March 6, 1998

Today was my second visit with the Blonde Bimbo.  I remember feeling so happy and confident that this doctor knew exactly what she was doing.  Of course, at that time I had not read any of her notes or reports.  I had not seen any of my lab results.  I had no idea it was even possible to ask for copies of lab reports.  DUH!!

Following is the Blonde Bimbo’s report for March 6th, 1999 and it reads, “Widebertha remains on Atenolol and has not restarted her PTU since her scan.  She still complains of nervousness and tremor.  Her iodine uptake and scan show diffuse uptake within the gland and a mildly increased radio iodine uptake of 21%.  Recent lab tests are consistent with mild hyperthyroidism with a T4 of 113, a T3RA of 3.2 and a TSH of less than 0.1.  Liver enzymes are raised with an ALT of 78, AST of49 Alk. Phosphate of 549 and a Bilirubin of 9.4. This lady certainly does have thyrotoxicosis secondary to Grave’s disease.  She also has liver enzyme abnormalities in a cholestatic pattern.  These may be due to hyperthyroidism itself but are a bit more severe than one usually sees.  I guess the question is whether the PTU may be playing a role here or whether she might have another cause for abnormal liver enzymes.  I have discussed treatment options with her and in view of the longstanding nature of her symptoms and the question whether some of the liver abnormalities relate to the PTU; she has been booked for a treatment dose of Iodine 131, 14 mCu on April 3rd, 1998. In the interim I have asked her to stay off the PTU but to increase the Atenolol to 100 mg. o.d. I’ve asked her to come back in about 6 weeks after her radioactive iodine to reassess her both from the standpoint of thyroid and hepatic function.”

What really makes my hair stand up on end is her statement “I have discussed treatment options with her.”  This just did not happen!!  The Blonde Bimbo never mentioned surgery.  She never investigated to see whether the PTU was really causing additional liver problems.  She just insisted that I had to have the radio active iodine treatment; that this was the only treatment option available to me.  The Blonde Bimbo also told me that once I had the radio active iodine treatment I would take this little pill every day for the rest of my life and my health would return to what it was pre-Grave’s.  What a load of hog wash!!

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