The Endo & the Gastro

I saw both today. The Gastro spent time berating on my lack of good control (I don't really care,he doesn't know anything about type 1) and said the plan of action is to run a stool study(yay,poop collecting!) and a colonoscopy to make sure things look to be normal /not inflamed down there.(slated for middle of May) This is not a test that I ever envisioned myself having before the age of 50,but if it clears up the mystery of the magnesium problems I'll do it. The stool study will measure my pancreas enzymes.(or lack thereof)

A few hours after that, I hopped on over to my Endos office. She is going off on surgical leave and won't be back till Sep.so that's kind of sad.Last time she was off on maternity leave was 4-5 years ago...it's been awhile. The back up Endo I just didn't connect with. Anyway,we discussed all that was going on with my health...and my thyroid/Vit.D issues. I want to switch to the Armour brand of thyroid pills but she wanted to get another thyroid level (and ensure that you can't take it during pregnancy..no worries there) before she switches me.(I am really bad about taking pills, and I don't take it every single day like I'm supposed to.) Reviewed my abysmal CGM graphs.(new goal: AVOID (daily) 300's IF YOU CAN) and I kinda sorta got the "you need to be more aggressive about bolusing..you have a CGM and it will tell you if you are going low" talk. And I know that, but I hate lows,and one low is one too many. I've become that person for whom 80 is the end of the Universe and suck city for the next hour. It's hard to make yourself embrace the crappy hypo feelings all over again..and yet that is "control." But I am back on this band wagon and I am going to try to do better.A1c I have to get done at the lab..it's not covered by insurance at the office. I really feel like my Endo covered all the basics though..got a lot going on my life and she addressed all my concerns. It was a good appointment. As far as my magnesium,it's been steady w/weekly infusions.(it even went up last week!!) So far,they have found veins to infuse..and I am grateful for that.(hoping that I can increase the amount of time between infusions to help my veins heal for the next go-around and that a port won't be necessary.)


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Down

The phone rang,right on cue with my toddler's "waaaaaa"ing for some more juice.

Deep breath. Check number. Pick up.

"hello?"

"Hi Heidi this is Dr. Nephrologist. Your mag is still low at 1.1 and there's something not right going on..how much mag are you getting?"

"4 grams a week."

"I'm concerned you may have a malabsorption problem..you need to see your primary and a gastroenterologist,are you cramping?"

"All the time."

"And I think you will need a port,because your veins are probably giving up by now."

"Yes,"(fighting back the urge to bawl)..

"The pancreas is responsible for an endocrine function and an exocrine function and I think there may be something going on there..you need a full gastro work up. Are you having diarrhea?"

"Sporadically..once every few days."

"I think the malobsorption may be the cause of your electrolyte problems..also try soaking in Epsom salts,your kidneys can handle it. It will dry the skin out though."

"I know you don't want a port but I think you'll need one,this needs to be figured out. We will continue to check mag levels and talk again later."

Scared.


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Stuck

Unless things really improve with my mag levels in the next 2 weeks, I'm going to have to get a port.(in my upper arm or chest) All my arm/hand veins are completely shot. Ports scare the bejabbers out of me,& I refuse to have one done. But magnesium has to get in somehow. I'm trying to supplement with fast-acting magnesium liquid,& I 'm going to talk to my doc about Epsom Salt soaks(that is a very iffy method of upping levels though and my doc said he once knew someone who did it so much she put herself in a high magnesium coma that led to death). My mag levels are being drawn weekly.(and they are staying stable-low end with weekly infusions) I have to do something drastic,and it has to be hardcore or my levels will not go up and I'll have no choice but to get a port. Ports scare me because of the risk of blood clots/you have to take Coumadin/and your entire life revolves around the darn thing not getting infected and it can never come out,not at the rate I'm going and I'm afraid I'll need it forever. I'm fairly certain I'd need an anti-anxiety medication just for everyday functioning on the thing,not that I don't need one now but at least there's not something sticking out of my chest. I am willing to take magnesium,lots of magnesium,even if it makes me sick as a dog,to stabilize things. I just wish that they would stabilize because these veins need a break.I'm trying to take things a day at a time, tracking my levels and to be grateful for each day but it's not really working when my veins are responding by giving up the ghost..I got stuck 4 times today for an IV. Things really need to get better,soon.

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The 31 Days of Blood Sugar Control

(28,29,30...as the case may be.Warning:the below post is about women stuff!!)

If you don't have diabetes, or much of a relationship with a PWD..you are probably laboring under the assumption that blood sugar control is easy. You are either "in" or "out." (Think Top Chef) This is an assumption that has permeated every inch of society, to the point where even educating those willing to learn TAKES YEARS for them to get.(Namely,that blood sugars are a living,fluid thing...not at all static and stuck on "104")

- you go low in the grocery store,a kind soul hands you a sugary drink..and assumes you are fragile,etc.

-you eat a brownie,spend the afternoon shoveling snow, drop to 42 and your relative just cannot understand why (or they get the idea that because you ate a bad food, THAT is why you had the low).

Head smack. I'm sure you get the idea. I have been thinking though,that for a women with t1 diabetes, control is a River in Egypt.(much like the Nile) Why is this, you may ask? Well,much of it has to do with that monthly inconvenience (or lack thereof) which means in addition to the meds/exercise/other illness/food/no sleep/etc. normal ness of life,you get to deal with some pretty potent hormones which (in a normal cycle) drop to "normal" on Day 1, go flat-lining along merrily to the middle of the month and then skyrocket for the later part of the month (as do the insulin needs.) That's how it is for many women,anyway. (Others will drop their bgs.)If you get pregnant,that progesterone kicks in like a son of a gun and you can expect to see more high blood sugars along with your Endocrinologist going a bit/lot psycho.(later,the drop comes) I think that's why I will never not have highs (and lows)..you can live a lifetime with diabetes and not figure it out. (I have a very non-predictable life.)It's not entirely bad though, estrogen protects against heart attacks and the like.(however much diabetes is messing with that) Life is pretty tough for a woman with diabetes(DON'T YOU DARE GET PREGNANT OR I WILL KILL YOU MYSELF) along with the daily highs and lows. Options exist to smooth out those hormones, but that comes with the potential side effects of strokes/heart attacks and the like but in the eyes of the Endo,still better then pregnancy. It almost makes a person want to have a voluntary hysterectomy. And I guess it is better to have those options not to get pregnant, but one has to wonder what 30 years of diabetes plus pill taking is going to wrack on the circulatory system. But for a women with T1, still easier then going through multiple pregnancies.
One's body is just not ones own..

and then you are violently thrown to the Diabetes Police,masquerading as Health Care Providers, the supposed experts...who have no clue what you are talking about/doing..you've just got to realize that you are not a textbook,they do not have Crystal Balls and the future is an open book. But yes, it gets scary, because you think they are talking about you. Long story short,blood sugar control is rarely "easy"...you are thinking 1,000 things to stabilize one deficient hormone.

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