Thursday, December 14, 2006

A DIABETIC DIARY, Part Two


Tuesday night, I went to the clinic for my blood test results and an official diagnosis on the diabetes. Gulp. I was not looking forward to the inevitable bad news. I sat patiently in one of those "holding" rooms the nurse stuffs you in to wait for the doctor. Why does it seem to last for hours before their grand entrance?

"Hello. I am Dr. Chan." That was as friendly as he got. He had the bedside manner of a Gestapo agent. Oh well, perhaps his manner was correct, given the somber news he was about to tell me. He scanned over the report and circled the (Comprehensive Metabolic Panel w/EGFR) glucose number. It was 182. That is the fasting number and 65-99 is what to aim for. He went to the second page and circled the Hemoglobin A1C number. Less than 6 is ideal. Mine is 8.0.

"You are a diabetic." He proceeded to give me strong directives. "You can eat all the fruits and vegetables you want. Do not eat coconut. No butter. Only poly and mono-unsaturated oil. NO SUGAR! Eat more fish. Avoid shellfish. Shrimp. Lobster. Cut all fat off beef. No chicken skin. Drink lots of water."

"What about cheese?"

"Follow this order," he said sternly. "Zero, zero, zero. That means you only eat things with 0% saturated fat, 0% trans fat and 0% cholesterol. Two egg yolks a week only. EXERCISE, EXERCISE, EXERCISE!!! You must eat 3 meals a day. You may have small snack in between." Protein is essential at each meal.

"What about salt?" I never put salt on anything, anyway.

"You don't worry about salt. Why you take Lisinopril?" Lisinopril is a BP med, an ACE inhibitor. "You don't need."

"Kelly, the Physician's Assistant wrote me the prescription two weeks ago when I was here. She told me it was to protect my kidneys from damage. She..."

"It does not help your kidneys. You don't need it."

"What should I do? Should I finish or stop taking it?"

"I don't care. You do what you want."

"But... but?"

"I don't care. You do what you want."

"She also told me I will have to go on a cholesterol drug."

"You may. We see when you come back. OK. Sit on table." He listened to my chest and heart. "We do another blood test. You wait here for nurse." And off he went. She came in a few minutes later and asked how things went.

"Well, he certainly laid it on the line. No messing around with Dr. Chan."

"Nope." She handed me the diagnostic test request for lipids and glucose. Oh, I have to pee when I go. He wants that, too. She gave me a prescription for Glucotrol. Typical doctor handwriting. I have no clue how pharmacists decipher that chicken scratch. Minus the skin, of course. I went across the hall to make an appointment a month from now for those results. It will be up to me to schedule the lab work. They only need a 24-48 hour turnover time. That will be my final visit to this clinic. I will need to find another doctor. For the rest of my life, I will need to take this medicine (or, eventually, insulin), test my sugar twice daily and have the A1C test done every 3 months. The test strips run about a buck apiece. This is not going to be a cheap disease, especially without insurance.

My platelet count is down. The normal range is 140-400. Mine is 102. He wasn't too concerned about that. He talked about my cholesterol level. The ideal number is below 200. Mine is 213. HDL (the good kind) is 41. That's good. LDL (the bad stuff) is 134. Not good. It's supposed to be less than 130. My triglycerides are high. 190. Less than 150 is best. My bilirubin is high. That's got something to do with the liver. Other than that, I checked out pretty good.

Last week, I was IMing with by best and oldest friend. He said it was from all those beers and pizza. Cheap women, too. I told him I haven't had a beer in a long time. Up until today, it was Bacardi & (DIET!) Coke. I typed in that it was from all those years working at the Weiner King, eating all those hot dogs, hamburgers and french fries. Who would think back then that all that junk would take its toll? How was I to know my mother and her sister would get it and be insulin-dependent? That's something we don't think about when we're young. We're going to live forever and never get old. I said it's also from all the trans fat that's in everything today, something food manufacturers have known will kill you for years.

This morning, I popped my first pill. I chose a generic brand because it's a lot cheaper. Glipizide ER 2.5mg. It is an anti-diabetic drug (sulfonylurea-type) used to control high blood sugar in patients with type 2 diabetes. It's meant to stimulate the release of natural insulin. With a proper diet and exercise, hopefully it will work. It's supposed to help prevent heart disease, strokes, kidney disease, blindness, and circulation problems, as well as sexual function problems (impotence). I'm waiting.

I would like to thank my family and friends for all the support they have given me. I also want to thank David W. Boles at Urban Semiotic and his dedicated legion of loyal readers and contributors, like Chris and Nicola. I especially want to thank fred for being such a caring person. He has helped me a lot by proffering some much needed advice. Many of the comments can be read here and here.

2 comments:

  1. It is a bit of a shock when they are that direct.

    If you have a questions or alternativ view points I can point you in the direction of a considerable group of people I know who also differ from various forms of the condition.

    What I would advise if you can afford it is is to keep dulpicate kit ot testing / injecting if you have to and your meds. Have a home pack and a travel pack. The travel pack should be split into two , one in hand luggage, one in amin luggage. On arrical have one set with you and leave anotehr set in the hotel.

    (A female friend of mine was mugged in Paris last week with 95% her kit in her bag - they had to go beg needles from Paharmacy and left early so they could stabilise her properly at the airport medical centre.)

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  2. Thank you so much, Nicola. Sure, if you want to point me out to some of your connections, I'd be happy to listen to what they have to say. In spite of the fact that my mother has been diabetic for 25 years now, and I have learned a lot about the disease, having it kind of befuddles me somewhat. I wonder how long it will be before I start feeling better, for example. Some people still eat butter, too. Should I try to heed his advice to a tee?

    Right now, I am not on insulin, so I don't have to carry that and needles around with me. I use the same test kit that my mother owns. Of course, I switch out the little needle pricker thingy. Eventually, I will have to get my own. I will have to start carrying candy or glucose pills from now on. I've never been much of a candy eater, though. Well, chocolate, but that will melt.

    Thank you, again. I appreciate your thoughts and input.

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