Wednesday, July 19, 2006

Sugar, Sugar: The Good, The Bad, the Ugly... the TMI Version (You've Been Warned)

Why is it I always end up being somebody's guinea pig?

When I was 16 and had my first gyno appointment, the doctor had an apprentice in there, and so propped me open and groped and pointed every couple of minutes to explain things to the apprentice while they both peered into my vagina.

When I had my IUD put in, there was a midwife apprentice in attendance who was there to observe the procedure. Said procedure ended up taking two clinicians, the apprentice, and 45 minutes to complete, cause I've apparently got a small cervix.

Today, Dr. S. had two newbie doctors in attendance. One of them was assigned me, and after quizzing me about bowel movements, shots, and not believing me when I said I wasn't on any other medications ("Your blood pressure is high. Don't you take any medications for it?" Uh, no, it's never been high before...), and chastising me for gaining *another* eight pounds this month, left me for ten minutes to go and consult with Dr. S.

And then all three doctors crowded into the little room to look over my sugar chart and talk about the fact that this new insulin was giving me some really watery shit morning and night. Apparently, insulin doesn't do this. Or, it shouldn't. But ever since I started this new one, it's been a problem - in addition to the spotty sugar levels.

I got another quiz on what I was eating. I told them I felt hungrier now than I had on the Lantus, but according to the eight pounds, I MUST be eating more. I told them I was working out at night, which I hadn't been the month before, but no, it's a matter of me eating too much, Dr. S. insisted.

And then he said it point blank:

I needed to lose weight.

I was a little taken aback. Seriously. Even at 191, that's on the low end of the scale for me. Anything under 200 is. I was running at 215 or 220 when I got sick. I understand the concern that I've gained 18 pounds since I've gotten healthier, but I thought that was the whole point - I've gotten healthier. I'm healthier (and much stronger) at 191 than I was at 176.

"The more you weigh, the more insulin you have to use," Dr. S. said, "you'll need to start cutting back."

Cutting back? Cutting back??? Cutting back to where????

Sweet jesus.

So, apparently, I need to lose 10 pounds.

Ha ha aha ahaah aha

I mean, shit, fuck, really, this is fucking ridiculous.

OK, yea, I've already switched out regular bacon for turkey bacon. And regular cheese for low fat mozzarella. And stopped adding salt to food. OK, I can do that....

And now, OK, well, I guess I can cut out butter. And I can measure my almonds in the morning so I don't snack on them all day. And cut the amount of string cheeses I eat from three a day to two. OK.

But I can't eat less than that. Which means my only other option is to bump up the cardio time from 30 min 4-5 days a week to 45 min 5-6 days a week.

And if, in a month, I've gained weight, I'm going to laugh at all of them.

Of *course* I've gained weight! I was *starving*!

The general consensus is that my sugar still hasn't stabilized, which is why it's bouncing around so much. Dr. S. put me back on the Lantus - oh, sweet Lantus! - and handed me $400 in free insulin.

Oh, *that* part fucking *rocked.*

"Here's some free samples," he says, and hands me 2 $80 bottles of Lantus and 2 $80 bottles of Novolog.

Fucking sweet!

Then I went home and cried.

I've worked so hard at getting the sugar levels to stabilize, and I had three doctors quizzing me with the assumption that I was doing something terribly wrong, and I hated that assumption, the assumption that I was living on cookies and regular soda, just for the hell of it. And then, to get told, after all this hunger, all this watching what I'm eating, all this stupid mandatory exercise, that I need to lose weight, oh for fuck's sake.

You think I'm not? You think I'm doing this for spite? This *is* a moderate weight for me.

But not moderate enough, apparently.

Fuck.

So I came home and cried and then put in my time on the elliptical machine. Now I'm gonna make some broccoli - without the cheese sauce - and pretend I'm doing it for fun.

The upshot of the day?

I have an interview tomorrow with a firm downtown who're looking for a project coordinator.

They didn't blink at my 50-55K a year salary requirement.

I'm trying to be optimistic.

I'm tired of things sucking.

13 comments so far. What are your thoughts?

Jeremy said...

I'll be thinking good thoughts your way for your job interview. I'm interviewing in Colorado next wednesday for a web design job. I'll be optimistic for you if you be optimistic for me. 

Posted by JeremyT

Patrick said...

I've found personally that I can do without the cheese on the vegetables if I use spices. You toss some garlic powder, sage, and a little onion salt on there, and that stir-fried brocolli starts to not suck, even if you used spray-stuff instead of olive oil.

The damsel isn't a fan of celery seed, but I like it. And, well, she puts up with my inappropriate use of dill and basil, so there ya go.

Hang in there, Kam.

Red Frique said...

Gawd, no, don't take away the butter.

I have different health issues than you, and being severely lactose-intolerant and a vegetarian (for over 20 years, I won't stop now it wouldn't make me any healthier) I have only butter left as my true love.

I wish you the best of luck with your struggle, not only will you come out the other end of it but we're all rooting for you.

Red

PS I've been reading for a while, following your ups & downs. thank you for sharing with us.

Jackie M. said...

I take it you write down your sugar measurements? Do you also write down what you eat and your exercise times? There's no way he could look at a diary full of the diet you showed me and tell you that it's "your fault."

Simply not possible.

And not to belabor the obvious, but the weight thing is bullshit. You're about as overweight as a paper airplane. Somebody's spending too much time squinting at little numbers on a chart and not enough time using their eyes to actually look at the patient.

Hey, good luck.

Anonymous said...

What Jackie M. says - I trust you to know your own body and set-point (re weight) better than these med-pro yokes. What a pity they weren't listening to your experience of your body, but, yeah, that would mean them relinquishing their all-powerful grasp of authority in favor of your point-of-view. *sigh* (And the medical profession complains that we put them up on a pedastal. Yeesh!)

I've gotten a doctor to back off of the critique of my diet by making him sit through a highly detailed record of my diet for the previous two weeks (charts, lists and everything printed out on my computer).

Still reading you, still rooting for you getting up to your feet again that one time more than you fall....

Crazy(but saner when I get to read honest writing like yours)Soph

David Moles said...

Oh, for fuck's sake. Ditto Jackie and Soph on the documentation.

Kameron Hurley said...

Jeremy - it's a deal!

Jackie - yea, they were really impressed with my documentation, actually, particularly the sugar chart. They're used to getting folded peices of paper with barely legible numbers on them, so I think having me in there with all my cross-referenced spreadsheets makes their day. So, they consult the sugar chart, ask why I had a low number, I consult my food diary for that day, and assure them that no, really, it's the same damn breakfast I have every weekday, and we move on. Then Dr. S. makes a xerox of the chart for my file. Very handy for all involved.

I swear that with the weight stuff, doctors feel they have to tell you *something,* and that's the first thing they can think that will aid you in some way. The new doctor must have asked me three times if I was on any other medications. He didn't believe that a diabetic could only be on insulin.

They wanted to start me on another drug called Metformin, which will apparently tell my liver to produce less glucose, and will therefore result in weight loss. The side effects? More watery bowel movements and severe stomach pain.

OHHhhhhh wheeee! Yay! Give me a drug for THAT!

For a diabetic, I'm OK healthwise, and not on any other meds, but I just think that's because the health care industry hasn't had enough time to hook into me yet.

And boy are they working on it.

To be honest, I want to lose the 10 lbs so they don't try and drug me up any more. The fewer meds I can get away with, the better. I really, really, don't want to take handfuls of perscription pills every morning for the rest of my life, cause once you start on pills, then you take pills to counteract the side-effects of those pills, and so on and so on, until suddenly you've got eight bottles of pills in your medicine cabinet.

David Moles said...

Mmm, stomach pain.

That Girl said...

Wishing you luck!

Jackie m. said...

I think what the doc is worried about is the possibility of combo diabetes (Type 1 1/2? Type 3?) If he's not worried he probably should be, given your late age of onset.

And yeah, sure -- the more "weight" you have, the more insulin resistance you'll have. Except "weight" in this case means "fat." You're 190 lbs, and you fit into a size 14? How tall are you? Well, who cares -- it's pretty obvious that you're solid muscle. And they tell you to "decrease your fat mass and increase your muscle mass".... yeah. Guess what, doc?

My Dad takes Avandia. He actually went through three different meds before they finally settled on this one. Most of his side effects were that they made him hypo all the time. Lucky him, sure... but you can't really live that way, either.

Susan said...

I know that right now you're very dependent on the doctors for insulin dosage adjustment, so maybe don't listen too hard to this advice right now. But in the long term, dealing with a medical condition that is a part of your life and isn't going to go away, you're eventually going to see doctor's advice as just another one of your input streams (rather than the only input that matters).

I have a congenital heart defect, and I've spent my entire life in and out of cardiologist's offices. Last year I had this incident where (it's a long story that makes sense in context) the GP at the student health center became worried that I was having a heart valve failure and sent me for an emergency consult with my cardiologist. The cardiologist didn't even bother examining me--she looked at my chart, saw that I'd gained ten pounds in the year and a half since my last cardiac evaluation, and told me that all of my symptoms were caused by being fat. "There's nothing wrong with you other than the physical strain of being very overweight" were her exact words. I'm 5'6", and at that point I weighed about 165 or 170, which is a good twenty or thirty pounds above my ideal weight, but it's by no means unreasonably heavy for my frame.

And because, you know, I was in doctor-visit mental state, I didn't argue with her or anything, I just left the appointment and went out to my car and cried hysterically for half an hour. Then I went back into the office and insisted that they schedule me for an echocardiogram anyway. Because the doctors don't know everything, they don't know your body and your experience of the symptoms in the same way that you do, and their needs and interests don't always align with yours.

Does your health insurance cover visits to a nutritionist? I'm wondering if a consultation with a food expert might help you put together some eating strategies that will be diabetes-friendly and not leave you starving all the time. I know that you know a lot about food, but if you're always really hungry and things still aren't working the way you want them to, it might be worth the time to get another opinion.

La Gringa said...

I think that what you need is another diabetes specialist, and probably a woman.

Kameron Hurley said...

I don't think health insurance covers the nutritionist. I can't even get them to cover my last day in the hospital becaue they consider it "too intensive" a level of care (???).

But yea, all comments noted, definately. We'll see what happens. I'm not digging the being hungry part, though. Also not digging the "stomach pains are good cause then you'll be thinner!" thing.

I mean, why not get a boob job and a face lift while I'm at it?

I'll look so much "better"!

According to whose standards? I'm the one that has to live in this body.