Grave's Disease

[jsbillie]

Graves Disease

Due to privacy I cannot release too much info. I have a student who was diagnosed with Graves Disease recently. Switched schools, came here. She states that she is feeling depressed, anxious, heart races at night, sees spots, dizzy. We have tried to convince this student to voluntarily go to the emergency room to avoid or possibly rule out a Thyroid Storm. Prior to her transfer here a few days ago... her specialist said her levels were just below danger. We are waiting on referral changes to get her a new specialist in this new stat she has come to. Her reason for wanting to wait on referral is because she doesn't want to miss her technical training class and we tried to tell her class would catch up with her.

Should we pursue taking her to an emergency room with the above symptoms?

[yankeeRN]

"Her specialist said her levels were just below danger"---there is a fine line and stress can make things worse.  Better to treat things BEFORE they get worse. I also have hyperthyroidism and for me Grave's. As I look back now I had been having symptoms for at least a year but I dismissed these symptoms as being caused by other things ie my hand tremors,spurts of rapid heart rate, boundless energy, and anxiousness must have been my morning coffee (2 cups for years never a prob before), the sweating was because it was so warm (but no one else around me felt as warm), the irritability my PMS which had gotten to be often.  Symptoms got worse and new more alarming symptoms started--weightloss in spite of a voracious appetite, muscle loss and weakness in arms and legs, increasing anxiety with panic attacks, more freq episodes of rapid heart rate with HR up to 170, POUNDING heart beat even when heart rate only 100 (my heart beat was so strong it was uncomfortable) , the hand tremors  progressed to episodes of full body shakes, headaches and dizziness, etc. Don't wait--my waiting caused me to have to take a 5 week leave of absence from work because I got so sick I could not work. I kept telling my husband I was going to make an appointment to see the md to see what was going on even tough I thought it might be my thyroid but was in denial.  The final straw was the day I was at work with a splitting headache and dizziness--I was just trying to get through the day--my heart started pounding and apparently my bp was off the charts-- I left work and went to the ER. In the ER they did lab tests--amongst them was urine test which I am sure must have been a drug screen--routine I am sure-- but ME-- who barely took Tylenol--it was negative I am positive--lol. I told the md in the ER all the symptoms I had been having and fortunate for me this particular md believed me when I told him I suspected it might be because he also had hyperthyroid (Grave's for him too).  Another md might have labeled it anxiety and told me to see my primary my thyroid  care md for follow up. I have seen and heard this "anxiety" diagnosis label more than once especially in regards to women--you really have to be your own advocate.  So the gist of all this is don't wait because all could get much worse. You can go from feeling invincible to  barely being able to walk across the room with chest pressure and shortness of breath to couch bound and I am not exaggerating--I was that sick.  Just a few weeks prior I had been kicking butt at the gym with weight lifting and up to 90 mins cardio 3-4  times a week. I am happy to say that I was able to get under control with an anti-thyroid med and for a short time I also needed a beta blocker for faster symptom relief.  I have had ups and downs but feel so much better now.

[jsbillie]

Thank you so much. I have been in the medical field for 12 years and have never experienced a student of optimal health have an illness/disease of this gravity before report to our school... so I appreciate the information greatly, coming from somone who typically provides support treatment for athletic injuries or illnesses.

[Red_Star]

The hallmark symptoms of a thyroid storm is a fever which can go as high as 40.5 - 41.1 C (105 - 106 F). Symptoms of a thyroid storm are severe and complications include fever, dehydration, rapid heart rate, irregular heart beat, nausea, vomiting, diarrhea, weakness, confusion, disorientation, heart failure, death.

You may see a wide or high pulse pressure.  Pulse pressure is normally around 40mmHg. Eg: 120/80 = 40, enlarged thyroid gland, exophthalmos (protruding eyes).  A thyroid storm is a life threatening medical emergency and needs to be treated before before all confirmatory diagnostic tests are performed.