Medical Updates & Supplementation Tweaking

Two days ago I had appointments: First with my neuro who is local to me; and secondly with the endocrinologist who is in NYC. 

The appointment with the neuro was a bit more involved than it normally is. Normally, I just go for follow ups, he gives me my refills for my Frova for my migraines and we bid each other adieu for another six months. 

Thanks to the last six months of 2013 being so chock-a-block with unexpected medical wild goose chases (thyroid nodules, lung granuloma, etc etc), I hadn't had time to address all my "rainy day projects" (pain  management, follow up sleep study, colonoscopy, to name a few items), so I figured I'd start with the most pressing: PAIN.

Given I was going to explore pain management with a "pain specialist," and given that the particular specialist in question was a neuro, and given I ALREADY have a neuro, I figured I'd unload on him everything, to see if HE can address and treat those issues:

• Migraines
• Headache from herniation at my C4
• Adenomyosis/endometriosis pain
• Anxiety/Depression

I told him I was on Wellbutrin from November to the end of December, and it gave me horrid dry mouth, a persistent baseline headache, increased my predisposition to anxiety attacks, and brought me to a full on feral, frothing rage, and due to this, I stepped myself off it, as it truly wasn't value added. Also? Taking Frova (my migraine Rx) with Wellbutrin is contraindicated, so yeah, there's that.

He considered other things, the tramadol, my use of an occasional vodka tonic, and realizing nothing's really helping the pain, which is debilitating, and sometimes the migraines and adenomyosis pain are not running immediately in tandem with one another, so I'm losing between 2-4 days a month due to this, and really it's unacceptable.

In addition to the myriad of things going on with me, the latest Dx: Chronic Pain Syndrome.

His recommendation: Cymbalta. 

I'm pinning some hope on it that it will help me, even get my pain managed a smidge better, to allow me to be more predisposed to getting more active, which I am convinced will make me feel better for an assortment of reasons. I just hope it doesn't make me add weight.

Then it was off to the endocrinologist for my four month, standard appointment with him. Pretty standard fare. Nothing too alarming. A slight, 4 lb uptick in weight (perhaps due to an ineffective poop that a.m., and perhaps water weight due to my period due any moment now, or perhaps due to total inertia, thanks to the fucking weather we've been having (Mother Nature: A snow storm every week, really?).

We discussed my right lower quadrant pain and spitballed ideas about if it were related to the adenomyosis, or if it were related to something else. And he did a manual exam of the abdomen, and quipped about that pesky fatty liver syndrome, which I thought was managed or thwarted by the gastric bypass I had three years earlier. My triglycerides and overall cholesterol are great; however, either my good cholesterol is low or my bad cholesterol level is high (I don't know specifics at this very moment and I'm too lazy to pull out the blood work to verify, not that it matters herein, does it? really?) 

And again, the topic of my occasional cocktail came up. One a week (maybe one more if I'm at a function?) doesn't seem too outlandish, but given the concerns of fatty liver syndrome morphing its way into NASH (essentially non alcoholic cirrhosis of the liver), it IS a concern. Ideally I shouldn't drink, but if I want (because hey, life is meant to be lived), to try to limit it to one cocktail a week. So I guess moving forward, I should be very particular about the deliciousness of my weekly potable.

This is of particular interest to me, of which I find hilarious and ironic, given my mother's lecturing of me in December about my latent alcoholism, citing dad's family's predisposition to drink. One cocktail does not make one an alcholic. Funny thing here is, it's not dad's family's predisposition which is hindering me taking a nose dive into a vat of limoncello, but MOM's fucked up gene pool, given the fatty liver syndrome is from the obesity and insulin resistance issues on mom's side of the family. Hilarious, and of course, pointless to point that out to her, given she won't listen anyway.

Doc hooked me up with some samples of Lovaza, given that I am already on Omega 3 capsules. And lo-and-behold, my insurance will pick this up! So I'm happy about that, though I'm not sure of the merits this will have.

I had to laugh at the doc, as he told me some insurance doesn't pay for the Rx, but he's got a bunch of samples he can give me. I compared him to a heroin dealer, saying, "The first hit's always free." 

Part of my personal make up is that I like to try to find work arounds for life's problems. Kind of like puzzle solving. Well, I would like to keep having my weekly beverage. So, I have decided to dump off one supplement out of my daily routine (evening primrose oil) and bring a new player up at bat: a liver tonic with milk thistle.  Additionally,  I'd like to try to cut my carbs down, even though my intake is not carb-intensive, I need to try to find a way to wring out the fat out of my liver.

One more talking point was about calcium supplementation, and apparently there's a bit of conflict/controversy over how much is too much calcium. Doc suggested I read this article, and I found it interesting enough to warrant that I get a 24 hour urine collect done now, go 1-2 months taking a lower dose of calcium daily (dropping down to 1500 mg daily instead of 2000 mg which my bariatric surgeon recommends), then do another 24 hour urine collect right before my appointment in May. And at the May appointment, we will numbers crunch and see if by dropping my calcium intake if there's any negative impact. I don't want to overdo things, as too much calcium can mask other issues and adversely impact the thyroid.

So, the current supplement line up moving forward will be thus:
First thing in the a.m.:

Cymbalta 30 mg, 1x
2 Gummy VitaFusion Prenatal Multivitamins
2 Gummy VitaFusion Sugar Free Fiber Chews, 5 gm, 1x
Lovaza 1x
Colace 200 mg (1x)
Vitamin C, 400 mg
Feosol 325 (2 tablets)  *I boost to 3 tabs during menses
Alpha Lipoic Acid 250 mg
KAL Brand B12 spray (1-2 spritzes under the tongue)

Right before leaving the house, I take a zinc losenge, and then throughout the day I manage to get these in:

Standardized turmeric in capsule form
Boron, 3 mg, 1x daily 
Magnesium 400 mg, 1x daily *I boost to 2x daily during menses 
D3 2000 IU (1x) 
Calcium Citrate, 250 mg (3x) 
CoQ10 (50 mg, though I'm thinking of boosting this) 
Vitamin C, 400 mg

Then in the evening, I take:

Quinipril, 80 mg
Alpha Lipoic Acid 250 mg
Milk thistle 

Items highlighted in red are new additions to my line up. Note: The Lovaza was just an experiment, as my endo gave me some samples. I'm back to taking my regular Omega-3 fish oil supplement, as I did not see any marked change in my blood chemistry (and the doc never prescribed an Rx).