Short version:

I got labs back from the 29th. I have an abnormal thyroid test result with an inconsistent normal thyroid test result, so my doctor wants me to come back in for more tests. I don't think she took all of the pertinent thyroid tests, because there are more than two. I have a nodule on my thyroid that my doc claims is too small to worry about (3mm).

I also have very low vitamin D levels and very high sugar levels (though not high enough for preventative care, since I don't meet the requisites for prediabetes).

I'm scared.

This is the long version:

Where I live, there's crisis standards of care.

The VA Hospital takes an overflow of civilians when the neighboring hospitals get full. From what I heard, the VA Hospital is only taking non-Covid ER and non-Covid ICU patients at the moment, to free up space at the civilian hospitals for Covid patients, and to keep space available for veterans who need the VA Hospital for Covid care in the ER and ICU.

That said, I still have to visit the VA Hospital to get my labs done. I last visited them at about 6:40 a.m. on 10/29/21. There was hardly anyone there, and everyone wore a mask. I wore two masks (one N95 with a KN95 on top). I felt somewhat protected.

Then, on Saturday, I received an unexpected message from my primary care. The lab results came back and she message me. Although my lab results aren't yet up online, she messaged me some of the results that were abnormal. She said I would need additional labs to check my thyroid because the two thyroid labs she took (blood tests only) were inconsistent (one showed up as normal range, whereas the other showed up as high - meaning that I have low levels of something). So she wants to run more tests.

Meanwhile, I had already told her about the 3mm nodule on my thyroid, which was detected by the VA Hospital in a different state back in 2019. They said that I needed a follow-up ultrasound in a year, which would have meant 2020 was the year I should have it rechecked to see if it has grown. Well, I moved to a different state in 2019, and then the pandemic hit. Although my records are visible to the new VA, the new VA doesn't operate by the same rules as the old VA, so they don't allow for ultrasounds unless the nodule was larger initially or unless I experience worsening symptoms. I find it unfair that people have to get sick with a stage of cancer or a stage of any preventable illness before something gets checked out. I've read online that many people are under-diagnosed or not even diagnosed with a thyroid condition that actually exists. There are more than two blood tests for thyroid, and she should have ordered all of the tests, instead of making me come back a second time.

She knows I have chronic fatigue syndrome, so it takes me a while to build up my strength again in order to return. Additionally, I just received my third Moderna booster after the labs were drawn, so I want to wait until I'm fully covered by that (which I'm assuming is about 2 to 4 weeks after that jab). I've got enough going on that I really don't need my providers to overlook my other conditions. Our hospitals are still in crisis standards of care, so every visit to the hospital is a huge risk, especially for disabled, high-risk people like me.

Additionally, she said that my vitamin D levels are very low. She told me to double whatever vitamin D I was taking. But I told her that I barely started taking vitamin D (5000 IU with vitamin K, for better absorption). I'll have to ask her if it is too risky to double that, as I don't think that's what she meant. I think one a day would suffice, since I wasn't taking any for over 19 months! I also have been homebound for over 19 months, as I'm still isolating in place. My skin is prone to skin cancer moles, as I've already had three removed in the past. I try to avoid getting that. My dad's side of the family is prone to lupus, so I worry whenever I have low platelet counts (thankfully, she said I didn't have that) or other abnormalities that I had last year (which indicated either kidney or liver issues, but this year those seem to have been normal, unless she took different tests). At any rate, before I even took my labs, I told my primary care that I've had a few years of low vitamin D levels, even before I was on constant isolation mode. So that was no surprise. What is surprising is that she didn't prescribe me the 50,000 IUs of that one drug to help with my vitamin D levels. That's what I was always prescribed in the past. Either they have a shortage because they are using it now on Covid-19 patients as a sort of prophylaxis, or this VA (again) is negating the continuity of care that I've been asking for since 2019 - when I moved to this state.

Adding on to all the above, I now have high blood sugar counts. Thankfully, she said my cholesterol was fine, which is in stark contrast to last year, when my cholesterol counts were very high. But this year, she said that those were within normal range. However, she said that I don't qualify yet for prediabetes, even though I'm just a few points off from that. She basically stated that it's all reversible if I cut down on sugars and carbs. I was most concerned about that, including my weight gain, my stress incontinence, my uterine disorder, my occasionally having the urge to urinate frequently, my occasionally being thirsty all the time, my occasionally having different body temperature feelings, etc. But I think she forgot about what I told her. So, I have to figure this diet on my own.

She did mention in the past that my irritable bowl syndrome is common for people with PTSD, and that the FODMAP may help (though it doesn't help in all cases). She suggested that I try that in conjunction with reducing sugars and carbs. I have no idea what I can or cannot eat anymore. And I also haven't been able to get the upper and lower endoscopies that were scheduled for me in 2019 and then cancelled because I didn't have a known rider to take me home or accompany me on the train or in an Uber. So then I thought I'd be able to get the continuity of care when I transferred my records from one VA to another state's VA, where I'm now at. But no. They won't approve of it now, even though the other VA already approved of it. Then, after that, the pandemic hit. So I'm stuck with just following self-care steps on my own, without being able to see a nutritionist, like they had scheduled for me at the other VA. I seriously think that my rapid weight gain (30 pounds increase within a month) is due to a number of factors, including my IBS, thyroid, insomnia, other risks for metabolic syndrome, and issues within my colon area or lower intestines.

So these are the labs I have to deal with so far.

I'm freaking out.

I am also overdue for an eye exam and periodontal work. I'm very nervous about those two things. The only good thing about the dental is that they make all the veterans take a Covid-19 test the day before their scheduled appointment. They get the test back rapidly, so then if I'm negative, I can return the following day for my dental appointment. That's safer than a week or three days prior, and they claim that all the dentists and orthodontists and hygienists wear masks. Not all of them are vaccinated, and they claim in this state that it is "discriminatory" to ask if a provider is vaccinated. If I were in the other (blue) state's VA, they would have no problem. Also, when I asked my mental health providers outside of the VA, as well as the recreational rehabilitation therapist within the VA here in this state, they were more than open to telling me that they were vaccinated. So a reluctance on them claiming vaccination status tells me that they are likely unvaccinated. So now I have to highly rely on their cleaning and mask-wearing abilities, in addition to my vaccinations.

I really cannot afford to get sick with Covid-19 on top of all that I have. It doesn't matter if I'm not severe enough to go to the ER or ICU, and even then, they are on crisis standards of care, so lots of people aren't being seen for certain things here. But I can't afford for my conditions to worsen because of long-Covid or due to the effects of Covid-19 exacerbating my other conditions. It's unfair for people to blame me, a trauma victim, for bringing my risks upon myself, or for stating that I don't deserve to live or get treated as much as other able-bodied people are. It makes me feel like I'm being threatened over and over again, and it really worsens my PTSD and dissociative disorders.

Meanwhile, people are being mean, which exacerbates my cortisol levels, my PTSD, my insomnia, my metabolic syndrome, my weight gain, my hormones, my thyroid, my dissociative disorders, and more. I can't keep running into stressor after stressor after stressor. It's like they are purposely trying to kill people like me off, and they will continue to do so if it means getting what they politically want, or being supreme, or winning the invisible wars they think is going on, or weeding out the weak, or whatever their extremists views are. And maybe I'm paranoid, but I swear that I'm not getting the same treatment as others, or that I'm at least not getting the same treatment as I once had in a different state's VA system.

Going to a civilian doctor would be 10 times worse, because their civilian doctors out here are not overseen by the federal government, and therefore are under the directives of people like Dr. Cole, who believes in ivermectin for treatment of Covid-19, among other conspiracy theories.

I'm really scared for my health and safety out here. I want to get all this done, but it's a risk to be seen by any doctor in this state. It's hard to trust them, being a minority at least. Then again, many veterans would also say that it's hard to trust the VA system altogether.