But before that (and apologies, Higher Being, if you do in fact exist) there are more pressing matters. In fact, I’ve got a (short) week’s worth of questions, so even though we aren’t supposed to ask the Four Questions til Passover in the spring, I’m going to ask them now.

You, GIAPH readers, are my kitchen cabinet. And I need some advice.

First up today is a rather specialized topic: The Thyroid.

It’s barely 6 a.m. here, hours til I can call the cardiologist — which I fully intend to do — to share the information the endocrinologist gave me Friday. From what that doctor said, Sophie’s thyroid issues are borderline. He suggests medicating now because, as he put it, what the heck, her body will simply get rid of any extra thyroid medication it doesn’t need.

Really? I asked. Then why don’t you just give this medication to people with Down syndrome from birth on, since so many develop thyroid problems and you’re telling me that unchecked, they cause developmental delays this population can ill afford?

The doctor — who runs the practice at an esteemed local childrens hospital here — couldn’t really answer that, even in front of the two students he was clearly performing for. (Yeah, it got crowded in the exam room, with five of us. And yeah, as you can tell, I’m not this guy’s hugest fan at this point. For one thing, don’t hug me, doctor. We just met.)

Anyhow, I do like Sophie’s cardiologist, so we’ll chat about whether this medication is a good idea for a kid who’s had open heart surgery twice and still has underlying cardiac issues. But meantime, anyone have any advice/personal experiences to share?

Here are the facts, sent to me by one of the doctor’s students (lack of command of the English language is all hers):
TSH = 6.73 ( ref. range 0.5- 5.4 mU/L)

Free T4 = 1.1 ( 0.9- 1.6 ng/dL)

Based on 2 blood determinatios that showed elevated TSH, we are recommending sophie to start on low dose thyroid hormone ( Levothyroxine 25 mcg daily).