Surgery was brutal but apparently routine. I managed my own blood sugar before and after surgery; it wasn't even checked during surgery. Cholocysectomy was performed laparascopically and took two hours due to adhesions. First, second, and third days were agonizing; the fourth has gone pretty well. Blood sugar going into surgery was 218 and coming out was 221. Blood sugar has mostly been as good or better than usual; appetite is absent. Insulin are very low but on the rise (no insulin resistance seen).
One thing I'm wondering about is this: I was having really dramatic rises in blood sugar at the same time as excruciating pain before. Now I'm having lots of pain without any rise in blood sugar. Were the previous elevations in blood sugar due to the same thing causing the pain, rather than the pain itself?
Saturday, April 25, 2009
Wednesday, April 22, 2009
Good News
And about time, huh?
It turns out that I had two messages on the patient info network and I thought both were my pre-op results but one of them was actually from a couple of weeks ago. My lvier enzymes were elevated; they are down to normal now. I was polycythemic; I'm not now.
I really did have an A1c of 7.2%, although my two week average is currently 130, with a 7 day of 126, and a 30 day of 144. I don't know where the 7.2% comes from.
I really do have a TSH of 0.2, but my doctor says that the T3 and T4 are not quite over the top of normal, so I am cleared for surgery. He says he wants to meet with me a week or two after surgery to discuss my treatment options, which I assume means we'll be treating it.
My TSH, he says, hadn't been tested since January 2007, more than two years ago, when it was 0.56, which is in the normal range but already kind of low.
TSH, by the way, stands for thyroid stimulating hormone. When the thyroid is already making too much hormone, the TSH tends to go down, and in hypothyroidism, when the thyroid is spluttering and inefficient, the TSH tends to get high. The normal range at the lab is 0.4-4.5.
It turns out that I had two messages on the patient info network and I thought both were my pre-op results but one of them was actually from a couple of weeks ago. My lvier enzymes were elevated; they are down to normal now. I was polycythemic; I'm not now.
I really did have an A1c of 7.2%, although my two week average is currently 130, with a 7 day of 126, and a 30 day of 144. I don't know where the 7.2% comes from.
I really do have a TSH of 0.2, but my doctor says that the T3 and T4 are not quite over the top of normal, so I am cleared for surgery. He says he wants to meet with me a week or two after surgery to discuss my treatment options, which I assume means we'll be treating it.
My TSH, he says, hadn't been tested since January 2007, more than two years ago, when it was 0.56, which is in the normal range but already kind of low.
TSH, by the way, stands for thyroid stimulating hormone. When the thyroid is already making too much hormone, the TSH tends to go down, and in hypothyroidism, when the thyroid is spluttering and inefficient, the TSH tends to get high. The normal range at the lab is 0.4-4.5.
Sunday, April 19, 2009
Graves Disease
I have a lot of bad news.
First, my insurance company is only covering the CGMS for those 25 and up. Yours truly is not quite 20.5. Furthermore, the price of the transmitters has gone up to 650. I'm not sure I'm willing to pay.
Second, my pre-op labs are awful. The somewhat bad news is that my liver enzymes are elevated and my polycythemia is slightly worse and my A1c is all the way up to 7.2%. Yuck.
The really bad news is that my TSH came in pretty low (although my endo says he's seen worse), indicating hyperthyroidism, and the surgery may or may not be postponed because of this. Most cases of hyperthyroidism, particularly in type 1 diabetics, are due to Graves Disease, the autoimmune form of hyperthyroidism. The nonsurgical treatments take months to kick in at all and years to kick in fully. The disease sometimes goes into remission (and sometimes comes back out of remission too). Treatment by surgery or radiation results in hypothyroidism most of the time, but offers a clean cut cure about a fifth of the time.
Thyroid abnormalities that are not under control present a very high surgical risk, but leaving a gallbladder alone when it is busy obstructing part of my liver is also a high risk thing to do, and of course, I'm a diabetic which puts the infection risk up.
Why don't you kick a fellow while he's down, huh? This is so not fair!
In preparation for surgery and because of the liver, I've gone off of testosterone until further notice. Also, my six year old brother has started puberty, which is strong evidence that he and I do indeed have adrenal hyperplasia; he'll be seeing a ped endo in three weeks.
First, my insurance company is only covering the CGMS for those 25 and up. Yours truly is not quite 20.5. Furthermore, the price of the transmitters has gone up to 650. I'm not sure I'm willing to pay.
Second, my pre-op labs are awful. The somewhat bad news is that my liver enzymes are elevated and my polycythemia is slightly worse and my A1c is all the way up to 7.2%. Yuck.
The really bad news is that my TSH came in pretty low (although my endo says he's seen worse), indicating hyperthyroidism, and the surgery may or may not be postponed because of this. Most cases of hyperthyroidism, particularly in type 1 diabetics, are due to Graves Disease, the autoimmune form of hyperthyroidism. The nonsurgical treatments take months to kick in at all and years to kick in fully. The disease sometimes goes into remission (and sometimes comes back out of remission too). Treatment by surgery or radiation results in hypothyroidism most of the time, but offers a clean cut cure about a fifth of the time.
Thyroid abnormalities that are not under control present a very high surgical risk, but leaving a gallbladder alone when it is busy obstructing part of my liver is also a high risk thing to do, and of course, I'm a diabetic which puts the infection risk up.
Why don't you kick a fellow while he's down, huh? This is so not fair!
In preparation for surgery and because of the liver, I've gone off of testosterone until further notice. Also, my six year old brother has started puberty, which is strong evidence that he and I do indeed have adrenal hyperplasia; he'll be seeing a ped endo in three weeks.
Wednesday, April 08, 2009
10 Things About Jonah
1. Jonah sees life as alternately a puzzle and an adventure. Sometimes both.
2. Jonah likes everybody. Yes, really.
3. Jonah cries every day. Usually for less than a minute.
4. Jonah prefers to sleep sitting up.
5. Jonah will be having his very first surgery on April 22- a colocystectomy. He is trying to see this as an adventure.
6. Jonah is the firstborn son of a firstborn son, so he always attends a siyum with his father on the day before passover. Which is today.
7. Jonah likes to sort things.
8. Jonah is ticklish. Don't tickle him though, because he will hit you if you try it.
9. Jonah likes to read, and keeps lots of lists of books. Sometimes he reads books because one of his lists is missing a book by an author whose name starts with X, or that is catalouged under SK in the library of congress, or some other silly reason.
10. Jonah's least favorite key on the keyboard is the one that says "Ins" because he keeps pressing it by accident.
2. Jonah likes everybody. Yes, really.
3. Jonah cries every day. Usually for less than a minute.
4. Jonah prefers to sleep sitting up.
5. Jonah will be having his very first surgery on April 22- a colocystectomy. He is trying to see this as an adventure.
6. Jonah is the firstborn son of a firstborn son, so he always attends a siyum with his father on the day before passover. Which is today.
7. Jonah likes to sort things.
8. Jonah is ticklish. Don't tickle him though, because he will hit you if you try it.
9. Jonah likes to read, and keeps lots of lists of books. Sometimes he reads books because one of his lists is missing a book by an author whose name starts with X, or that is catalouged under SK in the library of congress, or some other silly reason.
10. Jonah's least favorite key on the keyboard is the one that says "Ins" because he keeps pressing it by accident.
Friday, April 03, 2009
Thursday, April 02, 2009
Cholesystitis
I can't even remember the name of what I have for very long. Anyways, my gallbladder has a bunch of stones in it (probably it had a bigger one that was hurting and I'm in less pain because the big one is now in pieces). Also my gallbladder is inflamed and at risk for infection. My endo wants me to have it removed. He isn't sure about how urgent it is. I have a Monday morning appointment to talk to the surgeon that the endo recommended. I hope the surgeon will let me direct my diabetes care, is comfortable with queer people, is familiar with adrenal hyperplasia, and is great with gallbladder removal. Any comments from diabetics whose gallbladders have been removed on what that does to diabetes would be appreciated.
My blood sugar currently is vaccillating wildly. I don't think it's been this bad in over two years. I hit the 30s and the 290s today, and it wasn't even a rebound or correction- the 34 was in the mid afternoon, when I maybe had a little bit of lunch novolog on board, and the 290 was in the evening out of nowhere.
Lee sent me three multiclix and some drums. After using the softclix for a month, I am very grateful for the multiclix. I keep expecting the sharp stab of the softclix and in comparison the multiclix does not hurt at all. I keep not even feeling the prick. I love the multiclix! Thank you, Lee.
Some crazy stuff is happening with insurance re:CGMS coverage. The rep still thinks that I'll be able to get coverage within a month, but I may need to wear an iPRO to prove that my blood sugar does indeed fluctuate. If I do, Medtronic will pay for the one time use of the iPRO, since my doctor doesn't use an iPRO. My rep is hoping that as a pre-existing Guardian user, I won't have to wear an iPRO. After speaking to my rep, I read a rumor that only people 25 and over will be covered. Aaeee! I'm 20. I think the rep knows that, but maybe he doesn't.
My blood sugar currently is vaccillating wildly. I don't think it's been this bad in over two years. I hit the 30s and the 290s today, and it wasn't even a rebound or correction- the 34 was in the mid afternoon, when I maybe had a little bit of lunch novolog on board, and the 290 was in the evening out of nowhere.
Lee sent me three multiclix and some drums. After using the softclix for a month, I am very grateful for the multiclix. I keep expecting the sharp stab of the softclix and in comparison the multiclix does not hurt at all. I keep not even feeling the prick. I love the multiclix! Thank you, Lee.
Some crazy stuff is happening with insurance re:CGMS coverage. The rep still thinks that I'll be able to get coverage within a month, but I may need to wear an iPRO to prove that my blood sugar does indeed fluctuate. If I do, Medtronic will pay for the one time use of the iPRO, since my doctor doesn't use an iPRO. My rep is hoping that as a pre-existing Guardian user, I won't have to wear an iPRO. After speaking to my rep, I read a rumor that only people 25 and over will be covered. Aaeee! I'm 20. I think the rep knows that, but maybe he doesn't.
Wednesday, April 01, 2009
I Guessed Wrong
You know how I said that my doctor wouldn't have the ultrasound results for at least a few days? He left a message on my answering machine that I should call to talk to him about the ultrasound. It was around 7:30 PM when I got in, and I figured I'd let it wait until morning. Da da dum...
Since he has the results so much quicker than usual, and since he called, and since he sounded pretty concerned, my guess is that something or other showed up abnormal, but I'm hopeful that it won't be anything particularly horrible.
Or maybe he doesn't have the results at all and they got lost and he's calling to tell me that I have to do it again. I don't know- but tommorow I will.
Since he has the results so much quicker than usual, and since he called, and since he sounded pretty concerned, my guess is that something or other showed up abnormal, but I'm hopeful that it won't be anything particularly horrible.
Or maybe he doesn't have the results at all and they got lost and he's calling to tell me that I have to do it again. I don't know- but tommorow I will.
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