Friday, August 8, 2008

Fi Fi Fo Fum...I smell the blood of a..........


I just had blood work done this week to try to figure out where I am with endocrine issues, my sinus issues, and health-wise overall. The term "human pincushion" is indelibly inked on my brain even if I forget what a pincushion is.

This time was easier than in the past. I drank a lot of water to keep my veins halfway plump, and I wore a jacket over my long sleeves even if it was in the 80's outside. I wasn't hot. I seldom get hot. I often get aggravatingly cold in air-conditioned places.

I go to my local lab because I like the lab techs there. My endo prefers Labcorp or Esoterix for multiple reasons, but my local lab will draw the blood and send it to Labcorp for me if I ask them to. I have my reasons and it all has to do with 1) the quality of the blood draws and 2) the way I'm treated, in that order.

My local lab folks know to put the purple-topped tubes on ice, and they put them in a finger of a glove before doing that so no water will contaminate them. They know to collect the ACTH and renin in the purple-topped tubes, and they know to spin and freeze them immediately. Do you know how may labs I've been to in my Cushie journey who did not know that? Me, neither. Too many to count, though.

These same dear people admit when they've made a mistake. Unlike some unnamed labs with the initials L-A-...oh wait...guess I'd better stop there. And they cry when they have to stick me umpteen times. Prior to surgery, it got to be a marathon at times. No one was allowed to stick me more than twice. Hot towels and drawing straws were a given when I came in. The towels for my arms. The straws for who had to go first. No joke. So many times they wanted to stop, but I had to have the blood work, so I encouraged them to go onward.

I don't remember the longest marathon. I remember the most emotional one. I was fine until one of the dear ladies had tears pouring down her face watching the fourth person attempt the 8th (and final) stick. I'm a sucker for tears. She couldn't cry alone. So I cried, too.

It's like one of those vignette moments. Those two faces are forever etched on my memory in sepia tones with edges clouded, close up,and soft, tears prominent on their cheeks and caring in their eyes. I don't remember their names. But I sure do remember their faces and their touch.

This blood draw proved to be much easier, thankfully. I only had 9 tubes this time, too. My tech not only made sure she had the proper tubes, but she made sure she had the right sequence and the right number of tubes so they'd have enough blood to do all the testing. I did say I had beaucoups of tests done, didn't I? Then she called her supervisor in to double-check it all. Love 'em....they were backed up, too, with oodles of folks waiting right outside.

We only had one small glitch. Well, maybe two. 1) The lady tech wanted me to clench my fist and pump it. Since I'm hypokalemic, and that can cause a false elevation of serum potassium levels, I simply told her I'd rather not and why. She understood immediately, thankfully. 2) She got the needle in, could feel the vein, but couldn't get it to slide right on in the vein. Since she knows me well enough to know how my veins do, rather than pull it out and start over, she called her supervisor in, again. (I mean she Supervisor came in, wiggled that sucker just a little and phew...blood. She got it. So, only one stick!

We were done in minutes. My vein didn't collapse which is another post-surgery victory! She hugged me 'bye and I told all the other techs 'bye, too. Oh, I forgot the best part!!!! I could fit in the regular chair, not the "big" chair and put the arm down on it!! Now, that's victory! My gut always got in the way before.

My endo believes in partnering with his patients, and he wants us to get our lab results back just as quickly as he gets them. Thus he always tries to release them to the patient, too. I can also sign a waiver and get mine anyway. Most of mine were faxed to me yesterday, with one today. I still have my IGF-1, Vitamin D levels, and testosterone levels pending.

Here's the kicker. My cortisol was only 6.9 ug/dL and my ACTH was only 7 pg/mL. That's not very high. Since I've weaned down to 5 mg of hydrocortisone a day, but have been having problems, that may be why. I was on 20 mg a.m./5 mg p.m. post-surgery. I made next to no ACTH or cortisol of my own for months. It's been a bear weaning, but now I wonder if I'll ever be totally off of it. 20 months out from surgery....sigh. I want so badly to be rid of the stuff.

Other blood work was a bit iffy. It's obvious with my manual differential I've been fighting infection. My ferritin has increased to a whole 35. 9ng/mL which is very low, still. But it did go up. Free T3 and free T4 (thyroid hormones) were mid-range. They had gone down a bit, but I know that can vary daily. My anti-TPO was up again, though, way above normal. Ugh. It never was high until after surgery. My high cortisol kept it under control. Go figure.

Estradiol is very low as are all my "female hormones". Potassium was borderline at 3.5 mmol/L. Since I take potassium supplements, the question is WHY?

I'm anxious to see if the genotropin has increased my IGF-1 at all. I hope I get that result soon.

All-in-all, it looks pretty good. My levels are so much better than they were. I feel so much better than I did. I can't complain.

Anyone up for watching Nosferatu? Bring your own popcorn. I don't have any!

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