Diagnosis

I was reading over last Sunday's blog post, as I usually do, to remind myself of what I was thinking about last week and what I've already talked about. And I was struck by how sure I was that I would receive a diabetes diagnosis at my follow-up doctor appointment the next day, and how I was unhappy about that and about the diabetes medicine (and blood pressure medicine) that I would probably have to start taking.

Then I went to the doctor and received my Type 2 Diabetes diagnosis and my world fell apart.

I mean, why? Why, when I knew it was coming? 

I suppose it was partly because I'd managed to avoid it this long. My blood sugar was funky back in my 20s. I remember going to Planned Parenthood when I was, hmm, 22? because I wanted to go back on birth control pills (we don't need to go into why, exactly). Because my father had been diagnosed with type 2 diabetes since my last prescription, they insisted on giving me a glucose tolerance test before they'd prescribe the pill, and I failed it. At age 22! With a BMI of 22 or 23. And here I am at age 60, with a BMI over 40, having had gestational diabetes 13 years ago -- I mean, obviously, I was long overdue for this diagnosis.

It still blew my mind. And continues to.

It hasn't changed my lifestyle a lot yet. I've started taking metformin, the drug of choice for those newly diagnosed, but I only take one pill a day in order to get used to the side effects. Next Wednesday I'll start taking two pills a day, and so on up to four pills a day. I'm trying to eat three reasonable meals a day, instead of eating breakfast late and then snacking my way toward dinner. I'm trying -- but so far mostly failing -- to exercise every day. (Another foot of snow and subsequently icy sidewalks are complicating my plans. But at least I'm not in poor, poor Texas.) 

I'm trying to get enough sleep, but the metformin is messing with that. I'm sure it's the metformin, because it started the very first night I took the drug, and I didn't even know it was a possible side effect. According to an article on the NIH website:

Metformin-induced insomnia is widely mentioned in old and obese diabetic patients who have been diagnosed with diabetes mellitus recently...

Old and obese diabetic patients -- that's me -- who have been diagnosed with diabetes mellitus recently -- me again. The main problem I'm having is that I don't feel sleepy at bedtime. I turn off the light and settle down to sleep, but I feel wide awake. My mind isn't racing, I'm just not sleepy. Eventually I sleep, but as I start to drop off, I'm likely to wake up again. The first couple of nights I also woke up repeatedly throughout the night, but the last two nights that didn't happen, so maybe I'm adjusting to the drug. I hope so. It figures that the side effect I experience would be a mental one, not the gastrointestinal stuff that everyone else gets.

This morning I woke up at the usual time, around 7 or so, and felt awful, as though I hadn't slept well. Soon after, Kid A looked in on me, saying "This thing fell down in the night. A cat must have jumped up and grabbed it." "This thing" is a wall hanging my sister made for us years ago. It only falls down when a person bumps up against it -- no cat has ever managed to do it. Immediately I wondered if I'd been sleepwalking (another possible, though rare, complication of metformin). To the best of my knowledge I have never sleepwalked, so I'm going to chalk up the wall hanging falling down to... whatever.

The only other possible side effect I've experienced is chills, which is supposedly a symptom of lactic acidosis. But I don't have any other symptoms of it, I'm just cold. You might say, it's winter, of course you're cold. But I'm colder than normal. However, at the same appointment where I got my diagnosis, I was also given a flu shot and a pneumonia shot, and I stayed in bed most of the next day because I felt like I had the flu. So maybe the chills have something to do with that. I don't know.

It's been a bad week. I'm not even going to talk about how I drove for several miles with my parking brake on, which led to a tow by AAA, a $120 bill at the car repair place, and a long walk on icy sidewalks, which led to me falling down... OK, I said I wasn't going to talk about it. Anyway.

What really upset me, what really caused my head to explode, was what the doctor said after she gave me the bad news about my A1c level (6.7). Because a diabetes diagnosis triggers other things. Among these,

• I have to see the podiatrist again, because diabetics are prone to foot problems, leading to amputations and all that.
• I have to have a special eye exam for diabetics, not just a regular eye exam.
• I have to take a statin, eventually, because even though my cholesterol is only 176 and my LDL and HDL are only slightly off, diabetics are at a much greater risk of heart disease and stroke.
• I had to have a pneumonia shot, even though they're normally only recommended for people over 65, because people with diabetes are at increased risk of pneumonia.

In other words, diabetes puts you at a higher risk for everything. It ages you. Type 2 diabetes can lower your life expectancy by up to 10 years.

For a little while after I got my diagnosis I felt inspired, challenged. I thought, "I'll exercise and eat right and take metformin and I'll get my A1c level back down below the diabetes range." It's totally doable (well, for some people). But then, on an interesting website I found called Diatribe I read this:

Type 2 diabetes is a progressive disease, meaning that the body’s ability to regulate blood sugar gets worse over time, despite careful management. Over time, the body’s cells become increasingly less responsive to insulin (increased insulin resistance) and beta cells in the pancreas produce less and less insulin (called beta-cell burnout). In fact, when people are diagnosed with type 2 diabetes, they usually have already lost up to 50% or more of their beta cell function.  

And that's kind of where I am. Not to mention the fact that eating better and getting a lot more exercise sounds really daunting. And the fact that I've almost completely given up hope of ever losing any of my weight. Metformin is supposed to help you lose a little weight, but so far (after a whole four days) I've gained a pound.

When I woke up this morning (after what seemed like a bad night's sleep, as I mentioned above), I just felt really down. I felt as though I were dying, as though I didn't have long to live. I don't know what that's about, but I felt so sad. I started thinking about how little I've achieved in my 60 years, how totally not ready I am to leave this world.

I haven't even mentioned my high calcium level, which I have to have re-tested this coming week. If the number holds, I could have minor surgery in my future. Yeah, let's not think about that.

Oh, and my blood pressure! Jesus. I'm just falling apart. That's supposed to happen at 80, not 60.

To cheer ourselves up, how about a look at the coronavirus (complete with photo of drying masks)? The death rate has finally started to drop, though I know it might be partly due to reporting problems, with the dreadful winter storms across the country. Last week 484,621 people had died, and as of today 498,033 have died -- 13,412 this week, for an average of 1916 per day. That's a big drop from over 3000 a day. So that's really good. But still, almost 500,000 people. Monday or Tuesday we'll hit that number. But maybe deaths will continue to drop. It seems possible.

It's the start of a new week, so I should probably look at my plans for it. Everything's been thrown off by my diagnosis, but I'm still trying.

• Cook dinner with one twin. It was Kid A's turn last Wednesday, but we didn't manage to make it happen, and then things got worse. So he's cooking with me tonight -- chicken fingers and lemon bars. Then Kid B will need to choose his dish for this coming Wednesday. I also need to plan the rest of the week's meals. My doctor told me to avoid salt, prepared foods, and takeout. Of course, that's all I want to eat (oh, and sugar). Must find the strength, somehow, to prepare healthy meals.
  
• Exercise. I've got to keep trying. The snow on the ground and the fall I took on Friday are not making me feel like getting out.
  
• Write. This weird feeling that my life is ending makes me want to spend more time on writing. It's a pleasant thing to do in the morning. I'll try to make time for it a few days this week.
  
• Work on the taxes. I got a lot of papers sorted and am all set to start filling in our "tax organizer." I'll try to work on this a couple of times this week. It would be nice to be mostly done by the time Rocket Boy comes back, so we can finish it up together and send it to our preparer.
  
• Cleaning. Rocket Boy is planning to come back for another visit starting March 5th. This means I have less than two weeks to clean the house. Well, I guess I can get going on that. Finally putting away Christmas would be a good place to start. Sigh.
  
• Kids' stuff. The twins have dentist appointments (finally!) tomorrow afternoon at 2 and 2:30. Kid B also has an appointment on Thursday morning at CU to test his speech/hearing. I'll also need to help them both with school a lot this week, because they're both behind and they're both supposed to be writing research papers. Ha ha ha ha ha ha -- ok, just try.
  
• Medical stuff. Go in on Monday or Tuesday (probably Tuesday) to get my blood re-tested. Start taking 2 metformin a day on Wednesday. Work on those phone calls. The only appointment I managed to set up last week was for Merlin to get his nails trimmed (which happened, for $31, and now he is so much easier to love). This week I'll try for the eye doctor, and maybe the mammogram, the podiatrist, the dermatologist, the orthodontist -- oh, whatever. Just try.
  
• Reading. Read more of the Lincoln bio. I only managed to read 50 pages of it this week, and still want to reach page 495 by next Sunday, which is about 120 pages more. It's so boring and depressing now that the Civil War has started. I'll wait to start the Classics Challenge in March.

It crossed my mind yesterday that now that I'm an old sick dying person, maybe I'm going to need some help -- a cleaning lady, or someone to shovel the walks. Then I remembered that the twins should be the ones shoveling the walks, and that I am a bad mom for not making sure that happens. Oh God, that's all I need right now, to go down the Bad Mom rabbit hole. 

This isn't a very cheerful blog post. I think things will get better. Just have to keep putting one foot in front of the other (while trying not to slip and fall).