Not Over Till The Fat Lady Sings

After the farcical visit to Blonde Bimbo on June 2, 2000, I decided to make an appointment with Old Man at the country clinic.  Old Man was the one who had finally diagnosed my Graves Disease after I came to emergency late one afternoon in December 1997.  At that point I had completely lost my voice for several weeks and was experiencing thyroid storms.

The appointment was this afternoon. Old Man took the time to read through my notes and then told me that I should not be feeling as miserable as I do.  Wow, a medical professional who actually acknowledges that I should not be feeling so miserable!  What a miracle!

Old Man looked at my T3 and T4 results from several thyroid panels. He then told me that I was obviously not converting T4 into T3 even though I had been taking Cytomel since October, 1999. He asked me if anything was being done about my <0.1 TSH level. I told him that nothing was being done so he ordered another thyroid panel.

Old Man than addressed the issue of fibromyalgia. He told me that I was anything but depressed and ruled out fibromyalgia with a pressure point test. He did order a bone density scan. He told me that if a person has had hyper symptoms for as long as I did before diagnosis, minerals are leached from the bones. He believes this could be the reason for my hip and leg problems.

Old Man asked what was being done about my high serum cortisol levels. Again I told him nothing was being done. He said he was concerned about the high serum cortisol levels because this could be an indictor of a pituitary or adrenal problem.  He also feels the high cortisol levels could be interfering with T4 to T3 conversion. He feels the high cortisol levels could be the reason for the weight gain around my middle, the water retention in my face, hands and feet, the shape of my face and the constant fatigue.

Old Man told me that just because I was 52 years did not automatically mean that I was depressed. He also told me that no 52-year-old woman should have to put up with symptoms like I have because medical professionals do not take the time to figure out what is wrong.

Even though I still have a long road ahead of me, maybe Old Man will be able to help me.  I must not get my hopes up too high. I have learned the hard way that the disappointment is too great.

After waiting patiently since June 3rd, I finally received a copy of the report Blonde Bimbo wrote regarding my June 2nd, 2000 appointment

The enclosure that comes with a cytomel prescription reads as follows, and I quote,

“WARNING:

This product is to be taken with caution and only under a doctor’s supervision by patients with myocardial infarction, angina pectoris, myocarditis, cardiac insufficiency with tachycardia, arterial hypertension.

Patients in this category taking sympathomimetic amines should be monitored. Patients with coronaropathy who are treated with thyroid hormones are to be closely observed during surgery as the likelihood of cardiac arrhythmia can be greater.

At the beginning of CYTOMEL treatment, both diabetics taking either insulin or medicine for hypoglycemia by mouth and patients taking anticoagulant products should undergo laboratory tests to prevent phenomena of alteration and also adapt to a new daily dosage.

Since rare cases have been seen of the patient is recommended to lower the dosage or even stop treatment if he should experience fever or weak muscles, or if the results of laboratory tests for hepatic functioning should so indicate.

Diphenylidantoin must not be injected during CYTOMEL treatment. Patients with panipopituitarism or other problems related to surrenal insufficiency may react unfavorably to thyroxine; patients are thus advised to initiate a corticosteroid based treatment before taking CYTOMEL.”

I, of course had not read the insert until after my June 2nd appointment with the Blonde Bimbo.  When I first started to take cytomel I truly believed that my symptoms improved.  However, a couple of weeks after my January 5th appointment my symptoms reared their ugly heads with a vengeance.   I continued to take cytomel until the beginning of March.  At that point I decided that the cytomel was the only new drug I had introduced into my body so I would quit taking it.  My symptoms however, did not improve.   In desperation I made the June 2nd appointment with Blonde Bimbo.  Blonde Bimbo never once mentioned that a person suffering from hypertension or from hepatic dysfunction in connection with thyroid preparations, or from adrenal dysfunction should heed the warnings on the cytomel information enclosure.

This then is the Blonde Bimbo’s report from my June 2nd, 2000appointment and I quote, “I reviewed Widebertha on June 2nd, 2000 with regards to her fatigue.  As you know, when I last saw Widebertha in early January she felt quite good and attributed this to her combination therapy for her hypothyroidism.  Now she tells me she has had recurrent fatigue since late December or early January.  She has a disturbed sleep pattern which is non-restorative and describes a lot of hip and anterior thigh discomfort at night.   She feels exhausted in the morning.  Energy level begins to improve late morning and she feels best in the afternoon.  Most of her discomfort is in her hip and legs.  She describes achy arms as well and she tells me she is too tired to do housework or go to the office.  She denies any depression.  She denies hot flashes.

Currently she is on Moduret 1 tablet o.d., Metoprolol 25 mg. b.i.d.   Her weight has increased a further 4 kg.  She has no other well defined complaints apart from about an hour of morning stiffness and , as well, a history of one day of some degree of spotting which may have been per vagina or urethral.  As per your forwarded results she had a non-specific rise in liver enzymes in January that is now normal.  An ultra sound of the liver has been normal.  A recent A.M. cortisol was 850 and the P.M. was 550.

Physical examination revealed an overweight middle aged woman.  She was not Cushingoid in appearance.  Her B.P. was 130/80 sitting; pulse was 64 and regular.  On head and neck exam she has a small firm symmetrical thyroid.  Chest, cardiovascular and abdominal exams were essentially normal.  On musculoskeletal exam she has a large number of trigger points in both shoulder and hip girdle.  She is exquisitely tender in particular over the left SI joint.  She has no evidence of any active joint disease peripherally.  Range of movement of her right hip is good.  She has reasonable range of movement of her left hip apart from some difficulty with rotational movements and flexion which cause discomfort.  Right at the present time Widebertha’s clinical presentation is most consistent with fibromyalgia.  I think it would be important to rule out underlying arthritic condition given her more exquisite tenderness in the SI joint, the minor hip findings and the previously transiently abnormal LFT’s for which I do not have a good explanation.  For the present time I have arranged for her to have some x-rays done of her hips and of the SI joints and I have initiated a screen for connective tissue disease.  I have also asked her to do 24 hour urine for free cortisol but apart from the mood changes really there is little here to suggest hypercortisolism.  If these investigations are negative consideration could be given to two therapeutic interventions either together or separately; that is a trial of hormone replacement therapy assuming that her PV bleeding is not on a sinister basis and/or a trial of an h.s, tricyclic to try and improve her sleep pattern  at night.

I have not arranged to see her again at present but certainly will be in contact with her should any of her investigations suggest the need for further work-up.  I will try and forward the investigations to you when they are available.

Thank you for asking me to see this pleasant lady again.”

After the way I was treated by this woman at my June 2nd appointment, she must be incredibly arrogant to add to the end of her report, “Thank you for asking me to see this pleasant lady again!”  Trust me, there will never be a next time but if heaven forbid there is a next time, this pleasant lady will have evolved into a royal pain.

I have included some of the lab results the Blonde Bimbo ordered on June 2nd and they are as follows:

Creatinine was 91 marked high with the lab normals being 53-88

Urine Volume was 2760 marked high with the lab normals being 500 – 1500

Creatinine Clearance was 61 marked low with the lab normals being 80 – 125.

Urine Creatinine per Day was 8567 marked low with the lab normals being 9000 – 18000

Urine Cortisol was 75 with the lab normals being 65 – 300.

The hip x-ray report states that there is no bone or joint abnormality seen.

Yesterday was a very frustrating and disheartening day. I had an appointment with my endocrinologist, Blonde Bimbo. My husband had taken me into the city since I had been feeling so miserable. I was walking with a cane since that was the only way I could remain in an upright position. I asked the guardian of the consultation room if my husband could join me. The guardian thought for a while and said yes. After the regulation wait of 15 to 20 minutes, we were honoured by the presence of the Blonde Bimbo. And oh my! what an honour that was! The Blonde Bimbo walked into the consultation room, took one look at my husband and the rest of the visit went straight to hell in a hand basket. I told Blondie that I had asked my husband to join us to make sure that I did not forget something that I needed to tell her. By this time, the woman should have officially changed her name to Dr. Grouch. I have seldom seen such pouting on the face of child let alone a so-called educated adult! I had done what all Internet Support Boards tell you to do which is to make a concise and to the point symptom list. I handed Blondie my symptom list. She barely glanced at it, and threw the list aside without reading it. She told me she had just gotten my thyroid numbers from my family physician and my symptoms had nothing to do with my thyroid. I actually had a fleeting moment of joy! But alas it passed very quickly.  My husband mentioned to Blondie that he had made graphs showing the constant fluctuations in my TSH, T4 and Free T3.  Before he could finish his sentence she told him that she was not interested in any graphs. Then Blondie got very rude, (basic good manners do not seem to be a requirement for Medical School) and told me that I no longer had a thyroid problem since I was on medication. She told me that I had told her I was doing much better when I had seen her on January 6th, 2000. I replied that at that time I thought I was doing better on the Cytomel but my health had been steadily declining. Blondie said that was impossible! I asked her about my <0.1 TSH and she won’t answer my question. Blondie did a physical exam after which she informed me that I had fibromyalgia. She told me that I must be depressed because that is what caused fibromyalgia.  She also mentioned that I was at the right age for depression!  She told me I had 4 options: to take cytomel, not to take cytomel, take something for deep sleep, or take Estrogen.  She told me she did not care what I took or what I did.  I told her that the cytomel caused my heart to race among other side affects. I asked her very politely if I could stop taking the cytomel and go back to taking .175 of synthroid. Her answer was “I don’t care – do what you want.”  She did not give me a prescription for any of the medications she suggested and at that point I certainly did not ask.  I tried to bring up a few of my symptoms but she refused to listen. Blondie then told me that she had had a patient who Blondie thought was psycho. Apparently after taking estrogen the patient had been okay.  Made me wonder if she was implying that she thought I was psycho.  I had finally had enough.  I told her that fibromyalgia was a label that doctors liked to give women my age when the doctors did not have the expertise to figure out what was wrong with us.  I told her that fibromyalgia was a nice long name and that the doctors hoped women my age were too stupid to pronounce it or know how to spell it.   They also expected we silly women to be impressed by the long name of the disease we were supposedly dealing with.  I told her I knew exactly what fibromyalgia implied. By diagnosing me with fibromyalgia she implied that I was a depressed hypochondriac who might even be psycho and that I as an intelligent woman refused to accept that.  She answered with, “fibromyalgia is caused by depression and thyroid problems do not cause depression.”  The Great One had spoken!!!

During the whole visit she kept mumbling about the fact that my family doctor had not written her a letter outlining his concerns and that her nurse, the guardian, had to have my lab results faxed to them that morning. When she was ready to show me out of her office I casually mentioned my high serum cortisol levels.  Blondie sat right back down on her throne when she heard this.  She wrote out requisitions for blood work to be done immediately.  I left the consultation room and sat down with her nurse while I waited for the requisitions to be filled out. In the meantime, Blondie was standing beside the nurse’s desk muttering about my family doctor and flicking through my file that was still in her hand.  Well to Blondie’s amazement guess what she pulled out – a four page letter from my family doctor.  Blondie then quickly flipped through the letter, ordered a 24 hour urine cortisol and started to walk away muttering under her breath that her nurses don’t know where to file things. That was the straw that broke the camel’s back. I stood up and said rather loudly “And where exactly do you think the nurses should have filed my doctor’s letter and lab reports if not in my file where you just found them?  Blondie alias the Grouch walked off in a huff as only those with MD behind their names can do!

This is a list of the symptoms that I have developed since I had RAI
done in April, 1998:

1. Huge weight gain. All the weight gain is around my abdomen, on my back, around my shoulders, around my neck and on my face. My arms and legs have not gotten proportionally fatter. I gained about 20 lbs. in the first 6 months after RAI.   Between June 2, 2000 and August 30th, 2000 I gained a total of just over 50 lbs.  Since September 2000 I have gained another 30 lbs.

2. Sleep is but a distant memory because I wake up several times a night. I wake up for two reasons. One reason is because my legs are crawling so badly that I cannot lie still. The other reason is that at times I literally get jolted awake by what I can only describe as adrenaline rushes. Whether I wake up because of the horribleadrenaline rushes or because of the crawling in my legs, I spend about 1 to 1 1/2 hours pacing the floor before I can fall asleep again. This happens three to four times a night. I am literally beyond exhausted!

3. I have terrible intermittent pain in my hips, legs and Achilles Tendons. The bones in my hips, feet and legs hurt. My Achilles Tendons both hurt to the point where I can no longer properly lift my heels off the floor when I walk.

4. Climbing stairs is very difficult. The muscles in my legs are gone!  When I walk up my basement stairs I actually get cramps and pain in the muscles in my thighs and calves. When climbing stairs my legs feel like they have turned to rubber and will buckle under me.  This happens all summer long even though I swim an average of three hours every day from May until September . When I say swim, I mean swim. My 7-year-old  grandson, an excellent swimmer, expects me to be Wanda the Whale when we swim together. You can imagine all the energy I have to exert as Wanda! This consistent and constant daily exercise during the summer does absolutely nothing to strengthen my muscles.

5. I usually feel sick to my stomach or very lightheaded after any kind of exercise.

6. My face has changed its shape. It is very hard to describe but I do not look like I did two years ago. People who have not seen me in the last twelve months do not recognize me.

7. I have suffered from high blood pressure for years. I have been on high blood pressure medication for 3 1/2 years.

8. I retain fluids to the point where my hands and feet swell up and my eyes are just slits. I have been on a diuretic since October 1999.

9. I have a mild hump at the back of my neck, which is becoming an aggravation as well as painful when I put my head back.

10. My eyesight has deteriorated very much over the last two years. I find this very frightening and worrisome. My peripheral vision has been affected.

11. I have constant buzzing in my ears. This combined with my vision problem and hearing problem causes me to become very disorientated. At times objects will literally float in front of my eyes. The disorientation causes me to become dizzy and nauseous.

12. I have had problems with boil like eruptions in some unmentionable places on my body. They look like angry red and purple boils.  Sometimes they get as big as a dime. In the last little while I have been getting them on my stomach and under my armpits. Quite often these boils will appear over and over again in the exact same place.

13. I have lost all the hair under my arms.

14. I have noticed that I now have big purple veins showing through my underarms, my breasts and stomach area. I also have areas where the blood veins seem to have burst leaving spider like purple marks. I also have vertical white stretch marks.

15. When I exert myself in the least little bit, like putting dishes in the dishwasher, I will sweat so much that the water runs down my neck and back. The sweat comes from my head and neck area.

16. I have a lump on each of my Achilles Tendons. The lumps are painful to touch.

17. I have a constant thirst. I drink continuously and of course as a result spent a lot of time in the bathroom.

18. I have had high sodium levels, high cholesterol levels, high BUN, low potassium, high Urine volumes (over 4 liters), high Creatinine levels, below normal Arginine Vasopressin levels, high ESR and high C reactive protein levels.

When I try and discuss these symptoms with the physicians supposedly involved in my care, the standard answer is “I really have no idea why you would have these symptoms or these abnormal lab results!”

Added September, 2001

A little while ago, I questioned No Name about my abnormal lab results.  I was particularly interested in why I had low potassium, high cholesterol, a high ESR result and a high C Reactive Protein result.  I also wanted to know what could be done to correct these problems.  No Name sat for a moment in what I presumed to be “in deep thought.”  He then looked at me and answered “I really have no idea what to do.”  I thought to myself “so much for deep thoughts” and told No Name that IF and WHEN he had an idea he could call me.”

When I first began taking Cytomel I noticed a dramatic improvement.  I lost some weight, the water retention was not as severe, fewer muscle cramps, less bone pain and I “felt” better.   Finally a little pill that would actually take the nasty symptoms away and make my life better.  I felt there was hope after all.

My follow up appointment with the Blonde Bimbo was on January 5th, 2000.  In her report about that particular appointment she writes and I quote, “I reviewed Widebertha on January 5, 2000 with regards to her hypothyroidism post iodine 131 and possible mild Graves’ ophthalmopathy.   She has now been on combination therapy with Levothyroxine 112 mcg. and Cytomel 12.5 mcg. daily since her last visit here in October.  In addition she has been taking Moduret 1 tab p.o. o.d. (once daily by mouth).  She feels much better on this combination.  She notices that her energy level is better, she is less stressed, her leg cramps have resolved, her weight has gone down considerably before Christmas, and is still about 1.4 kg. lower than it was on her last visit.  She has no symptoms suggestive of hyper or hypothyroidism at present.  She continues to be amenorrheic and does notice some problems with memory and concentration.  In terms of her eyes she denies any proptosis or diplopia.  Her periorbital edema is improved somewhat.

Blood pressure today was 140/80, pulse was 72 and regular. On head and neck exam she had normal range of movement of both eyes. She still has some periorbital edema on the left but improved from previously.  Her thyroid is unchanged to palpation and reflexes are normal.

Lab work from her last visit shows her to have an estradiol level of 140 and an FSH of 66. As of December her potassium is 4.5, T3 is 1.9, free T4 is 12.6 and TSH is 3.7.

Widebertha is euthyroid on her current thyroid hormone replacement therapy and as she feels better with the combination I would see no problems with continuing this.  I would recommend that TFT’s be rechecked in about six months’ time.

It also appears likely that she is menopausal which may account for some degree of her symptoms particularly the irritability and difficulty with concentration. I have discussed with her briefly the pros and cons of hormone replacement therapy. Given the fact that she has had some focal neurological symptoms in the past with her migraines this may not be the best idea and certainly if hormone replacement therapy was considered it may be worthwhile to consider a transdermal route to avoid any hypercoaguability. I have left her to discuss this with you further.

With regards to the eyes, it is difficult to know whether the edema is improved due to the Moduret or to the change in thyroid hormone replacement.  I have told Widebertha if she wishes to she can try a trial of discontinuation of the Moduret and see how her eyes do.  I have cautioned her however that her blood pressure should be rechecked off the Moduret if she decides to stop this.

I have not arranged to see Widebertha again at present but would certainly be happy to review her on request.”

The following was included in every one of the Blonde Bimbo’s reports to Squirt, “Thank you again for asking me to see this pleasant lady.” Of course I was a pleasant lady; I was too dumb to be anything but a pleasant lady. I agreed with everything the Bimbo said and did; I did not know better at the time.

The following excerpt is from Blonde Bimbo’s October 14th, 1999 report which reads as follows,  “I saw Widebertha on October 14th, 1999 at your request.  She, of course, subsequently had radioactive iodine and became hypothyroid.  On last review in March of 1999 while on levothyroxine 175 mg daily her TSH was 0.2 and she felt quite normal.  I am not sure where Blonde Bimbo got the idea that I was feeling quite normal.”

By that time the nasty hypo symptoms had been going on for almost a year.  Blonde Bimbo kept reassuring me that if I gave it a few more months all would be well!   Blonde Bimbo went on to say, “Widebertha tells me that over the spring she has developed problems with restless legs.   The restless leg problem became worse and did not respond to an increase of her physical activity over the summer.   I understand that she changed to levothyroxine 150 mg alternating with 175 mg in September and since then her legs have been better. Other concerns at the present time are chronic loss of energy and a continuing weight gain. By our scales she has gained 4.6 kg. since she was seen here in March.   She also notices that the weight gain is more of a central distribution than it was previously.  She feels bloated with this and still has some insomnia.  Of note menses are very sporadic with the last period being in June of 1999. She denies any hot flashes or any major emotional changes.  She really has no clear cut symptoms of hyper or hypothyroidism at the present time apart from the non-specific ones mentioned.  The only other thing of note is she has had problems with periorbital edema since April or May of this year.   She has some very occasional grittiness of the eyes but no injection, diplopia or pain on movement of the eyes. The only thing of note is that she has been started on Metoprolol for hypertension.”

“Physical examination revealed a middle aged woman.  Blood pressure was 170/90 sitting bilaterally.  Pulse was 60 and regular.  On head and neck exam she had normal range of movement of both eyes.  No proptosis or lid lag was noted.  She does have periorbital edema more marked on the left than on the right.  No adenopathy was present in the neck.  Her thyroid is about 25 gm. in size.  Chest, cardiovascular and abdominal exams were normal.  A screening neurological exam was within normal limits.”

“Widebertha is clinically euthyroid on exam at the present time and I doubt that many of her residual symptoms relate to hyperthyroidism. Given her recent oligomenorrha I would wonder whether some of the weight gain and fatigue is perhaps peri menopausal symptomatology.   Having said this assuming her TSH is normal on her current levothyroxine replacement the only other thing that could be tried would be a trial of combined T3 T4 replacement which does give subjective benefit in some people.  She is interested in this and I have taken the liberty of giving her a prescription for Cytomel 112.5 mg daily to take together with the levothyroxine 112 mg. daily.  With regards to the periorbital puffiness this may well be due to some soft tissue changes from thyroid opthalmopathy although she doesn’t have much else to suggest at the present time.  I have advised her to elevate the head of the bed and I have taken the liberty of placing her on a low dose diuretic i.e. Moduret 1 tab o.d. to see if this helps her.  Hopefully this will have a beneficial effect on her hypertension as well.  I have asked her to come back and see me after she has been on the combination T3 T4 therapy for about eight weeks to see how this works out for her.”

Today was to have been my last appointment with the Blonde Bimbo.  Her report concerning this appointment reads as follows, “I reviewed Widebertha on March 26, 1999 with regards to her hypothyroidism post Iodine 131.  She has now been taking levothyroxine 175 mg daily for the last two months and she feels much better with improvement in energy and a decrease in myalgias.  She has had one period that was heavy and a second period that was more normal in flow.  She has been a bit more anxious over the last week and a half but this may relate to intercurrant stressors.

On examination today her blood pressure was 160/100.  I understand it is much better at home.  Pulse was 72 and regular.  She continues to have some very mild left proptosis.  Range of movement of her eyes was normal and her periorbital edema has almost completely resolved.  Reflexes were normal with no delay in relaxation phase of deep tendon reflexes.  Recent values showed her to have a free T4 of 24 and a TSH of 0.2 with the lower limit of 0.3 on the assay.

Widebertha is euthyroid at the present time on her current dosage of levothryroxine.  I have given her a further prescription for this and have recommended to her that she see you in about six months for re-evaluation.  I haven’t arranged to see her again at this point but would certainly be happy to re-evaluate her on request should she have any difficulties.”

The big mistake I made was to believe that last sentence she had written.  Quite frankly, as experience proved, the last thing she wanted was to see me again.  Heaven help you if your thyroid levels fluctuate!  Endocrinologists cannot handle a TSH that keeps changing.  I guess medical school has not equipped them with the ability to handle with grace and dignity a patient who has continuing problems.

Nineteen Ninety Nine arrived and I was still battling hypothyroidism.  I saw Blonde Bimbo on January 21st, 1999.  Her report for that appointment reads as follows, “Currently Widebertha is on 150 mg of Levothyroxine for the past two months.  Her previously severe myalgias have diminished markedly.  Temperature perception is normal.  Her headaches are much improved.  One menses in the interval has been normal and one has been heavy.  She still has some periorbital puffiness but no other ocular symptoms suggestive of opthalmopathy.

On examination today her blood pressure was 170/90.  Her pulse was 72 and regular.  She does have some periorbital puffiness but normal range of movement of both eyes.  The left eye is somewhat protuberant with a measurement of 20 mm; with the right eye measurement of 18 mm.  She was otherwise clinically euthyroid on exam with normal reflexes with no delay in relaxation phase.  Recent lab work shows her to have a free T4 of 16.1, TSH of 5.9 with an upper limit of normal of 3.6 on the assay.

Widebertha is still slightly under-replaced with regards to her hyperthyroidism post Iodine 131.  I have asked her to increase her levothyroxine to 175 mg daily.  She has been asked to return for review on one further occasion to evaluate the affect of this.”

Blood Test Results from August 28th, 1998 are as follows:

• TSH at 15.9 with lab normal being .46 -3.6
• Free T3 was 4.7 with lab normal being 1.5 – 5
• Free T4 – Thyroxine was 17.3 with lab normal being 9.4 – 25.9

Blood Test Results from November 2, 1998 are as follows:

• TSH was 9.7 with lab normal being .46 – 3.6
• Free T3 was 4.0 with lab normal being 1.5 – 5
• Free T4 – Thyroxine was 17.0 with lab normal being 9.4 – 25.9

Blood Test Results from January 21, 1999

• TSH was 5.9 with lab normal being .46 – 3.6
• Free T4 – Thyroxine was 16.1 with lab normal being 9.4 – 25.9

My first adverse symptoms after RAI began to appear on June 6, 1998.  The first symptom was fatigue such as I had never experienced .  My nephew was getting married on June 12 and my son and daughter in law were arriving from Vancouver on June 6th.  We left for the lake on Saturday, June 7th and stayed one night.  To my horror I slept most of the time.  By Monday, June 8th I had a migraine from hell and was beginning to bloat up.  By Tuesday, June 9th I realized that the dress I had been planning to wear for the wedding would not fit.  This sent me on a mad scramble to find a new outfit suitable to wear to a wedding.   I have vague recollections of the wedding on Friday, June 12th.  My darling grandson was the ring bearer and I remember the supper and part of the dance.  By Friday the migraine was completely out of control and I had also begun to hemorrhage.

I called Blonde Bimbo’s office on Friday only to be told that she was on six weeks of holidays.  I asked the “nurse” who answered the phone if what I was experiencing the symptoms of hypothyroidism.  She assured me that hemorrhaging, fatigue, bloating and migraines had nothing to do with becoming hypo.  Fool that I was, I believed her.

The nightmare continued and on June 25th I presented in emergency at the country clinic with this continuing migraine.  The doctor on call gave me a shot of Demoral.  I managed to sleep for 3 hours and woke up to the same intensity of pain as before the shot.  I then placed another call to Blonde Bimbo’s office reiterating my symptoms and asking again if this had anything to do with becoming hypo.  I also told Blonde Bimbo’s “nurse” that I was retaining fluids and that my face and hands were very puffy.  I was assured that these were not the symptoms of becoming hypo and that I would have to wait to see Blonde Bimbo on July 25th when she returned from her six week vacation.  I was becoming afraid; very afraid.

By the time I saw the Blonde Bimbo on July 25th I had had a full blown migraine for 32 days.  I had also been bleeding like a stuck pig for 32 days.  I could barely walk into her consultation room.  By July 25th I was so swollen from the water retention that the skin between my fingers and toes was splitting.

The ultimate insult was Blonde Bimbo’s report from July 25th, 1998.  To cover her butt and the butts of her nurses who gave me wrong information when I called in for help, Blonde Bimbo wrote in her report and I quote, “Unfortunately Widebertha missed a couple of appointments in the follow up of this and represented in the middle of the summer with menorrhagia, severe headaches and marked fatigue.  At that time her free T4 was less than 1 and her TSH was 37.  She was placed on Levothyroxine at that time.”

Trust me; I NEVER EVER missed an appointment.  This bimbo goes on holidays for six weeks.  When I get very ill during this time she accuses me of missing appointments!!!  This is when I started to realize that doctors did not necessarily have my best interest at heart.

My blood test results from July 25th, 1998 were as follows:

• TSH was 37 with lab normal being .46 to 3.6
• T4 was <1 with the lab normal being 9.4 – 25.9
• T3 was 0.7 with lab normal being 1.5 – 5

Today was my first appointment after the RAI treatment.  I had blood work done on May 8th.  All I was told was that things looked very good and that if I felt any flu like symptoms I was to get in touch with Blonde Bimbo’s office.  She informed me that she was going to be gone on six weeks holidays and that my next appointment would be on July 25th.

My lab results from the May 8th blood work is as follows:

TSH was 0.2 with the lab normal being .46-3.6

• Free Thyroxine was 29 with the lab normal being 10-26
• Thiiodothyronine was 2.6
• AST was 18 with the lab normal being 9-29
• Alk. Phosphate 167 with the lab normal being 32-103
• Total Bilirubin was 4 with the lab normal being 0-19