[emmtee]

#1058757

I know each treatment option has its pros and cons, and some carry more weight for different people. I was going back and forth, changing my mind every day until it finally became clear that the issue that carries the most weight for me is speed. I could deal with any of the other cons, but it’s important for me to get euthyroid as quickly as possible. I have an abdominal abscess that is over 6 months old and hasn’t finished healing. As long as I’m still hyper, I don’t think it ever will.

I had an appointment with the general surgeon (for my abscess) last week, and told him I was considering a thyroidectomy. He recommeded another surgeon who does a lot of them. Later, I googled the throat surgeon’s name and he seems to be well liked by his patients. I called his office to see how soon they’re scheduling surgeries. (I was thinking that if it couldn’t be scheduled for a few months, it wouldn’t have any time advantage over RAI.) The nurse said they can often schedule surgeries just 2 weeks out. I also confirmed that they take my insurance.

So this morning I told my endo that I wanted the thyroidectomy. She had left the decision up to me, and she’s kind of hard to read, so I’m not sure if she completely approves or not. She said surgery isn’t the conventional treatment, but it’s a valid one. She is submitting a request to the insurance company to refer me to the surgeon. I’m supposed to call in a couple of days to see if I have the okay to make an appointment for a consultation. In the meantime, she gave me a prescription for methimazole and a lab order to get my blood tested in 3-4 weeks. She also wrote a prescription for iodine drops, but said not to fill it until the surgery is scheduled.

Here’s the part where I have questions (and I will call my endo tomorrow, but I don’t think she’s back in the office until Thursday.) When she gave me my prescription, I thought she said to take 20 mg twice a day. When I picked up the prescription this evening, the instructions were to take two 10 mg tablets once a day. I asked the pharmacist to confirm, and she said that’s what was ordered. I asked her if I should take the tablets 12 hours apart, and she said that I could take them both at the same time. I looked online, and read that the daily dose is usually spread out evenly throughout the day. What do you think I should do while I’m waiting to hear back from my endo? I just took one tablet tonight and I’ll take another in the morning. It’s no problem for me to take it twice a day because I already take my metoprolol twice a day and the pharmacist said I could take them together.

[Bobbi]

#1169824

You did the right thing by checking with the pharmacist. If the pharmacist checked the Rx, as I assume he/she did, then you are good to go with that dose. I don’t know if it makes any difference whether you take them separated by twelve hours or not. If you were taking PTU, it would make a difference. Methimazole often gets taken only once a day. If you are certain that you heard your doctor say "twice a day" then separate them, until you can talk with the doctor. But I don’t think you should take more than the pharmacist indicated on the Rx bottle until you talk with the doctor, or with someone in your doctor’s office who can check your file and see what the doctor actually wrote. The one thing you should not rely on is your memory of what was said. Memory gets mangled at times, especially when we are taking in lots of info all at once, or are under stress (as you are, coming to this decision). We all think our memories are carved in stone, when in reality they are more like granules suspended in a liquid.

[snelsen]

#1169825

Well, 20 mgm twlce a day (what the endo might have said) is a lot different than two 10 mgm once a day! Frustrating that the endo is not there until Thursday. You could, in the meantime, call the endo office, as the nurse to read your chart, see what she wrote. And,t here should be a copy of that RX in your chart. And, I alway have a high index of suspicion with the possibility that there has been a mistake or miscommunication made somewhere along the way, and that does not rule out the pharmacy. So you could bird dog that whole process, too. Was the RX called in? Or, did you take the RX in and hand it to the pharmacy? In either case, you can call the pharmacy, ask them to look at the original rX, and/or in the computer, just to double check that part of the process. I imagine when you were handed the RX, you were told to do what the bottle said. But, there is always a possibility that it got processed incorrectly. i am mostly suggesting this, because because it is frustrating to have to wait until THursday! You’ve done all that you can to get the right info, so I guess your only choice is to check it out as much as you can again between today and Thursday. From what I can read, the frequency of the medication varies with the amount of the dose, ie the bigger the dose, it is more likely to be given twice a day, the smaller the dose, once a day. But, as you know,a nd as Bobbi said, you’ll just have to find out this info so you can move on with taking the med! How frustrating.

Also, be sure the communication is up so that you hear about the Medicaid acceptance asap. Does that info go directly to the surgeon’s office, or does it go to the endo’s office. I know how much you are looking forward to getting everything scheduled, and moving on with your life! And we are more highly motivated to get this info than the people who work in the office, who will get around to calling you when it comes to the top of the pile of stuff they have to do! (: I hope you get all this scheduled very soon.
shirley

[emmtee]

#1169826

Until I hear otherwise, I’m definitely not taking more than the prescription says. I’m just dividing it into two doses. I did receive the prescription from the doctor and I remember seeing "20 mg" but I don’t know the pharmacy abbreviations, so I couldn’t tell from reading it what the directions were. When I handed it to the pharmacy clerk, she noted that it was 20 mg, but that the tablets only come in 5 and 10 mg. Now that I’m going over it in my head, I remember that she couldn’t tell me the price until it was submitted to the insurance company, but she gave me the cash price and it was 40-something $, which is about double the price that was quoted to me for 30 tablets when I called last week to get the pricing of methimazole vs. levothyroxine. So if the clerk quoted me the price for 60 tablets, that would be 2 per day, and that would mean I’m taking the right amount and the real question is whether or not I need to divide it into 2 doses.

I was up so late last night that I overslept today and didn’t call. I’ll call tomorrow and maybe they’ll have an answer about the referral as well.

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