Well, I had my first appointment with my endocrinologist. I like him pretty well, which is good, because I have this feeling I'm going to get to know him real well.
He had some good-natured grumbling about how early I was showing up - I.e. most patients don't show up in his office until they have unmistakeable symptoms. Contrariwise, I'm so early that most symptoms are equivocal - tight judgement calls about what's going on. My fingers have gotten bigger - is it bone growth (definite acromegaly), or soft-tissue growth (could be acromegaly, Cushing's, or something else). Likewise for pretty much every other symptom. Dad's firmly of the opinion it's acromegaly, but Dr. Williams has to show some concrete evidence for a diagnosis - and he doesn't have a baseline of what my face and hands looked like ten years ago.
This is actually a pretty common problem in the specialties. Doctors don't see their patients until they're already sick, so they don't know what "normal" looks like for this particular patient. A friend of mine from when we lived in Iowa had this problem big-time. After some heavy (near toxic level) treatments for a neurological disorder, she noticed that her school performance had dropped dramatically - from A's at a private college, to struggling for C's and B's at a community college. Her neurologist tested her, and she tested out normal, yet she was plainly not normal for her. The lack of a baseline meant that the neurologist couldn't tell what had changed. This is pretty much what's going on with me. My hands aren't outsized beyond the norm (though they are large), my face looks like an ordinary face. Nobody has any objective measurements of what my face and hands and skin condition were like a decade ago to compare to. At best I can pull out some photos from my wedding to compare - and even then it's a case of "is it bone growth or soft tissue swelling?"
The first blood panel shows normal GH, borderline cortisol, and high TSH. Since one normal GH draw means about squat, we're working from ground zero to find out what's going on with my hormones. I had a second panel drawn Monday. Tuesday I had an elimination test for Cushing's. I should get results back from those on Friday or next Monday. Then if the Cushing's is negative, we proceed with the tests for acromegaly. If the Cushing's test isn't negative, then we proceed with the positive tests for Cushing's. (The negative test means: if it's negative, I don't have Cushing's, but if it's positive, I might or might not have Cushing's) In and around all this, we'll be chasing the high TSH levels as well, and trying to figure out what they mean.
I've been deemed "interesting". I could really have lived my life without becoming interesting to an endocrinologist.