Girl #1 saw her psychiatrist Dr A today. He was happy to hear that she feels that her OCD symptoms are non-existent, and that she actually did fairly well in school considering that she’d missed several weeks of the first semester. Since she appears to be stable on her current dose of fluoxetine and is happy with where she is, he will see her in three months’ time.

However, he did write a referral to the endocrinology department for her. She’s been reporting hair loss, feeling cold all the time, having dry skin…basically all the symptoms of hypothyroidism except for the weight gain. Girl #1 last had her TSH levels measured in June last year, at which time they were normal, but Dr A says there’s no harm in having an endocrinologist take a look at her again. There was one day last week when she was so cold that she could no go to school, and her body temperature was between 35 to 36 degrees Celsius, which is definitely not normal. Below 35 degrees Celsius is considered hypothermia!

I pointed out that her issues could be either due to thyroid problems, anaemia, or simply the continuing side effects of fluoxetine, and that sometimes it’s hard for us to decide whether it’s a true problem, or her just being dramatic as some teenagers are wont to be. Dr A agreed, but said that the approach should be to do due diligence, and if everything turns out normal, to assure her that her concerns are being addressed or managed and that she should continue with daily activity as usual.

On balance, I think it was a good review. Let’s hope the next three months are OK and that the endocrine doctors are able to give us some answers when we do get an appointment to see them.