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    Old 10-01-2007, 03:47 PM   #1
    weavers5
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    Look at this diagnoses

    Ok. I see you all like to see labs, but I have one better. Here is my diagnoses from my last Endo. in Sept. . It cost me $288.00. Lets just say I had only one visit with this nut case.I found a new Endo. And now I am having my thyroid radiated 10-2-07 at 12:45. Take a close look at #3 on the diagnose. The only problems are from my thyroid. I do get depressed but nothing that isnt caused by my thyroid. Also look at the great gramer.

    Diagnoses
    1. (Graves) TOXIC DIFFUSE GOITER WITHOUT MENTION OF THYROTOXIC CRISIS OR STORM (242.00)
    Moderate eye involvement. Pt needs to STOP SMOKING.’!! Pt to return to Occu/oplastics for further eva!. Warned that continued smoking may threaten his vision.
    2. OTHER POSTABLATIVE HYPOTHYROIDISM (244.1)
    Biochem daily ideal, but swinging dramatically. Will attempt careful dose titration over next 2-6 months, then may consider surgical removal of thyroid.
    3. ADJUSTMENT DISORDER WITH MIXED ANXIETY AND DEPRESSED MOOD (309.28)
    Needs Psychiatric eva/for mood stabi/Ler, which should help. Pt’s underlying thyroid changes are certainly an exacerbating isue, but not the underlying primary difficulty.
    History 06/20/2007 01:31 PM
    Graves Disease (Reason for Visit)
    The patient is a 45 year old male who presents with a complaint of graves disease.
    The onset of the graves disease has been Date first recognized: (2003 sxs of insomnia, heart racing, sweating and anxiety. 2004- finally diagnosed by blood tests.) and has been occurring for years. The graves disease are relieved by medication (methimLa/e 2004.). Graves Disease notes: RAI rx Mar2005. Had to take methimazole for a few months after. Then switched to Levoxyl. Has been having dramatic biochemical and symptomatic swings over last few months. Eva! by Optha!m Aug - Nov 05. None since then. Has had blurry vision x .1 month. Smokes 1/2 ppd a/though rarely actually finishes each cigarette..
    Hypothyroid post-ablative
    The onset of the hypothyroid post-ablative has been Date first diagnosed: (2004) and has been occurring in fluctuating pattern for years. The course has been variable. The hypothyroid post-ablative is described as moderate to severe. Associated features include none reported. Hypothyroid post-ablative notes: June 07 c/o fatigue, insomnia, anxiety, lost 10 lbs over 2 weeks, poor appetite. on Levoxyl 125 mcg since May 252007 when TSH is rising, develops itchy hive rash..
    Mood swings
    The onset of the mood swings has been variable and they have been occurring in a persistent pattern for years. The course has been recurrent. The mood swings are described as severe.
    Thursday, Septenter 20, 2007

    Last edited by weavers5; 10-01-2007 at 06:08 PM.

     
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    Old 10-02-2007, 06:32 AM   #2
    scoobagirl
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    Re: Look at this diagnoses

    I don't understand what you are finding exception to, besides your medication doesn't seem to be working. I hope you get some relief with your RAI treatment.

    Jeri in Texas

     
    Old 10-02-2007, 07:18 AM   #3
    mkgb
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    Re: Look at this diagnoses

    Smoking is a WELL documented aggravant of Graves and its symptoms. It will also improve you lifespan in the long hall. I support you MD to the fullest extent here about your need to stop smoking. One because both my grandfathers died of lung cancer from cigarette's and two I know what is in the blasted things chemically. I hope you have had luck getting off the cigs.

    It is amusing how the mood swings are aggravated but not caused by the thyroid.. I have seen worse diagnosis.. the OB that sent me home when I was suffering from a uterine infection and septic pelvic vein thrombosis and running 103 degree fevers.. had a real good write up. Patient is a young female who had an emergency C section after 13.5 hours of labor where swelling and size complications resulted in a failure to convert. Hospitalization for more than five days is unnecessary for a patient of this age. Complaints of abdominal pain and fever are insignificant and a natural result of a C-section.. patient was told to follow up with her OB when it is time for staple removal. Well next day my fever was 105 and I was at my OB's when they opened. She looked me over and cussed then called to the hospital and checked me right back in. So much for 18 hours of freedom. My OB gave the OB that let me go a real good lecture in the hall. If I hadn't been strapped to 4 IVs and unable to walk effectively.. I would have put my two second degree black belts to use on the fellow and blamed it on hormones. You can do that right?

    Sincerely,
    MG
    __________________
    If we learn by our mistakes, I am working on one hell of an education.

    Last edited by mkgb; 10-02-2007 at 07:24 AM.

     
    Old 10-02-2007, 08:30 AM   #4
    weavers5
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    Re: Look at this diagnoses

    The diagnoses says that my thyroid is a problem but not the primary difficulty. Give me a brake. I was, two and a half years ago, a self employed person with a thriving business. I had to sell my business two years ago when things got worse. So you tell me is it my thyroid or mental. Never had any mental problems. With the quick swings in my TSH I get very tired. I wouldnt classify this as mental. Just run down. I think all that have had or are still having thyroid problems can see what I am saying. The Endo. didnt even do any tests on me. She just read the other doctors notes. With my new Endo she did several test and found out my thyroid is still 10% active. HUMMMMMMMMMMMMM Where my other Endos brain dead , lazy???? This is there job to find out what is wrong, and quessing shouldnt be part of it.

    This is why I am so frustrated with Endos and Doctors. There are some good ones, but I seemed to find the slakers.

     
    Old 10-02-2007, 12:31 PM   #5
    scoobagirl
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    Re: Look at this diagnoses

    the way I read it, you have 3 diagnoses (2 of which are directly thyroid-related).

    1. (Graves) TOXIC DIFFUSE GOITER WITHOUT MENTION OF THYROTOXIC CRISIS OR STORM (242.00) and
    2. OTHER POSTABLATIVE HYPOTHYROIDISM (244.1)

    your PRIMARY DIAGNOSIS is item #1.

    It is the doctor's opinion that diagnosis #3 -
    3. ADJUSTMENT DISORDER WITH MIXED ANXIETY AND DEPRESSED MOOD (309.28) is exacerbated by the thyroid issues but is not responsible for them. That is a subjective diagnosis. You seem to be defensive about having a diagnosis related to depression and anxiety. With what you've been through, who wouldn't be depressed and have anxiety? There isn't anything wrong with that. If your new doctor doesn't mention it, then you probably don't exhibit signs of anxiety or depression; if the new one brings it up, perhaps he/she will refer you to a therapist.

    Believe me, I'm not ragging on you. My husband has been disabled for the past 4 years due to a broken back (on the job) and has only recently been referred to a therapist to deal with anxiety and depression. He would never have asked for a referral - his pain management doctor suggested it. He is learning some great coping skills that no one else could teach him, and he is able to talk to the therapist about the feelings he thought he couldn't share with us, his family. We had been living with him and kept telling him he needed to get some help, but he wouldn't listen to us. He also had the therapist contact his primary care physician, who has prescribed meds that are helping immensely.

    All I'm saying is to not just blow it off if your new doctor suggests that you should see a doctor or therapist. It is very common for people with chronic illness to feel anxiety and depression and you don't have to live with it - there are meds and treatments to make your days easier to get through.

    Best wishes to you,

    Jeri in Texas

    Last edited by scoobagirl; 10-02-2007 at 12:32 PM. Reason: spelling

     
    Old 10-02-2007, 02:20 PM   #6
    weavers5
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    Re: Look at this diagnoses

    Thanks for the reply. I am on the the defnsive because I knew it was my thyroid. The endos up until my newest one just wanted to see me in six to eight weeks. They never did a second uptake test to see if my thyroid was still active. This is what chaps my hide. The endos I had just did the min. amount. They never investigated why my thyroid was going up and down. My new endo is great.

     
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