The change in Wal-Mart generic insulin manufacture has brought more frequent periods of discomfort with "low" sugar levels. I use quotes on "low" as acknowledgment that this is by feel, not by blood testing numbers.
Overall the sugar has felt lower with the Novolin than it had been with the Humulin formula. Since the toe problem that landed me in the hospital in the spring, I was making a concentrated effort for an overall lowering of the blood sugar. The change in insulin seems to have made a sharper change in that direction, unfortunately at a time when I was looking to slowly raise it again so I would feel overall better health.
People, including my GP, do not understand that last statement. Diabetics do. I do not feel as good when the sugars are lower. Diabetics who are good doobies and paint by numbers also report that they feel less well when their sugars are at better numbers. I’m still waiting for that lucky day when I meet a doctor who understands that how a patient feels is somewhat more important than what test numbers statistically say about their health. At least two of the three other diabetics with whom I have most recently spoken with in general terms report that they primary care givers and/or diabetic specialists have railed against missed target numbers without regard to how the patients were actually feeling, so I am not holding my breath on meeting the more compassionate and logical doctor. Both of those acquaintances were discouraged that no effort seems enough.
I have never recovered the feelings of wellness and functionality I possessed prior to "taking care of myself better." By the full chains of events, I would not be blind nor crippled by the collapsed ankle via Charcot foot if I had not started taking care of myself better. I My numbers had risen again and things got better, but never back to where they had been, even discounting the blind thing and the cripple thing.
I did make a renewed effort on my own after this spring’s hospitalization. The Charcot foot had nearly totally impeded circulation in the foot, allowing for the sudden infection and almost instantaneous gangrene and the collapse of the bone structure that has permanently impaired my ankle. My largest steps were to eliminate as much of the big (and hidden) source of sugar in my diet as possible, and letting my sugar levels stay at critically low feeling longer than I usually would.
I don’t need an A1C test to know I have succeeded. I don’t feel as well as I did prior to the hospitalization. Fatigue is constant. When the sugar hits a low feel level, the physical symptoms hit much sooner after the temperament issues than they used to. Those temperament issues are more severe and the "calm" times between are periods of severe depression that is biochemically impacted beyond the constant "useless gimp" feelings that are situational depression that anyone would feel in my situation. My thoughts are usually slower. I tire more easily. Stamina is gone. Neuropathy burns are more frequent. The depression had reached such an abyss that I found no choice other than to resume antidepressants.
Does this sound like healthier living?
It sure don’t feel like it.
Tuesday, October 9, 2012
Feeling it Out: Wal-Mart Generic Insulin Change
With a few more weeks of (mostly) twice daily dosages under my skin, I think there are larger differences to the Novo Nordisk manufactured Novolin from the generic it replaced, Eli Lilly Company Humulin. I report these changes from feel, not from home monitoring of blood sugar numbers. I am also talking about the time release "N" variety and have not begun using the instant "R."
The Novolin seems to peak less often in the day. The humulin would spurt in several times over twelve hours and then it was just gone, fully absorbed and needing replenishment. The Novolin peaks are stronger than the humulin peaks. This makes sense with the lesser frequency of peaks.
The first surge is strongest and is not always easily leveled.
The Novolin lasts longer than the 12 hours I was used to with the humulin. That strength of the first peak after the injection may be that the first of the latest injection is combining with the last of the prior injection.
The change has brought more frequent periods of discomfort with "low" sugar levels. Overall I feel that the sugar is lower than it had been with the humulin formula. Since the toe problem that landed me in the hospital in the spring, I was making a concentrated effort for an overall lowering of the blood sugar. The change in insulin seems to have made a sharper change in that direction, unfortunately at a time when I was looking to slowly raise it again so I would feel overall better health.
Diabetic patients do need to watch themselves more closely when adapting to the new generic.
The Novolin seems to peak less often in the day. The humulin would spurt in several times over twelve hours and then it was just gone, fully absorbed and needing replenishment. The Novolin peaks are stronger than the humulin peaks. This makes sense with the lesser frequency of peaks.
The first surge is strongest and is not always easily leveled.
The Novolin lasts longer than the 12 hours I was used to with the humulin. That strength of the first peak after the injection may be that the first of the latest injection is combining with the last of the prior injection.
The change has brought more frequent periods of discomfort with "low" sugar levels. Overall I feel that the sugar is lower than it had been with the humulin formula. Since the toe problem that landed me in the hospital in the spring, I was making a concentrated effort for an overall lowering of the blood sugar. The change in insulin seems to have made a sharper change in that direction, unfortunately at a time when I was looking to slowly raise it again so I would feel overall better health.
Diabetic patients do need to watch themselves more closely when adapting to the new generic.
Saturday, October 6, 2012
Anniversary
My quirky mind works by association. Prior to 2009, October 6 was always my "un-birthday," the date of turning age + half. Don’t ask me why this was always so; I barely acknowledge my actual birthday.
Since 2009, 6 October has been and probably always will be the anniversary of the blood hemorrhage that made a sometimes uncomfortable life into something perpetually difficult.
I’ve been in a deep "melancholy" state of late as it is. The blog post records acknowledgment and lets me move on with the day, with my life.
Don’t ask me how I’ve done this through these bleak and darkening three years. Many times I would find myself completely unable to answer.
Today it will be concentrating on getting a fiction story or two out to editors for submission before the glare of the TV used as a computer monitor overwhelms my vision. I don’t submit stories often any more; the task is impeded by the vision and always takes time from everything else.
Perhaps that feeling of so many things left undone is the fuel I use to propel myself forward. I don’t want to look too deeply, though. The blur frustrates me when I look too hard at anything, and I am afraid the charm will lose its magic if I try to understand its workings.
Since 2009, 6 October has been and probably always will be the anniversary of the blood hemorrhage that made a sometimes uncomfortable life into something perpetually difficult.
I’ve been in a deep "melancholy" state of late as it is. The blog post records acknowledgment and lets me move on with the day, with my life.
Don’t ask me how I’ve done this through these bleak and darkening three years. Many times I would find myself completely unable to answer.
Today it will be concentrating on getting a fiction story or two out to editors for submission before the glare of the TV used as a computer monitor overwhelms my vision. I don’t submit stories often any more; the task is impeded by the vision and always takes time from everything else.
Perhaps that feeling of so many things left undone is the fuel I use to propel myself forward. I don’t want to look too deeply, though. The blur frustrates me when I look too hard at anything, and I am afraid the charm will lose its magic if I try to understand its workings.
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.
Tuesday, October 2, 2012
Post-op Pattern
The retina reattachment procedure did not go as well as either my eye doctor or I had hoped. I dealt with that disappointment OK, all things considered.
I noticed a pattern that is giving me reason to look at things more deeply, so to speak. I have noticed a definite pattern that my eyesight gets worse. When it recovers from the visit, it does .
My theory is the light sensitivity effect. Glare is worse, sensitivity to light is worse and darkness vision is worse, all worse aftert each exam.
In these visits, they are dilating my eye and strobing the eye with very bright light. This is how the doctor is able to see the retina to note changes. I think this has the same damaging effect as staring at the sun.
I don’t see the point of going to the doctor–even this very good doctor–to be told I can’t see.
The eye is unstable, and the condition is currently made worse by the resumption of eye drops for eye pressure and the report of a cornea scratch. There’s more to the latter, and those have the texture of anchovy paste and the effect of making things worse.
I still have a procedure to go. The center of my eye is filled with silicone oil, which is meant to keep pressure on the retina to keep it in place.to be drained. My realistic hope is that the oil has gotten clouded over time and that the procedure will ewatore some acuity.
Other things to hope for are just not realistic. For me, realism always trumps optimism. The doctor wants to continue waiting before changing the silicone oil. If it is potentially creating a glaucoma problem, and if my vision worsens every time I am examined, we’re crossing the threshold of the treatment being worse than the disease.
I noticed a pattern that is giving me reason to look at things more deeply, so to speak. I have noticed a definite pattern that my eyesight gets worse. When it recovers from the visit, it does .
My theory is the light sensitivity effect. Glare is worse, sensitivity to light is worse and darkness vision is worse, all worse aftert each exam.
In these visits, they are dilating my eye and strobing the eye with very bright light. This is how the doctor is able to see the retina to note changes. I think this has the same damaging effect as staring at the sun.
I don’t see the point of going to the doctor–even this very good doctor–to be told I can’t see.
The eye is unstable, and the condition is currently made worse by the resumption of eye drops for eye pressure and the report of a cornea scratch. There’s more to the latter, and those have the texture of anchovy paste and the effect of making things worse.
I still have a procedure to go. The center of my eye is filled with silicone oil, which is meant to keep pressure on the retina to keep it in place.to be drained. My realistic hope is that the oil has gotten clouded over time and that the procedure will ewatore some acuity.
Other things to hope for are just not realistic. For me, realism always trumps optimism. The doctor wants to continue waiting before changing the silicone oil. If it is potentially creating a glaucoma problem, and if my vision worsens every time I am examined, we’re crossing the threshold of the treatment being worse than the disease.
Monday, October 1, 2012
Kidney Pie
Kidney disease as part and parcel of the entire nightmare of diabetes is easy to understand with a little knowledge of how kidneys work. In essence, they are filled with blood vessels.
Learning that simple fact also tied the connection between blood pressure and kidneys in my brain. I had not been able to grasp the logic of the kidney-blood pressure correlations even asking questions of doctors. I knew that blood pressure medications are usually also beneficial to kidney health.
The tiny blood vessels within the kidneys act as the actual filters for waste products in the blood. The kidneys expel the waste through urine.
Those facts make a lot of the diabetes connections self evident to me.
The primary symptom of high blood sugar in diabetes is severe thirst and frequent urination. The kidneys sense too much waste sugar and make you thirsty to give them the fluid they need to expel the waste at peak efficiency.
Constant high blood sugar damages blood vessels. This damage is most apparent in retinapathy and circulation. Kidneys follow closely behind these problems. Knowing that the blood vessels in the kidneys are tiny makes it quite understandable that they can be damaged easily.
High blood sugars thicken the blood. The thicker blood passes less easily, especially through smaller vessels. Like Coca-Cola that was wiped but not washed from a surface, the blood becomes sticky, and this further reduces the blood’s ability to pass freely. The smaller vessels and passageways clog. Weaker blood vessels can break, restricted vessels can increase blood pressure, and smaller vessels will clog or reduce circulation, which deprives body parts of needed oxygen.
Constant high blood sugar overworks the kidneys on a regular basis and thus can hasten damage just by effectively wearing out the kidneys with overwork. The waste products that the kidneys remove from the blood slide through "filter holes" in the kidney. The waste stays molecularly smaller than protein and healthy blood cells. Overwork of the kidneys essentially enlarges the holes over time and allows good protein molecules to pass into the urine.
The lab test for kidney function and performance is usually a simple test. The lab checks for amounts of protein in the urine. The kidneys are supposed to filter waste but retain protein. The presence of protein in the urine indicates a problem. This really is the best way to determine kidney problem at a stage where further development of the problem can be kept in check.
Other "early symptoms" of kidney disease are vague and overlaps with too many other potential problems with the body. The overlap is also high with other symptoms that diabetics may feel on a daily basis without kidney problems. These general symptoms include fatigue, poor appetite, poor concentration, insomnia or other sleeping difficulties, general weakness, and upset stomach.
The best preventative maintenance for kidneys is to drink a lot of water regularly, not just when your body says it’s thirsty.
Learning that simple fact also tied the connection between blood pressure and kidneys in my brain. I had not been able to grasp the logic of the kidney-blood pressure correlations even asking questions of doctors. I knew that blood pressure medications are usually also beneficial to kidney health.
The tiny blood vessels within the kidneys act as the actual filters for waste products in the blood. The kidneys expel the waste through urine.
Those facts make a lot of the diabetes connections self evident to me.
The primary symptom of high blood sugar in diabetes is severe thirst and frequent urination. The kidneys sense too much waste sugar and make you thirsty to give them the fluid they need to expel the waste at peak efficiency.
Constant high blood sugar damages blood vessels. This damage is most apparent in retinapathy and circulation. Kidneys follow closely behind these problems. Knowing that the blood vessels in the kidneys are tiny makes it quite understandable that they can be damaged easily.
High blood sugars thicken the blood. The thicker blood passes less easily, especially through smaller vessels. Like Coca-Cola that was wiped but not washed from a surface, the blood becomes sticky, and this further reduces the blood’s ability to pass freely. The smaller vessels and passageways clog. Weaker blood vessels can break, restricted vessels can increase blood pressure, and smaller vessels will clog or reduce circulation, which deprives body parts of needed oxygen.
Constant high blood sugar overworks the kidneys on a regular basis and thus can hasten damage just by effectively wearing out the kidneys with overwork. The waste products that the kidneys remove from the blood slide through "filter holes" in the kidney. The waste stays molecularly smaller than protein and healthy blood cells. Overwork of the kidneys essentially enlarges the holes over time and allows good protein molecules to pass into the urine.
The lab test for kidney function and performance is usually a simple test. The lab checks for amounts of protein in the urine. The kidneys are supposed to filter waste but retain protein. The presence of protein in the urine indicates a problem. This really is the best way to determine kidney problem at a stage where further development of the problem can be kept in check.
Other "early symptoms" of kidney disease are vague and overlaps with too many other potential problems with the body. The overlap is also high with other symptoms that diabetics may feel on a daily basis without kidney problems. These general symptoms include fatigue, poor appetite, poor concentration, insomnia or other sleeping difficulties, general weakness, and upset stomach.
The best preventative maintenance for kidneys is to drink a lot of water regularly, not just when your body says it’s thirsty.
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