Tuesday, September 30, 2008

The book I read...The Thyroid Hormone Breakthrough

I went to the library after work yesterday...I checked out the books I could find about thyroid disorders. Of those, this one is the best...the others are all out of date and are still saying 5.0 is the high for TSH.

I cannot believe how much I didn't know. And to post it all here would take me all night. I have a hundred and one symptoms that point to Hashimoto's. I had no idea that all of these symptoms went back to this disease! I'm flabbergasted!

I made it through the book in record time. I've made a list of supplements I need to be taking and the amounts and compared to my One Day for Women's Health...I'm not even at half for 95% of them...despite the bottle saying 100%. So I'm going to need to revamp my supplement intake.

I also visited her website at work and found where she says as a person suffering with Hashimotos I need to cut back on sugars and carbs and increase my lean protein and whole grains and fruits and veggies.

Exercise is a must if I am to lose the weight...even once Dr. Devries changes my meds.

She talks about the delicate string of hormones that run through a woman's body and likens it to a string of Christmas lights. If one goes awry all the others can darken. I have to be vigilant with my testing until I find something that works and I'm very hopeful Dr. Devries will help get me there.

I got to the end of the book and this quote made me cry:

"What we do deserve is information, careful consideration from our practitioners, safe and effective relief of troublesome symptoms whenever possible, and someone who WANTS to understand the bigger picture so that we can live and feel well into our senior citizenhood!"

I added the emphasis...not a single doctor ever suggested there could be something causing my hypothyroidism. That this underlying cause has it's own symptoms that can be treated. No one ever bothered to test anything but TSH and total T4...a far cry from thorough testing to say the least. Only one of those doctors ever helped me achieve feelings of health and well being.

What a bunch of wasted money...wasted effort...wasted time. So many tears shed. So many feelings of no self-worth, so many efforts to step up my game with exercise and diet to no avail. And all of it could have been solved if I just had a competent doctor willing to listen and work with me!

Again, I repeat....I can't wait until Monday!!!!

Appointment with Dr. Devries on 9/29

I have high hopes as I drive the hour to get there. I wait a long time in the lobby reading a book about King Henry I. I figure it's worth it if he delivers!

I leave the office after a battery of tests including palpation of the thyroid, listening with the stethocope, checking reflexes, blood pressure etc. And lots and lots of questions!

He draws my blood himself!

He is sure I have Hashimotos which complicates simple hypothyroidism. Solution: Draw blood, see you on Monday!

He is an old, sweet man....he's smoked all his life and drank coffee too. Go figure.

He listens to my every complaint. I show him prethyroid problem pictures from 2003 / early 2004 and pictures from this past March. I tell him I just want to feel good...I want to get this weight off, but nothing works etc.

He is sympathetic and very kind. He tells me about his experiences and how he got into thyroid issues...he has them, his wife, his daughter. She had trouble conceiving. They checked her thyroid, started her on a good plan and she had a baby within a year.

He shows me a diagram illustrating the difference between simple hypothyroism and Hashimoto's Thyroiditis. He has convinced me I have it...and he seems convinced too. We draw blood to do a battery of tests including T4, TSH and antibodies. He says he doesn't bother to test T3 right off, since if antibodies are present he knows there is no T3 so the antibody test confirms that for him.

I can't wait until Monday!!!

Dr. Devries Reviews

His reviews on the database say:

Robert DeVries, MD, Family medicine physician, 214 368 6197, SW corner of Preston and Forest. "A friendly and interesting fellow, he was a researcher in endocrine and fertility issues who now does medicine in private practice. He is hypothyroid himself, as is his wife, so he is very current on the issue and sympathetic as well. His office manager/receptionist is kinda wacky, but just let it slide. He listens well and uses quality labs for his blood work. From the Netherlands originally, his accent is a bit thick, but he has been in Texas for 30 years and speaks perfect English. I feel very safe in his hands." Submission thanks to the Moonlady News endocrine list)

Another reader adds:
"A friendly and interesting fellow, he was a researcher in endocrine and fertility issues who now does medicine in private practice. He is hypothyroid himself, as is his wife, so he is very current on the issue and sympathetic as well. His office manager/receptionist Debbie, is very refreshing and in control of the office, she is a extremely capable Manager, who usually has multiple tasks in process at once, she is very friendly, you simply must visit with her and get to know her. Dr. DeVries listens well and uses quality labs for his blood work. From the Netherlands originally, his accent is still noticeable, but he has been in Texas for 30 years and speaks perfect English. My condition is noticeably improving whereas to last MD I went to (for a year) did not have any success." (Added 11/02)

More praise from a reader for Dr. DeVries:
"After 13 yrs. of being ignored and told I had to live with the effects of hypothyroid because a stupid piece of paper said my T4 was in normal range, I have found this wonderful human who is a doctor that will treat me as a person and not that piece of paper. He is a God send." (added 1/04)

Another fan:
"I was undiagnosed for 4 years. He completed a 90 minute health history and head to toe exam. He has sure I had Hashimotos , but the blood tests revealed hypothyroidism. He is kind, compassionate, a good listener, loves people and medicine. He believes you should listen to the patient because they know their body." (Added 1/06)

More praise:
"Dr. DeVries is the one to go to in Dallas if you have Hashimoto's. Thyroid disease is his passion (he attends international endocrinology conferences). He diagnoses not only with blood tests but with the Heel Reflex Response used by physicians long before blood tests were available (If you're not getting enough thyroid in your system, there will be a subtle reduction in your foot's response to the mallet--just like the test ALL doctors do on your knee to see if your leg "kicks" in response). He will give you Synthroid samples to take, telling you to increase the dosage every two weeks until you start to feel symptoms of getting too much--rather than ONLY relying on blood tests. (He believes in prescribing Synthroid because of quality control issues with Armour and generics.) He also understands the complexities of T3 and T4 balance. After having to BEG my previous doctor for an increase in my 25mcg Synthroid prescription, I was relieved to find a doctor who takes my SYMPTOMS into account as well as my TSH level (now almost zero, which doesn't bother him in the least!). Dr. DeVries even increased me from 175 mcg to 200 mcg just to get my cholesterol level down some more. He orders a FULL range of blood tests, but takes most insurance plans. Though he's listed as a family practice physician, he doesn't do gynecological exams or examine young children, so you'll need to go elsewhere for those. But if you're infertile from hormonal (not physical) problems, I would recommend him over a reproductive endocrinologist." (October 2006)

More input:
I just want to give a great feedback on Dr. DeVries, I read the good feedbacks in this website but once I met him my life changed, no one understood my conditions as well as he does and I felt I was in good hands, after he examined me I gain strength I was able to do my shores at home. I have hypothyroidism and I feel weak depressed but after I met him I felt much much better. I definitely recommend him."(August 2007)

A reader writes:
"Robert A.C. DeVries, M.D., PhD., has been my internist and endocrinologist since 1992. Dr. DeVries is a highly compassionate practitioner who cares deeply about his patients. His "old world" medical schooling (he is from Holland and received his first medical degree from The University of Amsterdam) is most apparent in his approach to his patients. Dr. DeVries know medications/drugs better than some pharmacist because, as a medical doctor in Holland, he had to learn to compound medications for his patients who lived too far away from a chemist (pharmacy). He is a naturally affable man who can diagnose illness by talking to and LISTENING intently to his patients (something most doctors do NOT do), examining them and then, at least in my case, has been proven correct by empirical tests. Dr. DeVries tries to give samples of a medication as opposed to prescribing it to help the patient defray the cost of the drug, in case it does not work or is inappropriate. Once it is decided that the medication works, he will then write a proper scrip for the drug. Until fairly recently, whenever I was admitted to the hospital where he has physician rights, whether or not he was on call, he would come to visit me every evening in the hospital, look over my charts and reassure me as only he has ever been able to do. Pressing family matters have caused him to discontinue his hospital visits, however, he always refers his in-hospital patients to physicians he trust. So far, they have been extremely competent and reliable, though they don't have his personality or his gentle assurances. I have recommended him to many friends and acquaintances and, without exception, he has helped them all in finding out their problems. He is honest and forthright, and if he feels he cannot handle your particular medical problem, Dr. DeVries will refer you to another physician he knows and trust (quite often his own personal physicians). I cannot say enough about what a kind, caring pe" (Added October 2007)

Summary of Where I was as of 9/23

In 11 1/2 years I have seen a total of 9 doctors. Two were work related physicals and two were for prenatal care. The others were just regular doctor's visits for allergies or symptoms I was having that couldn't be explained. The first time thyroiditis was suggested to me was when I was 15. The doc said I had an enlarged thyroid and asked my mom if I'd been tested. No test was done at that time, but he suggested it in the future. That was when I was 15! SEVENTEEN years ago! I am now convinced that I have had hashimoto's disease for at least that length of time...likely longer since it takes time for a thyroid to enlarge. When I was 18 and paying my own way I did opt to be tested and everything came back "normal." What I would give to see those lab results now.

I was not tested again until I was nearly 22 (4 days before I turned 22 to be exact.) That was after a work related physical 5 months prior indicated I had an enlarged thyroid. I told the doctor then, that I'd heard that again and again, but since I have never had any corresponding symptoms no test was done. He highly encouraged me to watch my symptoms and gave me a list that included hair loss among other things I can't recall now. Sure enough, in April a week or so before my birthday I realized I was shedding like crazy. Went in, got tested. He called me April 20th to tell me I am hypothyroid. I didn't know what in heaven that meant. Thank goodness ask jeeves existed. That was 1998, and there just wasn't much available to me. But before hanging up the doctor said... "Don't worry. If there's any disease in the world you'd have to have this is the one to pick." From then on I didn't worry too much about it. He put me on levothyroxine which was supposed to replace my T4 hormone that my body wasn't producing enough of. Once my TSH was in the normal range we kept the dosage there. I stayed there for three years in which time I began eating healthy and lost the weight I'd gained and even managed to have a baby without any changes in my tsh level. At that point I really thought the doctor was right!

After that baby I could not lose the weight for anything. I made a move with my husband which necessitated a new doctor. This new doctor was great. But even then my thyroid problem was never explored further than just a tsh and slight increase in my thyroid replacement. With that increase I found it easier to get the weight off, but a lot of symptoms lingered. I just chalked them up to just being the way I am. Once the weight was off and I felt a bit better, we still kept the thyroid placement there at .088mcg. Originally I was on .075 so even that small change made a difference in how I felt and functioned. What did my doctor do? He listened and made a change. Maybe if he'd done an antibodies test, or I had kept better track of it, I could have saved myself the following 4 years worht of heartache.

Then in 2004 I went through some stressful life experiences that included finishing my put-off-for-birthing-children college degree. Once I graduated I found it hard to find a job that met my education level because of being in a rural area. I became depressed...did the thyroid cause the depression or did the depression cause the thyroid problem? Who knows...point is, I gained weight, TV became my best friend, not to mention the inability to get off the couch, the problems I had waking each day and getting out of bed. I woke tired and never feeling rested. My allergies were in high gear. Everything seemed broken...well, except my husband and children. I stopped seeing friends or answering calls. Stopped volunteering at the school. I read books and watched TV almost continually. This stopped for a brief period when I felt a bit better and ended up directing a community play for children. Then I went right back to it.

Then in the summer of 2005 we moved again. Again for my husband's career. The depression like symptoms continued. I continued to gain weight. Finally in January of 2006 I saw a new doctor. She tested me...yes my TSH was high. I got put on .075mcg. I've been there ever since. The weight continues to pile on. I saw my doctor again 6 months after my tsh was in the "normal" range. I complained of not feeling well despite eating right and exercising and I was really frustrated with my inability to lose weight. I went in once having palpitations and dizzy spells. She had an EKG done. Her solution? Eat less, exercise more-I need to lose the weight. Oh, you are? Are you sure? Well, if 45 minutes of exercise 5 times a week isn't doing it then maybe you need to do 60 minutes 7 times a week. Never once did she suggest looking at doing doing other thyroid tests besides the TSH. Never once did she suggest I had something other than hypothyroidism and that being the case the TSH was the determining factor of my treatment.

In the fall of 2007 she refused to refill the thyroid meds without a tsh. At that point I decided I needed a new doctor since I was having severe clotting during my menstruals and I never felt good, I was constantly tired and lethargic. I couldn't lose weight despite regular exercise and low-fat dieting. I was up to exercising 1 1/2 to 2 hours 5 times a week. Somedays I even managed to get 3 hours in.

At that point I got online and started doing research again. I learned a lot. Found myself a new doctor. She's young and I figured she'd be more up to date on thyroid treatment. Her solutions: keeping my thyroid replacement at .075 and birth control pills to basically eradicate my period completely. 3 days later my TSH came back at 3.55, within her labs normal range. I called back asking for an appointment to discuss lowering that to under 2.0-or at least under 3.0 as per the American Association of Clinical Endocrinologists recommendation. I go in...she says doing that won't change anything and instead gives me her diet to do...and keep up the exercise.

In February I go back for a check up having lost not a single pound and still not feeling better. We change birth control pills that won't take the period away, but will help with the acne, the cramping, and "unbalanced" hormones. We retest the TSH-now it's at 3.64 no change-according to her.

I decide I need to find a doctor who will listen to me. I see a new doctor in March of 2008. This guy I go to church with and naively think maybe I'll have a little leeway with him. Lab results in hand I sit in the lobby and see a handout from the manufacturers of synthroid also recommending TSH should be no higher than 3.0. I think to myself "YES!!! Finally a doctor who knows this and recognizes it." Much to my disappointment he tells me the same thing my former doctor did. Oh, that doesn't have anything to do with weightloss. You're so close to under...this .64 does matter. I'm thinking to myself...wait, if the healthy range is a total of 2.7 points and I'm off by .64...that seems big in proportion. I mean that's nearly a third of the range that it should be in. So I tell him that and I ask if we can at least try to get below 3.0. Not right now...let's see you again in 4 weeks and see if there's a change. By the way, at this point my allergies have been the worst of my life...since September the previous year. I'm talking using an inhaler up to 10 times a day. We did address those by throwing a bunch of expensive medicines at it. Medicines I can't afford! By blood pressure was also registering high and so we through a $60 a month prescription at that too. I was up to nearly $300 a month out of pocket for medication each month.

April 2008: We retest the thyroid and I tell him that I have a constant tickle in my throat and wake nightly coughing and clearing my throat. My husband says I clear my throat even in my sleep. Solution: wait for TSH results and try a new blood pressure med. At this point I am at 180 pounds. A week later my TSH comes back at 3.69 and he still refuses to make a change to my dosage.

Since then I have put on 20 pounds, putting me at my highest weight ever. My allergies are little more under control. My ankles swell almost on a daily basis and I've developed symptoms pointing to plantar's fasciitis...which makes it very hard to exercise. I've been trying to lift some weights and getting a weekly walk in on the day I actually feel up to it.

Last Tuesday, on the 23rd , I told members of my fitness club that I felt like giving up but part of me won't let me do that. I'm just too stubborn and my flame of hope hasn't quite died out. I'm convinced all these troubles have something to do with my thyroid and that I just need to find a doctor who will work with me.

Wednesday I get to work and decide to visit Mary Shomon's websites again. I discover she has a handy dandy doctor finder! A database of doctors known to dig deeper and think outside the box when it comes to thyroid disorders.

I make an appointment for the following Monday (yesterday) with a Dr. Robert Devries. The supersticious person inside thinks finding a doctor named Robert will make a difference since my brilliant-no seriously genius IQ-son's name is Robert. I am hopeful again!

A New Beginning

"Knowledge comes by eyes always open and working hands; and there is no knowledge that is not power." --Ralph Waldo Emerson

I am beginning this blog with the intention of tracking my progress with Hashimoto's disease and corresponding thyroiditis. Beginning today I am making a committment to my health. Components of that committment are as follows:

-updating this blog at least weekly, if not more. Updates will include how I am feeling emotionally and physically; what I have been doing for my health, including exercise, food intake, supplement intake, water intake and stress relief efforts.

-keeping a running tally of lab results and doctor's appointments. That includes words of advice from my doctor as well as, things I learned that day and changes to medications.

-exercising regularly.

-eating in such a way that promotes my health and overall well being. Drinking plenty of water and continuing to obstain from coffee, tea, alcohol and tobacco.

This blog will be my go to spot for stress relief and times when things aren't quite right and I'm feeling beaten down. I will then visit here and re-address what I'm doing and what I can change.

Let it be so!