Sunday, July 19, 2009

"This is one of the best disease you can have"

" This is one of the best disease you can have"..........
......oops what I am saying to this patient?
I stopped myself.Is there anything like a good disease or a bad disease?
I was speaking to a 40 year old lady sitting in front of me. She had come to me 2 days ago with feeling of fatigue and tiredness. She is sleepy during day time even though she sleeps well at night.She said she is feeling depressed as she is not able to work properly. She is working as a clerk in an office and also have to do lot of work in her house.
" How is you bowel habits? Are you constipated? " I asked.
' Yes, I do not get regular motion nowadays" she said in a hoarse voice.
"Is your voice like this or is there any recent change?"
"Oh that is because of my throat,it is like this for few days now" she replied.
" Do you always feel like sleeping under a blanket?
" Yes feeling chilly sometimes" was her reply.
" Any increase in hair loss?"
" Yes, after I started using that new shampoo it is like that. I stopped using that but still I loose tonnes of hairs every day".
She seemed to have a reason for all her problems.
When I touched her hand the skin felt coarse. Otherwise I could not find anything wrong in her physical examination. I carefully palpated her neck and could make out mild enlargement of her thyroid gland. Even if I did not find an enlargement I never had any doubt what test to order for her. She needed a Thyroid function test. Most probably she is suffering from Hypothyroidism.

Now the report of the Thyroid function test is in front of me and I was sitting with a smug smile.
"Is it normal doctor?" She might have thought it is normal seeing my smile.
'No it is abnormal. You are suffering from Hypothyroidism".
"Is it a dangerous disease?" Her face showed her extreme worry.
"No. It is treatable but usually not curable."
"So I am having an incurable disease?" She seemed to be almost in tears.
Then I said the above line.
"This is one of the best disease you can have."
"Hypothyroidism is easy to treat in almost all the patients," I explained.
"Your thyroid gland is incapable of producing enough hormone.So you need to take Levothyroxine,a hormone tablet daily and check to see your thyroid hormone levels are maintained in normal range. The medicine is safe and after you have stabilised your dose you need to test only once in a year. There are no complications. So it is much better than conditions like Diabetes,increased blood pressure or increased cholesterol".
"When can I stop the medicine?"
" Most probably you will have to continue the medicine life-long".
" Can I try Ayurveda or Homeopathy? I do not like to take toxic 'English' medicines life long".
"As far as I know Ayurveda and Homeopathy or any other alternative system of medicine do not have any therapy for Hypothyroidism. I very well know that family members of Ayurvedic and Homeopathic doctors are taking 'English' medicine Levothyroxine.So better not to take a chance."
Then I narrated the story of a nurse who had hypothyroidism. She was working in my hospital. About 7 years ago. I had diagnosed hypothyroidism in her and started treatment. As I had changed my place of work I did not see her for long time. Recently she came to me with almost the same symptoms as she had 7 years ago. I was surprised.I thought she may need an increase in dose of the drug. I asked her how much of levothyroxine she is taking. To my surprise she said she stopped the medicine 8 months ago. Some one said Homeopathy can cure hypothyroidism and so she is now taking homeopathic treatment. I was shocked to hear this,that too from a Nurse. I asked her to do her Thyroid function tests which proved that she is again hypothyroid.
' So don't worry,soon you will be all right". I reassured my worried patient.
I am sure with in 2 months she will be fine.Among the chronic illnesses such a confidence I get only while treating hypothyroidism,because it is an easily treatable condition.
That is why I said 'this is one of the best disease you can have".

To know more about Hypothyroidism click here

13 comments:

Sunil S Chiplunkar said...

Thyroid disease is an important endocrine disorder today. While diabetes is well known, hypothyroidism or hyperthyroidism does not enjoy the same level of publicity. However, it should enjoy wide publicity, particularly women are more susceptible to thyroid disease - I wonder why? May be you could highlight on this aspect with reference to latest medical findings in your forthcoming posts.

There are many therapeutic approaches in society, however, finally proven and evidence based medicine only works.

Indian Home Maker said...

I always say any condition that can be controlled is nothing to worry about... I am on this blog after ages, I generally read your other blog! Let me read some more of your informative posts here!

nimmy said...

:)

My baby girl has mild atopic dermatitis and we used Elocom and like steroids..When we came back to kerala,all here pressurized me to give her homeo treatment..I don't know how far willit work..As far as I know,ADitis cannot be cured and can only be controlled.. She has intense itching now..I am so worried and depressed as she doesn't sleep at all these nights....I hope homeopathy works for her and the difficulities doesn't come back anytime in her life......

Arun.N.M. said...

Sunil, Yes Thyroid problems are not well known and sometimes tricky to diagnose but easy to treat. Will post about the theories in why there is female prediliction for hypothyroidism

IHM,Welcome back.Yes most conditions do not have a cure but can easily be controlled

Arun.N.M. said...

Nimmy, you can try Homeopathy for atopic dermatitis as modern medicine is not giving your child good relief. Do not worry. Your child will be better soon. Here is a link! to scientific article on atopic dermatitis.

seema said...

I guess people with Thyroid problems gain excessive weight. Is that True?
Just a thought on if giving out drug names is correct or not, because some pharmacies sell prescription drugs over the counter.

scorpiogenius said...

Nice anecdote!

I know for many people consuming meds for the remaining part of their life is the worst crisis of all. I appreciate the way you handled it. :)

Arun.N.M. said...

Seema,Those with hypothyroidism may gain some weight,but not too much. The name I gave is not a brand name but the pharmacological name which is there in most websites educating ppl about hypothyroidism. Is that wrong?

Arun.N.M. said...

scorpiogenius, thank you.Yes when you tell them you have to take it life long they are stunned.Then I will tell them it is like oxygen,food and water for your body,essential for life,to be taken life long.

Seema said...

Probably not, Here in north america it is a generic name people use that is why I got confused with brand names of levothroid and levoxyl. My mother has hypothyroidism :(

Anonymous said...

Isn't homeopathy just superstition? Or is homeopathy as practiced here different from the original scam?

Arun.N.M. said...

Seema, Hope your mom will read this post so that she can feel happy about her hypothyroidism.

Arun.N.M. said...

Anonymous, In my opinion the scientific basis of homeopathy is dubious. It has placebo effect though.