Saturday, May 10, 2014

Some Docs for Her, Some Docs for Me....

Babygirl isn't the only one who has been busy catching up medically.  Last week I saw our family doctor.  In addition to the shingles shot I had a crap ton of blood work.  I was a bit behind, having missed a six month set, oh, say about six months ago.  Since the formal step up form prediabetes to diabetes four years ago (triggered by the medications for my headache madness), I've had very good control.  We're all familiar with kidney numbers here now, so let's talk diabetes numbers.

Normal blood sugar should be 60-100 fasting.  There is a test called a Hemoglobin A1c (HgA1c) that sneakily measure the amount of sugar that is trapped inside red blood cells that can give an accurate average of daily blood glucose over a period of three months.  Normal for this test is 5.6 or less.  There are lots of ways to assess prediabetes - elevated fasting sugars from 100-123, alterations in cholesterol and other lipid levels, and elevate HgA1c 5.6-6.3 (plus or minus, depending on whose guidelines you are following).  For the sake of simplicity (and because my cholesterol is controlled independently of my blood sugar) I'll stick to the A1c as my guide. 

At its worst, until now, my A1c has been in the 5.8-6.2 range for the past 8 years, including the past 4.  The first year of Babygirl's illness I fought hard to maintain my three-times-weekly workouts and daily walks.  The second year, still fighting.  But this third year....

I don't know what happened.  I can blame the headache medications - they are exhausting.  I can blame the headaches themselves, and the discouragement that comes with them.  I can blame my exhausting worry over Babygirl, and the addition of my Mom and her care to my schedule.  But I really want to blame my bank LOL.  When our bank sold itself to another bank, my gym membership renewal failed to enter the 'new' checking account automatic withdrawal system.  And I failed to correct it, and just stopped going.  The dog is aging out of inspiring long walks, the winter was terrible, and you can't ride your bike to work in the snow, right? 

It's all bullcrap, really.  I put on 10 stubborn pounds in the aftermath of Babygirl's transplant and never lost them back.  My recent foray into gabapentin for headaches added an additional fifteen, largely because I had long since stopped the exercise habit and had no reserves.  And my A1c last week?  An appalling 8.2. Of course, if I had tested my sugar even once at home in the last three months I'd have picked up on that, but, true confessions here, my sugar had been under perfect control for seven years.  I haven't been as vigilant as I should have been.

The rest of my blood work was pretty fabulous except for my cholesterol, which, of course, lives and dies by the blood sugar control.

To complicate matters further, I saw my neurologist this week.  She is, needless to say, appalled at my lack of headache control.  We went over the list of failed medications:  Amitriptyline, imiprimine, Depakote, Topamax, verapamil, diltiazem, nadolol and gabapentin.  The summatriptan generally works to treat the headaches but I went through nearly 20 of them in the past two months. The increasing frequency and severity of the headaches, coupled with a couple of interesting new auras (something feels like it is under the scalp on my right side, pulling it tight and wrinkling it), have made her restart the steroids.  Going on the steroids four years ago sent my sugars into the 400's from a baseline of 120.  Baseline right now is 220, so that's getting wonderful, but I haven't had a headache since they started.  I'm starting Zonegran (seizure med, completely unfamiliar to me or my knowledge base) as a last-ditch effort to avoid Botox.  But if it messes with cognition (like the majority of the seizure meds have) I am DONE. 

The only good news here is that I am the only person in the history of the universe to lose weight on steroids.  I'm down five pounds and eating anything but protein makes me sick to my stomach, so here here. 

Ugh.  Damn.  And ugh.


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