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Old 08-26-2009, 10:20 AM   #1
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Chucky89 HB User
Preparing for my doctor visit. Any help?

Ok, so I'm having a doctor visit soon, anyone who read my previous message is aware that I'm at home wasting time because I'm being misdiagnosed and undertreated. I don't have any time to lose.

So, my goal for this visit is to get the doctor to refer me to an endocronologist. Last year, during a time when I wasn't overly concerned about my thryoid, i went to him and he had me tested for my thryoid. The office didn't call me back so I guess the results were normal. The deal is that I'm very certain my thyroid is sick. Reading all these stories about peoples difficulties in setting up endo appointments and tests returning normal even when they say they're still sick, has me feeling more assurance about my disfunctional thyroid.

Anyway, I need some help here because I'm getting more and more impatatient. I guess i'm 2 steps away from possible salvation, so to speak. Once I start talking to an endo I'm not leaving his/her office until they hear me out


so I was wondering if someone can help with me with this:

1. since this doctor already had me tested for my thyroid, how do I convince him that I desperately need to see an endocronologist?
maybe I should show him this..I have some related information printed out and this is what I found on one of my prinouts: " TESTS FOR HYPOTHYROIDISM ARE NOT ALWAYS ACCURATE (i most likely have hyperthyroidism). TSH TESTS AND BLOOD TESTS ARE USEFUL TO HELP DIAGNOSE HYPOTHYROIDISM BUT SHOULD NOT BE USED ALONE. SYMPTOMS ARE THE MOST IMPORTANT FACTOR. IR IS RARE THAT A BLOOD CHEMISTY PANEL SHOWS YOUR TRUE CONDITION BECAUSE THE VALUES MEASURED ARE ONLY ABOUT 30% ACCURATE."


2. this is pivitol..I want to be absolutely 100% accurately tested for my thryoid, so what tests specifically should I ask to be tested for?

there are so many..are all of them necessary and am I missing anything? this is what I found:

hypotatremia
low blood sodium in older adults
neck swelling: self care flow chart
biopsy
thyroid gland biopsy
blood tests
TSH
elisa test
ferritin test
t3
t4
thryroid function tet
thryoid scan
ultrasound


this seems like a lot..will the doctor get angry if I ask for all these tests? which are most important?

thank you in advance and much appreciation

 
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Old 08-26-2009, 02:34 PM   #2
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hayley3 HB User
Re: Preparing for my doctor visit. Any help?

Really, it all depends on the doctor...mine would laugh at me and tell me to go home.
The best way to get tested or referred to an Endo, IMO, is to tell them the symptoms they want to hear..that raises a red flag in their mind...but mine would do the TSH test and if it's normal, not refer. Sorry my post was not very positive

 
Old 08-26-2009, 03:24 PM   #3
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Chucky89 HB User
Re: Preparing for my doctor visit. Any help?

"mine would laugh at me and tell me to go home"

for someone like myself that is not in the least bit hard to envision, its like i posted somewhere that you need to have luck on your side and hope the doctor is not having a bad day
i had an appointment with a doctor on a day where he received a speeding ticket..needless to say my visit did not go very swimmingly

you're right though, doctors only go by results and you need to tell them things they want to hear..i was joking with my mom the other day about how maybe i should give myself a couple of jabs to the face, a bruise here and there so i look hurt

but seriously, its rediculous to say that i need to put on some sort of an act and exaggerate when based on my symptoms alone the docs should be acting fast

 
Old 08-26-2009, 03:53 PM   #4
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javelina HB Userjavelina HB Userjavelina HB User
Re: Preparing for my doctor visit. Any help?

I advise you start with getting the right bloodwork done. The best tests you need right now to rule in or out thyroid are TSH, Free T3, Free T4, Tpo-Ab, TG-Ab, & TSI. It's a good idea to add ferritin and Vitamins D and B12 too. Most docs will also order a CBC and Chem Panel for a normal workup. If your last TSH was "normal" then you should list the symptoms you are experiencing and specifically request that he check further for thyroid dysfunction since this is a major concern of yours.

Your doc should also palpate your thyroid and if he feels something out of normal or your bloodwork indicates, the ultrasound would be a good idea. But I don't believe you are at a point where biopsies or any more invasive tests are warranted yet. And the ELISA isn't needed unless you believe you've got Lyme disease or have been exposed to ticks. ELISA isn't considered by some to be the best test for Lyme out there by some anyway. IgeneX is far more sensitive.

So I think you will have more success if you keep it a bit more simple and not go in both barrels blazing. Try to see if your doc will work with you on this. Many of us here have found that Endos aren't all they're cracked up to be and do just fine with a regular doc if they are open minded, flexible and can listen to their patients. Good luck and let us know how it works out for you.

 
Old 08-26-2009, 04:22 PM   #5
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Chucky89 HB User
Re: Preparing for my doctor visit. Any help?

that was very helpful javelina thanks

i got my info i will have those tests written and on me during the visit..the doctor is actually a clinic doctor meaning patients pop in and out of his office like hedgehogs..very quick

there is a good chance he's not overly informed in regards to ones thyroid but in any case he can guide me in the very least

so as you mentioned:

TSH, Free T3, Free T4, Tpo-Ab, TG-Ab, & TSI.

So can I ask this doctor to order these tests for me or would I need an endocronologist to do this?

 
Old 08-26-2009, 04:50 PM   #6
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javelina HB Userjavelina HB Userjavelina HB User
Re: Preparing for my doctor visit. Any help?

Any doc can order (or PA or NP for that matter). But getting him to interpret the results correctly if he's not up on this stuff can be tricky. See if you can get the tests run then post your results here with the ranges and we'll see if we can help you figure them out. Good luck!

 
Old 08-26-2009, 05:50 PM   #7
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Becky092008 HB User
Re: Preparing for my doctor visit. Any help?

I have been trying to get diagnosed for a year now...still waiting. You might ask to have an ANA profile too. Mine was positive. My thyroid TSH T3 & T4 are normal but my thyroid peroxidase was off so that is how I got the endo referral. He has not been of any help. He was so focused on my weight that he would not admit anything was wrong with my thyroid. (Although, the ultrasound showed mild enlargement and thyroid nodules--ordered by the PCP after a med student felt my nodules and listened to my symptoms--yeah for med students!). The pain & tightness in my throat are part of the proof for me. The rhuemotologist thinks it is thyroid related but my endo will not admit it. I have asked to change endos and that is in the works....wonder how long that will take... You really have to advocate for yourself. Many doctors don't seem to diagnose people that easily. It gets old always going to the doctor and bothering them to figure out something. I hope you will get the right doctor and the right tests. Hang in there!

 
Old 08-26-2009, 05:52 PM   #8
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Oppida HB User
Re: Preparing for my doctor visit. Any help?

If this is your family doc, I would tell him that you want a referral or you will find a new doc. Period. Your doc works for you. Not the other way around and we often must remind them of this!!

When I was looking for a endo, I found the right one by calling ahead. I asked him 5 questions and based on the answers I decided to go with one of them. I then told my family doc that I wanted a referral to this certain endo. Not all endos are good, in fact in my experience, most aren't. Even the one I go to, after answering my 5 questions, still is a jerk and wanted to give me anti-depressants and anti-anxiety meds when it was obvious the anxiety and depression swings were from my HAshimotos!! But I got what I wanted from him, so it worked out.

My five demands were:

1. Test my Free T3 and T4.
2. Put me on Armour.
3. Test me for celiacs
4. test my adrenals
5. let me dose by symptoms as well as labs.

If your primary doc won't refer you, then find one that will. Call ahead. I'm sorry you have to fight so hard to be cared for. Go with your gut, though. You know your body best.

 
Old 08-26-2009, 06:47 PM   #9
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cutejenny77 HB User
Re: Preparing for my doctor visit. Any help?

Quote:
Originally Posted by Oppida View Post
If this is your family doc, I would tell him that you want a referral or you will find a new doc. Period. Your doc works for you. Not the other way around and we often must remind them of this!!

When I was looking for a endo, I found the right one by calling ahead. I asked him 5 questions and based on the answers I decided to go with one of them. I then told my family doc that I wanted a referral to this certain endo. Not all endos are good, in fact in my experience, most aren't. Even the one I go to, after answering my 5 questions, still is a jerk and wanted to give me anti-depressants and anti-anxiety meds when it was obvious the anxiety and depression swings were from my HAshimotos!! But I got what I wanted from him, so it worked out.

My five demands were:

1. Test my Free T3 and T4.
2. Put me on Armour.
3. Test me for celiacs
4. test my adrenals
5. let me dose by symptoms as well as labs.

If your primary doc won't refer you, then find one that will. Call ahead. I'm sorry you have to fight so hard to be cared for. Go with your gut, though. You know your body best.

Calling first, that is a good idea

 
Old 08-27-2009, 09:14 AM   #10
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Chucky89 HB User
Re: Preparing for my doctor visit. Any help?

i can't help but feel depressed over this entire ordeal..all these questions run through my head: will the results show i'm not well? will i need to go on an endo hunt before i finally land one who gives a sh*#? do i need to bribe these guys to help me? will i be treated within the next 12 months? will i waste another 2+ years of my life by feeling horrendous? should i create a website about how doctors suck?

i really wish some doctors can read these boards to get a feel of how certain people think about certain aspects of the medical community. why do some doctors not believe patients and refuse to help them? what are they scared of? pisses me off

my appointment is tomorrow morning and the doctor is not really a family doctor..its this big clinic he probably sees a patient every 3-4 minutes so that is why i say he might not know about thyroid conditions very well..but i don't care i just need him to do the tests for me and refer me

i did a google search and found a site called CANADAS TOP DOCTORS..i'm not allowed to post the url..but anyway i found one doctor who deals 'only with metabolic issues' and deals with 'misdiagnosed and undertreated patients'
so my dilemma is do i ask for a referall to him? since this doc is so good i'm assuming i'd have to wait a while before seeing him and would it be worth it? or do i just ask for any endocronologist i could see as soon as possible?

in any case the most important thing i will be asking is to be tested for:

>>>TSH, Free T3, Free T4, Tpo-Ab, TG-Ab, & TSI<<<

and i'm assuming i can do these the very same day? or i need to be fasting?

Last edited by Chucky89; 08-27-2009 at 09:16 AM.

 
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