The Post-Specialist Post

Good News:

• 6 lbs lost since starting Topamax over a month ago.
• BP: 117/70 [Last: 138/80].
• Hemoglobin A1C: 5.5 [Non Diabetics <6.0%]>
• Cortisol, total serum: "In range," 11.3
• LDL Cholesterol: "In range," 122 [<130>
• HDL Cholesterol: 34, "Low," [>/=40 mg/dL]
• T4, total (Thyroid Function): "In Range," 8.5 [4.5-12.0 ug/dL]
  

Bad News:

• Menses still MIA. [Though starting to spot 8/24]
• Glusose, fasting: 108, "High," [65-99 mg/dL]
• Insulin, serum: 22 [ <17>
• Uric Acid still elevated. [9.7; Range: 2.5-7.0 mg/dL]; Still concerned about possibility of Gout.
• Fatty Liver Syndrome still a concern:
  Triglycerides: 238 [<150 mg/dL]
  AST: 55 [10-30 U/L]
  ALT: 114 [6-40 U/L]
• Discussed "gravel" stones in Gall Bladder.
  

Plan of Action:

• Double up on Tricor.
• Continue taking Topamax for migraines and hoping for best with appetite suppression.
• Follow up w/Neuro re: Topamax [might increase due to mild breakthrough headaches].
• Gradually switch to Metformin XR, since my evening ones are appearing in morning stoolage.
  

Specialist is concerned about my depression and how I'm "not myself."

No shit.