My GP doesn’t fully understand the quirks and nuances of my sugar levels, and that seems to permanently maintain our lack of consensus on treatment. I do try to go along with his recommendations, but for me, it is more important to feel good than to be good according to numbers.
I feel good and function when my A1C runs towards 14, double the guidelines. Standard home testing numbers have run at 400 and I have felt a relative low in the blood sugar.
This isn’t normal, and I know it.
I do not let the sugars linger at levels that feel high. If I start peeing too much or get the heavy "clunky" feeling of high sugar, I take more insulin, without hesitation.
I’m not recommending this high life, but am just accounting for the slow rise in my numbers over a period of years, with note that my body adapted well to it.
Periods of sincere attempts to manage more according to my doctor’s wishes ushered in periods of not feeling well. The lowered numbers always seemed to usher in other problems, including the problems that now have me permanently disabled. I do not believe it just "caught up with me." I think the changes made me a "fragile" diabetic. The timing of bodily changes to the development of problems that led to other problems was too exact. For all the "typical" connections between the things that have afflicted me and being diabetic, none of my problems spontaneously "combusted." All of them had catalysts that can be traced outside the diabetes.
I’d love to feel healthy again, but I am too much of a realist to entertain pipe dreams. The damages are now done and there is no going back.
I talk with other diabetics I know, whether Type 1 or 2. I have yet to meet anyone who maintains proper numbers–A1C >7 and home testing at 120–who actually feels good. Most seem to get more discouraged by berating from doctors and caregivers when they can’t get their numbers to those levels. Those that do don’t feel good when or if they get there.
Average people in diabetics’ lives just don’t seem to get the delicacy of the balance.
Showing posts with label My GP. Show all posts
Showing posts with label My GP. Show all posts
Wednesday, October 17, 2012
Tuesday, October 16, 2012
The Stable System
My "lack of control" regarding my blood sugar developed over years. At the point of "taking care of myself better" circa 2005, I had stable but definite signs of old diabetic damage. Diabetes effects became opportunistic in the face of other problems that developed independently. Throughout those years I had a stable situation that resulted in good health, at the very least as defined by how I felt.
Those years of being a "better" diabetic–never a good diabetic–destabilized me. I have not felt healthy since.
I know this sounds like a load of bull poop. I can’t count how often I am told I am wrong about how I felt and how I feel. I am told that what I report just isn’t possible.
I don’t think it’s that impossible, and I can explain it with knowledge of another hobby I have mostly had to give up to being blind.
If you set up a new tropical fresh water fish tank, you have to create specific conditions that the fish find comfortable. Otherwise, they die. There’s things you shouldn’t put in the tank, there’s things you can’t put in the tank, and things you can’t put in together. There’s some fish such as tiger barbs that thrive in a new tank while your desire for something like neon tetras must wait until the tank’s enclosed system ages. You set the tank up successfully and get it off to a good start.
Time passes. Your diligence fades and you pay less attention to the tank’s ongoing water conditions. The fish in the tank continue to thrive with minimum care of filter cartridge changes and daily feeding. You stop testing the water. Some fish die by attrition. You get more of the same to maintain a school, and they die off quickly. Testing shows that the water is not healthy for the fish. You effect changes to accommodate new fish you want to add, and the changes kill all the old fish that were thriving in the "unhealthy" water. Because the bad changes had happened over time, the old fish adjusted to it.
My body was an enclosed system thriving under bad conditions. The changes I made under my GP’s guidance were textbook and statistical moves towards the way things should" be and they massively disrupted my thriving unhealthy system. The chain of events of unintended consequences directly led to the loss of the good eye and the Charcot foot.
My impossible desire isn’t going back to not taking that dose of Cialis, but going back and never putting myself under care and making those efforts to "take care of myself better." I never needed boner pills when I "wasn’t taking care of myself." Every other function worked better back then too.
My GP says that it all just caught up with me. I find the timing of the decline too perfectly coincidental to believe anything other than that the GP’s statement is just more bull poop.
Those years of being a "better" diabetic–never a good diabetic–destabilized me. I have not felt healthy since.
I know this sounds like a load of bull poop. I can’t count how often I am told I am wrong about how I felt and how I feel. I am told that what I report just isn’t possible.
I don’t think it’s that impossible, and I can explain it with knowledge of another hobby I have mostly had to give up to being blind.
If you set up a new tropical fresh water fish tank, you have to create specific conditions that the fish find comfortable. Otherwise, they die. There’s things you shouldn’t put in the tank, there’s things you can’t put in the tank, and things you can’t put in together. There’s some fish such as tiger barbs that thrive in a new tank while your desire for something like neon tetras must wait until the tank’s enclosed system ages. You set the tank up successfully and get it off to a good start.
Time passes. Your diligence fades and you pay less attention to the tank’s ongoing water conditions. The fish in the tank continue to thrive with minimum care of filter cartridge changes and daily feeding. You stop testing the water. Some fish die by attrition. You get more of the same to maintain a school, and they die off quickly. Testing shows that the water is not healthy for the fish. You effect changes to accommodate new fish you want to add, and the changes kill all the old fish that were thriving in the "unhealthy" water. Because the bad changes had happened over time, the old fish adjusted to it.
My body was an enclosed system thriving under bad conditions. The changes I made under my GP’s guidance were textbook and statistical moves towards the way things should" be and they massively disrupted my thriving unhealthy system. The chain of events of unintended consequences directly led to the loss of the good eye and the Charcot foot.
My impossible desire isn’t going back to not taking that dose of Cialis, but going back and never putting myself under care and making those efforts to "take care of myself better." I never needed boner pills when I "wasn’t taking care of myself." Every other function worked better back then too.
My GP says that it all just caught up with me. I find the timing of the decline too perfectly coincidental to believe anything other than that the GP’s statement is just more bull poop.
Saturday, October 13, 2012
Relativity Theory
I generally feel very stiff at the times when my body is feeling high sugar. I say this with the acknowledgment that strictly by testing numbers, my sugar is always high. By functionality and my body will frequently disagree with testing results. This is a phenomenon of relative highs and lows. I do not home blood test. As I learned more about the home testing process as my GP tried pushing it on me, I was not able to get satisfying answers to what I should do if my body said my sugar was low and in need of food but the numbers ran in three- or four hundreds.
This happened in my GP’s office a number of years ago. He was doing the usual rant on higher sugar. I told him normally my sugars felt healthy to low and that in fact I was in an insulin peak that very moment and needed to eat. He had an assistant do a home test. My sugar was in the 400’s.
I asked how could be having the feelings of excess insulin. He only shrugged. I could only shrug at his questions. I was not exaggerating how I felt or making anything up. I had to eat something before I could feel comfortable driving home.
As my GP had no answers, I turned to the internet. The disparity was a general theory of relativity. For good or bad, I took the situation as reinforcement of my own theory of self management. My doctor considers it rationalizing my own recklessness. He does not understand how I have never been in a coma. He will not consider causes other than my "poor sugar control" for any malady or complaint that can overlap with diabetes.
I face my own experience. While I was an "uncontrolled" diabetic, I had no effects that could be attributed only to the diabetes. Some things, such as periodontal problems and the loss of vision in the right eye certainly resulted from diabetes being opportunistic of other problems, but no condition spontaneously began without influence from factors outside the diabetes. That has not remained true in the time since I have been "taking care of myself better."
Here’s my train of thoughts on this.
My baseline number may be at 450, a blood sugar number that should have other people in a coma but at which I was healthy and strong. A "good" diabetic has a baseline of 120 but home testing numbers. We take our insulin. The insulin peaks and lowers our respective blood sugar numbers by 40 points. I drop to 410 and the goodie drops to 80. My change was under 9% while the goodie suffered a 33% drop in sugar level. We’re both feeling the effects of low blood sugar, including the sweaty panic. We overcompensate, raising our blood sugar by 70 points. My new change from 410 to 480 is 17% while the goodie caused a whopping 87% change from his low of 80.
The percent of change is far more drastic to the good diabetic than to the surly bastard that is me. By these numerical statistics, the healthy diabetics are comparatively fragile diabetics.
I am not advocating that diabetics intentionally raise their numbers to levels that could kill them. My "lack of control" developed over years. At the point of "taking care of myself better" circa 2005, I had stable but definite signs of old diabetic damage and some of these became opportunistic in the face of other problems that developed independently. I had a stable situation that resulted in good health, at the very least as defined by how I felt.
Those years of being a "better" diabetic–never a good diabetic–destabilized me. I have not felt healthy since.
This happened in my GP’s office a number of years ago. He was doing the usual rant on higher sugar. I told him normally my sugars felt healthy to low and that in fact I was in an insulin peak that very moment and needed to eat. He had an assistant do a home test. My sugar was in the 400’s.
I asked how could be having the feelings of excess insulin. He only shrugged. I could only shrug at his questions. I was not exaggerating how I felt or making anything up. I had to eat something before I could feel comfortable driving home.
As my GP had no answers, I turned to the internet. The disparity was a general theory of relativity. For good or bad, I took the situation as reinforcement of my own theory of self management. My doctor considers it rationalizing my own recklessness. He does not understand how I have never been in a coma. He will not consider causes other than my "poor sugar control" for any malady or complaint that can overlap with diabetes.
I face my own experience. While I was an "uncontrolled" diabetic, I had no effects that could be attributed only to the diabetes. Some things, such as periodontal problems and the loss of vision in the right eye certainly resulted from diabetes being opportunistic of other problems, but no condition spontaneously began without influence from factors outside the diabetes. That has not remained true in the time since I have been "taking care of myself better."
Here’s my train of thoughts on this.
My baseline number may be at 450, a blood sugar number that should have other people in a coma but at which I was healthy and strong. A "good" diabetic has a baseline of 120 but home testing numbers. We take our insulin. The insulin peaks and lowers our respective blood sugar numbers by 40 points. I drop to 410 and the goodie drops to 80. My change was under 9% while the goodie suffered a 33% drop in sugar level. We’re both feeling the effects of low blood sugar, including the sweaty panic. We overcompensate, raising our blood sugar by 70 points. My new change from 410 to 480 is 17% while the goodie caused a whopping 87% change from his low of 80.
The percent of change is far more drastic to the good diabetic than to the surly bastard that is me. By these numerical statistics, the healthy diabetics are comparatively fragile diabetics.
I am not advocating that diabetics intentionally raise their numbers to levels that could kill them. My "lack of control" developed over years. At the point of "taking care of myself better" circa 2005, I had stable but definite signs of old diabetic damage and some of these became opportunistic in the face of other problems that developed independently. I had a stable situation that resulted in good health, at the very least as defined by how I felt.
Those years of being a "better" diabetic–never a good diabetic–destabilized me. I have not felt healthy since.
Friday, October 12, 2012
Intensity of Feelings
(Feeling it Out: The High Sugar, Part 2)
Unquenchable thirst and heavy urination are the most obvious feelings and signs of high sugar, but far from the only ones.
I generally feel very stiff at the times when my body is feeling high sugar. I say this with the acknowledgment that strictly by testing numbers, my sugar is always high. As discussed in the posts, the numbers and my body feeling can be contradictory. When faced with a decision over the contradictions, I would always choose to listen to my body’s demands.
When I eat dinner towards the end of my insulin cycle, my body can react quickly. I reasonable meal without a lot of sugar content can cause an uncomfortable spike in blood sugar levels, and the urination cycle will often not be the first or most apparent sign.
My ankles get particularly stiff under those circumstances. It can trigger what has been dubbed by pharmaceutical companies looking to push drugs as "restless leg syndrome." Food is in, the sugar goes up, the blood thickens, and circulation reduces. I feel no need to test when this happens. It’s easy enough to think what time it is now and when I took the last dose of insulin. The stiff ankles will always trigger after a meal consumed about 11 - 14 hours after the insulin dose, even when I have eaten very little throughout the day. When the insulin has been absorbed, it is gone and any intake will trigger a blood sugar spike.
I react by taking my evening dose of insulin. I don’t advocate that other diabetics avoid home testing because I understand the danger of the advice when misapplied. I, however, pay attention to the situational factors of my day and their effects on my diabetes.
For me, high sugar feel somewhat different when it is high from food or sugar excess than when the spike comes from the insulin having just run out or been absorbed.
High sugar from the insulin petering out is a vague discomfort. The stiffness is pronounced in the ankles and a more distant feeling elsewhere; it’s almost something that has to be specifically considered than something that would be readily noticed on its own. Thirst will not be automatic, but the tongue just doesn’t taste right and may feel thick on the surface.
I feel more intense when the sugar rises due to actual excess or having eaten something better avoided. The ankle ache won’t be a dull stiffness, but outright "cramping" pain. The overall stiffness will also have intensity enough that motor control may diminish. The tongue may taste fruity and overly sweet in that way that produces the fruity breath that is an indication of diabetes. As a child, I used to look at that last sign as a curse of how my own body would betray me to others.
These signs will usually affect me before the thirst and urination cycle begins.
I pay attention to these signs. I shoot up at first opportunity. The side effects and debilitating conditions that accompany diabetes occur from the sugar being too high. It always made sense to me not to let those feeling linger. Those aren’t comfortable feelings anyway, so I deal with them at first opportunity. Regular insulin will begin improving the feelings almost instantly.
I do not let high sugar feelings remain for long, but in years of effort, I have not been able to rectify the feelings with numbers my doctor feels comfortable with.
Whose feelings should I prioritize, my doctor’s or my own?
Unquenchable thirst and heavy urination are the most obvious feelings and signs of high sugar, but far from the only ones.
I generally feel very stiff at the times when my body is feeling high sugar. I say this with the acknowledgment that strictly by testing numbers, my sugar is always high. As discussed in the posts, the numbers and my body feeling can be contradictory. When faced with a decision over the contradictions, I would always choose to listen to my body’s demands.
When I eat dinner towards the end of my insulin cycle, my body can react quickly. I reasonable meal without a lot of sugar content can cause an uncomfortable spike in blood sugar levels, and the urination cycle will often not be the first or most apparent sign.
My ankles get particularly stiff under those circumstances. It can trigger what has been dubbed by pharmaceutical companies looking to push drugs as "restless leg syndrome." Food is in, the sugar goes up, the blood thickens, and circulation reduces. I feel no need to test when this happens. It’s easy enough to think what time it is now and when I took the last dose of insulin. The stiff ankles will always trigger after a meal consumed about 11 - 14 hours after the insulin dose, even when I have eaten very little throughout the day. When the insulin has been absorbed, it is gone and any intake will trigger a blood sugar spike.
I react by taking my evening dose of insulin. I don’t advocate that other diabetics avoid home testing because I understand the danger of the advice when misapplied. I, however, pay attention to the situational factors of my day and their effects on my diabetes.
For me, high sugar feel somewhat different when it is high from food or sugar excess than when the spike comes from the insulin having just run out or been absorbed.
High sugar from the insulin petering out is a vague discomfort. The stiffness is pronounced in the ankles and a more distant feeling elsewhere; it’s almost something that has to be specifically considered than something that would be readily noticed on its own. Thirst will not be automatic, but the tongue just doesn’t taste right and may feel thick on the surface.
I feel more intense when the sugar rises due to actual excess or having eaten something better avoided. The ankle ache won’t be a dull stiffness, but outright "cramping" pain. The overall stiffness will also have intensity enough that motor control may diminish. The tongue may taste fruity and overly sweet in that way that produces the fruity breath that is an indication of diabetes. As a child, I used to look at that last sign as a curse of how my own body would betray me to others.
These signs will usually affect me before the thirst and urination cycle begins.
I pay attention to these signs. I shoot up at first opportunity. The side effects and debilitating conditions that accompany diabetes occur from the sugar being too high. It always made sense to me not to let those feeling linger. Those aren’t comfortable feelings anyway, so I deal with them at first opportunity. Regular insulin will begin improving the feelings almost instantly.
I do not let high sugar feelings remain for long, but in years of effort, I have not been able to rectify the feelings with numbers my doctor feels comfortable with.
Whose feelings should I prioritize, my doctor’s or my own?
Wednesday, October 10, 2012
Pissing the Days Away
(Feeling it Out: The High Sugar, Part 1)
The most obvious sign of high sugar is the most obvious symptom of the onset of juvenile diabetes itself the insatiable thirst and frequent to constant urination. This makes sense with basic understanding of how the body works. The body senses the excess sugar as waste material that must be purged. It makes you thirsty to give itself the raw material of water to ease and speed the removal. In Type 2 onset, this is also present as a condition and symptom, but less prominent. Not being able to sleep through the night without a need to get up and pee is one of many subtle signs.
With some but surprisingly little exaggeration, when my sugar is really high–and I do not let it stay that way–you could pretty much stand me over a toilet with a garden hose to my mouth. At a critical high I remember (caused by having forgotten to take the insulin before work and not realizing it until after having eaten) I had to go every fifteen minutes. I’ve had nighttime surges that had me awake more frequently than every hour, and more frequently than every half hour if unable to get fully back to sleep in between trips.
This is not a comfortable situation. I do not hesitate to shoot up to resolve the problem. If I get up a second time in the night ro pee, I shoot up no matter what. Often I shoot up if I wake at all without having an "innocent" cause such as having drank a lot just before bed. Most of the time, barring other issues such as insomnia, I sleep through. I feel healthy when I do that.
This is part of the very difficult balancing act. Other people often do not understand the true difficulty involved in "controlling" the blood sugar and maintaining balance.
If my sugar is too low, I cannot sleep at all. A night of higher sugar does not provide restful sleep. For purposes of sleep "normal" hours in duration and the actual time, I rest best when the sugar is starting at (by feel) a somewhat elevated level but is on the way down. Daytime function can also feel best under those circumstances.
Most of my sugar control problems have been the at night, either too high or too low, one extreme or the other.
Because I have managed by feel rather than testing numbers for so long, I tend to notice changes in my system rather then effects on numbers. One of my HP’s weaknesses is a tendency to blame any symptom on the sugar instead of other possible factors. Prozac acts as a diarrhetic on my system, creating excess urine from the amount of water taken with the pill. My GP waved that off as urination due entirely to high sugar. My body says otherwise in function, particularly as that first draining after a Prozac pill tends to be very foamy.
While the thirst and urine cycle is the most obvious sign, I always note that diabetics can get thirsty or piss more for other reasons. A handful of pretzels can trigger great thirst for the salt but not actually raise the blood sugar. Diet soda can be a diarrhetic, causing urination in quantities beyond the amount of fluid consumed.
The most obvious sign of high sugar is the most obvious symptom of the onset of juvenile diabetes itself the insatiable thirst and frequent to constant urination. This makes sense with basic understanding of how the body works. The body senses the excess sugar as waste material that must be purged. It makes you thirsty to give itself the raw material of water to ease and speed the removal. In Type 2 onset, this is also present as a condition and symptom, but less prominent. Not being able to sleep through the night without a need to get up and pee is one of many subtle signs.
With some but surprisingly little exaggeration, when my sugar is really high–and I do not let it stay that way–you could pretty much stand me over a toilet with a garden hose to my mouth. At a critical high I remember (caused by having forgotten to take the insulin before work and not realizing it until after having eaten) I had to go every fifteen minutes. I’ve had nighttime surges that had me awake more frequently than every hour, and more frequently than every half hour if unable to get fully back to sleep in between trips.
This is not a comfortable situation. I do not hesitate to shoot up to resolve the problem. If I get up a second time in the night ro pee, I shoot up no matter what. Often I shoot up if I wake at all without having an "innocent" cause such as having drank a lot just before bed. Most of the time, barring other issues such as insomnia, I sleep through. I feel healthy when I do that.
This is part of the very difficult balancing act. Other people often do not understand the true difficulty involved in "controlling" the blood sugar and maintaining balance.
If my sugar is too low, I cannot sleep at all. A night of higher sugar does not provide restful sleep. For purposes of sleep "normal" hours in duration and the actual time, I rest best when the sugar is starting at (by feel) a somewhat elevated level but is on the way down. Daytime function can also feel best under those circumstances.
Most of my sugar control problems have been the at night, either too high or too low, one extreme or the other.
Because I have managed by feel rather than testing numbers for so long, I tend to notice changes in my system rather then effects on numbers. One of my HP’s weaknesses is a tendency to blame any symptom on the sugar instead of other possible factors. Prozac acts as a diarrhetic on my system, creating excess urine from the amount of water taken with the pill. My GP waved that off as urination due entirely to high sugar. My body says otherwise in function, particularly as that first draining after a Prozac pill tends to be very foamy.
While the thirst and urine cycle is the most obvious sign, I always note that diabetics can get thirsty or piss more for other reasons. A handful of pretzels can trigger great thirst for the salt but not actually raise the blood sugar. Diet soda can be a diarrhetic, causing urination in quantities beyond the amount of fluid consumed.
Saturday, October 6, 2012
Untested Theory
I do not test my blood sugars for reasons that make logical sense to me, including the hastening of neuropathy problems in the fingers and moral outrage that pharmaceutical companies’ financial interests take priority in this country over the long term interests of patients. Other alternatives exist but are suppressed for the profitability of test strips and lancets. I am not alone in this; one of the doctors I saw about a specialized problem in the past year is a Type 2 diabetic who also does not home test. Like me, he relies on A1C tests to gauge his progress or lack thereof.
Readers, however, should keep in mind some things about this (non) practice. The first is that I fell into it out of necessity during financially destitute times, not an intentional rebellion from the inescapable status of being diabetic. I had been diabetic for fifteen or more years by that time and paid attention to what my body would tell me.
Non-testing could be dangerous to those who can’t or won’t pay attention to their bodies’ telltale signals and I do not advocate the practice even while discussing it. Knowing the signs can take time, so newer diabetics need to go through the regimen up until a time that other home testing alternatives are made available.
I stopped even urine testing due to financial constraints sometime around 1989 to 1990 and managed the sugar by feel. One key aspect of this, something I had to "unlearn" from prior diabetic education and parental control. In that abandoned approach, the theory impressed on me was that the insulin was taken only at certain times and the rest of your life was to be planned around that until the nest scheduled dose. I think most people can imagine the post high school difficulties in this, with college schedules and variable work schedules. Employers certainly understood it: I had been told outright in 1987 that I would not have been hired if the boss had known I was diabetic. Wonder how many bosses since just never said so outright after such statements became illegal.
The new approach I adopted was to react to what my body told me. This is not just a matter of eating when my body said it needed food, but shooting up with more insulin if my body said it needed that. This had not been an approved method of treatment growing up. Starving the patient was the directive on food, and taking insulin outside the approved times was also not allowed. This mentality left me with long stretches of feeling uncomfortable and probably triggered some aspects of old bodily damage.
My refusal to test my sugars outside occasional A1C lab tests (the same method that doctor I mentioned uses) does not equal not taking care of myself or emotional denial of my condition. I feel uncomfortable whenever the body feels that the sugar is too high or too low, and will make efforts to moderate extreme feelings.
But as I managed by feel for more than two decades, my body diverged entirely from the medically approved number scales of any blood testing. I feel good at what are considered to be horrifically dangerous numbers. Any and all efforts to control the sugar by the numbers has resulted in the manifestation of side effects and complications. I felt healthier when I was a purely "bad diabetic" by professional standards. In the decades of no testing, even by A1C, my body regulated itself to a place it wanted to be and I could fully function in every way, but the numbers rose to levels that make my GP wonder why I had never been in a coma. I had managed by feel and in light of the problems that have developed as a result of "taking care of myself better," I wish I had stayed with the "lifestyle" that had worked so well for me for so long.
Readers, however, should keep in mind some things about this (non) practice. The first is that I fell into it out of necessity during financially destitute times, not an intentional rebellion from the inescapable status of being diabetic. I had been diabetic for fifteen or more years by that time and paid attention to what my body would tell me.
Non-testing could be dangerous to those who can’t or won’t pay attention to their bodies’ telltale signals and I do not advocate the practice even while discussing it. Knowing the signs can take time, so newer diabetics need to go through the regimen up until a time that other home testing alternatives are made available.
I stopped even urine testing due to financial constraints sometime around 1989 to 1990 and managed the sugar by feel. One key aspect of this, something I had to "unlearn" from prior diabetic education and parental control. In that abandoned approach, the theory impressed on me was that the insulin was taken only at certain times and the rest of your life was to be planned around that until the nest scheduled dose. I think most people can imagine the post high school difficulties in this, with college schedules and variable work schedules. Employers certainly understood it: I had been told outright in 1987 that I would not have been hired if the boss had known I was diabetic. Wonder how many bosses since just never said so outright after such statements became illegal.
The new approach I adopted was to react to what my body told me. This is not just a matter of eating when my body said it needed food, but shooting up with more insulin if my body said it needed that. This had not been an approved method of treatment growing up. Starving the patient was the directive on food, and taking insulin outside the approved times was also not allowed. This mentality left me with long stretches of feeling uncomfortable and probably triggered some aspects of old bodily damage.
My refusal to test my sugars outside occasional A1C lab tests (the same method that doctor I mentioned uses) does not equal not taking care of myself or emotional denial of my condition. I feel uncomfortable whenever the body feels that the sugar is too high or too low, and will make efforts to moderate extreme feelings.
But as I managed by feel for more than two decades, my body diverged entirely from the medically approved number scales of any blood testing. I feel good at what are considered to be horrifically dangerous numbers. Any and all efforts to control the sugar by the numbers has resulted in the manifestation of side effects and complications. I felt healthier when I was a purely "bad diabetic" by professional standards. In the decades of no testing, even by A1C, my body regulated itself to a place it wanted to be and I could fully function in every way, but the numbers rose to levels that make my GP wonder why I had never been in a coma. I had managed by feel and in light of the problems that have developed as a result of "taking care of myself better," I wish I had stayed with the "lifestyle" that had worked so well for me for so long.
Thursday, October 4, 2012
Burns and Blood
It’s easy to confuse the specifics among generalities and similarities. I have caught myself doing this recently in causes and effects within my legs. I don’t think aspects of this mistake hit the blog, but it’s better to be clear.
A diabetic is inclined to have many problems with their extremities. My earliest side effects of being diabetic related to my legs below the knee. My lower legs easily cut or scrape with the slightest aggravating touch. These minor mishaps generally heal well but do scar easily. The other longstanding sign is caused by my good habit of protecting my feet with constant covering of quality socks. I should all along have been using socks that did not constrict around my ankles as much. I should have been choosing socks with less upper elasticity. The tighter socks had a tendency to rub constantly on my legs. My legs could rival the hairiness of a spider’s legs, except that socks tend to shear away hairs along the lower shins and ankles. The natural indent behind the knobby bone of the ankle maintains a tuft of hair because the socks stretch over the area rather than rub against it.
These quirks result from diabetics’ reduced circulation. Neuropathy is a completely different affects the same areas as reduced circulation, but is a completely different thing. Neuropathy is a condition of the nervous system. Circulation is blood flow. Reduced circulation hinders the main function of the blood stream: delivering oxygen throughout the body.
Neuropathy causes different problems. Usually the first sign is reduced sensations of touch and feeling. The diabetic may not feel minor cuts or other injuries to the feet and lower legs and the hands. This can be dangerous as unknown injuries will remain untreated. The poor circulation conspires with the neuropathy to raise these risks of infection and gangrene, as I perilously learned last May, as recounted in most of the entries under the "Sturdy Hospital" label.
The second most common sign of neuropathy is burning sensations. This generally occurs as the problem advances. It feels as though someone took a wooden match, lit it, then pressed it against my skim. The burns may throbs. I never had this problem until after "taking care of myself better" by working with my GP starting in 2005.
The burns will often throb in time with my pulse, and may synchronize with points of pain in different locations. The pain is not generally constant, and occurs more often at night. It can manifest from the toetips and up the legs to the waist.
My sugars have been up and down over the past few years in self-comparison. Oddly enough, I feel the burns when my A1C blood tests are higher.
A diabetic is inclined to have many problems with their extremities. My earliest side effects of being diabetic related to my legs below the knee. My lower legs easily cut or scrape with the slightest aggravating touch. These minor mishaps generally heal well but do scar easily. The other longstanding sign is caused by my good habit of protecting my feet with constant covering of quality socks. I should all along have been using socks that did not constrict around my ankles as much. I should have been choosing socks with less upper elasticity. The tighter socks had a tendency to rub constantly on my legs. My legs could rival the hairiness of a spider’s legs, except that socks tend to shear away hairs along the lower shins and ankles. The natural indent behind the knobby bone of the ankle maintains a tuft of hair because the socks stretch over the area rather than rub against it.
These quirks result from diabetics’ reduced circulation. Neuropathy is a completely different affects the same areas as reduced circulation, but is a completely different thing. Neuropathy is a condition of the nervous system. Circulation is blood flow. Reduced circulation hinders the main function of the blood stream: delivering oxygen throughout the body.
Neuropathy causes different problems. Usually the first sign is reduced sensations of touch and feeling. The diabetic may not feel minor cuts or other injuries to the feet and lower legs and the hands. This can be dangerous as unknown injuries will remain untreated. The poor circulation conspires with the neuropathy to raise these risks of infection and gangrene, as I perilously learned last May, as recounted in most of the entries under the "Sturdy Hospital" label.
The second most common sign of neuropathy is burning sensations. This generally occurs as the problem advances. It feels as though someone took a wooden match, lit it, then pressed it against my skim. The burns may throbs. I never had this problem until after "taking care of myself better" by working with my GP starting in 2005.
The burns will often throb in time with my pulse, and may synchronize with points of pain in different locations. The pain is not generally constant, and occurs more often at night. It can manifest from the toetips and up the legs to the waist.
My sugars have been up and down over the past few years in self-comparison. Oddly enough, I feel the burns when my A1C blood tests are higher.
Monday, September 17, 2012
Quantity or Quality?
I refuse to test my blood sugars with home tests and meters.
I do not recommend this approach or encourage others to follow my obstinacy. I am blogging about my own life and experiences. I will detail the how’s and why’s of my situation, but I am not dispensing medical advice here. Constant home testing was necessary as I grew up in the 1970’s, but this was done with urine testing rather than constant blood letting. Standard modern thought is that this can be some 10% more inaccurate than constant blood monitoring. There is additional concern that thee accuracy can be further skewed if the diabetic has kidney damage. I counter this by saying the diabetic should be tested for kidney damage and told how to adjust.
I will get into the reasons, logical and perhaps some emotional, of my opposition to testing in the posts that will follow. Right now, I will outline how I do manage the sugar in broad terms. This is information sharing and not medical advice. Barring digressions and other topics that come up in life, the blog will focus on blood testing issues for a while. It’s a serious and central issue of diabetic "lifestyle" that I feel needs attention and further thought.
The not testing reveal comes with another public confession that I have only really alluded to in prior posts over the past year. My blood test numbers are typically astronomically high. My body operates well and in healthy regards with numbers in the 200’s and 300’s. Tests have shown spikes exceeding 600. At those times, my sugar felt high, but I have suffered symptoms of low blood sugar with numbers in the 400’s.
I know this sounds horrifying to people with even passing knowledge of the numbers game. The target of meter numbers is around 120. The target A1C is 6.5 to 7. Mine have been to 16.
My GP has said he does not understand how I have never been in a coma. Others don’t see how those numbers can be true because I have always been a fit and lean and healthy diabetic. All medical professionals see my refusal to self test and the high numbers as poor blood sugar control.
I don’t agree with the assessments. Not testing by pharmaceutical means is not the same as paying no attention to the underlying condition. I "manage" my diabetes by feel. My emphasis is on how I feel, not what the numbers say. I avoid "high" blood sugar–when it feel high–for the most basic reason: I don’t feel comfortable when the sugar feels high.
Since starting with the GP in 2005, I had several prolonged periods of getting my numbers significantly lower. A1C numbers of 14-16 have gone down to 9, still short of doctors’ targets and always conveyed to me as not enough.
The lower numbers are healthier, I am told. I haven’t been able to believe that, not because I am obstinate, but for a basic, almost primal reason. Every time my numbers get and stay into the "better" ranges, I feel like shit. Clinical depression overwhelms me. I can’t sleep right or function like the dynamo I prefer being. My quality of life feels non existent.
Therein lies the irreconcilable difference between me and my GP. He wants to paint by numbers until he can declare me healthy by statistical standards. I want to feel good. I see little to no value of a prolonged life if it is inescapable, endless days of feeling bad. There’s a quality over quantity issue over which we will never agree.
I do not recommend this approach or encourage others to follow my obstinacy. I am blogging about my own life and experiences. I will detail the how’s and why’s of my situation, but I am not dispensing medical advice here. Constant home testing was necessary as I grew up in the 1970’s, but this was done with urine testing rather than constant blood letting. Standard modern thought is that this can be some 10% more inaccurate than constant blood monitoring. There is additional concern that thee accuracy can be further skewed if the diabetic has kidney damage. I counter this by saying the diabetic should be tested for kidney damage and told how to adjust.
I will get into the reasons, logical and perhaps some emotional, of my opposition to testing in the posts that will follow. Right now, I will outline how I do manage the sugar in broad terms. This is information sharing and not medical advice. Barring digressions and other topics that come up in life, the blog will focus on blood testing issues for a while. It’s a serious and central issue of diabetic "lifestyle" that I feel needs attention and further thought.
The not testing reveal comes with another public confession that I have only really alluded to in prior posts over the past year. My blood test numbers are typically astronomically high. My body operates well and in healthy regards with numbers in the 200’s and 300’s. Tests have shown spikes exceeding 600. At those times, my sugar felt high, but I have suffered symptoms of low blood sugar with numbers in the 400’s.
I know this sounds horrifying to people with even passing knowledge of the numbers game. The target of meter numbers is around 120. The target A1C is 6.5 to 7. Mine have been to 16.
My GP has said he does not understand how I have never been in a coma. Others don’t see how those numbers can be true because I have always been a fit and lean and healthy diabetic. All medical professionals see my refusal to self test and the high numbers as poor blood sugar control.
I don’t agree with the assessments. Not testing by pharmaceutical means is not the same as paying no attention to the underlying condition. I "manage" my diabetes by feel. My emphasis is on how I feel, not what the numbers say. I avoid "high" blood sugar–when it feel high–for the most basic reason: I don’t feel comfortable when the sugar feels high.
Since starting with the GP in 2005, I had several prolonged periods of getting my numbers significantly lower. A1C numbers of 14-16 have gone down to 9, still short of doctors’ targets and always conveyed to me as not enough.
The lower numbers are healthier, I am told. I haven’t been able to believe that, not because I am obstinate, but for a basic, almost primal reason. Every time my numbers get and stay into the "better" ranges, I feel like shit. Clinical depression overwhelms me. I can’t sleep right or function like the dynamo I prefer being. My quality of life feels non existent.
Therein lies the irreconcilable difference between me and my GP. He wants to paint by numbers until he can declare me healthy by statistical standards. I want to feel good. I see little to no value of a prolonged life if it is inescapable, endless days of feeling bad. There’s a quality over quantity issue over which we will never agree.
Sunday, September 16, 2012
Rationale and Rationalizations
I don’t test my blood sugars, Instead I pay attention to the indications my body gives, which is a constant process. I will post with more specific details, but this post will I’ve a run down of the rationale and rationalizations behind my seat-of-the-pants management of my diabetes. Please note, as I will explain in more detail, that the "feeling it out" process started by lack of funds, not specific or intentional disregard for medical practice. Nor do I recommend this to anyone, even given my cynical first point. I don’t even claim to be right on this issue. I just know it has worked for me.
I find the home blood testing process to be something of a captured audience racket by pharmaceutical companies. The technology exists for scanner devices that would not require test strips or lancet needles that must be bought for each individual test. The industry has no motivation to make these technologies available as it would mean serious revenue loss for the test strip and lancet manufacturers. It would, however, also mean millions of dollars in saving for medicare and insurance coverages.
I manage by feel. It happened in my doctor’s office that the numbers and the sensations appeared contradictory. As my body went through a relative drop, it triggered that low sugar feeling as it always does. One of the medical assistants ran a meter test and it came out around 400. If there’s any contradiction between the numbers and my body, I’m going to pay attention to my body. It may not look like much, but I trust it.
The finger pricking, and the "other site" poking hurts. The blood letting is far more uncomfortable than the needles used to take the insulin. Unlike taking insulin, test pricks are not strictly necessary for survival.
I do not see how constantly driving needles through fingertips can fail to hasten the development of neuropathy in diabetics. It seems scientifically impossible for the constant poking of the fingers’ and arms’ nerves not to further neuropathy problems via injury and stress to the nerves.
On the same token, it makes no sense to me to warn diabetics about being mindful of cuts or problems on the extremities due to risks of infection, then have them inflict multiple skin breaks per day. Sterilization at the site at the time does not guarantee germs can get in the hole later or that the holes will not reopen.
Non intrusive gauges such as urine testing served diabetics for decades. They are less costly, and obviously would not raise the same profits for the pharmaceuticals.
Tests such as the A1C can guide the diabetic to how he is doing. Yes, there are lab costs involved, but most doctors order these tests in addition to running home meter tests anyway.
In the ultimate equation of time, money and aggravation equation that I run on most anything, the entire process seems wasteful. The benefits to the pharmaceutical companies and those suppliers who ship automatically and bill Medicare such as Liberty Medical seem far greater than any direct benefit I (or Medicare) receive.
I find the home blood testing process to be something of a captured audience racket by pharmaceutical companies. The technology exists for scanner devices that would not require test strips or lancet needles that must be bought for each individual test. The industry has no motivation to make these technologies available as it would mean serious revenue loss for the test strip and lancet manufacturers. It would, however, also mean millions of dollars in saving for medicare and insurance coverages.
I manage by feel. It happened in my doctor’s office that the numbers and the sensations appeared contradictory. As my body went through a relative drop, it triggered that low sugar feeling as it always does. One of the medical assistants ran a meter test and it came out around 400. If there’s any contradiction between the numbers and my body, I’m going to pay attention to my body. It may not look like much, but I trust it.
The finger pricking, and the "other site" poking hurts. The blood letting is far more uncomfortable than the needles used to take the insulin. Unlike taking insulin, test pricks are not strictly necessary for survival.
I do not see how constantly driving needles through fingertips can fail to hasten the development of neuropathy in diabetics. It seems scientifically impossible for the constant poking of the fingers’ and arms’ nerves not to further neuropathy problems via injury and stress to the nerves.
On the same token, it makes no sense to me to warn diabetics about being mindful of cuts or problems on the extremities due to risks of infection, then have them inflict multiple skin breaks per day. Sterilization at the site at the time does not guarantee germs can get in the hole later or that the holes will not reopen.
Non intrusive gauges such as urine testing served diabetics for decades. They are less costly, and obviously would not raise the same profits for the pharmaceuticals.
Tests such as the A1C can guide the diabetic to how he is doing. Yes, there are lab costs involved, but most doctors order these tests in addition to running home meter tests anyway.
In the ultimate equation of time, money and aggravation equation that I run on most anything, the entire process seems wasteful. The benefits to the pharmaceutical companies and those suppliers who ship automatically and bill Medicare such as Liberty Medical seem far greater than any direct benefit I (or Medicare) receive.
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.
Monday, August 27, 2012
The Good and Bad
Separate feedback has dubbed it both odd and contradictory that I continue to see a General Practitioner who I do not really like. People have been calling me odd my entire life and contrary for all of my adult life, so I don’t understand where the surprise comes from. I’ll explain the GP thing anyway.
Other friends who are far more accustomed to seeing doctors regularly don’t like my GP. One of those primary two has actually met the GP. Neither thinks he is a very good doctor. I don’t feel all that qualified to judge. I know when I have a bad doctor, such as when one scares me into surgery that can cause the very thing it is supposed to prevent. I do not, however, necessarily know when a doctor is good.
My GP has not done anything that has directly caused harm. That’s part of my minimum criteria in keeping with a doctor who may not be the best match for me. As stated above and perhaps often exaggerated with defensiveness and warped pride, I can be contrary. Don’t think I would agree with any doctor 100% and don’t want to go through the effort of training someone new how to deal with me and where the lines in the sand are drawn. I can deal with a face-to-face disagreement without getting mad, but if a new potential doctor were to try to move the line in the hopes the blind guy won’t know the difference, I’m inclined to get annoyed.
I live a fairly healthy life with two things that are "bad bad bad" according to all doctors and most common sense. I’ll save the full confessions for some other time. It’s safe to say that any doctor would have objection to either. Some doctors would decline me as a patient for one or both.
I live and eat healthier than most Americans. I don’t eat a fiber and fart rich diet chock full of fruits and vegetables with every meal, but I seldom stray into bad foods at either take-out or at-home levels. I eat few pre-pared foods and when having a choice "on the road" I always choose Subway over the burger joints. At home, I am inclined to an occasional can of soup and the worst thing to get through the door is the Hamburger Helper stroganoff. I hope that adding string beans or peas to the salty mix makes it less bad. (It doesn’t.)
None of that is enough for my GP. I appreciate that he holds the hardline, and there’s seldom conflict about it. I’m honest with him and expect the same from him. The few actual cross words have come when he pushes some issues. when the hard line holding becomes nagging, I get put off no matter who the nag is.
I am realistic. If I eliminate the few extravagances–which are never diabetic catastrophe such as a package of Oreos–I will feel deprived. That feeling is the universal doom to any diet, diabetic or average-Joe weight loss diet. No diet will work unless it can be lived for the rest of the dieter’s life. Otherwise, the gains and benefits are only temporary, and lost the first time the dieter overcompensates for feeling deprived. When my doctor gives m the impression he will never be pleased, I stop trying to please him. That does not extend to becoming contrary just to be contrary.
My doctor is no dietician and has been unable to answer some questions I have raised. He could stand to lose some weight himself, though I have yet to point that out to him directly.
Other friends who are far more accustomed to seeing doctors regularly don’t like my GP. One of those primary two has actually met the GP. Neither thinks he is a very good doctor. I don’t feel all that qualified to judge. I know when I have a bad doctor, such as when one scares me into surgery that can cause the very thing it is supposed to prevent. I do not, however, necessarily know when a doctor is good.
My GP has not done anything that has directly caused harm. That’s part of my minimum criteria in keeping with a doctor who may not be the best match for me. As stated above and perhaps often exaggerated with defensiveness and warped pride, I can be contrary. Don’t think I would agree with any doctor 100% and don’t want to go through the effort of training someone new how to deal with me and where the lines in the sand are drawn. I can deal with a face-to-face disagreement without getting mad, but if a new potential doctor were to try to move the line in the hopes the blind guy won’t know the difference, I’m inclined to get annoyed.
I live a fairly healthy life with two things that are "bad bad bad" according to all doctors and most common sense. I’ll save the full confessions for some other time. It’s safe to say that any doctor would have objection to either. Some doctors would decline me as a patient for one or both.
I live and eat healthier than most Americans. I don’t eat a fiber and fart rich diet chock full of fruits and vegetables with every meal, but I seldom stray into bad foods at either take-out or at-home levels. I eat few pre-pared foods and when having a choice "on the road" I always choose Subway over the burger joints. At home, I am inclined to an occasional can of soup and the worst thing to get through the door is the Hamburger Helper stroganoff. I hope that adding string beans or peas to the salty mix makes it less bad. (It doesn’t.)
None of that is enough for my GP. I appreciate that he holds the hardline, and there’s seldom conflict about it. I’m honest with him and expect the same from him. The few actual cross words have come when he pushes some issues. when the hard line holding becomes nagging, I get put off no matter who the nag is.
I am realistic. If I eliminate the few extravagances–which are never diabetic catastrophe such as a package of Oreos–I will feel deprived. That feeling is the universal doom to any diet, diabetic or average-Joe weight loss diet. No diet will work unless it can be lived for the rest of the dieter’s life. Otherwise, the gains and benefits are only temporary, and lost the first time the dieter overcompensates for feeling deprived. When my doctor gives m the impression he will never be pleased, I stop trying to please him. That does not extend to becoming contrary just to be contrary.
My doctor is no dietician and has been unable to answer some questions I have raised. He could stand to lose some weight himself, though I have yet to point that out to him directly.
Monday, August 20, 2012
Flashpoint
My GP and I have certain fundamental differences in approach and philosophies. He wants to paint by numbers with an objective of a long life. I want to feel good for as long as I happen to live, a quality-over-quantity preference. The last couple years of diminishing abilities has only reaffirmed my outlook.
Any doctor would have gasped in horror at my numbers in 2005 when I started seeing my GP. Perhaps a diabetes specialist would have had more experience with diabetics who were "living high" and had taken a more cautious approach to making changes. It's way too late to speculate now. Egged on by a couple friends who felt I didn't take care of myself, I went along with the changes promoted by my GP, the largest of which was doubling my dose of insulin. He did not change my daytime dose, but specifically prescribed taking an equal dose at night. Gauging my sugars by feel, I knew that most of the time my sugar ran high, it was doing so only at night.
I specify here that my highs and lows were relative changes to my own bodily system. The lows were not numerical lows by standard practices. My lows would be sugar-shock coma-inducing highs to a fragile diabetic.
This did work at drastically lowering my A1C.
This period of change, from spring to summer of 2005, also spelled the end of what I refer to as "The Healthy Years." My numbers improved, still not to the GP's satisfaction, but I felt like crap. The better my numbers got, the worse I felt.
With the onset of diabetes at age 4 and a hospitalization at age 12, 2005 at the age of 36, became my third flashpoint with the sugar. This was a period of massive change, and none felt then–or now–like changes for the better.
I encountered this GP in kind of a literal way, by accident. Results of a car accident had left me with a broken shoulder, and I ended up with physical therapy in the GP’s practice. The accident triggered a mid-life crisis. It became a practice run at being needy
My vehicle was a stick shift, unworkable with a shoulder brace and sling. I was living alone at the time of the accident and the medical aftermath. Some people in my life at the time proved themselves more loyal and caring–more there–than I would have expected. Some of the ones I would have expected to be there for me (because I had been and always was there in their times of need in so many ways) were either conspicuously absent or made the inconvenience factor well known when they were there.
I think part of the reason I have adjusted so well to the permanent disability was for having lived through that temporary bout. I looked at the new presence of an internist doctor in my life as fate, especially while in the middle of a mid-life crisis. Loose and independent threads had seemed to converge. With clearer thinking, with less acceptance of "fate" to where I ended up. With less criticism and disfavor from some of the people closest to me and if other factors had been different at the time, I would not have continued seeing my GP when the shoulder issue cleared up.
I do firmly believe that in the entire cycle of events, I would not be in this permanent predicament of neediness now.
Any doctor would have gasped in horror at my numbers in 2005 when I started seeing my GP. Perhaps a diabetes specialist would have had more experience with diabetics who were "living high" and had taken a more cautious approach to making changes. It's way too late to speculate now. Egged on by a couple friends who felt I didn't take care of myself, I went along with the changes promoted by my GP, the largest of which was doubling my dose of insulin. He did not change my daytime dose, but specifically prescribed taking an equal dose at night. Gauging my sugars by feel, I knew that most of the time my sugar ran high, it was doing so only at night.
I specify here that my highs and lows were relative changes to my own bodily system. The lows were not numerical lows by standard practices. My lows would be sugar-shock coma-inducing highs to a fragile diabetic.
This did work at drastically lowering my A1C.
This period of change, from spring to summer of 2005, also spelled the end of what I refer to as "The Healthy Years." My numbers improved, still not to the GP's satisfaction, but I felt like crap. The better my numbers got, the worse I felt.
With the onset of diabetes at age 4 and a hospitalization at age 12, 2005 at the age of 36, became my third flashpoint with the sugar. This was a period of massive change, and none felt then–or now–like changes for the better.
I encountered this GP in kind of a literal way, by accident. Results of a car accident had left me with a broken shoulder, and I ended up with physical therapy in the GP’s practice. The accident triggered a mid-life crisis. It became a practice run at being needy
My vehicle was a stick shift, unworkable with a shoulder brace and sling. I was living alone at the time of the accident and the medical aftermath. Some people in my life at the time proved themselves more loyal and caring–more there–than I would have expected. Some of the ones I would have expected to be there for me (because I had been and always was there in their times of need in so many ways) were either conspicuously absent or made the inconvenience factor well known when they were there.
I think part of the reason I have adjusted so well to the permanent disability was for having lived through that temporary bout. I looked at the new presence of an internist doctor in my life as fate, especially while in the middle of a mid-life crisis. Loose and independent threads had seemed to converge. With clearer thinking, with less acceptance of "fate" to where I ended up. With less criticism and disfavor from some of the people closest to me and if other factors had been different at the time, I would not have continued seeing my GP when the shoulder issue cleared up.
I do firmly believe that in the entire cycle of events, I would not be in this permanent predicament of neediness now.
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.
Tuesday, July 24, 2012
“Irregular” Insulin
Regular insulin, known as "R," is considered fast-acting or instant acting. It begins working in as little as ten to fifteen minutes. It stays in the body for mere hours. Once it is absorbed, it’s gone.
The other common base insulin is known these days as "N." This used to be known as NPH, for neutral protamine Hagedorn, but seeing that amounts to a steaming BS heap of gibberish and jargon, I’m not surprised they gave up and now just call it N..
Time release insulin has a delayed action in the body. "N" is considered a midrange time action and does not begin effecting the body for two to three hours. Nor does it release all at once. By what I feel (meaning scientific or official definitions may differ from my practical experience) N takes effect in several spurts throughout the day. In my subjective experience, it seems to have three spurts and is completely gone after about 12 hours.
When I say it is gone, I do mean gone. I must take two shots a day. In that twelve to fourteen hour range, I can feel symptoms of both low and high blood sugar at the same time if I haven’t adequately eaten throughout the day. Eating at that time will kick the discomforts of high sugar into speedy overdrive.
My GP has had me on two equal doses of insulin daily. The morning dose works well for me, but I have problems with the evening dose. This does not surprise me, as this dosage model does not mimic the way a "healthy" person’s body releases insulin in response to food. The body may continue to release small amounts of insulin to keep the body regulated throughout the night. My body can’t do that, but cannot go without insulin for so long.
Nighttime balance has been the great difficulty for me. If I don’t eat enough, I cannot sleep. Eat too much and the sugar is at an uncomfortable and possibly damaging peak by the time I wake up. I’ve tried experimenting with dosage reductions, never with results I have bee n comfortable with. The time release insulin releases whether I eat or not. Not eating will bring insomnia when the insulin kicks in, even if it does not dip to a more critical low. With reduced dosage, that same reasonable snack (usually cereal) is often too much; the sugar will be higher through the night and when I wake.
Once the time release has been injected, it’s there, needed or not. A busy or chaotic day that does not allow time to eat can be devastating. Things can be put off only so long before there’s a crash. This would be true for anyone, but is more amplified for a diabetic. The balance diabetics must maintain isn’t quite difficult to maintain, but is far too easy to get sidetracked.
The other common base insulin is known these days as "N." This used to be known as NPH, for neutral protamine Hagedorn, but seeing that amounts to a steaming BS heap of gibberish and jargon, I’m not surprised they gave up and now just call it N..
Time release insulin has a delayed action in the body. "N" is considered a midrange time action and does not begin effecting the body for two to three hours. Nor does it release all at once. By what I feel (meaning scientific or official definitions may differ from my practical experience) N takes effect in several spurts throughout the day. In my subjective experience, it seems to have three spurts and is completely gone after about 12 hours.
When I say it is gone, I do mean gone. I must take two shots a day. In that twelve to fourteen hour range, I can feel symptoms of both low and high blood sugar at the same time if I haven’t adequately eaten throughout the day. Eating at that time will kick the discomforts of high sugar into speedy overdrive.
My GP has had me on two equal doses of insulin daily. The morning dose works well for me, but I have problems with the evening dose. This does not surprise me, as this dosage model does not mimic the way a "healthy" person’s body releases insulin in response to food. The body may continue to release small amounts of insulin to keep the body regulated throughout the night. My body can’t do that, but cannot go without insulin for so long.
Nighttime balance has been the great difficulty for me. If I don’t eat enough, I cannot sleep. Eat too much and the sugar is at an uncomfortable and possibly damaging peak by the time I wake up. I’ve tried experimenting with dosage reductions, never with results I have bee n comfortable with. The time release insulin releases whether I eat or not. Not eating will bring insomnia when the insulin kicks in, even if it does not dip to a more critical low. With reduced dosage, that same reasonable snack (usually cereal) is often too much; the sugar will be higher through the night and when I wake.
Once the time release has been injected, it’s there, needed or not. A busy or chaotic day that does not allow time to eat can be devastating. Things can be put off only so long before there’s a crash. This would be true for anyone, but is more amplified for a diabetic. The balance diabetics must maintain isn’t quite difficult to maintain, but is far too easy to get sidetracked.
Thursday, May 10, 2012
Practice Dummies
After writing the post that listed the doctors who have seen for the eye/s, it occurred to me that the three I most recommend–Magdalena G. Krzystolik, Heinrich Krosschell and to a lesser extent Harold Woodcomb –share something that all the other doctors lacked.
The three who did best by me each essentially owned the practice. Krzystolik and Woodcomb are listed first among their associates on their letterhead and in their advertising. Krosschell is his practice.
Now that I have noticed this, I will probably never see a new doctor, for eyes or anything else, who is not the principal doctor within the practice.
When choosing a doctor, I want the head honcho who can make the decisions. I want the one who had ambition enough to branch out on hir own.
What I do NOT want is people like Koch’s Michael O’Brien or the Smiley clown who briefly worked for Woodcomb. They are associates, and thus employees. Any employee in a business needs to be able to rationalize hir salary, and the subordinate doctors in any practice can be under any level of real or imagined pressure to increase their billings. Their financial contribution to the practice may often take precedence over patient care. This is America: healthcare is a business.
This newly realized pattern among the doctors I have seen applies equally well to Paul Arrigg and Deborah K. Schlossman at the Joslin Eye Clinic. The latter demonstrated the worst of paid employees: she tried to leave a paper trail of work that she had not actually fully preformed and was rushing out the door to leave on a Friday. Arrigg strung me along with separately and steeply billed follow-up visits and tests and in-house referrals that generated separate bills, all in preparation for procedures he had no intention of performing.
The near year of treatment with Arrigg allowed my vision to worsen, which all but guaranteed less success with the eventual retina reattachment not performed at Joslin.) My association with Arrigg ended when I persisted in my interest for the procedures he had outlined. He then told me I would be better off seeking treatment more local to me in Rhode Island.
I doubt the retina reattachment would have been necessary if O’Brien had not scared me into the PRP laser. I’m sure to have been forgotten in a flow of new paying patients since then, but they took in fees and "earned" their salaries back then. Their mothers ought to be proud.
The employees will always worry about their job first, even above what is best care for the patient. Only the primary owner has the motivation to keep the long term reputation of the practice as a priority.
The three who did best by me each essentially owned the practice. Krzystolik and Woodcomb are listed first among their associates on their letterhead and in their advertising. Krosschell is his practice.
Now that I have noticed this, I will probably never see a new doctor, for eyes or anything else, who is not the principal doctor within the practice.
When choosing a doctor, I want the head honcho who can make the decisions. I want the one who had ambition enough to branch out on hir own.
What I do NOT want is people like Koch’s Michael O’Brien or the Smiley clown who briefly worked for Woodcomb. They are associates, and thus employees. Any employee in a business needs to be able to rationalize hir salary, and the subordinate doctors in any practice can be under any level of real or imagined pressure to increase their billings. Their financial contribution to the practice may often take precedence over patient care. This is America: healthcare is a business.
This newly realized pattern among the doctors I have seen applies equally well to Paul Arrigg and Deborah K. Schlossman at the Joslin Eye Clinic. The latter demonstrated the worst of paid employees: she tried to leave a paper trail of work that she had not actually fully preformed and was rushing out the door to leave on a Friday. Arrigg strung me along with separately and steeply billed follow-up visits and tests and in-house referrals that generated separate bills, all in preparation for procedures he had no intention of performing.
The near year of treatment with Arrigg allowed my vision to worsen, which all but guaranteed less success with the eventual retina reattachment not performed at Joslin.) My association with Arrigg ended when I persisted in my interest for the procedures he had outlined. He then told me I would be better off seeking treatment more local to me in Rhode Island.
I doubt the retina reattachment would have been necessary if O’Brien had not scared me into the PRP laser. I’m sure to have been forgotten in a flow of new paying patients since then, but they took in fees and "earned" their salaries back then. Their mothers ought to be proud.
The employees will always worry about their job first, even above what is best care for the patient. Only the primary owner has the motivation to keep the long term reputation of the practice as a priority.
Wednesday, January 4, 2012
Diabetic Complications: Charcot Foot
The foot problem that developed this past Autumn is another complication of diabetes called Charcot Foot. The condition name is French and the French can’t spell, so it’s pronounced "Sharko foot."
Being a blind fool, I kicked into something hard. The foot became swollen and painful but I had full movement and strength. My GP told me to wrap it but determined nothing was broken and casually gave me an X-Ray referral.
Wrapping it caused the swelling to drastically increase and spread up to the knee. This was something beyond normal fluid swelling, thick matter under the skin. I can press into it with a finger and a dent remains behind as if I had poked into clay.
The X-rays revealed nothing broken, nor did MRIs. The sports medicine doctor prescribed an immobilization boot anyway.
I’m contrary to the Charcot statistics just as some people tell me I’m contrary to most everything. I have pain in the foot and did from the original injury. Nothing is fractured or broken. My neuropathy is not as advanced as most Charcot patients’; many when diagnosed remain unaware of the catalyzing injury, which often leads their doctors to mistakenly treat the swelling as a massive infection.
I do have the traditional signs of massive swelling and elevated foot temperature. The swelling is part of what is a prolonged healing process. Most patients get worse if their doctors treat the swelling, so my GP and the urgent care doctor did things right by denying my requests for treatment of that aspect. The absolute worst thing a doctor could have done is puncture the foot to release the fluid; infection would have been more than likely and created further complications that could be a fast track to amputation.
The boot is preventative only, but I have been diligent in wearing it. A common subsequent malady is foot ulcers formed by damaged bones popping out from beneath the skin when the patient does not immobilize and rest the foot. Even if patients do not progress so far, such skin ulcers easily lead to amputation. Permanently malformed feet often develop as fractured bones grow out of place.
I seem to have inflicted a non-neuropathy level of nerve damage in the foot. I can touch one area of the foot to produce a burn, pain or spasm in a seemingly unrelated part of the foot. Other times little spasms start on their own and make it feel as though there is a writhing mouse in the boot. I call over a cat just in case, but the increased temperature of a foot restrained to a heavy boot produces a smell that the cats don’t care for.
The healing process is a careful wait-it-out routine. Artificial reduction of the swelling is likely to cause infection, but the prolonged state of swelling can cause impair calcium and nutrient distribution. This can also malform bone structure. The immobilizing boot and elevation are both important.
This has naturally further diminished my capacity to do anything and has only added to my frustration and boredom and thus to my edgy disposition.
I think I was lucky when the sports medicine place prescribed the boot. Most places I go, I get a boot square in the ass. There, they tenderly placed it on my foot.
Being a blind fool, I kicked into something hard. The foot became swollen and painful but I had full movement and strength. My GP told me to wrap it but determined nothing was broken and casually gave me an X-Ray referral.
Wrapping it caused the swelling to drastically increase and spread up to the knee. This was something beyond normal fluid swelling, thick matter under the skin. I can press into it with a finger and a dent remains behind as if I had poked into clay.
The X-rays revealed nothing broken, nor did MRIs. The sports medicine doctor prescribed an immobilization boot anyway.
I’m contrary to the Charcot statistics just as some people tell me I’m contrary to most everything. I have pain in the foot and did from the original injury. Nothing is fractured or broken. My neuropathy is not as advanced as most Charcot patients’; many when diagnosed remain unaware of the catalyzing injury, which often leads their doctors to mistakenly treat the swelling as a massive infection.
I do have the traditional signs of massive swelling and elevated foot temperature. The swelling is part of what is a prolonged healing process. Most patients get worse if their doctors treat the swelling, so my GP and the urgent care doctor did things right by denying my requests for treatment of that aspect. The absolute worst thing a doctor could have done is puncture the foot to release the fluid; infection would have been more than likely and created further complications that could be a fast track to amputation.
The boot is preventative only, but I have been diligent in wearing it. A common subsequent malady is foot ulcers formed by damaged bones popping out from beneath the skin when the patient does not immobilize and rest the foot. Even if patients do not progress so far, such skin ulcers easily lead to amputation. Permanently malformed feet often develop as fractured bones grow out of place.
I seem to have inflicted a non-neuropathy level of nerve damage in the foot. I can touch one area of the foot to produce a burn, pain or spasm in a seemingly unrelated part of the foot. Other times little spasms start on their own and make it feel as though there is a writhing mouse in the boot. I call over a cat just in case, but the increased temperature of a foot restrained to a heavy boot produces a smell that the cats don’t care for.
The healing process is a careful wait-it-out routine. Artificial reduction of the swelling is likely to cause infection, but the prolonged state of swelling can cause impair calcium and nutrient distribution. This can also malform bone structure. The immobilizing boot and elevation are both important.
This has naturally further diminished my capacity to do anything and has only added to my frustration and boredom and thus to my edgy disposition.
I think I was lucky when the sports medicine place prescribed the boot. Most places I go, I get a boot square in the ass. There, they tenderly placed it on my foot.
Sunday, November 6, 2011
Feedback 1
Addressing reader concerns:
Comments are welcome. Anyone who feels that their thoughts shouldn’t be pubic for any reason are free to privately e-mail me. E-mail links are common on my kozzi.us page.
Light sensitivity is a standard complication of diabetes. I have found no internet mention that the dilated light tests are a probable cause. A good part of the blog’s intention is to get my crazy theories out there. I don’t think they’re all that crazy. They need to be out there to be considered. We live in a country where healthcare is a capitalist venture. Doctors will run every test they can get paid for, as often as they can get paid for them. From my experience they are not forthcoming in volunteering potential risks or side effects. More scarey, some doctors will deny the risks and side effects even when asked. My GP is big on that. He often just brushes off specific concerns as me being a difficult patient rather than discussing the my concerns.
I understand that doctors do not want to discourage anyone from having treatment they need, but too many will give more treatment than needed if there’s a buck to be made. I am a strong believer that patients need to be fully informed to enable the best decisions. Whether it’s minor light sensitivity or something major, such as Cialis and Viagra causing a massive stroke or hemorrhage in the eye, the patient should be told of the risks so he can make his own decision. Patients should not have to independently research things . Doctors should not rely on pharmacists to prevent drug interactions.
I have always believed that, and the experiences that conveyed on this site show the importance of patient knowledge and dire consequences of their ignorance.
Shame on doctors who do not cover every detail of these risks. Relying on the patient to ask is not appropriate. If a patient has never heard of something cannot ask about it.
The same reader was unsure of my statements about the "retina weld" as a benefit of PRP surgery. Not every site I have researched to fact check lists it. More than one did. Instead of calling the benefit a "weld" I’ll qualify it that it can retain the retina’s contact to the back of the eye. There is NO benefit of PRP surgery that even approximates re-attachment of a retina that has begun to separate.
I do aim for accuracy, especially when trying to make complicated terms and procedures more understandable than many doctors would prefer.
Tomorrow, back to my procedures in January 2010. It should be as entertaining as watching a blind guy walk into a ladies’ room because his roommate can’t tell the difference between "first door on the right" and "first door on the left."
Yes, that happened today. My apologies to the women in there when I left the stall. They weren’t there when I went in.
And I think I left the seat up.
Comments are welcome. Anyone who feels that their thoughts shouldn’t be pubic for any reason are free to privately e-mail me. E-mail links are common on my kozzi.us page.
Light sensitivity is a standard complication of diabetes. I have found no internet mention that the dilated light tests are a probable cause. A good part of the blog’s intention is to get my crazy theories out there. I don’t think they’re all that crazy. They need to be out there to be considered. We live in a country where healthcare is a capitalist venture. Doctors will run every test they can get paid for, as often as they can get paid for them. From my experience they are not forthcoming in volunteering potential risks or side effects. More scarey, some doctors will deny the risks and side effects even when asked. My GP is big on that. He often just brushes off specific concerns as me being a difficult patient rather than discussing the my concerns.
I understand that doctors do not want to discourage anyone from having treatment they need, but too many will give more treatment than needed if there’s a buck to be made. I am a strong believer that patients need to be fully informed to enable the best decisions. Whether it’s minor light sensitivity or something major, such as Cialis and Viagra causing a massive stroke or hemorrhage in the eye, the patient should be told of the risks so he can make his own decision. Patients should not have to independently research things . Doctors should not rely on pharmacists to prevent drug interactions.
I have always believed that, and the experiences that conveyed on this site show the importance of patient knowledge and dire consequences of their ignorance.
Shame on doctors who do not cover every detail of these risks. Relying on the patient to ask is not appropriate. If a patient has never heard of something cannot ask about it.
The same reader was unsure of my statements about the "retina weld" as a benefit of PRP surgery. Not every site I have researched to fact check lists it. More than one did. Instead of calling the benefit a "weld" I’ll qualify it that it can retain the retina’s contact to the back of the eye. There is NO benefit of PRP surgery that even approximates re-attachment of a retina that has begun to separate.
I do aim for accuracy, especially when trying to make complicated terms and procedures more understandable than many doctors would prefer.
Tomorrow, back to my procedures in January 2010. It should be as entertaining as watching a blind guy walk into a ladies’ room because his roommate can’t tell the difference between "first door on the right" and "first door on the left."
Yes, that happened today. My apologies to the women in there when I left the stall. They weren’t there when I went in.
And I think I left the seat up.
Thursday, October 27, 2011
The Bug-eyed Monster
After being disillusioned by Dr. Woodcomb’s statement "It’s doubtful that Cialis causes any eye problems," I sought a new eye doctor to check out my blood-filled orb. I didn’t know precisely what I did want or need, but I knew what I did not want: a retina specialist. This was a clear hemorrhage...oh, wait..."clear" is really a bad word choice as I was seeing everything through a sheen of bright blood red. Anyhoo, what had occurred was not a retina issue per se, and I sought to avoid having the words diabetic and eye being used to shoehorn me into distraction from the problem at hand.
I ended up seeing Dr. Michael Negrey at Koch Eye Associates. My parents drove me to the appointment. While waiting, they read the resume that Koch provided and were greatly impressed.
I wasn’t so sure. There’s an emotional factor in waking up to a blood filled eye and the inability to do anything for yourself that will cloud anyone’s judgment. I did not like his bedside manner, but I can be pretty rough and gruff myself, so I probably should not criticize. Negrey had a distant and superior manner that I did not care for, but the reality is that his technical ability was more important than his mannerism. His nannerisn quickly manifested as a God Complex.
He prescribed an MRI with concern that I may have ab enlarged thyroid or other foreign growth behind the right eye. I wondered if the thyroid possibility would prove my GP right. Health measured by how I feel had drastically declined under his care. My GP said the health decline was hard living and had nothing to do with me becoming healthier according to his color-by-numbers standards. The MRI came back clear. My mother noted that I had "buggy eyes" since I was a child.
Negrey clearly noted that blood had filled the existing cataract and preplanned surgery for the near future.
But first he wanted me to see Koch’s retina guy, Michael O’Brien.
I ended up seeing Dr. Michael Negrey at Koch Eye Associates. My parents drove me to the appointment. While waiting, they read the resume that Koch provided and were greatly impressed.
I wasn’t so sure. There’s an emotional factor in waking up to a blood filled eye and the inability to do anything for yourself that will cloud anyone’s judgment. I did not like his bedside manner, but I can be pretty rough and gruff myself, so I probably should not criticize. Negrey had a distant and superior manner that I did not care for, but the reality is that his technical ability was more important than his mannerism. His nannerisn quickly manifested as a God Complex.
He prescribed an MRI with concern that I may have ab enlarged thyroid or other foreign growth behind the right eye. I wondered if the thyroid possibility would prove my GP right. Health measured by how I feel had drastically declined under his care. My GP said the health decline was hard living and had nothing to do with me becoming healthier according to his color-by-numbers standards. The MRI came back clear. My mother noted that I had "buggy eyes" since I was a child.
Negrey clearly noted that blood had filled the existing cataract and preplanned surgery for the near future.
But first he wanted me to see Koch’s retina guy, Michael O’Brien.
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