I went to his office the other day to tell him that I’d finished the Clonidine and that I didn’t like it. Since I’m unemployed, I offered to sit in his reception area and wait until he had a spare minute to talk to me. But his receptionist sent me away and said that the doctor would call me later. When he called, he agreed that I should stop the Clonidine. He said that he could prescribe some beta blockers, but that the effect would likely be the same. He also said that there were some pretty hardcore surgical options to address the sweating, but he wouldn’t recommend them.

Then he divested again, telling me that I should go to my family doctor and get him to submit a request to the HMO for a second opinion with a specialist at Mass General. Apparently, this is something the HMO offers for people on their supplementary plans. Perhaps I’ll do this. Perhaps I won’t.

In the mean time, I’m starting a gluten-free diet. I’ve done the gluten free diet several times, but usually combined with something else. Once it was no grains, once gluten-free and dairy-free, a couple times paleolithic. I have long believed that I might have Celiac disease, especially after I failed to rule it out with genetic testing about five and a half years ago (HLA DQ2 was not detected; HLA DQ8 was detected). Still, the blood tests usually come back in the normal range toward the high end, and I’ve had two upper endoscopies that were clean, as well as a colonoscopy.

Both hypothyroidism and Celiac can affect pretty much every part of the body, so excessive sweating could be caused by Celiac, as well as the fact that I had diarrhea every day for the past 17 days.

I’m two days into the gluten-free diet and feeling ok. I’m a little bloated because of all the fruit, but I’m having an easier time than I did in the past because I’m eating rice and dairy and processed foods. I plan to keep it up for two weeks and then evaluate how I feel and whether the sweating has diminished at all.

I called the endocrinologist who prescribed the Clonidine and told him about what had happened. At that point I had already begun to doubt that the problems had been caused by the Clonidine. Vomiting and sweating are not really among the common and expected side effects, so I wanted to notify him and get his opinion about whether I should continue taking it.

He agreed that my reaction was probably not to Clonidine and that I should go to a regular doctor about what sounded like an infection. So then I started to get worried that I might have the swine flu. My understanding is that swine flu is quite a bit like regular flu except it comes on suddenly, which had happened in my case. After some deliberation, I decided to go to the HMO’s urgent care center and get tested.

So I took a taxi there, because I was way too weak to walk. My fever had completely subsided, but I had that “sick” feeling of overall weakness and fatigue, muscle ache, headache, etc. They drew blood and hooked me up to an IV for a while and gave me some liquid Optalgin orally (Optalgin, for people who live in the United States where it isn’t available, is a highly effective medication for pain that is not a narcotic).

The doctor there was kind of a moron and he kept taking my head in his hands and jerking it around. Then he’d ask me if it hurt. Of course it hurt, I told him; I had a headache and it was painful and unpleasant to have my head jerked around. After my saline drip ran out, the nurse came by and told me that I didn’t have swine flu (yay!) but that I might have meningitis and that I needed to go to one of the local hospitals to see a neurologist so it could be ruled out (boo!).

Apparently it was urgent enough for them to insist that I go to a hospital, but not so urgent that they transport me to one, so I took another taxi to the hospital closest to my home. After arriving at the emergency room, I waited for a very long time to see a doctor. Finally I did see one, and he told me that he was going to order some blood tests and x-rays of my chest. Why, I asked, couldn’t he just use the HMO’s blood tests, the results of which I was carrying around in my backpack? And why was he ordering a chest x-ray? He didn’t answer.

So l let them draw my blood again. It is a HUGE hassle every time I get blood drawn, because I faint if I’m not lying down, and because my veins are always really hard to find, so the nurses always want to draw it from my hand, but that is painful so I never allow it. Actually I originally fell asleep while I was waiting there for someone to draw my blood, so that was a nice little nap.

Then I went over to the x-ray area and sat there for a very long time until it was my turn for chest x-rays. I told the technician that I was there complaining of a headache and didn’t see the need for chest x-rays, but she told me that she only follows orders. Then I was sent back to the emergency room area to wait. The receptionist told me it would be at least one hour before a doctor could review my results.

After about an hour and a half, I finally got to see a doctor. He had my chest x-ray on his computer screen. The first thing he asked me was: “I can see from your charts that you’ve been here in the emergency room a really long time – like many, many hours. Why have you been here so long?” And my response was: “Are you fucking serious?”

So that got him on edge a little bit, which is good, because a doctor who isn’t on edge stops thinking and then patients might die. He started looking hard at my x-ray and told me that he was really concerned about my bowels. When was my last bowel movement? he wanted to know. I could pretty much only laugh, because I’d gone to the HMO thinking there was a chance might have swine flu; they’d sent me to the hospital thinking I might have meningitis; the hospital had ordered chest x-rays; and now a doctor was so totally absorbed by my freaking bowel that he was not focusing on the fucking issue at hand.

I explained this all to him, and told him I’d like to see a damn neurologist so I could leave. He replied that I probably didn’t have meningitis and that I could leave if I’d sign a document stating such and such. I asked him just how long it would take to see a neurologist, since I knew there had to be at least one neurologist in the hospital at all times.

He brought me back to the receptionist and told her to get a neurologist down to the emergency room for me. After another very long wait, a neurologist materialized who didn’t speak any English or enough of our local language. She was in fact an immigrant like me, but we had no mutually communicable languages! So we got a translator to interpret a very brief exchange that settled the issue: I did not have meningitis. BUT … I might have sinusitis, and she wanted … to order … x-rays. Of my head. Right.

I refused this x-ray, on the grounds a) that if I had sinusitis, it was not an emergency and was best not dealt with in an emergency room, and b) the more time I spent in an emergency room, the more likely I was to get sick there.

It took another half hour or so, but I finally got all the paperwork squared away to leave the hospital. As I was heading out the door, I could see the doctor pull over one of his colleagues to discuss my bowels.

I intentionally didn’t get my thyroid blood tests done this time, because I don’t give a damn what the results would say. No matter what, I’ll continue taking whatever medications, in whatever amounts, I find to treat my symptoms.

I desperately want, and have wanted for the past two years, this endocrinologist to address the fact that many of my hypothyroid symptoms have not gone away with treatment for hypothyroidism, whether using synthetic T4, synthetic T3, or natural T4+T3. The main three are weight gain, sleep disturbance and sweating. Right now I’m managing the sleep problem with melatonin, though I prefer not to; the weight gain isn’t such a big deal because I don’t really care about my weight; but the sweating, however, is really awful.

He seemed surprised that I hadn’t tried anything for the sweating yet. He gave me a prescription for Clonidine, which is a medication for high blood pressure that is also used to treat some other things. I am kind of worried to take it because I have already fainted a half dozen times and strongly prefer not to do so again. But I’m going to take it at night when I take my melatonin, so I’ll be in my bed or close to it anyway.

The doctor asked me to call him in two weeks and tell him how it’s going with the Clonidine. His receptionists do a terrible job and he never gets messages, so I guess I’ll have to go back over there to deliver the message in person.