Went to the docs for my lab results

The doc and I had a long talk, I like him because he's actually been overweight before so he knows how it is.  It's hard to believe he's been obese before since he looks like a bean pole.  I talked to him about SB and he said that was fine, jus****ch out for calories in a lot of the meats.  He was still pushing a little bit on "his plan", but he was fine with SB although he admitted he didn't know a lot about it.  I told him about it and he just said to write everything out daily so I can make sure I catch what foods doesn't work for me.  He also said he wants me to work toward an hour a day of exercising.  At the end of the visit he asked me when do I think I'll want to see  him again.  I said..."never".ha  He laughed and told me to come back in three months.lol  He said he wants to see a pound a week off, a goal of 12 pounds by that three month mark.  That is how he lost his weight and was able to keep it off.  He says it helps if I know I have to come in and have a check up with him about my weight loss.  He's hoping this will push me to do what he says I guess.lol  Guess it might, it's not like I'll make the appointment if I don't lose the weight!ha  He's a good guy, I like him, I think that's why it's so hard for me to change doctors!  Ya gotta like who you see.  So I guess he's taken it upon himself to become my "weight loss doctor".

Now for the nitty gritty....the lab results...cringe.

The good news is that my hard work on at least eating right has gotten my cholestrol better.  Six months ago it was still high even with meds.  Now my triclycerides are 139, cholestrerol total-149, HDL-36 (my bad one..exercise!), and LDL-85.  WOOT!!  So I have to stay on crestor, it's just not going to be increased!yay

My glucose was 109, which is about where it normally is I think?!?!  My A1c is 5.5.  My tsh is 3.42.  Carido CRP is 4.1- he's making me start taking a baby asprin every day for this since it's putting me at high cardiovascular risk. :(  Also 3 grams of fish oil a day.  My microalbumin ratio was at 2.  Then all the other stuff

He said between one of them and my bp he's going to be watching out for me to get on bp pills.  Im not sure which one that was???!?!  Also he mentioned my thyroid was a little low?!?!!? So he was going to watch that one.  Which looked fine to me, so I'm sort of confused.

So I wasn't too happy with all my results.  My cholestrol yes..but the rest no. More risks..high bp to watch for, and a daily baby asprin.  He also kept on me about sleep apnea.  He really thinks I might have it, but I'm sort of fighting him on it.  This is too much, I just need all this to disappear.  

He sort of freaked me out with the CRP results, and with the apnea, and bp.  Then he wants to keep tabs with my lung issues, and wieght so that is why only three months before the next visit.  I'm feeling very old today.  I left there in tears. 

Hey Holly, Don't be too discouraged.  Your cholesterol was lovely.  Your BP is just something to keep an eye on - it's not in the bad-zone yet.  Relax - you're doing everything you can to fix your situation and your efforts will pay off.     

Everything looks great except your TSH.  3.42 is not low, it's high but not terribly high.  Most people report feeling best and their symptoms (such as weight gain, slow metabolism) lessened when around a 1.0 on the TSH scale.  You are definitely hypo but a mild dosage of synthetic T4 would fix that in no time. Probably 50mcg.   Your doctor may not be very up to par on thyroid issues and only knows what the old med books told him. I'd recommend seeing a specialist, an endocrinologist. For example, my TSH was 3.16 at my last doctor visit. My doctor upped my dosage of synthroid to 88mcg from 75mcg. If that number was too low then he would have decreased my dosage. The number is too high and we're shooting for a 1.0 - 1.5.  I'm also going to see and endocrinologist for a second opinion.  If the endo concurs with my doctor then I'll just see my regular doctor, though his bedside manners aren't the best. My TSH was 6.5 in 2006. May I also add that hypothryoidism can cause lowered HDL. (mine is a 36) It can also cause your LDL to be elevated.  Also, blood pressure can be directly affected as well. There are about 500 other things that it causes too like dry skin, fatigue, depression, etc.

I thought you would catch this. :)  I'm a little confused on it actually.  Because he said it was low, and said something about the "2", which is the other one.  I have no idea about microalbumin and it being "2".  I don't even know what this is. He sort of confused me talking about so many different things!  Those two doesn't intertwine do they??  I don't think they do.  I remember that threw me off too, because it looked average.  Not sure..I'm lost.

Hey you know alot about this stuff, I've looked one up and I still can't figure it out.  My absolute monocytes were high, at 1025.  What does this mean? 

I don't know a whole lot about albumin but I pulled this below from the web. If your albumin is low then it could lead the doctor to question liver issues. They will then run a AST and ALT test.  I know that thyroid issues can cause your ALT [used to be SGPT] to be high. From the ALT and AST they can determine which type of liver disease (if any) that you have.  Since you have hypothyroidism then I suspect the albumin levels has been affected by this.  You need to get a copy of the lab results so that you can see what the scale was for your albumin test. My scale says normal is 3.5-5.5 and mine was a 4.4. Albumin: Low albumin levels can suggest liver disease. Other liver enzyme tests are ordered to determine exactly which type of liver disease.

Low albumin levels can reflect diseases in which the kidneys cannot prevent albumin from leaking from the blood into the urine and being lost. In this case, the amount of albumin (or protein) in the urine also may be measured. 

Low albumin levels can also be seen in inflammation, shock, and malnutrition.

Low albumin levels may also suggest conditions in which your body does not properly absorb and digest protein (like Crohn’s disease or sprue) or in which large volumes of protein are lost from the intestines.

High albumin levels usually reflect dehydration.

I stole some verbiage from the web but monocytes are a type of white blood cell that create an immune response to infected tissue. Monocytes are helpful in fighting severe infections and are considered the bodies second line of defense against infection and are the largest cells in the blood stream. Elevated levels are seen in tissue breakdown or chronic infections, carcinomas, leukemia (monocytic) or lymphomas. Low levels are indicative of a state of health. My uneducated assessment?  Your doctor doesn't seem too concerned about these levels but it seems like he's 'watching you' for some type of liver problem. He probably thinks that because of the elevated monocytes and the low albumin. Seems to me that you probably are just fighting off some type of infection. Been sick lately?  I would go for a second opinion though. See and endocrinologist.

 

Elevated levels are seen in tissue breakdown or chronic infections, carcinomas, leukemia (monocytic) or lymphomas.

It was high, not low.  It was 1025 (norm 200-950).  Not sure, could be why my immune system is so high atm??  Not sure.  We will have to ask our nurse! ha 

I do have a copy of it. My albumin was fine, it was 3.8

My AST and ALT was alright too, at 20 and 25.

Think I might live?lol I'm not sure what he was talking about, he's got me confused.

I know this results wasn't too bad, but I have to tell ya, this CRP thing really got me down. A baby asprin a day, come one, that's what my mom has to take for her heart condition. I hate heart issues, well chest issues PERIOD. Think I'm just mad at myself, and a little scared too. Too many chest issues going on at one time, I don't like it. Then with this sleep apnea idea, it just creeped me out today big time. Got to understand, I have panic problems, so when I thought of myself not breathing..even more problems than right now, I panicked. So this just sort of freaked me out today.

I'll get over it..gonna go turn on some hard metal or scream music on my ipod and put my frustration out on my bike. :) lol argghh!

Holly, this may not make you feel any better about it.. but I gotta say it... KNOWLEDGE IS POWER!  The more you know about what's going on in your body, the better off you are. This weight takes a toll on our bodies, and you've done well with getting that cholesterol in line... give yourself an "atta girl" for that! I'm glad you're going back in three months.. that's responsible.  My pcp has had me on a three month schedule for like 6 years now and YES, when I KNOW he's going to be looking.. I tend to work harder on it. I'm also glad he didn't give you a thumbs down on the SB.  His way worked good for him, and that's wonderful, but SB may be where you find YOUR groove.. and it's good to hear of a doctor who is openminded enough to accept that HIS way may not be what's best for you. Keep your head up girlie... you did well.. and don't worry about the aspirin thingie..  it's more of a precaution.. and yes.. with the added weight, we are at a higher risk for cardio issues.  I got ordered to do the aspirin thing when I hit like 240 (years ago).  it's a good thing.. :)  it's just going to thin your blood a bit.. let things run more smoothly. I have to give him kudos for suggesting you work on getting up to an hour a day of exercise.  That's sound advice for all of us.  What's really good is that he feels your health is good enough to handle it!  So that's another good thing. How can ya fight on the sleep apnea though.... either ya have it or ya don't and it'll wear your butt out.  Again.. something good... you're gonna do the SB thing and as you lose weight....you might start finding relief fairly quickly from that as well.  Has he suggested a sleep study?

This is the second time he's suggested that I have it.  I don't sleep well, but I told him that I don't know why I wake up.  I told him just because I "think" a lot.  Not only am I over weight, but he says I have a really small opening and to him this makes him believe I might have it.  I blew it off both times, and didn't really "think" about how I sleep.  I just don't want anymore issues.  One thing that I keep telling my husband about that I wanted to ask him but never have, and today I totally spaced it out.  But a lot of time when I sleep I have to sort of like stretch my body, like to get oxygen.  Sort of like yawning, but with your body.lol  I guess that would  stretching, but it's even past that.  Sometimes I feel like I have to be careful, like if I do it too much I'll go into a spasm.  Not sure if this is related or if it's allergies.  But other than that, I don't think I have it.  I think all of my life I've only caught myself gagging and woke me up once, and that was a couple of years ago.

Holly...  seriously... I'd get the sleep study done.  It's a very tiny piece of time out of your busy life to find out something very important.  We all know how important sleep is to our weight loss efforts.. that alone would be motivation for me.  I don't think a diagnosis is ADDING another issue... I think a proper diagnosis and treatment would probably help ELIMINATE some other issues.. no? Of course I can't convince you one way or the other.. the bottom line is that you have to do what makes you feel comfortable.. but sweetie... maybe the "answer" and "treatment" could give you some long overdue physical comfort.  You have such a hard time with allergies and your lungs....   I think this would be a very important study with the issues you are dealing with already. I REALLY hope you decide to do it.... this study could give you answers and help make you better.

Holly... First of all, I have to say that Chris certainly does know his stuff!  I have to admit that I haven't practiced in the realm of clinical medicine in a long time, so not on top of all these values and wht they mean.  I do know that the baby aspirin is something that's recommended these days for most people....just makes sense to thin the blood and have less danger of coagulation and arteriosclerosis.  With your mom's history, that is a given.  I actually take a whole aspirin every day (due to my periodic A-fib). I don't know what the absolute monocyte count is all about or how it differs from the plain monocyte count.  I do know it indicates bacterial infection sometimes and did see some reference to increased cardio risk. The CRP will be elevated in anyone who has the risk factors of being overweight, increased BP, high cholesterol etc.  My doctor doesn't even bother doing that test cause it's a given it would be elevated with me. Your lipid panel (cholesterol) looks really good!  I agree with Lori...have a sleep study done and find out once and for all if you have sleep apnea.  That can cause many other problems and with your lung issues, I think that test would be a given.  Does your hubby remark about you snoring at all?  Sleep apnea can actually lead to some cardiac problems.  I had a study done for my a-fib, but don't have it.  It's really not bad....just try to sleep all night in a strange bed with a zillion wires attached to your skull...lol.  No, honestly, I was able to sleep all night and didn't find it bad at all.....definitely worth looking into. I know you're concerned about all this, but look at it this way.....you are aware and informed and so is your doctor.  You are tackling the problem and starting on a journey of weight loss that's going to nip a lot of these problems in the bud!  Keeping on top of all this will prevent you from having the problems your mom has.  You can never be too informed.  Just keep doing what you're doing and have the doc keep an eye on your BP (what was it?) and blood work.  I'm hoping to wow mine in three months when I return. Don't lose sleep over all of this or stress out about it.  Now if you weren't seeing the doctor and not doing anything about your weight....then you'd have reason to worry.