# back to work -- part time



## gelf

had my tt Friday as well as the breast mastectomy. tired but sitting at my desk clearing out my emails and getting a little bit of work done. I feel better sitting up than laying down in the bed.

I at a lot of orange kool aid jello at the hospital and chocked down the regular trays they brought me. sucked a lot of of ice and drank several juices. too the pain shot whenever they offered it. they released me at noon on Saturday.

my left arm looks like a war zone. I couldn't hold an iv and even the last one the needle was bent when they removed it. the one vein was blown and I've a nasty bruise.

compression bra is ok. the gauze keeps slipping. been keeping track of my j-p pump levels.

post surgery on 122 synthroid (lovely bright pink pills) and .25 calcitriol. calling today for follow up appointments and to get pathology reports.


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## gelf

112 not 122, darn fingers


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## gelf

most of my pain has not been with the thyroid scar nor the mastectomy scar. its been halfway between on the chest wall and some below. i'm slowing working on getting my arm and shoulder rehabbed by the arm walking the wall methods and a few other gentle exercises


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## DustingMyselfOff

You are back at work 3 days after a TT and mastectomy??????? Oh my word - I feel like such a wimp! Are you (hopefully) working from your home office at least????

God Bless You! But what's the rush?
Sue


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## gelf

nope, at the office. sitting up feels so much better than laying down. and its only 2-3 hours a day.


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## gelf

I work at a major university. it is near the end of the summer semester and getting ready for the fall semester. my co workers are not trained on parts of my job and my boss is not ready to handle my work on top of her's so I come in, do a little, and go back home to the couch.


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## Velcro

Bless your heart. I'm glad you are doing well but be careful not to overdo it.


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## Andros

gelf said:


> had my tt Friday as well as the breast mastectomy. tired but sitting at my desk clearing out my emails and getting a little bit of work done. I feel better sitting up than laying down in the bed.
> 
> I at a lot of orange kool aid jello at the hospital and chocked down the regular trays they brought me. sucked a lot of of ice and drank several juices. too the pain shot whenever they offered it. they released me at noon on Saturday.
> 
> my left arm looks like a war zone. I couldn't hold an iv and even the last one the needle was bent when they removed it. the one vein was blown and I've a nasty bruise.
> 
> compression bra is ok. the gauze keeps slipping. been keeping track of my j-p pump levels.
> 
> post surgery on 122 synthroid (lovely bright pink pills) and .25 calcitriol. calling today for follow up appointments and to get pathology reports.


There is no question but what you are the "bomb!" I want you on my team of positive thinkers with a high level of determination.

You truly are a special woman.


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## gelf

my exact instructions were: resume activities as tolerated. i'm tolerating light work, so i'm doing it. i'd be stir crazy at home!
I even did a light workout last night and I'm walking around campus for some more exercise. during commercials while watching tv, I stand up and do my fingers walking up the walk exercise to work on the breast site and shoulder flexibility. it might not seem like much but over the course of 3 hours, that about 15 minutes of stretching.
my neck flexibility is slower to return, but I know it will. 
i'm still eating a lot of jello and drinking my boost since there is still some swallowing difficulties. lunch yesterday was 1/2 plate of spaghetti, 1/2 bowl of bowtie pastas with cream of mushroom sauce and chicken, 1/2 piece of garlic bread. (hubby ate the rest!)


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## gelf

FINAL PATHOLOGY
4 sentinel lymph nodes -- all negative for malignancy
2 non-sentinel lymph nodes -- ""

Breast -- DCIS involves approximately 4 of 15 blocks
Archetectural pattern: cribriform and solid
Nuclear grade: intermediate
necrosis: rare comedonecrosis
margins: widely free of DCIS

previous procedure site changes: fat necrosis, stromal fibrosis, foreign body giant cell reaction

ancilliary studies: estrogen receptor 95%, progesteterone reception 50%

Pathologic Tumor stage: pTis(DCIS) pNo(I-)

Left THyroid -- benign thyroid with no significant histopatholic abnormalities
Right Thyroid -- hurthle cell adenoma


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## gelf

question for any one:

My ENDO insists that I don't need the initial RAI scan after this thyroidectomy because "it did not come back as a cancer. I can regulate it with medication and blood levels."

should I get a 2nd opinion on this?
Personally I'd feel better getting it because of the high risk that I grow it back (I grew back tonsils and adenoids!) and the fact that it was all but cancer.


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## gelf

argh, when it rains it pours
another uti, so 3rd round of antibiotics since surgery
and I keep getting blisters along the mastectomy incision site. ugly things.
I've called the dr and he wants me to keep them covered and use antibiotic cream/ointment on them until my return visit on Tuesday.

i'm so depressed.


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## jenny v

Honestly, the recurring uti doesn't totally surprise me. Your body has been through a major amount of trauma and that makes it difficult for your system to fully fight off an infection. Hopefully, they are keeping you on this latest antibiotic for a good long while (like 10 days)?

Hang in there! At this point next year, this will all be a distant blip on your radar.


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## Andros

gelf said:


> argh, when it rains it pours
> another uti, so 3rd round of antibiotics since surgery
> and I keep getting blisters along the mastectomy incision site. ugly things.
> I've called the dr and he wants me to keep them covered and use antibiotic cream/ointment on them until my return visit on Tuesday.
> 
> i'm so depressed.


Did they not do a culture re the UTI? And the blisters; is it staph do you think? LHM!! This is such a worry; it has been a very very hard road for you!

GELF; soon you will be kicking up your heels. This is a really down time but believe me; good times are straight ahead.

The pendulum always swings in the opposite direction. We'll give it a push!!


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## gelf

Manuel Urinalysis with scope results

Color Ur YELLOW 
Clarity, UA SLCLOUDY Clear 
Sp Gr Ur Strip 1.010 1.010-1.030 
pH, UA 6.0 5.0 - 8.0 
Protein, UA NEGATIVE Negative 
Glucose Ur Ql Strip NEGATIVE Negative 
Ketones, UA NEGATIVE Negative 
Bilirubin, UA NEGATIVE Negative 
RBC, UA 2+ Negative 
Urobilinogen, Ur 0.2 0.0-1.0 EU/DL 
Nitrite Ur Ql Strip NEGATIVE Negative 
Leukocytes, UA 2+ Negative 
WBC #/area UrnS HPF 11-20 0 - 5 
RBC #/area UrnS HPF 6-10 0 - 5 
Epi Cells #/area UrnS HPF Moderate 
Bacteria UrnS Ql Micro Moderate None Seen 
WBC clumps #/area UrnS HPF Present None Seen


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## gelf

i've finished my antibiotics late last week. still having bladder cramps and now the diarrhea cramps secondary to the antibiotics. (sorry, tmi I know). my scar and neck sometimes feel thick and swollen. I get the ice pack out then or massage the scar like my OT showed me.

My mastectomy scar is another story. I've started sleeping on my side (yay!) but now the scar is getting very hard and not just the bias of the cut. it's about 1" thick with the hardness. and pain! I was hoping to be away from the Percocet, but I can't go more than 5 hours now without grabbing one. (well it used to be 3 hours, so its a little improvement). I see the OT today and hopefully she'll say I'm ready for a real bra again (its been the sport cami/vest/compression thingy they put on me after surgery). I see the regular surgeon tomorrow morning on my weekly visit and then after that, a different plastic surgeon for reconstruction option 2. Option one is off the books for now. my arm hurts too much to consider getting my back cut open and jerking big hunks of muscle around to the front. I want the liposuction/grafting method. More treatment days, but less invasive means. No major hospital stay either. All should be able to be done at outpatient surgery site instead of hospital.


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## Octavia

That Option 2 does seem a bit better than Option 1. And I hope they can address the hardening tissue for you.

:hugs:


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## gelf

went last week to the endo and she ordered tsh and calcium. had the blood drawn and waited for the results. by friday, only the calcium came back (9.6 on the 9.0-12 scale). i left a message about the tsh. they finally called back late Monday to tell me that the lab screwed up and couldn't do the tsh, and i'm to drop by at my earliest convenience to get it drawn. razzenfruten!


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## gelf

Standard Range Free T4 0.93-1.70 ng/dL
Pre-surgery:
4/25/2013 1.38

7/2/2013 1.35

Post-Surgery:
8/12/2013 1.10

9/24/2013 1.17

Standard Range TSH 0.27-4.20 uIU/mL

Post-Surgery

8/12/2013 9.94

9/24/2013 7.95

dr changing me to 137 mg


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## Octavia

That's good.


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## Andros

gelf said:


> Standard Range Free T4 0.93-1.70 ng/dL
> Pre-surgery:
> 4/25/2013 1.38
> 
> 7/2/2013 1.35
> 
> Post-Surgery:
> 8/12/2013 1.10
> 
> 9/24/2013 1.17
> 
> Standard Range TSH 0.27-4.20 uIU/mL
> 
> Post-Surgery
> 
> 8/12/2013 9.94
> 
> 9/24/2013 7.95
> 
> dr changing me to 137 mg


Wow! TSH really up there! Does your doc ever run your FREE T3?

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/health-medicine/understanding-thyroid-why-you-should-check-your-free-t3


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## gelf

i figure i'll be at the 175-200 mg range when we're done titrating the tsh down from the surgery. maybe the next step up even. i'll see if they'll do a t3.

they kept insisting on the calcium levels but mine when very low or very high.


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## Andros

gelf said:


> i figure i'll be at the 175-200 mg range when we're done titrating the tsh down from the surgery. maybe the next step up even. i'll see if they'll do a t3.
> 
> they kept insisting on the calcium levels but mine when very low or very high.


FREE T3

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/health-medicine/understanding-thyroid-why-you-should-check-your-free-t3


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## gelf

Component Standard Range 7/2/2013 11/11/2013

T3, Free 2.3-4.2 pg/mL 3.4 2.6

Component Standard Range 4/25/2013 7/2/2013 8/12/2013 9/24/2013 11/11/2013

Free T4 0.93-1.70 ng/dL 1.38 1.35 1.10 1.17 1.42

Component Standard Range 8/12/2013 9/24/2013 11/11/2013 (post surgery values)
TSH 0.27-4.20 uIU/mL 9.94 7.95 5.73

Component Standard Range 9/6/2012 4/25/2013 7/2/2013 (Pre surgery values)

TSH 0.45-5.50 mIU/mL 1.18 1.69 2.48

****

Component Your Value Standard Range Units

Glucose 123 (<100 mg/dL )

BUN 14 (6 - 22 mg/dL )

Creatinine, Ser 1.02 (0.50 - 1.20 mg/dL)

Calcium 9.4 (8.4 - 10.5 mg/dL)

Sodium 139 (134 - 146 meq/L)

Chloride 100.0 (98.0 - 111.0 meq/dL)

Potassium 4.0 (3.6 - 5.3 meq/L)

CO2 29 (20 - 34 meq/L)

EGFR 58

Component Standard Range 9/6/2012 1/8/2013 4/25/2013 7/22/2013 11/4/2013

Creatinine, Ser 0.50-1.20 mg/dL 0.91 0.90 0.99 0.90 1.02

BUN 6-22 mg/dL 12 19 21 16 14

EGFR 66 67 60 67 58

I saw my urologist last week because of the 58 egfr and also I had creatinine and microalbumin in my urine. he didn't think much of it, even after I described my past problems with my kidney. but he did order a mag3 renal exam that I did yesterday. the results were not good. my left kidney is almost 3x the volume of my right kidney. and the functioning is 91 vs 9 again. I don't want another surgery 

thyroid going a little better. finally transisited to 137 mg synthroid last week. I was happy the tsh dropped in spite of me not changing to 137 the last time. the endocrinologist doesn't want to add cytomel yet but she is also pulling back on the monitoring to every 3 months instead of every 6 weeks. too fast too quick of steps the other way.


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## gelf

I had the mag-3 done for my kidney functioning. Right kidney is back at 9%, left at 91%. This urologist doesn't want to do anything with it. At least he finally signed the referral to the renal clinic for a Nephrologist. I really don't want to have another surgery any time soon. The urologist said point blank "you have a dead kidney and there is nothing to revive it."

in the meantime, i'm finally getting the appointment to get my colon checked out. with 3, no 4 doctors urging me to get it checked out soon (medical oncologist, radiation oncologist, surgeon and internal medicine dr). I think even the endo said to. so I have an appointment on Dec 30 for a "consult".

Tired many days. Peeing a lot!!! and its cold so I'm trying to keep my kidney from getting infected again. We think the kidney infections after my surgery made it that much worse.


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## jenny v

Yuck, that's not good news to hear. Will they remove the dead kidney or just leave it in there? Is your left kidney picking up the slack for the right one?


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## gelf

so far the left one is. the right one is still functioning at the very low rate of 9% and I dont' seem to have a blockage this time around. urologist doesn't think its cancer or sarcoidosis. (he first almost blew me off by not believing me that they had removed a polyp and I had a 15 lb mass of scar tissue blocking the ureter). I won't be going back to him until I see the nephrologist.


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## gelf

hey all, just checking in. had my 3 month checkup on my thyroid levels.

*TSH (.27-4.2 ulU/mL)*

9/6/12 1.18

4/25/13 1.69

7/2/13 2.48

8/12/13 9.94 (post TT)

9/24/13 7.95

11/11/13 5.73

2/5/14 5.78

*T4 Free (0.93-1.70 ng/dL)*

4/25/13 1.38

7/2/13 1.35

8/12/13 1.10 (post TT)

9/24/13 1.17

11/11/13 1.42

2/5/14 1.34

*T3 total (0.80 -2.00)*

4/25/13 152

2/5/14 1.14

*T3 Free (2.3- 4.2 pg/mL)*

7/2/13 3.4

11/11/13 2.6

2/5/14 2.7

She's moving from 137 mg to 150 mg. I hope I don't have the reaction that I did from 125 to 137, but I really need the increase. My night sweats have been horrible again and I'm easily irritated. I looked at the dr and told her flatly that I could tell that I needed the higher dosage. She thought from what I was telling her that my dosage was too high. but my blood work said otherwise. I also gained about 14 lbs....grrr. just what i needed to also deal with. my colonoscopy was postponed last month because of the horrible weather around here (they can't drive when its snowing or sleeting around here!). i go for that on the 25th.


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## gelf

Colonoscopy went alright. Prep was a nightmare. For those of you with artificial sugar problems, don't ever let them prescribe Suprep -- it contains sucrolose. I can't stand the flavor of Sucrolose.

Findings of the Colonoscopy: Moderate diverticulosis was found with no evidence of associated inflammation, stricturing or bleeding throughout the colon. the remainder of colon and rectum were otherwise normal. The terminal ileum was unremarkable.

I'm to return in 5 years for a followup.


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## gelf

4 days to my 1 year anniversary of my surgery !!!!

latest test results 2/5/14 6/6/14

Free T3 (2.3-4.2 pg/ml) 2.7 2.4

Total T3 (0.8-2.0 ng/ml) 1.14 1.07

Free T4 (0.93-1.7 ng/ml) 1.34 1.30

TSH (.27-4.2 ulU/ml) 5.78 3.72

vit d 25 hydroxy n/a 30.8

She did not raise my levothyroixine, so I'm still on 150 mg

pulmonary dr had me do an overnight O2 test --- I had 127 episodes where my O2 levesl dropped 4 or more % -- he wants me to do a sleep study. hubby doesn't want me to do it until my kidney is more staable (had high uric acid in may 10.2 now 8.2 -- need to get below 6.0 but its getting there -- and i feel much better)

bad news, sort of, looks like i've been perimenopausal for several months. my fSH levels was a 35.2 (1.2 -21.0 scale)  no estrogren because of the breast cancer.   

arty0045: One Year Anniversary July 26

:sick0012: menopausal

hugs4 uric acid levels dropping!!!


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## gelf

i know. too long since my last visit.

had to change both my endo and rheumatologist in the past few months as they left the clinic i go to.

uric acid still high 8.2 still -- so they are moving me to 300 mg allopurinol

thyroid tests!!!!

tsh 1.38 (.27-4.2 uIU/mL) ==== finally back in the range i was before my thyroid was taken out -- been on 175 levothyroxine since Oct 14 (7.54 at that time)

T4free 1.65 (.93-1.70 ng/dL)

still dealing with scar tissue from the appendectomy. wearing an abdominal belt at times. some days better than others.


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## gelf

micro urinalysis

Component

Standard Range

Your Value

Color Ur

Yellow

Clarity, UA

Clear

Cloudy

Specific Gravity

1.010-1.030

1.010

pH, UA

5.0 - 8.0

7.0

Protein, UA

Negative

Negative

Glucose Ur

Negative

Negative

Ketones, UA

Negative

Negative

Bilirubin, UA

Negative

Negative

RBC, UA

Negative

Negative

Urobilinogen, Ur

0.0-1.0 EU/DL

0.2

Nitrite Ur

Negative

Positive

Leukocyte Esterase, UA

Negative

1+

WBC

0 - 5

11-20

RBC

0 - 5

0-2

Epi Cells #/area UrnS HPF

Few

Bacteria UrnS Ql Micro

None Seen

Moderate


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## gelf

microalbunin

Component

Standard Range

Your Value

Creatinine, Ur

114.0

Microalb Creat Ratio

0.0 - 18.0 mcg/mgcr

35.4 H


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## gelf

LDL Direct

60 - 135 mg/dL

135


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## gelf

Glucose

<100 mg/dL

169

BUN

6 - 22 mg/dL

12

Creatinine, Ser

0.50 - 1.20 mg/dL

0.91

Total Bilirubin

0.2 - 1.1 mg/dL

0.4

Alkaline Phosphatase

42 - 121 IU/L

82

AST

10 - 42 IU/L

15

ALT

10 - 60 IU/L

16

Calcium

8.4 - 10.5 mg/dL

9.4

Sodium

134 - 146 meq/L

137

Potassium

3.6 - 5.3 meq/L

3.8

Chloride

98.0 - 111.0 meq/dL

99.0

CO2 Total

20 - 34 meq/L

28

Total Protein

6.1 - 8.5 g/dL

6.7

Albumin, Ser

3.2 - 5.5 g/dL

4.0

eGFR NON-AFR. AMERICAN

 

66


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## gelf

WBC

4.0 - 11.0 K/uL

9.4

RBC

4.20 - 5.40 M/uL

4.57

Hemoglobin

12.0 - 16.0 g/dL

13.8

Hematocrit

37.0 - 47.0 %

40.2

MCV

80.0 - 100.0 fL

87.9

MCH, POC

27.0 - 31.0 pg

30.2

MCHC

31.0 - 37.0 g/dL

34.4

RDW

11.6 - 14.8 %

15.5 H

Platelets

150 - 450 K/uL

256

Neutrophils

37.0 - 80.0 %

67.6

Lymphs

10.0 - 50.0 %

21.6

Monocytes

0.0 - 15.0 %

7.6

Eos

0.0 - 7.0 %

2.5

Basos

0.0 - 5.0 %

0.8

Neutrophils Absolute

2.0 - 8.0 10^3/uL

6.4

Lymphocytes Absolute

0.6 - 3.8 10^3/uL

2.0

Monocytes Absolute

0.0 - 1.5 10^3/uL

0.7

Eosinophils Absolute

0.0 - 0.7 10^3/uL

0.2

Basophils Absolute

0.0 - 0.2 10^3/uL

0.1

Nucleated RBC

 

0.1


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## gelf

Hemoglobin A1C

4.2 - 5.8 %

8.1

Note:

 

Effective 4/10/15, A1C testing will be performed on new instrumentation using the same methodology.

EAG (mg/dl)

 

183.73


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## gelf

TSH

0.27 - 4.20 uIU/mL

1.38

Free T4

0.93 - 1.70 ng/dL

1.65

Glucose

<100 mg/dL

200

BUN

6 - 22 mg/dL

15

Creatinine, Ser

0.50 - 1.20 mg/dL

0.91

Calcium

8.4 - 10.5 mg/dL

9.8

Sodium

134 - 146 meq/L

137

Chloride

98.0 - 111.0 meq/dL

97.0

Potassium

3.6 - 5.3 meq/L

3.4

Note:

SLIGHT HEMOLYSIS

CO2 Total

20 - 34 meq/L

29

eGFR NON-AFR. AMERICAN

66

Uric Acid

2.2 - 7.2 mg/dL

8.2

these were done 4/1/2015

the ones above were done 6/4/2015


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## gelf

some lab work done last week:

Glucose (<100 mg/dl) 150

BUN (6-22 mg/dL) 19

Creatine, Ser (0.5-1.2 mg/dl) 0.93

Calcium (8.4 -10.5 mg/dl) 9.6

Sodium (134-146 meq/L) 138

Chloride (98-111 meq/L) 99

potassium (3.6-5.3 meq/L) 3.7

CO2 Total (20-34 meq/L) 27

eGFR 64

Uric Acid (2.2-7.2 mg/dL) 6.4 (Yay -- it was 8.2 last time)

TSH (0.27-4.2 uIU/mL) 5.11 (  it was 1.38 last time)

Free T4 (0.93-1.70 ng/dL) 1.67

I'm stil waiting on the A1C, Free T3, Liver and Cholesterol panel and a couple of otehr tests. They annoyed me because they did not have all the tests ordered and I had to badger them to get the correct tests


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## Octavia

Interesting. I'm guessing you are low in Free T3. By any chance, are you still waiting for those results, or did they not test that?


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## gelf

they did them, just did not put the results up. now i have them.

LDL direct (60-135mg/dL) 107

Lipid panel

Total Choles (140-200 mg/dL) 225

Trig (35-150 mg/dl) 533 ( I can't take statins, so its diet controlled)

HDL Chol (>50mg/dL) 34

Risk (0.00 - 4.45) 6.62

Non HDL Chol 191

Total Bilirubin (0.2-1.1 mg/dL) .3

Alk Phosphatase (42-121 IU/L) 78

AST (10-42 IU/L) 15

ALT (10-60 IU/L) 13

Total Protein (6.1-8.5 g/dL) 6.9

Ser Albumin (3.2-5.5 g/dL) 4.0

Hemoglobin A1C 7.3 (last time was 8.1!!!!!!)

Free T3 (2.3-4.2 pg/mL) 2.7 (last time was 2.4)


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## gelf

Hi Everybody! Its's been awhile since i've posted here. Parts of my life have been good, some could be better. I developed a very large hernia after a ruptured appendicitis in 2015, so i've been trying to get my labs to where I can safely endure a big operation. 

my latest labs: 6/7/17

Microalbumin Random Urine

Creatine, Ur 84 mg/dl

Microalb Crea Ratio 159.0 (range 0.0 - 30.0)

* I need to consult my urologist on this too.

Vitamin D (have been on weekly 50,000IU for 8 weeks now, 16 weeks to go -- 6 months total)

38.1 (Yay == was 22 nine weeks ago)

LIPID panel

Total Cholesterol (140-200 mg/dl) 229 (which is very good for me -- as long as I stay under 250 with it!)

HDL Cholesterol (>50mg/dl) 34 (I've been steady at 34 or 35 for about 2 years now)

Risk (0.00 - 4.45) 6.74 (I've been around 6 for the past 2 years)

Non HDL Cholesterol 195 (the highest it has been for the past 2 years)

Triglycerides (35-150) 797 (I think I've been loosing weight, and I've ate a lot of peanuts lately)

Hemoglobin A1C (4.2 - 5.8) 7.7 ( sad, but I've switched insulins and the sugars have been running high) (Last time I was 6.8)

TSH (0.27 - 4.20) 1.35 !!!! (he switched me to 225 3 months ago)

Free T4 (0.93 - 1.7) 1.81 (last one was 1.49)


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