APPT #38 - Dr. Michaels

I finally made it to an endocrinologist!

After I saw Dr. Maria Hordinsky in June, she has been urging me to see an endocrinologist to discuss my low DHEAS and Testosterone levels. I tried for over a month to get into the OHSU endocrinology clinic, but my paperwork kept getting lost, no one would call me and tell me that, and (after having a generally had a bad attitude about the loops of the medical system) I basically told them I was too good for their services.

Thank god Pam and Cornwall had someone to refer me to in Salem.

Dr. Michaels was an hour late for our appointment. Which isn't the greatest start to someone who is nearing her 40th appointment for alopecia and visiting her 8th doctor. My patience is wearing a bit thin. However, Dr. Michaels was such a nice and intelligent man, I couldn't stay upset about the tardiness of our appointment.

There were easily 10 degrees framed on Dr. Michael's wall of his office. You could tell the guy was passionate and informed about the hormone system because he wanted to go deep in the details, using words and terms I've never heard of.

He patiently listened to all of my issues and promptly went on to discuss the areas he felt he could help me with: 

  • adrenal insufficiency
  • fatigue

He suggested an ACTH (Cosyntropin) Stimulation test to asses the functioning of my adrenal glands' stress response. It's an intravenous test that requires me to get an IV, inject a hormone (ACTH) that stimulates the adrenal glands to produce cortisol, and then draw blood to measure the amount of cortisol being produced.

This test will tell him if my adrenals are still functioning insufficiently and also if the cause is rooted in my adrenal glands or pituitary glands. Based on the results, we will then discuss treatments.

We also talked about my everlasting fatigue and he had me take a sleep disorder assessment quiz. It had me rate how likely I was to fall asleep in certain situations throughout the day (fall asleep in the car if you are a passenger for over 1 hour, fall asleep talking to someone, fall asleep while reading a book, etc.). There were also some questions on my overall sleep behavior. My results came out abnormal, so he suggested I look into a sleep study to assess if I am getting enough REM sleep or perhaps have sleep apnea.

While this wasn't the appointment to end all other appointments, I'm feeling good about this path of diagnosis and treatment.