Wednesday, February 25, 2009

Doctor's Orders

Timing is everything, right? As I'd mentioned, I finally had my physical check-up with my doctor this morning and I had a whole list of things to discuss with her. What I didn't plan for was that I'd get the nasty DC cold for the 3rd time this year 2 days ago -- so I did go to the appt, but mostly was a zombie with a runny nose, sneezing, with gross watery eyes and that "I habe a code" monotone. My lymph nodes are all swollen up, so I hope that combined with the cold in general didn't do too much to screw with my blood work and the appt as a whole.

I did go over the list, though, and here are the results...

1. I got a refill on the BP meds. It was up a little bit today, still in the normal range but at the upper limits - but I think that could be cuz of just feeling like crap and rushing to take a cab rather than the Metro this morning.

2. I did get a referral to a nutritionist, hooray! My doctor loves that I'm learning how to cook and was very encouraging about trying to find ways to make that work with my IBS.

3. As for my pain in the neck? She said it's probably muscle spasms, and may be related to the start of arthritis in my neck. My Dr. Dad had said that too but I thought he was just being gloomy - I don't want to think about arthritis already! But she said as a start I should do the things that make sense, lighten my purse, switch sides with it, stretch more, go back to doing yoga, etc. She said even in looking at me she could see that I scrunch my right shoulder up and out of alignment, so i need to work on all of that.

4. Here's the new thing - which I'm not going to stress about until I need to. She thought my thyroid seemed a little enlarged, just on the right side. This may be nothing, it may be enlarged, it may be hard to tell cuz my lymph nodes and glands were swollen already from this cold. But I'm going in for a thyroid sonogram next Monday just to figure it out. Not stressing.

In general, she reminded me that I need to get more exercise - but she actually never said the words "lose weight," and I appreciate that cuz obviously I *know* that's what I need to do. I really do love this doctor, and this was only my 2nd visit with her but I know she's got the best bedside manner of anyone I've been to. I had a *terrible* primary care doctor for years here in DC, who was just not friendly or encouraging or supportive at all, and i'm so glad I've found this new - literally -caregiver. Even as I was sick as a dog this morning and stressed about the stuff we were talking about, she kept things light - she asked about what books I've been reading (turns out we're both Malcolm Gladwell fans), she asked what I'd thought about the Oscars, she asked what the best thing was that happened to me so far in 2009 (I said the Inauguration). I love it, I love that she makes it a 2-person conversation and that she makes it seem like she's really interested in me as a person rather than just numbers on a chart. It makes all the rest of this stuff so much easier to handle.


Anonymous said...

First of all, it is difficult to determine thyroid size by inspection or palpation, unless the person has thin neck.
Usually PAINLESS thyroid enlargement on one side may suggest the presence of thyroid nodule[s] which is not as uncommon as was previously thought. Therefore the ultrasound can be a good idea especially if blood test for TSH, T4 and thyroid antibodies is normal.
Solid nodules larger then 2 cm [these which require more investigation] can be found by doing thyroid neck check self-exam (AACE, 2005).
In many cases thyroid enlarges as a result of thyroid inflammation, [silent thyroiditis], and shows at ultrasound as heterogeneous echo structure. The upper limit of normal thyroid volume is 18 cu. cm for women per WHO guidelines (2002) with most frequently measured volume between 8 and 11 cu cm for US population

Stef said...

Thanks, OT. I'll report back here what happens...