Blood Work: A Trajectory

Cortisol is problematic. So far every other test (so every six months) the numbers spike. I suspect it might be White Coat Syndrome given the horrid quality of care/service I get at Quest Diagnostics. I'm tired of complaining to corporate about it, as it doesn't amount to jackshit in the scheme of things, and I've seen zero improvement. And the last time I was there (May), the blood draw was so bad, I had a very painful welt the size of a halved tangerine in the crook of my arm for DAYS.

I have no doubt that the stress I undergo each time I've been to Quest Diagnostics has adversely affected my cortisol levels. The undue wait time, the rushed nature of finding a vein, how harried the single solitary lab staffer is. To under staff a  heavily trafficked site like Quest does is not only a fuck you to those who work there, but also to the clients/patients who rely on this being the most proximal lab for them to go to for their blood test needs. Plus? Most of us are fasting, so yeah, make us all wait LONGER, make us MISERABLE while we're there. Fuck you. I'll take me, myself, and more importantly MY INSURANCE MONEY elsewhere. Labs are a dime a dozen. I think there's one spitting distance away. Sayonara, motherfuckers.
Anyway, where was I? Oh yeah... A trajectory of my blood work results:


5/2/13:
Creatine, Random Urine 91
Protein, Total Urine
Urine Total Protein 769 H Range: 50-240 mg/L
Protein Total, Urine 846 H Range 21-161 mg/g
Creatine: 0.62 Range 0.50-1.10 mg/dL
Bun/Creatinine Ratio Normal Limits
Uric Acid: 5.3 Therapeutic target for gout patients: <6 br="">Albumin 4.2
Cortisol, Total serum  31.0 H (Reference range: Cortisol AM 4.0-22.0 mcg/dL; Cortisol PM 3.0-17.0 mcg/dL
C-Reactive Protein 0.1
Hemoglobin A1C 5.3 (Reference range: <5 br="">

2/20/13:
Creatine:  0.57 (ref: 0.50-1.10 mg/dL)
Bun/Creatine ratio Normal limits
Protein (serum) 6.7 (6.1-8.1 g/dL)
Albumin 4.1 (3.6-5.1 g/dL)
C-Reactive Protein 0.1
Hemoglobin A1C 5.5
(No microalbumin tested in Feb)
Uric Acid: 5.5 (2.5-7.0)  *Therapeutic target for gout patients: <6 br="">Cortisol (total serum): 21.9H (Cortisol a.m.: 4.0-22.0 mcg/dL)

November 2012:
Creatine: 0.64
Bun/Creatine ratio Normal
Microalbumin (random)  314H <30 br="">Blood Moderate (2+) negative
C-Reactive Protein 0.1
Hemoglobin A1C: 5.3
Plasma Renin ACT, LC/MS/MS  8.37H (0.25-5.82 ng/mL/h
Uric Acid: 5.3

July 2012:
Creatine: 0.66
Bun/Creatine ratio Normal
C-Reactive Protein 0.1
Hemoglobin A1C: 5.5
Uric Acid: 5.7

April 2012:
Creatine: 0.67
Bun/Creatine ratio Normal
C-Reactive Protein 0.1
Hemoglobin A1C: 5.5
3A Adnrostanediol-G 30L (60-300 ng/dL)
Uric Acid: 5.5
DHEA Sulfate: 448H (25-220 mcg/dL)
Cortisol: 10.9  (Cortisol a.m. 4.0-22.0 mcg/dL)

Obviously, between the cortisol, microalbumen and the uric acid, SOMETHING is cookin' in my kidneys. I have been wanting my docs to adjust/tweak my blood pressure Rx for months now, as I have been having "break through migraines" which are not in line with my usual, predictable menses-related migraines.  Endocrinologist mentioned something about the possibility for Cushings. (Yet no retest for anything. Yet. We have more pressing matters. Read on.)

Yes. I have about seven thyroid nodules, one of which is problematic, as it's nearly an inch in size, is close to my windpipe, and has "unclean margins." Hurry up and wait for four days to hear back from the diagnostic center, to find out that HURRY UP AND WAIT the earliest they could get me in for a fine needle biopsy is NEXT FRIDAY, which means that it will be nearly two solid weeks (from today) until I finally know if this nodule is cancerous or not, if so, what type of cancer is it (papillary vs follicular, for example), and if it's not cancerous, can we get this thing out of me LIKE YESTERDAY, M'KAY?

I've sent a thoughtful email to my bariatric office to find out, if, worst case scenario, if the thyroid (whether partial or entirely) needs to be removed, will this adversely affect my body's ability to absorb calcium, as being someone who is living post-op gastric bypass I am already contending with vitamin absorption issues, I want to know how this will impact me.

At this juncture, I'm not getting morose or morbid. I want as much information I can muster as possible, regarding how am I going to live, quality of life wise, post-op, should my thyroid be removed. I'm not indulging in death fantasy yet. Ideally I'd like to live to a nice old age like my late 80s, have a good meal, a few good laughs my last day and perhaps lay down for a nap, and it'll be GOOD NIGHT IRENE. I do NOT want to even think about dying a grizzly death of cancer, being taken apart piece by piece like my grandmother was for seven years following an oral cancer diagnosis. Nope. I just want to know what's it going to take for me to get through each and every day. Pills? Supplements? What's one more pill in the grand scheme of things?

Like I've said to friends, I don't know if I'm THAT strong, if I'm THAT much of a stoic, or if I'm THAT much in shock about the possibility of this being cancer.

And if I had my 'druthers, I'druther and just assume get all my surgeries/procedures all done at the same time or the same week, so I can get on with the business of recovering and more importantly get on with the business of LIVING. As it stands, I have my ablation and tubal ligation scheduled for next month at Mt. Sinai, and I'druther get my nodule-ectomy or thyroidectomy done at the same time, as the doctor I'm seeing for that is at that hospital too.

Sis and aunt both are aware of what's going on, yet neither one of them have texted or called me to see how I am doing. In stark contrast the very few folks at work (boss) as well as a friend of the husband's (who has adopted me, as sort of an adopted older sister) seem incapable of NOT asking how I am doing. Heavy duty stuff I'm going through for sure, but no sense in worrying until I know, DEFINITIVELY, what I am going to worry about. 

PS: FUCK YOU QUEST DIAGNOSTICS! FUCK YOU SERIOUSLY AND SIDEWAYS. IN YOUR PROVERBIAL EAR AND REAR END.