I had a lot more doctors appointments this week.

I had sclerotherapy done on my left leg on Tuesday this week.

One down by my ankle and another in my back calf – both on the left leg.

It burned and felt super, super bruised for quite a few days.

It felt real bruised, like there was this pressure screaming to be let out.

Today it has started to fade finally, and it’s been almost a week now (I wrote this sentence on Sunday).

So now I know what to expect for the other leg at least.

Also on Tuesday morning I had to get lab work done.

I got the results early Thursday afternoon.

The only labs that were left were my TSH levels.

I have already touched on my “normal” CRP levels in my last entry.

So the normal, or typical, TSH levels are between 0.5-4.5 or so, roughly, right?

Well, when I looked at my results that came in on Thursday, my level was at a 20.9.

That’s super fucking high – or low, technically.

It means I’m super low on the hormone, and that I need more medication.

The “highest” I can remember it being before this in my life is a 17.something, when I was in my late teens, when I had just moved out of my parents house and was having a very difficult time remembering to take my medicine.

I do not remember a time where my TSH levels were this high, like they were this week, ever.

I looked up if high prolactin levels can affect hypothyroidism and found that hypothyroidism can actually increase prolactin levels.

So on top of the antipsychotics causing high prolactin levels, the haloperidol specifically, my hypothyroidism can too.

It’s called hyperprolactinemia, and basically has most to do with infertility and bone loss.

But it can also cause mood swings, headaches and joint pain too.

Which makes sense.

And I remember that doctor, when I had the 17.something TSH levels years and years ago, said that I would have a very, very difficult time getting pregnant throughout my life.

I’m guessing, because, I remember we were going over bloodwork – that he probably did my prolactin levels too back then, and they were no doubt high then too.

And I never did end up trying to get pregnant, so it never mattered anyway.

But they do go hand in hand.

I just cannot believe how out of whack my TSH levels are!

The last time I did blood work, on 9.2.25 (it was a Tuesday), my TSH levels were at 9.37, significantly high.

The time before that, on 7.1.25 (a Tuesday), it was 6.76, high as well.

And all the while my T4 has been a 1.6-1.8, which is not technically above the cutoff of a 1.8, but close.

But she didn’t test my T4 for some reason this time, but I bet it would’ve been officially high (which is really, again, technically, low) if she would’ve tested it this go around.

Even on 10.8.24 (another Tuesday) my TSH levels were sitting at a 8.17…

I’m kinda mad at myself for not really paying attention all that well this year.

For not seeing the pattern of an overtly high TSH levels.

I know my T4 was a touch more “typical” at 1.4 at that time, but still that’s running on the higher marker side..

I like to keep my leaves more in the middle of “normal”, ya know? 

It’s mindblowing to me that my levels have been significantly high for well over a year now and my general practitioner (GP) hasn’t done much about it.

She upped my levothyroxine once in the past year.

From 2 tabs of 112mcg (a total of 224mcg’s) daily, to 2 tabs of 125mcg’s (a total of 250mcg’s) daily.

Not much of a difference. 

I had a friend tell me that I very well may need to see an endocrinologist again, and I agree with her.

I mean, we’ll see what my GP says, and what my nutritionist says this upcoming week.

That’s another thing I had this week – a 15min starter call with a nutritionist who my Mom has been working with for a while now.

I’m excited for our first 2-hour call on Monday this upcoming week.

I’m excited to see what she has to say and what she thinks I can do food and supplement wise to help me with my arthritis and physical issues.

I told her that I don’t really want to mess much with my mental illness issues.

Because right now I feel like I have a good grip on things – even though I still have a ton of breakthrough symptoms, I have a good support system going with that now.

Well, not good, but decent.

Well, realistically, it’s alright.

I have a crisis line I can call, a therapist I can text, you know, that kind of thing.

I have a plan for when my psychosis gets out of hand basically.

And my therapist and I are starting back up on the EMDR work this upcoming week too.

I’m a touch nervous about it.

But I’m sure it’ll go smoothly.

I’ve been having the strangest, most vivid dreams lately.

But I want to talk about the doctor appointments this week, so I’ll save those for another entry.

I had a rheumatologist appointment on Thursday this week.

It went… alright.

I hesitate because it started out with him wanting to know the “history” of my rheumatoid arthritis journey.

So I started telling him that my knees started to hurt in middle school.

Yada yada yada…

Got to 2006, they did the first MRI because my MCL was a “grade 2 tear” and with that MRI, they found significant arthritis on my left knee joint.

He said “I’m going to stop you there. Someone telling you they found arthritis is about as useful as a dermatologist telling you you have a rash. What kind of arthritis was it?”

And he was harsh in his tone.

Very unforgiving, very poor bedside mannerisms straight away, very standoffish.

So I started crying.

I said “look, I’ve been called -“

He interrupted “ WOAH WOAH, there’s no need for emotions, there is NO NEED for emotions, I’m just asking you a question…”

And I came back with “if you’d let me talk…”

“Okay, okay, there’s just no need for emotions” he said again.

And believe you me, I’m not going to push down my emotions and shove them aside for a doctor I just met.

So I let myself cry through telling him “look, I’ve been called a ‘mystery patient’ for decades because they don’t know where exactly to put me” I said through tears.

I went on “look, I’ll jump ahead to this month, I had cut way back on my methotrexate”

He interrupted “why did you -“

“Let me finish” I said back

“I went down on my methotrexate because my GP was feeling uncomfortable giving them to me, so about 4 weeks ago I went down to one tablet per week instead of the six per week, so she didn’t have to write another script before I saw you.”

He interrupted again.

I said “this will just take a second, let me finish please.”

So I went on “fast forward to my orthopedic appointment last week, week before, and that doc asked me if I have RA because my imaging looks similar on both sides”

He looked understanding put out a hand as if to say okay and said “alright, okay, that’s something”

And then I told him “the orthopedic doc told me that whatever I do, to stay on my medications and to make sure to keep this appointment.”

I went on “So I went home and boosted back up to the 6 tablets a week, it was my day to take them, and within about 4 days, I felt and saw less inflammation all over my body.”

And he said “okay, now we’re getting somewhere.”

So then we backed up and I gave him the reamianing “history” of my RA diagnosis and the docs and meds I’ve been on for it.

By the end of the appointment we were talking and joking about how I shouldn’t get my information on methotrexate from reddit and he had some better resources for me and everything.

He seems very thorough and particular and I didn’t bring any imaging with me, so I understand his apprehensions.

But that doesn’t mean that I don’t know what I’m talking about, and I why the fuck would I seek out drugs like methotrexate and hydroxychloroquine and folic acid?

It’s not like they hold any street value or anything. 

I mean, c’mon.

Who would want to randomly be on those medications?

Anyway, I did some lab work for him and I’ve got a bit more to do for him in another 5 weeks or so.

So I’ll adhere to what he needs me to do.

I do feel like I may get some answers from him.

They may not be what I’m expecting or looking for, but they’ll be answers.

He seemed thorough and knowledgeable, even through the rough exterior.

Moving on to the last appointment of the week – my bilateral cortisone knee injections at my orthopedic doctors office.

Gee howdy, I tell you what, by the way that doc did the injections, I can tell he’s a great surgeon.

He was quick and painless.

He didn’t get in the knee joint and move the needle around like most every other doc has.

He was succinct and to the point and done, bing bam boom.

Just like that.

I would trust him with surgery, I know that much.

Just by the way he did those injections.

It was amazing.

And my knees aren’t pain free this weekend, but they’re as close as they can get, that’s for sure.

They just feel tight and sliiiiiightly bruised is all.

The sharp shooting pains are dulled for now, thank fuck!

The cortisone shots are working right now, for how long?

We shall see…

Hopefully a few weeks at least.

All in all it was a super hectic and all over the place week.

I’m ready for a calmer one, but this upcoming week isn’t looking to be much calmer.

It all depends on if some insurance authorizations have gone through or not.

So it could be another hectic week, could be quite chill.

It all depends.

I won’t know much till Monday morning.

I’m just glad that the initial rheumatologist appointment is over.

That was a rough one.

Thank goodness I don’t have to go through that again.

My Mom had a good point and said that I should come up with a spiel of my psychosis/divorce/car accidents/stabbing/assault by customer – that 6-8 month period that basically helped throw the rest of me into psychosis, so my “emotions” make sense to the provider.

And she’s not wrong.

It’s actually a really good idea.

Because once that rheumatologist knew I was dealing with schizoaffective disorder, about 1/2 to 3/4 of the way through the appointment, his entire mood shifted.

He became softer and gentler.

It shouldn’t take me opening up about my years long psychotic break to have decent bedside manners come from a doctor.

But it did.

So I’ve been thinking about wording this weekend with that.

Because a shitton happened to me within a very short amount of time and the people that I work with professionally like this – these doctors – should be aware of that.

It would help me make more sense to them.

My reactions, and my seemingly random emotions aren’t really random at all.

I’m actively working on my trauma in therapy and it’s an extremely difficult and painful process.

And what I went through, though years ago now, still feels like it was just yesterday.

And they do need to be aware of that impact on me.

It’ll help everyone involved be on the same page.

– Keren