u/osurdun

I’m a primary care physician and I’ve had a long relationship with this patient. She’s smart and put together but seems to be easily influenced. I’m sure this is due to distrust of the system from an issue in the past. This has led to her seeking advice from some less than stellar “specialists”. I’ve been able to gradually make some progress and build trust with her. Nonetheless, she came to see me recently after a hospitalization for what was thought to be a stroke due to a nerve palsy seen by the eye doctor and then myasthenia gravis (negative work up). This entire episode stems from an “endocrine specialist” NP in Florida (we live in Virginia) who misinterpreted her TSH of 8.2 and free t4 at 0.6. Claimed she was clearly hyperthyroid and cut her thyroid dosing in half. She’s been on half dose for the last 3 months. This patient had months of symptoms claiming they MUST be related to hyperthyroid due to what her “endocrinologist” is saying. This led to worsening symptoms and the aforementioned hospitalization. She had rescheduled multiple appointments with me over this time but we finally sat and talked through all of previous events. Not quite sure how this wasn’t clearly determined in the hospital with multiple specialists on the case but here we are. I put her back on her normal thyroid dosing and lo and behold….shes feeling a lot better. I advised her to please just follow with me for her thyroid care ongoing.

Now, I’m just processing what to do about this negligent (maybe that’s offering too much grace….down right IDIOTIC) care from someone who claims to be a specialist in this field. 3rd year medical students can do a better job. My mind is thoroughly boggled.