Re: Intro from new patient

[Guest guest]

-----Original Message-----From: Jan Sent: Tuesday, October 21, 2003 7:46 PMTo: Texas_Thyroid_Groups Subject: Re: Intro from new patient

Hi, !

State the name of the doctor you are seeing. Someone in this group may know something about him.[[LL]] Cary s

Always ask for hard copies of all lab reports. [[LL]] Always do.

The first question for a thyroid doc is "Which thyroid tests do you normally run?"

TSH only is OK until your TSH is down to about 1. If you are still not feeling well, then you need Free T3 and Free T4 tests as well. If the doc says, "I never order anything but TSH," turn and run. Likewise, if the doc prescribes only $ynthroid.

If the doc orders the older "Full Thyroid Panel," with T4, T3 Uptake and Free Thyroxine Index, know that these are obsolete tests. Turn and run![[LL]]

So exactly which tests do Clinical Pathology run of which you approve and find indicatory of anything?

Forget about question #1. Most docs think they are successful at treating thyroid patients because they get the numbers right. Don't even mention "endocrinologist." With a few notable exceptions, the better thyroid docs in Texas are mainly in primary care. Check out my list in "Files" on this site. [[LL]] Well my brother in law is an MD doctor and he says finding out how often he treats a similar situation is indicative of experience. Sheer numbers.

Question #3. Change it to "Will you run antibodies tests?"Thyroglobulin antibodies and anti-thyroid peroxidase antibodies. Do I have nodules? a goiter? If he tells you you are just getting old, turn and run.

#4 & 5 are good.

#6. "Which thyroid meds are you willing to prescribe? Any brand of T4? Synthetic T3? Armour Thyroid? (Yes, , you do need an Rx for Armour.) With synthetic T4, ask for generic. With Armour, ask for brand name. [[LL]] Jan you obviously are very confident prescribing drugs. What is your education in this area, if you don't mind my asking?

I would not worry about #7 for now. Most docs do not understand dietary issues for thyroid patients. If he wants to sell you supplements, turn and run after you get your thyroid prescription. Do not go on any kind of strict diet until you get your thyroid levels optimized. [[LL]] How will I know when I reach "optimized"?

thanks for your help - can you tell me what to look for to do the opposite of turn and run? Can you tell me what to look for to stay and pay attention?

Thanks!

[Guest guest]

, I am usually a very quiet lurker on this site. I have been a part of this site and of the about.com thyroid web site for about two years.

Your responses to Jan seem to be quite defensive. I must tell you that Jan has always tried her best to help those of us who have thyroid problems. She does not prescribe medications. She has learned which medications seem to help many of us (Armour, to be exact but there are others, also) and she suggests that Armour may be something to consider. Some of us need both Armour (primarily a T3 medication) but also Unithroid or another T4 medication. Many of us have tried other thyroid medications which were detrimental to our health and only made us feel worse. Jan is very knowledgeble about which tests are helpful and which tests are basically not used that much anymore. She has listened to a great many of us complain quite bitterly about endos who do not treat us like patients but like lab values only. How we feel does not matter. What matters to them is only what the numbers say. That is wrong!

Please do yourself a favor and give her the benefit of the doubt and listen to her comments and thoughts. She has helped many of us so much. I will be forever grateful to her.

Nanette

RE: Intro from new patient

-----Original Message-----From: Jan Sent: Tuesday, October 21, 2003 7:46 PMTo: Texas_Thyroid_Groups Subject: Re: Intro from new patient

Hi, !

State the name of the doctor you are seeing. Someone in this group may know something about him.[[LL]] Cary s

Always ask for hard copies of all lab reports. [[LL]] Always do.

The first question for a thyroid doc is "Which thyroid tests do you normally run?"

TSH only is OK until your TSH is down to about 1. If you are still not feeling well, then you need Free T3 and Free T4 tests as well. If the doc says, "I never order anything but TSH," turn and run. Likewise, if the doc prescribes only $ynthroid.

If the doc orders the older "Full Thyroid Panel," with T4, T3 Uptake and Free Thyroxine Index, know that these are obsolete tests. Turn and run![[LL]]

So exactly which tests do Clinical Pathology run of which you approve and find indicatory of anything?

Forget about question #1. Most docs think they are successful at treating thyroid patients because they get the numbers right. Don't even mention "endocrinologist." With a few notable exceptions, the better thyroid docs in Texas are mainly in primary care. Check out my list in "Files" on this site. [[LL]] Well my brother in law is an MD doctor and he says finding out how often he treats a similar situation is indicative of experience. Sheer numbers.

Question #3. Change it to "Will you run antibodies tests?"Thyroglobulin antibodies and anti-thyroid peroxidase antibodies. Do I have nodules? a goiter? If he tells you you are just getting old, turn and run.

#4 & 5 are good.

#6. "Which thyroid meds are you willing to prescribe? Any brand of T4? Synthetic T3? Armour Thyroid? (Yes, , you do need an Rx for Armour.) With synthetic T4, ask for generic. With Armour, ask for brand name. [[LL]] Jan you obviously are very confident prescribing drugs. What is your education in this area, if you don't mind my asking?

I would not worry about #7 for now. Most docs do not understand dietary issues for thyroid patients. If he wants to sell you supplements, turn and run after you get your thyroid prescription. Do not go on any kind of strict diet until you get your thyroid levels optimized. [[LL]] How will I know when I reach "optimized"?

thanks for your help - can you tell me what to look for to do the opposite of turn and run? Can you tell me what to look for to stay and pay attention?

Thanks!

[Guest guest]

Your responses to Jan seem to be quite defensive.[[LL]] I am listening to her, but I am looking for positive points with which to approach my doctor. I am looking to Jan's experience. She was clear about what to run from. I want to know what to look for! Is that so bad? I am trying my best to remain positive in the midst of a host of hypothyroid symptoms. I have to work with a doctor.

I must tell you that Jan has always tried her best to help those of us who have thyroid problems. She does not prescribe medications.

[[LL]] She said "Yes, , you do need an Rx for Armour." If she is uncomfortable justifying her prescription, I am surely uncomfortable accepting it. I'm sure she has good reason to prescribe it. I'd like to hear those reasons so that I can positively approach my physician. If I need an Rx for Armour, can I get it from Jan?

She has learned which medications seem to help many of us (Armour, to be exact but there are others, also) and she suggests that Armour may be something to consider. Some of us need both Armour (primarily a T3 medication) but also Unithroid or another T4 medication. Many of us have tried other thyroid medications which were detrimental to our health and only made us feel worse. Jan is very knowledgeble about which tests are helpful and which tests are basically not used that much anymore.

[[LL]] Yes indeed. That is why I asked specifically which tests she will accept from ClinPath --- those are the ones I want my doctor to run. I did ask for her opinion here!

[[LL]] She has listened to a great many of us complain quite bitterly about endos who do not treat us like patients but like lab values only. How we feel does not matter. What matters to them is only what the numbers say. That is wrong![[LL]] Please see my question #5 in my original post.

Please do yourself a favor and give her the benefit of the doubt and listen to her comments and thoughts. She has helped many of us so much. I will be forever grateful to her.[[LL]] I am asking for some positive points so I can approach my doctor with the same open mind you ask me to keep.

I am sorry if you think this is defensive. I am looking for optimism that a doctor can help me. If Jan cannot offer me any hope, what should I do?

[Guest guest]

,

Jan was merely answering the question in your first post as to whether

or not Armour required a prescription. The answer is yes, it does.

She was not telling you to get a prescription for Armour... simply

answering the question you posed originally.

Cathryn

[Guest guest]

OK thanks, that is very helpful! Sorry I misunderstood that part!

-----Original Message-----From: Cathryn Sent: Tuesday, October 21, 2003 9:54 PMTo: Texas_Thyroid_Groups Subject: Re: Intro from new patient,Jan was merely answering the question in your first post as to whetheror not Armour required a prescription. The answer is yes, it does. She was not telling you to get a prescription for Armour... simplyanswering the question you posed originally.Cathryn

[Guest guest]

DITTO,

Ben

RE: Intro from new patient

-----Original Message-----From: Jan Sent: Tuesday, October 21, 2003 7:46 PMTo: Texas_Thyroid_Groups Subject: Re: Intro from new patient

Hi, !

State the name of the doctor you are seeing. Someone in this group may know something about him.[[LL]] Cary s

Always ask for hard copies of all lab reports. [[LL]] Always do.

The first question for a thyroid doc is "Which thyroid tests do you normally run?"

TSH only is OK until your TSH is down to about 1. If you are still not feeling well, then you need Free T3 and Free T4 tests as well. If the doc says, "I never order anything but TSH," turn and run. Likewise, if the doc prescribes only $ynthroid.

If the doc orders the older "Full Thyroid Panel," with T4, T3 Uptake and Free Thyroxine Index, know that these are obsolete tests. Turn and run![[LL]]

So exactly which tests do Clinical Pathology run of which you approve and find indicatory of anything?

Forget about question #1. Most docs think they are successful at treating thyroid patients because they get the numbers right. Don't even mention "endocrinologist." With a few notable exceptions, the better thyroid docs in Texas are mainly in primary care. Check out my list in "Files" on this site. [[LL]] Well my brother in law is an MD doctor and he says finding out how often he treats a similar situation is indicative of experience. Sheer numbers.

Question #3. Change it to "Will you run antibodies tests?"Thyroglobulin antibodies and anti-thyroid peroxidase antibodies. Do I have nodules? a goiter? If he tells you you are just getting old, turn and run.

#4 & 5 are good.

#6. "Which thyroid meds are you willing to prescribe? Any brand of T4? Synthetic T3? Armour Thyroid? (Yes, , you do need an Rx for Armour.) With synthetic T4, ask for generic. With Armour, ask for brand name. [[LL]] Jan you obviously are very confident prescribing drugs. What is your education in this area, if you don't mind my asking?

I would not worry about #7 for now. Most docs do not understand dietary issues for thyroid patients. If he wants to sell you supplements, turn and run after you get your thyroid prescription. Do not go on any kind of strict diet until you get your thyroid levels optimized. [[LL]] How will I know when I reach "optimized"?

thanks for your help - can you tell me what to look for to do the opposite of turn and run? Can you tell me what to look for to stay and pay attention?

Thanks!

[Guest guest]

>>The truth is that most of us have received less than optimal thyroid care from otherwise good docs. <<

Well I think this is very understated! LOL I have had hypothyroidism for about 30 years and have given up finding a good doctor for it. I did convince my current GP to prescribe Armour, and I insist on the Free T3 & Free T4 tests as he only orders the TSH otherwise. I judge for myself when I need more thyroid. My needs have steadily climber with age. My last labs showed my T3 very low, so I did it myself when my Doc said "It's FINE"... I ordered my own meds and am slowly adjusting the dosage. I feel better than I have in 15 years since taking over my own dosages. I have gone from stroke range high blood pressure even with 3 different meds for it to low/normal with no meds. I have completely corrected the swelling and water retention in my legs that was threatening to cripple me. I have no more tendonitis, half my arthritis has disappeared! In 30 years of seeing doctors they couldn't accomplish this, I am NOT impressed with the medical profession at all. Maybe if I had good doctors that knew what they were doing I might have been able to have children when I was younger & so desperately wanted them, but that's maybe a curse I was blessed for not having! LOL I know my life would have been MUCH different if I hadn;t had so many years spent in miserable depression and total exhaustion and overweight, hearing how it was all my fault that I MUST have bad eating habits. Well it takes under 600 calories a day for me to lose weight. Nothing wrong here.... (as Kurt Vonnegut would say- If you've never read Breakfast of Champions, it is a riot in a sick way... ) So listen to the folks that have been thee & don't get too attached to any one doctor till you KNOW they will listen to your symptoms and not treat you strictly by labs. Good luck & hope your thyroid experience is better than mine (and SO many others) has been.

T- Artistic GroomingHurricane, WV Reply to valharley@...Education before vaccination www.catshots.com

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[Guest guest]

Love ya already ! Excellent start. But down on $ynthroid and cynical about docs with good reason. The only other crucial question I can think of right now for the doc is "I want to make sure that you are willing to do the Free T3 and Free T4 tests because I feel that they give a better picture of my thyroid hormone output, for these reasons---------".

>I expect to get copies of all my test results to keep in my possession

Really , you shouldn't be so shy and backwards! TeeHee! I love it.

Most of the people here have had very bad experiences with doctor after doctor because most doctors are not exploring a deeper understanding and treatment option whys and wherefors. Then, again, some doctors have been extremely rude and arrogant and heartless with their patients, believing that they were given a license to say and do what they want with your health, at your expense, and also expecting you to pay for your own misery, while his/her family gets the best healthcare available that your money can buy. You don't have to go into the doc's office expecting the worst, but do go in knowing what you're going to say, ask, what you're going to tell the doc that you expect. Communication and boldness are key. If all that doesn't work, and you're still not feeling better after you've been treated, and you've told him so, then----time to find one who WILL give you good care, in the way that YOU expect. It's your health and your money, not his.

Intro from new patient

Intro -

I'm a fifty year old woman very newly diagnosed with hypothyroidism and am interested in knowing what I should ask my doctor (a GP) for my first visit discussing the results of my blood work. Here's what I'm thinking I'll bring in to the visit, and I would like to know from you all what to add, and what to expect.

Let me preface this by saying this is a new doctor for me, and I very much liked my first visit. He immediately suspected hypothyroidism and Fibromyalgia based on my presenting symptoms, and we are now following up after the first blood work. I liked this doctor and would like to give him a fair shake.

Here's my list:

1. How many hypothyroid patients do you have now? How many do you feel are successfully treated? How many are difficult for you?

How often do you find it necessary to refer on to an endocrinologist?

2. I expect to get copies of all test results to keep in my possession.

3. Are we going to check for the cause of the hypothyroidism? (Hashimoto's, cancer, what other options are there? Am I going to be told it's just getting old?)

4. Can we check the adrenals too please?

5. Will you treat based on how I feel, or based on test results?

6. Will you prescribe anything else besides Synthroid ever? My health insurance will only pay for generic. I'm willing to go with whatever works best. Fortunately we are comfortable financially and I can afford to go with brand name if it makes a difference. (for you guys - Is Armour available without a prescription?)

7. I am eager to change my lifestyle to improve my health. Will you offer a diet specific to my needs to help me get to a normal weight and combat the other symptoms of hypothyroidism? Supplement recommendations?

What do you think I need to add, subtract, and expect?

I have felt so physically and emotionally terrible, that I am excited that I might have a chance for feeling normal again. On the other hand, I am very depressed after reading the archives of these lists, because everyone is so down on Synthroid and cynical about their doctors.

I'm likely to lurk but I appreciate all your first hand experiences.

Thanks

Austin, TX

[Guest guest]

Without trying to sound all gushy here, Jan, I've got to say this because I feel led to. I prided myself on total reliance and worshipful idolatry to the world of doctors and the world of medicine. Yes, it is an astounding world, and so much progress has truly been made for the ills of man. Also, back in history, many a good doctor died experimenting on him or herself, trying to find a better way for all mankind, so that the future would not have to suffer. The amazing introduction of anesthesia proves that. On the other hand, this world has become full of graft and greed, which extends all the way through the medical profession, and those holding the keys to the kingdom of prescription drugs, the drug companies. Just because someone is a doctor does not necessarily make them less vulnerable to this graft and greed. However, I know that there are still doctors out there that truly care, but just don't have that knowledge. Some that don't would humbly learn what we have. That's not only a good doctor, that's a hell of a man or woman. I know that they "just don't make em like they used to."

The day that I was so desperate for help (that I didn't feel, at the time, that I could find in a doctor around my immediate city), that I reached out to a support group, was one of the darkest days of my life. I had turned to doctors and gotten very disillusioned because of the lack of caring, and also, many doctors have an attitude t'wd a member of a nursing staff. I have seen doctors operating in my facility while I'm on duty, and it might surprise any of us to know what sorts of lousy attitudes a lot of todays new breed of doctors have. I don't think that that is exclusive to just the facility that I work at---it's all over the place.

I have been studying the info on thyroid for the last 2-3 yrs, but I never dreamed that there was such a wealth of information. I've been constantly astounded at what I've learned here. My main point is that, like B., I feel like I was literally led here by God Himself. I have learned so much from Jan and everyone here on this site. That's what we're here for, is to network and to learn and to share. When we can't do that anymore, we've defeated the purpose of this site. I believe that God uses people for various things, and this is one of them, believe it or not.

It IS like you said, Jan. Believe me now or believe me later. I just hate to see someone go down that bad old road, like many of us did. It's sort of like "Oh, no, catch them before they fall off into the canyon!"

[Guest guest]

,

I've found that my nutritionist knows far more about nutrition and over-the-counter supplements than doctors I have seen, which makes sense since nutritionists have had more specialized education in these areas. Since you are in Austin, I highly recommend the nutritionist (and pharmacist) Beth Shirley at Peoples Pharmacy on Westbank. I'm 51 and have hypothyroidism, and following her recommendations has helped me tremendously.

Rosemary

>7. I am eager to change my lifestyle to improve my health. Will you offer a

>diet specific to my needs to help me get to a normal weight and combat the

>other symptoms of hypothyroidism? Supplement recommendations?

[Guest guest]

Thank you Rosemary that is very helpful. I know that Pharmacy and will ask for Beth.

Re: Intro from new patient

,

I've found that my nutritionist knows far more about nutrition and over-the-counter supplements than doctors I have seen, which makes sense since nutritionists have had more specialized education in these areas. Since you are in Austin, I highly recommend the nutritionist (and pharmacist) Beth Shirley at Peoples Pharmacy on Westbank. I'm 51 and have hypothyroidism, and following her recommendations has helped me tremendously.

Rosemary

>7. I am eager to change my lifestyle to improve my health. Will you offer a

>diet specific to my needs to help me get to a normal weight and combat the

>other symptoms of hypothyroidism? Supplement recommendations?