I’ve Got Some Work To Do

A month ago I started seeing a new primary care physician.  I was nervous after my first attempt at a PCP switch resulted in my wanting to run away in horror.  But I am happy to report that I adore my new doctor.  His name is Dr. Witana and he’s an internal medicine doctor.  When I told my brother that I needed to find a new doctor due to an insurance change he told me to look for an internal medicine doctor.  My brother has had his fair share of health issues  and saw tons of doctors until he went to an internal medicine doctor who helped him immensely.  He’s down over 30 lbs and feeling better than ever. So thanks, big bro for the excellent advice!

My first appointment was February 9th.  I called only four days prior and they were able to schedule me right away which was a very good sign.  I had all the regular nerves going into the appointment, maybe even a little more than usual.  But the nurses were nice and they sat with me for almost 40 minutes entering all of my information into a computer program that they use to store all their patient records.  They also had me answer a series of questions pertaining to my complaints.

By the time I got to see the doctor I felt at ease and ready to be open about all the issues that have been plaguing me.  The main issue I wanted to discuss was my weight and my anxiety that has been getting progressively worse.  Based on the series of questions the nurse had me answer the doctor started addressing another issue that I had no real intention of discussing with him:  depression.  He told me based on the my answers that I was considered severely depressed and that I had moderate anxiety.  He asked me where the depression was coming from and I immediately started crying.  He asked Ramses to leave the room so we could discuss things privately.  I explained that last year was extremely difficult what with Ramses losing his job and struggling financially but I revealed that I’ve had signs of depression since I was probably 12 years old.  I decided not to get into the issues from my childhood but I explained that being diagnosed with cancer as a (very) young adult effected me deeply as well as my infertility and my miscarriage.  He was very kind and gentle as he listened and comforted me.

He went ahead and prescribed me with an anti-depressant/anti-anxiety medication called Cymbalta and ordered a series of lab tests.  I left the office after over an hour spent with the nurses and doctor drying my tears and feeling optimistic.

I took my first Cymbalta that same night and two hours later a horrible headache set in and I threw up my dinner.  The week that followed was terrible.  I started researching the side effects of the drug and sure enough I had nearly all of them:  nausea, headache, fatigue, vomiting, trouble sleeping, night sweats, dry mouth, shakiness, and a general feeling of fogginess.  It  felt like I had a really bad flu.  The symptoms persisted for about 6 days without easing up.  I called the doctor on day 4 and he said to stay on the medication for a few more days.  And like magic on day 6 I felt great.  Also, on day 6 was the first test of whether or not the pills were doing their job when we woke up to find our that our little Kai had a huge swollen booty.  I surprised both myself and my husband when I handled the situation with complete calm and level-headedness.  It really was amazing.  Our little guy needed surgery but he’s 100% better aside from his unevenly shaved right butt cheek.

Early last week I went to the lab to have my blood drawn for the testing Dr. Witana ordered and went into to see him last Friday to go over the results.  It turns out that he had them run over 80 tests and this what they found:

• High triglycerides (fat in the blood)
• High TSH (thyroid hormone)
• High Blood Sugar (the early stage of type II diabetes)
• Borderline High Blood Pressure

The high TSH was expected.  As a Thyroid Cancer survivor my endocrinologist purposefully prescribes a high dosage of  thyroid hormone.  This is meant to suppress whatever minute thyroid gland that may still be in my system to reproduce.  And no thyroid means no thyroid cancer.  However, my new doctor thinks I should lower the dosage because the excess hormone may be effecting my pituitary gland.  He forgot to write a new script for the lower Synthroid so I plan on emailing him to discuss my concerns for lowering the dosage since I failed to do so in his office.  When I first saw him I told him that my endocrinologist is Dr. Dial and he said, “Oh!  Dr. Dial and I are good friends.”  Another plus for my treatment.

The high triglycerides, blood sugar, and blood pressure along with excess belly fat equal something called Metabolic Syndrome.  Which basically means that all my excess fat is effecting the way my body produces hormones and puts me at higher risk for heart disease and stroke.   It is also suspected that I have PCOS (Polycystic Ovary Syndrome) and that I am insulin-resistant.  Surprisingly or not surprising all of these things are related to each and all can be treated with the same medication called Metformin (Glucophage) along with a low Glycemic Index (GI) diet and exercise.  I was supposed to be tested for PCOS along with the other tests but the box didn’t get checked on the lab slip.  I will get more labs done this week and see the doctor again in a month.  I was familiar with Metformin and it’s treatment of PCOS and conception.  I told the doctor that I knew what it was and that it also treats insulin-resistance.  His response, “How do you know that?!”  He was pleasantly surprised how well-researched and educated I was on my health.  He explained that he loved when patients shared the same knowledge as their doctors because it leads to greater trust between the two.

I took my first Metformin last night and so far no real side effects.  After the Cymbalta hell, I am grateful for that.  Now I get to work on sketching out our meal plans and getting my butt on the treadmill.  This rhino need to turn into a unicorn!

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