Yesterday brought another slew of blood tests – just what I wanted for Boxing Day! Ye olde V58.69 – long-term use of medications – is the prescription code for “any and all tests I want to run.”
My last comprehensive panels were about a year ago, just after the bipolar diagnosis. Last time I had endocrine levels done was just the start of the “lumpy gonads” shebang (thanks to the Amazing Sara Lomas for that phrase!)
This time I had a whopping 17 tests:
- CBC diff (complete blood count with differential)
- CMP (complete metabolic panel)
- T3 T4 TSH (thyroid levels)
- Lipid panel (cholesterol levels)
- HgAiC (blood glucose)
- Dhea sulfate (endocrines – same for the next 5)
- Testosterone: free, total
- Folate (folic acid)
- Lamotrigine levels (minding the dosage)
- LFTs (hepatic function)
- 25 OHViTD (total Vitamin D)
- VB12 (Vitamin B-12)
A metabolic/lipids panel has to be a fasting draw, and they can’t split up the “prescription” for tests. My body hates fasting draws; my blood sugar is low, I’m uncaffeinated and cranky, and vasovagal syncope – fainting – is practically guaranteed.
Miraculously, however, I stumbled onto the best phlebotomist ever! She did the cleanest, quickest, most painless draw I’ve had in years. It sounds kinda sad, but I’m more excited to find an awesome phlebotomist than I would be to find a great stylist. And boy, could I use a good stylist…
Anyway, the Amazing Phlebotomist drew 3 large and 3 small vials – the most I’ve ever had done at one time – and I didn’t pass out! I think part of it was the Amazing Phlebotomist, and part was having taken Ativan beforehand. I’m much less likely to have a panic attack when my blood serum levels of lorazepam are just peaking.
Some of those 17 tests are standard ongoing monitoring, like verifying that my liver is still working alright and critical vitamin levels are OK. But the rest is taking a closer look at reproductive hormones.
Therein lies the Insidious Grain of Hope.
At a recent 4-month checkup on polycystic ovaries, there had been no improvement in the large cysts from hormonal birth control, so the GYN just had me go off it entirely. My PNP was puzzled about that – the pill had substantially improved cramps and acne (clearly suggesting hyperandrogenism associated with PCOS) so it would have made sense to try a different pill that might work better. Personally, I think the GYN doesn’t want to be bothered to dig any deeper. She probably thinks I’m just crazy.
The PNP, however, seems pretty convinced that PCOS may be one of the root issues. I can’t help but agree. What I can’t guess is whether it’s PCOS and bipolar, or just PCOS. After 7 months trying to get that question resolved, I’d guess “both” but who knows? The hormone levels from these tests will likely get me referred to a reproductive endocrinologist.
In the meantime, this is-it-isn’t-it thing is driving me up the wall. How can I accept and deal with these problems if even the doctor hasn’t fully bought into the diagnosis? At the same time, I just can’t ignore the possibility that it may be entirely hormonal (with a little neuroticism.) Although I’ve struggled with acceptance all along and this is just making it harder, it seems we’re keeping that insidious little grain of hope alive for awhile longer.