Thursday, October 31, 2013

It's Just Weird

You know, sometimes I get so lost in the way I perceive my own health problems that I forget how others must see it.

As a general rule, my health isn't a conscious thought. It's usually a fleeting perception, like "oh, my legs are really tired. I hope there's a Do Not Walk sign soon" or "gee, my heart is racing, my blood sugar must be high" (I know, it's a weird symptom). But I don't see myself as sick or disadvantaged.

And then, every once in a while, someone says something that makes me think about it. Or someone reacts with shock, surprise, or horror when I tell them something that, for me, is normal.

I had several experiences like that this week. But the weirdest one was this morning, after my history class.

My history professor made an announcement the first day of class that he doesn't allow laptops in his class because they're distracting (otherwise known as, students use the internet in class). We had a short discussion about how I really can't hand write notes, and that was the end of that. I did end up using a notebook for a few weeks while I waited for a new laptop battery (during which time I wrote stories, not notes). Other than that, my laptop has been my best friend and he has left me alone.

Last week, we had a handwritten quiz. He usually gives one multiple choice quiz per week, but last week was different. This week, he repeated it. To be honest, the quizzes were short, with today's having much less writing than last week's. (Also, last week my left wrist was bothering me, which didn't help the whole hand writing thing.)

I approached him after class about it. Honestly, I can take the quizzes. The pain doesn't last too long, the muscle fatigue doesn't last too long, and overall I'd rather be like everyone else than singled out. But if he gives every quiz like that for the rest of the semester, then I might have some problems. I asked him more out of curiosity than out of concern for my well-being.

His immediate response was, "I know it's hard for you to take these quizzes", practically before I could finish my sentence. He said we can work something out if it's too difficult.

My immediate answer to that is no. It still is, because I'd rather suffer for the ten minutes it takes to take the quiz than inconvenience him or myself. I don't like to be different. I don't like to be singled out. Maybe it's because the muscle issues have a greater potential to make things difficult in the long run than diabetes does. Maybe it's because the muscle stuff is less treatable. Maybe it's just because I hate the muscle issues more than I hate diabetes. But I don't want special treatment, even from myself.

On some levels, this is quite stupid. On a day when my finger joints hurt, I can barely type, let alone write. The fact that I have the opportunity to alleviate my discomfort should be appreciated, and it is, but I don't want to use it.

It's times like this that make me wonder what other people really think about me.

Last night, my very close friend's mother asked me if I can have ketchup if it's cooked in something (she used it to make some kind of stewed meat, and since it wasn't sweet, I'm guessing there wasn't much in it). She knew to leave out the pita and the potatoes, but she asked about the ketchup (and was horrified to learn that onions and carrots have carbs, too). It's extremely sweet of her to worry about something so simple, but how fragile does she think I am?

My sister doesn't like it when I go for a run without my phone (something I've never done, but considered once when I couldn't ind it). I think she's worried about lows. Again, very sweet, very considerate, and how fragile does she consider me to be?

My honors program director knows a lot about my family issues. As in, more than most people. But he knows almost nothing about my health issues. I missed one seminar for a doctor's appt (and I might still miss another one). He knows I've seen a lot of doctors, but he doesn't know why. He doesn't even know why I want to do my paper this semester on the mismanagement of and lack of education about type 2 diabetes. (Actually, he might know that I'm a diabetic, but it's not something we've ever talked about or even something I've ever alluded to.) He doesn't know a single thing about my muscle issues. In fact, the only health issue he knows about is my allergies, because I almost died in a Bio 1 lab when I was a freshman from a severe allergic reaction.

I'm an extremely open person. For the most part, people know about my health problems, and I'm usually okay with that. I don't know how people reconcile what I tell them with the seemingly healthy person sitting in front of them. I don't know what my fellow pre-meds think when I tell them. In general, pre-meds are a healthy bunch, because it's physically demanding to even just be pre-med. I know one other pre-med in my school with major issues. She and I are, according to us, the two least healthy (and probably the two most well-versed) pre-meds in the whole school.

In a way, it's pretty stupid to be so worried about what people think of me. I do everything I can for people to think I'm capable. Sometimes I push myself too hard because of that. But I don't want anyone to think I'm not capable because of the stuff I live with. I don't want myself to feel incapable.

This is a topic that has always interested me, yet I feel completely uncomfortable with the notion that others see me as damaged or disabled or something to worry about. And I don't have an answer.

"Am I the fool/ Am I a victim/ I'd rather know" ~Faber Drive

Saturday, October 26, 2013

The Healthcare Problem

When I was three years old, I decided I wanted to be a surgeon. I made my mother get me an anatomy book, and long before I could read it myself, I studied it. My mother read it to me at night, sitting in our recliner with me in her lap. This blond haired, tiny, precocious girl didn't want anything to stop her.

I spent my ENTIRE elementary school life talking about it. I spent a ridiculous amount of time reading a thick, so-heavy-I-couldn't-hold-it book of common childhood diseases. (I literally had to lay my head next to the book on the couch so I could read it.) When we dissected frogs in the seventh grade, I was the only girl who didn't pair off with someone (mostly because they didn't like me), and I was thrilled to get the whole frog to myself.

When I finished my first year of college, I was asked by a local girl's high school to dissect a frog and a sheep's heart. I did so gladly, for a group of six very interested freshman and sophomore girls.

This is the only thing I have ever wanted to do. Though I've vaguely considered other things (teaching math and science, becoming a writer, musician, other things that could never happen), none of them have ever been serious considerations.

No one ever told me I'd have to take the MCAT or that getting into med school is damn near impossible. No one ever told me there was an extremely good chance I'd never get in. Until I got to college, I had never dreamed that my life-long obsession could be shot down with a simple "no."

Allow me to explain something about being pre-med. You have to take a year of chemistry, a year of biology, a year of physics, and a year of organic chemistry. Just short of none of this stuff is actually important for medical school, but it's still required.

So say that 60% of all incoming freshman (at my school it's waaay more) are pre-med. After chem and bio, it's down to 50%. After organic, it's 15%. If you survived organic but couldn't make it through physics, there's something seriously wrong with you. (No, not really, but really, organic is SO much everyone except me.)

So we've cut out 3/4 of the students who want to be doctors. Some of them may have done well in medical school, but many were probably not motivated or smart enough.

What's left is a group of highly motivated, crazy-smart, sometimes just plain crazy undergrads, dying for a chance to go to medical school.

Of them, how many have wanted to only be doctors?

I'm not sure of the answer, but I know that most of them don't care about the patients. From what I've seen, most of them just want the prestige of having M.D. at the end of their names. Some think they'll make a ton of money working as plastic surgeons in Beverly Hills. Maybe they will. But the compassion isn't there.

(Supposedly there's a class in the first year of medical school about compassion. I don't see how you can teach compassion.)

I'm not saying I'm the only qualified medical student candidate I know. That simply isn't true. But the vast majority of pre-med students just don't care about the patients.

Which, of course, was how I got to see something like ten doctors before someone was willing to sit down and explain that my joint and muscle pain are not all in my head. It's how I got to see a pediatric endocrinologist who insisted there was nothing wrong with my blood sugar. It's how I got to see a dermatologist who gave me an antifungal shampoo for eczema on my scalp. It's how I got to see an allergist who refused to give me an epi-pen for a nut allergy (and I almost died of anaphylactic shock six months later). It's how I got to see a pulmonologist who insists there's nothing wrong with my breathing, even though when I started to see her, I literally couldn't finish a sentence.

And it makes me wonder if medical schools are doing the right thing when they pick us based mostly (or solely) on academics.

The best doctors aren't the ones who got an A+ in Orgo. The best doctors aren't the ones who got a 45 on their MCATs. The best doctors aren't even the ones who graduated at the tops of their med school classes or got the best residencies and fellowships.

The best doctors are the ones who care enough to give a damn. They're the endocrinologists (without diabetes) who try on the OmniPod (when it first comes out) and all the pen needles so they know what to tell their patients. They're the (very, very nice) M.D. at Montefiore who had the EMG done on him first so he'd understand why patients ask him to stop. They're the doctors who run around and then breathe through a straw so they know what asthma feels like.

There aren't very many of these anymore. And though compassion can be made up for with diagnostic skills (assuming they have basic bedside manner), most doctors don't have this, either.

Now you're probably wondering why I want to go into a profession as cold and heartless as medicine, with the good sprinkled in like cookie dough bits in the larger ice cream. (Because there's usually so little cookie dough that you're surprised when you actually find one in-between all the bites of only vanilla, right?)

I want to be that endocrinologist who sits in with the parents of a newly diagnosed child and tells them that it's not going to be easy, but that it WILL be okay. I want to be that doctor who can tell the fifteen-year-old girl that I know exactly what it feels like to be excluded from the birthday party stuff because you can only have cake OR ice cream OR pizza, but not all three. I want to be that doctor who has been low during a college interview (and then went on the train afterwards and nearly fainted into the subway tracks and STILL has not told her father about it To. This. Day.) and can tell her patient that sometimes you get accepted to the program, anyway.

There is so much more to being a doctor than prescriptions and terrible handwriting. I have both the compassion and the people skills to help, maybe even make a difference in some patient's lives. The medical schools won't know it until I'm there, but I'm not one of those people who gets A's in everything but can't look you in the eye. (No, I don't get A's in everything...I kinda wish I did, though.) I just hope they can look past some of my lower grades and know that there's more to people (and me) than just the grades. I'm hoping they see me, not the number of B's I've gotten.

Maybe one of them will see the potential I hold. Medical stuff sticks in my brain. Physics? Not so much. But that won't make me a terrible doctor or even a mediocre one. My endocrinologist thinks I'll make a wonderful doctor, no matter what my grades are. I hope they can see that, too.

So yes, I'm applying to medical school now. I need all the luck I can get, and I can only hope that someone will look at me and say, "Yes, I think you'll do wonderfully here."

That, and now I want cookie dough ice cream.

Saturday, October 19, 2013

After the Endocrinologist

Okay. I feel so much better now.

I made a deal with my father on Friday on the way to the appt that he didn't get to be in there when I had my appt. To my shock, he agreed to leave when I discussed things I didn't want him to hear (everything?).

So my father's appt went first. It took all of five minutes. And then my endo kicked my father out and sat down in the chair next to me.

We talked a bit, then I told him I can't take Metformin anymore. He took my BP, then went to his computer and asked why. So I explained it to him. And he said I absolutely shouldn't take it anymore. When I brought up the B12 deficiency, he said he didn't even have to test me to know I have one. I asked him to test me anyway because I already have tingling issues and I want to make sure it's the B12, not those getting worse. He agreed. (His view is that as long as he's drawing blood, he might as well draw more.)

He offered me Precose, which I refused because I don't have a phase 1 insulin response (the initial, immediate surge of insulin you get when you eat. It lasts for about a half hour, until your pancreas makes more. I don't have this built-up store, and my body doesn't make enough insulin (or use it productively enough) to cover the rest of it. So I get stuck with a high blood sugar very quickly, and it doesn't go down for a while. Precose doesn't help this issue). He didn't argue with me, just thought.

I told him that I'm terrified of the other diabetes meds. Some, like the sulfonylureas, can cause beta cell burnout. His response was, "I wouldn't put you on a sulfonylurea--you'd be dead" (presumably of low blood sugar).

So he then said he had a brilliant idea and popped up to get me a sample. He came back with four bottles (21 pills each) of a drug called Cycloset. It's really used for pituitary tumors (to control the symptoms), but it's approved for T2 in low doses.

He explained that the working dose is 2-6 pills per day, all taken in the morning with breakfast. It has virtually no side effects (or at least none for me, since I'm not on any other meds), except for some mild nausea when first starting. I start with one pill, go up to two after a week, and then stay there for a couple of weeks and call him.

He gave me so much because he wants to make sure it works for me before he prescribes it. He knows that Metformin wasn't great at controlling my BG, anyway, so I think he's trying to circumvent that. (Actually, now that I think of it, he always gives me tons of samples. I guess he's worried that these things won't work for me.)

For the time being, I haven't had any real nausea (I had some this morning, but I really think that was because I was expecting to have it). The Metformin hasn't left my body yet, so I can't tell you if it works or not.

I then asked him if I really have insulin resistance. Based on my negative antibody tests and a couple of high c-peptides I had about a year ago, he said yes. He said that IR isn't based on body type nearly as much as the media makes it sound, and that in my case it's extremely genetic. (He also was shocked at my weight. He thinks I'm nearly 20 pounds lighter than the scale says I am. HA!) I asked because of my age, not my weight, but I guess I'll ask him about MODY when I talk to him about the Cycloset.

I asked him some other questions about my health, most notably the use of CoQ10 for my fibromyalgia (he said there's no reason why not), and why running helps my breathing so much. He said a pulmonologist should test my breathing before I run, and then again about a day later. Mine will never do that, but the one he gave me the name of might.

Overall, I'm very happy with how this appt went. He spent nearly a half hour with me (he's always willing to spend more time if necessary, but it's always nice when he does). He answered all of my questions honestly and in a completely straightforward way. He was kind, gentle, and listened. I think if I asked him to put me on insulin, he'd probably give me the same answer he gave me about sulfonylureas, but if Cycloset works, then I don't really care yet.

Now I just have to wait for the rheumatologist to get an opening earlier than the end of November. Yay?

Saturday, October 12, 2013

Planning for the Upcoming

For the first three or so years, I looked forward to endocrinologist appts. I loved going to see him--he was fun to talk to, a good listener, and it felt great speaking with someone on my scientific level or higher (I'm the only academic in a non-academic family).

Then I started having consistent highs. Not the occasional only-before-my-period ones I'd had almost since he gave me a meter, but constant I-can't-eat-anything highs that knocked me out several times a week and disrupted my life.

And that's when it started. When I realized that there was more going on than he would acknowledge. That was when I started dreading the appointments.

I hate it when my problems (and their absurdities) aren't acknowledged. But I think I'm beginning to hate being mistreated more.

He knows that it makes no sense for me to be a type 2 diabetic. Hell, he knows that pre-diabetic shouldn't apply to me. He KNOWS there's stuff going on.

There was one night that he called me back at 11 PM after I'd left a message for him that morning. During that phone call, I asked him if I was the only one who thought it was weird that I needed my Metformin dose upped just weeks after going on it. (To be fair, he was titrating me up, but I don't think he expected me to need 1,000 mg or, later, 1,500 mg, per day.) And he replied that it's very weird, and have I ever heard of a type of diabetes called MODY.

There are tears in my eyes as I type this.

I've tested negative for type 1 twice--most recently in June. My father has followed the same bizarre blood sugar trajectory that I have. MODY makes sense. It makes a LOT more sense than T2.

There is such a thing as a thin T2. There is such a thing as a young T2. There is no such thing as a T2 teenager who is all of eight pounds overweight (and, if it weren't for certain extra muscle in a place I don't want it, I wouldn't be overweight at all). Most of my fat isn't even in my stomach area. I walk a minimum of two miles a day several days a week (it's usually more). I don't eat only veggies and fruits, but I don't eat too badly. I've been trying to run. T2 just doesn't sound right.

The ONLY thing going for the T2 diagnosis is the high c-peptide I had for a couple of months that went away on its own (or with Metformin). I can think of two or three bizarre but possible things that could cause that and my diabetes.

Lately I've been on Metformin 1,500 mg. I hate it. On 1,500 mg a day, my stomach hurts almost all the time, I have frequent, terrible heart burn, occasional nausea, and...other unpleasantness that makes me wonder where the nearest bathroom is just in case All. The. Time. I can't take 1,500 mg.

So I switched back to 1,000 per day. I feel SO much better that it's almost ridiculous. But my blood sugar is already freaking out about that. I don't even want to think about what it'll be like when the rest of the 1,500 leaves my system in a few weeks.

Here's the thing, though. I don't want to go on any of the other pills.

Most of them have lovely side effects. Some of them (like Januvia) have been proven to cause higher rates of pancreatic cancer. Actually, it was suggested about a year ago that Januvia actually has higher rates of ALL cancers to its name. (I don't know if that ended up being true or not, but it's still scary.) An entire CLASS of drugs apparently causes the patient's body to "run out" of insulin several years into treatment.

I am not a lab rat.

Even without the side effects, I can't do this. I can't handle repeatedly changing dosages and meds. It's my personal, rather strong, feeling that I will switch meds more and more until I end up on insulin.

And that makes me think, what's the point?

Why am I going crazy over meds that may or may not work, may or may not kill me, when there's one, very obvious, alternative?

Insulin is, obviously, natural. Its only real side effect is hypoglycemia. It's guaranteed to work.

I'm not belittling hypoglycemia or even insulin itself. Insulin is an extremely powerful tool, which therefore has a lot of room for mistakes and problems. A little too much can lead to severe hypoglycemia, a little too little can lead to highs.

Unlike most patients who start on pills, I'm not afraid of insulin. I spent years chasing lows before my blood sugar turned completely upside down. I often had weeks where I had multiple lows in the 50's. I was almost always low when I came home from school (a mile's walk will do that, I guess). I still keep sugar with me everywhere because I know I can go low, even though I don't really anymore.

Let's say I have a healthy respect of insulin.

My preference for insulin also probably has something to do with how sure I am that I don't have T2. Very early onset LADA or MODY, I don't care--but I'd choose insulin for both of them, anyway.

I'm seeing my endocrinologist on Friday. And because of all of this, I'm terrified.

He doesn't like meds. The fact that I got Metformin from him was a miracle. I MUST get off that med.

In the past, he recommended a different drug that I don't foresee helping at all. I get the feeling he'll try recommending it again. We need to have a serious talk about what meds I will or won't take, as well as what he believes I might have. (Like that's going to get me anywhere.)

Of course, all of this needs to take place without my father in the room, which won't be easy. (We usually have dual appts, which works fine for time issues but doesn't work well when I have a serious issue I need to broach--I don't want to bring this up in front of my father.) My father believes he has a right to be in there. Maybe he did--when I first started seeing him at 16. And I don't mind having him in there usually. I do for Friday.

And no matter how much I try to pretend I'm not nervous, it's obvious I'm terrified. I've woken up grinding my teeth so many times in the last week that I'm surprised I've gotten any sleep (or have any teeth left). I can hardly concentrate, and the only thing I want to do is listen to really loud music.

The best part? I don't know anyone in real life who gets it. This is the only place I can really vent or even TALK about all this stuff.

I'm so sure he won't listen. I'm so sure he'll brush off my fear of these meds. I'm so sure he'll brush off the T2/MODY/LADA debate. I love him because he's so knowledgeable and helpful and sweet--but is it really worth it? Is it worth keeping a doctor I know is giving me a hard time? A doctor whose appointments I dread? (Though honestly, I hate all doctors appts at this point. If I never see another doctor, it will be too late.)

I might be back here before I see him to rant some more, I might not. But at least I know there are one or two people listening.

"Underneath my skin is it/ Just anger just frustration/ Underneath my skin is it/ Just nothing all these feelings" ~Faber Drive

Friday, October 4, 2013

Running Outside

Today was the first time I ran outside.

I haven't been doing a great job of keeping up with the Couch to 5K regimen. It's been a combination of school, holidays, and health crap, mostly. But I went today for the first time in nearly two weeks.

Of course, there was tons of stuff on the treadmill, so I didn't have much of a choice. I threw a skirt on over my pants, put on a loose 3/4-sleeved shirt, put my Tummietote on over that (with an Epi-Pen, my meter, phone, winkies, and iPod), and went outside.

It was hot and sticky, and my legs already started getting tired on the walk up the hill. At the top of the hill, I turned right and began to run.

I didn't get very far, and I started walking not too long after. I alternated running and walking for two circuits around the oval. People stared (mostly kids getting off their buses), but I did it.

Some things I learned:
1. It was very smart of me to choose that oval, because it was flat and I wouldn't have been able to handle any more hills.

2. I need a better shirt to do this in if I intend to go running outside; the one I wore was too hot.

3. People stare. Let them. I'm doing something good for myself.

4. I run more than I walk when I'm on the treadmill. Maybe it was too humid, but I think I walked MUCH more than I ran today. I'm oddly okay with that.

5. Running is much more fun outside.

6. I may have eaten through every calorie I burned with lunch (or all the chocolate I ate today), but I'm proud of myself nonetheless.

If I can figure out the cold air problem, I think I'd run outside, even in the winter. It's SO much better than the treadmill.

The Appointment

So I saw Dr. S., my pulmonologist, on Tuesday.

I actually missed a class to see her, which I hate doing. (And it's a class with 12 people in it--everyone knew I wasn't there, though at least my program advisor knew I had a valid excuse.) I missed a speaker I wanted to hear.

I was early, which was awesome because I was taken in 10 minutes before my appointment time. She came in to do my exam after I was in a nice, gray-blue gown.

She greeted me with "Hello, stranger," which I thought was awesome (I hadn't seen her in nearly 10 months). She proceeded to tell me how awesome I looked, health-wise. She also complimented me on my hair cut. (How did she remember that I had such long hair the last time I saw her?)

My lungs were clear (as usual), everything else was fine (as usual, and thank God). She sent me off for a breathing test, which she assured me would be fine (as usual), and off I went.

I hate the breathing tests. I don't find them annoying nearly as much as I find them painful. Yeah, that's right. I said painful. They aren't supposed to be. But my chest hurts during and after every, single time. Also, I tend to be more short of breath afterwards.

And then I got in to see her. My breathing test was normal (yay), my diffusion capacity was normal (no surprise, but also yay). But there was this one test that was off.

There's a test they can do that shows the muscle strength of the muscles you use for inhalation and for exhalation. They make you blow (or suck) as hard as you can against resistance. My exhalatory muscles, apparently, were working at 51% capacity.

She told me that it's not an objective test--it relies heavily on the participation of the patient (meaning me). But I DID try, which makes things...interesting.

I don't think this test is used as a diagnostic test so much as it's used for confirmation. But we KNOW I have muscle issues, mostly with repeated movement. (Or at least I do, since no one ever makes you do repeated muscle movements for a strength exam.)

She recommended that I see the neurologist I saw last year again. If she says nothing's changed, she'll do another exercise study to be sure, followed by...nothing.

I hated the neurologist I saw last year. She's an MS specialist, and I went to see her because the neuromuscular diseases clinic wouldn't give me the time of day (apparently she'd had trouble with several other patients and these idiots, so she no longer sends people there). But this doctor wanted nothing to do with me because I (VERY THANKFULLY) don't have MS. She kinda waved me off and left me to hang out there to dry. But she also told me to stop testing my blood sugar so much, because there's obviously no reason to. (Like I said: I hated her.)

I brought up the wrist pain I'd been having for...months. (I've been ignoring it, and it's been getting worse.) She recommended that I see my rheumatologist for that. Yay.

Someone recommended that I see the rheumatologist instead of the neurologist, because he did strength testing, too, and because the neuro is basically useless, and because I have to see Dr. A., anyway. I put in a call to Dr. S. about it, but I missed her call back because I was meeting with my creative writing professor. Now I have to put in another call to her and hope she calls when I have my phone on me (and that my phone decides to ring when she calls).

I made an appt with Dr. A. for November 26th. And I'm to call back every week or so to see if there are cancellations, because I don't want to miss another lecture for that seminar class. (It was either that appt or something at the very end of December).

I went home in a terrible mood. I'd basically been told that there's nothing wrong with my lungs except stress and if I stop seeing doctors, it'll go away. Now, aside from the obvious "that's no way to treat a patient", there's another reason why that bothered me so much.

I've had breathing problems since I was seven. Yes, I had just switched schools, but no, I wasn't terribly stressed. And it only happened when I ran. It got worse as I got older, especially after I had mono when I was ten, and then gradually worse after that.

I know myself. Quite well, actually, since I live inside my own head. I know what shortness of breath feels like, I know what stress feels like, and I know when one is causing the other. I only get shortness of breath when I feel extremely stressed (like when I have two exams and a paper due in the same week). I don't get it when I'm minimally stressed or when I don't feel very stressed.

But also, I started seeing her at a time when I could hardly finish a sentence. That went on for six months. It was the worst "attack" of whateverthehell this is I've ever had. It started when I got bronchitis, it went away after another bout of bronchitis and another course of antibiotics (same antibiotic, same dosage--go figure). Those aren't stress-marked situations, they're health-marked situations. Correct me if I'm wrong, but does that sound like stress to you?

Admittedly, this is the first time I've gotten the stress talk from a doctor who really tried to figure it out first. Usually I get it when doctors have no clue what's going on. She admitted that she doesn't know, but she also spent a year and a half looking.

Maybe it is muscular, after all that. (She got upset when she heard I still have trouble with my arms getting tired when I wash my if cutting it all off would've helped with that. It helped with brushing, since there's very little to brush and no knots, but it didn't help enough with the washing. Admittedly, I didn't know it was that abnormal.) Maybe the muscles around my lungs are weak. There's no real way for me to know. But I do know that on that day, I had trouble with my legs getting tired while doing the stairs. Some days my arms get tired when I get dressed. (No, I'm not kidding.) There are things I don't even notice, because they're so usual for me by now that they're beyond normal. Maybe my other issues are the key to my breathing problems.

I do wonder what my rheum is going to say. My wrist isn't swollen, it isn't hot, it isn't red. I don't recall any injuries to it. And it only hurts with one motion. (If you have your hand with your thumb pointing up and push down, that's the motion.) But it's been interfering with putting on my backpack, carrying pots between the stove and the table, washing dishes, and some other things. It's inconvenient, and this is my non-dominant hand. (Therefore I guess it could be worse?)

I just don't know what to think anymore. I'm sick of being sick, I'm sick of seeing doctors, but more, I just wish I felt healthy.

And I get to see my endocrinologist in two weeks. Yay again?

Saturday, September 28, 2013

I Know It's Been A While...

...And there's lots to tell. But the most recent events come first.

The most recent is that I've officially had Enough of dealing with metformin side effects and I'm back to dreaming about insulin. My blood sugars may be happier with the increased dose of met, but my GI system is NOT. I have an endocrinologist appt in just under three weeks. I'm not looking forward to the conversation I'm going to have with him.

The next most recent is that I had TWO (or three) airborne allergic reactions to nuts over the three day holiday we just had (actually, it was an eight-day holiday and only two of the three days I'm referring to were actually part of that holiday...the last was just plain old normal shabbos...and here is where things get too complicated to explain unless you're a religious Jew and know exactly what I'm talking about).

The first was on Thursday night. We went to shul (synagogue) for a holiday called Simchas Torah. Basically, in this holiday the men get to make utter fools of themselves and the women get to watch and talk to each-other.

A very important aspect (if you're a kid) of this holiday is getting small packages with candies and other treats inside. For years one of my neighbors made them, then we did for quite a while, followed by this year, when we said that enough was too much and my neighbor went back to doing it.

She used to just put in pretzels and a water bottle and some small things. This year she put TONS of things in, including a candy called nutty chews, which are the Jewish equivalent of Snicker's bars.

I'm airborne allergic to peanut...if it's being cooked. But that night, I started having trouble breathing within minutes of her having handed out the packages. My sister and I left, and we ended up going to a neighbor's house to have somewhere to go and something to do. (She and her son are both airborne allergic to nuts, so they left as soon as the packages were handed out.) I didn't take Benadryl (too stubborn) until about 12:30 that night, when my cough and shortness of breath disappeared within ten minutes.

The next night we went to the same neighbor's house (the one who made the packages, not the one allergic to nuts). She had made a bunch of salads, and they had nuts in them. I literally walked into her kitchen and couldn't breathe--that was all it took. I sat in her living room, took a Benadryl, and didn't say a word.

My sister thinks I'm out of my mind. Since when am I airborne to pecans and peanuts and hazelnuts and everything else? Therefore, in her mind, I must be making it up. It makes me terribly angry that I'm the only one around here who gets it. But it also scares me--because if my sister, who lives with me and knows I never leave the house within an epi-pen, won't believe me, then why should the server in a restaurant or the people I go to for meals?

I hate having a food allergy. I hate being neurotic and interrogating the people who give me food. I hate being that nutcase (no pun intended) who comes over sometimes and freaks out when there are nuts around. It seems so innocuous to everyone else--to me, it's literally deadly.

On Thursday, we went to the N's. We go to the N's every, single week--almost without fail. During holidays like this, we're often there a few times in the same week.

They threw a birthday party for my father. There was a cake, some fruit, and lots of little things like chocolate covered pretzels and trail mix.

If you don't have a nut allergy, you probably just skipped over "trail mix" the same way you did over "fruit" and "chocolate covered pretzels". My heart skipped a beat reading it over.

I couldn't believe that they had put out trail mix (with walnuts! my archenemy!) along with everything else. Like the chocolate covered pretzels coated in nuts aren't bad enough.

I sat at the other side of the table. When it was passed my way, I pushed my chair all the way to the wall. Thankfully, we were outside. I had a mild, mild reaction (enough to pretend that it wasn't a reaction) and I moved on.

These people don't remember--almost ever. I have to interrogate them every, single time I go over there. We eat there every week. How hard is it to remember that I could die if someone ate that stuff in front of me?

I had a bad experience in my favorite restaurant a few weeks ago. I ordered an eggplant rolatini, which I've had about a thousand times before. I cut it open, and there were little, green flecks inside the ricotta cheese, which I've never seen before in this restaurant.

I got up and asked the manager (who makes it his business to not only be nice to me but also go crazy over trace amounts because he has a strict "no dying in my restaurant" policy) about the green flecks. As I'd suspected, they were pesto. Pesto has nuts in it--usually pine nuts, but I've heard of walnuts being used. This time it was almonds.

He literally turned dead-white. This energetic, wonderful man nearly fainted just because I had green flecks in my food. This is someone who gets it.

I ended up getting a new order without pesto, no problems, no questions asked. The event chilled me for a day and then I moved on. This happens All. The. Time. I almost eat something I shouldn't, I don't, then I move on.

(For the record, he hadn't known there was pesto in the eggplant rolatini until he asked the chef. They changed chefs a few weeks ago and he still hasn't figured out what has been changed. He said that he was going to speak to the chef to go over what has which allergens in it. He will NOT let this happen again, as he has assured me. I trust him, so I believe him. It will not happen again. I can continue eating safely in his restaurant.)

But this is my reality. I live in constant fear of having a reaction. I keep epi-pens with me for a reason, after all. I read food labels. I'm careful.

But the people around me aren't. Many of the people around me have no regard for food allergies, no response to "you could have killed me", no second thought that maybe what they're doing isn't safe.

It's a ridiculous notion to them. I've even met some doctors who tell me it's no big deal. Like hell it isn't. It's the single scariest thing that could happen to me in a split second.

The scariest part is that this allergy keeps getting worse. I used to only be allergic to walnuts, and mildly so at that. It quickly progressed to peanuts and almonds, followed by, well, everything. Then I was airborne allergic to walnuts. Then hazelnuts. Then everything. What's next? Anaphylaxis from seeing a Snicker's bar?

There's a new (supposedly) miraculous allergy drug called Xolair. I might just go back to seeing an allergist to see if it's worth a try. To think that I might not have to constantly have my ears primed for hearing "nut" at the end of every word might be wonderful. It wouldn't be a cure--there's no such thing yet and I don't expect one in my lifetime--but it would be something.

And that's everything I'm putting in this post.

"If you're lost and alone/ Know you're sinkin' like a stone/ Carry On" ~Fun.

Monday, August 26, 2013

I Want Them to Know

I'm applying to medical schools now. I haven't had the best experience with school or with doctors, or even with life in general. There are things I can't tell the medical schools--things both good and bad--because they don't want applicants who have chronic health conditions (it makes us look bad as applicants). These things are important, though, so I'm posting them here.

I want them to know that I'm a good student, no matter what my grades say. I want them to know that I know my Organic Chemistry 2 and Biology cold, despite the grades I got in those classes. I want them to know that crap happens, and that my health has messed up my test-taking more than once, but that it doesn't mean that I don't know the material.

I want them to know that I've wanted to be a doctor my whole life, and that nothing else is even a thought in my head. I want them to know that my bad experiences have made me want to be a doctor more, not less.

I want them to know that medical school will not be easy for me, but that I will do my best. I want them to know that I will do whatever it takes to make it through with the most medical knowledge I can accumulate. I want them to know that I understand that medical school and residency and fellowship will be physically demanding, but that I consider myself up to the challenge (assuming there's always coffee at hand).

I want them to know that there will be times when I am not myself, and that it's okay. It's not okay to penalize me for what I am completely unable to control if it only happens once in a while.

I want them to know that I am sensitive, physically and emotionally. I want them to know that my social skills are self-taught, and that I'd really appreciate a book of social protocols (like the Liaden Code of Conduct which, unfortunately, only exists in the Liaden Universe series). I want them to know that it's okay to tell me that I did something wrong, but that they shouldn't be overly harsh on me. People confuse me sometimes.

I want them to know that I can be a good doctor despite my physical incapabilities. I will not give up on CPR just because my arms hurt like hell after the first three compressions. I will not leave an OR because my back and legs hurt. I will not go home early because I have a migraine. I probably won't even complain about any of that stuff. Therefore, I should not be brushed off because of them.

I want them to know that, as a doctor with chronic diseases, I will understand patient compliance and the emotional aspects of living with diseases better than most doctors.

I want them to know that I want to be the inspiration that keeps people going. I want to be the person that tells her patients that they can do it because I did. I want to stand there and say that I know it isn't easy, but that if anyone knows they can live their life despite their challenges, it's me.

"My wish for you/ Is that this life becomes/ All that you want it to/ Your dreams stay big/ Your worries stay small/ You never need to carry more than you can hold" ~Rascal Flatts

Sunday, August 25, 2013


One of my first symptoms was an indescribable sensation in my legs. It felt awful, and the only thing that helped it even a little bit was walking. Of course, once I stopped, the feeling was unbearable, and there was nothing I could do about it.

At night, I'd sleep with my legs up on a huge pillow, and I'd take both Aleve and Benadryl so I could sleep.

Heat made it infinitely worse. So much worse, in fact, that I dreaded the next summer, because I was so unable to deal with it.

Now that I think about it, I wonder if I had RLS, or something like it. I still get the feeling sometimes, but not ever as bad as it was that first summer.

I had some transitory numbness and tingling in my hands and feet, some pain with no cause (which I still have). I was often afraid of burning my hands because I couldn't tell if things were hot--but only sometimes. It came and went as it pleased.

Since then, things have changed a lot. Now, my body is overly sensitive to the strangest things.

I love the way clothing feels. I can waste an hour rubbing my hands over and over a pair of socks. It sounds ridiculous, but it feels awesome.

I can't wear turtlenecks anymore, even though I used to love them. I can't handle the feeling of something on my neck.

I get cold a lot, though I'm usually hot. I get cold at weird times, too, and for no apparent reason. (Migraines and nausea and lack of sleep make me cold, but that used to be it.) I happen to be freezing now. Go figure.

Sometimes, for no reason I can understand, singing annoys my body. Singing is one of my favorite things, and when I can't sing, it scares me. I worry that I'll never be able to sing without making every hair on my body stand on end. I worry that my dream of doing something with music will never come true. I worry that everyone will ask me to sing and I won't be able to--and they'll all wonder why.

At those times, singing makes my skin crawl, it feels like metal is screeching in my ears, it brings tears to my eyes. It isn't the sound, it's the vibrations through my body.

The other most annoying sensation? Long hair.

I've donated my hair twice--once when I was 14, once when I was 17, and now, at 20, I'm going to do it again.

The second time I'd donated it, I'd been living with fibro for a year. My hair was annoying, but it wasn't physically uncomfortable.

By the second year after I'd donated it, it had crawled past my shoulders and was growing down my back. And it itched.

No one I know has ever heard of anything like it, and I'd never experienced it before. To this day, my back itches when my hair touches it. This has been going on for two years. I'm ready to get rid of it. And I don't think I'll be able to do this again.

I love donating my hair. I think of all the kids with cancer who had long, curly hair and get short, curly wigs. The longer I grow my hair, the longer their wigs will be. Additionally, my hair is a weird color, and I can't imagine that many people donate curly hair with my coloring. I hate that fibromyalgia could keep me from doing it again.

Regardless of fibro, I happen to be very, very, VERY happy that I'm donating my hair next week. I like it better short.

Thursday, August 22, 2013


Sometimes it's hard to remember that I'm a person, rather than a mess of things that don't work properly.

Nothing in particular happened to make me feel like I've completely fallen apart. I've finally seen my podiatrist, who diagnosed me with flat feet and a very collapsed ankle as a result of this stupid thing. He refuses to do anything until my new orthotics come in because he says that it's impossible to differentiate actual damage and pain from the flat feet. (So I've been using a combination of taping my arch up and a tightly wrapped ace bandage doing the same to help--which it actually has been.)

My blood sugar is, for the most part, holding steady--no major surprises. I had a 170 on Sunday night from sesame chicken (which I haven't made in a while), but it was probably from the fever I'd had for two weeks rather than the food. I had a 70 today, for reasons I don't understand. C'est la vie.

My fibromyalgia is neither worse nor better, though I think I'm going to try taking CoQ10 (a supplement with no real side effects but has been shown to help certain muscle problems that stem from issues with mitochondria, which it seems fibromyalgia stems from). I want to ask someone first, be it my endocrinologist, my rheumatologist, or even my pulmonologist. I probably need to see my rheumatologist sometime this year because I have pain in certain joints that just refuses to go away.

My breathing is fine--or as fine as it ever is (though exercise seems to help for a couple of days and I haven't done any lately).

I haven't had any major allergic reactions or sudden realizations that I'm more allergic to something than I thought I was. Even my eczema has been behaving pretty well lately.

So I don't know what it is that makes me feel like I'm drowning in my body's prison tonight, but I am.

I hate being in constant pain. I hate knowing that I have to eat something because I have to take Metformin, a multivitamin, two vitamin C's (it keeps me from getting colds, which usually leads to bronchitis, which has variably bad breathing outcomes), vitamin D, and Zyrtec. I hate craving sweet, cakey foods but knowing I shouldn't eat them. I hate the fact that I gained nearly six pounds this summer for No. Reason. I hate the fact that a patient asked me what my Tummietote was today. I love the thing, but I know that patients wonder why I'm wearing a thick, bumpy black band around my waist.

I find something interesting--maybe it's just me.

There's so much of me that's hidden from the rest of the world. I write, I sing, I play guitar. I'm donating my hair for the third time in a few weeks. I'm left-handed. I'm really, really good at science and math. I type fast. I have truly terrible handwriting. I love to learn. I hate clothes shopping, but I can (and have) spend hours in Target. I love planning every bit as much as I love going places or doing things. I love, love, LOVE music.

The health stuff is more hidden in that I actively hide some of it. The things that don't impact my functionality are well-known by the people around me. They probably think that diabetes and allergies are my central focus because those are what they hear about. In fact, I think fibromyalgia has the harshest impact, but I don't talk about it because it actually has the capacity to destroy my life. I don't tell people when I'm in pain or when I'm too tired to do something (unless the only thing I have the energy for is sleeping). I often will push myself to do things I don't have the strength to do rather than cancel plans or admit that I'm not up for it. I'm so desperate to keep fibromyalgia from controlling my life that it is, in fact, controlling my life.

I can still remember what it felt like sitting in that doctor's office in April, begging him to tell me that he found something, anything that could explain my symptoms. I remember his answer, too: "Why would you want a potentially life-threatening disease?"

It isn't that I wanted to be diagnosed with lupus or Sjogren's disease or anything else potentially scary, it's that an explanation, a possible prognosis, a possible treatment, were the only ideas, however far away and abstract, that were keeping me going. The idea that I might one day become too incapacitated to be useful is terrifying--especially given all of my talents and loves. There are some things I can handle--diabetes, Hashimoto's, food allergies--and there are some things I can't--deafness (because of music), lack of enough motor skills to type or play guitar or piano. I've already lost most of my ability to hand write. My guitar playing is not as good as it was--and not because I'm out of practice. I'd been playing for nearly a year when I woke up one morning and could hardly hold my guitar, let alone play it. It was like my heart had been ripped out. I think I've regained most of it, but I went from being my guitar teacher's prized student--according to her the best she'd taught in 30 years--to being clumsy and barely able to pluck out a tune in one night. It could happen again.

I had a very scary time about a year ago when I wondered if I could even become a doctor. There are days when I have a significant cognitive impairment. Everyone says they don't notice it, but I do. Some days, if you tapped on my nose, I couldn't tell you what it is, even though I know what it is. There are days when I can barely process other people's speech, let alone create my own. Sometimes this can be overcome with enough caffeine to make my brain rattle around in my head, sometimes it can't. I practically failed a Genetics test on one of those days (I ended up with an A- in this class, so you know that that wasn't usual for me). And then I wondered: if I can't pass a "simple" biology test, then how can I safely treat patients? And yes, that scared me for a long, long time.

And I have to wonder if my flat feet were caused by this damned disease, too. I know that my ankle issues are definitely worse because of it, because it seems like I'm more fragile because of this damned disease.

I truly feel that I do not function at a good level on a regular basis. I often don't feel well, I'm almost always in some minor amount of pain. I'm always, always, always tired, no matter how much I sleep and no matter how much coffee I drink. I honestly don't remember what it's like to feel good. I get by, sure. At the end of the day, I function well enough to get decent grades and get through the day, but I could be doing so much better. I think of all the students, all the pre-meds, all the people who don't understand the material on the same level I do but are getting better grades, anyway. It makes me sick to think that my lifelong dream of becoming a doctor--something I'd be really, really good at--might not happen just because of some horrible disease I never asked for, could not have prevented, and can't do anything about.

When I get like this, I have a friend who likes to tell me that I get more done with the limited amount of energy and strength I have available to me than anyone else she knows (this coming from a person who does more than I could ever imagine). It just makes me wonder what things would be like if I were a fully functioning, capable person whose ambition was reflected in the things she did and whose intelligence was reflected in her grades.

I realize this is a long post. If you're still reading, you're really, really awesome. Everyone feels like this sometimes, and I don't feel like this often. I don't know what set it off, but I feel much better now that I've let it out. If anyone has any words of encouragement, I'd appreciate it!

"Sometimes I don't want to be better/ Sometimes I can't be put back together/ Sometimes I find it hard to believe/ There's someone else who can be/ Just as messed-up as me" ~Skillet

Friday, August 16, 2013

Puzzle Pieces

Sometimes it's hard to put the pieces together and figure out what's wrong. It doesn't necessarily matter what bothers what, except for potentially preventing it from happening again. Other than that, it's another frustration about living with multiple chronic diseases.

For example, on Sunday I went swimming. 

Now, swimming lowers my blood sugar much more than running does (strange, right?). Usually, if I have ice cream first, I'm fine. Now that's a good excuse to have ice cream. (And I just realized that that was completely irrelevant, but it's still part of my swimming routine.)

No matter whether I'm in the pool for exercise or playing (with my sister or little kids--no one's too old to push their sister's head under the water), swimming makes me cold. I know that this happens, so I come prepared with a long-sleeved shirt and a sweater. 

Of course, it happened last Sunday. It was about 80 degrees that day and the pool was 86. This is totally normal for me. But I couldn't get warm (usually I can't until I take a ridiculously hot shower). 

Even after my shower, I was still cold. No fever supposedly,  but I was freezing. 

I woke up the next morning feeling fine. I went for a run on Monday night, and I was freezing after that, too. The only thing that bothered me was my ankle (which has taken a rather strong dislike to running). 

It happened again on Tuesday night, for no reason. 

On Wednesday I was freezing all day. The doctor I was shadowing has a very cold office,  but I couldn't get warm. Lo and behold, I had a "fever" of 99.8. And I had to go to a wedding. 

I took an Aleve for the fever and the mild headache that had been nagging me all day. It helped neither, and the headache went away on its own after a few hours. I came home with the same fever I'd had apparently all day. 

My ride threatened that I shouldn't go to work on Thursday, but I told her that I'd only been having fever at night. I actually called to tell her that I didn't have fever on Thursday morning (99.6, no real chills after I got dressed--and no, I'm not proud of lying to her). I dressed a little warmly, partially because it was cold and partially because I didn't want to freeze all day again. So I was hot all day. And I came home with a fever of 100.3. Gee, no wonder I was hot. 

The highest temperature I've seen today is 99.6. Nothing I've had is really high and I feel fine, minus the weird body temperatures. I'm still cold, which is just getting annoying. 

What is it? Do I have a virus? Is something autoimmune bothering my ridiculous body? Is my body rebelling against exercise? 

I know better than to run when I have fever, so I haven't since Monday night. I'm not thrilled, because I'm afraid I won't be able to force myself back into it. 

I dissect everything--why my knees hurt, why my blood sugar is high, why I'm tired. It's annoying that the obvious answers are "I have fibromyalgia", "I have diabetes", and "I have fibromyalgia", respectively. But I need to find the deeper reasons, the things that annoyed those conditions, so I can keep it from happening again. It's unfortunate, because exercise somewhat annoys the fibro, eating annoys the diabetes, and everything annoys something in my crazy, messed-up body. It's like an overtired three-year-old; everything will make it scream and cry and whine. It doesn't know what it wants. 

All I know for sure is I want some chicken soup and maybe some weight loss out of the deal because of the appetite I seem to have lost.

"Shrouded in proof, you're the mystery/ You're the truth that lives within the world we see" ~Skillet

Sunday, August 11, 2013

Deep Thoughts

I had a different post planned for tonight--one about which disease to attribute issues to. After the conversation I had with a friend tonight, though, I have something else I need to say first.

I'm different from most people. We all have different life stories, but mine is so extreme that it's in a category by itself. Several books could be written, each about a different crazy thing that happened to me. That doesn't bother me--in fact, it's usually a source of pride that I've had such a diverse, crazy life.

There are things that I like to "forget." If you asked me about them, I might have to think about it to remember everything--or even that it happened at all. Every once in a while, stuff comes up from a forgotten part of my past, and I dredge everything up again.

I'm not going to share the story here because I'm afraid of who will see it. To most people, it wouldn't seem horrible. To a fellow religious Jew, though, it's a nightmare. (Yes, I'm a religious Jew, and that was also a post that I was going to write--even before tonight. I'm saving it for another day.) Suffice to say that, as a whole, we're not very accepting of people who are different within our own social circles. Revealing some of the things I did as a kid and early teen would be suicidal in an almost-real kind of way.

There are a lot of things about myself that I don't generally tell people I don't know well, but there are few that I never, ever tell anyone. Most people I speak to for long periods of time will find out that I have diabetes, that my mother died, that I'm a religious Jew, that I have a sister. Some might get to hear about my crazy medical history. These are things that just come up, and I don't actively hide them.

There are other things that I don't actively hide, but they almost never come up. One would be the crazy, seriously messed up friendship I had with someone I just can't handle speaking to anymore. Another would be how badly I was bullied in elementary school. These things aren't secrets, exactly, but I don't like to think about them.

I wonder what it says about me that there's one story that people never hear about?

I think there might be five people who have heard this story--and maybe two of them have heard it in its entirety. The person I spoke to tonight had no real reason to hear everything, and she isn't the kind of person to push for information. (For the record, I wouldn't have minded telling her.)

Does everyone have secrets? Are there deep, dark parts of your life that you'd rather forget? (Actually, now that I think about it, I have two secrets, but one of them comes up way more often, so I remember it even though I don't talk about it.)

This person I was speaking to tonight suggested that I write an article about my story and send it to a Jewish magazine or two. It's a story that, in its entirety, is a heartwarming and really, really nice story. I'd send it without any real names, but no one would publish it. (It would really fit better in a small book, but that's really not going to happen.) Remember when I said we as a whole don't accept what's different? Well, no one would publish this story for that very reason. The fact that everything turns out well in the end doesn't excuse, in their minds, the things I did in the past.

Maybe I should type the article up. It wouldn't hurt to try, right? The worst thing that could happen is that someone in the editor's office gets a good laugh, right? Why am I so afraid to try? Could it be that I'm afraid of people recognizing me through every attempt to disguise myself and my family?

And now I see that it's far easier to write a blog post about how I feel about my crazy, messed up body than about my crazy, messed up life.

"Times will be bad, times will be good/ Things I wish I hadn't done and some I wish I would" ~Skillet

Thursday, August 8, 2013

Funny How It Works Out

If you'd asked me to describe life when I'm 20 when I was six years old, I would never have painted a picture of where I am now.

If it had been up to me, the only things that would be the same would be that I would wear glasses and that I'd be pre-med. That's it. Honestly.

When I was seven, I switched schools. I ended up being severely bullied from the 3rd grade until I graduated 8th. I also developed "asthma", which wasn't diagnosed until I was ten. Three years of being told I was a couch potato.

When I was ten, I was diagnosed with basically untreatable asthma. While I might have seen asthma in my future, I never knew that there was such a thing as untreatable asthma.

When I was fourteen, my mother was diagnosed with cancer. Though it had been a fear of mine, I was blindsided.

I also developed a severe allergy to nuts when I was fourteen. I developed a bunch of other allergies then, too--which I probably could've seen coming, considering I always had lots of allergies. And I was diagnosed with Hashimoto's disease.

When I was sixteen, my mother died of cancer. Nope--never saw that one.

Also when I was sixteen, I started having symptoms of what we're currently terming fibromyalgia. I also was finally diagnosed with reactive hypoglycemia, which I'd had symptoms of for years.

When I was nineteen, my father was diagnosed with cancer.

I'm twenty now. I was finally diagnosed with "fibromyalgia" this year. I was finally put on meds for my persistent high blood sugars--even though my endocrinologist has still never said the word "diabetes" to me.

After expecting everything to somehow be wonderfulawesomeamazing, all I have to show for myself is a TON of health issues and a very, very strong family history of cancer.

I promise--there's a point here.

This summer, I was exposed to a lot. I think the first practical thing I learned was that patients aren't seen as people sometimes.

People hate it when doctors look at them like a specimen rather than a person. Having been on both sides now, I understand it better.

Today I was shadowing a cardiologist. All of the patients were men--except for one.

The men just stripped their shirts off, no problems, no questions asked. The woman got a hospital gown in shirt form.

When the doctor went to listen to her lungs, he couldn't lift up the shirt--he had to have her unsnap it. So he's standing behind her, I'm standing more in front of her, and her chest is basically completely exposed. No matter how hard I try, my peripheral vision still catches some of what she's trying to hide.

I'm part of the same species as her. I'm even a member of the part of the species that shares equipment with her. Modesty is important--I really, really understand that. But I wasn't seeing a woman's breasts out of the corner of my eye--it was like that part of her didn't exist for the moment.

This has happened periodically throughout this summer. I see parts of patients that I know they don't want me to see, but it's like that isn't what I'm really seeing. I unconsciously take a step back when I see something like that, and I'm able to separate in a way I didn't think was possible.

Here's where the first bit comes in.

Had I lived the easy, carefree life I'd always expected to live, I might be able to sink into my ability to separate. Some doctors have a way of seeing people in a very...clinical...way. I have that ability, but I can't sink into it. Because when I'm face to face with a patient, they're more a person than a patient to me. That doesn't mean that I get all emotional, but it does mean that I can be distant when I have to be and can still be a human being when I should be.

When confronted with the terrified parents of a four year old newly diagnosed with Hashimoto's disease, I'm not above telling them that I have it, too, and being a living example of the normal life he can live despite it. By the same token, I was able to hold down a five year old boy slipping under anesthesia who kept thrashing around. I remember the feeling of slipping away, not being myself as I held gently but firmly onto his leg.

I don't think I would have been able to retain the human aspect if I hadn't been confronted with what it means to be HUMAN--fallible, weak, powerless on so many levels--if I hadn't been confronted with it myself so many times. Having been the difficult patient, I know the frustration. My patients will appreciate the pain I went through someday, because I've been through more in twenty years than most people go through in a lifetime.

"This is how it feels when you take your life back/ This is how it feels when you finally fight back/ When life pushes me I push harder/ What doesn't kill me makes me stronger" ~Skillet

On Exercise

People who run have always fascinated me. There's something about moving fast and smooth that's so...relaxing-looking. Sometimes when I was younger (before my body had trained my brain to not even think about it) I'd be overcome by these crazy urges to RUN. I remember getting off the bus at sleepaway camp one year and I was so happy that I needed somewhere to put all that crazy, misplaced energy. I went for a run around the camp that ended in a horrible "asthma attack." It was so worth it...

But I resigned myself to never being able to run. I had "asthma", and though there are plenty of asthmatic athletes, those were always the people who could be controlled by meds. And, of course, if they caused an attack, they could just take something and it would go away. But since it never worked like that for me, I could never be one of those people.

I don't know what it was that inspired me to really buckle down and try it, no matter what the cost. There are quire a few of them. And since my brain thinks better in lists, well, here they are, in no particular order.

1. Last summer, I could barely finish a sentence before needing to take a breath. I gained about twelve pounds in three weeks before I decided I had to do something about that. (We have NO idea what caused me to gain so much weight so fast, especially since it was after more than a month of sitting and doing nothing--during which time I gained no weight.) So I went on the treadmill for an hour and forty minutes every morning before work (I was an assistant to a division head in a local day camp). I just walked, but I noticed that my breathing was better during the day. Also, I was less hungry, I had more energy, and I felt better overall.

2. Two of my professors in college run marathons. They were two of my favorite profs, and they both seemed to really enjoy it. One of them pushed me to start running, stating that my breathing would get better, that I'd feel better. I didn't believe her, and I argued with her. (I can't wait to see her this Fall so I can tell her!)

3. Diabetes is a scary disease. It can cause a ton of damage, raise your risk for all kinds of heart problems, and it's overall a terrible thing to have. Exercise reduces the risk of complications from diabetes, but it also lowers blood sugars, which further reduces the risks....What's the opposite of a vicious cycle?

4. Running burns more calories in less time than any other form of exercise. I'm supposed to be losing weight (and I somehow managed to GAIN weight this summer...*sigh*). I can't see that happening, because my weight usually stays the same no matter what I do, with a couple of exceptions. (Those are: when I get bronchitis, I usually lose between 2-5 pounds, which I do gain back slowly over the following months; Passover, when I basically starve for a week and also usually lose about 5 pounds; last summer and this summer, when I gained weight for NO reason.)

5. As mentioned before, the relaxation and the coolness of running...and have I mentioned that I'm the most uncoordinated person ever, and that running somehow seems to help that?

6. My mother's father died of a heart attack. I'm pretty sure her mother died of the same. My father's mother died of a stroke. My father has had high blood pressure for more time than I've been alive. He's also had high cholesterol for forever. I get migraines, which are a risk factor for strokes. Have I mentioned the diabetes risk factor? Let's face it--I have a million factors against me for cardiovascular issues. I want to do everything I can to reduce those.

7. Fibromyalgia is, supposedly, helped by exercise. So far I'm seeing more joint pain and stiffness with exercise, and I think my muscles might be getting worse, too, but we'll see what ends up happening.

So there you have it! Reasons to run! And the weirdest thing out of all of it?

I'm enjoying it.

"If I had the chance to make one wish/ Every, single moment would be like this" ~Rascal Flatts

Wednesday, August 7, 2013

What They Don't See

I'm very thankful for having chronic diseases that I can, for the most part, hide. It makes things easier in some ways--I don't have to explain anything unless someone offers me food or sees the MedicAlert bracelet on my wrist. But it makes things hard in other ways.

I'll use my recent trip to Maryland to visit my friend as an example.

What she saw:

My best friend, S, picked me up at the bus station and we took the Metro together. We sat on the benches and talked and laughed and enjoyed being able to speak in person. She handed me an iPod full of music we've both recently discovered and we shared headphones the whole way to her stop. We waited for the bus for about a half hour, got on, listened to more music, made each-other laugh really, really hard. We got off, went to the grocery store, walked a mile to the house she's been staying at this summer.

What I saw:

My best friend, S, picked me up at the bus station, after I'd been standing around holding a very heavy laptop case (that I was using as an overnight bag) with an even heavier backpack on my back. The straps dug in to my shoulders and the laptop case pulled and pulled. I felt myself getting dehydrated but I didn't want to drink because we wouldn't be near a clean bathroom for a couple more hours.

We sat on a bench and waited for the Metro. I was happy just to get the backpack off and stretch my back. We listened to music, and I was happy to share the headphones even though leaning over hurt my neck a bit. We sat on a bench and waited for the bus, and the heat made me dizzy. I said nothing.

The walk to her house was brutal. Uphill, uphill, uphill. Some downhill. Uphill, uphill, uphill. My arm ached from the laptop case, the outside of my knee ached where the case kept brushing against it, my back ached from the backpack, my shoulders hurt from the straps. I said nothing.

I enjoyed being with my friend. I really, truly loved it. I have no regrets about going, because the pain is fleeting but our friendship means a lot to both of us.

I don't like to tell people about the fibro and how much it bothers me. I don't like to tell people about my diabetes and how much it drives me crazy. I don't like to complain about how much trouble breathing I have. I don't like to complain at all, really. If I can avoid telling people about these things, then I do.

I doubt anyone I'm shadowing notices how much I bend my knees when we stand for "too long." I doubt they hear my knees crack after standing for five minutes. I doubt they notice how much I drink.

On Monday, the doctor I've been shadowing kept making comments on how tired I looked (he's a pulmonologist/sleep specialist). I was tired, but no more than I usually am. He might've been seeing the leftovers of the bad run I had on Sunday, but more than that I can't account for.

I could've told him about the run. He would've understood. But that would've meant telling him about the fibro, and I didn't want to do that. I left it alone, but I wonder if that makes a difference to him...

"I'll need a little more luck than a little bit/ 'Cause every time I get stuck the words won't fit" ~Faber Drive

Thursday, August 1, 2013


Today was not a great day, health-wise.

I woke up tired, which happens almost every day. I haven't slept much this week because I slept at a friend's house for two nights and I was up half the night packing right before I left. Then I just didn't get my necessary 8-9 hours (which is a goal but not an attainable one--I usually get closer to 6 or 7).

So I was tired this morning. No big deal.

I shadowed in the morning, went to lunch, then went to shadow in the NICU.

I shadowed in the NICU before, when I was part of the program in June. It was a wonderful experience, and I jumped at the chance to do it again.

We changed into scrubs and followed the same doctor around.

The other girls asked lots of questions. In my opinion, asking questions is an excellent thing. However, when their questions cause us to stand in the exact same place for nearly an hour, I don't do too well.

I didn't say anything, but my back started to hurt. Then my knees. I kept bending them so they wouldn't stiffen up too badly, but they did, anyway. They also cracked almost every time I bent them, where that usually happens once every five minutes or so.

My shoulder/neck area started to hurt, but I still kept my mouth shut. At some point I was able to sit down for five minutes, and I was so miserable that I didn't want to get back up.

When I'm walking or moving around, this doesn't happen. But when I'm standing still, forget it. It took me more than an hour to get back to "normal", and even then I still wasn't okay.

I kept dozing off on the train on the way home. Generally the train is pretty safe, and there were lots of people around, but I don't like sleeping on the train. When I woke up to get off, I discovered that the muscle behind my knee and lower thigh had decided to cramp in one leg--and I kept feeling it pull when I moved my leg.

We went to the grocery store, where I just couldn't function. Then we went home, where I made dinner for everyone but me.

I had a BUNCH of Chip's Ahoy cookies and milk for dinner. Honestly, I don't even want to think about how many carbs that was. I don't even know if I spiked from that or not, because I then curled up on the couch and took a two hour nap (with about forty interruptions from the two family members, who don't seem to understand the word "sleep").

I feel better now, but it's days like this that make me nervous.

It could've been the rain. It could've been mild dehydration (even though that usually causes muscle sensitivity in my messed-up body, but anything's possible). It could've been the fact that it was cooler outside than it's been in a while. It could've been that the NICU was warmer than any other place in the hospital. Really, there are so many factors that it's impossible to tell what caused so many problems.

I've never had pain and stiffness in my knees that wasn't resolved after a few minutes of walking. I've never had back pain that wasn't resolved by stretching a bit. Today was more extreme than it usually gets.

If I've learned anything while shadowing, it's this: my health will be a major burden in medical school.

Most med students are uncomfortable standing for long periods of time, but they can do it. I really can't. And no one wants med students to need accommodations, because that makes them "unfit doctors" somehow, which makes no sense to me. Shouldn't taking care of your own health be important, too? Where's the harm in needing accommodations as long as it doesn't affect the quality of patient care?

It's likely that no one else in my med school class will have diabetes. I'm okay with that. But if you need to deal with a low, that's life-threatening, and assuming it doesn't happen too often, no one will get too upset. But if I were to ask for a chair while we present patients' cases in the hallway for three hours, I'd be condemned.

I honestly don't know what to do here. My rheumatologist offered me meds the last time I was there, but I'd prefer not to take them. There are many reasons, but the biggest is that it's an anti-depressant and I don't want anything messing around with my brain chemistry. His view (and it's a good one) is that there's already something messed up in there and that we're just fixing it. He's right--I just don't want to admit that.

There are other factors. He made a point out of not being sure what exactly this is. If it's, say, Lupus, then I'm messing with my brain for nothing--there's something else going on that won't be fixed by a little Lyrica. And though I don't hesitate to take pills that I need, I'm not so sure I need this. It might help, the same way it might not, or might interfere with my ability to think, or sleep, or not be completely crazy.

My joints have been bothering me a lot lately, which could be a source of some of my fears. But it should be noted that medical school is extremely hard--mentally, physically, and emotionally. I've worried about the work and the psychological impact in the past, and I've often thought about diabetes management in the clinical setting--but mostly I've worried about residency and fellowship, not medical school. Now, though, I'm worried about that, too, and I've been thinking about how the hell I'm going to deal with the fibromyalgia/my-body-hates-me crap, too. That stuff scares me.

There will be a talk with my rheum about this in the future. I was told to come back when new symptoms show up or when I think I need to see him, because there really isn't much he can do for me now. It might be later--like when I know I'm accepted to medical school and this will be a definite issue that MUST be resolved, but it will probably have to happen this year. (I'd also like to speak to my endocrinologist, but that's a problem I'll get to when I see him next or the time after that--he's very supportive of my desire to become a pediatric endocrinologist and he'll do whatever he can to help me.)

In the meantime, I get to worry about the AMCAS application, my school's incompetence in transcript building and mailing out, and finishing up my shadowing hours. Yay?

"I know you're scared out of your mind/ But just take a little baby step, baby step/ Right toward the finish line" ~ The Chromatics

Thursday, July 25, 2013

Tales From the Shadows, Part II

To properly tell this story, we need to go back--waaay back, to when I was seven, and work our way up from there. (Warning: the background is 90% of this post.)

When I was going into the third grade, I switched schools. In my old school, recess was spent on the jungle gym or the swings or sitting in the grass. In my new school, we got a parking lot in the back. There were two options: sit on the side and be bored, or play tag. 

I noticed then that I had trouble breathing when I ran. I told my mother, who took me to my pediatrician, who said I was a couch potato and needed more exercise. He suggested that I start walking on the treadmill. (I hated that, by the way, because my father ALWAYS made me walk at 1 mph, which was so slow it hurt my legs to try to walk it.)

Needless to say, it didn't help. When I started seeing an allergist when I was ten, my mother made me tell him. He had me run up and down the stairs a few times. Then I came back to his office, where he listened to my lungs and told me I had asthma. 

He prescribed a bunch of different medications, none of which worked. Eventually, I got sick of trying--it was only when I exercised, anyway. And it went away no matter what I did. I got a note for gym that said I couldn't run and that was that. 

Until I started having "real" shortness of breath in the 8th grade. 

That was the first year that the changing seasons made me cough. The nurse actually sent me home so I could see my allergist that day. He gave me an inhaled steroid to be used every day. That helped, a little bit.

But I was still having trouble breathing every day. After I got bronchitis (the first of many, many bouts) at the end of the year, the trouble breathing got worse. I pretended it wasn't there, since it didn't seem like there was anything anyone could do for it. I took my inhaler multiple times--sometimes multiple times in an hour. It didn't do anything.

I saw a pulmonologist at that point. He said I definitely had asthma, and that I should keep taking my inhaler because it was probably doing something, even if I didn't know it was. 

This went on throughout high school. Something would set off my asthma and it would get worse. It rarely got better after it got worse. 

In college, the same thing happened. I got sick of it and made an appt with an allergist that my neighbor recommended. 

She put me on a slew of steroids, tried various different inhalers and even a nebulizer, but nothing worked. The steroids annoyed my blood sugar, one of the inhalers actually annoyed my asthma, and nothing helped much. 

During this time, the only thing I noticed was that I didn't get the asthma cough when I was on steroids since before the spring started. It was very nice not to get that awful deep, painful cough. 

Eventually, she said that she couldn't help me and she recommended I see a pulmonologist. So I did.

I happened to start seeing this doctor a week after I'd gotten a bad bout of bronchitis. What made it bad (other than the cold that made me more miserable than the bronchitis itself) was the shortness of breath. I literally couldn't finish sentences, couldn't walk and talk at the same time, and had to slow down my walk to school. I couldn't do stairs, I couldn't concentrate, and I was really, really uncomfortable all the time because of how bad the shortness of breath was. 

The first thing she told me was that asthma responds to bronchodilators, and that if mine doesn't then it isn't asthma. My PFT (breathing test) was normal like it always was, but my lung's ability to use the gasses in there was pretty low. 

The first thing I was evaluated for was vocal cord dysfunction, which can mimic asthma. Not surprisingly, I don't have that.

She took me off the steroids once the bronchitis got better and I had the methacholine challenge. She also sent me for an echo, just to be sure it wasn't a heart problem. The methacholine challenge came back so normal that the guy who was performing the test was begging the screen to show that I had a decrease in pulmonary function so we'd have something to go on (he liked me and he knew that if it wasn't asthma, we'd be hard-pressed to figure it out). 

The echo came back "abnormal", which was determined to be normal by the cardiologist my pulmonologist referred me to. I had a stress echo (which was the worst test I've ever had, including the EMG I had in the 12th grade), which came back normal. I had a pulmonary stress test, which also came back normal.

At that point, my pulmonologist made me get a letter from a psychologist that my breathing problems weren't caused by stress. To her credit, she accepted the letter at face value and never questioned it again.

I had bronchitis again in October of this year, almost exactly six months from the last time. At that point, I was still practically unable to finish a sentence, minor things like brushing my hair made me short of breath, and I was going out of my mind. After day two on antibiotics (the same antibiotic I'd been on the last time, in the same dosage), my breathing got infinitely better. That is where I stand now.

During that entire period of severe shortness of breath, my diffusion capacity (the part of the breathing test about how well my lungs use gasses) was in the mid to high 60's, when 80 is borderline low. Once I stopped having so much trouble, it went up to the low 80's. That was in December, when I last saw my pulmonologist and I assume it's been the same since.

Last I heard, she wanted me to go for acupuncture (as long as I was going for the fibro, anyway). That probably isn't happening because my insurance won't cover it. I'm seeing her in October. 

Now for the shadowing part. 

I shadowed a pulmonologist during my first month. (I now shadow him steadily, but that's beside the point). Somehow, we ended up in a discussion about how I don't have asthma.

He asked me a bunch of questions, including what sets it off. When he heard that the changing seasons, cold air, exercise, allergies, humidity, stress, laughing, hiccups, crying, etc all set it off, he said there's no way I don't have asthma. He said that negative methacholine challenges don't mean too much, and that exercise studies don't mean much, either, because you warm up when you do them for a long time. When you warm up, he said, the lungs don't overreact as much. As far as medications are concerned, there is such a thing as hard to treat asthma. 

So what, you ask, do you do to treat it, then? Allergy pills (thank you, Zyrtec), regular exercise with long warm-up periods and no exercise in cold air. Avoidance of triggers is also necessary, which would be great if I weren't allergic to common things like dust, mold, and pollen (and nuts and nickel and ibuprofen and contact lenses and lens solutions and soap and shampoo and laundry detergent and perfume and makeup and...the entire world, basically). And, you know, I love to laugh, I can't help it if I cry, and no one can prevent hiccups.

That day had been an eye-opener for me. I don't know if he's right or not, but I'd honestly rather a diagnosis of hard-to-treat asthma than no diagnosis at all.

Wednesday, July 24, 2013

It's Raining

You know that saying, when it rains, it pours? Well, sometimes it's wrong.

My blood sugars finally (FINALLY!) calmed down a couple of weeks ago. I don't know why, other than maybe the higher dose of Met finally kicked in. Maybe that was it. Or maybe it's because my body knew something else was coming.

Right around the time I started the Couch to 5K program, my fibromyalgia started acting up. It hasn't been terrible, but it's more noticeable than it's been in a while.

Sometimes my fibro's just joint pain and stiffness. Sometimes it's just muscle stiffness. Sometimes it's brain fog. Sometimes it's exhaustion. Sometimes my muscles bother me, with pain or without. Fibro is such a variable disorder with such a vast array of symptoms and so many different combinations that it can be hard to keep track of it all.

Lately, it's been my muscles, mostly without pain. I've had some on and off knee pain (my ankle doesn't count in this because it isn't fibro-related, but it's making itself known, too). I don't know if the exercise has anything to do with it--honestly, I hope it doesn't. I may not be enjoying myself, but I really, really want this exercise thing to work.

I haven't told anyone about my flare-up. I don't see much reason to. My sister would only get upset, my father wouldn't understand, my best friend wouldn't be able to help at all, and my close family friend who's the closest thing I have to a mother doesn't need to be upset.

Speaking of her (we're going to call her L here), she's been driving me home some days after shadowing. The past two times I've gone home with her, she's asked if I was up for doing the stairs before we went down to her car. She has three kids with major joint and back issues, so she understands, but I never expected her to ask. It feels strange to have someone check with me if I can do something, rather than whether I can eat something.

The truth is, no one ever asks me. My best friend takes the elevator with me if it's more than one flight up, but unless I ask, we always take the stairs down. (The one flight up thing is for my breathing.) My sister never, ever asks--to her, there's nothing wrong with me. My father is too oblivious to notice. If I'm shadowing a doctor, I don't say a word, even if they do ask.

Speaking of shadowing, I've been having trouble with that. My fingers and feet swell a little when I stand for too long, which feels a lot worse than it sounds. My knees get stiff when I stand and don't walk for a long time. It bothers my muscles, too. It's very frustrating, because I can't say a word, but I'm SO uncomfortable sometimes.

It isn't bad enough for me to consider meds yet. I'm not at the point I was when I saw the rheum in April--I was desperate then. Now, I'm just annoyed.

I'd rather the joint stiffness and muscle stiffness any day to this. This weird feeling in my muscles is awful. The swelling is annoying. I'm just so sick of this.

At least my diabetes is behaving. It's about freaking time.

Wednesday, July 10, 2013

Tales from the Shadows, Part I

These stories are in no particular order, other than what stands prominent in my mind whenever I log on. Tonight, it's about allergies.

Remember when I blogged about how the Disabilities Center refused to let me bring my epi-pen into the testing room? I now have a story for them (and my doctor, which will get me a note of consent to bring my epi-pens in).

One morning, we shadowed in pediatric hematology/oncology. There was a room in the back of the clinic for the doctors and residents to log information into the computers, consult with each other, and just rest between patients.

My partner (whom we will call A from now on) and I were sitting at one of the desks together, whispering just to have something to do before we started seeing patients.

I heard the word "walnuts". My head whipped around so fast that I swear I could've gotten whiplash. One of the doctors was telling another doctor about the topping for her yogurt. I turned to my partner and whispered that I'd go wait in the hallway, and that she could come if she wanted but she didn't have to. I told the doctor we were shadowing where I was going and I left.

My partner came about five minutes later. I was grateful that she'd come, and that she didn't make fun of me. (She did say something about how hypersensitive to my surroundings I am, but considering my history of severe reactions from airborne allergens, I don't feel weird about it at all.)

After about twenty minutes of standing outside and leaning against the hallway walls, we decided it was safe for me to go back in. I sat across the room from the garbage can and from where she'd been sitting. I didn't feel safe, but I didn't feel threatened, either.

We saw a few patients, then we came back. We sat for another hour or so with a resident, who was explaining to us and a med student how to read a chest X-ray. We were then given permission to leave early, so we did.

Around the time we left, my palm felt very, very itchy. I figured that it was nothing, given the fact that, well, skin itches sometimes. But it refused to go away.

We walked all the way back to the office before I noticed that my right palm was bright, bright red. The redness from an allergy is so red that it almost glows, and it's immediately recognizable to people who know what they're looking for. If you've ever seen a skin infection, it looks something like that.

I knew I should take a Benadryl, because that's the first step I take for ANY allergic reaction unless I can't breathe or can't swallow. However, since I wasn't 1000% sure that it was, in fact, a reaction, I was hesitant to take something that would make me sleep. And I couldn't take Zyrtec because I'd been taking it every, single day for months. (If it isn't a bad or rapidly progressing reaction, I'll take Zyrtec sometimes because Benadryl can have weird side effects for me. But I also take it for seasonal allergies.)

I went to the bathroom to wash my hands before lunch while I decided. And about a minute after I'd washed my hands, the itching completely stopped. The redness took about an hour to subside.

My theory is that this doctor had touched the yogurt or the topping (it happens) and touched the desk afterwards. HOURS later, I must've put my hand down in the same spot, which caused the reaction.

Honestly, I'm lucky. I've had one very severe reaction from airborne walnuts and several smaller ones from airborne tree nuts or peanuts. I'd imagine that touch reactions should be worse, but I think that the nightly Zyrtec was what saved me.

This has never happened to me before, and it had me a bit spooked for a few days. Life goes on, but the memory of what could happen remains. When I see my doctor next (he's a neighbor--I can just ask the next time I'm at his house), I'll tell him that I need a note permitting me to bring my epi-pens into the testing room. The risk of someone else eating a peanut butter sandwich and using the keyboard before I do is too great--and if I'm not taking Zyrtec at that point...I don't want to think about it.

The funny thing is that my FA is rarely on my mind. Oh, it's there subconsciously--I always, always check food labels before I eat, I always, always ask what's in the food, but I don't think about it all the time. My epi-pen is just there, like my wallet it--loaded into my bag with no thoughts. It makes me feel safe, but that isn't a conscious thought, either. It's more like the song stuck in your head for days--you find yourself mindlessly humming it, but you don't bring it up in a thoughtful kind of way. It's the first thing my mind jumps to if I'm itchy, or if I can't breathe. It's the first thing on my mind if I feel dizzy or my heart rate is fast. But it's not a constant presence.

In fact, I'm happy this happened--now I have proof that this CAN and DOES happen. The Disabilities Center won't know what hit them.

"They've had eons more time than we/ Is it possible could it be/ Am I watching you watching me?" ~The Chromatics (Astrocapella)


And just as an update, I was high (140's and 150's) from dinner for nearly three hours. Yay.

The Ballad of the Repeat Highs

Sometimes I make "bad" food choices. It happens. Sometimes (read: almost always) it causes problems for the rest of the day.

This morning, I had a bowl of cereal for breakfast. It's an oatmeal-based cereal, and I'm well aware of the fact that it makes me high. I usually combat this by eating a half serving, which, with milk, is about 30g of carbs.

This morning, I was sick of seeing the bottom of the bowl through the cereal. 1/2 cup of cereal really is enough, but the plastic bowls my father buys are very wide, so it doesn't look like much. (I know the solution to this problem--use a plastic cup.)

So this morning I had a full serving, plus maybe a drop extra, plus milk. We're talking something perilously close to 60g of carbs here. Not my usual AT ALL and it's a number of carbs I never, ever eat. With good reason.

About a half hour after finishing breakfast, I was 179. I deserved it, I know. I felt it, though not too much. It was more like an ache behind my eyes that I could ignore if I wanted to, and a slight feeling of dizziness. Was the cereal worth it? Probably.

I didn't sit up high for long at all, and I was coming down within ten minutes or so. My guess is that I came all the way down, since that's how my body usually works on Metformin as long as it isn't time for another dosage change.

Not even an hour later, I made myself a coffee. Since I don't really like coffee itself (just the caffeine and the milk and the fake sugar), I have a very specific coffee recipe that includes a TON of coffee grounds, very little water, a lot of milk, a lot of Splenda, and ice. Occasionally, when I have half and half in the house, a splash of that goes in, too. (It did today.)

Well now wasn't I surprised to see a 147 before I'd even finished the coffee? (Okay, one or two Madelines might've gone in there, too.) Usually, coffee and Madelines aren't enough to bring me above 130. Especially since Madelines are mostly fat and coffee is mostly milk, which doesn't usually bother me.

I'm back to 99 now, which is about 25 minutes after the 147. I feel fine, which is great, but I'm seriously pissed off.

This is a phenomenon that's been bothering me for a while. If I overdo it on the carbs on any given day, it's like my body runs out of insulin for the rest of the day. Sometimes if I'm really unlucky, the repeat highs stick around for a few hours before going back to normal. Today might still be one of those days, since I haven't really tested the waters yet with the repeats.

This is one of the reasons I'm so sure insulin is a better bet for me than Met or any of the oral drugs. It's clear  that my body is insulin deficient. I'm clearly pretty insulin-sensitive if I drop so fast after highs. (No, I do not think it's a result of oversecretion, because if it were, I'd probably drop slower, and I'd end up with reactive hypos at the end, which I do if I don't eat for hours and hours after a high. If it were oversecretion, I'd steadily drop until I'm low, not drop to about 120 and hang out for a few hours before going low.) But if I'm experiencing repeat highs like this, it means my body is running out of insulin and it can't make up the deficit fast enough.

Tonight I'm supposed to be going out to dinner. Though I wasn't intending to order an entire plate of pasta, I was intending to go a little more carb-heavy than I usually do. I guess I should've thought about that before I had a nice bowl of cereal this morning, but that's easier said than done.

Emotionally, low-carbing is hard. People like to see lots of food on their plate, even if it's too much. Often enough, people eat more than they should just because their eyes are bigger than their stomachs. In the case of carbs, they're often hungry again 3-4 hours later. I find that the more grain carbs I eat, the hungrier I am. (Except in the case of this cereal, which has awesome powers of filling.) Protein and salt seem to be the key to filling me up.

But even if I know, intellectually, that 1/2 cup of cereal is enough, it looks so sad to have a huge bowl with nothing in it. And eating cereal in a cup isn't eating it from a bowl. I don't really miss eating all carbs all the time, but I do miss the freedom that it used to afford.

"So you've made a lot of mistakes/ Walked down the road a little sideways...You can do what you think is impossible/ Keep on believin' don't give in/ It'll come and make you whole again" ~Rascal Flatts