Blah, blah, blah - with your medical history we have to be sure

Yesterday I had my annual physical. Or Woman Wellness Exam or whatever the correct term is for it these days.

It did start off interestingly while I was waiting to check in at the desk, there was a woman who was being told she can't call the doctor's office every day making demands, should go back to her psychiatrist, and perhaps become an inpatient at a psychiatric facility. We'll just say that I was very happy that was not me. My health/mental stability is not that bad.

My primary care, who I like, just had a baby and is out for the summer on maternity leave so I met with her nurse practitioner who was one I had not met before. She was very nice and very thorough in her questioning after she let me go through my list of questions. We talked about my ganglion cyst which makes my wrist hurt, we talked about my arthritis, we talked about back pain, car accident, back procedures, previous surgeries, my general health, how much I exercise, and more. Then she examined me and thought I was pretty normal (wow!).

I left with two to-do items - one is a cholesterol blood test which can be done the next time I have blood work done - every two months for rheumatoid, every six months for thyroid - so whenever the next one rolls around.

The other is a much bigger test (where I might feel a 'little pinch') that she wants done in the next two weeks. I can understand wanting the test but I didn't realize she considered it to be more urgent. That part I don't like. I'm not looking forward to the test itself but really dislike it when I have tests which must be done right away.

Grrr.... All the little 'what if' voices in your head start to kick in when I have 'urgent' tests.

It is scheduled for July 5 - which is fine because we had no plans to go away for the weekend - which is 2 1/2 weeks. I have no idea why it is so urgent. But of course I get to stress about it. I will take my avoidance mode until then and discuss it in more detail when I feel like it.

Cancer blood test

Here's some more promising news. A group in Kansas has developed a blood test which can detect breast and lung cancer in its early stages. This is cool.

Cancer caught in its earlier stages leads to better outcomes. Breast cancer is most often caught in stage II and lung cancer in stage III or IV. If a blood test can catch breast cancer in stage 0 or I and lung cancer in stage I or II, more people will live longer.  They are also testing it on pancreatic cancer.

This means high risk groups could get regular blood tests as screening for these cancers.

However, (of course there is a caveat) it is a relatively small study and it is not yet approved.  But it might mean moving to Kansas is a good idea.

I did not get the math class

I did not get the thyroid cancer math class. I am sorry. I can't remember it all. I get confused. I fake it and pretend I understand. But I don't.

I am blaming a combination of chemo brain and the fact that when I had thyroid cancer the world was different my doctors just gave me a Synthroid (synthetic thyroid hormone) dose and never explained numbers. Every so often they would look at my blood test results and say 'hmmm, let's adjust your dose'. Part of that was because that back then Synthroid was not available in a million different dose levels. I think it was just 100 mcg or 200 mcg. Now its available in doses of everything from 37.5, 50, 75, 87, 100, 125, 150, 175, 200 mcg and many more.

At my last appointment with my endocrinologist, my TSH level was a little too low. It was .22 and should be at the low end of the normal range of .35 to 4.5. So instead of taking 1/2 a pill once a week my dose was reduced by another 1/2 pill a week and as a result my TSH level went up to .53 which is in the acceptable range. When they decrease your dose, your levels go up - just to make it confusing.

My doctor pulled out a calculator to figure out what the dose should be. Should I go down to 125 mcg with a half pill once a week or go with 137 mcg and take a half pill twice a week? This way I am getting an average of 117.4 mcg each day. If I went to 125 mcg and took 1/2 a pill once a week I would be at 116.1 mcg which she thought was too low. She asked me if I used a daily pill box before deciding what the dose should be.

Then there are T3 and T4 levels that need to be monitored and kept to barely detectable levels so I don't remember those numbers either. These are monitored because if they are detectable it could be a sign of recurrence (I think).

If you go to the thyroid cancer message boards there are all these people asking about changing TSH, T3, and T4 levels and another test that I cant remember. They ask about why they go up and down, should they change their drug levels or change their doctors or change something else. What happens when you gain or lose weight or get pregnant or go vegetarian or all sorts of things. And its all about the numbers. I never comment on those discussions. I read them and think 'some day this will all make sense'.

But it appears it will never make any more sense than professional football rules to me. I have both explained to me a million times and I still don't get it. Back when I was in my 20's. I would get together with a friend for drinks often on Monday nights. We would sit at the bar and the bartender and some nice men would always explain foot ball too us. We lied and pretended we understood but never really did.

I think I am okay with this. I get my blood tests. My doctors explain them to me. Its one less thing to worry about.