Friday, May 23, 2008

Synthroid Okay

Taking my 225 mcg. synthroid at night now. If I have a little snack as I did last night (popcorn), I wait two hours to take it. I am feeling good, actually quite energized. I only napped one day this week after work. For those of you who have had the total thyroidectomy, you know only one nap in a week is good progress. I actually lost two pounds, although I really can't count it until it has been off a week...

Wednesday, May 21, 2008

Or does he?

The endocrinologist’s office called again when I came home from work today. It was a different woman, who wanted to know if the appointment that was made for me last night was a “needed” appointment. I told her I did not know what she meant by needed. She told me that he just saw me in October and she didn’t know if he needed to see me again. Besides the fact that my TSH isn’t straightened out yet, I told here that I was told he likes to do an ultrasound a year after a total thyroidectomy if the total thyroidectomy was for thyroid cancer. I kind of got upset by this call, I told her if he doesn’t want to be my doctor anymore it didn’t matter. She said no, that’s not it and quickly got off the phone.

I was just feeling that they had just “let me go” and were making things right. Until this phone call, of course. I didn’t’ know that the lab should have been sending them my TSH levels along with sending them to my primary care physician. My thing is, is that first the surgeon takes care of your synthroid and checking your TSH and then you go to the endocrinologist, or they work together. I know my surgeon called him, so that was good. Then I get the primary care physician because the surgeon can’t do it anymore, because they only get you so far after surgery. The primary care says they can take care of the synthroid and TSH levels. When that doesn’t work out like they thought, that nurse recommends calling the endocrinologist and you start talking to them again. They are upset they haven’t heard from me since October, but I didn’t know they were supposed to. I did not get a pamphlet on aftercare etiquette from any of the various offices and doctors that have been in my life for the last year, so I do not know. someone needs to tell patients what is expected of them. All I know is that I need my levels checked every six weeks, and a prescription, and someone to keep increasing the Synthroid prescription. Beyond that I don’t really know the protocol and it wasn’t explained to me. I am aggravated now, is it a “needed” appointment? I don’t know.

The endocrinologist cares, he really does...

I spoke to another one of the endocrinologist’s nurses last evening. She called me. It was nice of her to call and admit that they had lost track of me and wanted my TSH to be checked by him and not my primary care physician. I said that was find and she said they would send me lab papers. She even apologized.

The endocrinologist’s nurse called back and said that the endocrinologist usually sees patients a year after their total thyroidectomy. If the patient had thyroid cancer, he likes to do an ultrasound a year after the total thyroidectomy. Since I had the thyroid cancer and the total thyroidectomy, she wanted to schedule me for the ultrasound. Well we schedule that up for August. We discussed taking the synthroid at night, TSH levels actually needing to possibly go lower that they should for a person who had thyroid cancer and the total thyroidectomy. The levels need to be lower than the 1.5 to 4.5 range that they recommend. The optimum TSH level for someone who had a total thyroidectomy because of cancer is right at 1. She explained that sometimes the synthroid will take the patient lower than the optimum TSH into the hyperthyroid instead of hypothyroid and then the endocrinologist with lower the micrograms of synthroid.

I felt good after speaking to her, I certainly felt a lot better about the endocrinologist and his office in general. They say online if you don’t feel a good rapport with your endocrinologist, you should find a new one. Well, there is only one endocrinology office in the town I live in, so I’d like to make it work so I’m not traveling 45 minutes or something to the doctor when I can just go 10 minutes away. So I feel a renewed faith that the endocrinologist knows what is going on and what he is doing, and cares about what happens to me...

Tuesday, May 20, 2008

Endocrinologist Conversation... Finally

I spoke to the endocrinologist finally, well to the endocrinologist’s nurse anyway. They actually do want me to start taking my synthroid at bedtime instead of in the morning. So it wasn’t a mistake on the letter, people are taking synthroid at bedtime. The endocrinologist’s nurse said that the key is no eating at least an hour before you take the pill and at least an hour after. Since I am not absorbing the synthroid as well as some people do, this would allow the whole night to go without eating or taking any vitamins or anything that may blog the absorption or synthroid.

I asked her when to make the switch like if I take it in the morning and then the next night, she said that it would be okay to take it in the morning and then that night again to start. Well, that makes me a little nervous. So I usually take it at 5:30 a.m. I think I will take it at 11:00 for the bedtime one, right before I doze off. I am going to wait until Friday though, if I feel funky because of taking too much I’d much rather it not be on a workday.

I really thought the endocrinologist had made a mistake on the letter. After I found the article on About.com from January about studies regarding people taking their synthroid at night, and talked to the endocrinologist’s nurse. I think I will try taking my synthroid at night, seeing if I get better absorption. Then perhaps eventually I will be able to drop back to 200 mcg of synthroid, and only having to pay the one prescription deductible each month. Well, we’ll see.

Sunday, May 18, 2008

Hold on

http://thyroid.about.com/b/2008/01/17/when-should-you-take-your-thyroid-medication.htm

Ok wait a minute at the URL above there is an article about taking your medicine at bedtime instead of in the morning. Again it is on about.com because aparently Mary Shomon is the only one on the net letting us know about these things. Monday I will call the endo and see about this now... I'll let you know.