Denial. Or something.

It never ceases to amaze me how certain patients just will not do what their doctor tells them. For instance, I have a patient who is on thyroid replacement after she had a thyroid cancer removed. Well, I should sAy she is supposed to be on thyroid replacement. Several times when I try to check her levels the results indicate she isn't taking the med. I ask her if she is taking it and she says she is. I stress to her that she will feel much better if she takes it, that it is bad for her health when she skips. It doesn't seem to help. She has occasionally taken it, because her labs have come back normal a few times, but then it seems she just stops. Sigh. I had a similar situation in a much younger patient I saw this morning. She is only 22, and has been hospitalized 3 or 4 times because she has very irregular periods that are also so heavy that she bleeds enough to require transfusions. She also is hypothyroid, which makes your periods irregular and can make your blood clot poorly also. Furthermore, she is obese and obviously will never loose weight if her thyroid isn't working. She also just quits taking her thyroid medicine even though she has had several transfusions from her bleeding. She is also supposed to be taking birth control pills to regulate her cycles, which will also stop these dangerously heavy ones. She obviously understands that the reason for her heavy periods is because of her thyroid issue, but she will just up and stop taking it. I can understand when someone who doesn't have insurance and is on an expensive medicine has to stop because of the cost. But when someone has insurance or takes a medicine that you can buy for $4 at Walmart, it makes no sense to me to suddenly stop taking it. Not to mention the fact that when you have hypothyroidism, you feel crappy, tired, And gain weight. So I write her prescriptions, explain why they are important, and hope she listens.....