsy came back “normal tonsil tissue.” However, my doc was very surprised because he has never seen a tonsil produce a white, puss-like polyp before. He was thinking it was caused by a virus, like a wart or something. But reading the report satisfied him because they tested the whole polyp, not just sections, because it wasn’t that big. He wants me to be on the look-out for any other growths like that and just keep on top of it. But, my tonsils were given a clean bill of health. Yippee.

 

Dear Dr. Zemel,

I wanted to write you this letter to let you know why I am going to have to find a new Primary Care Doctor.

It is nothing personal. I believe you are an excellent Endocrinologist and I am grateful you ultimately discovered my thyroid cancer. However, I believe you have gotten greedy. Now, I can’t say if this is due to a natural propensity you had to becoming greedy or if it is a general defect of the current condition of the state of Healthcare and HMOs in the United States. I would like to say that I truly, from the bottom of my heart, hope it is the later.

My issues were small to begin with– in fact, I was willing to overlook and even make excuses for you until I could not even fool myself into believing them any longer. Not being able to get an appointment with you for a month after my first referral was approved should have been my first sign. Waiting for up to an hour and forty minutes after my scheduled appointment time had passed should have been another. But you spent ample time with me. You were thorough in getting my medical history. You answered all of my questions and then some. I know you really cared about me. I still believe that.

So what’s my issue? What’s more important than being cared about when I’m in the office in front of you? All the other things related to your office when I’m not directly in front of you.

The waiting a long time to get an appointment. The waiting a VERY long time to see you for EVERY scheduled appointment. (In fact, now that I think about it, I had to wait an hour at the hospital for you to do my thyroid biopsy. The lab tech even said something about you never being on-time.) The number of drug reps coming in and out of the office. (Those people are a sign of a whole other problem… don’t get me started!) The way I can’t see you for general things like my sinus infection or this horrible upper-respiratory thing I have going on right now. The way your front office staff laugh about how behind you are on any given day. (“Ha, you’re lucky, he’s only half an hour behind so far today!”) The way your staff talk about how busy your practice is now. (“Being busy is a sign of a successful practice.”) The fact that your nurse can be bribed into seeing a patient with no appointment ahead of everyone with appointments just because he brought in a hot breakfast for everyone in the office. (Yeah, I was there that day with an appointment.)

But today was the kicker. Today I had an appointment to see your nurse practitioner about my chest congestion.  The appointment went fine. In fact, I left relieved. (“Phew, I can see someone in this office when I am really sick! Thank God!”) She seemed like she knew what she was doing. So I went to the hospital with the order for a chest x-ray in my hand. However, when I got there at 12:10, I was informed it was NO GOOD because it wasn’t signed. The hospital tried calling to get verbal authorization, but your office phones are turned off at noon and go straight to voice-mail. I waited until 1:35 when someone finally got a hold of your office. It must be nice to be able to shut down for lunch for an hour and thirty minutes! Here’s the thing…. I know YOU are still working, you have to get caught up sometime, but why doesn’t anyone else answer? Can’t the front desk girls alternate lunch hours like most businesses? Or how about at least check the part of the voice-mail that says to “page the doctor dial XYZ”? Dr. Zemel, would you tolerate waiting anywhere for over an hour and a half because someone forgot a signature??? That’s what I thought.

The second item today occurred when I went to fill my prescription. Your Nurse Practitioner wrote me a prescription for a steroid inhaler that is NO LONGER AVAILABLE– generic or name brand. The pharmacist says she hasn’t seen it for YEARS. She looked it up and it is not even a medication she can order. I called 2 other pharmacies not related to the first pharmacy and was told the same thing. I can understand not being up-to-date on all medications available these days, after all aren’t hundreds of new medications available each year? But is it too much to ask that the NP have a current copy of The Physicians Desk Reference AND know when it is appropriate to check said reference?

Do you see why I’m frustrated? If your practice is successful and you want it to stay that way, some things have GOT to change. To my untrained eye, it seems like you have three options:

1. Hire a new doctor to share your practice with.
2. Stop taking new patients.
3. Only be a specialist and stop being any one’s PCP.

And this is why I have called you out on being greedy. I realize that ANY of those above options will result in less money in your pocket. I don’t know anyone who would willingly take a pay cut. I know you have two teenagers who will be in college very soon. I’m sure you have bills like everyone else. And Dr. Zemel, I am sure you are NOT being paid what you are worth. However, my family of four pays $600 each month for our HMO plan, plus BIG co-pays for each office visit, and HUGE co-pays for any medications. We are tapped out. This is why I’m sure the problem is larger than both of us and boils down to one of the many problems with Healthcare in the United States.

But what can I do, the lowly patient? The only thing I can think to do: find a new Primary Care Physician. I’ve decided I can probably put up with your office for the 3-4 times per year I’ll need to see you as my Endocrinologist. Like I said, I trust you and your knowledge about my thyroid issues. However, I can’t do it to myself for everything else. I don’t know why it will matter to you, because now you’ll get a $25 copay out of me each time, rather than the $20 copay I pay currently since you’re my PCP. I don’t know if my HMO pays you  some meager monthly amount to be my PCP, and I hope it doesn’t affect your bottom line. But I’m sure you will easily find a replacement patient. After all, your office is full of patients just waiting to be seen.

Sadly, I cannot send this to you if I still want you to be my Endocrinologist specialist. As much as I want to believe you would want to know these things I have written, I cannot be sure you would still treat me unbiasedly. I hope you’ll at least notice I’ve no longer listed you as my PCP and take a tiny moment to wonder why. Maybe a moment of self-reflection is all it will take for you to realize some things about your practice that can and need to change. However, I believe that since you are an extremely intelligent man that you already know these things about your practice. How can you not?

I wish you luck and continued success.

Sincerely,

Me

 

Mumps Status: Negative

Just a quick update to say that I do not/did not have mumps. I’m thinking now that my salivary glands were just reacting to my being sick. I hope this is not a reoccurring event. Swollen and painful salivary glands SUCK! I’m also beginning to wonder if this is a latent side effect from the Radioactive Iodine I did back in March to kill off the rest of my thyroid. Hmm. Google, what says you?

 

Caught me

Even though I knew I was sick, even with a possible case of Mumps, I haven’t really felt horrible. Its weird. I knew I was sick, and I felt sick, but I was able to do most or even more things than I normally do. I think it is a testament to my thyroid levels being back to normal. Even when sick with a horrible sinus infection, a dry-hacking cough, and the possibility of mumps, I still feel better as far as my energy goes than I did when my thyroid levels were out of whack. I’m pretty impressed. Although, 3 days of doing all the things I’ve been doing (mainly social) have taken a toll on me. Today I was wiped out. So I’m going to bed early and just concentrating on getting better.

 

Mumps, anyone?

I may have Mumps. Imagine that. It wouldn’t surprise me since I always seem to get the weird illnesses. Plus, since I’ve now done some reading up on the subject, I realize that I TOTALLY have all of the symptoms. I’ll get the results in a couple days. However it doesn’t really matter since it’s like chicken pox and there is nothing they do for it. Perfect.

 

Count down to a yeast infection

Maybe that was more than you wanted to know about me, huh? Oh well. Too late now, you can’t erase knowing it so you may as well keep reading.

I decided to take a round of antibiotics, but not for the cough, which I still have– so maybe they will help with that too. No, I’m taking them for a sinus infection. I am no stranger to sinus infections, unfortunately. But this one has hit me HARD and left no doubt as to what it is. Usually I go to the doctor and I am told to do the decongestant and flonase and wait. In fact, I officially had been diagnosed with chronic sinisitis and had been offered to have my sinuses “drilled” (yeah, NO THANK YOU!). But this was different and more severe. I didn’t need a doctor to tell me that this time it was acute. In fact, I felt guilty about using my stash of antibiotics without seeing a doctor. I am allergic to many antibiotics so I REALLY don’t like to take them unnecessarily and risk a new allergy or antibiotic-resistant strains of illnesses. Anytime I am prescribed antibiotics I always consider how badly I’m feeling, with how strongly the doctor thinks it is bacterial, with the fact that I WILL get a yeast infection before I decide to take them. Which is why I had 2 types of antibiotics to chose from– because the last 2 times I didn’t take them because I was hoping to get better on my own, which I obviously did. So why did I take them this time? Because my face hurt so bad I couldn’t see straight!!

It started with my left cheek. It was sore, like a bruise. I asked Scott if he hit me in his sleep, ha ha. He didn’t think that was funny. Then this morning I woke up and both cheeks hurt so badly. If I bent down to the ground my face felt like it was going to explode! (I really had no idea how many times I bent down in the corse of getting ready for church until this morning I was made VERY aware!!) My upper teeth were hurting right under where my cheeks hurt. I was slightly dizzy all day. I’ve had some of these symptoms before, but never all at the same time!

So I researched which of my two choices of antibiotics were best for sinusitis and bought some yogurt. I can’t remember how long it takes for me to start feeling better and for the yeast to attack, since it has been a long time since I’ve taken antibiotics. But boy, there is nothing quite like waiting for the itching to begin!

By the way, I am also doing the decongestants, the Flonase, the Mucinex, and Advil. Man, I’m like a walking pharmacy!!!

 

Sick

Ugh, I’ve been fighting being sick for about a week. However, after hanging outside for 3 hours last night in 38 degree weather, drinking around a fire pit… I think I’ve finally done it. Can’t quite name what I have. Not a cold, I know that much. My chest is hurting and I had coughing fits that required my inhaler about 8 times today. My ears hurt and feel like they have a lot of fluid in them. I have a horrible headache and a very low fever– probably not even a real fever to a medical person, but since my normal temp always runs around 97.1, I consider anything over 99 a fever.

Ugh. It’s not horrible, but I’m just waiting for the other shoe to drop. I think if I still have a “fever” tomorrow I’m going to start my stash of antibiotics. One of them is going to expire anyways. I’ve been waiting until I’ve been sick enough to use them. I just can’t afford to have bronchitis right now.

I know you all wanted a health update.