I am permanently blind, not from the Cialis-induced vitreous hemorrhage, but because of the PRP laser treatment inflicted by Dr. Michael O’Brien of Koch Eye Associates. I think his employer is as much to blame as Koch has advertised for PRP patients rather than eye tests to see if PRP treatment is prudent for specific patients.
But I still see it as my own fault for letting myself be scared into it. "O’Brien had said, "You’re probably right about the Cialis, but what if you’re not?"
Yes, three years later I remain angry and bitter about this, and other massive "wrongness" from the Koch offices and associates.
I suppress the anger and fight the negativity on a daily basis. Some days don’t succeed as well as others. This is a pattern that has enshrouded me for my entire life. I won’t get into why that’s so. Who wants to hear self pitying whining?
I’ve lost maybe eighty percent of my life to this, and maybe more. Nothing is the same and everything is different, every function, every relationship.
My blindness is legal blindness. The left eye is not dark, just greatly impaired by a few different factors. As long as I have that bit of vision left, as long as I can still find the fridge and the toilet and the keyboard, I can make the most out of what I have left.
I have to content myself with that.
I will content myself with that.
Showing posts with label Medical Malpractice. Show all posts
Showing posts with label Medical Malpractice. Show all posts
Wednesday, February 6, 2013
Tuesday, October 9, 2012
Blood Sugar Downer
The change in Wal-Mart generic insulin manufacture has brought more frequent periods of discomfort with "low" sugar levels. I use quotes on "low" as acknowledgment that this is by feel, not by blood testing numbers.
Overall the sugar has felt lower with the Novolin than it had been with the Humulin formula. Since the toe problem that landed me in the hospital in the spring, I was making a concentrated effort for an overall lowering of the blood sugar. The change in insulin seems to have made a sharper change in that direction, unfortunately at a time when I was looking to slowly raise it again so I would feel overall better health.
People, including my GP, do not understand that last statement. Diabetics do. I do not feel as good when the sugars are lower. Diabetics who are good doobies and paint by numbers also report that they feel less well when their sugars are at better numbers. I’m still waiting for that lucky day when I meet a doctor who understands that how a patient feels is somewhat more important than what test numbers statistically say about their health. At least two of the three other diabetics with whom I have most recently spoken with in general terms report that they primary care givers and/or diabetic specialists have railed against missed target numbers without regard to how the patients were actually feeling, so I am not holding my breath on meeting the more compassionate and logical doctor. Both of those acquaintances were discouraged that no effort seems enough.
I have never recovered the feelings of wellness and functionality I possessed prior to "taking care of myself better." By the full chains of events, I would not be blind nor crippled by the collapsed ankle via Charcot foot if I had not started taking care of myself better. I My numbers had risen again and things got better, but never back to where they had been, even discounting the blind thing and the cripple thing.
I did make a renewed effort on my own after this spring’s hospitalization. The Charcot foot had nearly totally impeded circulation in the foot, allowing for the sudden infection and almost instantaneous gangrene and the collapse of the bone structure that has permanently impaired my ankle. My largest steps were to eliminate as much of the big (and hidden) source of sugar in my diet as possible, and letting my sugar levels stay at critically low feeling longer than I usually would.
I don’t need an A1C test to know I have succeeded. I don’t feel as well as I did prior to the hospitalization. Fatigue is constant. When the sugar hits a low feel level, the physical symptoms hit much sooner after the temperament issues than they used to. Those temperament issues are more severe and the "calm" times between are periods of severe depression that is biochemically impacted beyond the constant "useless gimp" feelings that are situational depression that anyone would feel in my situation. My thoughts are usually slower. I tire more easily. Stamina is gone. Neuropathy burns are more frequent. The depression had reached such an abyss that I found no choice other than to resume antidepressants.
Does this sound like healthier living?
It sure don’t feel like it.
Overall the sugar has felt lower with the Novolin than it had been with the Humulin formula. Since the toe problem that landed me in the hospital in the spring, I was making a concentrated effort for an overall lowering of the blood sugar. The change in insulin seems to have made a sharper change in that direction, unfortunately at a time when I was looking to slowly raise it again so I would feel overall better health.
People, including my GP, do not understand that last statement. Diabetics do. I do not feel as good when the sugars are lower. Diabetics who are good doobies and paint by numbers also report that they feel less well when their sugars are at better numbers. I’m still waiting for that lucky day when I meet a doctor who understands that how a patient feels is somewhat more important than what test numbers statistically say about their health. At least two of the three other diabetics with whom I have most recently spoken with in general terms report that they primary care givers and/or diabetic specialists have railed against missed target numbers without regard to how the patients were actually feeling, so I am not holding my breath on meeting the more compassionate and logical doctor. Both of those acquaintances were discouraged that no effort seems enough.
I have never recovered the feelings of wellness and functionality I possessed prior to "taking care of myself better." By the full chains of events, I would not be blind nor crippled by the collapsed ankle via Charcot foot if I had not started taking care of myself better. I My numbers had risen again and things got better, but never back to where they had been, even discounting the blind thing and the cripple thing.
I did make a renewed effort on my own after this spring’s hospitalization. The Charcot foot had nearly totally impeded circulation in the foot, allowing for the sudden infection and almost instantaneous gangrene and the collapse of the bone structure that has permanently impaired my ankle. My largest steps were to eliminate as much of the big (and hidden) source of sugar in my diet as possible, and letting my sugar levels stay at critically low feeling longer than I usually would.
I don’t need an A1C test to know I have succeeded. I don’t feel as well as I did prior to the hospitalization. Fatigue is constant. When the sugar hits a low feel level, the physical symptoms hit much sooner after the temperament issues than they used to. Those temperament issues are more severe and the "calm" times between are periods of severe depression that is biochemically impacted beyond the constant "useless gimp" feelings that are situational depression that anyone would feel in my situation. My thoughts are usually slower. I tire more easily. Stamina is gone. Neuropathy burns are more frequent. The depression had reached such an abyss that I found no choice other than to resume antidepressants.
Does this sound like healthier living?
It sure don’t feel like it.
Sunday, September 30, 2012
The Cure Found!
I have long had the view that diabetes should be an easy thing to cure. Do a pancreas transplant. I figured there might be factors I don’t know which may make such solutions more complicated or risky or impossible than I realize, but I always figured my cynical assumption fit this lack of solution best: Pharmaceutical companies and other for-profit medical industries do not want the cash cow that is diabetes cured. Their desperation to hold onto income sources is more important than the comfort and well being of patients who are a captured market for the products and services. Manufacturers of diabetic products are the biggest donors to diabetic organizations. With their money to the charities comes their power over the charities. Their money via lobbyists and research gives power over the government and their agencies. any people, particularly doctors, are quick to call me cynical or paranoid.
My response is one of two old quotes about paranoia: "Even paranoids have real enemies" and "A paranoid is someone with all the facts at his disposal."
While worrying myself that a bad combination of probably separate digestive tract issues was diabetic kidney problem, I was perused a website:
http://www.netdoctor.co.uk/diseases/facts/diabetickidneydisease.htm
From this site I picked up an offhand quote at the very bottom of the article before references are listed,
"In some centres a transplant of the pancreas is done at the same time as the kidney transplant – removing the need for insulin or tablet treatment for diabetes."
So, they are already doing pancreas transplants. They are not doing them here in capitalist America, but a country with an evil "scourge" in medicine, a socialist system.
I’ve never found this information when looking for it directly. Finding it in such an offhand and almost accidental way certainly feeds my paranoia.
My response is one of two old quotes about paranoia: "Even paranoids have real enemies" and "A paranoid is someone with all the facts at his disposal."
While worrying myself that a bad combination of probably separate digestive tract issues was diabetic kidney problem, I was perused a website:
http://www.netdoctor.co.uk/diseases/facts/diabetickidneydisease.htm
From this site I picked up an offhand quote at the very bottom of the article before references are listed,
"In some centres a transplant of the pancreas is done at the same time as the kidney transplant – removing the need for insulin or tablet treatment for diabetes."
So, they are already doing pancreas transplants. They are not doing them here in capitalist America, but a country with an evil "scourge" in medicine, a socialist system.
I’ve never found this information when looking for it directly. Finding it in such an offhand and almost accidental way certainly feeds my paranoia.
Saturday, September 29, 2012
Type 2 at 72
I had occasion to recently talk to a friend who has been a Type 2 diabetic for almost 10 years. He is on insulin shots and had "well being" issues during a time when his doctor would prescribe any designer insulin. He also does not feel as well when his sugars are lower.
He most definitely developed Type 2 diabetes for dietary excesses. He lost a lot of weight when he started the diabetes regimen, but never saw true success with diabetes management until he stopped experimenting with oral medications and went to the needle. I have him solidly in mind whenever I advise anyone to skip the designer oral medications that doctors and their pharmaceutical sponsors push and go right for the needle.
He is not someone "similar" to me but of a different generation. People, including sometimes his own (adult) children, consider him kind of stupid. He speaks often and too much, sometimes approaching levels of a gossiping housewife, but he does not speak well. He is not well educated, and I am not even certain he graduated high school. His presentation may not be polished and of high vocabulary, but he is not stupid. He is quite intelligent in that life experience way.
He tests his sugars via home meter twice a day these days. He used to do it far more often. He rotates fingers, using all ten. He’s experimented with finger adjustment with an innate curiosity that should tell anyone that this is no stupid person. His experimentation showed him that even the finger used can alter results of the meter test. A 100 on the middle finger might be a 103 at the thumb or a 98 at the pinky. "Never callin’ a 200 when it’s there at 120, but it’s different," he assured me.
He uses all ten fingers in rotation. "I went like a week or so only using one finger," he told me. He was noticing decline in his sense of touch, so was looking to reduce that in most of his hands. "The entire fingertip turned black," he said. This told his common seismical brain to rotate fingers. He knows the number will be off from finger to finger, but only by a few points, and always "in the ballpark."
He has to show more caution with everything he does. He has so little sensation left in his fingertips that he is prone to drop dishes when washing them. Other times, "just for no reason" his fingertips will burn from the inside.
I told him, with my usual cynical humor, that he should send thank you letters to One Touch Ultra and Accu-chek. After telling me I always was a smart ass, he told me that the fingertips problem makes writing more difficult than it’s worth.
This diabetic’s problems that I bring up is not "just" a problem of diabetes. Diabetes reduces circulation and other metabolic and neurological functions, but did not spontaneously cause the extent of neuropathy he suffers. The home meter testing caused the actual problems.
I urge anyone and everyone to talk about all treatments with their doctors and to research every aspect on their own. As debilitating as diabetes can be on its own, many of the treatments cause their own problems. Regular readers of the blog know that my own experiences have taught me these lessons, often in irreversible ways. PRP laser treatment can cause the very problems it is supposed to prevent. Routine diabetes eye care with dilation of the pupils then strobing with intense light can cause light sensitivity. Home blood sugar testing can cause neuropathy. These treatment will not change if patients follow recommendations like sheep, without thought or input of their own. Without patient input and with a love of the perks and enticements, doctors will not question the information that the pharmaceutical companies provide. Without pressure, the [pharmaceuticals will never relinquish profits, even when those are derived from the discomfort and detriment of the patients (and their government) paying for it.
He most definitely developed Type 2 diabetes for dietary excesses. He lost a lot of weight when he started the diabetes regimen, but never saw true success with diabetes management until he stopped experimenting with oral medications and went to the needle. I have him solidly in mind whenever I advise anyone to skip the designer oral medications that doctors and their pharmaceutical sponsors push and go right for the needle.
He is not someone "similar" to me but of a different generation. People, including sometimes his own (adult) children, consider him kind of stupid. He speaks often and too much, sometimes approaching levels of a gossiping housewife, but he does not speak well. He is not well educated, and I am not even certain he graduated high school. His presentation may not be polished and of high vocabulary, but he is not stupid. He is quite intelligent in that life experience way.
He tests his sugars via home meter twice a day these days. He used to do it far more often. He rotates fingers, using all ten. He’s experimented with finger adjustment with an innate curiosity that should tell anyone that this is no stupid person. His experimentation showed him that even the finger used can alter results of the meter test. A 100 on the middle finger might be a 103 at the thumb or a 98 at the pinky. "Never callin’ a 200 when it’s there at 120, but it’s different," he assured me.
He uses all ten fingers in rotation. "I went like a week or so only using one finger," he told me. He was noticing decline in his sense of touch, so was looking to reduce that in most of his hands. "The entire fingertip turned black," he said. This told his common seismical brain to rotate fingers. He knows the number will be off from finger to finger, but only by a few points, and always "in the ballpark."
He has to show more caution with everything he does. He has so little sensation left in his fingertips that he is prone to drop dishes when washing them. Other times, "just for no reason" his fingertips will burn from the inside.
I told him, with my usual cynical humor, that he should send thank you letters to One Touch Ultra and Accu-chek. After telling me I always was a smart ass, he told me that the fingertips problem makes writing more difficult than it’s worth.
This diabetic’s problems that I bring up is not "just" a problem of diabetes. Diabetes reduces circulation and other metabolic and neurological functions, but did not spontaneously cause the extent of neuropathy he suffers. The home meter testing caused the actual problems.
I urge anyone and everyone to talk about all treatments with their doctors and to research every aspect on their own. As debilitating as diabetes can be on its own, many of the treatments cause their own problems. Regular readers of the blog know that my own experiences have taught me these lessons, often in irreversible ways. PRP laser treatment can cause the very problems it is supposed to prevent. Routine diabetes eye care with dilation of the pupils then strobing with intense light can cause light sensitivity. Home blood sugar testing can cause neuropathy. These treatment will not change if patients follow recommendations like sheep, without thought or input of their own. Without patient input and with a love of the perks and enticements, doctors will not question the information that the pharmaceutical companies provide. Without pressure, the [pharmaceuticals will never relinquish profits, even when those are derived from the discomfort and detriment of the patients (and their government) paying for it.
Wednesday, September 19, 2012
Diabetes Complications: Neuropathy
Diabetes stands as one of or the very mos common causes of neuropathy, specifically the forms of neuropathy frequently called diabetic neuropathy or peripheral neuropathy.
Diabetic neuropathy roots solely from the diabetic condition rather than external injury or toxin exposure or infection. Diabetes is just one of a number of metabolic disorders that can lead to neuropathy. Diabetes is at its core a major metabolic disorder. Neuropathy is all but inevitable in diabetes.
Peripheral neuropathy is nerve damage away from the brain and spine, which form the center of the nervous system. The nerves are damaged. With diabetics, reduced circulation–also a near inevitability–causes the nerve damage. In my experience, doctors downplay the inevitabilities of diabetes because they are afraid patients will too quickly resign themselves to the eventualities without ever truly trying to take care of themselves. These problems are nearly inevitable, but the lack of self care will bring the problems sooner rather than later. I seek to communicate more honestly than doctors have by my experience, but am not dispensing medical advice. Nor do I think much of anyone who gives in to the negatives without a fight. "Inevitable" should never be interpreted as "immediate."
The nerve damage can affect sensations of temperature and pain. Neuropathy causes pain and numbness, most frequently in the hands and feet. This is the source of foot problems and high risk for them among diabetics. If the diabetic cannot feel pain in his feet, he can be unaware of injuries. Ignorance of bone problems most often results in my friend Charcot Foot. The more common risk that plays out is infections from cuts, punctures and abrasions on the feet that the diabetic cannot feel. Diabetics should wear socks and shoes at all times in an effort to prevent avoidable problems. Yet, as always with this miserable conditions, the patient must also take precautions with the precautions. Socks should not be so tight as to reduce circulation. Shoes should be well fitted, neither tight enough to cut into the feet nor loose enough to cause friction burns and abrasions. Shoes should never be worn without socks. Open wounds caused by shoes can be the most sinister; their gradual development makes them the easiest to not realize you have caused.
I learned one thing about neuropathy in a hard way that almost cost me my life. The neuropathy and generalized reduced diabetic circulation in my feet have made "toe testing" of water temperatures completely unreliable. On a friend’s boat a few years back, I had sat in the back with my feet in the water. It didn’t seem that cold. I dove in. The water was cold, so cold it triggered shock. I almost drown. Conversely, bath water might be much hotter than the diabetic toe can judge. Always check with an elbow rather than an extremity.
The neuropathy topic directly bridges into the running blood sugar testing topic. Please note the information from earlier in this post, a very subtle point in the overview: "Diabetic neuropathy roots solely from the diabetic condition rather than external injury..." Medical professionals probably will not point out to you that all the finger pricking of traditional home testing is likely to advance or cause neuropathy in the patient’s fingertips. You cannot keep sticking lancets into your fingertips without causing nerve damage on some level. This, and not the discomfort, prompted the recent push for non fingertip testing. Some sources on the net do not cite better than the 10% inaccuracy of arm testing than the patient could see with urine testing.
This risk to the fingertip nerves stood as one of my rationalizations against hopping on the home meter testing bandwagon. Again I warn: I have managed my diabetes with care, but in contrast to modern preferences and standards. I recommend anyone reading this to have frank conversations with their doctors before just doing what I do, and recent Type 2 diagnoses will require some form of home testing.
Diabetic neuropathy roots solely from the diabetic condition rather than external injury or toxin exposure or infection. Diabetes is just one of a number of metabolic disorders that can lead to neuropathy. Diabetes is at its core a major metabolic disorder. Neuropathy is all but inevitable in diabetes.
Peripheral neuropathy is nerve damage away from the brain and spine, which form the center of the nervous system. The nerves are damaged. With diabetics, reduced circulation–also a near inevitability–causes the nerve damage. In my experience, doctors downplay the inevitabilities of diabetes because they are afraid patients will too quickly resign themselves to the eventualities without ever truly trying to take care of themselves. These problems are nearly inevitable, but the lack of self care will bring the problems sooner rather than later. I seek to communicate more honestly than doctors have by my experience, but am not dispensing medical advice. Nor do I think much of anyone who gives in to the negatives without a fight. "Inevitable" should never be interpreted as "immediate."
The nerve damage can affect sensations of temperature and pain. Neuropathy causes pain and numbness, most frequently in the hands and feet. This is the source of foot problems and high risk for them among diabetics. If the diabetic cannot feel pain in his feet, he can be unaware of injuries. Ignorance of bone problems most often results in my friend Charcot Foot. The more common risk that plays out is infections from cuts, punctures and abrasions on the feet that the diabetic cannot feel. Diabetics should wear socks and shoes at all times in an effort to prevent avoidable problems. Yet, as always with this miserable conditions, the patient must also take precautions with the precautions. Socks should not be so tight as to reduce circulation. Shoes should be well fitted, neither tight enough to cut into the feet nor loose enough to cause friction burns and abrasions. Shoes should never be worn without socks. Open wounds caused by shoes can be the most sinister; their gradual development makes them the easiest to not realize you have caused.
I learned one thing about neuropathy in a hard way that almost cost me my life. The neuropathy and generalized reduced diabetic circulation in my feet have made "toe testing" of water temperatures completely unreliable. On a friend’s boat a few years back, I had sat in the back with my feet in the water. It didn’t seem that cold. I dove in. The water was cold, so cold it triggered shock. I almost drown. Conversely, bath water might be much hotter than the diabetic toe can judge. Always check with an elbow rather than an extremity.
The neuropathy topic directly bridges into the running blood sugar testing topic. Please note the information from earlier in this post, a very subtle point in the overview: "Diabetic neuropathy roots solely from the diabetic condition rather than external injury..." Medical professionals probably will not point out to you that all the finger pricking of traditional home testing is likely to advance or cause neuropathy in the patient’s fingertips. You cannot keep sticking lancets into your fingertips without causing nerve damage on some level. This, and not the discomfort, prompted the recent push for non fingertip testing. Some sources on the net do not cite better than the 10% inaccuracy of arm testing than the patient could see with urine testing.
This risk to the fingertip nerves stood as one of my rationalizations against hopping on the home meter testing bandwagon. Again I warn: I have managed my diabetes with care, but in contrast to modern preferences and standards. I recommend anyone reading this to have frank conversations with their doctors before just doing what I do, and recent Type 2 diagnoses will require some form of home testing.
Saturday, September 15, 2012
Bad Diabetic!
Specific disagreements exist between my GP and me. If I tell him about a new problem, he is inclined to do one or both of two things. Blane the diabetes without considering other likely factors I report, and toss another drug my way. I have always been one to seek natural solutions or even suffer through something temporary before resigning myself to chemical solutions. The Cialis-caused vitreous hemorrhage does not steer me closer to taking a drug for any and every complaint. As a result, my GP is less effective to me because I tend not to mention minor or recurring problems if I think he will not consider the contributing factors.
The GP is not alone in this. When I reported the side effects of prednisone to my current eye doctor, she waved me off and told me "that’s the diabetes" and that I should get my kidneys checked. This is hard to accept when the symptoms matched those listed as side effects of prednisone and their onset coincided exactly with taking the prednisone. They also stopped in perfect timing when I had temporarily discontinued the prednisone.
Type 2 diabetics beware: one thing you will learn about your status as a diabetic is that medical professionals will stop looking for other causes to problems.
I pay more attention to my health and well being than people realize. If I am feeling different, I am going to look at recent changes or adjustments before I resign myself to blindly accepting general statistics that something "just happened" because I am diabetic. Yes, diabetes can contribute to dozens of problems and complications.. My system had been stable for years, and in my experience including the eye and foot problems that now permanently plague me, diabetes was a sinister opportunist in amplifying problems, not a spontaneous cause of any of them.
My GP does not accept this. Many don’t. My GP has one glaring annoyance with me. I do not think he is wrong on this point. He may very well be right, but this issue has side effects and other problems that he finds acceptable. Don’t. There’s discomfort involved, and permanent problems that diabetes can become opportunistic of, even though the problem roots from diabetes treatment.
The warning before the big reveal here: I can get away with this. Arrogant as this sounds, I’m smarter than average. More importantly, I pay attention to my body and what it says and what recent changes may contribute to new or different feelings for good or bad. I have been diabetic for almost forty years, and that’s a lot of experience.
Type 2 diabetics especially should not take my discussion of how I handle myself as medical advice or encouragement for them to do things the same way. The learning curve of the newly diagnosed takes years to develop, and anyone without the innate knowledge of themselves and their body’s reactions cannot handle this the same way.Here’s the basic, drastic reveal of death defying management that baffles and angers most medical professionals. This will be shaping the direction of the blog for a while as I go into details in the future.
I refuse to home test my blood sugar.
The GP is not alone in this. When I reported the side effects of prednisone to my current eye doctor, she waved me off and told me "that’s the diabetes" and that I should get my kidneys checked. This is hard to accept when the symptoms matched those listed as side effects of prednisone and their onset coincided exactly with taking the prednisone. They also stopped in perfect timing when I had temporarily discontinued the prednisone.
Type 2 diabetics beware: one thing you will learn about your status as a diabetic is that medical professionals will stop looking for other causes to problems.
I pay more attention to my health and well being than people realize. If I am feeling different, I am going to look at recent changes or adjustments before I resign myself to blindly accepting general statistics that something "just happened" because I am diabetic. Yes, diabetes can contribute to dozens of problems and complications.. My system had been stable for years, and in my experience including the eye and foot problems that now permanently plague me, diabetes was a sinister opportunist in amplifying problems, not a spontaneous cause of any of them.
My GP does not accept this. Many don’t. My GP has one glaring annoyance with me. I do not think he is wrong on this point. He may very well be right, but this issue has side effects and other problems that he finds acceptable. Don’t. There’s discomfort involved, and permanent problems that diabetes can become opportunistic of, even though the problem roots from diabetes treatment.
The warning before the big reveal here: I can get away with this. Arrogant as this sounds, I’m smarter than average. More importantly, I pay attention to my body and what it says and what recent changes may contribute to new or different feelings for good or bad. I have been diabetic for almost forty years, and that’s a lot of experience.
Type 2 diabetics especially should not take my discussion of how I handle myself as medical advice or encouragement for them to do things the same way. The learning curve of the newly diagnosed takes years to develop, and anyone without the innate knowledge of themselves and their body’s reactions cannot handle this the same way.Here’s the basic, drastic reveal of death defying management that baffles and angers most medical professionals. This will be shaping the direction of the blog for a while as I go into details in the future.
I refuse to home test my blood sugar.
Tuesday, September 11, 2012
Drive and Function
I did not use the boner pills that my GP had provided when I complained to him about sexual drive issues. I know myself and pay attention to how I am feeling and factors medical and emotional that would have me feeling that way. I was pretty certain that I was having drive issues, not dysfunction. My general practitioner waved this theory off and gave me a free trial of Cialis.
I tested my theory before popping any blue pills. I forced myself to watch some favorite porn. On the computer. I used the picture viewer to roll through still images at a pace that allowed them to penetrate the subconscious rather than fixating on the familiar favorites. Everything worked as well as it had before. That proved to me that the issue was not dysfunction that could be medicated, but depressive disinterest. I took none of the boner pills, not even out of curiosity or some dim witted hope that they would make it even better. I am single and unattached, so my disinterest was not something impeding or impacting anyone else. I was really OK with it.
That changed when I did start on an anti-depressant, a generic of Prozac. The Prozac lifted the deep clinical aspects of the depression. My drive returned, but the Prozac triggered actual dysfunction. Off anti-depressants, I had function without drive. On them I had drive without function. Rocks and hard places, I guess.
On 5 October 2009, in preparation for a good opportunity in the afternoon, I took on of the boner pills my GP had given me. It had only been the third time I had taken one ever, and the prior dose had been a month or more before.
On 6 October 2009, a vitreous hemorrhage dumped blood into my eye. I could see a shadow slowly rolling through my sunlight eyelid as I woke, the spread of a thick liquid rolling over my sight, not unlike many old horror movies would have blood flow the screen to black. Opening the eye brought brilliant rose colored vision. The slow flow was blood.
I’ve written about this before, in the most detail on the very earliest posts on this blog in October 2011. I have never added the details of the source of the Cialis.
I doubt that I would have ever asked about a straightforward dysfunction issue with my doctor. If so, I probably would have brought it up in question of the effects of the Prozac. He probably would have told me the problem had nothing to do with the drug, but was all because I am diabetic and solely because I am diabetic. He has shown this attitude about other things that had overlap with the sugar, and he has totally waved off legitimate questions about potential side effects of other drugs he or his office has prescribed, both before and after the hemorrhage.
I point no finger at my GP for my blindness, even though the storm of problems would not have begun without that free sample of Cialis. I blame myself for taking it. I blame Eli Lilly and Company and the other boner pill manufacturers for downplaying and suppressing this horrifying side effect. I am not above pointing fingers, but I never do so casually or defensively. The aim of the fingers I do point is very accurate. I’m not sure enough about this situation.
Blaming my GP would be one things. I can avoid the impulse because I do not believe he had any awareness of the potential problem. I do think that maybe he should have had that awareness.
While I don’t blame him, neither do I trust him. There, I think, rests some friends’ argument that I should look for a new GP.
I tested my theory before popping any blue pills. I forced myself to watch some favorite porn. On the computer. I used the picture viewer to roll through still images at a pace that allowed them to penetrate the subconscious rather than fixating on the familiar favorites. Everything worked as well as it had before. That proved to me that the issue was not dysfunction that could be medicated, but depressive disinterest. I took none of the boner pills, not even out of curiosity or some dim witted hope that they would make it even better. I am single and unattached, so my disinterest was not something impeding or impacting anyone else. I was really OK with it.
That changed when I did start on an anti-depressant, a generic of Prozac. The Prozac lifted the deep clinical aspects of the depression. My drive returned, but the Prozac triggered actual dysfunction. Off anti-depressants, I had function without drive. On them I had drive without function. Rocks and hard places, I guess.
On 5 October 2009, in preparation for a good opportunity in the afternoon, I took on of the boner pills my GP had given me. It had only been the third time I had taken one ever, and the prior dose had been a month or more before.
On 6 October 2009, a vitreous hemorrhage dumped blood into my eye. I could see a shadow slowly rolling through my sunlight eyelid as I woke, the spread of a thick liquid rolling over my sight, not unlike many old horror movies would have blood flow the screen to black. Opening the eye brought brilliant rose colored vision. The slow flow was blood.
I’ve written about this before, in the most detail on the very earliest posts on this blog in October 2011. I have never added the details of the source of the Cialis.
I doubt that I would have ever asked about a straightforward dysfunction issue with my doctor. If so, I probably would have brought it up in question of the effects of the Prozac. He probably would have told me the problem had nothing to do with the drug, but was all because I am diabetic and solely because I am diabetic. He has shown this attitude about other things that had overlap with the sugar, and he has totally waved off legitimate questions about potential side effects of other drugs he or his office has prescribed, both before and after the hemorrhage.
I point no finger at my GP for my blindness, even though the storm of problems would not have begun without that free sample of Cialis. I blame myself for taking it. I blame Eli Lilly and Company and the other boner pill manufacturers for downplaying and suppressing this horrifying side effect. I am not above pointing fingers, but I never do so casually or defensively. The aim of the fingers I do point is very accurate. I’m not sure enough about this situation.
Blaming my GP would be one things. I can avoid the impulse because I do not believe he had any awareness of the potential problem. I do think that maybe he should have had that awareness.
While I don’t blame him, neither do I trust him. There, I think, rests some friends’ argument that I should look for a new GP.
Sunday, September 9, 2012
General Principle
OK, so after depressive diversions and digressions, it’s back to the issue of my General Practitioner. I like him. He is a nice guy. He is a competent doctor. I’ve been seeing him since 2005, so he and I typically can deal with each other well. He can be difficult and I freely acknowledge it: so can I.
A couple people that are closest to me do not like my GP. Both encourage me to change doctors. I am resistant to do that because the "interview" process is something I dread, and because there’s no inflammatory problem with my GP. If I dismissed him, I would be likely to go without until I actually needed a doctor. My GP is competent. I just don’t know that he is all that good.
My GP has gained points by being honest when saying he did not know about certain aspects. To me, that is always preferable than someone who pretends to know and makes matters worse through ignorance. He has stated outright that he was not knowledgeable about advanced eye issues past generalities. He is not up on dietary remedies, causes, or alleviation to specific problems. On the upside, he was able to explain things like the eye problems being potentially as much of a cause of vertigo or balance issues as the inner ears can be. Like anyone and almost everything, he has both good and bad points, and the balance is acceptable to me, most of the time.
My big complaint is a glaring point to me. This may sound odd with the general occupation that he practices medicine, but I do not like his fixation on prescription medication. This was a source of dislike for him from the time I first met him while being treated for the broken shoulder. He had told me then that if he took me on as a regular patient, he would want me on a cholesterol medication and a blood pressure medication and a couple other things, all because I am diabetic. My problem with that was and is very basic: my blood pressure reading was in the normal range (~138/78) and he had not tested for cholesterol. I find something wrong with doctors prescribing drugs on "general principle" and not by demonstrated need. This makes me feel as though he is puppet and pawn of the pharmaceutical companies. I have never lost that opinion. I have just tempered it with the certainty that I would never find a doctor with whom I agree about everything
My roommate numbers among those who think I should find another doctor because of the drug pushing issue. The roommate doesn’t necessarily think casual and automatic reliance on chemical concoctions is a bad thing. Because I know my GP is inclined to throw a drug at any problem I mention, I don’t mention many problems and discomforts. My roommate feels I am disservicing my own best interests with my reluctance to communicate issues with the GP.
He’s probably right.
A couple people that are closest to me do not like my GP. Both encourage me to change doctors. I am resistant to do that because the "interview" process is something I dread, and because there’s no inflammatory problem with my GP. If I dismissed him, I would be likely to go without until I actually needed a doctor. My GP is competent. I just don’t know that he is all that good.
My GP has gained points by being honest when saying he did not know about certain aspects. To me, that is always preferable than someone who pretends to know and makes matters worse through ignorance. He has stated outright that he was not knowledgeable about advanced eye issues past generalities. He is not up on dietary remedies, causes, or alleviation to specific problems. On the upside, he was able to explain things like the eye problems being potentially as much of a cause of vertigo or balance issues as the inner ears can be. Like anyone and almost everything, he has both good and bad points, and the balance is acceptable to me, most of the time.
My big complaint is a glaring point to me. This may sound odd with the general occupation that he practices medicine, but I do not like his fixation on prescription medication. This was a source of dislike for him from the time I first met him while being treated for the broken shoulder. He had told me then that if he took me on as a regular patient, he would want me on a cholesterol medication and a blood pressure medication and a couple other things, all because I am diabetic. My problem with that was and is very basic: my blood pressure reading was in the normal range (~138/78) and he had not tested for cholesterol. I find something wrong with doctors prescribing drugs on "general principle" and not by demonstrated need. This makes me feel as though he is puppet and pawn of the pharmaceutical companies. I have never lost that opinion. I have just tempered it with the certainty that I would never find a doctor with whom I agree about everything
My roommate numbers among those who think I should find another doctor because of the drug pushing issue. The roommate doesn’t necessarily think casual and automatic reliance on chemical concoctions is a bad thing. Because I know my GP is inclined to throw a drug at any problem I mention, I don’t mention many problems and discomforts. My roommate feels I am disservicing my own best interests with my reluctance to communicate issues with the GP.
He’s probably right.
Wednesday, September 5, 2012
Power and Responsibility
I never lost that childhood and perhaps childish ideal that people in certain professions should be held to higher standards than "average" people. I hold a number of professions to higher standards. This includes teachers, clergy, police, politicians, and, yes, doctors and nurses. These people, and others, need to recognize the importance of their positions on the people they deal with every day. I’ve never been in those professions, but took my time as a property manager with similar consideration for others. It was a business, so foolish to make any decision that would lose money. In my case, however, it was the business of people’s homes, not just given apartments. While that does not mean I can willy-nilly assign apartments to every grifter who calls with a hard luck story or "demonstrates" their goodness by imploring the name of God or passing Hir blessing with every stage of their needful tales of woe that I personally can solve for them. I looked at that position as having a responsibility to and for the people renting from me, not just the power to toss them out. Multi-page rental agreements can make me look like a control freak at the start, but in reality I just wanted everyone else knowing what is expected of them and me and having opportunity to walk away before entering into commitment.
I don’t see much attention to the responsibilities of power these days. Maybe that has something to do with news trucks hounding then ratting out city workers because they stopped in the city vehicle for lunch or ran an errand in the city vehicle on the way home. That’s a long cry from the days of suppression. Back in the 1987-88 academic year, the journalism teacher of the high school I had attended presented a student’s (not mine, which is why I don’t name names) work as her own to the Providence Journal and allowed the piece to be published under the teacher’s own name. We all know the stories of crooked cops and self serving politicians like David Cicilline. I find all the stories stem from the same root: the abuse of power.
Doctor’s God complexes can ruin peoples’ health and well being. They whine about the rates of their malpractice insurance without stopping to consider why those rates have skyrocketed. I see both sides, and admit that we live in too litigious of a society The beneficiaries of this are insurance companies and attorneys. Doctors and patients alike only seem to suffer for it.
I would think that doctors’ best proactive defense would be to remain conscientious in dealing with their patients, in trying their best to treat every patient as an individual with a unique body and needs that will never be absolutely normal in every regard. There are no absolutes. Nothing can be absolute in preventing malpractice claims; there will always be someone ready to sue when se did not get hir own way. However, an approach free of the doctor’s ego and sense of power over patients goes a long way in decreasing the likelihood of dissatisfaction.
I don’t know how many doctors would actually do this when it is easier and rewarding in materialistic ways to blindly do as the pharmaceutical reps indicate to move new products, but I retain enough of that childish idealism to keep my fingers crossed.
I don’t see much attention to the responsibilities of power these days. Maybe that has something to do with news trucks hounding then ratting out city workers because they stopped in the city vehicle for lunch or ran an errand in the city vehicle on the way home. That’s a long cry from the days of suppression. Back in the 1987-88 academic year, the journalism teacher of the high school I had attended presented a student’s (not mine, which is why I don’t name names) work as her own to the Providence Journal and allowed the piece to be published under the teacher’s own name. We all know the stories of crooked cops and self serving politicians like David Cicilline. I find all the stories stem from the same root: the abuse of power.
Doctor’s God complexes can ruin peoples’ health and well being. They whine about the rates of their malpractice insurance without stopping to consider why those rates have skyrocketed. I see both sides, and admit that we live in too litigious of a society The beneficiaries of this are insurance companies and attorneys. Doctors and patients alike only seem to suffer for it.
I would think that doctors’ best proactive defense would be to remain conscientious in dealing with their patients, in trying their best to treat every patient as an individual with a unique body and needs that will never be absolutely normal in every regard. There are no absolutes. Nothing can be absolute in preventing malpractice claims; there will always be someone ready to sue when se did not get hir own way. However, an approach free of the doctor’s ego and sense of power over patients goes a long way in decreasing the likelihood of dissatisfaction.
I don’t know how many doctors would actually do this when it is easier and rewarding in materialistic ways to blindly do as the pharmaceutical reps indicate to move new products, but I retain enough of that childish idealism to keep my fingers crossed.
Wednesday, August 22, 2012
Caution: Blind Bowler
For newer readers and people who haven’t seen me all summer, here’s a recap of my eyes as they see (or don’t) these days.
In 2003 I had a cornea injury that I did not leave covered up long enough. My eye started "looking around" the scratch on the surface, which caused muscle striations that pulled the eye to the side. Ever-present diabetic retina problems became opportunistic. The right eye has been dark and out of alignment ever since.
In 2009, Cialis caused a vitreous blood hemorrhage in the left eye. This filled an existing cataract and the center of the eye with blood. They did cataract surgery, which gave me good distance vision but eliminated reading vision due to the type of lense they used (with no consultation with me, the patient.) Because of the hemorrhage, I let them scare me into the "preventative" diabetic laser surgery to burn the retina on the back of the eye. The stresses of that and the cataract surgery and the hemorrhage all kind of made the diabetic thing happen, which reduced my peripheral in that eye.
In January 2012 I had retina reattachment surgery and another procedure where they replaced the blood-dirtied vitreous gel with silicone oil. This brought some clarity and keeps pressure on the back of the eye. The retina reattachment did not succeed as well as either the doctor or I had hoped.
The sight in the left eye has no perineal, so with the dark right eye, I can see only what I am looking at and cannot see that too clearly. My eye takes a long time to adjust to changes in lighting and does not process light very well. I see colors better, up to certain distances. My test by finger sight ranges from one to four feet depending on how adjusted I am to room lighting. I see most people in shadows, and can’t adjust distance vision very well. That brief experience of being eagle-eyed after the cataract surgery is long past.
I see by color, motion, contrast and feel. My brain fills in gaps. Familiarity is always an asset to getting around. I can’t successfully fake it for too long anymore. I cling to the last bits of independence I have left and learned to accept offered help without much comment or resistance.
Being stubborn and fiercely independent have been assets through all this. I need aids , such as contrasting-color tape on microwave buttons or using a 32-inch TV as a monitor and a magnifying mouse and glasses to see the computer. There’s things I can no longer do, like drive, but I try what I can before surrendering helplessly to the things I can’t., but I can do most things at least some of the time.
Life has always been pretty rough for me. I am not a fragile diabetic or a fragile person, so I try not to let it stop me. I will hold on to what I have of the old life for as long as I can,
It is unlikely things will get much better, even after the silicone oil is drained out. I will always need bowling teammates to tell me what pins are still standing in between throws, but at least I will be able to tell them that I
am still standing.I’m usually aware of it when I fall down. I’m smaht that way.
In 2003 I had a cornea injury that I did not leave covered up long enough. My eye started "looking around" the scratch on the surface, which caused muscle striations that pulled the eye to the side. Ever-present diabetic retina problems became opportunistic. The right eye has been dark and out of alignment ever since.
In 2009, Cialis caused a vitreous blood hemorrhage in the left eye. This filled an existing cataract and the center of the eye with blood. They did cataract surgery, which gave me good distance vision but eliminated reading vision due to the type of lense they used (with no consultation with me, the patient.) Because of the hemorrhage, I let them scare me into the "preventative" diabetic laser surgery to burn the retina on the back of the eye. The stresses of that and the cataract surgery and the hemorrhage all kind of made the diabetic thing happen, which reduced my peripheral in that eye.
In January 2012 I had retina reattachment surgery and another procedure where they replaced the blood-dirtied vitreous gel with silicone oil. This brought some clarity and keeps pressure on the back of the eye. The retina reattachment did not succeed as well as either the doctor or I had hoped.
The sight in the left eye has no perineal, so with the dark right eye, I can see only what I am looking at and cannot see that too clearly. My eye takes a long time to adjust to changes in lighting and does not process light very well. I see colors better, up to certain distances. My test by finger sight ranges from one to four feet depending on how adjusted I am to room lighting. I see most people in shadows, and can’t adjust distance vision very well. That brief experience of being eagle-eyed after the cataract surgery is long past.
I see by color, motion, contrast and feel. My brain fills in gaps. Familiarity is always an asset to getting around. I can’t successfully fake it for too long anymore. I cling to the last bits of independence I have left and learned to accept offered help without much comment or resistance.
Being stubborn and fiercely independent have been assets through all this. I need aids , such as contrasting-color tape on microwave buttons or using a 32-inch TV as a monitor and a magnifying mouse and glasses to see the computer. There’s things I can no longer do, like drive, but I try what I can before surrendering helplessly to the things I can’t., but I can do most things at least some of the time.
Life has always been pretty rough for me. I am not a fragile diabetic or a fragile person, so I try not to let it stop me. I will hold on to what I have of the old life for as long as I can,
It is unlikely things will get much better, even after the silicone oil is drained out. I will always need bowling teammates to tell me what pins are still standing in between throws, but at least I will be able to tell them that I
am still standing.I’m usually aware of it when I fall down. I’m smaht that way.
Tuesday, August 14, 2012
Generally Unpracticed
It’s no surprise to the blog’s readers if I freely confess to being cynical about doctors. A look over the posts under the "Medical Malpractice" tag gives account of experiences and observations about the why’s. Unable to afford doctors for most of my adult life, I had to manage my own sugar with attention and common sense. Not seeing a doctor does not automatically equate with making no attempt to control blood sugars.
I approach every new doctor with hope and childish optimism that this one will be a good one. I want to have a cooperative relationship with my doctors. Theoretically, it’s in my own best interest.
I’ve tried this with my general practitioner. He is not a bad guy at all, and I don’t think he’s a bad doctor, although several in-the-know people in my life have a poor opinion of him and frequently urge me to find a good one.
I know myself. I could fire this one, but I would not run out to find another, not until I needed one again, and that is not the time to be looking for someone to guide you long term.
Despite seeing him for seven years now, the relationship remains contentious. I take my share of responsibility for that, but do know it’s not just me.
Many shades of gray cloud the situation. For that reason, I have from the beginning chosen not to name him or his practice. There are elements that I think he is wrong on and other that I know he is right on but I can’t or won’t do anyway. Many of our differences are more philosophical than black and white wrong or right. He is an internist rather than a diabetes specialist. That fact may also widen the gap between us.
I didn’t help matters much on the last visit several months ago. When he mentioned one of those things I can’t or won’t do, I accepted it as him doing his job. When he brought it up again, it came across as nagging and I slapped that down fast. I wouldn’t want to let nagging become a habit by being too accepting of it at the outset. He was probably furious with me when I left, for me being me. The GP had recommended Dr. David Greenberg–Doctor Dumbass–to other patients. I lifted my leg to show the other people the Crow boot as evidence that I had more than passing experience with podiatrists, then told them what a dumbass Greenberg is and told them how I came by that opinion. I gave them the name of Thomas Mancini as a competent podiatrist. That’s how I am.
I started seeing my GP in 2005. It’s been downhill ever since.
I approach every new doctor with hope and childish optimism that this one will be a good one. I want to have a cooperative relationship with my doctors. Theoretically, it’s in my own best interest.
I’ve tried this with my general practitioner. He is not a bad guy at all, and I don’t think he’s a bad doctor, although several in-the-know people in my life have a poor opinion of him and frequently urge me to find a good one.
I know myself. I could fire this one, but I would not run out to find another, not until I needed one again, and that is not the time to be looking for someone to guide you long term.
Despite seeing him for seven years now, the relationship remains contentious. I take my share of responsibility for that, but do know it’s not just me.
Many shades of gray cloud the situation. For that reason, I have from the beginning chosen not to name him or his practice. There are elements that I think he is wrong on and other that I know he is right on but I can’t or won’t do anyway. Many of our differences are more philosophical than black and white wrong or right. He is an internist rather than a diabetes specialist. That fact may also widen the gap between us.
I didn’t help matters much on the last visit several months ago. When he mentioned one of those things I can’t or won’t do, I accepted it as him doing his job. When he brought it up again, it came across as nagging and I slapped that down fast. I wouldn’t want to let nagging become a habit by being too accepting of it at the outset. He was probably furious with me when I left, for me being me. The GP had recommended Dr. David Greenberg–Doctor Dumbass–to other patients. I lifted my leg to show the other people the Crow boot as evidence that I had more than passing experience with podiatrists, then told them what a dumbass Greenberg is and told them how I came by that opinion. I gave them the name of Thomas Mancini as a competent podiatrist. That’s how I am.
I started seeing my GP in 2005. It’s been downhill ever since.
Saturday, August 11, 2012
Onsets
Another aspect of the Mayo Clinic’s website statement "The A1C test is a common blood test used to diagnose type 1 and type 2 diabetes..." bothers me. Specifically, I do not know that the part "common blood test used to diagnose type 1" is true.
Type two is in many ways a different disease. It’s onset is gradual and the patient can live for years without knowing they have it.
The A1C test measures sugar coating on cells in the blood. This coating forms over two to three months until the coated cells die by attrition. The A1C test can diagnose Type 2.
The onset of Type 1 is not a matter than the pancreas reduces insulin production or the body has increased difficulty metabolizing or using the insulin. In Type 1, the pancreas just stops. There is no gradual development of the condition that would show up in a test that calculated sugar in the blood over time. Doctors diagnose Type I "Diabetes Mellitus" by the symptoms in front of them. A test of the here-and-now blood sugar levels will confirm the symptoms of extreme thirst, constant urination, tiredness, apathy, sweet-smelling breath and a quick question to the patient or hir parents about weight loss.
It seems to me that claiming an A1C test as a useful diagnostic tool for Type 1 is more a matter of running profitable tests.
I could be wrong; this wouldn’t be the first time in life. I am basing the commentary on near-40 years of diabetes experience rather than academic studies telling what tests can be run for information and profit to the industry. But I don’t think I am wrong.
My onset was sudden. I do have memories of the day, true memories, not memories of retellings. I was wasted and drained and had lain down on a picnic table in the back yard and had no interest in being called for dinner. There’s no true or retold memory of a lead in to illness.
The other true diabetes-onset memories are odd snippets. I do not remember the first shot of insulin or blood tests in the hospital.
I do remember my older siblings not being able to visit, but they had been dragged along to wave from the end of the hall of the children’s ward. I remember that because one of my brothers always terrified me and I felt safer knowing he could not get near.
I remember being given tomato juice for the first time and gagging on it in distaste.
I remember playing "Old Maid" with my grandmother. She was sore winner about it, way too triumphant for having won against a four-year-old who had just learned the game. I remember suspecting she cheated. I observations of her character later in life dissuaded me from thinking that even if she didn’t cheat, she would.
Type two is in many ways a different disease. It’s onset is gradual and the patient can live for years without knowing they have it.
The A1C test measures sugar coating on cells in the blood. This coating forms over two to three months until the coated cells die by attrition. The A1C test can diagnose Type 2.
The onset of Type 1 is not a matter than the pancreas reduces insulin production or the body has increased difficulty metabolizing or using the insulin. In Type 1, the pancreas just stops. There is no gradual development of the condition that would show up in a test that calculated sugar in the blood over time. Doctors diagnose Type I "Diabetes Mellitus" by the symptoms in front of them. A test of the here-and-now blood sugar levels will confirm the symptoms of extreme thirst, constant urination, tiredness, apathy, sweet-smelling breath and a quick question to the patient or hir parents about weight loss.
It seems to me that claiming an A1C test as a useful diagnostic tool for Type 1 is more a matter of running profitable tests.
I could be wrong; this wouldn’t be the first time in life. I am basing the commentary on near-40 years of diabetes experience rather than academic studies telling what tests can be run for information and profit to the industry. But I don’t think I am wrong.
My onset was sudden. I do have memories of the day, true memories, not memories of retellings. I was wasted and drained and had lain down on a picnic table in the back yard and had no interest in being called for dinner. There’s no true or retold memory of a lead in to illness.
The other true diabetes-onset memories are odd snippets. I do not remember the first shot of insulin or blood tests in the hospital.
I do remember my older siblings not being able to visit, but they had been dragged along to wave from the end of the hall of the children’s ward. I remember that because one of my brothers always terrified me and I felt safer knowing he could not get near.
I remember being given tomato juice for the first time and gagging on it in distaste.
I remember playing "Old Maid" with my grandmother. She was sore winner about it, way too triumphant for having won against a four-year-old who had just learned the game. I remember suspecting she cheated. I observations of her character later in life dissuaded me from thinking that even if she didn’t cheat, she would.
Thursday, August 9, 2012
Campaigning Conditions
From the Mayo Clinic website: "The A1C test is a common blood test used to diagnose type 1 and type 2 diabetes..."
There is an important aspect to this for Type 2 diabetic and some healthy patients: it is used to diagnose. Over the past decade, the exact number used to diagnose Type 2 has changed up and down several times and is reported inconsistently by different sources. The pharmaceutical companies are involved in that, the same way those companies create "syndromes" such as "restless leg." The pharmaceutical companies are for-profit enterprises that are looking to sell you products, and the lower diagnosis numbers favor their sales. Realistically, how many of us would have heard of things like fibromyalgia if we had not been for all the ads hawking drug treatments? These drugs amount to patented combinations of pain relievers and antidepressants.
If you feel I am being cynical about a serious condition that cripples so many poor unfortunate women, I will steer you towards the latest pharmaceutical ad campaign. The male problems of all aging but not yet old male farts could be "Low T." Ad campaigns like this begin with apparent innocence. You can go to a web site to learn about the condition. The TV ads do not mention the new designer drugs that may solve the problem you did not previously know existed, never mind that the tired feelings and loss of drive may mean that you have this debilitating but potentially crippling condition. Future ads will sell you on the drugs; right now the pharmaceuticals are trying to sell you on a condition. You do have a condition with that tiredness and diminished drive and/or capacity. It’s called old age. Older guys are statistically more likely to carry chromosomal imperfections. Your "Low T" and diminished drive and/or function is nature’s way of making you less likely to share sperm that could produce weak or unhealthy offspring. You can try the drugs, or do what our fathers did: be more physically affectionate with your wife/partner and make sure there’s always a fresh supply of batteries in the house.
In the diabetes sense, the "created" condition is "pre-diabetes." They’re setting you up as early as possible to be receptive to taking drugs in the near future.
In fairness, early detection of Type 2 can prevent devastating ill effects of diabetes. Unfortunately, pharmaceutical profiteers help define the diseases you will soon have.
People need to use their own judgment, and take to heart the catchphrase "when diet and exercise are not enough." Your body very well has the level it wants to be at on its own. Taking drugs will almost certainly change that biochemically, but the pharmaceutical balance sheets may derive more from it than you will, and beginning the drugs too early may make your body lazy with its own functions. If that happens, you are guaranteeing lifelong dependence on the drugs.
I have overweight friends who have low A1C numbers, and fit friends who are told by their doctors that they are pre-diabetic or have "a touch of" diabetes.
Don’t tale my word for this casually, but don’t agree to doctors’ recommendations without asking questions and doing your own research.
There is an important aspect to this for Type 2 diabetic and some healthy patients: it is used to diagnose. Over the past decade, the exact number used to diagnose Type 2 has changed up and down several times and is reported inconsistently by different sources. The pharmaceutical companies are involved in that, the same way those companies create "syndromes" such as "restless leg." The pharmaceutical companies are for-profit enterprises that are looking to sell you products, and the lower diagnosis numbers favor their sales. Realistically, how many of us would have heard of things like fibromyalgia if we had not been for all the ads hawking drug treatments? These drugs amount to patented combinations of pain relievers and antidepressants.
If you feel I am being cynical about a serious condition that cripples so many poor unfortunate women, I will steer you towards the latest pharmaceutical ad campaign. The male problems of all aging but not yet old male farts could be "Low T." Ad campaigns like this begin with apparent innocence. You can go to a web site to learn about the condition. The TV ads do not mention the new designer drugs that may solve the problem you did not previously know existed, never mind that the tired feelings and loss of drive may mean that you have this debilitating but potentially crippling condition. Future ads will sell you on the drugs; right now the pharmaceuticals are trying to sell you on a condition. You do have a condition with that tiredness and diminished drive and/or capacity. It’s called old age. Older guys are statistically more likely to carry chromosomal imperfections. Your "Low T" and diminished drive and/or function is nature’s way of making you less likely to share sperm that could produce weak or unhealthy offspring. You can try the drugs, or do what our fathers did: be more physically affectionate with your wife/partner and make sure there’s always a fresh supply of batteries in the house.
In the diabetes sense, the "created" condition is "pre-diabetes." They’re setting you up as early as possible to be receptive to taking drugs in the near future.
In fairness, early detection of Type 2 can prevent devastating ill effects of diabetes. Unfortunately, pharmaceutical profiteers help define the diseases you will soon have.
People need to use their own judgment, and take to heart the catchphrase "when diet and exercise are not enough." Your body very well has the level it wants to be at on its own. Taking drugs will almost certainly change that biochemically, but the pharmaceutical balance sheets may derive more from it than you will, and beginning the drugs too early may make your body lazy with its own functions. If that happens, you are guaranteeing lifelong dependence on the drugs.
I have overweight friends who have low A1C numbers, and fit friends who are told by their doctors that they are pre-diabetic or have "a touch of" diabetes.
Don’t tale my word for this casually, but don’t agree to doctors’ recommendations without asking questions and doing your own research.
Friday, June 29, 2012
Feet on Solid Ground
I nay be harsh at times, but I always aim to be fair.
I am so direct and open when dissatisfied with a doctor that I feel a need to post when I encounter a really good one. Dr. Thomas Mancini, with offices in East Greenwich, RI and on Mineral Spring Avenue in North Providence, is one of the good ones.
I do not know (or care) if he is related to the other podiatrist Mancini who has an office on Armistice Boulevard in Pawtucket.
Just as I state why I come to dislike or distrust specific doctors, I want to point out the factors of Mancini’s positive appraisal.
He listens. This can’t be overstated. As a diabetic, I have heard a lot of pop-psychology jargon about needing a "medical team" for my care. In such terms, Mancini would be part of the "team" of which the patient should always be captain and manager. We’ve fully discussed aspects of my foot problems, including the infection and the ongoing Charcot condition. It is also obvious to me that Dr. Mancini had put independent thought into things.
He made himself fully available to me and my roommate when and since things went bad with the toe infection. He has been great in booking timely emergency visits as issues arose.
The foot has been fully inspected with each visit and he has done anything and everything necessary, from the Charcot to the infected toe to routine things.
He has answered any questions I posed rather than become defensive or offended by them. There are darker aspects of my long term prognosis that he stayed quiet about, but he sugar coated nothing when I raised such issues. If anything, he seemed genuinely relieved that I was able to bridge the subjects, which included my belief that it is probably inevitable that, sooner or later, I will lose the right foot below the knee due to the Charcot condition.
Dr. Mancini has no God Complex. He is approachable and knows his own limitations. When the hospitalization for the infection ended, the Charcot condition was much worse. Without hesitation, and without trying to pawn me off on someone else, he recommended me to another foot doc, Douglas Grod to look into treatment beyond what Mancini felt he could do. As it turns out, Mancini was not sold on the ultimate wisdom of doing what Grod could do. The point to me is that even with his unvoiced objection to the potential procedure, Dr. Mancini made the recommendation for me to look further into the situation.
I have seen very little humility like that among doctors, and the entire experience–which is ongoing–makes me recommend Dr. Thomas Mancini above any other foot doctor in Rhode Island, for diabetics or people with other foot problems.
I am so direct and open when dissatisfied with a doctor that I feel a need to post when I encounter a really good one. Dr. Thomas Mancini, with offices in East Greenwich, RI and on Mineral Spring Avenue in North Providence, is one of the good ones.
I do not know (or care) if he is related to the other podiatrist Mancini who has an office on Armistice Boulevard in Pawtucket.
Just as I state why I come to dislike or distrust specific doctors, I want to point out the factors of Mancini’s positive appraisal.
He listens. This can’t be overstated. As a diabetic, I have heard a lot of pop-psychology jargon about needing a "medical team" for my care. In such terms, Mancini would be part of the "team" of which the patient should always be captain and manager. We’ve fully discussed aspects of my foot problems, including the infection and the ongoing Charcot condition. It is also obvious to me that Dr. Mancini had put independent thought into things.
He made himself fully available to me and my roommate when and since things went bad with the toe infection. He has been great in booking timely emergency visits as issues arose.
The foot has been fully inspected with each visit and he has done anything and everything necessary, from the Charcot to the infected toe to routine things.
He has answered any questions I posed rather than become defensive or offended by them. There are darker aspects of my long term prognosis that he stayed quiet about, but he sugar coated nothing when I raised such issues. If anything, he seemed genuinely relieved that I was able to bridge the subjects, which included my belief that it is probably inevitable that, sooner or later, I will lose the right foot below the knee due to the Charcot condition.
Dr. Mancini has no God Complex. He is approachable and knows his own limitations. When the hospitalization for the infection ended, the Charcot condition was much worse. Without hesitation, and without trying to pawn me off on someone else, he recommended me to another foot doc, Douglas Grod to look into treatment beyond what Mancini felt he could do. As it turns out, Mancini was not sold on the ultimate wisdom of doing what Grod could do. The point to me is that even with his unvoiced objection to the potential procedure, Dr. Mancini made the recommendation for me to look further into the situation.
I have seen very little humility like that among doctors, and the entire experience–which is ongoing–makes me recommend Dr. Thomas Mancini above any other foot doctor in Rhode Island, for diabetics or people with other foot problems.
Thursday, June 28, 2012
Charcot Bait-sics
There’s not a lot on the Internet about Charcot Foot, so here’s some basic facts and warnings.
The chief "precondition" is diabetes.
The second "precondition" is a foot injury, usually a broken bone that neuropathy in the diabetic ma prevent the diabetic from realizing.
The chief symptom is massive foot swelling, usually with no pain or very little.
Other symptoms will usually include elevated temperature in the swollen foot, up to 7 degrees Celsius from the unaffected foot.
The "old" feet smell" may be pervasive even when the foot is clean. I took to spraying my foot with Right Guard.
The swelling may get larger or recede on its own throughout the day. Be aware that your shoes may not fit correctly and could cause cuts or abrasions that could infect easily. The changes in swelling can also infect the skin, including potential for splits or pits as the skin expands and contracts.
If the patient does have broken/fractured bones, se must stay off the foot. If the bones are not given opportunity to heal, they can poke through the foot from the inside.
The patient should see a competent podiatrist regularly. Tell the doctor about any drugs being taken, including anti-inflammatory drugs such as prednisone.
Taking anti-inflammatory drugs is not particularly a good idea if there are broken bones. The swelling protects the broken bones.
Ask your podiatrist or other doctor about bone-solidifying drugs usually prescribed for osteoporosis. This could limit or prevent bone density loss during the healing process.
If you must have some mobility, a Crow boot will buffer the ankle mush more effectively than a flexible cast boot.
Charcot foot is something of an exotic or esoteric condition and is not well known outside the medical circles of diabetes and foot specialists. Go right to pone of those specialists or a sports medicine practice rather than to an urgent care center. Well intentioned doctors who do not recognize the true problem can do you grievous harm.
Do not, under any circumstances, allow any doctor or medical person (or anyone else) to insert anything into the foot, not to drain the swelling or extract to test for infection or any other reason, no matter how reasonable it sounds. The risk of infection is too high, and any infection exponentially increased the chance for immediate amputation. If you see any treating professional coming at your foot with a needle, kick them in the face (with your good foot, of course.) Those professionals will have long forgotten jabbing you when you’re on the operating table having your foot sawed off.
The chief "precondition" is diabetes.
The second "precondition" is a foot injury, usually a broken bone that neuropathy in the diabetic ma prevent the diabetic from realizing.
The chief symptom is massive foot swelling, usually with no pain or very little.
Other symptoms will usually include elevated temperature in the swollen foot, up to 7 degrees Celsius from the unaffected foot.
The "old" feet smell" may be pervasive even when the foot is clean. I took to spraying my foot with Right Guard.
The swelling may get larger or recede on its own throughout the day. Be aware that your shoes may not fit correctly and could cause cuts or abrasions that could infect easily. The changes in swelling can also infect the skin, including potential for splits or pits as the skin expands and contracts.
If the patient does have broken/fractured bones, se must stay off the foot. If the bones are not given opportunity to heal, they can poke through the foot from the inside.
The patient should see a competent podiatrist regularly. Tell the doctor about any drugs being taken, including anti-inflammatory drugs such as prednisone.
Taking anti-inflammatory drugs is not particularly a good idea if there are broken bones. The swelling protects the broken bones.
Ask your podiatrist or other doctor about bone-solidifying drugs usually prescribed for osteoporosis. This could limit or prevent bone density loss during the healing process.
If you must have some mobility, a Crow boot will buffer the ankle mush more effectively than a flexible cast boot.
Charcot foot is something of an exotic or esoteric condition and is not well known outside the medical circles of diabetes and foot specialists. Go right to pone of those specialists or a sports medicine practice rather than to an urgent care center. Well intentioned doctors who do not recognize the true problem can do you grievous harm.
Do not, under any circumstances, allow any doctor or medical person (or anyone else) to insert anything into the foot, not to drain the swelling or extract to test for infection or any other reason, no matter how reasonable it sounds. The risk of infection is too high, and any infection exponentially increased the chance for immediate amputation. If you see any treating professional coming at your foot with a needle, kick them in the face (with your good foot, of course.) Those professionals will have long forgotten jabbing you when you’re on the operating table having your foot sawed off.
Wednesday, June 27, 2012
Charcot Foot Phase 1.2
At least one account I encountered estimates that approximately 3% of diabetics will "come down with" Charcot Foot. In bygone eras it used to afflict others, but nowadays it’s all but exclusively a diabetic problem. Brief basics, normally the diabetic breaks or fractures a foot bone, usually does not feel the injury due to diabetic neuropathy and the foot swells up in response. Treatment is typically immobilization to prevent the broken bone from displacing. The displaced bone can rip through the foot from the inside.
My injury and affliction was atypical. I had tendon and/or nerve damage (and still do) but not breaks or fractures. (Breaks and fractures are both breaks, just of different severity and separation of the pieces.) The reports that cleared me came from both X-ray and MRI. Doctors at an urgent care center and a sports medicine practice, my GP and "Dr. Dumbass" all gave diagnoses of "no breaks."
So imagine my surprise when Dr. Dumbass–aka podiatrist David Greenberg–told me on the second visit that I did have breaks and fractures.
I had resumed bowling as exercise with limits on frequency and duration based on the "no breaks" diagnosis. This tail-spun me into stressful second guessing and worries of what further damage I could have inflicted to myself. Bowling was neither particularly successful nor painless, but it remained one of the few things I could still do and just about my only social interaction.
The bowling may seem haphazard. Maybe it was. My reasoning was that Phase Two of Charcot Foot is typically a long duration of rebuilding strength and integrity in the foot, things lost by a combination of inactivity and poor circulation that limit the flow of nutrients to the foot. Basically, immobilized and unused feet tend to atrophy during Phase One. I experienced the most evident ankle collapse in the month that I did stay off the foot almost entirely, and little to no evident progression when I did get the limited exercise. The human body is an odd machine: it works better the more it is responsibly used.
Dr Dumbass gave the new diagnosis without the benefit of any new X-ray or scan. Subsequent images ordered and reviewed by a later doctor showed structural damage that is natural progression of Charcot but seemed to confirm that there had been no initial bone damage.
I rectified Dr. Dumbass’s inconsistencies as statistical generalizations of the overall condition rather than any result of examination.
I started seeing Dr. Thomas Mancini when the foot swelled back up in response to discontinuation of prednisone.
Doctor Mancini had some concerns after a thorough examination of my foot, which is something Dr. Dumbass never really bothered to do. Dr. Mancini wanted me to consider Boniva type drugs and wanted me to pick up the leg brace that Dr. Dumbass had prescribed and I had been fitted for custom manufacture before the leg and foot re-inflated.
The toe infection that sent me to the hospital for four days interfered with those plans. The hospital, deeming a blind gimpy guy as a trip and fall hazard, kept me immobilized for the weekend. That proved a long enough time of absolute inactivity for the ankle to suffer further collapse. This change for the worse could be seen in the shape of the foot, felt when the foot was used or moved on its own, and it could be heard when I tried walking on it.
My injury and affliction was atypical. I had tendon and/or nerve damage (and still do) but not breaks or fractures. (Breaks and fractures are both breaks, just of different severity and separation of the pieces.) The reports that cleared me came from both X-ray and MRI. Doctors at an urgent care center and a sports medicine practice, my GP and "Dr. Dumbass" all gave diagnoses of "no breaks."
So imagine my surprise when Dr. Dumbass–aka podiatrist David Greenberg–told me on the second visit that I did have breaks and fractures.
I had resumed bowling as exercise with limits on frequency and duration based on the "no breaks" diagnosis. This tail-spun me into stressful second guessing and worries of what further damage I could have inflicted to myself. Bowling was neither particularly successful nor painless, but it remained one of the few things I could still do and just about my only social interaction.
The bowling may seem haphazard. Maybe it was. My reasoning was that Phase Two of Charcot Foot is typically a long duration of rebuilding strength and integrity in the foot, things lost by a combination of inactivity and poor circulation that limit the flow of nutrients to the foot. Basically, immobilized and unused feet tend to atrophy during Phase One. I experienced the most evident ankle collapse in the month that I did stay off the foot almost entirely, and little to no evident progression when I did get the limited exercise. The human body is an odd machine: it works better the more it is responsibly used.
Dr Dumbass gave the new diagnosis without the benefit of any new X-ray or scan. Subsequent images ordered and reviewed by a later doctor showed structural damage that is natural progression of Charcot but seemed to confirm that there had been no initial bone damage.
I rectified Dr. Dumbass’s inconsistencies as statistical generalizations of the overall condition rather than any result of examination.
I started seeing Dr. Thomas Mancini when the foot swelled back up in response to discontinuation of prednisone.
Doctor Mancini had some concerns after a thorough examination of my foot, which is something Dr. Dumbass never really bothered to do. Dr. Mancini wanted me to consider Boniva type drugs and wanted me to pick up the leg brace that Dr. Dumbass had prescribed and I had been fitted for custom manufacture before the leg and foot re-inflated.
The toe infection that sent me to the hospital for four days interfered with those plans. The hospital, deeming a blind gimpy guy as a trip and fall hazard, kept me immobilized for the weekend. That proved a long enough time of absolute inactivity for the ankle to suffer further collapse. This change for the worse could be seen in the shape of the foot, felt when the foot was used or moved on its own, and it could be heard when I tried walking on it.
Sunday, June 24, 2012
Doctor Dumbass
Dr. David Greenberg is one of the founding partners and president of Rhode Island Foot Care, Inc. I saw him three times in the winter of 2012. He had been referred by the doctor at Foundry sports medicine, where the Charcot foot had been first diagnosed. Liked the Foundry doctor and that practice. The sole negative I can say about the Foundry practice was that they recommended Greenberg. I heard Greenberg referred to as the best podiatrist in Rhode Island. Maybe that gave me unrealistic expectation. My GP had referred another patient to Greenberg at the checkout desk this spring. I shook my cast-boot covered foot at the patients, told them I referred to Greenberg as "Doctor Dumbass" and urged them to see the podiatrist I later experienced successful with, Thomas Mancini.
While I did not come to think of Greenberg as dumbass until the third visit, I really did not like him from the first. This was a basic consumer issue that I did not feel as though he really looked at the foot or listened to me. Supposedly he had looked over disks containing the MRI scan and X-ray before he entered the room. Am I wrong in thinking that was not enough without an on the spot exam? The MRI was a couple weeks old by that time and the X-ray was approaching four weeks past. The swelling had changed for the worse in that time, and the tendon in the foot had gained much more pronounced deformity. I left feeling as though I had paid for him to arrogantly confirm, "Yup, that’s Charcot foot," and nothing more. Between the Foundry doctor’s diagnosis and my research of the diagnosis, there wasn’t any doubt that Charcot was the problem. He gave advice of the best thing for my foot was to take care of my diabetes and sounded no different from every busybody with diabetic cousins who think the cousin makes them qualified to dispense advice about diabetes.
The second appointment got postponed by Greenberg’s office, and they indicated that one of his associates would see me o the follow up. I had no problem with that, and was disappointed when Greenberg saw me. He at least did look at the foot, in part because the swelling had receded on significant levels. He thought that was a good sign and did not correlate the prednisone eye drop prescription with the healing. My attitude: he is a doctor and should have suspected that, particularly because I mentioned it prominently; my tummy was rolling when I was there, and this had been the first time I had seen him after the retina reattachment surgery..
He was worse this time for being nice. He came across as patronizing, complete with a shoulder pat best reserved for little leaguers who hit a home run. I am not sure if his superior attitude or the prednisone is the true cause of my need to vomit before I left the office. I managed to contain the eruption to the medical waste barrel in the examining room.
The third (and guaranteed last ever) visit was in March. He declared the Phase One of the Charcot foot over and Stage Two healthily begun. He gave me a prescription for an in-the-shoe brace, a print out with choices of where to have it custom made, and no future appointment. Any actual examination was at best cursory.
He officially became "Doctor Dumbass" the day I went to get molded for the brace. The address on his printout had the wrong number on the right street. The orthopedic appliance place said they had moved twelve and had frequently asked Greenberg’s practice to update this. The prescription contained minimal information, and said nothing about the ankle collapse or how that problem had shortened my right leg.years before
The real kicker came in April, when (with the eye doctor’s approval) I stopped taking the prednisone. The leg swelled right back up, proving that Charcot’s Phase One had not passed, but had been disguised by the anti-inflammatory steroid.
While I did not come to think of Greenberg as dumbass until the third visit, I really did not like him from the first. This was a basic consumer issue that I did not feel as though he really looked at the foot or listened to me. Supposedly he had looked over disks containing the MRI scan and X-ray before he entered the room. Am I wrong in thinking that was not enough without an on the spot exam? The MRI was a couple weeks old by that time and the X-ray was approaching four weeks past. The swelling had changed for the worse in that time, and the tendon in the foot had gained much more pronounced deformity. I left feeling as though I had paid for him to arrogantly confirm, "Yup, that’s Charcot foot," and nothing more. Between the Foundry doctor’s diagnosis and my research of the diagnosis, there wasn’t any doubt that Charcot was the problem. He gave advice of the best thing for my foot was to take care of my diabetes and sounded no different from every busybody with diabetic cousins who think the cousin makes them qualified to dispense advice about diabetes.
The second appointment got postponed by Greenberg’s office, and they indicated that one of his associates would see me o the follow up. I had no problem with that, and was disappointed when Greenberg saw me. He at least did look at the foot, in part because the swelling had receded on significant levels. He thought that was a good sign and did not correlate the prednisone eye drop prescription with the healing. My attitude: he is a doctor and should have suspected that, particularly because I mentioned it prominently; my tummy was rolling when I was there, and this had been the first time I had seen him after the retina reattachment surgery..
He was worse this time for being nice. He came across as patronizing, complete with a shoulder pat best reserved for little leaguers who hit a home run. I am not sure if his superior attitude or the prednisone is the true cause of my need to vomit before I left the office. I managed to contain the eruption to the medical waste barrel in the examining room.
The third (and guaranteed last ever) visit was in March. He declared the Phase One of the Charcot foot over and Stage Two healthily begun. He gave me a prescription for an in-the-shoe brace, a print out with choices of where to have it custom made, and no future appointment. Any actual examination was at best cursory.
He officially became "Doctor Dumbass" the day I went to get molded for the brace. The address on his printout had the wrong number on the right street. The orthopedic appliance place said they had moved twelve and had frequently asked Greenberg’s practice to update this. The prescription contained minimal information, and said nothing about the ankle collapse or how that problem had shortened my right leg.years before
The real kicker came in April, when (with the eye doctor’s approval) I stopped taking the prednisone. The leg swelled right back up, proving that Charcot’s Phase One had not passed, but had been disguised by the anti-inflammatory steroid.
Friday, June 22, 2012
Charcot Attack
Charcot Attack
The last ongoing or recent medical BS to update is the Charcot foot. I could deal with this better if I wasn’t so visually impaired. The original injury that triggered this rare diabetic problem would not have happened last autumn if I was not blind.
Very briefly, Charcot is a massive and typically painless swelling of the foot in response to and injury, one of the body’s usual defense mechanism gone into overdrive. There’s two main stages, both typically prolonged. The first is the healing of the triggering injury. The second is recovery from the healing. During the Stage One process, the swelling typically restricts circulation and thus limits nutrient and blood supply to the foot. These reductions cause the foot to atrophy and weaken. As my triggering incident did not include broken bones, I was able to be more active during Stage One than most people can be. I tried to stay active despite my roommate’s restrictive mothering in order to reduce any atrophy.
Maybe things would have been worse if I had completely reposed last autumn and winter, but a sinister level of atrophy did occur.
The almost cartoonish level of swelling ran from the toes to the knee with the most bloated and most stubborn point at the ankle. It stayed swelled for months, from October to February. It drastically reduced in February through April, but this was in reaction to the prednisone prescribed for the retina reattachment recovery, not true healing. I learned this when I temporarily discontinued the prednisone to reduce the steroid’s side effects.
I seemed to have two periods in which the ankle collapsed. Both of these happened at times when I was fully resting the foot and leg, the first in November when I temporarily ceased bowling, and the second while I was imprisoned in the hospital.
I note here for people reading this via an online search for Charcot foot: in the times in between the full rest periods, I could use the foot only because I had no broken or fractured bones that might shift and stab out of the foot. Most Charcot patients do have broken bones and should stay off the foot entirely.The difference before and after the hospital stay was drastic and unignorable. Before, the foot was uncomfortable to use. After four days totally off the foot, the boned in the ankle creaked and clicked if I tried to use it. The longer period of rest in the autumn made the changes less obvious at the time, but drastic changes had occurred.
The foot had swelled and remained that way for months. This did reduce circulation, which inhibited the flow of nutrients to the foot. The are that developed the worst problem was deepest, not furthest in the foot and maintained the worst swelling: the center of the ankle.
The ankle collapsed enough that my right legs was about a half inch shorter than the left leg.
I had seen a podiatrist three times, and on the third visit he prescribed a brace to be made and wished me luck.
True to my luck, I just keep hitting the jackpot with the quality of doctors I end up with. People referred to that first podiatrist as the best in the state. I quickly came to refer to him as "Doctor Dumbass."
The last ongoing or recent medical BS to update is the Charcot foot. I could deal with this better if I wasn’t so visually impaired. The original injury that triggered this rare diabetic problem would not have happened last autumn if I was not blind.
Very briefly, Charcot is a massive and typically painless swelling of the foot in response to and injury, one of the body’s usual defense mechanism gone into overdrive. There’s two main stages, both typically prolonged. The first is the healing of the triggering injury. The second is recovery from the healing. During the Stage One process, the swelling typically restricts circulation and thus limits nutrient and blood supply to the foot. These reductions cause the foot to atrophy and weaken. As my triggering incident did not include broken bones, I was able to be more active during Stage One than most people can be. I tried to stay active despite my roommate’s restrictive mothering in order to reduce any atrophy.
Maybe things would have been worse if I had completely reposed last autumn and winter, but a sinister level of atrophy did occur.
The almost cartoonish level of swelling ran from the toes to the knee with the most bloated and most stubborn point at the ankle. It stayed swelled for months, from October to February. It drastically reduced in February through April, but this was in reaction to the prednisone prescribed for the retina reattachment recovery, not true healing. I learned this when I temporarily discontinued the prednisone to reduce the steroid’s side effects.
I seemed to have two periods in which the ankle collapsed. Both of these happened at times when I was fully resting the foot and leg, the first in November when I temporarily ceased bowling, and the second while I was imprisoned in the hospital.
I note here for people reading this via an online search for Charcot foot: in the times in between the full rest periods, I could use the foot only because I had no broken or fractured bones that might shift and stab out of the foot. Most Charcot patients do have broken bones and should stay off the foot entirely.The difference before and after the hospital stay was drastic and unignorable. Before, the foot was uncomfortable to use. After four days totally off the foot, the boned in the ankle creaked and clicked if I tried to use it. The longer period of rest in the autumn made the changes less obvious at the time, but drastic changes had occurred.
The foot had swelled and remained that way for months. This did reduce circulation, which inhibited the flow of nutrients to the foot. The are that developed the worst problem was deepest, not furthest in the foot and maintained the worst swelling: the center of the ankle.
The ankle collapsed enough that my right legs was about a half inch shorter than the left leg.
I had seen a podiatrist three times, and on the third visit he prescribed a brace to be made and wished me luck.
True to my luck, I just keep hitting the jackpot with the quality of doctors I end up with. People referred to that first podiatrist as the best in the state. I quickly came to refer to him as "Doctor Dumbass."
Monday, June 18, 2012
Feedback 3
When recounting my experiences of recent hospitalization, I usually referred to the caregivers as "nurse types." In discussing this, it was pointed out to e that you really can’t tell who is what in a hospital anymore. The days of nurses in specific and distinct uniforms are a thing of a bygone era. Now, everyone that works at the hospital seems to wear scrubs. Employers try to assign job titles to make even the lowest-on-the-pole peons feels important, to the confusion of a public who really doesn’t know just how much training, education or qualifications a "certified" nursing assistant does or does not have. Are these people anything more than an old style after-school candy striper? How do we know that it’s not a janitor changing our IV?
I’ve gotten lazy in one aspect of the blog writing, and feel the need for apologizing for that. I run a spell check, but proofreading is a lot more on my eye and drains a lot, so I tend to skip that for blog posts in a way I never would for anything I would write to send to an editor. "Our" and "out" may be confused. The mechanical spell-checker won’t flag this, and the grammar checker chastises my general style more than it finds actual errors. And I have a hard time seeing the difference so might often miss it anyway. While a spell-checker does not know the difference between public service and pubic service, human readers do. Eye hop ewe cam four give an E weigh this us dis tracking fir ewe.
Anyone who might feel as though I mentioned the misplaced portable urinal bottle too many times should invite me to dinner. You must pick me up and bring me home. I will bring a bottle and set it on the table in front of your other guests and we will see just how much of an issue other people find piss bottles on the eating table. Restaurants have been closed down for far less.
The blog has spread from being a blind man’s bluff to a broader medical things. I am relating subjective experiences. I’m smart enough to have been one with more interest and educational opportunities, but I am not a doctor and do not aim to be giving medical advice. My goal is more important, to share on a consumer awareness level that it is important for patients as the consumers of health care to know what they are getting by questioning their doctors. Diabetes is a profitable niche in the healthcare market. People should do their own research. If three years ago someone had told me "always include ‘side effect’ in any procedure or medicine you Google" I probably would not be so blind today.
I’ve gotten lazy in one aspect of the blog writing, and feel the need for apologizing for that. I run a spell check, but proofreading is a lot more on my eye and drains a lot, so I tend to skip that for blog posts in a way I never would for anything I would write to send to an editor. "Our" and "out" may be confused. The mechanical spell-checker won’t flag this, and the grammar checker chastises my general style more than it finds actual errors. And I have a hard time seeing the difference so might often miss it anyway. While a spell-checker does not know the difference between public service and pubic service, human readers do. Eye hop ewe cam four give an E weigh this us dis tracking fir ewe.
Anyone who might feel as though I mentioned the misplaced portable urinal bottle too many times should invite me to dinner. You must pick me up and bring me home. I will bring a bottle and set it on the table in front of your other guests and we will see just how much of an issue other people find piss bottles on the eating table. Restaurants have been closed down for far less.
The blog has spread from being a blind man’s bluff to a broader medical things. I am relating subjective experiences. I’m smart enough to have been one with more interest and educational opportunities, but I am not a doctor and do not aim to be giving medical advice. My goal is more important, to share on a consumer awareness level that it is important for patients as the consumers of health care to know what they are getting by questioning their doctors. Diabetes is a profitable niche in the healthcare market. People should do their own research. If three years ago someone had told me "always include ‘side effect’ in any procedure or medicine you Google" I probably would not be so blind today.
Friday, June 15, 2012
Sturdy on My Feet
I did learn a couple things from my three-plus day visit to Sturdy Hospital.
I did find the diabetes educator helpful and approachable about things. I learned some of the reasons for some establishment thinking, even if I think some seem more like excuses or covers for profiteering than legitimate reasons.
The night of my admission, I had been having stomach acid problems due to the prednisone and had drunk almost a half gallon of milk before leaving the house. Because they ran blood sugar tests on my arrival, I learned how seriously I was underestimating the blood sugar effects of 1% milk; that was the reason for the spike into the 600’s, which was high by my reckoning of the numbers and how I was feeling in the ER that night.
I unfortunately learned a little more disdain for the "lower levels" of health care providers, and perhaps for declining American work ethic. That single nurse-type who did bother to rinse the portable urinal had a foreign accent. None of the American-accented nurse types–whether they would officially be termed registered nurses, nurses, or certified nursing assistants–could have been bothered. The priority of the nurse types’ convenience over actual patient comfort and care astounded me. I have a strong customer service background, and do not see how many of the staffers I encountered that weekend would ever have lasted under some of the expectations I have had to meet.
I did not find hospital food to be all that bad, but most certainly bland for the lack of "unhealthy" flavorings. The salt substitute packets on the tray didn’t cut it for me. As far as I am concerned, something called "Mrs. Dash" should be put on a woman’s yeast infection, not on food. My roommate smuggled in real salt. I’m not a heavy salt user, but need it when it is needed.
I learned to stick to my guns. Both Sturdy’s podiatrist Dr. Harris and my own podiatrist Dr. Mancini complimented my successful battle zone of not letting the surgeon poke anything into the Charcot foot. Support like that, along with the hospital roommate’s compliments to my willingness to stand up to doctors might be dangerous praise with the ability to make a monster out of the raw material I provide.
I’ll try to keep myself in check.
Six weeks after admission and the weekend imprisonment, the toe is OK. I still have it, which is a feat for diabetic feet with infection that gangrened. I am stillbothered overseen by a visiting nurse that my podiatrist wants keeping an eye on the infected area. Mancini himself sees me every couple weeks to check on the toe and the same foot’s broader Charcot problem. He cuts away strips of dead or undesirable skin. As I can’t particularly see or feel what he’s doing, he finds me an easy patient because there’s no real need for even local anaesthesia. The removed toenail is growing in nicely, perhaps as a positive consequence of all that milk I drink.
I did find the diabetes educator helpful and approachable about things. I learned some of the reasons for some establishment thinking, even if I think some seem more like excuses or covers for profiteering than legitimate reasons.
The night of my admission, I had been having stomach acid problems due to the prednisone and had drunk almost a half gallon of milk before leaving the house. Because they ran blood sugar tests on my arrival, I learned how seriously I was underestimating the blood sugar effects of 1% milk; that was the reason for the spike into the 600’s, which was high by my reckoning of the numbers and how I was feeling in the ER that night.
I unfortunately learned a little more disdain for the "lower levels" of health care providers, and perhaps for declining American work ethic. That single nurse-type who did bother to rinse the portable urinal had a foreign accent. None of the American-accented nurse types–whether they would officially be termed registered nurses, nurses, or certified nursing assistants–could have been bothered. The priority of the nurse types’ convenience over actual patient comfort and care astounded me. I have a strong customer service background, and do not see how many of the staffers I encountered that weekend would ever have lasted under some of the expectations I have had to meet.
I did not find hospital food to be all that bad, but most certainly bland for the lack of "unhealthy" flavorings. The salt substitute packets on the tray didn’t cut it for me. As far as I am concerned, something called "Mrs. Dash" should be put on a woman’s yeast infection, not on food. My roommate smuggled in real salt. I’m not a heavy salt user, but need it when it is needed.
I learned to stick to my guns. Both Sturdy’s podiatrist Dr. Harris and my own podiatrist Dr. Mancini complimented my successful battle zone of not letting the surgeon poke anything into the Charcot foot. Support like that, along with the hospital roommate’s compliments to my willingness to stand up to doctors might be dangerous praise with the ability to make a monster out of the raw material I provide.
I’ll try to keep myself in check.
Six weeks after admission and the weekend imprisonment, the toe is OK. I still have it, which is a feat for diabetic feet with infection that gangrened. I am still
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