Doctor visit

I had my appointment with an endocrinologist yesterday.  My goal was to find out what the significance is of having a diffusely enlarged pituitary.  Nothing else.  I don't want more cooks in this (IF) kitchen than necessary.  The appointment went okay...apart from the ten minutes or so when I was led to believe I had a brain tumor.  But I did learn what I wanted to know so I'm satisfied.

The doctor spent the first part of the appointment explaining my "macroadenoma."  My heart sank.  (that word means large tumor)  I was sitting there thinking, "I guess I do have a brain tumor."  She said it was just starting to impinge on the optic nerves.  She asked me multiple times if I had any vision loss or problems.  She talked about getting another MRI in six months to see if it decreased in size.  At some point I interrupted her and asked, "So I do have a tumor?"  "Yes, you do, and macro means it's larger than 1 cm."  Then she stopped and pulled up my MRI report.

"My mistake.  No, you don't have a tumor.  Your pituitary is just enlarged.  You won't need another MRI." 

That's a relief (to find out for the second time).  I wish she would have read the report a little more closely.  It's really not fun to be told you have a tumor when you thought you didn't.

She said the enlarged pituitary could very well be a normal variant.  Normal!!  I was not expecting to hear that.  Her only guess as to why my pituitary was enlarged was the HCG I've been taking post-peak for four years.  She said it's common in pregnancy for the pituitary to become enlarged due to the presence of HCG.

She did want to do some labs to see how else the pituitary is functioning, but she said she can't check the hormones I'm being treated for because it won't tell her anything.  The (anterior) pituitary makes six hormones, and I'm on medicine that affects five of them.  (Example:  The pituitary makes TSH, which tells the thyroid to make thyroid hormones.  If you take thyroid hormones as a medicine, the pituitary goes to sleep because TSH isn't needed.)  The only one of the six she could test is growth hormone, so she's doing that.  She's rechecking my prolactin since I've been on the medicine just over a month; she said it didn't matter that I wasn't fasting.  I asked her to recheck my vitamin D, since it was low last fall.  There's something else too but I don't remember what...I do remember the four tubes of blood they took from me.  I'm glad it wasn't more.  :)

She said she would refrain from commenting on my thyroid labs from February if that's what I preferred.  Yes, that's what I preferred.  :)  She did let me know what she thought of them in a back-handed way.

As I expected, she was very skeptical of NaPro, both the long-distance concept and the actual treatment approach.  She asked me why I was originally put on T3 ("because it's standard everywhere to only use Synthroid/levothyroxine") so I explained it was due to low temps, symptoms, and a low T3 to reverse T3 ratio.  (reverse T3 is inactive)  "That's not mainstream medicine," she says.

Clearly.   You can say that again.  (She did say it again later.)  :P

If I didn't roll my eyes, I definitely wanted to multiple times...she wasn't just asking out of curiosity; she bordered on condescending...  The thing that usually stopped her accusatory tone was when I said, "NaPro has some great pregnancy success rates.  They've found    (insert NaPro medicine here)     worked for their patients."  I said that when she asked why I was working with a doc in another state, how I picked PPVI in the first place, and why reverse T3 ratios are used to plan treatment.  She did ask if there were papers published so she could read to learn more.  I told her they (Dr. H) tried, but no one wanted to hear about that.  (Dr. H got sick of journals rejecting his research paper submissions for that reason so he stopped submitting.)  She nodded in understanding.  I mentioned if she really wanted to, she could buy the 1000+ page NaPro textbook.  As soon as I said that, she scribbled something in her notes, but didn't say anything.  I have no idea if she would actually consider purchasing the textbook.  I would be shocked if she did.  I'm supposed to go back in three months for another appointment, so maybe I'll find out then.

With all the questioning she did of my NaPro treatment, I'm a bit disappointed that she didn't ask about naltrexone.  (It's the ONLY one she didn't ask about.)  Knowing that they expect me to say I'm on it to treat an alcohol or drug addiction, I like seeing people's faces when I say it's a miracle drug for PMS.  :)