posted by
malnpudl at 09:42pm on 28/08/2013
Very full day! I haven't even answered comments from yesterday yet, and I've been trying to keep up the discipline of doing that before doing the new day's post -- but I'm taking it out of order today, just this once, because I got very little sleep last night (the neighbors are weaning calves, I think? much bovine hollering all night long; such angst and woe, you cannot imagine) and may crash very early tonight.
Day 5 post, I guess, is going to be Mal's medical update, which I imagine the majority of y'all will skip on by, and I can't say I blame you. I'll work on being more interesting tomorrow.
Saw primary care doc, he of fewest possible words and briefest possible office visits while still giving competent care, for 3-months diabetes check-up. I'm two years and a few months post-diagnosis, and after the initial phase of slowly coming down from blood sugar readings in the 375-425 range (yikes!) right after diagnosis to the 90-130 range that's my target, today marks right around 18 months of "excellent" blood sugar control. During that time, my A1C levels have all been between 5.9 and 6.1, which has my doc delighted if slightly astonished, if I'm reading him correctly. He's used the word "perfect" more than once.
Less sparkly news is that I've had pins-and-needles prickling first in the feet and more recently the lower calves (pretty much the area that a sock would cover) for about five months. At this point it's 24/7, if I pay attention to the sensations, but I'm usually only really aware of it at night while trying to fall asleep. The weird thing -- seriously, I perplexed my doctor, got the full forehead crinkle out of him, and he's not an expressive guy -- is that when he does the special-pokey-filament test on the soles of my feet, I can feel every poke at every spot on both feet. With diabetic peripheral neuropathy (the presumed culprit in my pins-and-needles, which are a typical symptom), apparently the diabetic person will normally lose fine, pinpoint sensation in the feet and fail the pokey-filament test before developing any of the prickling stuff. I'm doing it backwards.
So my doc is going to "do some research" and see if there are any tests I ought to have to find out what's going on with my nerves. No clue what those might be. Not sure what would happen as a result of whatever might be found; I think the only options are in medications, but I certainly can't swear to that. I asked if there were any proactive things I could/should do or not do in the mean time (exercise, for instance). Not really, he says, aside from "Don't injure your feet, don't wear tight shoes or get blisters, and don't do things that make the prickling worse." So pretty much exactly what I'm already doing. All righty, then. Though I must admit it tickles me to be wearing nothing but Birkenstocks or shearling slippers on doctor's orders instead of just because they're comfy and my feet are happy in them. (I have always been willing to trade pretty for comfortable. Always.)
Wish me quiet cows tonight. *cross fingers*
Day 5 post, I guess, is going to be Mal's medical update, which I imagine the majority of y'all will skip on by, and I can't say I blame you. I'll work on being more interesting tomorrow.
Saw primary care doc, he of fewest possible words and briefest possible office visits while still giving competent care, for 3-months diabetes check-up. I'm two years and a few months post-diagnosis, and after the initial phase of slowly coming down from blood sugar readings in the 375-425 range (yikes!) right after diagnosis to the 90-130 range that's my target, today marks right around 18 months of "excellent" blood sugar control. During that time, my A1C levels have all been between 5.9 and 6.1, which has my doc delighted if slightly astonished, if I'm reading him correctly. He's used the word "perfect" more than once.
Less sparkly news is that I've had pins-and-needles prickling first in the feet and more recently the lower calves (pretty much the area that a sock would cover) for about five months. At this point it's 24/7, if I pay attention to the sensations, but I'm usually only really aware of it at night while trying to fall asleep. The weird thing -- seriously, I perplexed my doctor, got the full forehead crinkle out of him, and he's not an expressive guy -- is that when he does the special-pokey-filament test on the soles of my feet, I can feel every poke at every spot on both feet. With diabetic peripheral neuropathy (the presumed culprit in my pins-and-needles, which are a typical symptom), apparently the diabetic person will normally lose fine, pinpoint sensation in the feet and fail the pokey-filament test before developing any of the prickling stuff. I'm doing it backwards.
So my doc is going to "do some research" and see if there are any tests I ought to have to find out what's going on with my nerves. No clue what those might be. Not sure what would happen as a result of whatever might be found; I think the only options are in medications, but I certainly can't swear to that. I asked if there were any proactive things I could/should do or not do in the mean time (exercise, for instance). Not really, he says, aside from "Don't injure your feet, don't wear tight shoes or get blisters, and don't do things that make the prickling worse." So pretty much exactly what I'm already doing. All righty, then. Though I must admit it tickles me to be wearing nothing but Birkenstocks or shearling slippers on doctor's orders instead of just because they're comfy and my feet are happy in them. (I have always been willing to trade pretty for comfortable. Always.)
Wish me quiet cows tonight. *cross fingers*
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*hugs you*
Please to keep after them about this?
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Thanks for the hugs. :-)
And yes, I will definitely be proactive -- and, if necessary, politely pushy -- though my doc said I'd probably hear from him about whatever his research turns up, as he may well be ordering some tests -- long before my next 3-month blood work check-up.
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Wishing you less miserable calves in the vicinity, too.
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I owe you an e-mail; hopefully I'll get to that tomorrow. It's been a very busy few days!
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Yes. Yes there was, but it was unintended. *facepalm*
No hurry with the email. : )
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HOLY SHIT!! Uh, yeah, he is astonished. I can't even...I've NEVER had a patient actually make that kind of blood sugar goal and maintain it for any length of time. Most of my 2 year old diabetics are hovering around 8-10, with a few who are hanging out at 13 still. You're a rock star!
Less sparkly news is that I've had pins-and-needles prickling first in the feet and more recently the lower calves (pretty much the area that a sock would cover) for about five months.
If you're interested in unsolicited medical advice from the internet, this really doesn't sound like diabetic neuropathy - you'd loose sensation before the pins and needles set in, and at an a1c of 6 and only 2 years post diagnosis, it's extremely unlikely you're having that kind of complication. If it's on just one foot, or only parts of your feet, I'd think nerves in your back. Both feet all over, and I'm wondering if it's more like B12 deficiency. IMO, he really ought to do some blood work and xrays and send you to neuro for evaluation before just shrugging off new onset nerve issues in someone without an obvious reason to have developed them and just treating with meds. I hope you guys find a cause.
May the cows be quiet tonight! *hugs*
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Must admit, the probiotics discovery has been an ENORMOUS help. I take Metformin with breakfast, a dose of probiotics with lunch, and Metformin again with dinner, and nothing ever spikes me significantly over 130 unless I've done something really stupid with food choices or quantities. I didn't know the probiotics would do that, but it's incredibly consistent. My doc hadn't heard of the effect before, but was unsurprised, said it makes sense given recent research on gut flora, and since it works, keep doing it.
I am very much interested in medical advice from you! You may consider it an open invitation (though not an expectation); feel free to chime in on anything, any time, should something ping you.
It's interesting you mention a nutrient deficiency. I'd fallen out of the habit of taking vitamins; I don't even remember when I stopped, it's been that long. More than a year, anyway. And the whole depression/inertia thing means my diet is never great (though it's better in summer with more quick and easy fruit and veggies). I should try taking them again, see if anything changes. Can't hurt, might help?
FWIW, he does the all-around blood test thing annually, and the last time was very early this year. Not sure what it would or would not have revealed.
Hmmm... I hope I don't need a referral to neuro, because it's unlikely we have one up here in Humboldt County. I'd probably have to travel at least a four-hour drive, maybe all the way down to the Bay Area. (My friend Suz has made many such trips, often with me to help parse the jargon and keep her company.) Tiresome and expensive. *sigh*
Anyway, thank you so very much for your thoughts! I value and appreciate them very, very much. <3