IT'S NOT THYROID RELATED...BULL!

This week’s blog is short because it is my hope that you will consider taking some time to peruse the list below. This list comes from the Medicare National Coverage Determinations report. Extracted from that report is the Thyroid Testing list (below). The list indicates that thyroid function testing may be medically necessary with the following patient conditions/complaints/symptoms.

It is important to note that many major insurance companies adopt Medicare’s (The government) reimbursement coverage guidelines.

So the next time a doctor says to you “I don’t think your symptoms are “thyroid related” show them this list. I had an ER doctor tell me one time that memory loss has nothing to do with thyroid disease. It would have been great to have this list at the time…I could’ve said “Nuh Uh buddy, check out code number 780.93.”

The government assembles a team primarily of doctors to create, update, review and edit this list annually.

Here is the entire 2013 Medicare National Coverage Determinations Report - http://www.cms.gov/Medicare/Coverage/CoverageGenInfo/downloads/manual201301.pdf

THYROID TESTING LIST

Code	Description
017.50-017.56	Tuberculosis of the thyroid gland
183.0	Malignant neoplasm of ovary
193	Malignant neoplasm of thyroid gland
194.8	Malignant neoplasm of other endocrine glands and related structures
198.89	Secondary malignant neoplasm of the thyroid
220	Benign neoplasm of ovary
226	Benign neoplasm of thyroid gland
227.3	Benign neoplasm of pituitary gland and craniopharyngeal duct
234.8	Carcinoma in situ of other and unspecified sites
237.4	Neoplasm of uncertain behavior of other and unspecified endocrine glands
239.7	Neoplasm of unspecified nature, thyroid gland
240.0-240.9	Goiter specified and unspecified
241.0-241.9	Nontoxic nodular goiter
242.00-242.91	Thyrotoxicosis with or without goiter
243	Congenital hypothyroidism
244.0-244.9	Acquired hypothyroidism
245.0-245.9	Thyroiditis
246.0-246.9	Other disorders of thyroid
249.00-249.01	Secondary diabetes mellitus without mention of complication
249.10-249.11	Secondary diabetes mellitus with ketoacidosis
249.20-249.21	Secondary diabetes mellitus with hyperosmolarity
249.30-249.31	Secondary diabetes mellitus with other coma
249.40-249.41	Secondary diabetes mellitus with renal manifestations
249.50-249.51	Secondary diabetes mellitus with ophthalmic manifestations
249.60-249.61	Secondary diabetes mellitus with neurological manifestations
249.70-249.71	Secondary diabetes mellitus with peripheral circulatory disorders
249.80-249.81	Secondary diabetes mellitus with other specified manifestations
249.90-249.91	Secondary diabetes mellitus with unspecified complication
250.00-250.93	Diabetes mellitus
252.1	Hypoparathyroidism
253.1	Other and unspecified anterior pituitary hyper function
253.2	Panhypopituitarism
253.3	Pituitary dwarfism
253.4	Other anterior pituitary disorders
253.7	Iatrogenic pituitary disorders
255.2	Adrenogenital disorders
255.41	Glucocorticoid deficiency
255.42	Mineralocorticoid deficiency
256.31-256.39	Ovarian failure
257.2	Testicular hypofunction
258.0 – 258.9	Polyglandular dysfunction and related disorders
262	Malnutrition, severe
263.0-263.9	Malnutrition, other and unspecified
266.0	Ariboflavinosis
272.0	Pure hypercholesterolemia
272.2	Mixed hyperlipidemia
272.4	Other and unspecified hyperlipidemia
275.40-275.49	Calcium disorders
275.5	Hungry bone syndrome
276.0	Hyposmolality and/or hypernatremia
276.1	Hyposmolality and/or hyponatremia
278.3	Hypercarotenemia
279.41	Autoimmune lymphoproliferative syndrome
279.49	Autoimmune disease, not elsewhere classified
281.0	Pernicious anemia
281.9	Unspecified deficiency anemia
283.0	Autoimmune hemolytic anemia
285.9	Anemia, unspecified
290.0	Senile dementia, uncomplicated
290.10-290.13	Presenile dementia
290.20-290.21	Senile dementia with delusional or depressive features
290.3	Senile dementia with delirium
293.0-293.1	Delirium
293.81-293.89	Other specified transient mental disorders due to conditions classified elsewhere
294.8	Other persistent mental disorders due to conditions classified elsewhere
296.00-296.99	Episodic mood disorders
297.0	Paranoid state, simple
297.1	Delusional disorder
297.9	Unspecified paranoid state
298.3	Acute paranoid reaction
300.00-300.09	Anxiety states
307.9	Other and unspecified special symptoms or syndromes NEC
310.1	Personality change due to conditions classified elsewhere
311	Depressive disorder, NEC
327.00	Organic insomnia, unspecified
327.01	Insomnia due to medical condition classified elsewhere
327.09	Other organic insomnia
327.29	Other organic sleep apnea
327.52	Sleep related leg cramps
327.8	Other Organic sleep disorders
331.0, 331.11, 331.19, 331.2	Alzheimer’s, pick’s disease, Senile degeneration of brain
331.83	Mild cognitive impairment, so stated
333.1	Essential and other specified forms of tremor
333.99	Other extrapyramidal diseases and abnormal movement disorders
354.0	Carpal Tunnel syndrome
356.9	Idiopathic peripheral neuropathy, unspecified polyneuropathy
358.1	Myasthenic syndromes in diseases classified elsewhere
359.5	Myopathy in endocrine diseases classified elsewhere
359.9	Myopathy, unspecified
368.2	Diplopia
372.71	Conjunctival hyperemia
372.73	Conjunctival edema
374.41	Lid retraction or lag
374.82	Eyelid edema
376.21	Thyrotoxic exophthalmos
376.22	Exophthalmic ophthalmoplegia
376.30-376.31	Exophthalmic conditions, unspecified and constant
376.33-376.34	Orbital edema or congestion, intermittent exophthalmos
378.50-378.55	Paralytic strabismus
401.0-401.9	Essential hypertension
403.00-403.91	Hypertensive chronic kidney disease
404.00-404.93	Hypertensive heart and chronic kidney disease
423.9	Unspecified disease of pericardium
425.7	Nutritional and metabolic cardiomyopathy
427.0	Paroxysmal supraventricular tachycardia
427.2	Paroxysmal tachycardia, unspecified
427.31	Atrial fibrillation
427.89	Other specified cardiac dysrhythmia
427.9	Cardiac dysrhythmia, unspecified
428.0	Congestive heart failure, unspecified
428.1	Left heart failure
429.3	Cardiomegaly
511.9	Unspecified pleural effusion
518.81	Acute respiratory failure
529.8	Other specified conditions of the tongue
560.1	Paralytic ileus
564.00-564.09	Constipation
564.7	Megacolon, other than Hirschsprung’s
568.82	Peritoneal effusion (chronic)
625.3	Dysmenorrhea
626.0-626.2	Disorders of menstruation
626.4	Irregular menstrual cycle
648.10-648.14	Other current conditions in mother, classifiable elsewhere, but complicating pregnancy, childbirth, or puerperium, thyroid dysfunction
676.20-676.24	Engorgement of breast associated w/ childbirth & disorders of lactation
698.9	Unspecified pruritic disorder
701.1	Keratoderma, acquired (dry skin)
703.8	Other specified diseases of nail (Brittle nails)
704.00-704.09	Alopecia
709.01	Vitiligo
710.0-710.9	Diffuse disease of connective tissue
728.2	Muscle wasting
728.87	Muscle weakness (generalized)
728.9	Unspecified disorder of muscle, ligament, and fascia
729.1	Myalgia and myositis, unspecified
729.82	Musculoskeletal cramp
730.30-730.39	Periostitis without osteomyelitis
733.02	Idiopathic osteoporosis
733.09	Osteoporosis, drug induced
750.15	Macroglossia, congenital
759.2	Anomaly of other endocrine glands
780.01	Coma
780.02	Transient alteration of awareness
780.09	Alteration of consciousness, other
780.50	Insomnia
780.51	Insomnia with sleep apnea, unspecified
780.52	Insomnia, unspecified
780.60	Fever, unspecified
780.61	Fever presenting with conditions classified elsewhere
780.62	Postprocedural fever
780.63	Postvaccination fever
780.64	Chills (without fever)
780.65	Hypothermia not associated with low environmental temperature
780.66	Febrile nonhemolytic transfusion reaction
780.71	Chronic fatigue syndrome
780.72	Functional quadriplegia
780.79	Other malaise and fatigue
780.8	Generalized hyperhidrosis
780.93	Memory loss
780.94	Early satiety
780.96	Generalized pain
780.97	Altered mental status
780.99	Other general symptoms
781.0	Abnormal involuntary movements
781.3	Lack of coordination, ataxia
782.0	Disturbance of skin sensation
782.3	Localized edema
782.8	Changes in skin texture
782.9	Other symptoms involving skin and integumentary tissues
783.0	Anorexia
783.1	Abnormal weight gain
783.21	Abnormal loss of weight
783.6	Polyphagia
784.1	Throat pain
784.42	Dysphonia
784.43	Hypernasality
784.44	Hyponasality
784.49	Other voice and resonance disorders
784.51	Dysarthria
784.59	Other speech disturbance
785.0	Tachycardia, unspecified
785.1	Palpitations
785.9	Other symptoms involving cardiovascular system
786.09	Other symptoms involving respiratory system
786.1	Stridor
787.20	Dysphagia, unspecified
787.21	Dysphagia, oral phase
787.22	Dysphagia, oropharyngeal phase
787.23	Dysphagia, pharyngeal phase
787.24	Dysphagia, pharyngo-esophageal phase
787.29	Other dysphagia
787.91-787.99	Other symptoms involving digestive system
789.51	Malignant Ascites
789.59	Other Ascites
793.99	Other nonspecific (abnormal) findings on radiological and other examination of body structure
794.5	Thyroid, abnormal scan or uptake
796.1	Other nonspecific abnormal findings, abnormal reflex
799.21	Nervousness
799.22	Irritability
799.23	Impulsiveness
799.24	Emotional lability
799.25	Demoralization and apathy
799.29	Other signs and symptoms involving emotional state
990	Effects of radiation, unspecified
V10.87	Personal history of malignant neoplasm of the thyroid
V10.88	Personal history of malignant neoplasm of other endocrine gland
V10.91	Personal history of malignant neuroendocrine tumor
V12.21	Personal history of gestational diabetes
V12.29	Personal history of other endocrine, metabolic, and immunity disorders
V58.69	Long term (current) use of other medications

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SICK DURING A CHRONIC ILLNESS

My immune system and I were once close allies…Then all hell broke loose. It forged a large-scale attack on my thyroid.  I couldn’t figure out why my body betrayed me until extensive research of my new foe took me to its primary location-in the digestive tract.  I had been feeding it garbage, explaining the tyranny.

Thirty years of consuming junk tarnished our relationship, resulting in numerous viral and bacterial infections.

Some medical professionals don’t believe that having an autoimmune disease can cause a poorly functioning immune system.  I don’t agree with this, they should see my pharmacy bills post this autoimmune anarchy.

In spite of my reconciliation efforts my IS still a little miffed at me, I tend to catch more bugs than the average person but this has lessened immeasurably. At the time of this writing I have a little cold which inspired me to offer sickness tips for those with chronic disease:

What do doctors advise us to do when this happens? Here are the basics:

1.       Get a lot of rest

2.       Drink plenty of fluids

3.       Eat a healthy diet

While these are all excellent recommendations to follow, I believe we need a little more to help us get well.

1.       Don’t get paranoid – Since we’ve experienced a grim diagnosis before, (“You have an incurable autoimmune disease.”) we’ve probably lost our “illness innocence”. As a thyroidian, I am very paranoid and firmly believe this is a symptom of thyroid disease. I have been guilty on more than one occasion, of believing that a simple sinus infection has turned into my last moments on earth.  This is stress we don’t need during our convalescence.  

2.       Don’t get frustrated with the length of time it takes you to heal - An illness can run through our household, my hubby and son can be sick for a few days; meanwhile, I am down for a week or more. Having to spend more time and work much harder to be well used to cause me so much frustration.  Frustration can lead to stress and this can lead to depression and anxiety all these things exacerbate an illness. I’ve had to remember I have a body with a chronic illness and in healing mode.  I must be a patient, patient. If it takes a week to get better than I will continue to rest a week.  Your timetable of healing may not be the same as someone else’s’ so  keep that in mind

3.       “Eat a healthy diet” – Is a very vague statement. It’s best to consume only organic foods, not processed foods stay away from sugar, alcohol. DO NOT OVER EAT or eat a big meal before bed.  Don’t do anything that will tax where the majority of your immune system is housed. Autoimmunees, don’t make your immune system madder than it already is.

  

After several years of peace talks (eating healthier, taking supplements), I think my tract is heading down the right track. I’m not 100% and don’t know if I will ever get there, the damage may be irreparable… but each day I feel myself getting better, stronger.  My IS and I are now on good speaking terms.

Crazy Thyroid Lady

THE MUCH NEEDED...

THYROETRY

Why is it so wonderful now

I fought it staunchly as a child

But, back then, it took me away from my play

And now, I need it to get me through some days

Stress, sickness and strife…for just a few moments is out of my life

For a nap is not just a slumber

Its restoration of the soul, while under

Ahhhh...Now All is Perfect

Crazy Thyroid Lady

What!? You still haven't purchased my thyroid book yet? Do it now, it is a quick and easy read. Wow Your Mom Really is Crazy

YOUR BRAIN FOG LOG

Since my thyroid disease diagnosis, I have mastered the art of list making. I have to create lists on a regular basis, or else many important tasks don’t get done.  The daily schedule I was able to keep contained in my brain must now get jotted down on my portable brain fog log.

My list making skills have been perfected over the years through trial and error,  because I have to make lists for just about everything now.  I thought I would share the top 3 things to remember when creating your “to do” lists.

1.Find the right handy, dandy notebook.  I personally feel more
  comfortable using a notebook instead of an electronic device
  because it is easier for me to have just one notebook dedicated
  to my daily duties…but if an electronic notebook works better
  for you than go for it, the important thing is to come to the
  realization that you probably need to make lists now instead of
  relying on your memory.  Less stressful to:  jot it down, get
  it  done, and then cross it off.

2.Make your lists realistic. Don’t write down an exorbitant 
  amount of tasks to accomplish each day or tasks that are
  completely unrealistic, for example:

Not Ideal                                                                                        Ideal

·         Baby sit the neighbor’s kids for 2 hours                 •  Babysit the neighbor’s kids for 2 hours

·         Clean the house for dinner guests                          •  Nap

·         Make dinner                                                                 •  Work on menu for the rescheduled dinner

·         Entertain house guests                                                 party

·         Help child with homework                                        •  Delegate house chores to family for dinner

                                                                                                            Party

                                                                                                       •  Help child with homework

Note: The “Not Ideal” example may have you in bed for the next two days trying to recuperate.

3. Don’t be cryptic with your lists. Remember your to do lists are there to help you, which means you may have to write a little more than what you are used to.  For example:

Not Ideal                                                                                             Ideal

•   Boogeymom1975@email.com                                              • Boogeymom1975@email.com –   

                                                                                                       need to email her today to let 

                                                                                                       her know I want to take

                                                                                                       the next Zumba class

Note:  The “Not ideal” example…If you are like me, you can walk away from your list for just 10 seconds then come back to it and ask yourself… “Who the heck is Boogeymom?”  You think you will remember when writing it down, I mean come on…how can you forget who Boogeymom is…Ahhh… but trust me the thyroid brain has other ideas.

Click here for some fun Brain Fog Logs aka thyroid notebooks.

Crazy Thyroid Lady

                                                                                                                                                                                                                 

IT IS WORLD THYROID DAY!

Today is World Thyroid Day, what does that mean?

To me, it means none of us are alone in our struggle with this disease. It means there are people not just in your neighborhood, your community, your city/state or country who must deal with the difficult changes to their body that accompanies thyroid disease, rather it is a worldwide epidemic.

The thyroid is a butterfly-shaped gland situated at the base of the neck.  It weighs only one ounce, but controls just about every cell in the body. After being diagnosed with thyroid disease, I look at butterflies differently now. Butterflies start out as ugly, slimy little creepy crawlies that in my opinion, aren’t great to look at, but they have their purpose in nature.  Then, after the caterpillar’s cosmic contribution, they change into one of the most beautiful living things on the planet.  No more crawling around for these creatures as they begin to fly and some species even travel around the world, as far as 3,000 miles. The same butterfly I had the privilege of admiring in all of its beauty, can also be admired by someone thousands of miles away.

On World Thyroid Day, I reflect upon my own butterfly and even though it is not completely functional anymore, my butterfly is symbolic in that it has put me through a lot of changes and each transition that I’ve gone through, during this disease has a universal purpose…The Butterfly Effect.  Some of the changes are ugly, but don’t think that what you are going through is meaningless, there is a reason, don’t think things won’t get better, don’t think that your butterfly will never take off and show its beauty to the world, because it will, if you choose it. Reach out to one of the over 300 million worldwide who may be having a very difficult time with their disease and help them transition into a beautiful butterfly with a purpose.

Crazy Thyroid Lady

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YOUR THERMOSTAT IS BROKEN

Have you ever had a room temperature control tug-of-war with someone?  I’ve had some very heated ones throughout my lifetime.

In the 80’s I had a window war with a co-worker. She would constantly open the window in our office; it didn’t matter if the temp was 10 or 100 degrees outside. Drove me crazy, she would open, I would close, she would open, and I would close…Oh how I welcomed her days off.

In the 90’s I had a temperature tiff with the company’s maintenance man, who kept our office thermostat at “frozen tundra.”  It’s hard to be productive with mittens and a ski mask.  When he wasn’t around, I would use my lock picking tools (bobby pin in my hair) adjusting the temp to normal human-like conditions.

In the 2000’s I battled with my Ford Focus, nearly tearing it apart trying to figure out how to add Freon, so that I could arrive at my destinations not looking and smelling like a zoo animal. When your TSH levels are on the hyper side, the heat you can experience is like no other.

Today My husband and I are in the middle of a ceiling fan fracas, which is just like the window war, but the “on and off” interchange is sometimes done unconsciously. Even when I’m asleep, my body is fighting to feel comfortable.

 

Throughout my life, I think those body temperature issues and the tenacity to feel comfy, was an indication of the thyroid disease which was unknown to me at the time. I had no idea until I was diagnosed with Graves’ disease that the thyroid plays such an important role in body temperature.

Others don’t understand what it is like to have your internal thermostat broken. Under extreme conditions, climate control is of the essence, it is hard to concentrate on anything else at that point.  Right now, in most parts of the world you are heading into seasonal weather change, I hope my fellow battle-tested thyroidians win the fight for comfort.

 Crazy Thyroid Lady

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THYROID MAMA CALLS A FAMILY MEETING

**Where’s my?

**Why didn’t you remind me?

**How come you are just now telling me?

**Did you forget to?

Thyroid suffering mothers, do these statements sound familiar?

There are two males in our household (my husband and teenage son) and before thyroid disease, I kept things in order, kept my boys in line - managed things well. You could even say that mama ran a tight ship. But now, that ship has sailed...annnndddd I’m totally OK with that.

But, I’ll have to admit, that immediately after my diagnosis, I wasn’t OK with the domiciliary disarray that ensued. At present, I’ve come to terms and realized that I can’t and shouldn’t be omnipotent-like to my brood. I am not the same as before, I’m not the same as before, I’m not the same as before... Ahhhh so liberating to say... acceptance is key.

It took me awhile to embrace this concept. Remember my other blog post about going crazy http://crazythyroidlady.blogspot.com/2012/09/go-crazy.html .  To remain sane, I had to go crazy Conserve, Restore Adding Zest to You.

After years of hearing those above phrases from my guys over and over again for many years, I felt it was time to call a family meeting:

"I used to juggle my life and yours with ease, but men, we’ve embarked on a new era. An era that focuses on the realization that undue stress is not ideal for yours truly. At one time I reveled in the all consuming management of this household, even though it may not have been healthy, I had it mastered. But now remembering just my stuff is almost a full-time job. I am asking you to take on more responsibilities around the house.

OK, so...I don’t know where it is, I’m not going to know where it is, I forgot to tell you...let’s get over it, I could try to remind you, but is this a risk you are willing to take? 

Well, now that we got this out of the way, you guys can make dinner while mama takes a nap. Love ya!"

In reality, this is probably how it should have been all along, after all, experts say giving your kids more responsibilities will build confidence and increase self-esteem. And it will help hubby feel like da man! I like to find as many positive as I can post-disease.

Crazy Thyroid Lady

Don't forget to get your copy of my thyroid book Wow Your Mom Really is Crazy