I am doing the best that I can

Wednesday, January 01, 2020

I wrote the below in November.  Egad, did I ever feel rotten. My lipase has started to come down and I am due for more tests in the next couple of weeks here in January 2020.  My body finally succumbed to the onslaught of insulin with the addition of an insulin sensitizer.  I am seeing fasting glucose numbers of 90 in the morning. 

It isn't pancreatic cancer, not that we can see from any of the million scans, blood draws or ultrasounds.  That, I think, was the first fear. Was my pancreas shutting down/eating itself because of a tumor or malignancy? That doesn't seem to be the problem but we still don't know just why all of this is happening. The tests continue.

As I head into my fifth decade, I have become acutely aware of my fragility. I know it sounds cliched, but I never considered aging. Not like this.  I knew, of course, that I was aging but the failure of my body was truly unexpected. My perimenopausal body bucks and kicks against it's confines, shocked at the ways in which I used to be effortlessly strong or renewable. 

I have spent the last two weeks of December 2019 ensconced in bed, reading and recharging.  It is almost time to begin the march to the beginning of the Spring semester and I am nearly ready.  I face this new decade with more humility than I have ever felt in my entire life. 

The beauty of youth is the sense that you are infallible, that you know everything and that the older adults in your life simply do not know of what they speak. That is a state of grace that allows youth to do amazing things, outside of what is considered possible.

The strange beauty of looking at 50 is that I am deeply aware that I know nothing and that I am crushingly mortal. 

I am doing the best that I can, and that is more than enough.

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It's been a rough year, friends.

The kidney failure knocked me off of my axis for quite a while.  My summer was strange and I found I couldn't work as hard or as long in the garden as I had in previous summers.  I would get really tired after only two hours. I know - two hours! But that was far less than in summer past.

I was coping well with everything and have found myself to be more easy going about many things.  Some of that is age, I think. I am 49. I have tenure. My kid is in year 3 of college.  I have a cat who loves me.

Other things, though.

My knee hurts at odd times. It occasionally crosses my mind that heels aren't a super idea, but I push that thought WAY down deep since there is no way that I am not wearing the heels. Seriously. You will find my cold, dead broken ankled body before I give up the heels.

I was put on half the dosage of Metformin after the kidney fiasco. We supplemented that with a different med that was doing an OK job at controlling my blood sugar. I felt ...fine, I guess. Always really, really thirsty but I assumed that it was part of my kidney recovery.

In August, we spent some time in Cape Cod. We try to do a couple of weeks vacation before we launch Emily back to college.  Early in the week, I felt just awful. My stomach was in agony. I wrote it off to eating as if I was on vacation - you know minimal vegetables, lots of sugar and fried things. I dispatched Terrance for some Zantac ( since Prilosec is now on the "apparently can fuck a kidney" list).

Oof. It was bad. We would try for little trips, but I would have to cut us short because of the discomfort I was having.  We did make it through the Edward Gorey House, which made me happy.

As I am a trooper, I just take medication  and just suck it up.

This, gentle readers, is a mistake we can all see, right?  Dawn's body is flagging her down. Dawn says "It must be a virus" and keeps going. Dawn's body eventually falls apart.

Now, in my defense I now know kidney failure. I know the signs and the symptoms. There are NO signs of kidney failure. No pain. No ibuprofen use (sob). I am urinating just fine and as copiously as always.  Ergo, it must be a virus.

We drop Em off to college. We go home. I get ready to start the semester.  Boy, my stomach isn't feeling better. Still hurting all the time.  Like ALL the time.

By week three of the semester, I finally acquiesce and make an appointment to see my doctor.  The day before the appointment, I felt a little better and thought "Hmm, I should just cancel. It WAS a virus."

The morning of the visit, I was vomiting. And I was dizzy.  These are the exact things  I ignored before the kidney failure.  "Shit.", I think.

I get to the office.  My patient doctor is like "What the actual fuck, Dawn?" (not her exact words) and begins to order tests. I am to have blood taken and sit there in case my creatinine is rising and I have to be hospitalized again. "Oh shit," I think some more.  Now I am going to have to tell Terrance.

I text Terrance: "Have to have some blood tests. Will know more soon!" I resist throwing in smiling emoticons, hoping my exclamation point = careless optimism

The phone rings. It's Terrance. He is on his way. I attempt to protest. He ignores me.

We sit for an hour, waiting. As we sit there, a tech enters the room and states:  "I am supposed to start an IV on someone in this room."  I am confused and scared. "Are you?", I stammer.  "Are you sure?"

She leaves and I start to cry. "I was doing everything right! No ibuprofen. I can't drink any more water! There was no kidney pain at all!"

Terrance pats my arm.

My doctor comes in. My creatinine is actually great! I stare at her. I explain about the tech.  She laughs. No, that was a mistake, not for me.

BUT my lipase is through the roof!  What is happening with my lipase!

It seems that I had an acute pancreatitis attack in August. You know, no big. I am, it seems, continuing to have a lesser pancreatitis attack.

Do I fit the profile for a person to have pancreatitis? No, not at all!

Thus began the mystery of why Dawn's pancreas has decided to eat itself! As part of this mystery, we have had to take me off of all my diabetes medications, then retry things, then re-test my blood to see what is happening in Dysfunctional Pancreas Land. ( don't vacation there)

I've made friends with the lab techs since I see them every week.  I give informed and specific notes on where the best vein to hit might be, since I have fussy veins and I can now predict where they will hit best. I try to drink a full bottle of water before a blood draw because it plumps my stubborn veins up a bit more.

By October, this mystery had not abated. In fact, it had gotten weirder and more puzzling.  I am sent to an endocrinologist.  We go off the other diabetes agents, as they may irritate the pancreas. I am to try a tiny bit of Metformin for a week. Then another blood draw.

Now, my blood glucose levels have been atrocious since August. For reference, a diabetic should have numbers of about 180 at their 2 hour post meal test.  You should wake up and see a number at or under a 120 fasting blood glucose.  HAHAHHAHHHAHAAHA!

Waking up in the morning and having a fasting BS of 200 starts your day off on a shitty trajectory.  It means that anything I eat is going to send me spiraling up into the 300's.  When I am under-medicated, my glucose doesn't fall. I will get to 297 after dinner and then STAY there for 5 or 6 hours.  Last night, for instance,  when I ate at 5 p.m. I was 237 at 9 p.m. By 11:45, as I was getting ready to go to bed I was 197. 

You know that sleepy foggy feeling you can get when you have had a carb heavy meal? Yeah, I feel like that all the time. Headache. Foggy. Forgetful. Cranky.

I was placed on insulin when the last Lipase came back too high. It's doing nothing.  My glucose has gotten far worse while on the insulin.  As a Type 2 diabetic, my primary problem is insulin resistance. I make ( or have made ) enough insulin...my body just ignores it.  Metformin should not have caused the lipase spike. It only works on the liver, so the pancreas should be unaffected.


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