Graves Eye Disease and Hyperthyroid

TSH? What to make of your labs results . . .

I highly recommend you subscribe to Mary Shomon's e newsletter from About.com.  This morning in my e newsletter was a terrific article clearing up the confusion when it comes to understanding your TSH levels.  Why a below normal TSH level means hyperthyroid, and why an above normal TSH levels means hypothyroid.  Very straightforward, easy to understand.  I highly recommend you read it.  It'll take you 5 minutes.  Well worth it from Mary Shomon. 

Here's the link:  Clearing up confusion on TSH

In addition, you can sign up for her e newsletter at the bottom of the article.  Please do!

Lab results: demystifying what they mean

In a recent comment I just entered, I asked patients to be sure they receive a copy of their lab results for their personal medical file at home.  I'd find another doctor if mine wouldn't give me a copy.

As I looked over my recent lab report, it occurred to me that there are 25 tests on the list including 3 that are thyroid related:  TSH, T3 and T4.

In addition, there are a bunch of other tests that look like alphabet soup:  WBC, RBC, HCT, and more.  They fall into 3 categories:  1) chemistry, 2) hematology and 3) hormoneanalysis.  What to make of them?

Here's a link that might help you  -- Blood tests explained, in alphabetical order, you can click for definition.  Click here and you'll find an alphabetical listing of many blood tests.  That way, you will be able to know that those I just listed mean white blood cell count (WBC), red blood cell count (RBC), hematocrit (HCT).  Here's another list I found to be helpful as well -- reference ranges for blood tests. 

Give one or both a try.  And if you find others you like, let us all know right here!

-----

Edit July 3, 2008--the above two links no longer work--Here are three I found useful in learning more about thyroid blood tests:

http://www.medicinenet.com/thyroid_blood_tests/article.htm (discussion of thyroid blood tests)

and two really good ones from Mary Shomon--

http://thyroid.about.com/library/howto/htthyroid-test.htm (how to interpret your thyroid test results)

http://thyroid.about.com/cs/newsinfo/l/bltest_values.htm (specific thyroid function tests and interpretation)

And the cardiologist says?

The cardiologist walked in the room I was waiting in, sat down and said, "this will be easy" and he continued, ". . .your EKG indicated your abnormal heart beats occur from the upper and lower chambers of your heart (see also previous blog entry on PVC's).  What you have is rare, but not life threatening.  Your stress test was fine otherwise."

He also suggested my heart beat troubles stem in part from the fact I don't get enough sleep (I know I don't) and I'm under stress nearly continually with my job.  Even stress in a job I enjoy can be a problem.  Apparently it is.  Couple both with lack of fitness and voila, you have a 3 ingredient recipe for problems.

It's not life threatening.  I know more today than I did yesterday.  I will do something about it.

Visit to the cardiologist

Stress test and echocardiogram.  A test that just might help me get some answers.  To what is causing my premature ventricular contraction, or PVC.  That was on my agenda today.

This is a test that starts out with a pre-stress test echo.  Then you get hooked up to all the wires and walk on the treadmill.  Every 3 minutes the treadmill speeds up and the incline rises.  When your heartbeat reaches a certain beats-per-minute level the test stops.  Then you immediately have a post-stress test echo.  In all, it takes about 45 minutes.

Now I wait and see. 

It's a beautiful thing, watching your heart beat on the monitor during the echocardiogram.  In plain visual view, beating away.  You can actually see the valves opening and closing.  And then there are the blue and red spots which indicate the direction of the blood flow. 

I was fascinated.  I'm fascinated by medical imaging of all types.  The MRI of my head when my eyes were bulging was equally fascinating.  I'll have to see if I can get a digital copy of the images to post here.  Hadn't thought about that until now.

I've said it before:  the single biggest factor in your overall treatment is the quality of the medical care you receive.  Both my family physician and my endocrinologist are great.  The doctor and nurse today didn't disappoint.  Thorough, professional, answered all of my questions.  I couldn't have asked for better care today.

Resuls will be posted here in a couple of days.

Until then, I bid you g'nite.

Thyroid Scan in Grave's Disease--Radioactive Iodine Uptake Test

Another test I had was the radioactive iodine uptake test--a test that measures the uptake of the radioactive "tracer" by your thyroid, with the "tracer" being iodine.  You actually swallow radioactive iodine in the form of a pill.  I should mention this test was done in the nuclear medicine area of the hospital, complete with hazard signs.  Haz Mat all the way. 

I took the pill in the morning, went back to the hospital about 5 hours later, and again the following morning, for the required follow up tests to determine the uptake levels.  What they told me they look for is an uneven uptake, a low uptake or a high uptake.  Mine turned out to be high.  At this time, my family physician sent me to see an endocrinologist, pretty certain of what was going on.

Finally, the answer I've been waiting for--Graves Disease-Hyperthyroid

November 2005.  I land in my hometown Tuesday night.  I'm excited to still be on vacation and take care of a few things on Wednesday, running errands and preparing for my trip to Santa Fe and Telluride.  Thursday rolls around and I've just a few hours to spare before I head back to the airport to catch my flight to Albuquerque and my cell phone rings.  I am visiting my parents (they live close to the airport).  It's my family doctor.  Without hesitation, she simply states, "you have Graves Disease."  That was it.  But what exactly was IT? 

She was particularly concerned about my fast, irregular and hard-beating heartbeat and asked that I get a prescription filled immediately.  Immediately?  I explain to her I'm headed out the door to catch a flight, on vacation, out of town.  She insists I pick up my prescription and begin taking the medication immediately.  The medicine is a beta blocker.  I stop by my local drug store en route to the airport and off I go. 

On the plane my mind is racing.  Graves Disease.  The name itself makes it sound like a grave diesase.  I specifically recall her telling me we'll have to watch the eyes.  The eyes?  What do my eyes have to do with anything?  For many, there are no eye symptoms, ever.  For others, they can range from mild to quite severe and require surgery.  More specifically, she said we'd have to watch for eye bulging.  Now THAT got my attention.  She had explained the potential complications and although I didn't realize then that they'd already started (it'd be a few months before I'd really discover first hand what was happening) I would later look back, put 2+2 together, and remember how odd I thought it was that when I opened and closed my eyes slowly one eye would go up faster than the other.  A little thing but not in any way normal.  Only later would I know that was the first sign something was wrong, with my eyes that is.  There's so much you need to learn about when you're eyes are affected with Grave's Disease.  Especially when the pressure and swelling behind the eyes causes them to move outward, or bulge.  This is called Graves Ophthalmology.   I will be blogging quite a bit about that for sure.