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.
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.
Tuesday, March 31, 2009
Update on Abdominal Agonies
The stomache pain has faded but isn't gone.
I saw the endo last week, and he did some bloodwork (electrolytes, white blood cells, etc), although I don't know the results. He gave me two bottles of Nexium40 samples, which should help if acid is the problem, but they don't seem to have made any difference thus far.
I had a gallbladder ultrasound this morning, where a student of some kind (with supervision) took pictures of my gallbladder, liver, and pancreas. I asked if the pacreas looks normal in diabetics, and the supervisor said yes. I wonder if I can get a copy of the picture of my pancreas. That would be cool. The doctor won't have my results from the ultrasound all that soon, and I won't have the results any sooner than he will, so I'm guessing that I'll have no more news on that topic for a few more days.
I saw the endo last week, and he did some bloodwork (electrolytes, white blood cells, etc), although I don't know the results. He gave me two bottles of Nexium40 samples, which should help if acid is the problem, but they don't seem to have made any difference thus far.
I had a gallbladder ultrasound this morning, where a student of some kind (with supervision) took pictures of my gallbladder, liver, and pancreas. I asked if the pacreas looks normal in diabetics, and the supervisor said yes. I wonder if I can get a copy of the picture of my pancreas. That would be cool. The doctor won't have my results from the ultrasound all that soon, and I won't have the results any sooner than he will, so I'm guessing that I'll have no more news on that topic for a few more days.
Wednesday, March 25, 2009
Abdominal Agonies
I've been in abdominal pain of various levels of severity since Thursday evening, and it is now Wednesday morning. The pain has woken me up every night, I've spent over an hour each day (and more than six hours on some days) in the kind of agony that shuts out everything else, the rest of the time being in pain but not so bad that I can't walk or shelve or dress a loom or go to a museum.
I have not thrown up (though some weird gobs came up to my throat). The pain itself has sent my blood sugar up, as much as 300 points in under an hour. The abdominal pain doesn't seem to be caused by food, although eating sometimes makes it a little bit worse- but not eating doesn't help, I haven't thrown up, and it's been six days so I don't think it's the food.
This morning, after waking up in pain and spending an hour rolling, pacing, thrashing, rocking, etc, I asked my mother whether she thought I should see one of my usual doctors or a regular internist or a gastroenterologist, and she suggested my endocrinologist, so in four minutes, when his office opens, I intend to make an appointment for this morning, tommorow evening, or Friday. I've packed in case the visit results in a hospitalization (my mother the MD thinks it may be a gallbladder stone, and I keep wondering about appendicitis). I decided not to take the Lantus with me, but I labeled it in the fridge so that my parents will be able to locate it if I need them to.
I have not thrown up (though some weird gobs came up to my throat). The pain itself has sent my blood sugar up, as much as 300 points in under an hour. The abdominal pain doesn't seem to be caused by food, although eating sometimes makes it a little bit worse- but not eating doesn't help, I haven't thrown up, and it's been six days so I don't think it's the food.
This morning, after waking up in pain and spending an hour rolling, pacing, thrashing, rocking, etc, I asked my mother whether she thought I should see one of my usual doctors or a regular internist or a gastroenterologist, and she suggested my endocrinologist, so in four minutes, when his office opens, I intend to make an appointment for this morning, tommorow evening, or Friday. I've packed in case the visit results in a hospitalization (my mother the MD thinks it may be a gallbladder stone, and I keep wondering about appendicitis). I decided not to take the Lantus with me, but I labeled it in the fridge so that my parents will be able to locate it if I need them to.
Monday, March 09, 2009
Lantus formats
11 days ago, I mailed in a prescription for Lantus penfils. Yesterday I got an automated phone call that there'd been a problem with my order but that it would ship in a couple of days. Today my mother conveyed a message from my endocrinologist; the pharmacy called him to ask if I wanted the Solostar or Opticlix. I'm supposed to call him and tell him. Of course, I want the Opticlix because that's just plain insulin cartriges; the Solostar is an actual disposable insulin pen. I mean, I could draw the insulin from that too; but it doses in full units only, requires more force than I want, and isn't known to be accurate.
I am sooooo impatient for my supplies to come!
I am sooooo impatient for my supplies to come!
Sunday, March 08, 2009
Waiting for the Shipment
I am waiting for the new supplies. Anxiously. It was time to use a new thing of Lantus last week but I was hoping to start on the new penfills (I'm not switching to a pen, it's just that I hate wasting the stuff), so I waited. But I changed Lantus vials today. It was really time for that.
I'm no longer upset about the 6.9 A1c because I've figured out that the higher hemoglobin level probably caused the rise. It's okay. If it was just a tad higher, insurance might care because I'd be "uncontrolled" but for insurance purposes, the difference between the 6.4 I expected and the 6.9 I got doesn't exist. And I know perfectly well what my blood sugar average is without an A1c to tell me. I am somewhat concerned about the high hemoglobin level now that I've read more about it, but I'll be sure to talk about it at my next appointment in another two and a half weeks. Maybe I'll have a fructosamine drawn while I'm at it.
When my supplies come (from Prime Mail Pharmaceuticals, btw), I'm sure I'll take pictures and post them. In the meantime, here are some of my thoughts.
Tip: Always get your endo to write prescriptions for more than you need. Your needs may increase between now and when you next get scrips, it might take the pharmacy too long to fill your order- whatever. More is better. This is particularly true for the insured.
Tip: For drugs other than narcotics and anabolic steroids and stuff like that, prescriptions are generally good for twelve months. The doctor can check a little box that says you get to refill and he can either write in a number of refills or check unlimitted refills (I get unlimitted refills on glucagon and limitted on the rest of my stuff).
It's possible that it's your insurance's fault if you have to resend prescriptions every 6 months.
Tip: Prescriptions will be kept on record by most mail in pharmacies and walgreens, so you'll only need them once, but you can get your doctor to write two versions if you think you'll switch pharmacies.
Tip: Get the NDC or a very exact description on the prescription itself if you use a mail in pharmacy; otherwise you may get something that wasn't exactly what you want. For example, a couple of years ago I got a prescription for pen needles. I wanted BD 5mm pen needles, which are preferred by my insurance; the mail in company sent me 6mm novofine needles, which are not preferred by my insurance and are longer besides.
Also, have the doctor check that no substitutions are allowed!
Tip: If you use a mail in pharmacy, avoid ordering in December. The mail is way too slow.
Tip: Complain to the pharmacies if you need to. They replace stuff.
Tip: If you use a mail in pharmacy and they send you insulin, you'll never need to buy an ice pack again. Save the ice thingies.
Tip: The labels that are on your boxes of prescription items have details that the pharmacy will want next time, and they also count as prescriptions for police and airline security purposes. Don't lose those labels! If the pharmacy prints your name wrong on them, get them to give you new labels. Walgreens gives me labels than say "John" instead of "Jonah" most of the time, then put on a new label with my actual name after I complain.
I'm no longer upset about the 6.9 A1c because I've figured out that the higher hemoglobin level probably caused the rise. It's okay. If it was just a tad higher, insurance might care because I'd be "uncontrolled" but for insurance purposes, the difference between the 6.4 I expected and the 6.9 I got doesn't exist. And I know perfectly well what my blood sugar average is without an A1c to tell me. I am somewhat concerned about the high hemoglobin level now that I've read more about it, but I'll be sure to talk about it at my next appointment in another two and a half weeks. Maybe I'll have a fructosamine drawn while I'm at it.
When my supplies come (from Prime Mail Pharmaceuticals, btw), I'm sure I'll take pictures and post them. In the meantime, here are some of my thoughts.
Tip: Always get your endo to write prescriptions for more than you need. Your needs may increase between now and when you next get scrips, it might take the pharmacy too long to fill your order- whatever. More is better. This is particularly true for the insured.
Tip: For drugs other than narcotics and anabolic steroids and stuff like that, prescriptions are generally good for twelve months. The doctor can check a little box that says you get to refill and he can either write in a number of refills or check unlimitted refills (I get unlimitted refills on glucagon and limitted on the rest of my stuff).
It's possible that it's your insurance's fault if you have to resend prescriptions every 6 months.
Tip: Prescriptions will be kept on record by most mail in pharmacies and walgreens, so you'll only need them once, but you can get your doctor to write two versions if you think you'll switch pharmacies.
Tip: Get the NDC or a very exact description on the prescription itself if you use a mail in pharmacy; otherwise you may get something that wasn't exactly what you want. For example, a couple of years ago I got a prescription for pen needles. I wanted BD 5mm pen needles, which are preferred by my insurance; the mail in company sent me 6mm novofine needles, which are not preferred by my insurance and are longer besides.
Also, have the doctor check that no substitutions are allowed!
Tip: If you use a mail in pharmacy, avoid ordering in December. The mail is way too slow.
Tip: Complain to the pharmacies if you need to. They replace stuff.
Tip: If you use a mail in pharmacy and they send you insulin, you'll never need to buy an ice pack again. Save the ice thingies.
Tip: The labels that are on your boxes of prescription items have details that the pharmacy will want next time, and they also count as prescriptions for police and airline security purposes. Don't lose those labels! If the pharmacy prints your name wrong on them, get them to give you new labels. Walgreens gives me labels than say "John" instead of "Jonah" most of the time, then put on a new label with my actual name after I complain.
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