[Naisly August 2, 2012 at 9:21 am Post count: 143]

#1059249

Does anyone have an idea how long one can stay on beta-blockers before treatment begins? The reason I ask is, seems I won’t get to see an endo for 6+ months.

Thanks

~Naisly

[Carito71 August 2, 2012 at 11:31 am Post count: 333]

#1173349

Hello Naisly,

6 months is a long time to wait to see the Endo. Can your primary Dr. see if she/he can get you in sooner? Or perhaps prescribe the medication for the thyroid? Primary Dr.’s know about thyroid medications as well. Or, you can try seeing an ENT (Ear Nose Throat Dr)?

I was on the beta blocker a week before seeing an Endo. I called around to see when I could see an Endo when I wanted to change the Endo I was seeing but they were wanting to schedule me 4 months out. Fortunatelly, when I really needed it, the ER Dr. who saw me called the Endo’s office and the Endo, who later on I was wanting to change and who prescribed Methimazole, saw me a week later. I since then changed Endo Drs. but I did this already taking the Methimazole.

The Methimazole took a while to work so in my personal opinion, the sooner you get treated the better … Unless, your case is not GD. There are times when the thyroid gets inflamed and spills over the hormones and that is what makes one hyper. In that scenario it is not the thyroid that is producing more than needed hormone and therefore one does not need thyroid treatment. In that scenario one is prescribed only a beta blocker. You do have GD, right?

Caro

[Jules August 2, 2012 at 11:52 am Post count: 85]

#1173350

After they found out I was allergic to MMI and PTU I was on beta blockers for 3 months. By then my numbers were off the charts and I was begging for RAI. (I wanted surgery but that was not an option for me).

I suggest you contact the primary and see about getting a stat appointment with the endo or ask to see if they can prescribe and check blood work every 4 weeks until the endo appointment. Or go to a new primary that will treat you and get you a stat appointment.

Those 3 months were no fun at all.

Good luck.

[KimberlyOnline Facilitator August 2, 2012 at 1:04 pm Post count: 4294]

#1173351

Hello – I agree with Jules and Caro that you should look at other options to try and get a quicker appointment/evaluation.

If you have a definitive diagnosis of Graves’, some primary care physicians are comfortable prescribing and adjusting dosing for anti-thyroid drugs.

If your schedule is flexible, you can also ask to be placed on a cancellation list, which might get you in more quickly.

Take care — and keep us posted!

[Naisly August 2, 2012 at 1:48 pm Post count: 143]

#1173352

Thanks for the response…

I wish I could get another endo, but this is the only one close enough for me.

They said it was graves, and I had T4 and THS test done, they would not do T3. I also had an uptake scan done. The labs will not do any more tests unless a endo asks. My GP doesn’t know enough about graves or the medication. He said he can start me on the medication but cannot follow up with testing, diet, lifestyle changes, so personaly, if I want to do this right and know where my levels are, I believe it to be important to see the endo first.

I’ve been on the beta-blockers since May….

[adenure August 2, 2012 at 2:18 pm Post count: 491]

#1173353

Hi!

Yes, you absolutely must get in sooner than 6 months. I had to wait a month, but I called daily, twice a day, asking if there was a cancellation. Then I asked my GP to give me an emergency referral. Once she did that, they called me and got me in that week. I was losing 1 lb. a day, diarrhea, not eating, basically a mess!

You mentioned that your doctor is willing to prescribe the medication (ATD), but can’t follow up with labs?? I’m trying to understand why he’s willing to prescribe medication, but unwilling to write up a lab slip? It would seem that GP’s can interpret the most basic of thyroid tests. He must have to diagnose you. I would ask him to prescribe the ATD (since he said he was fine with that) and then ask for a TSH & T4 test 6-8 weeks later telling him that you’re calling the endo. daily to get an apptmt. sooner– maybe you could approach your GP with that idea- that you’d like the ATD’s and a lab slip, but will continue to call the endo daily with the hopes of getting an apptmt within that time. I don’t know, but I do know that waiting 6 months while you’re hyper isn’t okay (especially since you’ve been on betablockers since May). Diet and lifestyle changes are helpful, but they are not going to really sway your treatment one way or another. Eating healthy and avoiding stress are important, but you need treatment and monitoring (labwork) more than anything. Don’t give up on your GP just yet; sometimes a little prodding will go a long way.

Do avoid exercise until your levels are stable though (even if your heart rate is stable and in range). Graves give our bodies and hearts a beating; exercise won’t help and could very easily make things worse right now.

Alexis

[Carito71 August 2, 2012 at 8:43 pm Post count: 333]

#1173354

Naisly wrote:

My GP doesn’t know enough about graves or the medication. He said he can start me on the medication but cannot follow up with testing, diet, lifestyle changes

Then, since he knows you have Graves and cannot help you maybe he can call the Endo’s office to see if the Endo can see you sooner. It is dangerous to be in a hyper state without medication. I’m glad you are at least taking a beta blocker. Kimberly and Alexis have given you a great idea about asking to be on a cancelation list or calling them often to see if anyone has cancelled and if you can take their place.

I hope things get better soon. It is terrible being hyper and even worst without treatment.

Please keep us posted.

Caro

[gatorgirly August 3, 2012 at 5:53 am Post count: 326]

#1173355

I thought I posted this yesterday, but I guess I never clicked “submit.” I have found that being a little bit dramatic when calling to request an appointment can result in an earlier appointment. If your resting heart rate is above 100, or if you’re losing a lot of weight, having loose bowels, etc., tell the receptionist this. He or she may freak out and tell the physician they need to get you in soon. I’m not suggesting you be dishonest, but when I could tell I was either hyper or hypo but had no lab slips or upcoming appointments, I would call and exaggerate a little because I KNEW I needed a med adjustment but the gatekeepers were making that extremely difficult.

Worst case scenario, please go to the ER if your heart rate is above 120 resting or if you start to feel seriously ill.

[Naisly August 3, 2012 at 11:05 am Post count: 143]

#1173356

Thank you again for helping.

One thing about Canadian medicare is – it may be free but it’s lousy. it’s so bad people often die in the ER hallways waiting for treatment, because there are not enough doctors or RNs. That being said, it is very hard to see a specialist and or GP. This is why it took me 4years to get a GP.

It’s not that my doctor ‘won’t’ order labs, its just that the ‘lab’ won’t do them without an endo ordering them, or I have to pay for the lab work. Even the first lab work I had done, they wouldn’t do them until my doctor phoned them, and the lab told him they would do it that one time only.

I took all of your advice and had my partner phone the endo’s office. He told them my symptoms and that I needed to get in asp, the receptionist told him my referral would go into triage this weekend and since it is a long weekend here, I won’t hear back until later next week.

I’ll post something later today because I don’t understand my symptoms, I have to get ready for a phyc appt.

~Naisly

[ncpatches August 4, 2012 at 6:33 am Post count: 66]

#1173357

You’ve gotten a lot of good advice here, but I want to chime in about beta blockers. They are safe, in/of themselves and have been around for MANY years. Many people are on them for years and years for high blood pressure, myself included. I agree, you absolutely must get in to an endo sooner than 6 months. But, if you are concerned about taking them for 6 months or more, please rest easy, they are ‘tried and true’ and have few side effects for most people. Best of luck to you, it does get better, or so ‘they’ tell me. Big Hugz!

ps… I wish people screaming about wanting universal health care could see what you’re going through. I’m guessing you aren’t close enough to the border to come across and see a DR here? I know a lot of Canadians do that, when they need medical care NOW.

Oh, and I wanted to add, I am on Metoprolol, twice daily, 50 mg. Which is why I didn’t have the palps, etc, (I’m guessing) usually associated with Grave’s, when I was hyper. My ONLY symptom was extreme weight loss, like 6 lbs a week, without trying.

[Carito71 August 6, 2012 at 12:48 pm Post count: 333]

#1173358

Naisly,
How are you doing? I hope you are close to getting an appointment. I agree about the heart rate situation. If it is above the normal range (60-100 bpm), I would recommend going to the ER if you can’t get an appointment. A heart rate that reaches 120 can change to Atrial Fibrillation and then you will need more than a beta blocker for that. I hope you get an appointment soon or see a Dr. soon.

Caro

[Carito71 August 6, 2012 at 1:03 pm Post count: 333]

#1173359

Naisly, I forgot that in your other post you mentioned that you are on beta blocker (http://www.gdatf.org/forum/topic/42735/). I’m glad you are taking them.

Then you stated your heart rate was 90+ with the beta blocker. How is your heart rate now? Did it start going down with the beta blocker? 60-100 bpm at rest is normal range. I, personally, was not comfortable when my heart was in the 90s but my Dr. changed my beta blocker from Propranolol to Metoprolol. If your heart rate still is elevated with the beta blocker that you are taking, you might want to see if your Dr can change it to a different beta blocker or increase your dose. The thing is though, that you have to take it as recommended to start seeing a change. Hope you feel better soon.

[Carito71 August 6, 2012 at 1:04 pm Post count: 333]

#1173360

[Naisly August 6, 2012 at 3:00 pm Post count: 143]

#1173361

I went to the walk in clinc and the on call doctor said my bp was 98/48 pulse 100. He was a quack anyways asking why I wasn’t on PTU I said I was waiting for blood work and he said, “all they need it your THS” then he sent me home. My normal for pulse has always been around 50ish. I only went in to the clinic because I had these add heart flutters – I know most people get them, but it lasted for 5mins and wouldn’t stop.

I don’t think the beta-blockers are working and I’m up to 240mg daily.

~Naisly

[Carito71 August 6, 2012 at 8:04 pm Post count: 333]

#1173362

I’m so glad you are taking the beta blockers. I know it is hard for you but I’m glad you are finding the power to take them. 100 bpm for heart rate is in the high end of normal and can be elevated for you especially if your normal pulse was in the 50s before you had the heart rate problems. Normal range is 60-100 but 100 is already uncomfortable for me b/c I also used to run a low heart rate before my heart rate issues. Was the 100 bpm at rest? What was it before you started the beta blockers? It could be that the beta blocker is working but you might need a different one or a little bit higher dose. As I mentioned earlier, I had to have mine changed b/c the Propranolol was not working for me.

Did they do an EKG for your heart at the walk in clinic? With 100 bpm and “flutters”, I would have asked for an EKG. Did they feel your pulse/listen to your heart? And if so, did they tell you if it was regular or irregular? An irregular heart beat can be anything and needs to be checked out with an EKG to make sure that it is not Atrial Fibrillation (A Fib) or PVCs that are running close together (dangerous rhythms).

Is your dyastolic BP always low (48)?

He is probably worried that you are not on any treatment for GD and that is why he might have asked you why you were not on PTU. You will need more than a TSH though but if the TSH is almost not there then that might be enough to get you started on Methimazole or PTU … not sure. You do have more than a TSH result from the time that they ran your labs (I think you said T4?). Maybe the walk in clinic, with what they know about your vital signs and having asked you about the PTU, can help you see your Endo sooner????

I sure hope you can start the treatment you need so that your hear rate can start regulating and you can start feeling better. The thing with GD is that when it affects the heart it is even more dangerous. You don’t want to develop an irregular heart rhythm on top of everything. My GP told me that my heart could have easily turned A Fib if we hadn’t caught it when they did and if I didn’t have a young heart. Mine was 124 bpm though when I arrived at the ER. I’m glad yours was not more than 100. Keep your activity to a minimum. Do not exercise. Rest when you can.

Glad you went to the walk in clinic. Maybe they can help you with seeing your Endo sooner.

Caro

[Author]

Posts