Chapter 3: I've Got To Look This Up
The day of my endocrinologist appointment was a hot day. It was now July. The heat was really bothering me because of my undiagnosed hyperthyroidism. The word hyperthyroidism had not even been mentioned yet. All I knew was I was hot, shaking, couldn’t breathe, and felt extremely tired and weak. I was shaking so violently that while sitting on the exam table waiting for the doctor, I needed to hold on to the sides to keep from falling off. I had to keep my eyes closed in order to concentrate on my breathing. Plus, my nerves were out of control because I was afraid of what I was going to hear from her. In short, I was a mess. And I knew it. The medical assistant took my blood pressure, pulse, and weighed me. My usual blood pressure of 90/60 had skyrocketed along with my pulse, and my weight had dropped to 102 pounds. That’s right…..102 pounds. I had lost 11 pounds so gradually that I had not noticed it, and neither did anyone around me. (Looking back, this was only the beginning of how low my weight would go).
My doctor came in, introduced herself, had looked over my vitals before she entered the room, and almost immediately began assessing me. Her statement of, “You’re very sick”, was an understatement. She explained to me what she thought I was suffering from - hyperthyroidism - and wanted to run some labs to confirm it. She also wanted me to get an ultrasound of my thyroid to see what was going on.
For the very first time I heard the words “Graves Disease”.
At that point, she was not entirely sure of the reason for my hyperthyroidism, and prescribed methimazole and metoprolol to control my symptoms.
You read that right…..to control my symptoms. At that exact moment, in the condition I was in, it was all I was looking for. However, it became the unexpected reason that we just could not agree on my treatment a year later, which resulted in the eventual end of our doctor-patient relationship.
I let her know that I was a nurse - because I wanted “straight talk”. I wanted to let her know that if she was tip toeing around something or not being completely forthright and upfront with me I would know it. I did not come right out and say this. I just let her know I was a nurse, and she understood why I had told her. She said, “So you know what I’m saying…“. What I wanted and needed most was a doctor who would listen to me. Not listen like, “Listen to me!“, but listen like, “I hear and understand what you’re saying“. And I truly believed in that moment that we would be a good team.
She explained that on methimazole I would need regular blood testing to check my liver because the drug can be toxic to the liver. I needed to regularly monitor my blood pressure and pulse because I was now on metoprolol. I also was advised to stop working, at least for a while. I was to see her again after my blood work and ultrasound to confirm my diagnosis and discuss my treatment options.
I went home, scheduled my ultrasound, started taking my medication, and my symptoms began to lessen. And so, for the first time in my life, I was dependent on some serious medication to feel better. I was very unhappy.
Life Lesson #3: Sometimes you need to do things you don’t want to do.
Thyroid Note #4: Graves disease is the autoimmune cause of a hyperthyroid state. The hyperthyroid state is a symptom, not the cause of this disease. This is extremely important to understand. It is the basis upon which I will begin researching how I will supplement my medical treatment to achieve the best possible results.
- Dorian A., RN, CHLC
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