Flotsam

I made my deadline—pages have been mailed to the state for revision and approval. I am not sure how, exactly, but 1:00 yesterday afternoon found me carrying a stack of 1,511 pieces of paper (I was sure they were going to fall in a huge rustling sheaf, but they didn’t) down two flights of stairs and a jog of hallway to the shipping dock. I raced back up the steps convinced that the fifteen minutes it took me to complete this errand would be the fifteen minutes during which Dr. Doctor attempted to call me, but I returned to no blinking lights on my phone, no new messages.
I spend my Wednesday lunch hours volunteering with a third-grader from a nearby elementary school, listening to her read, so I was sure that Dr. Doctor would call then, too, but she didn’t.
Eventually I stopped panicking every time I left my desk long enough to pee that Dr. Doctor was going to call right then…and started panicking that she wasn’t going to call at all. Then, on my way back from a vending machine, I heard my phone ringing a few offices away and sprinted back to it, my Fresca extended like a baton.
It was Dr. Doctor. My 24-hour urinary cortisol was normal. Not even close to the border of normal.
However, last night as she was doing some research about my case (I swooned a little when she said this) she discovered that this particular test has a high probability of false negatives, as cortisol is excreted intermittently—i.e. you may excrete a slew of it on Wednesday, and none at all on Thursday.

“Have you had a chance to do any reading about Cushing’s?” asked Dr. Doctor.
I barely suppressed an unattractive guffaw and answered:
“Yes, a little.”
“What do you think?” she asked, (again, the swooning) “There are many clinical signs you don’t exhibit, such as high—“
“—blood pressure,” I finished, “In fact, my blood pressure is consistently very—”
“—low,” agreed Dr. Doctor.
We went on like this for a while, and I idly considered what sort of flowers we would have at our commitment ceremony, when after a whirlwind courtship I pulled a ring from beneath my paper gown and she agreed to be my wife.
“I was putting all of your symptoms into this medical database I have…”
{I wiped a delicate strand of drool from my chin at the thought of such a database.}“…and it wasn’t coming up with much, except diabetes. So, just to be safe, I’d like to do a two-hour—”
“Glucose Tolerance Test,” I said, nodding.
“Yes, but I really don’t think that would explain the sudden weight gain—40 pounds in 18 months…”
“…is more like a metabolic shift,” I mused.
And that is how we started talking about thyroid.

For all my Googling skills, I was so focused on PCOS after seeing my lab results from the H&IBOML (That high LH! That Insulin) that I really didn’t think much about my TSH result of 2.12, because, after all, it was under three, which means normal, nothing to see here, move along.
Or does it?
Dr. Doctor looked at the reference range for the lab where the test was run, and it was .34-2.50. So, my 2.12 is on the high end. And TSH, apparently, does not tell the whole story. She would like to have a Free T4 drawn, a test that–for all of my virtual medical expertise, and despite my thyroid-indicating symptomology (which could also be explained by PCOS)–I have never requested.

All of this to say that next week, on November 1st (the day after my birthday, thank you very much) I will be reporting to the lab (again) for a Free T4 level, Thyroid antibodies, and a two-hour Glucose Tolerance Test. If those come back negative, we will consider further testing for Cushing’s and reevaluate for the 800th time.

So…what do you know about thyroid testing? Thyroid problems are very treatable, are they not? And Dr. Doctor made it clear that a pregnancy with untreated thyroid problems was most likely doomed, so if I do have a thyroid issue, it might explain the miscarrying. But that, really, is the extent of my knowledge. If anyone knows anything about thyroid-y things, feel free to enlighten me.
And cross your fingers that my tests next Tuesday show something definitive, and I can climb off this diagnostic Tilt-A-Whirl once and for all.
Ha! BwahahahaHAhaHA!
Ahem.