For the first time in my life, I work for a big company. A big company which generally treats their employees well. One of the perks I get is called HealthResource, a great little benefit that basically works as a health advisory service. When I have questions, I go to them, and they give me advice and information.
Starting out with diabetes, they were very helpful right from the beginning: the nurse took a couple days, but managed to compile a great list of doctors of various types for me, including both a endocrinologist and internists. The internist was for the original problem I had gone into the doctor for to begin with: my swollen glands/nods around my neck and head.
At first glance, an internist sounds like he would be someone fetching coffee for the real doctors, but that's a real misperception. Internists specialize in Internal Medicine. This seems to make them feel like they are also specialized Endocrinologists, but don't let them talk you into allowing them to treat your diabetes - that's not their specialty as a general rule.
I was advised by HealthResource to seek out an Internist for my swollen lymph nodes, which by now had been swollen for quite some time - 6 months or so by my best estimate. After giving up yet more blood and fending off his assurances of being quite capable of handling my diabetes, he was able to recommend more doctors for the lymph nodes.
This is about the time I found out that they were, indeed, lymph nodes that were swollen. Lymph nodes carry and store lymph throughout the body, which helps your body fight infection. usually, when you find your nodes swollen, it is a sign that your body is trying to fight some kind of infection.
My internist ultimately recommended both a surgeon and a hematologist - which was really just a cover-up, I think - he didn't want to scare me with the oncologist word, but that's what he is in actuality. The surgeon was for a biopsy on one of the nodes.
My oncologist actually turned out to be a very odd sort of fellow, but very skilled. It turns out he is the Head of Oncology at my hospital. He definitely seconded my internist's desire to get a biopsy... and of course wanted more blood tests done.
The next step was the surgeon. Quite a nice fellow, not much of a personality or handshake, but those hands were rock steady. Those first two qualities don't mean much to me in a surgeon, but that third quality had me convinced he was the right man for the job.
I had hoped to convince him to just do a "needle biopsy" where they use a needle repeatedly to remove small areas of tissue from the node, but he urged that it was never as effective, and most of the time led to having to get the removal/full biopsy done, anyway. I took his word for it, and I gave him the green light to get this done.
I was still quite optimistic about everything at this point.
Wednesday, March 10, 2010
Tuesday, March 9, 2010
Beginning of the End: Beyond Diabetes
Type 2 Diabetes isn't the end of the world. It can be treated and controlled by medications, and sometimes even by just diet and exercise. What it means is that your body isn't creating enough insulin to deal with the sugars in your body. I had all the signs, and despite my ex-wife having been diabetic since childhood, I didn't recognize them: perpetually thirsty yet with frequent urination. Classically, diabetes also comes with a third symptom: weight loss, but it seems my hearty appetite was countering that - I had maintained the same weight for several years.
One of the first things that I learned first hand was the Metformin, one of the two drugs the doctor had given me, is a terrible, evil product. It's a diarrhetic, meaning it makes you poop... a lot. And the more you take, the more you poop.
After I found out I was diabetic, I called my various family members to tell them the news. Among the first was my mother, to a rather startling discovery: she, too, had just been diagnosed with Type 2 diabetes, just days before. They had put her on Metformin, and they were ramping her up to 4 500mg pills a day, where I was only put on 2 (though I also had the Glipizide.)
My mother was adopted, and so we have no family history to go on from her side of my family. (Apparently, there's a history of diabetes lol...)
So we've been able to compare notes along the way on what we'd learned and read. I had worried when I'd read about Metformin, and both of us were experiencing diarrhea. Don't use me as a scientific resource - go to About.com or your doctor, but the way I understand it is that Glipizide works to coax your pancreas into better production of insulin (which counters your sugars), while Metformin works on your stomach to more directly lower them. I stuck with the combination of medicines for a more than a week with this perpetual condition before I decided I needed to confirm what was causing the problems. Two days made it clear that it was definitely the Metformin. Diarrhea with it, none without it. I consulted my doctor, but he said to stick with it, and to come back for another visit if it persisted another week.
Living with that sort of symptom isn't easy, but work was busy, the holidays were all about me, and of course my wedding. We had family in town, things were busy. I made it through til the new year.. and then I went back. I had scheduled an initial visit with Dr. Gandhi (I know!), my endocrinologist, but endocrinologists are very busy people.. I wouldn't be able to visit him until mid-February. I will never forget the somewhat skeptical look on my doctor's face when he asked me, "Do you think you could just deal with this until then?", to which I flatly told him, "Doc, if I could deal with it any more, I wouldn't be here." I'm quite fond of retelling this story for some weird reason.
Anyway, he ultimately decided to double my doses of Glipizide and do away with the Metformin, and this worked quite well. My sugars aren't perfect, but they're doing much better, and I'm not a walking shit volcano in danger of erupting at a moment's notice.
My endocrinologist is a fine fellow, young but very knowledgeable, and I really like him. He supported my Glipizide-only doctrine, though pressed me to find myself a nutritionist.. which almost a month later, I have yet to do. Of the few I called, they were very booked, and few things annoy me more than being made to feel like someone doesn't have time for me.
Another thing I learned was to be wary of sugar-free substitutes, for much the same reason as Metformin. Splenda isn't TOO bad, but to be honest, I'm a notorious snacker, and while all the sugar-free cookies and snacks recommend serving sizes of '3-4 pieces', that's just ludicrous. 3 cookies? Riiiight. I fell in love with sugar-free wafers. Like the sugar wafers, but without the sugar. Unfortunately, some of those sugar-substitutes cause some astonishing tummy effects - my pipes were literally rattling in my stomach as they worked on that stuff.
I had to learn the hard way, I guess. Now I have to stick with Splenda-only treats, and really limit my snacking. It sucks, but I'm learning to cope.
I've kept diet sodas as my last gripe about diabetes. Before I found out that I was diabetic, I drank sugar in just about every form. OJ, soda, iced tea, chocolate milk, you name it. I didn't hesitate in switching to diet sodas, despite my previous loathing for them. I can honestly say that it takes about a week, but once you do it, you'll be glad you did. I still miss my other sugar habits like chocolate milk, but after finding out just how much sugar is already in milk (generally as much as is in the chocolate powder or syrups - and that's even in 1% and 2% varieties!), it sort of soothes it out a bit.
It took some experimenting. While I was a general Coca-cola lover in the Sugar Days, I found Diet Coke far too "chemically". Diet Pepsi is much nicer. And then I found Diet Pepsi Vanilla. OMFG it's good. I buy it in multiple 12-pack cases. I guarded it from the kids.. and then I started noticing that it was growing scarce. WTF! More and more, it's dwindled from shelves, and now it's to the point that I rejoice in a find, and buy whatever is there. I haven't found any notices that Pepsi is discontinuing it yet, but it seems plain that the writing is on the wall. :( Bastards.
One of the first things that I learned first hand was the Metformin, one of the two drugs the doctor had given me, is a terrible, evil product. It's a diarrhetic, meaning it makes you poop... a lot. And the more you take, the more you poop.
After I found out I was diabetic, I called my various family members to tell them the news. Among the first was my mother, to a rather startling discovery: she, too, had just been diagnosed with Type 2 diabetes, just days before. They had put her on Metformin, and they were ramping her up to 4 500mg pills a day, where I was only put on 2 (though I also had the Glipizide.)
My mother was adopted, and so we have no family history to go on from her side of my family. (Apparently, there's a history of diabetes lol...)
So we've been able to compare notes along the way on what we'd learned and read. I had worried when I'd read about Metformin, and both of us were experiencing diarrhea. Don't use me as a scientific resource - go to About.com or your doctor, but the way I understand it is that Glipizide works to coax your pancreas into better production of insulin (which counters your sugars), while Metformin works on your stomach to more directly lower them. I stuck with the combination of medicines for a more than a week with this perpetual condition before I decided I needed to confirm what was causing the problems. Two days made it clear that it was definitely the Metformin. Diarrhea with it, none without it. I consulted my doctor, but he said to stick with it, and to come back for another visit if it persisted another week.
Living with that sort of symptom isn't easy, but work was busy, the holidays were all about me, and of course my wedding. We had family in town, things were busy. I made it through til the new year.. and then I went back. I had scheduled an initial visit with Dr. Gandhi (I know!), my endocrinologist, but endocrinologists are very busy people.. I wouldn't be able to visit him until mid-February. I will never forget the somewhat skeptical look on my doctor's face when he asked me, "Do you think you could just deal with this until then?", to which I flatly told him, "Doc, if I could deal with it any more, I wouldn't be here." I'm quite fond of retelling this story for some weird reason.
Anyway, he ultimately decided to double my doses of Glipizide and do away with the Metformin, and this worked quite well. My sugars aren't perfect, but they're doing much better, and I'm not a walking shit volcano in danger of erupting at a moment's notice.
My endocrinologist is a fine fellow, young but very knowledgeable, and I really like him. He supported my Glipizide-only doctrine, though pressed me to find myself a nutritionist.. which almost a month later, I have yet to do. Of the few I called, they were very booked, and few things annoy me more than being made to feel like someone doesn't have time for me.
Another thing I learned was to be wary of sugar-free substitutes, for much the same reason as Metformin. Splenda isn't TOO bad, but to be honest, I'm a notorious snacker, and while all the sugar-free cookies and snacks recommend serving sizes of '3-4 pieces', that's just ludicrous. 3 cookies? Riiiight. I fell in love with sugar-free wafers. Like the sugar wafers, but without the sugar. Unfortunately, some of those sugar-substitutes cause some astonishing tummy effects - my pipes were literally rattling in my stomach as they worked on that stuff.
I had to learn the hard way, I guess. Now I have to stick with Splenda-only treats, and really limit my snacking. It sucks, but I'm learning to cope.
I've kept diet sodas as my last gripe about diabetes. Before I found out that I was diabetic, I drank sugar in just about every form. OJ, soda, iced tea, chocolate milk, you name it. I didn't hesitate in switching to diet sodas, despite my previous loathing for them. I can honestly say that it takes about a week, but once you do it, you'll be glad you did. I still miss my other sugar habits like chocolate milk, but after finding out just how much sugar is already in milk (generally as much as is in the chocolate powder or syrups - and that's even in 1% and 2% varieties!), it sort of soothes it out a bit.
It took some experimenting. While I was a general Coca-cola lover in the Sugar Days, I found Diet Coke far too "chemically". Diet Pepsi is much nicer. And then I found Diet Pepsi Vanilla. OMFG it's good. I buy it in multiple 12-pack cases. I guarded it from the kids.. and then I started noticing that it was growing scarce. WTF! More and more, it's dwindled from shelves, and now it's to the point that I rejoice in a find, and buy whatever is there. I haven't found any notices that Pepsi is discontinuing it yet, but it seems plain that the writing is on the wall. :( Bastards.
The Beginning of the End: Diabetes Mellitus
Back on December 16, 2009, I innocently went to my doctor at Patients First medical center to find out why the lymph nodes in my neck and head were swollen. The doctor was quite patient with me, but a few things got fumbled in the process. They took a blood sample, of course - doctors are the modern-day vampire. They also did a chest X-ray, which was quite clear despite my 25+ years of smoking. From that blood sample, the doctor went down a laundry list of things the lumps could be, but these essentially boiled down to three things: cancers, virus/infections, or nothing at all. He made it clear that it could be HIV, which seemed an amusing possibility given that I've been a pretty good boy for like... forever... but I let him test for it.
Now obviously, I left that night hoping for category three, but as blood results take 24 hours to return at a minimum, there was little I could do immediately. I was planning to be married on December 20th, but I diligently explained the situation to my betrothed, and we shared the worry together.
The next day at work, I got a call from a nurse at the center, informing me that it was imperative that I come back to see them immediately. Now, I work quite some distance from where I live, and where they are, so I asked him why. He explained that my blood sugar levels were more than triple what they should be, and that I was in serious danger.
I informed him of this, and that I felt fine, and I would come in that evening, but he asked me to hold a moment so he could speak with the doctor. When he returned, he was even more adamant than before: if I could not come to them, I should go to the closest ER, or even consider calling for an ambulance to take me there.
Shoving aside his lunacy, I went to see my boss, and left for the day right after lunch to return to the center. After testing my blood again, they found it even higher than before: 362, where the average level should be below 125. I asked about the other test results - namely the AIDS test, but they said they had no idea what I was talking about: somehow, the doctor had made a mistake, and they had not asked for that test.
Obviously, their current focus was now on lowering my blood sugar levels. I was officially deemed to have Diabetes Mellitus, Type 2 diabetes. I was put on medications, Glipizide and Metformin, and sent home with orders to find myself a Endocrinologist and a nutritionist.
This was a disturbing change, but it was only the beginning of the end.
Now obviously, I left that night hoping for category three, but as blood results take 24 hours to return at a minimum, there was little I could do immediately. I was planning to be married on December 20th, but I diligently explained the situation to my betrothed, and we shared the worry together.
The next day at work, I got a call from a nurse at the center, informing me that it was imperative that I come back to see them immediately. Now, I work quite some distance from where I live, and where they are, so I asked him why. He explained that my blood sugar levels were more than triple what they should be, and that I was in serious danger.
I informed him of this, and that I felt fine, and I would come in that evening, but he asked me to hold a moment so he could speak with the doctor. When he returned, he was even more adamant than before: if I could not come to them, I should go to the closest ER, or even consider calling for an ambulance to take me there.
Shoving aside his lunacy, I went to see my boss, and left for the day right after lunch to return to the center. After testing my blood again, they found it even higher than before: 362, where the average level should be below 125. I asked about the other test results - namely the AIDS test, but they said they had no idea what I was talking about: somehow, the doctor had made a mistake, and they had not asked for that test.
Obviously, their current focus was now on lowering my blood sugar levels. I was officially deemed to have Diabetes Mellitus, Type 2 diabetes. I was put on medications, Glipizide and Metformin, and sent home with orders to find myself a Endocrinologist and a nutritionist.
This was a disturbing change, but it was only the beginning of the end.
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