All I can do right now is just whine, or curl up in the fetal position and make communicate in noises that only dogs and dolphins can decipher.
I'm really struggling with depression right now. Struggling to stifle the urge to just cry at my desk. I'm overwhelmed with resentment at work, this isn't what I signed on for 15+ years ago and now I'm trapped. No one will hire me in my current position, because currently I make more money than anyone will pay someone at entry level; furthermore, no one will take a chance on me if I wanted to transition to a project management position. Round and round I go, obsessing on what needs to get done, and then realizing, yet again, that it relies upon OTHER PEOPLE to help me make that happen, and the realization I keep coming back to is that OTHER PEOPLE just fucking disgust and disappoint me.
It's Thanksgiving week, and I'm depressed and anxious, and wondering why the hell I do this to myself every year. I enjoy the planning, but when the day comes closer I regret ever doing this. It's a lot of work in a general sense, and even more work when you factor in I am physically not up to it. Even less up to it when you couple that I'm depressed.
More details about what's going on with my mom and my brother are on the other blog; however, those two situations haven't resolved themselves, and there's the combination of angst and relief (but really much much more angst than relief) of living so damned far away from my mother and my brother for me to even BE THERE in any sense of the word, to help. But to be graphically honest, they are both beyond help. And being the elephants that they are, they cannot swim, and they will make very, very light work of dragging those (who attempt to help) down into the abyss with them.
I sent in my resume via LinkedIn to another government job--and it remains to be seen whether I'll even be called in for an interview. I'll be equally happy or pissed, either way. The stoic in me sees that the end result, whichever it will be, will ultimately be met with the same emotion. I recognize if I do land the job, it'll be akin to going from the frying pan directly into the fire itself--but I'm ready for a different kind of awful, and perhaps a fresh start with some new assholes. And again, I don't see this going anywhere. It's yet another of my acts of futility to try to bolster or ease my mind that I do have value, even if the assholes where I work do not validate that.
My stomach is up in knots, and my To Do List is extensive, and I'm hoping it'll save me by way of distraction, however, there's the matter of being trapped here at work, when I should be home, either working or napping (either would be equally productive at this point).
Pain, in one form or another, is my companion. Not a day goes by without me being aware that something hurts, or that I can't do something (or do it as long as I'd like) because of my limitations.
I had to reschedule my therapy session for this week, because the director insists that I come into work tomorrow by 8:30, robbing me of that additional hour sleep I need so desperately in the morning, to cover staffing because the other two secretaries are both scheduled out--something that should never have happened, because the director insists there are two secretaries working at all times--YET when it comes to me, it's perfectly acceptable. Fuck her. So I don't even get to talk to my therapist this week because of the director. Yet one more reason for me to get the hell out of here. The double standards and bullshit are too much.
I don't know why I even bother blogging. I doubt anyone is reading. It's merely a scream into the abyss at this point. It's like that bit about "if a tree falls in the woods and no one is around, does it make a sound?" If I blog and no one reads it (or no one reacts to it), what's the point? Do the words and sentiments exist? But then again, there I go again, that fucking trap of OTHER PEOPLE.
I keep circling back to worrying about "is this as good as things are going to get?" and then flailing (at least internally), as I am most-decidedly NOT content with this aspect of my life, and yet, I am powerless to remedy it. I don't want heart emojis or "thoughts and prayers," or "thinking of you," or even "I wish I could help..." Just fucking help me. I'm capable.
Right now I am living each day this week on an hour by hour basis, trying to not just power through until my Thanksgiving feast is over, but also powering through until Friday evening, as I will be working on Friday, so I am trying to focus on Friday evening, and then take a muscle relaxant and just sleep for 12 hours if I can.
And there's all this, and then the existential, interconnected angst of realizing that never again will I be able to go to my mother's house for Thanksgiving (or for anything else for that matter). My mother hasn't lived in her house since July, and soon her house will become someone else's house. I cannot even process this loss, as there's just too much other shit that needs my attention this week.
And on top of this, well-intentioned dinner guests pinging me, asking me what they can bring. JUST BRING YOURSELF. When I say that, I truly mean it. I have everything under control with food. Just come, and bring your appetite. And now I have to worry about making sure everyone else feels like a participant--which they should be, participating. I'm not in a good mindset for this.
And whatever. Even FB seems like screaming into the abyss or a political echo chamber, and it's not even a distraction anymore for me. I've been gradually culling people off my friends list of people who don't go out of their way to interact with me--so why should they be on my list? They know how to find me if they want me. Perhaps I'll end up whittling the "list" down to a solitary splinter, and... well. Whatever. What's the point of all of this.
I better quit my yammering and hit publish. Fuck you, Tuesday.
Tuesday, November 21, 2017
Wednesday, November 15, 2017
Struggling.
You know I'm struggling when/if I say I broke down and allowed myself to get not one, but two cortisone shots in the last 6-8 weeks.
First shot was in the bursa in my hip. According to my math, my right hip has been hurting since my first trip to India in 2012, from sleeping on a rock hard, ayurvedic type bed. It injured the bursa, and set me up for more issues, or it compounded other issues (like IT band syndrome).
Second shot was in my shoulder, as I've had problems with my shoulder, going on nearly 3 years. I have had symptoms of chronic elbow tendonitis which have been resistant to treatment (I've had a cortisone shot in the elbow, regular visits with a physical therapist, topical voltaren gel, ultrasound, TENS/EMS, and even cool laser). I had the shot in the shoulder and for about a week, the elbow seemed different; however, now it's nudging itself back to where it was before the shot.
I don't have the time (3 visits a week for 5 weeks) or the money (roughly $2500--and insurance doesn't cover it) for EPAT, which I've been promised would help. But what if I go through the logistical inconvenience of those 15 visits and spend all that money and be no better off? What then?
Next thing on my bitch list today is the fact that in August, my endocrinologist broke up with me, informing me he was going to retire by year end. Then September brought with it that little drama involving my glucometer readings and digestive enzymes--to date, he still hasn't bothered to reply to my last email to him.
The lack of a reply disappoints me, as in August he informed me he is my doctor until the end of December. Well, if he's not replying to me, then he's not doing much in the way of doctoring. Last week I received the stock letter that every one of his patients received--and they didn't even go to the trouble of doing a proper mail merge, to personalize each letter with our names. The letter might as well have opened with "To Whom It May Concern."
Despite the fact he's sold his practice to another doctor (or two), I've found someone closer to home and who takes my insurance, and who is a known entity to two friends/co-workers, who are seeing this new doc for thyroid issues, and I feel that is where my focus should be right now. So in January, when I return from what will be my most-recent travels, I'll set up an appointment. I have my "bundle" already for that visit, too. Blood work, etc. And I've been chipping away at sorting through the mountain of paperwork, and compiling a spreadsheet to document my progress since my bypass in 2011, to make things easy for the new endo to get a handle on me as a patient.
And lastly, this past week I visited my gyno for my annual exam. The visit went smoothly no real complaints, and I had my mammogram done the week before, so that came back clean. I mentioned how I was interested in getting "some work done" by having a "tuck and suck," possibly having my pannicula removed/tummy tuck, and having a fist-sized gob of fat removed/sucked out of me, not for vanity reasons but because I'm tired of carting this flab around, and I want to be more comfortable in my own body and have my clothing fit better.
So projects for 2018:
1. New endocrinologist;
2. Seek consultation with the plastic surgeon my gyno recommended (as well as seek a second opinion).
All this, coupled up with blatherings at my other blog wherein I detail the craziness going on with my mother, and my brother, etc, just adds up to me being anxious and depressed, and wanting to power through Thanksgiving, and power through until I am in Singapore and places beyond.
Which reminds me--I need to buy a biodegradable urn.
First shot was in the bursa in my hip. According to my math, my right hip has been hurting since my first trip to India in 2012, from sleeping on a rock hard, ayurvedic type bed. It injured the bursa, and set me up for more issues, or it compounded other issues (like IT band syndrome).
Second shot was in my shoulder, as I've had problems with my shoulder, going on nearly 3 years. I have had symptoms of chronic elbow tendonitis which have been resistant to treatment (I've had a cortisone shot in the elbow, regular visits with a physical therapist, topical voltaren gel, ultrasound, TENS/EMS, and even cool laser). I had the shot in the shoulder and for about a week, the elbow seemed different; however, now it's nudging itself back to where it was before the shot.
I don't have the time (3 visits a week for 5 weeks) or the money (roughly $2500--and insurance doesn't cover it) for EPAT, which I've been promised would help. But what if I go through the logistical inconvenience of those 15 visits and spend all that money and be no better off? What then?
Next thing on my bitch list today is the fact that in August, my endocrinologist broke up with me, informing me he was going to retire by year end. Then September brought with it that little drama involving my glucometer readings and digestive enzymes--to date, he still hasn't bothered to reply to my last email to him.
The lack of a reply disappoints me, as in August he informed me he is my doctor until the end of December. Well, if he's not replying to me, then he's not doing much in the way of doctoring. Last week I received the stock letter that every one of his patients received--and they didn't even go to the trouble of doing a proper mail merge, to personalize each letter with our names. The letter might as well have opened with "To Whom It May Concern."
Despite the fact he's sold his practice to another doctor (or two), I've found someone closer to home and who takes my insurance, and who is a known entity to two friends/co-workers, who are seeing this new doc for thyroid issues, and I feel that is where my focus should be right now. So in January, when I return from what will be my most-recent travels, I'll set up an appointment. I have my "bundle" already for that visit, too. Blood work, etc. And I've been chipping away at sorting through the mountain of paperwork, and compiling a spreadsheet to document my progress since my bypass in 2011, to make things easy for the new endo to get a handle on me as a patient.
And lastly, this past week I visited my gyno for my annual exam. The visit went smoothly no real complaints, and I had my mammogram done the week before, so that came back clean. I mentioned how I was interested in getting "some work done" by having a "tuck and suck," possibly having my pannicula removed/tummy tuck, and having a fist-sized gob of fat removed/sucked out of me, not for vanity reasons but because I'm tired of carting this flab around, and I want to be more comfortable in my own body and have my clothing fit better.
So projects for 2018:
1. New endocrinologist;
2. Seek consultation with the plastic surgeon my gyno recommended (as well as seek a second opinion).
All this, coupled up with blatherings at my other blog wherein I detail the craziness going on with my mother, and my brother, etc, just adds up to me being anxious and depressed, and wanting to power through Thanksgiving, and power through until I am in Singapore and places beyond.
Which reminds me--I need to buy a biodegradable urn.
Monday, September 25, 2017
The Digestive Enzyme Debacle
I did some reading up on digestive enzymes (amylase, lipase, and protease, in particular), and justified taking them for two reasons:
1. As you age, your enzyme production declines; and
2. As I had a gastric bypass, no doubt, that decreased my digestive enzyme production (along with my HCL production.
Well. LESSON LEARNED!
Amylase supplementation does NOT play nice with my reactive hypoglycemia. And fortunately I had the foresight to zap a blood glucose reading about 3 days into this experiment.
9/18 I started the supplement.
9/21 I started feeling like shit. I took a glucose reading and have continued to take readings (and being very very alarmed by it).
9/24 Was the last supplement I took.
How high is too high?
Well, my normal fasting glucose level is around 92-96.
This morning it was 141. Two hours after my first meal it only dropped down to 121. For me, this IS "alarming."
Right now I'm worried about whether it caused a cascade effect, triggering something in my pancreas. Only time will tell if my levels will revert back to my norm.
In the meantime, I zapped an email to my endo (Yes, the one who is retiring), and I'm hoping he'll give me a QUICK reply back to reassure me.
I've also zapped emails to a friend who is an RN, a friend who is a PA, and another friend who is an MD, all hoping one of them will reply and put my mind at ease.
My chiropractor and I always have conversations about supplements we're both taking, in a way, we're both comparing notes. And I mentioned to him about the glucose readings and asked him if HE personally thought the enzymes could be the culprit, or if I should just focus on lipase, since I lack a gall bladder. And he didn't see how it could impact my glucose--but then again, I KNOW MY ERROR, in asking a chiropractor about endocrine issues. Lesson learned.
And now I wait, and hope I didn't damage what I've managed to either achieve or maintain after my bypass.
1. As you age, your enzyme production declines; and
2. As I had a gastric bypass, no doubt, that decreased my digestive enzyme production (along with my HCL production.
Well. LESSON LEARNED!
Amylase supplementation does NOT play nice with my reactive hypoglycemia. And fortunately I had the foresight to zap a blood glucose reading about 3 days into this experiment.
9/18 I started the supplement.
9/21 I started feeling like shit. I took a glucose reading and have continued to take readings (and being very very alarmed by it).
9/24 Was the last supplement I took.
How high is too high?
Well, my normal fasting glucose level is around 92-96.
This morning it was 141. Two hours after my first meal it only dropped down to 121. For me, this IS "alarming."
Right now I'm worried about whether it caused a cascade effect, triggering something in my pancreas. Only time will tell if my levels will revert back to my norm.
In the meantime, I zapped an email to my endo (Yes, the one who is retiring), and I'm hoping he'll give me a QUICK reply back to reassure me.
I've also zapped emails to a friend who is an RN, a friend who is a PA, and another friend who is an MD, all hoping one of them will reply and put my mind at ease.
My chiropractor and I always have conversations about supplements we're both taking, in a way, we're both comparing notes. And I mentioned to him about the glucose readings and asked him if HE personally thought the enzymes could be the culprit, or if I should just focus on lipase, since I lack a gall bladder. And he didn't see how it could impact my glucose--but then again, I KNOW MY ERROR, in asking a chiropractor about endocrine issues. Lesson learned.
And now I wait, and hope I didn't damage what I've managed to either achieve or maintain after my bypass.
Thursday, September 14, 2017
Notes Re: Methylation, Homocysteine, Betaine, etc
Homocysteine & Methylation "Take Aways"
Note: Methylation = Complex combination of actions whereby Homocysteine + “Certain B Vitamins” (i.e., b6, b9 (folate), b12) + Betaine, SAM-e, Adenosine etc etc = (recycled into) Methiones
(Image from Wikipedia)
1. Homocysteine can be recycled into methionine or converted into cysteine with the aid of certain B-vitamins;
2. Normal homocysteine levels should be less than 13, with the ideal range being between 6-8, with hyperhomocysteinemia Dx at over 15;
3. Homocysteine levels are typically higher in men than women, and levels elevate with age;
4. MCV greater than 95 can indicate a methylation problem;
5. Blood or urine methylmalonic acid test for b12 deficiency (may be ordered as a follow up to a standard b12 test);
6. Daily diet should include one cup a day of dark green leafy vegetables, and daily protein intake should be between 80-120 gm;
7. Reducing AGE (advanced glycation end products) by diet and or supplementation can potentially lower homocysteine levels (and protect the kidneys);
8. Supplementation: All B vitamins, but IN PARTICULAR emphasis on b6 (up to 250 mg) & b12 (500 mcg), plus more than 400 mcg (RDA) folate (unless person has cancer), choline (precursor to betaine*);
9. NOTE: If one were considering supplementing with betaine to lower homocysteine levels, the IDEAL formulation appears to be BETAINE ANHYDROUS *NOT* betaine hydrochloride;
10. Digestive diseases, caffeine, some meds (i.e. acid blockers, methotrexate, or HCTZ), and no doubt, malabsorptive bariatric surgeries can impact levels of B vitamins in blood;
Interesting articles:
Betaine supplementation decreases plasma homocysteine in healthy adult participants: a meta-analysis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3610948/
Maximizing Methylation: The Key to Healthy Aging, by Mark Hyman MD http://drhyman.com/blog/2011/02/08/maximizing-methylation-the-key-to-healthy-aging-2/
Below the Radar: Advanced Glycation End Products that Detour “around the side” Is HbA1c not an accurate enough predictor of long term progression and glycaemic control in diabetes? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1320176/
Lowering homocysteine levels with folic acid and B-vitamins do not reduce early atherosclerosis, but could interfere with cognitive decline and Alzheimer's disease https://www.ncbi.nlm.nih.gov/pubmed/23224755
BEETS & GREEN LEAFY VEGGIES & METHYLATION
CONFLICT #1: Green, leafy veggies, lowers homocysteine yet elevates oxylates
CONFLICT #2: Green, leafy veggies lowers homocysteine (which would lower risks for DVT, clots, stroke) yet they contain Vitamin K which would increase risks for DVT, clots, stroke.
BEETS: Despite the fact that beets are high in betaine, which helps lower homocysteine levels in blood, they are ALSO high in oxylates, which elevates purines in the blood, which then elevates uric acid and contributes to gout inflammation.
GREEN LEAFY VEGGIES: People who have blood clotting disorders (Leiden varieties, in particular), like myself should be wary of ingesting too much in the way of green leafy veggies, as they are also high in Vitamin K (“klottenfactor”) and can have a potential negative impact (i.e. clots, stroke, dvt, etc), and it’s this reason (as well as having had a gastric bypass) that I use a variety of supplements to make sure my needs are met. ¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬
Notes on Benfotiamine (fat soluable, B1):
Below the Radar: Advanced Glycation End Products that Detour “around the side” Is HbA1c not an accurate enough predictor of long term progression and glycaemic control in diabetes? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1320176/
Note: Methylation = Complex combination of actions whereby Homocysteine + “Certain B Vitamins” (i.e., b6, b9 (folate), b12) + Betaine, SAM-e, Adenosine etc etc = (recycled into) Methiones
(Image from Wikipedia)
1. Homocysteine can be recycled into methionine or converted into cysteine with the aid of certain B-vitamins;
2. Normal homocysteine levels should be less than 13, with the ideal range being between 6-8, with hyperhomocysteinemia Dx at over 15;
3. Homocysteine levels are typically higher in men than women, and levels elevate with age;
4. MCV greater than 95 can indicate a methylation problem;
5. Blood or urine methylmalonic acid test for b12 deficiency (may be ordered as a follow up to a standard b12 test);
6. Daily diet should include one cup a day of dark green leafy vegetables, and daily protein intake should be between 80-120 gm;
7. Reducing AGE (advanced glycation end products) by diet and or supplementation can potentially lower homocysteine levels (and protect the kidneys);
8. Supplementation: All B vitamins, but IN PARTICULAR emphasis on b6 (up to 250 mg) & b12 (500 mcg), plus more than 400 mcg (RDA) folate (unless person has cancer), choline (precursor to betaine*);
9. NOTE: If one were considering supplementing with betaine to lower homocysteine levels, the IDEAL formulation appears to be BETAINE ANHYDROUS *NOT* betaine hydrochloride;
10. Digestive diseases, caffeine, some meds (i.e. acid blockers, methotrexate, or HCTZ), and no doubt, malabsorptive bariatric surgeries can impact levels of B vitamins in blood;
Interesting articles:
Betaine supplementation decreases plasma homocysteine in healthy adult participants: a meta-analysis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3610948/
Maximizing Methylation: The Key to Healthy Aging, by Mark Hyman MD http://drhyman.com/blog/2011/02/08/maximizing-methylation-the-key-to-healthy-aging-2/
Below the Radar: Advanced Glycation End Products that Detour “around the side” Is HbA1c not an accurate enough predictor of long term progression and glycaemic control in diabetes? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1320176/
Lowering homocysteine levels with folic acid and B-vitamins do not reduce early atherosclerosis, but could interfere with cognitive decline and Alzheimer's disease https://www.ncbi.nlm.nih.gov/pubmed/23224755
BEETS & GREEN LEAFY VEGGIES & METHYLATION
CONFLICT #1: Green, leafy veggies, lowers homocysteine yet elevates oxylates
CONFLICT #2: Green, leafy veggies lowers homocysteine (which would lower risks for DVT, clots, stroke) yet they contain Vitamin K which would increase risks for DVT, clots, stroke.
BEETS: Despite the fact that beets are high in betaine, which helps lower homocysteine levels in blood, they are ALSO high in oxylates, which elevates purines in the blood, which then elevates uric acid and contributes to gout inflammation.
GREEN LEAFY VEGGIES: People who have blood clotting disorders (Leiden varieties, in particular), like myself should be wary of ingesting too much in the way of green leafy veggies, as they are also high in Vitamin K (“klottenfactor”) and can have a potential negative impact (i.e. clots, stroke, dvt, etc), and it’s this reason (as well as having had a gastric bypass) that I use a variety of supplements to make sure my needs are met. ¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬
Notes on Benfotiamine (fat soluable, B1):
Below the Radar: Advanced Glycation End Products that Detour “around the side” Is HbA1c not an accurate enough predictor of long term progression and glycaemic control in diabetes? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1320176/
Effect of Benfotiamine on Advanced Glycation Endproducts and Markers of
Endothelial Dysfunction and Inflammation in Diabetic Nephropathy
Friday, August 25, 2017
Lots To Process!
A while ago, I said how 2017 was going to be the year where I streamline the circus that has been my medical care, and eliminate redundancies, and try to pare down how many doctors/specialists I see.
LAST January, I saw my internist and had him arm chair quarterback my endocrinologist, who, at the time, sent me in for a 2 hour glucose tolerance test, even though most people know (I didn't!) that bypassers like me shouldn't have this test done for obvious reasons (a lot of bypassers end up with Reactive Hypoglycemia/Post-Prandial Hypoglycemia). My internist didn't see much to be concerned about, though he did suggest to me that I find an endocrinologist closer to home and one who takes my medical insurance.
Two months ago, my husband and I were at the office where BOTH of our internists work, and we noticed there was an "In Memoriam" type book on the counter with a sign indicating that my internist had passed away. This saddened me greatly, and yet, oddly, it plays into the overall theme of what I verbally articulated 2017 to be, "The Year of Streamlining." Well, may he rest in peace, I was planning on acting on his guidance.
Monday was a regular appointment at the Endo for me, and I was steeling myself mentally to dispense the "It's Not You, It's Me" discussion wherein I let him know I can't financially sustain seeing him anymore.
Right here is a perfect example of a nugget of advice my husband's grandmother used to share, "If you do nothing at all, in 75% of cases, your problems sort themselves out on their own."
I walked into his office where we normally have a discussion before he examines me, and right off the bat, I noticed 2/3 of his books were off the shelves. And then HE gave me the news that he was selling his practice, and would no longer be seeing patients, and would be focusing his time on lecturing and teaching other doctors to do what he does.
I said, "Hey! You can't break up with ME! I was going to break up with YOU!"
The examination went as it normally does; however, I refused to hop on the scale, since this is the last visit. And I blurted out, "Nope. Not this time. I refuse to hop on that metallic bastard! I want my last visit to end on a good note!"
While it would be nice for me, to go to whomever is buying his practice, it's just not feasible for an assortment of reasons--and really, WHAT do I know about this person? So, now I'm actively looking for a new endo, and my search is going Goldilocks style: one that isn't too old, and isn't too young, someone capable of monitoring my thyroid nodules, and someone local-ish, and takes my insurance, and basically gives me 2-3 days of my life back (not to mention, $$$ I won't be spending for a doctor who doesn't take my insurance). Two of my co-workers go to an endo nearby, and speak highly of him, and he meets my criteria, so I need to get the new patient forms, and get things lined up so whatever medical records of mine can get transferred while my current Endo's office is still open and operating.
Even though I was planning on discontinuing, I wanted it to be my decision. And knowing my Endo, he's 85. I fully expected him to keep treating patients until the day he just ran out of steam and passed away, blissfully, at his desk in his office. Instead, there's THIS. And I know something must be going on with him for him to decide to go back to teaching and focus primarily on lecturing. And my hope for him is that whatever he's doing, I hope it brings him as much fulfillment as treating patients has.
It's wild to think he RETURNED to treating patients about 18 years ago, and of that 18 years, I have been seeing him 4x a year for 14 of those 18, so I've been there for the long haul as it were. And it was a good run. And he taught me a shitload about not just the assortment of things I need to stay on top of, but he's also taught me a lot about MYSELF.
I plan on getting a birthday card and sending that off to him, as his day is coming up; and I plan on getting two lovely thank you cards and send them to his secretary and his clinician--both of whom I will miss interacting with them. Great, super sweet, friendly and professional women, both of whom I hope end up on their feet. 18 years is a long time, and this change will break up that little, happy, work place "family."
Nothing lasts forever.
Change can be a good thing for all involved.
It's still sad and a bit of an unexpected shock.
LAST January, I saw my internist and had him arm chair quarterback my endocrinologist, who, at the time, sent me in for a 2 hour glucose tolerance test, even though most people know (I didn't!) that bypassers like me shouldn't have this test done for obvious reasons (a lot of bypassers end up with Reactive Hypoglycemia/Post-Prandial Hypoglycemia). My internist didn't see much to be concerned about, though he did suggest to me that I find an endocrinologist closer to home and one who takes my medical insurance.
Two months ago, my husband and I were at the office where BOTH of our internists work, and we noticed there was an "In Memoriam" type book on the counter with a sign indicating that my internist had passed away. This saddened me greatly, and yet, oddly, it plays into the overall theme of what I verbally articulated 2017 to be, "The Year of Streamlining." Well, may he rest in peace, I was planning on acting on his guidance.
Monday was a regular appointment at the Endo for me, and I was steeling myself mentally to dispense the "It's Not You, It's Me" discussion wherein I let him know I can't financially sustain seeing him anymore.
Right here is a perfect example of a nugget of advice my husband's grandmother used to share, "If you do nothing at all, in 75% of cases, your problems sort themselves out on their own."
I walked into his office where we normally have a discussion before he examines me, and right off the bat, I noticed 2/3 of his books were off the shelves. And then HE gave me the news that he was selling his practice, and would no longer be seeing patients, and would be focusing his time on lecturing and teaching other doctors to do what he does.
I said, "Hey! You can't break up with ME! I was going to break up with YOU!"
The examination went as it normally does; however, I refused to hop on the scale, since this is the last visit. And I blurted out, "Nope. Not this time. I refuse to hop on that metallic bastard! I want my last visit to end on a good note!"
While it would be nice for me, to go to whomever is buying his practice, it's just not feasible for an assortment of reasons--and really, WHAT do I know about this person? So, now I'm actively looking for a new endo, and my search is going Goldilocks style: one that isn't too old, and isn't too young, someone capable of monitoring my thyroid nodules, and someone local-ish, and takes my insurance, and basically gives me 2-3 days of my life back (not to mention, $$$ I won't be spending for a doctor who doesn't take my insurance). Two of my co-workers go to an endo nearby, and speak highly of him, and he meets my criteria, so I need to get the new patient forms, and get things lined up so whatever medical records of mine can get transferred while my current Endo's office is still open and operating.
Even though I was planning on discontinuing, I wanted it to be my decision. And knowing my Endo, he's 85. I fully expected him to keep treating patients until the day he just ran out of steam and passed away, blissfully, at his desk in his office. Instead, there's THIS. And I know something must be going on with him for him to decide to go back to teaching and focus primarily on lecturing. And my hope for him is that whatever he's doing, I hope it brings him as much fulfillment as treating patients has.
It's wild to think he RETURNED to treating patients about 18 years ago, and of that 18 years, I have been seeing him 4x a year for 14 of those 18, so I've been there for the long haul as it were. And it was a good run. And he taught me a shitload about not just the assortment of things I need to stay on top of, but he's also taught me a lot about MYSELF.
I plan on getting a birthday card and sending that off to him, as his day is coming up; and I plan on getting two lovely thank you cards and send them to his secretary and his clinician--both of whom I will miss interacting with them. Great, super sweet, friendly and professional women, both of whom I hope end up on their feet. 18 years is a long time, and this change will break up that little, happy, work place "family."
Nothing lasts forever.
Change can be a good thing for all involved.
It's still sad and a bit of an unexpected shock.
Friday, June 23, 2017
Supplement Comparison: Omega-3 vs Krill et al
Omega 3 vs Krill Oil vs Cod Liver Oil
On the Surface, both, Omega-3 and Krill
oils, supply Omega-3 fatty acids, HOWEVER, the source fish are different, and
more importantly, the potency of EPA and DHA differs MARKEDLY. There are claims online that Krill oil
“typically contains more EPA,” However, I did not find this to be true
(see chart).
Krill oil contains fatty acids similar to fish oil, and these fats are
thought to be beneficial in helping decrease swelling, lower cholesterol, and
make blood platelets less sticky, and less likely to form clots.
Omega-3 and cod liver oil are two different
oils even though they both come from fish and have a similar fatty acid
profile. Fish oil is extracted from the flesh of tuna, herring, cod and other
deep-sea oily fish species. Cod liver oil is a good source of omega-3 fatty
acids such as EPA and DHA but doesn't have much (if any) in the way of omega-3
fatty acids.
I’m not going to devote any more time to cod liver
oil—as that wasn’t part of the original discussion (which I had with my chiropractor), but thought I didn’t want
to exclude it from the entire discussion.
I found that the Mega Red Advanced 4-and-1
which contains both, fish oil and krill oil to be lacking, despite its high
regard in its reviews (as well as great marketing); however, that might be
related more to the antioxidant astaxanthin
which is in the krill oil rather than than the EPA/DHA that their
source fish, pollock, provides.
My theory/hunch is: whatever benefit
people MIGHT get from a krill oil supplement isn’t due to the EPA/DHA, but actually
from the astaxanthin.
- Marine Bioactives: Pharmacological Properties and Potential Applications against Inflammatory Diseases: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3366677/
- A worthy mention regarding astaxanthin and cancer: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4515619/
To cover all bases, I’m ALSO going to contrast/compare that Omega XL
supplement that Larry King promotes on TV into my analysis.
Despite the fact it
has “Omega” in the name, my
theory/hunch is: whatever benefit people
might derive from that (VERY EXPENSIVE) supplement actually comes from the
Green Lipped Mussel extract, which is high in boron.
SPOILER ALERT: At $1.11 per pill (PER
PILL!), rather than buying the Omega XL, perhaps it would be more economical to
consider buying a good quality omega-3 fatty acid supplement, and then buy a
separate and less expensive boron supplement.
- Nothing Boring About Boron: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712861/
Brand
|
# Pills
|
$ Per Pill
|
EPA (mg)
|
DHA (mg)
|
Total # Fish Oil (mg)
|
Source Fish
|
Notes:
|
Purified/Distilled
|
PacificCoast NutriLabs 2000mg Fish Oil
|
60
|
$0.17
|
800
|
600
|
2000
|
Herring, Mackerel, Salmon, Sardines
|
YES
|
|
Nordic Naturals - Ultimate Omega
|
90
|
$0.33
|
650
|
450
|
1280
|
Anchovies, sardines
|
"Other" Omegas: 180 mg
|
YES
|
Mega Red Advanced 4-in-1
|
80
|
$0.36
|
314 (combined)
|
339
|
Krill, pollock
|
Total Fish Oil + Krill = 500 mg (Krill contains astaxanthin)
|
YES
|
|
Omega XL
|
60
|
$1.11
|
12
|
7
|
?
|
Green Lipped Mussel Extract (high in Boron)
|
?
|
|
Carlson Super Omega-3
|
120
|
$0.12
|
300
|
200
|
600
|
Macerel, sardines
|
"Norwegian Fish Oil 1,000 mg"
|
?
|
Carlson Lightly Lemon Cod Liver Oil
|
300
|
$0.07
|
85
|
100
|
1000
|
Cod liver
|
"Norwegian Cod Liver Oil, 1000 mg" "Other" Omega-3: 45 mg
|
?
|
I, myself, have been on 3 mg of boron for a month or two now, and I originally started it out of concerns for bone density, as I'm getting older, plus I had gastric bypass six years ago. However, I might have a chat with my nephrologist (who treats me for hypertension), as the boron might impact my kidney function. I also started my husband on it due to his periodontal issues which have morphed into perio & endodontal issues.
Astaxanthin tibit: From what I can find online, astaxanthin is derived from krill or shrimp or salmon. And this site (while I don't know if it's credentialed) has some interesting information on the merits of consuming shrimp. Cliffnotes: 4 oz of shrimp contains about 1-4 mg of astaxanthin--the true amount of astaxanthin in shrimp pretty much vascillates depending on if it's wild caught vs farmed, as the whatever farmed shrimp is fed impacts the astaxanthin levels, whereas wild caught shrimp feeds off of kelp and other sea vegetation. Just a hunch here, but when buying shrimp or salmon, you want it to look as pinkish-orange as possible (I suppose this is why some farmed shrimp or salmon looks dull in comparison to wild caught).
Just sharing my notes and take-away a-ha! information I've culled thus far, and by no means am I suggesting someone use my information INSTEAD of talking with their doctor FIRST before starting these supplements. I've made up my own mind with what information I have on hand, and making judgment calls for MY OWN health; however, I do think that someone interested in adding astaxanthin (or boron, for that matter), SHOULD run it by their doctor first, to see if it's a good fit for them.
A preliminary caution on astaxanthin (in supplement form) can be found on this site. Again, that, too, is just a website, and not a replacement for talking to a doctor, but I think reading and thinking and wanting to be an advocate for your own medical care is KEY to optimal health. At best, the doctor might agree it should be included in your daily regimen, and at worst, the doctor would say to avoid it entirely (and hopefully provide a couple of reasons, too).
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