Saturday, January 31, 2009

Thyroid

Well, I had my thyroid appointment and the doctor - a really thoughtful, helpful man with a great bedside manner - thought at first that I was four months postpartum. My bloodwork shows a classic case of postpartum thyroiditis.

I can understand the confusion. The numbers make sense for that diagnosis, and I wasn't wearing a tight shirt. Sitting down in a long floppy top, I could easily be a new mother. It took a while to sort it all out, partly because he had a lot of paperwork from my OB, so I assumed he had all the facts. Also, part of his exam turns out to be just talking for a bit and trying to see if he picks up on any overt lethargy or jitters. So, the conversation was a little weird.

"Any problems with breastfeeding?"

"Not that I remember..."

"Concerns about post-partum depression?"

"Not really - I haven't really gotten around to worrying about anything like that yet..."

"And when did you deliver?"

"Ummm....1998."

The look on his face was absolute confusion. And I'm sure I had the same look. When we started all over again, he was wonderful. He drew pictures to show how the thyroid worked, what happened to the T3 and T4 and how the TSH was regulated. He was very specific and scientific, which I always appreciate, but with a kindly sense of humor and a great vocabulary. At one point he said my numbers were "not too bad, but nothing to be sanguine about".

He decided to retest everything at a high-spectrum lab. My TSH is .43, with normal being >.5 - he felt this was not too worrisome since my actual hormone levels are fine. So, it's wait-and-see, and least until the lab results are back.

The one interesting thing he did say is that steroids can affect the thyroid. Since I was on dexamethasone for this IVF cycle maybe that has something to do with it. Although the dose is tiny compared to the amount used to treat chronically inflamed tissues, but who knows? I always turned a blind eye to the possibilities of long-term side effects from everything necessary for IVF - if I thought about it too much I would never have been able to go through with any of it.

Obviously, this is not a giant disaster. I feel like I'm in good hands and as long as the baby is fine I can cope with just about anything. But it is like another little message from my body, like it's saying "Listen, lady, wasn't it kinda obvious that I didn't want to get pregnant again? Then you go and do IVF and somehow it works. Great. Well, you can't say I didn't try to warn you."

I wish there was a way to argue reasonably with this grumpy body - but I guess if that were possible I wouldn't have had to go through IVF in the first place...

4 comments:

PJ said...

Yea, I really don't get the thyroid numbers. I know mine was a 3.something last time and she was unhappy with that. The time before it was like 1.6 and she was thrilled with that.

So yea, I don't get the number system.

That mix up thing is kinda funny!

Lost in Space said...

So glad to hear your appointment went well (after all the confusion) and that things aren't too far outside of "normal". I'm hoping all continues to go well for you. Hugs.

Interesting about the dex.....

Sarah said...

haha! well i guess manageable is good! a great doctor makes all the difference, doesn't it?

Nikki said...

That's good that the doctor thinks it's nothing to worry about. Good luck!

I was on dexa this time too - if something like this happens with me, we'll know what to blame it to! :-)

BTW - loved your conversation with the doc. "when did you deliver?" "1998" - the doc must have been pretty confused! LOL