The Adventure Continues: Pizza

Today I did a follow up visit with my physiatrist, and after the appointment, considering I walked eight blocks there and there's a great pizzeria nearby which is too far for a regular type of thing, I walked an additional block out of my way to get a slice (with chicken and bacon on top).

As this is all new to me, I'm still curious about the chemical stuff going on if I eat certain foods (i.e. the only times my glucose dropped markedly was eating 1/2 a grapefruit or eating a piece of rum cake which contained 25 gm of carbs. So pizza was still an unknown entity to my glucose reads and response.

With that in mind, on a whim, I jabbed myself at work and here are my results:

Pre-pizza: 86
2 Hours post-pizza: 104 

So of course, I'm confused, somewhat pleased, but still confused! I was expecting a drop and instead, it jumped.

Note: I only ate roughly 1/2 to 2/3 of the slice, and started feeling regretful and glassy-eyed. 

Note To Self: Glucose Readings

Even though (at the moment) I don't have to test myself daily moving forward, I'm going to plunk down the images which are my readings.

No More Hard Pricks & Questions Left Un-asked

Ordinarily the short string of words, "hard pricks" would be enticing; however, it succinctly describes my difficulties in obtaining that elusive, optimally sized blood droplet for my glucometer. However, my fingers, blood, or circulation all are conspiring against me.

And after two weeks of this little ordeal, when I finally have figured out a routine (involving a moist heat pad on the hand right up until the pricking), my endocrinologist has informed me I no longer have to test out.

The last two weeks have been overwhelming for me. And I know the lack of finger pricking does not mean I no longer have an issue. Oh, it's still there. But I will manage it as I have all along, and now with more awareness of what exactly is at hand, and be a bit smarter (especially about booze).

And given how overwhelmed I am, and knowing that post-prandial reactive hypoglycemia is not diagnosed off the OGTT, I am not prepared to jump through yet one more firey hoop: the hyperglucidic breakfast test, to know with 100% certainty, yes, in fact, this is the thing I have.  Because to be honest, PCOS, Syndrome X, and the ever-increasing number of thyroid nodules I have, is enough of a collection of endocrine issues with which to deal (on top of everything else going on). 

Next up on my TO DO LIST is yet another thyroid sonogram (and possible BONUS! FNA!) scheduled for 3/30. I'd say that's enough for now--isn't it?

Note to self: Hyperglucidic Breakfast Test

The more I read, the more inconclusive I think my 2 hour OGTT results are.

Considering my endocrinologist is taking his time replying to my emails (odd for him, actually), and he's not answering everything, especially the million dollar questions of: 1. What should my target be; and 2. How long must I continue to stick myself? I'm holding off on asking the question of the moment: Are we going to do a hyperglucidic breakfast test to confirm the suspected Dx of post-prandial reactive hypoglycemia?

Sticking a pin in that thought and slapping it here, as a reminder for myself.

Note To Self: Glucose Target Range

Screen grab from today: 

http://www.niddk.nih.gov/health-information/health-topics/Diabetes/hypoglycemia/Pages/index.aspx

The Latest Development: Finding a Lancet That Works For Me

There are so many things I am feeling right now: anger, discouraged, fear, anxiety etc, related to the news of the reactive hypoglycemia. If that weren't enough, I am incapable of getting an "optimal STICK" with the lancet that came with the glucometer the doctor provided me:

Oh! It's a sporty little meter, and the Delica lancet is ever-so-fine; however, even at the highest setting (5), I cannot consistently get an optimally sized blood droplet for the test strip, which then requires me to do multiple sticks (wasting lancets), and also equals more OWIE.

A friend suggested the lancet he uses, a Relion. So before I trudge on over to Wallyworld to buy it, perhaps there's a way for me to comparison shop lancets. I have no idea what makes his better, and I have absolutely zero knowledge of any variation in lancet gauge from manufacturer-to-manufacturer. 

Yet another issue/event in my life that sucker-punches me, making me actively miss my dad. He would have been my Johnny-on-the-spot, letting me try out lancets and glucometers in his collection, until I landed upon the right one that works for me.

New Development: Post-Prandial Hypoglycemia

Every time some new development crops up, I am reminded that there are assholes out there who think either I'm a hypochondriac or think I'm imagining this shit (and that sentence is THE ENTIRETY of head space I am allocating to that bullshit). 

I'm now five years out from my RnY, and some symptoms I just thought were related to my hypertension (like lightheadedness) and I was experiencing that heart flutter thing, which we've been possibly incorrectly thinking was hormonal (I'm 47).  

Up until last Monday, I had absolutely no idea anything was wrong. I went for a two hour glucose tolerance test (I'm not sure why, though my insulin has been on the low side of normal, so I thought everything's okay). My fasting glucose was 90 (normal!), and after two hours, it bottomed out at 32. However, mind you, after the test? I honestly felt fine. Had no idea anything was wrong. It was only later on when my doctor called me in a panic, did I know something was going on.    

So, yesterday I had to stick myself six times (when in reality I think I should have stuck myself 12 times) as my doc wanted me to test fasting before each meal and 2 hours after; only problem is, I didn't tell him I actually eat roughly six times a day. So I'm sure all the sticks I did yesterday are probably inaccurate.  

We have been doing a differential, trying to pinpoint what it is exactly that's the cause of  me bottoming out with a 32 at the end of a 2 hour glucose tolerance test. So many variables. It could be a combination of things: 1. I was wearing scopolamine patches on my cruise last week; 2. I drink alcohol on an empty stomach; 3. I was taking evening primrose oil, and relora supplements. Or it could be something neither of us considered: an unfortunate side effect from my gastric bypass: post-prandial hypoglycemia.

Prior to all of this, the only indication I knew something was up was the fact I feel like crap eating something like bagels, pizza, or pasta, so for me, since the bypass, I thought it was a normal progression to get away from those foods--so that's how I manage that (I pretty much avoid them). 

I guess all along I have been managing this without my knowledge by eating smaller meals, focusing on proteins, and avoiding a lot of refined high glycemic carbs.  I ate a piece of rum cake yesterday, roughly 25 gm of carbs, and nearly 2 hours later, my blood glucose was 72--so, not perfect, but also not right at the danger zone either I think.   

I cannot help but be discouraged, as I haven't lost everything I wanted (I lost 100, regained 25), and have worked hard just to maintain what I have, and tried so hard not to become a diabetic, and now THIS. 

I'm regimented.  I pack a feed bag for work, and am pretty regimented with eating six times a day, remaining compliant about the no liquids after eating restriction, as well as staying on top of all my vitamin requirements etc.

Thursday was an emergency visit with the endocrinologist, so on Friday, on a hunch I googled post-prandial hypoglycemia and I'm just really dejected and not sure how to handle the news/possibility of this as a diagnosis. When I came home from the doctor's visit, I pitched the suspected supplements in the trash--in full on revulsion, and wanting to avoid any possibility I'd accidentally take them until we figure this out. Sure, not smart money wise, but I always can buy more if it turns out to be a fluke. 

I was hoping after ditching the supplements and avoiding alcohol for a bit (mind you I do 1-2 drinks a week), perhaps we can re-do the glucose tolerance test.   Nearly all of my readings 2 hours after eating have been normal, as well as my numbers when I wake up in the a..m. (Normal for me: 88-91 have been the norm).

So now, I'm vexxed by all this finger pricking, and my blood isn't cooperating. And thinking of never eating again, given how everything seems so driven by the act of eating. I'm fine when I wake up, as my fasting glucose is between 88-91. It's what I put into my mouth moving forward which is posing to be a new challenge.

Feeling dejected, disappointed and wondering why I've been working so hard just to maintain, only to have a new set back.