A battery of tests

January 5, 2010

So back to the story of the new doctor. After getting next to nowhere with my health center doc (or her replacement) I went ahead and found a new doctor. I looked around for an M.D. with a holistic practice, willing to prescribe natural thyroid meds (if thyroid turned out to be my problem then I didn’t want yet another fight on my hands) and a demonstrated understanding of SIBO/IBS. And since I would be paying out of pocket, the new doc also had to be in my price range.

A few emails and phone calls later I had found my guy. He didn’t diagnose me over the phone, but he said I sounded sick (obviously he was attempting to curry my favor right away! – imagine listening to me describe my symptoms and then flattering me by saying that I sound ill!) He mentioned a few things that he would look into were I to become his patient, such as low thyroid function and hormonal imbalances as well as fibromyalgia. He recommended me to look over his preferred treatment protocol and told me to call back and schedule an appointment if I liked what I saw. Which I did, so then I did.

Schlepping all the way from Queens to his Brooklyn office in the snow wasn’t easy (regardless of what you see on the map, the two boroughs are not that convenient to each other!) He asked about my symptoms and within a few sentences he was naming them all for me. Salt cravings, weight gain, inability to get warm, low blood pressure, lots of colds, PMS and painful periods. He definitely listened to me when I talked but he did tell me pretty quickly that he had my diagnosis all ready based on just a few answers – adrenal fatigue and hypothyroidism. He gave me a saliva test for cortisol to take home and perform. And a laundry list of bloodwork to get wherever I could and bring back to him for analysis to test for not only thyroid, but blood sugar problems and wacky hormone levels suggestive of Poly-cystic Ovarian Syndrome (PCOS.) He also gave me a prescription for Nystatin to clear up any yeast that I might have.

Walking to the train in the snow with my husband, I didn’t know exactly how to feel. I was exhilarated that someone with medical authority had finally declared me truly ill. I was terrified that I wouldn’t be able to get the tests done at the health center and worried that I could never pay for them on my own. I was a little skeptical and here is why. In a perfect world, where I would name off all of the things that I would suspect might be causing my symptoms, between a lifetime of a sluggish metabolism, suddenly getting ill four years ago, and then crashing into a brick wall this summer with my energy levels, weight control and digestion, he named every last one of my suspicions. Including a few things you really only hear from holistic doctors, things I used to “not believe in.” Thankfully, I’ve recently learned a lot about yeast from a really well-researched Yahoo group member; were it not for her I may have mistrusted any doctor willing to give me an antifungal. I had also just begun to research adrenal fatigue before I saw my new doctor, and between some reputable sources recently coming out about having or suspecting this condition, and every last one of the symptoms fitting me, I think I’m willing to accept it.

So back I went to the health center. Replacement Doctor had put me in for a transvaginal ultrasound to check for fibroids or ovarian cysts. And a chest x-ray for who knows what, my only guess, thanks to a helpful Yahoo group member, (do I talk about these guys a lot lately or what?) would be sarcoidosis. Both were entirely uneventful outside of having to drink about eight million gallons of water in prep for the ultrasound, which was miserable because I visibly and painfully bloat when I have to pee. Additionally, the technician was fantastic; we discussed girl diseases, gluten-free living and dismissive doctors while she probed me!

Then I saw my (old, regular) doc. I told her of her replacement’s dismissive attitude. I told her that nothing had gotten any better. I told her what had happened with the new doctor (I lied and said he was recommended to me by a friend of the family.) I made some purposely muddy statements about family medical history (being adopted, there is a lot that I do not know and in the past this has been held against me.) I sheepishly handed her the list of tests. All while the nurse was getting my BP and other vitals. Then she put me on the scale. “Wow, you have gained a lot of weight.” The words never sounded so lovely to me. She started ordering the tests. One by one, she put in almost every single lab that my new awesome holistic doctor had ordered for me.

I went in again a few days after Christmas to let them draw blood. It took two days of trying to get up early enough to go before work to actually get there. I went over all the labs with the technicians to make sure they would not do the hormone tests; as the doctor had asked me to do those on the 21st day of my cycle. Blood was drawn for a Vitamin D test, (Replacement doc denied me this test since my calcium levels months ago had been fine,) AM Cortisol, DHEA, Iron, B12 (even though I just tested terribly high two months ago) Hemoglobin A1C, and a comprehensive thyroid panel. I had terrible diarrhea after drinking the dextrose solution for the fasting insulin test. I ate lots of carbs that day thanks to getting all freaked out by 75 grams of sugar at 8 AM. I have eaten very clean ever since that day, as my bloating and abdominal aching have been quite bad due to my period. I’m going to go in on the 21st (because my cycle has it like that this month) and have more blood drawn for hormonal testing.

I will get the results of the tests tomorrow. Normally this would be a really harrowing experience and I would be getting a little anxious about going to the center just to get handed a bunch of normal results and told that I really just need to relax and exercise. Instead, I am just not that tense about it now, knowing that whatever the tests say, I will just smile and nod and take the labs to the new doc at the end of the month and let him make the decisions. I am  probably most interested in the results of the ultrasound,  since I had one a while back and never got the results but yet many a gynecologist (I have gone through a few but not by choice) has told me that my lady parts are riddled with cysts and fibroids. And I am a little worried that the health center’s idea of “comprehensive” just isn’t. I was put in for a thyroid panel back in 2007 and it didn’t include the very important free T3 test that my new doc wants. However, these things must be dealt with as we get to them; no more stressing out over future worries. Just a few weeks ago I thought I was staring at thousands of dollars worth of labs and I didn’t think I’d get any cooperation from my health center. Now they’ve done the lion’s share of them already. And I just found out that a program through my job will reimburse part of any of my out-of-pocket medical costs for tests. So anything can happen, and worrying about the future won’t get us anywhere. Bleeding a lot, into several small tubes, however, will.



  1. I have a fabulous endocrinologist, who is way better than some of the high profile endocrinologists that I had seen at a big city hospital. She has been treating me for almost 15 years. She did thyroid tests that no one had ever done before. And she was the one who also picket up on the Celiac. Smart Doctor.

    She tested me for thyroid antibodies, TSH, not only T4 and T3, but also “Free T4” and “Free T3,” no idea what all the difference is, but it gave her a complete and accurate picture.

    And from my experience, the typical TSH does not necessarily give a true picture of hypothyroidism, and hypothyroidism can lower your heart rate, weight gain, feeling cold and exhaustion. So it sounds as if the person you saw knows what they are doing. Good luck!

    (I just set up the celiacsurprise.com email, hopefully that will work.)

  2. Yay! I love that we’re talking on both blogs now! I also love your endo.

    And yes, I do have a great doc because you list off all the tests that he has requested, plus he asked for the Reverse T3. It’s just a matter of finding these tests on my own now, since the health center doc didn’t include them when she agreed to do all the tests. The health center doc is sending me to an endo, and I’m going, since its covered for me, but I have a feeling she will also be a TSH only kind of doc.

    I’ve found a place online to order the Free T3 and Reverse T3 if my suspicions about the endo are correct. Just more money out of my pocket, but its actually not that bad just for the two tests.

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