All The News That's Fit To Blog

Oh crap. I thought I had enough stamina and give a fuck to sit here and peck out an update regarding Monday's trinity of appointments. I guess I'll have to do a quick and dirty.

Appt #1: Rheumatologist. Clear bill of health. No auto-immune inflammatory diseases causing my pain. NEWEST DIAGNOSIS: enthesitis. On an upnote, my blood pressure was 110/64, so apparently, the combination of riding my bike 30 minutes each day, PLUS tinkering with my magnesium formulation (I transitioned from magnesium oxide which I was on for years, to magnesium glycinate, and in the last 3 weeks I transitioned to magnesium taurate). My bp was trending lower when I got my bp checked before acupuncture appointments, but this was my lowest reading yet.

Appt #2: Orthopedic surgeon. I went for a consult to see if I could get surgery on my knee. Turns out, despite the degeneration and oseophytes in the knee, I'm not "there yet," and the result of the physical exam was that the bulk of my pain isn't from the degeneration in the knee, but is soft tissue realted. Second diagnosis of the day: enthesitis.

Appt #3: Endocrinologist. I decided to err on the side of being conservative and seek out an endocrinologist. It was 14 long years of going 3-4 times a year to my former endo, and I was hoping I could get away without an endo. Initially I thought my GP could handle things, and then I got it in my head that a possible mover-and-shaker for the pain might be hypothyroid. The appointment was informative and uplifting, and I don't have to go back for another year.

So while yes, the results were good and positive: Yes, my blood pressure is the lowest it's been since I was in my early 20s; and NO, I don't have RA, Psoriatic Arthritis, Fibro, etc; and NO I don't need surgery yet--getting a diagnosis of enthesitis doesn't really help me. I already knew or sensed what this IS (pretty much it's a systemic tendonitis and inflammation of the enthesis, the point where tendons attach to the bone--and possible arthritis related to this too), it doesn't help me eliminate or even minimize my pain.

Hell, even my theory of it being pseudogout was a nonstarter--as my TSH report from the endocrinologist came back well within normal parameters. 

The day was beautiful, and appt 1 and appt 3 were both at the same location, with the ortho blowing a hole through my day by not being able to move that appointment later in the afternoon. 

Appt #1 and Appt #3 were at E85th, and Appt #2 was at E38th. And well, once Appt #2 was over, I convinced myself to WALK back to E85th. And I did more walking afterwards, and before I knew it, by the time I got home, I realized I overdid things. Here it is, four days later, and I am now walking with my cane. If I have a good day, a good day is as bad as a bad day (or perhaps even WORSE than a bad day), because I end up overdoing things and paying a hefty price for days or weeks after.

Imagine it. Me. In pain. Back, hip, knee, groin, you name it, and I managed to walk this far.

I have no recourse for treatment other than to find YET ANOTHER physiatrist*, start from scratch with them, get more Rx for PT, perhaps get some cortisone shots (yes, plural) and hope that helps get me through the hump. And I've been doing a bit of research regarding buying a cool laser so I can treat myself at home. Pricey! But I am sure it will all even out, if I were to factor in how many appointments I'd need with my chiropractor before I start feeling any relief. 

So, I am now bottoming out, mood-wise, I feel like shit, and I'm walking with my cane, and I'm wondering why it's an ALL OR NOTHING thing with me. Why couldn't I just have stopped walking?

*Note: It took me eight more months until I located my fourth physiatrist, aka P4.0. 

RLQ Another Diagnosis Dismissed

During last night's visit with my GP, we were discussing a few things, and I stated how I was still experiencing the RLQ pain, and I asked if he could examine me for a possible inguinal hernia, afterall the issues I've had with impactions and straining, it's *possible.* Doc was "game," and examined me, and well, we're ruling out the hernia.  And I asked if we could get an MRI of the area, which he declined. Perhaps my new pain doc might consider doing this.

Back to square one!  

Hurry up and wait... 10/13 is the appointment with the pain doc. 

ETA: In 2018, I finally got an answer about the mysterious RLQ pain. I was seeing a gastroenterologist due to hitting age 50 and that's the age you get a colonoscopy. 

NEW DIAGNOSIS: When I had my bypass and they punctured my abdominal wall to get the surgical equipment inside, they must have knicked a nerve. 

The gastroguy showed me the film of my colonoscopy, and everything is healthy and pink in my pipes. Each of my concerns and questions: cecal volvulus? Negative. Walking appendicitis? Negative. Malrotated mid-gut? Negative. 

So while it's setting my MIND at ease to know nothing more serious is causing the pain, it still is PAIN. And luckily it doesn't happen every moment of every day. But still!

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.