Fuming with endo letter

Popping out shortly but woke this morning absoloutely livid after receiving a letter sent to my gp from the endo i saw 22nd Jan letter typed 18th feb.

Thank you very much for referring this 46yr old lady to the endocrine clinic who i saw today. She told me she had been diagnosed with hyperthyroidism in 2003 (Hyothyroid!!) since then she has been on thyroid supplements. She says her main concern is her weight gain. (Not true. I said it was the tiredness). She has tried all methods to lose weight without success. She ttold me she was on slimming tablets back in September last year, which did not help. She walks 5 miles a day and eats a healthy diet. She has gained nearly 7 stone (it is actually 8 stone) in 6 years. Her main weight gain is around the neck (what?? I said stomach). She also told me she has been having headaches for the past few months ( no, i have always had headaches) she has a headache on ththe right side which is associated witn nausia. She denies any visual disturbances. She denies any photophobia or phenophobia. Her headache occurs in the morning and she sometimes takes nurofen for it. She also mentioned that she feels tired all the time even after 9 hours sleep. She denies having nightmares. She says she snores a lot (????). She also mentioned that she has had leg swelling for the past 5-6 years and has swollen feet and hanDs for the same time. She has shortness of breath after walking nearly25 steps on a flat surface which improves if she continues to walk. She denies any orthopnoea although she sleeps upright for comfort. She denies having bowel symptoms. She has a history of hair loss and easy bruising.

On further quetioning she told me that she is not enjoying life recently (because of the tiredness!!!) She used to do a lot of thi gs in the past but is now unable to do everything. She does not think she is depresed.

She has a past medical history of hyperthyroidism (HYpothyroid!,) diagnosed in 2003, menieres disease, CKD stage 3 _recently dignosed as per patient. She had a bebreast reductio surgery back in 2003 which was uncomplicated. She does not smoke or drink alchohol. She is not allergic to andany medication. She is a H&S supervisor at a solicitors however her main work is desk job.

She is on levothyroxine 100mcg per day. She is on dessixdessicated thyroid purchased on internet. She is on vitamin b12 tablets vitamin b3 (should be D3) selenium and b complex tablets. I also told her that i am not sure about the benefits of using dessicated thyroid. Also explained that sometimes a supplement can cause harm ( LIAR!,, she didnt even know what it was!!! She asked me to show her the bottle)..

On examination she looks anxious. Pulse 96 per min regular and blood pressure 180/100 she told me her blood pressure was always high in the surgery however it is normall range when she measures at home. Jvp is not raised. Her chest is clear. She has Swelling up to the knees. Her abdomen is soft and non tender. I noticed striae over the lower abdomen (?) . I also noticed erythematous rash over the anterior chest and behind the ear and the neck. Mrs xxxx was not aware of this rash and thinks whenever she is nervous it appears.

Today i have repeated her bloods including thyroid function tests. Full blood count. Hba1c, cortisol levels. I will see her with the results of the above tests in 10-12 weeks time.

P.s i can not see thyroid result on the system, i have attached a blood form for patient to repeat blood test (thanks for that! Shlep all over town again!!)

So there you go!!! I will post the results of all the other blood tests on a seperate post. Any comments welcomed.

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24 Replies

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  • Oh yes i am also HYPOTHYROID NOT HYPERTHYOID!!!!

  • How they can make such wide-ranging statements of patients that they do not know at all, is beyond me. Where is the compassion (do they know the definition) and their endeavour to assist a patient to recover their health instead of looking at computer print-outs for their reasoning (non-reasoning).

  • I'm not surprised you're fuming. Lots of mistakes, a long list of negatives, but the endo has made no attempt to put anything positive into the appointment at all. I also notice the sly suggestion that you are depressed but in denial. What use was he/she? If the endo had continued the letter "She has not lost any legs, and still has a nose" it would have fitted in well with the rest of the letter.

    What were you hoping for from the appointment? Did you have a specific goal?

  • I was hoping they would consider ndt or t3. Good job i am feeling so positive on my own purchase of thyroid s

  • I'm going through the same thing. Have you tried the Thyroid-S yet? Has it helped you?

  • Yes on thyroid s since december. It is helping but i am not sure i have the correct dose yet as my weight is fluctuating up and down by around 2 kg per week.

  • And what the hell are striae on lower abdomen?? Is she referring to my stretch marks from pregnancy??

  • Yes, almost certainly she is.

    nlm.nih.gov/medlineplus/enc...

  • After having two babies both born at 10lb 2oz and 10lb 11oz i would like to know who wouldnt have stretch marks. I would also like to know how relevent they are to my health at the moment...

  • It is as if your endo decided to put together a letter which is 99% waffle simply to prove to your GP that she has met you.

  • The stretch marks may not be relevant - although could be linked to a nutritional deficiency - but the large babies are. Hypo women tend to have bigger babies. My last was nearly 9 lb.

  • what does it mean when a medic states, 'she denies...' is that accusatory or am I being over sensitive ?

    KBO jacki x

  • I thought the same thing!

  • Me too!

  • It sounds like it but I'm told it's standard medical speak for "the patient says she does not have". It's very common and is not meant to imply you're lying.

  • Hi,

    It is so infuriating when a medical report/letter is full of incorrect info and innuendoes.

    I've only ever had one Consultant who writes true facts and info, the rest (and there are very many over years) rarely even seem to relate to me.... odd.

    Are they bored, have no memory or generally disinterested... all 😏?

    More seriously it's very important for the info to be correct as they make up the patients medical files and are what is used in the future.

    I have written back to a couple of Consultants correcting what they reported (and cc'd it to gp to be held on my file). As you can imagine it didn't go down well with the Consultant but actually....tough tbh.

    Oops.... sorry bit of a moan. I can sympathize totally.

    Xx

  • Am i able to add this endo to louise's nono list? I would hate anyone else to waste their time or be upset by her ignorance and indifference!

  • striae are reddish lines, like stretch marks, but not, associated with Cushings Disease and so are rashes and high blood pressure, high blood sugar and heart beat irregularities. It would be high Cortisol. Do you have Striae anywhere else?

  • Also, puffy red face, weight gain etc..

  • No straie anywhere else. Puffy face yes. Weight gain hell yes

  • When I get a letter like that, I reply with all my corrections and send a copy to the GP as well as consultant. That then goes in your records correcting all the inaccuracies, which I think is important to do.

    The striae can be indicative of Cushing's (as can the weight gain and hair loss - some thyroid symptoms are same as other endo issues).

  • Ah Mabes, what a good idea. I will do that today.

    How would the striae be differentiated from stretch marks? I had horrendous stretch marks, as you can imagine with two very large babies. I also have a very distended abdomen which has gradually emerged since I was diagnosed with uat.

  • Why does your letter not surprise me, my last letter from the Endo started with "this gentleman was seen today in clinic she said she felt crap". I was outraged and thought if he couldn't make up his mind what sex I was how could he help me feel better. I actually came out of his room after the allotted 5 minutes wanting to strangle him. It was a case of if you will not have a TT then I do not want to know.

    He told my partner I would need a liver transplant within a year if I did not have the op. Three years later my liver is fine thank you.

    Perhaps if the NHS managers actually listened to what patients had to say about their experiences then we might receive the treatment we are entitled to and not be fobbed of.

    Sorry it just makes me so mad that they treat people like this and actually get away with it.

  • Blimey, to get the disease wrong is bad, to get the sex wrong is something else!

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