While sorting through the mail today, I opened an envelope from the Rheumatology department at UCH, and was a bit surprised and baffled at the contents. Patty was snoozing at the time, so I couldn't even discuss them with her for some time. In handwriting atop a printed summary of medical results, I read, "Anti-thyroid antibodies / Hashimoto's thyroiditis; accounts for positive ANA." Huh? When were we going to be called about this?
When I delved deeper into the numbers themselves (or at least the ones highlighted as anomalies), and with the help of several web sites, I was able to extrapolate that the recent blood tests point to hypothyroidism as one of Patty's problems. We have not heard anything more from doctors, but this message sure got us moving on another note with lots of questions.
The online literature on Hashimoto's thyroiditis seems a bit hard to interpret, at least in terms of what it may mean for Patty. On paper, it doesn't sound like a big deal, but there are no "little deals" with our patient, it would seem. I did find some evidence to suggest that hypothyroidism and lupus are sometimes bedfellows, so we don't know if this new information really tells us anything new, in terms of Patty's future. I will say that I was a trifle unsettled when I read that hypothyroidism can be problematic for those who are prescribed prednisone, a major drug in most post-transplant regimens. Of course, I'm probably reading too much into what I'm scanning from pages, so I'll stop this for now.
Patty was tired all day. She continues to experience sore muscles and joints, shortness of breath and stomach discomfort. We wrote to Dr. Costanzo today, asking her to consider putting Patty back on milrinone as soon as possible. We'll be sure to share whatever feedback we receive on all of the above.
As I was writing this, Patty offered, "Wow, this is getting pretty complicated, isn't it?" I concur.