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    Old 09-17-2007, 10:56 AM   #1
    desiii
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    How do you convince your doctor?

    I'm having a hard time convincing my gp to send me to an endo. Just wondering if anyone here has found a tactic that works for getting a referral when you need one. I've tried a number of gp's and not one of them would do it. Very frustrating!

    Thanks.

     
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    Old 09-17-2007, 11:38 AM   #2
    2000airedale
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    Re: How do you convince your doctor?

    I had the same problem with my PCP. Since I also work with her, it was a little more difficult, because I was pretty much saying that I, a non-MD, disagreed with her medical opinion that TSH < 10 isn't worth treating. I finally realized that the quality of life right now is just too poor, so I listed my symptoms and asked her to give me some names of endocrinologists because I wanted a 2nd opinion. She gave it to me. If she had not, I would have switched PCPs, which I am already considering.

     
    Old 09-17-2007, 11:58 AM   #3
    GCC
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    Re: How do you convince your doctor?

    Desii, what is your TSH?

    What do you have to do to get a 2nd opinion in Canada? How does that work?
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    Old 09-17-2007, 04:40 PM   #4
    desiii
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    Re: How do you convince your doctor?

    My last test showed my TSH at 3. He won't run any further tests because he feels that's fine. Getting a second opinion is a matter of finding another clinic. But clinic doctors are terrible. This guy is the best I've ever seen. And there are no family doctors in my province who are taking on new patients. So I can only take my chances with the clinic dr's.

    Last edited by desiii; 09-17-2007 at 04:41 PM.

     
    Old 09-18-2007, 08:06 AM   #5
    mkgb
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    Re: How do you convince your doctor?

    I am in the US, so I can not tell you how to go through your system. But you can get research indicating that the new ATA guidelines for normal is 0.3-3 for a TSH. You are hypo girl. Talk your GP into running a FT3 and FT4 on you. If these are low inconjunction with the TSH you are definitely hypo and in need of seeing an endocrinologist. Also how about your family any of them show the signs.. mothers, aunts, siblings, granmothers in particular? Has anyone tested you for Hashimoto's thyroiditis. This is just stuff to look up and discuss with you GP. Maybe if you can convince them running the tests will back you off.. you can get the proof to get your referral. There is more than one way to skin the cat.. maybe you can get them to prove you wrong for peace of mind and thus prove you are right in the bargain.

    Sincerely,
    MG
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    Old 09-18-2007, 10:58 AM   #6
    desiii
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    Re: How do you convince your doctor?

    Thanks, MG. Those are some great tips. Play the "humour me" game... That sometimes works. And the clinic dr I've seen lately is actually pretty good with that approach.

    Family history does suggest potentialy hypothyroid. My sister and mother have always had low body temperature. Mine has fluctuated over the years, but is usually lower than it should be for the past few years. My sister doesn't have any serious health problems, and even after two kids does not struggle with weight. My mom has struggled with weight and a number of health problems for most of her adult life. No idea about other relatives as we're not close with many of them.

    No one has ever mentioned Hashi's, though I have read that you can have it even if your TSH is considered normal. Getting a Dr to do those additional tests is like pulling teeth, though. I don't think I have any of the primary symptoms associated with it (hair loss, etc.), but you never know. I am tired all the time, and have been for my whole life.

    I had a naturopath years ago who believed I would benefit from Wilson's Thyroid Syndrome T3 therapy. But I lived alone, had no money, and no one to help me regulate the meds, which sounded like a very difficult thing to do. Plus I was coming off 7+ years on depo provera, which was causing my temp to go crazy from hour to hour and a number of other symptoms that could mask the effect of the T3 therapy. But that was quite some time ago, so maybe time to look into all this stuff again.

    Thank you for the tips. I will try the "if you run these tests, I'll back off" approach. That may work. I do with I could find some kind of solid report that addresses the new standards for measuring TSH. He would take that seriously. But it's hard to find online! (Have tried the ATA website, but no luck so far).

     
    Old 09-18-2007, 12:18 PM   #7
    spp321
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    Re: How do you convince your doctor?

    I think one of the more frustrating issues I have dealt with through my gamet of symptoms is feeling as though my PCP doesn't hear me/believe me/care about me. I feel like I'm putting her out and hesitate to go to her. I did get a referral to a endocrinologist, but they can't get me in until Nov. 29th! Meanwhile, I suffer every day and feel like I just have to suck it up and pretend that everything's fine when it's not! But, how can I expect my family to believe there is something wrong when my own doc doesn't? VERY frustrating indeed!

     
    Old 09-18-2007, 06:15 PM   #8
    desiii
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    Re: How do you convince your doctor?

    Well, I did it! Saw the gp today and discussed my issues. I first said I'd like a referral to an endo, and then went on to explain why. I mentioned both my TSH score, and also my hormone symptoms that are most likely caused by PCOS (I've been told I most likely have it by other dr's in the past). That did it! First I pointed out the 3 score for the TSH, and he was shocked that he had missed it before. That blood panel was actually to sort out my heart problems, so I suspect it's just because he wasn't really looking for anything thyroid related at the time. Anyway, he agreed this is something to look further into and immediately wrote up the request for lab work so I can get the FT3 and FT4 done. Yay! And I have to find myself an endo now and just give him the contact info, and then he'll set up the referral. That's difficult though as I'm just about to move to a small city, and it looks like they may not have any in town. So I've got my work cut out for me. But I will find the closest one possible and go from there.

    So I may finally be on the right track! Woohoo!!

     
    Old 09-19-2007, 05:41 AM   #9
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    Re: How do you convince your doctor?



    I am glad for you. Yeah, check one for going in informed and making them listen. With males it is doubly hard. No offense to you males out there.. my husband and son were in the no listen mode this morning. Just ::grunt:: and "Do I have to?" mode. I can truly sympathize on the physician hunt. I am doing a double hunt. Cardiology and Neurology. After this I will only not have seen a psychiatrist. It might be fun to go see one and mess with his mind one day. I will put that on the back burner for when I am bored.

    Since my Endo wants to confirm what is AI thyroid related and what is just me.. How can one truly do this? I mean the thyroid is part of you so how can you ignore it might be a factor? Until you hack the thing out it is part of you, right? But I guess it goes on the philosophy that the thyroid is part of us, but we are not just our thyroid.. Wheew! I am a wander this morning.

    Cardiology issue:
    I have been have heart issues during heavy exercise (3 mi walking is fine 4 mi run my heart starts complaining about the second mile).. HR spikes to 240 then drops to 40 then back up to my 160 active HR. My Endo thought that this was something to do with my heart itself not Hashi's given my murmur and irregular heart beat. However my murmur has been since birth the irregular heart beat and other issues are post pregnancy. SO I am on the cardiologist electrophysiology hunt right now. Time to make my insurance company gag some more.. I love it. I will make sure that my cardio MD knows of my autoimmune history and we shall see what they think the source is.. I am not convinced that I do not have Graves as well as Hashi's, because my mom, and two aunts have it. My mom and her next sister in line have Graves and Hashi's. Their Graves was determined after uptake scans and biopsy. They never had positive blood work.. just groiters.

    Neurology:
    Migraines and visual impairment. Why?

    So you think if these two specialist think it is thyroid my Endo might change her mind about the biopsy? Who knows.. I will wait and see then go back and discuss it with her.

    I am tickled that you got your referral. Yeah!

    Sincerely,
    MG
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    Last edited by mkgb; 09-19-2007 at 05:42 AM.

     
    Old 09-23-2007, 06:50 PM   #10
    waratah
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    Smile Re: How do you convince your doctor?

    Quote:
    Originally Posted by spp321 View Post
    I think one of the more frustrating issues I have dealt with through my gamet of symptoms is feeling as though my PCP doesn't hear me/believe me/care about me. I feel like I'm putting her out and hesitate to go to her. I did get a referral to a endocrinologist, but they can't get me in until Nov. 29th! Meanwhile, I suffer every day and feel like I just have to suck it up and pretend that everything's fine when it's not! But, how can I expect my family to believe there is something wrong when my own doc doesn't? VERY frustrating indeed!
    Hi spp321, I am new to this board, but I saw your message and and thought "I'd bite the bullet" (Aussie vernacular) and make a post. Like you, I too have found it very difficult to get the medical fraternity to LISTEN to me and HEAR what I am saying about the symptoms that are destroying my quality of life, my kids and my husband's too. I really thought I'd lost the plot and gone completely mad, well at least my long standing GP of 12 years thought so. But during August I bean to feel ever increasingly unwell, so I began a weekly symptoms diary. Hubby then took this demented wife to see foreign trained local GP (who was extremely thorough) and then sent directly to Endocronologist - dealys - delays -delays, but getting closer to firm diagnoses every test. Recently discovered lots of Hashimoto's in family tree. Apparently, nearly all endocrine disorders are a familial thing, so perhaps to save yourself and any 'good GP' some time, you might begin doing a bit of family research of all your Aunts, Uncles, cousins, nieces and nephews. This was a real eye opener for me when I began asking, people popped out of everywhere and I had absolutley NO IDEA how prevalent the Hashi Disease is in my family, So you go search girl, and let me know what you dig up. Regards, waratah

     
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