Not Before You're Ready

My husband, Steve, and me at our son's recent graduation from his trade program. | 4 February 2016

My weight has been a struggle for, well, the past thirty years. Except for the periods when I have been pregnant*, dieted, or have gone on obsessive exercise binges, I have gained weight at approximately half a pound per month. I have an appetite that will not quit, and I have never found an exercise program that made me happy.

Well, over the past few months, a few things have conspired to push me to the point of readiness to make some changes.

Feed me, Seymour!

Poor Audrey II (the voracious blood-eating plant from Little Shop of Horrors). I completely identify with her/his appetite. Mine is insatiable. Truly. I can -- and have eaten a full turkey dinner with all the fixings while nursing an infected throat and then, half an hour later, wolfed down pie à la mode.

These boots are made for walking!

Brand new boots!

Never in my life have I walked so much in snow. Or, at least, not that I remember.

It is possible that I had better boots in my early years, when I was dependent upon shanks' mare for transportation. Though I contend that Ottawa gets more snow than either Burlington (where I grew up) or Kingston (where I went to university).

Pill Poppin'

Every morning (plus an injection)

It all started with an antidepressant. For more than a decade, I've taken Zoloft every morning. There have been periods when I've tried going off Zoloft or have tried other antidepressants or have supplemented with others, but Zoloft is the one that I've come to accept will never go away.

Then I was diagnosed with diabetes, which put me at the same risk for a heart attack as someone who has already had one. So I started taking a tiny pill for high blood pressure another one for cholesterol, neither of which were too high, but we were taking precautions. And a baby Aspirin.

And three years later, my diabetes kind of went crazy, so I went on Metformin.

And it progressed to this:

Morning and bedtime

Or, another way of looking at it:

Prescriptions on the left, non-prescription on the right.

Yah, I feel old.

Here's what you're looking at:

Prescription

• Metformin for blood sugar
• HCTZ for blood pressure
• Zoloft for depression
• Simvastatin for cholesterol
• Tecta for reflux
• Victoza (an injection) for blood sugar

Non-prescription

• Vitamin D for depression
• Vitamin B12 for depression (I think. Or it may be for memory loss.)
• Ibuprofen for bursitis
• Claritin for allergic rhinitis (to reduce the number of sinus infections I get)
• ASA to prevent heart attack

It's gotten to the point that filling my pill boxes takes about ten full minutes once a week. Actually taking the morning pills has to be done in two handfuls.

It sucks, but it's part and parcel of having a chronic illness. The alternative is even less appealing.

Lamentations of Wynn Anne

Empathetic kitty waved her tail in my face
while I lay prostrate with neck pain.

Aching joints and arbitrary pain
Beat me down to bed again,
Clinging to pillow and
Downy coverlet.
Eager for relief I reach for
Futile pills and unguents. They
Guarantee naught but prolonged days.

Hark, Lord!
I call to thee!
Jesus, lift me from this place!
Kneel beside my weakened form and
Lift me with your gentle arms.

Migraines wrack my pounding brain,
Nausea slams me back again.
Over and over and over -- the same.
Pulsing lights and empty hours spent
Questioning the whys and hows of
Redemption and of peace.

Sleep is sweet, while it lasts, until
Tomorrow comes with mounting bills.
Undone by stress and marching time, and
Vomit flung at importune times.
Weary am I,
X-hausted [Seriously? Ed.] by these
Years. I last, but rather would have rest, my
Zest for life eroded by this dolor.

---

Well. That sure was a miserable bit of poetry! I must add a few notes.

1. I am not depressed. I have struggled with this in the past, and will undoubtedly do so again, but I am not now (despite the tone of this post). I'm just frustrated and am indulging in a little visit to "Pity City."
2. My body has been dragging me through the sloughs of misery: anxiety attacks, worsening migraines, and various joint ailments have plagued me these past few weeks. Not to mention the diabetes that is my constant companion now.
3. The verse above is a rather sloppy acrostic of the Roman alphabet. (My poet friends will cringe while reading, no doubt.) I chose the title of this post before I started writing it. In doing "research," I learned that the Book of Lamentations in the Bible is written (mostly) in acrostic form, using the letters of the Hebrew alphabet to begin each line. I thought it gave a nice structure to this post.

Despite my lamentations, I have woken this morning (mostly) pain-free, without nausea or flashing lights.

Premature Aging

How old is she really?

According to our veterinary records (based on exams when she was first adopted in 2007), Elly's estimated date of birth is May 2006, which pegs her at six-and-a-half years old. Her body, however, seems to think it's much older than that. I offer as evidence:

• gum disease and dental decay (feline stomatitis)
• bone spurs (arthritic hips and spine)
• kidney failure

Poor thing. 

I sympathize with her. 

A year ago, I remarked that I felt I was "time expired." That post was well before I realized my diabetes was out of control and that migraines would become a routine event. Before I turned 50.

Which brings us to last week: I went for CT scan to see if my frequent migraines were a harbinger of something more sinister, like strokes or a tumour [gasp!] pressing on the optic nerve. [What? Are you saying you wouldn't have googled it?]

Imagine my surprise when my doctor's office called me on Monday and said the doctor wanted to go over the results of said scan with me. 

Bad news. It is never, ever a good thing when the doctor wants to see you, rather than the other way around.

Short story: I'm old.

Long story: the CT scan showed "micro-vascular changes." The blood vessels in my brain are on a weight-loss diet, which would be great, except that it means they aren't able to carry so much oxygen to the brain. My doctor, who is in her early thirties, said, "We wouldn't expect to see this kind of thing until you're about 70."

Seventy? 

She went on to say that this is likely because of my diabetes, which causes all sorts of systemic failure . . . in the heart, the kidneys, the nerves, the retinas. Especially if said diabetes is uncontrolled, as mine was for about a year. 

A year, folks, not a decade. And I've been quite conscientious about taking care of myself (as long as, you know, exercise isn't involved ).

The doctor says no follow-up is required, in the way of testing. But you know, and I know, that the only way to increase vascularization (blood flow) is exercise. It would appear that I have a 20-year deficit. Damn. I may have to start taking the bus to work. 

Wake-up Call

I was diagnosed with Type II diabetes, oh, three or four years ago. At first I was panicky, and tested my blood sugar several times a day, only to find that it was really fairly stable. It would spike after a meal, but then gradually settle down.

As a little background, here are some numbers for everyday blood sugar:

Description		Max mmol/L (units used in Canada and the UK)		mg/dL (units used in the US)
Normal		<6		110
Target for diabetics		<7		130

At the time of my diagnosis, my fasting results ranged from 90 mg/dL to about 150 mg/dL. Eventually, I saw an endocrinologist who suggested that I could probably just test my blood once or twice a week. Which, in my case, translated into "never."

Because, whether I like it or not, I am a creature of habit. If it doesn't happen every single day, it is likely never to happen at all. (Except Tiramisu, which I will take at random intervals.)

Then we moved back to Canada and finding a good family doctor was a pain. I visited our old family doctor who wasn't too concerned and suggested I check in once a year for an A1C test. (A blood test that gives a 2-to-3-month snapshot of what's going on with your blood sugar.) A healthy A1C is below 6.5%. Mine was about 7%. So, high, but not scary.

My diabetes was considered "diet-and-exercise controlled." Which, if you know me, translates to "Really not controlled at all. Pretty much random. Might just as well prepare some burnt offerings."

About six months ago, I thought I should probably start monitoring my sugar again. But I procrastinated. My old test strips were expired; my old monitor used U.S. units, not Canadian. I was feeling okay, and my doctors didn't seem too concerned ...

Well, today, I finally got around to buying a new monitor and test strips. Because I like playing with new toys, I immediately tested my blood.

My jaw just about hit the floor when I saw the result on the monitor.

That's 19.5 mmol/L = 351 mg/dL

I had NEVER, EVER had results that high. And I didn't feel ill. (Well, except for the constant thirst and the continual emptying of the bladder ... but those are also side effects of some of my meds and, um, middle age, right?) But there is no arguing with the meter. Yes, I tested again just before lunch because ... neurotic! The number had fallen to 13.4 mmol/L. Still not good.

For the record, I had not had a heavy "binge" the night before, and I'd only had a PB&J sandwich with coffee for breakfast.

I couldn't believe my pancreatic health had gone from "worrisome" to "we are having an emergency" in one short year.

To further feed my neurosis (and because I had just "broken up" with my old doctor so that I could  get a better one, and because the better one had not officially accepted me as a patient, so I was stuck in limbo as to OHIP-covered lab tests), I purchased an at-home A1C test.

These are a relatively new thing in Canada, and I'm sure the medical labs all scoff at their reliability, but I very carefully followed the instructions. My A1C was 9.6%.

In the orange zone.

Suddenly, this shit got real, in a way that the original diagnosis never did. It's time to give that diet and exercise regime a serious effort. Cuz the burnt offerings aren't working.

Crap.