Would you keep or cancel this Dr. appt?

[MidwesternGal]

Okay, so here's the story--I am 9m post-partum. I am having some issues with hair falling out and other things that made me think I was possibly hypothyroid. I also have been missing periods since April. Normally, I'm very regular, even when I was breastfeeding.

So I made an appt. at the doc's, thinking they would test me for thyroid issues and maybe give me some hormones (either BC or something else) to get the periods started up again and send me on my way.

I had my appt. yesterday and they drew blood. Test results came back in as very normal for everything. However, the doctor now wants me to go in for a vaginal ultrasound and two more thyroid tests on Tuesday morning.

Honestly, while my "symptoms" are *slightly* concerning (tiredness, screwy periods, etc), it's not anything that I haven't been living with for several months and that a lot of my friends have been through at some point or another that eventually just resolved themselves, w/o a doc. appt.

Plus, while we do have insurance, I know we will get quite a big bill because this is all tests (which our normally great insurance doesn't cover as much of, unforunately, esp. the ultrasound) and I'm thinking it would all be for naught if the initial tests all came back clear.

Would you all keep the appt. or cancel it?
Thanks.

[BethIrish]

I'd probably keep them.

But, if you're concerned that the tests are not neccessary, why not call your doctor and ask what exactly he's looking for with them?

[Hello Kitty]

I'm having similar problems (especially the hair!) and I want to get a full thyroid panel run, so the bloodwork makes sense. I'm just not sure what your doc woulc be looking for with the v. u/s - so I agree it would be good to ask.

I know how you feel with medical stuff - DH was just in and out of the doc the last whole month for what turned out to be a non-issue. He got a bunch of different comprehensive blood panels and an u/s, and while it did stink to pay for nothing - we paid for the peace of mind to know that nothing was really wrong, KWIM?

[jajacobsen]

Definitely. Low thyroid id NOT to be messed around with and will NOT cure itself.

[MidwesternGal]

With the vaginal ultrasound, he'll be looking to see if he needs to do a DNC (not sure if I wrote that correctly, but that's what it sounded like). He said if I haven't had a period for a while, too much stuff can get built up in the uterine lining and they may have to scrape it off, apparently?

jajacobsen--The thyroid test came back at 1.8, so well within normal ranges. I guess I'm just wondering why he'd order more if I'm not even borderline.

Hello Kitty--Thanks for understanding about paying for everything. I just hate feeling like a hypochondriac and don't want to go through a whole thing with major expenses.

I suppose I should keep the appt. I just feeling like a hypochondriac, even though the doctor wants more tests, not me, KWIM?

[laura]

Erm, what he meant was a D&C but I would definitely ask for clarification about the "stuff" he potentially wants to scrape off. I have endometriosis and you can't see the "stuff" for the most part on a vaginal u/s - that would be more for cysts, fibroids (?), etc. Has he or you considered PCOS?

I would maybe keep the thyroid tests but cancel the vag. u/s, just b/c it is unclear to me personally what he hopes to achieve w/ that. If it is clear to you what he hopes to achieve and it sounds like it makes sense, then by all means, keep it.

[MidwesternGal]

laura--I didn't know much about PCOS and so I did a little surfing on it. It seems many of my "symptoms" would fit an early diagnosis of PCOS. Especially when I look back and remember that when I had DS, they removed a cyst from my ovaries at the same time. That, combined with my awful skin since having DS (which I didn't mention to doc, since I thought it was my thyroid), loss of period, and super heavy periods before I got on BC (this was before DS) all fit the bill.

I think I will keep my appt and bring up PCOS because I'd want to know if I did have it, as we do want a 2nd child in the next few years. I asked several IRL people, who all think I should get checked out, esp. since loss of periods is very unusual for me.

[Esq.]

Actually, if you are hypothyroid, you have longer and heavier periods. If you are hyperthyroid, you miss periods or have shorter ones. Hair loss is a symptom of either.

It sounds like all he ran was a TSH test. A TSH test doesn't tell the whole story. If he is planning on doing a free t4, t3 and antibody panel, then I would have the additional testing if I were you.

I agree with pp's re: the vaginal u/s, though. I would ask for clarification before doing that one.

[jajacobsen]

And just looking at symptons will drive you crazy and may lead t more questions than it answers. For example, I am hypothyroid - extremely so. Yet I also suffered from amennorhea (lack of period) for years. Both of these problems were caused by a central problemof a pitutary tumor which was affecting all of my subordinate endrocrine systems. So while the hypothyroidism and the amennorhea were related, there was nto a causal relationship.

I think that thyroid consitions can't be fully diagnosed without the free t4, t3 and antibody panel, so he probably is looking in teh right direction there. I think he's looking for PCOS or something liek that with teh ultrasound.

Please don't panic; I don't think you have a pituitary tumor or anything like that (he would be pordering an MRI or cat scan if he suspected so). But he might be looking for some relationship between various symptoms. He'sjust being thorough a rare, but good, thing.

[Scooter]

The vag. ultrasound doesn't sound strange to me. Heres why:

With it he'll be able to check your ovaries to see if they're showing PCOS symptoms.
He'll also be able to see if you're slowly growing any follicles. If you look like you're close to ovualtion he might not start you on Provera or BCP etc yet to bring on your period.
Sometimes ovarian cysts can produce hormones which make irregluar cycles, so this could also rule that out.
It's also possible with that ultrasound to see abnormalities like polyps or fibroids, which might be a starting point if he suspects that.
And lastly,he can check your lining and its thickness. Doing a D&C means that the Dr would go in through your cervix and gently scrape off the lining of the uterus. That usually jumpstarts your next cycle. So it would make a lot of sense for him to check out the thickness of the lining to have more information for the procedure. A D&C can scrape off the lining and polyps, but doesn't effect cysts (on the ovaries) or fibroids (which are in the uterine wall).

One last thing--it's good to know that a D&C is not your only option. It carries risks, such as possibly scarring the uterus which can prevent implantation of a baby later. IMO it's good to have the facts and understand why your doctor is making that choice and what other options you have, so you can make the best decision for yourself. HTH, good luck!

[amygrrl]

Actually, if you are hypothyroid, you have longer and heavier periods

not necessarily true. i am hypothyroid and had long annovulatory cycles. i think it depends on many factors.

also, there are multiple panels for hypothyroid.... the basic panel tests for basic levels of hormone in the blood. however, if their are other tests which test your body's ability to 'use' the hormone. basically, you could be hypothyroid b/c you aren't producing enough hormone OR b/c your body isn't effective at using the hormone your body is using.

[MidwesternGal]

Oh, I didn't realize so many had posted since I last checked!

I kept my appt for both. The doctor is supposed to call later today or tomorrow with results.

And, the lady on the phone who told me it would be a vaginal u/s (w/probe) was wrong--it was just the normal over the skin one.

Thanks for all the replies, I'll let you know what the results are.

[MidwesternGal]

Turns out I am definitely NOT hypothyroid.

The u/s showed a cyst on my left ovary. I asked the doctor about PCOS and he kind of sloughed it off. . . put me on b/c pills (which is fine with me) for my face and to regulate periods and control future cyst growth.

As for the PCOS idea, he basically said that the only option was cyst removal if we'd try to have another kid later in life and we couldn't. Not a very satisfactory answer, but as we are somewhat short on money and aren't planning to TTC anytime soon, I am okay with it.