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Old 01-04-2013, 10:28 PM #1
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Heart went to the internist

So I went to the internist on Wednesday. I did not get to see the internist, but the nurse practitioner. She reviewed my previous wacky bloodworks and wrote orders for more bloodwork which I will do next Tuesday morning. She wants an ultrasound of my thyroid done and their office has started the process of getting that approved with my insurance. She was really patient and seemed to be interested and listening when I talked, big positive change from the endocrinologist.

There is a spot in my upper abs that has been hurting mildly. It is more tenderness than pain. I am so used to it that I didn't even think to mention it. After talking I sat on the table for her to listen to my heart, look in my ears, throat, yada yada yada. Then she had me lie down. She started pressing all around my stomach and when she hit that spot I said OW! She said do you know you have a hernia here? I said no. She says the internist will have to take a look at it. I go back on the 17th. The internist will feel the hernia and go over my bloodwork results.

I am aware of a hernia that I have near my bladder which my OB/GYN said at my last visit that I can put off for now but eventually will have to be corrected with mesh screen or part of a cadaver pig. I got weak just from her talking about it. The smells and thought of a hospital make me feel like I'm going to die just when I think about it. And the thought of having metal or pig parts in me does not sound lovely to me either. I just hope this hernia can be left alone or put off, too. I cannot handle this right now.

The nurse practitioner told me that my symptoms sounded to her like thyroid issue or adrenal fatigue. I have never heard of adrenal fatigue in my life but will google it when I have more time. Netflix is calling. I need to veg I am feeling overwhelmed. I will indulge in buttered popcorn and Star Trek:Enterprsie and xanax. I am trying to be light-hearted but I am really upset, that's why I haven't posted about it sooner. If you have had hernia surgery please let me know what it was like pain-wise and the recovery time. Thank you!

Please note: the internist has not even seen it yet, no one has told me I need surgery for the one in my abdomen. My mind has a tendency towards worst case scenarios. This is just who I am.

Last edited by butterfly11; 01-05-2013 at 12:24 PM.
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Old 01-04-2013, 10:37 PM #2
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I am glad that you found someone to listen to you. sounded thorough.
sorry about your hernia, that must have been a surprise.
I worry about stuff too...can't help it. my pdoc ordered more klonipin if I needed it.
I don't know anything about hernias.....
don't start googling them!
enjoy your netflicks
bizi
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I will not give up in this weight loss journey, nor this need to be AF. 3-19-13=156, 6-7-13=139, 8-19-13=149, 11-12-13=140, 6-28-14=157, 7-24-14=149, 9-24-14=144, 1-12-15=164, 2-28-15=149, 4-21-15=143, 6-26-15=138.5, 7-22-15=146, 8-24-15=151, 9-15-15=145, 11-1-15=137, 11-29-15=143, 1-4-16=152, 1-26-16=144, 2-24-16=150, 8-15-16=163, 1-4-17=169, 9-20-17=174, 11-17-17=185.6, 3-22-18=167.9, 8-31-18= 176.3, 3-6-19=190.8 5-30-20=176, 1-4-21=202, 10-4-21= 200.8,12-10-21=186, 3-26-22=180.3, 7-30-22=188, 10-15-22=180.9,
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Old 01-05-2013, 12:51 AM #3
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Dear Butterfly,

Quote:
Originally Posted by butterfly11 View Post
The nurse practitioner told me that my symptoms sounded to her like thyroid issue or adrenal fatigue. I have never heard of adrenal fatigue in my life but will google it when I have more time.
I apologize for reading this quickly as I am in the middle of a project for work. The nurse practitioner is using made up or (over simplified) language because the Mayo Clinic says that adrenal fatigue is not a medically accepted diagnosis.

On the other hand, actual Adrenal Insufficiency can be diagnosed by blood and other tests to show inadequate levels of adrenal hormones.
See link: http://www.mayoclinic.com/health/adr...atigue/AN01583

I believe that you can request what materials you want for those materials. If necessary, you can get a referral for another doctor who can use materials appropriate for you. I do remember that pigs have material that is very compatible with our parts. Years ago, diabetics relied on insulin that came from pigs.

Try to take one thing at a time:
1 go for the blood work on Tuesday
2 go for the thyroid untra sound

Try not to get ahead too far. You can handle these things one at a time.

M
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Old 01-05-2013, 03:01 AM #4
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Dear Butterfly,

Great that you had a positive experience at the doctor's office. She seemed thorough. Did you feel like she was asking the right questions and listening to you? You can write down additional questions you have for the appt with the internist.

It is great that you have an internist. Sometimes they are good at considering the patient as a whole person (instead of a collection of parts.)

I believe that you can do one or two things at a time very well. Focus on how great it will be to know that the issue with your thyroid is straightened out. (Think of the of the other stuff when the time comes.)


M
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Old 01-05-2013, 12:31 PM #5
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Quote:
Originally Posted by bizi View Post
I am glad that you found someone to listen to you. sounded thorough.
sorry about your hernia, that must have been a surprise.
I worry about stuff too...can't help it. my pdoc ordered more klonipin if I needed it.
I don't know anything about hernias.....
don't start googling them!
enjoy your netflicks
bizi
thank you bizi ! I did enjoy my popcorn & Netflix last night. It was a nice break from reality. Don't worry, I will not be googling hernias, I don't want to know.
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Old 01-05-2013, 12:45 PM #6
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Quote:
Originally Posted by Mari View Post
Dear Butterfly,



I apologize for reading this quickly as I am in the middle of a project for work. The nurse practitioner is using made up or (over simplified) language because the Mayo Clinic says that adrenal fatigue is not a medically accepted diagnosis.

On the other hand, actual Adrenal Insufficiency can be diagnosed by blood and other tests to show inadequate levels of adrenal hormones.
See link: http://www.mayoclinic.com/health/adr...atigue/AN01583

I believe that you can request what materials you want for those materials. If necessary, you can get a referral for another doctor who can use materials appropriate for you. I do remember that pigs have material that is very compatible with our parts. Years ago, diabetics relied on insulin that came from pigs.

Try to take one thing at a time:
1 go for the blood work on Tuesday
2 go for the thyroid untra sound

Try not to get ahead too far. You can handle these things one at a time.

M
Thank you for the link Mari. The symptoms that I see that I have for adrenal insufficiency are fatigue, body aches, low blood pressure, and lightheadedness. In fact I was telling her about how I see these silver flecks sometimes if I get up too fast from beding over or sitting up or laying down.

Just pulled out my paper - these are my bloodwork orders:
blood type
CBC, WBC
comprehensive metabolic panel
cortisol, free
vitamin B-12
Epstein-barr virus early antigen antibody
ferritin (which I think is iron, b/c I have been anemic in the past)
free T4
free T3
lipid panel
Lyme western blot test
magnesium level
Molecular isolation or extraction, each nucleic acid type(i.e. DNA or RNA) MTHFR
reverse triiodothyronine
thyroid peroxidase (TPO) antibodies
TSH
urinanalysis
vitamin D, 25-Hydroxy

I don't know what half this stuff is but I do remember her saying something about the cortisol having to do with the adrenal glands, and I see that in the bloodwork she ordered.
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Old 01-05-2013, 01:01 PM #7
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Quote:
Originally Posted by Mari View Post
Dear Butterfly,

Great that you had a positive experience at the doctor's office. She seemed thorough. Did you feel like she was asking the right questions and listening to you? You can write down additional questions you have for the appt with the internist.

It is great that you have an internist. Sometimes they are good at considering the patient as a whole person (instead of a collection of parts.)

I believe that you can do one or two things at a time very well. Focus on how great it will be to know that the issue with your thyroid is straightened out. (Think of the of the other stuff when the time comes.)


M
Yes, Mari, I felt like she was listening. My endocrinologist seemed to dismiss all of my fatigue symptoms and body aches to depression, just because I have a bipolar diagnosis. That was really frustrating!!!! I told this to the nurse practitioner and that I know my body and that there is something physical going on, I don't know what, that's why I'm here. This nurse practitioner actually told me that one of her good friends has bipolar disorder and is fully capable of distinguishing physical pain & fatigue from depression and I just thought to myself thank God!

Seems like she ordered everything but the kitchen sink. But she said we have to start ruling stuff out. My only worry is how much this will cost me. But I want to know whats going on.

I will be very relieved once the thyroid ultrasound is done. Every thing that gets ruled out is a good thing.

She said she wished she could give me a B-12 shot but said that she couldn't until after I draw my bloodwork. She said the internist may decide to give me one when I go back on the 17th. Although I'm not sure how they determine if you need one, I don't see anything on the bloodwork orders checking for Vitamin B but I could be missing it. Maybe their criteria is that you're tired all the time. I have heard that B-12 can give you energy.

Yes Mari, one thing at a time. one thing at a time. one thing at a time. You are right, one thing at a time is manageable. Or should I say more manageable :-) Thank you for the encouragement.
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Old 01-05-2013, 01:48 PM #8
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Butterfly,

It seems that she is responding to the symptoms you describe. For example, the Lyme disease and the Epstein Barr and B12 could relate to tiredness. I am not up to date on Magnesium.
Short explanation of the blood order:


CBC, WBC -- this is standard
comprehensive metabolic panel -- this is standard as well
cortisol, free --- this will check your cortisol / adrenal glands
vitamin B-12 --- doctors might be checking more than they used to. . . . not sure. . . it might be standard
Epstein-barr virus early antigen antibody --- lots of people have the Epstein-barr marker in their body so it is not a good test but maybe the nurse practitioner is looking to see why you have low energy
ferritin (which I think is iron, b/c I have been anemic in the past) --- Iron as you say
free T4 -- Thyroid
free T3 -- Thyroid
lipid panel -- Cholesterol
Lyme western blot test -- Lyme disease ( you can ask why she is checking for this.)
magnesium level -- Magnesium ( you can ask why she is checking for this.)
Molecular isolation or extraction, each nucleic acid type(i.e. DNA or RNA) MTHFR -- according to this link this has to do with B12
http://labtestsonline.org/understand...mthfr/tab/test
reverse triiodothyronine -- Thyroid
thyroid peroxidase (TPO) antibodies --- Thyroid
TSH -- Thyroid
urinanalysis
vitamin D, 25-Hydroxy --- It is good that she is checking Vitamin D.


M

Last edited by Mari; 01-05-2013 at 02:24 PM. Reason: bolding
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Old 01-05-2013, 01:57 PM #9
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Quote:
Originally Posted by butterfly11 View Post
I told this to the nurse practitioner and that I know my body and that there is something physical going on, I don't know what, that's why I'm here. This nurse practitioner actually told me that one of her good friends has bipolar disorder and is fully capable of distinguishing physical pain & fatigue from depression and I just thought to myself thank God!
Hi,

You won the Nurse Practitioner lottery!
I am sooooo happy!

She has two tests for B12. She cannot give you the shot until she knows how much you need. The good news is that it washes out of our bodies quickly like Vit C does so it is ok to take a lot. The bad news is that you usually have to keep it up.
Lack of B12 can have neurological ramifications so this is good that she is checking.

Mari
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Old 01-05-2013, 09:52 PM #10
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Quote:
Originally Posted by Mari View Post
Butterfly,

It seems that she is responding to the symptoms you describe. For example, the Lyme disease and the Epstein Barr and B12 could relate to tiredness. I am not up to date on Magnesium.
Short explanation of the blood order:


CBC, WBC -- this is standard
comprehensive metabolic panel -- this is standard as well
cortisol, free --- this will check your cortisol / adrenal glands
vitamin B-12 --- doctors might be checking more than they used to. . . . not sure. . . it might be standard
Epstein-barr virus early antigen antibody --- lots of people have the Epstein-barr marker in their body so it is not a good test but maybe the nurse practitioner is looking to see why you have low energy
ferritin (which I think is iron, b/c I have been anemic in the past) --- Iron as you say
free T4 -- Thyroid
free T3 -- Thyroid
lipid panel -- Cholesterol
Lyme western blot test -- Lyme disease ( you can ask why she is checking for this.)
magnesium level -- Magnesium ( you can ask why she is checking for this.)
Molecular isolation or extraction, each nucleic acid type(i.e. DNA or RNA) MTHFR -- according to this link this has to do with B12
http://labtestsonline.org/understand...mthfr/tab/test
reverse triiodothyronine -- Thyroid
thyroid peroxidase (TPO) antibodies --- Thyroid
TSH -- Thyroid
urinanalysis
vitamin D, 25-Hydroxy --- It is good that she is checking Vitamin D.


M
Thank you so much Mari!

I am such a knucklehead. I typed it out myself, it says right there Vitamin B-12, but I still overlooked it. sheesh. Anyway, she asked if we go camping which we do. That is the only reason I can think of that she is checking for Lyme disease. She asked if I had every gotten bitten while camping. ha! Are you kidding me? Mosquitos mostly though I think.

I don't know why she's checking magnesium levels. I didn't see the orders until the receptionist printed them out when I checked out. The nurse practitioner had typed them into a computer while we were talking. I kind of wish she would have showed them to me before I walked out so that I could ask line by line, what's this, what's that. But you've done that for me. Thank you Mari!
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