For those of you diagnosed with fibromyalgia, I highly recommend checking out the Fibromyalgia Forums at MDJunction.   It is a message board, of sorts, for fibromites (as they call themselves) and the wealth of information exchanged is unique and helpful as it all comes from others who live with this condition.

There are also areas to share recent news and articles relating to fibromyalgia, as well as a lounge for off-topic discussions.  Joining is fairly simple and allows you to create a profile to share with others.  They also have a diary feature for those who like blogging and sharing your experiences online.

I don’t often have the time and energy to keep up with two blogs, so this one has been neglected, somewhat, and I’m considering changing locations all together.  I’ve come to appreciate an audience of people who are walking in my shoes at MDJ, whereas here you sometimes get the random “STOP WHINING” comment from people who don’t understand what FM can be like.   They even have a forum just for folks with hypoglycemia, but I seem to be the only active member at this point.  Maybe because everyone else had a doctor who took it seriously enough to actually treat it?  Ha, ha.

Hope to see some of you there!

I’ve joined the fibromyalgia group over at MDJunction and now repeating my “events of the day” yesterday on wordpress seems a bit too redundant, ha, ha.  Let me summarize by saying I woke up feeling a little better and managed to get a few chores knocked out that took the wind out of my sails again.  Meanwhile, Kaden was acting rather “puny” and later that evening, started running a fever.  We both went bed at 6 p.m. and I woke up about an hour later feeling even worse that the day before!  Seeing how my son and I both were feeling pretty horrible, I’m thinking we’ve just come down with something.  Considering the amount of achiness, I was just sure we had the flu, but Kaden’s had considerable improvement this morning so perhaps it was just a little bug.

I’m still using the inhaler and could taste it in my mouth and smell it in my nose all day yesterday and felt that explained the scratchiness, but last night, my throat was just RAW!  Still is today.  My nose is a little stuffy, but I’m also still taking the decongestant so that may be why I’ve not had much issues with that.  Kaden has a little stuffiness and his throat is red, as well.  No sign of fever this morning, though… YAY!

I checked out the calendar yesterday to see when Spring was finally going to get here, thinking maybe we would be past all this cold/flu/bug season stuff and I’m counting down the days, ha, ha.

One step forward… two steps back.  That’s how I feel… time and time again.  I had a major setback today, but hopefully it is just a little bump in the road and I’ll be back on track tomorrow.  Don’t know exactly what’s going on and no guesses at what is even to blame.  I felt “rough” all morning, but that just got progressively worse as the day wore on.  I wound up taking a late nap this evening and since Kaden had been whiney the majority of the day, I stuck him in with me.  We both passed slap-out and stayed out quite a few hours.  Too many hours, most likely, because now I feel even worse.

Let me see if I can put into words how I’m feeling…

I feel like I’m the only “real” object in the world and everything around me is some sort of surround-viewing TV screen.  Better yet, I’m in that movie “Lawnmower Man” with a virtual reality helmet on.  Those hands I see reaching out are my hands, but the things they touch seem more a figment of my imagination than true objects.

My muscles are not relaxing as they should.  For instace, I tried to push the covers off my feet with my right foot and the muscles in my arch tensed up and would not release.  It wasn’t a crampy spasm like we all sometimes get, though.  I should be thankful for that at least, huh?  And my feet aren’t the only body parts having this problem.  My legs are the worst!  A simple walk from one room to the other tightens my muscles up so much that it seems they could snap at any moment.  

On top of that, I’m stiff as a board!  Popping and cracking like some 90 year old with arhritis from head to toe.  Oh wait… I practically do have arthritis head to toe, ha, ha.  Lets see… the rash is coming back, I’m having trouble swallowing again, my headache is teetering between bad and unbearable, my eyes and mouth are extremely dry again, and I have absolutely no ambition or get-up-and-go or whatever you want to call it.  

Dramatic change from yesterday to today!  Yesterday, I was feeling so good I actually got caught up on some neglected chores and STILL felt like getting out of the house for a while.  Of course that makes me have to ask myself if I over did it, but not even once yesterday did I feel like I was having to “push” myself.   

I got so down and overwhelmed today that I called and cancelled my appointment with the shrink tomorrow.  I knew taking a late nap would mean Kaden would be up half the night and that would mean dragging him out of bed with little to no sleep and then having to contend with him the remainder of the day.  My appointment was at 9 a.m. and I’m never up and “about” much before that.  The idea of getting up extra early was just too much, if that makes sense.  I’ll probably regret that decision if I wake up feeling better tomorrow, but that’s a gamble I was willing take.  There’s just no reasoning with myself when I’m like this.

I cannot believe how much better I am feeling today!  Amazing what a little breathing can do for a body, huh?  I’ve also not had any “anxiety” attacks, but that stands to reason because that’s not exactly what they were after all.  That wheeze my mother and the doctor picked up on comes from bronchial spasms and it causes what is pretty similar to an asthma attack.  I’ve never had that happen before so I was clueless.  All I knew was my chest was getting tight, my pulse was racing, my heart was pounding, and so on and so on.  I’ve never taken asthma lightly, but having experienced a taste of it myself, I have even more sympathy now for those who have to deal with that on a regular basis.  But the inhaler has brought all that under control with four simple puffs a day.  YAY!  I was able to walk to the mailbox today without getting winded, but longer distances still leave me a little gaspy.  Mom got me some “lung toys” to help build all that back up, though.  I’m blowing pretty good numbers, but nearly cough myself to death afterward.  That’s good too, though.  Need to get all this crap up and out before it turns into pneumonia.

I also got a call from the PA today and she tells me my lung x-ray was normal.  Another big YAY, but no real surprise.  Before the respiratory virus, I was perfectly fine in that regard and suspected this was more likely an acute problem than something chronic.  I realize in my last post I came off sounding like I didn’t much care for this new PA, but that is not the case at all.  We disagreed on a few things and I got frustrated about it, but that’s what this blog is for… to vent those frustrations.  Turns out, having such a lengthy debate may have paid off.  She asked me today if I had ever had a two-hour glucose test and I told her my last one was with Stephanie, the other PA at the office.  She checked my file and saw that I had, so now she’s planning to meet with Stephanie and discuss a plan for addressing the hypoglycemia.  I don’t know what that means exactly, but anything would be progress. 

I don’t think I mentioned here that when I was referred out to the rheumatologist there was a mix up in my doctor’s office and they assumed I was seeing another regular doctor so I lost my spot with Stephanie.  They offered to set me up with the PA I’ve just seen and I was all ANXIOUS (ha, ha) about it because I hate starting all over with someone else, but having met her now, I think it will work out just fine.  I keep referring to her as “the doctor” in this blog, but that’s out of habit, not misunderstanding the difference between the two.  Oh… and the biggest difference… PAs have more time for patients, ha, ha.  They haven’t had their humanity beaten out of them with 8 years of med school, either, ha, ha.

So now… back to enjoying my new found relief!

I signed on tonight to write a few short sentences about my much improved health, but after reading my latest comments I’m feeling rather frustrated and will do some venting instead.

Blaire seems to be very upset that some of the symptoms I’ve been having of late may be attributed to something other than mental illness.  In her efforts to convince me that all of my health problems have a psychological basis, she’s simply coming off as one of those people who would tell someone with fibromyalgia or autoimmune disease that they are just depressed.  Since the focus of one of her comments was dismissing my hypoglycemia, I would like to share an article by Vasudevan A Raghavan, MBBS, MD, MRCP from the Division of Endocrinology at Ohio State University (because someone clearly needs educated on the difference between reactive and fasting hypoglycemia):

Hypoglycemia is a syndrome characterized by a reduction in plasma glucose concentration to a level that may induce symptoms of low blood sugar. Hypoglycemia typically arises from abnormalities in the mechanisms involved in glucose homeostasis. To diagnose hypoglycemia, the Whipple triad characteristically is present. This triad includes the documentation of low blood sugar, presence of symptoms, and reversal of these symptoms when the blood sugar level is restored to normal.

Hypoglycemic symptoms are related to the brain and the sympathetic nervous system. Decreased levels of glucose lead to deficient cerebral glucose availability (ie, neuroglycopenia) that can manifest as confusion, difficulty with concentration, irritability, hallucinations, focal impairments (eg, hemiplegia), and eventually, coma and death. Stimulation of the sympatho-adrenal nervous system leads to sweating, palpitations, tremulousness, ANXIETY, and hunger. [hmmm... that all sounds very familiar, huh]

The adrenergic symptoms often precede the neuroglycopenic symptoms and, thus, provide an early warning system for the patient. Studies have shown that the primary stimulus for the release of catecholamines is the absolute level of plasma glucose. The rate of decrease of glucose is less important. Previous blood sugar levels can influence an individual’s response to a particular level of blood sugar. However, one must appreciate that a patient with chronic hypoglycemia can have almost no symptoms.

Symptoms of hypoglycemia may be categorized as neurogenic (adrenergic) or neuroglycopenic.

• Symptoms due to sympatho-adrenal activation include sweating, shakiness, tachycardia, anxiety, and a sensation of hunger.
• Neuroglycopenic symptoms include weakness, tiredness, or dizziness; inappropriate behavior (sometimes mistaken for inebriation), difficulty with concentration; confusion; blurred vision; and, in extreme cases, coma and death.
• The timing of onset of these symptoms relative to the time of meal ingestion is crucial in the evaluation of a patient with hypoglycemia. Fasting hypoglycemia typically occurs in the morning before eating or during the day, particularly in the afternoon if meals are missed or delayed. Postprandial hyperglycemia typically occurs 2-4 hours after eating food, especially when meals contain high levels of simple carbohydrates. Postprandial symptoms are typically due to reactive causes, but some patients with insulinoma also may present with postprandial symptoms. About 4-6 hours after food ingestion, plasma glucose concentrations are 80-90 mg/dL, and rates of glucose utilization and production are approximately 2 mg/kg/min. Glucose production is primarily (70-80%) from hepatic glycogenolysis, with a lesser contribution (20-25%) from hepatic gluconeogenesis.

Causes of Fasting Hypoglycemia

• Nesidioblastosis is characterized by a diffuse budding of insulin-secreting cells from pancreatic duct epithelium and pancreatic microadenomas of such cells; it is a rare cause of fasting hypoglycemia in infants and an extremely rare cause in adults.
• Causes of fasting hypoglycemia usually diagnosed in infancy or childhood include inherited liver enzyme deficiencies that restrict hepatic glucose release (deficiencies of glucose-6-phosphatase, fructose-1,6-diphosphatase, phosphorylase, pyruvate carboxylase, phosphoenolpyruvate carboxykinase, or glycogen synthetase). Inherited defects in fatty acid oxidation, including that resulting from systemic carnitine deficiency and inherited defects in ketogenesis (3-hydroxy-3-methylglutaryl-CoA lyase deficiency) cause fasting hypoglycemia by restricting the extent to which nonneural tissues can derive their energy from plasma FFA and ketones during fasting or exercise. This results in an abnormally high rate of glucose uptake by nonneural tissues under these conditions.
• Drugs – Ethanol, haloperidol, pentamidine, quinine, salicylates, and sulfonamides
• Insulin-producing tumors of pancreas: Islet cell adenoma or carcinoma (insulinoma) is an uncommon and usually curable cause of fasting hypoglycemia and is most often diagnosed in adults. It may occur as an isolated abnormality or as a component of the type I multiple endocrine neoplasia (MEN) syndrome. Carcinomas account for only 10% of insulin-secreting islet cell tumors. Hypoglycemia in patients with islet cell adenomas results from uncontrolled insulin secretion, which may be clinically determined during fasting and exercise. Approximately 60% of patients with insulinoma are female. Insulinomas are uncommon in persons younger than 20 years and are rare in those younger than 5 years. The median age at diagnosis is about 50 years, except in patients with MEN syndrome, in which it is in the mid 20s. Ten percent of patients with insulinoma are older than 70 years.
• Non–beta-cell tumors: Hypoglycemia may also be caused by large non–insulin-secreting tumors, most commonly retroperitoneal or mediastinal malignant mesenchymal tumors. The tumor secretes abnormal insulinlike growth factor (large IGF-II), which does not bind to its plasma binding proteins. This increase in free IGF-II exerts hypoglycemia through the IGF-I or the insulin receptors. The hypoglycemia is corrected when the tumor is completely or partially removed and usually recurs when the tumor regrows.
• Autoimmune hypoglycemia – Insulin antibodies and insulin receptor antibodies
• Surreptitious sulfonylurea use/abuse
• Hormonal deficiencies – Hypoadrenalism (Cortisol), hypopituitarism (growth hormone) (in children), glucagons deficiency (rare), and epinephrine (very rare)
• Critical illnesses – Cardiac, hepatic, and renal diseases; sepsis with multiorgan failure
• Combination of one or more of the above, for example, chronic renal failure and sulphonylurea ingestion

Diet

• Dietary therapy may be effective for improving symptoms in patients with fasting hypoglycemia. Frequent meals/snacks are preferred, especially at night, with complex carbohydrates.
• For patients with reactive hypoglycemia, initiate a carbohydrate restriction. Patients should avoid simple sugars, increase the frequency of their meals, and reduce the size of their meals. Patients may require 6 small meals and 2-3 snacks per day.

Activity

Because exercise burns carbohydrates and increases sensitivity to insulin, patients with fasting hypoglycemia should avoid significant activity. On the other hand, patients with reactive hypoglycemia often find that their symptoms improve after embarking on a routine exercise program.

Further Outpatient Care

• If the patient has fasting hypoglycemia and the cause is treatable, long-term follow-up usually is not needed. If the cause cannot be treated definitively (eg, inoperable pancreatic insulinoma), diazoxide can be used to elevate blood glucose levels and chemotherapy that specifically targets the beta cell (ie, using cytotoxic agents such as streptozotocin) should be considered.
• If the patient has reactive hypoglycemia, periodic outpatient monitoring is warranted to assess the continued presence of symptoms.

Complications

• Untreated fasting hypoglycemia can lead to severe neuroglycopenia and, possibly, death.
• Untreated reactive hypoglycemia may cause significant discomfort to the patient, but long-term sequelae are not likely.

Prognosis

• Prognosis depends on the CAUSE of the hypoglycemia. If the cause of fasting hypoglycemia is identified and curable, prognosis is excellent. If the problem is not curable, such as an inoperable malignant tumor, long-term prognosis is poor. [wonder what the prognosis is if your doctors don't even bother to look for the cause?] However, note that these tumors may progress rather slowly.
• If the patient has reactive hypoglycemia, symptoms often spontaneously improve over time, and long-term prognosis is very good.

 

I made it back to the doctor yesterday and after listening to my chest, she agreed that I’m pretty wheezy and not moving air as deeply as I should.  Score one for Mom… our resident respiratory therapist.  So the doc said it maybe bronchitis, but she’s leaning more toward emphysema.  I am a smoker and all smokers must have a smoking related disease, right?  Considering I caught a respiratory virus at Christmas, my money is on bronchitis.  I concede that the smoking probably led to the bronchitis and I do have it in mind to quit, not just because of this, but one thing at a time, please.  I have heard wonderful things about Chantix and plan to try it soon, but wanted to wait until spring so I can get outside more.  I don’t think about smoking so much when I’m able to get out and “do.”  Well, “do” as much as this body allows.

I also have an ear infection which would explain a lot of the lightheadedness, too.  This is another one of those instances where being so sick all the time makes it hard to know when something else is going on.  People typically get headaches with ear infections, but since I have a headache every day of my life, I never noticed, ha, ha. 

The doctor sent me home with some more meds and I should be on the mend soon, but not before feeling a little worse from all the side effects of the meds.  I keep telling myself it is only for a few days and will be well worth the future relief.  So here’s my current drug plan:

• Clonazepam: anti-anxiety for the short term to “fix it now” until the other stuff kicks in
• Effexor: anti-anxiety for the long term
• Proventil Inhaler:  for bronchial spasms
• Tessalon:  for the cough
• Zithromax:  antibiotic for the ear infection

So now I don’t feel so guilty for sleeping around the clock the last few days.  The ear infection or bronchitis alone would leave one feeling pretty puny.  And I certainly am happy to know that this hasn’t been just my chronic stuff getting worse.

On a side note, the doctor and I had another discussion, which felt more like an argument, about the hypoglycemia and I think she’s going to set me up with a nutritionist to help me learn which foods give me the most bang for the buck.  While it still isn’t trying to get to the heart of the matter, at least it is something.

We also argued about that too… getting to the cause of the problem.  She actually tried to convince me that if something is treatable, it shouldn’t matter what’s causing it.  My thinking is this:  if you figure out what’s causing something, the cause may be fixable and you won’t have to “treat the symptoms” the rest of your life.  I think it was one of those instances where doctor put a statement out there, then say some of the most ridiculous things to back it up.  To further complicate the problem, she seems to be confusing reactive hypoglycemia and fasting hypoglycemia.  In the reactive sort, they hardly ever find a cause, but with fasting hypoglycemia, there are a few clearly defined causes.  Still, in the grand scheme of things, the hypoglycemia isn’t the greatest issue so I’m not ready to take up arms to get answers for it.

After a horrible few days (and nights), I’ve decided I’m heading back to the doctor.  While the clonazepam has certainly helped with that “someone jumped out and scared me” feeling, it hasn’t done anything for the rapid pulse, weakness, or shaky feeling.  What’s more, I’m sleeping almost around the clock now.  However, I think I had a major revelation last night.  I’ve been battling some chest congestion on and off since before Christmas and I think we are about to find that the majority of this isn’t in my head, but rather in my chest.

I woke up in the middle of the night and started on a coughing jag that I nearly passed out from.  The chest pain was unbearable and my heart was pounding like mad.  My mother is a respiratory therapist and I had her give my lungs a listen today and she tells me I’ve got some wheezing and I’m not moving air very well at all.  Back when she first got this “respiratory bug,” she wound up with walking pneumonia and suspects that I’ve probably evolved to that or at least have bronchitis.  I argued that I haven’t ran a fever, but then she never did with her case of it, either.  I put this theory to the test with trying to take in a few deep breaths and VIOLA… increased pulse, chest pain, palpitations, and feeling weak!

So here’s my theory… when I get upset or anxious about something, I can’t move air deeply enough and it makes the anxiety attack all the more worse and it lasts longer than usual.  When I’m up moving around and trying to “do,” again, I’m not moving enough oxygen and it makes me shaky, weak, etc., etc.  That certainly explains why the “attacks” are happening both with stressful situations and with physical activity.

I’ve got an appointment for tomorrow afternoon and we’ll see if the new doc has the same findings as my mother did.  On my last visit, we didn’t get around to doing a physical exam or even discussing this horrible cough and congestion since the anxiety discussion took nearly an hour, but that is what I stated as the purpose of my visit this go around so we’ll see what happens.

I met a new doctor today who, after hearing I have hypoglycemia, proceeded to tell me that not all doctors “buy into hypoglycemia.”  Well, that was a first for me.  I know a lot of doctors don’t fully understand it, but to discount it all together?  So before I try to catch one wink of sleep tonight, I want to share some information about hypoglycemia.

First, it should be understood that hypoglycemia is not a condition, in and of itself, but more like a symptom, just as a fever would be.  Hypoglycemia occurs when blood sugar levels fall below normal, which is 70 to 150 mg/dl., and is most commonly associated with diabetes.  Medications used to treat high blood sugar can actually cause the blood sugar to drop too low resulting in a host of worrisome symptoms and possibly lead to unconsciousness, seizures, and can cause death.  The most common symptoms of hypoglycemia are:

• • hunger
  • nervousness and shakiness
  • perspiration
  • dizziness or light-headedness
  • sleepiness
  • confusion
  • difficulty speaking
  • feeling anxious or weak

Hypoglycemia can also occur in people without diabetes.  This form of hypoglycemia can be further classified into two types:  reactive and fasting hypoglycemia.  In reactive hypoglycemia, symptoms usually occur within 4 hours of eating.  There is no definitive answer as to why this occurs in most cases, while some cases can be attributed to rare causes such as enzyme deficiency or fructose intolerance.  With reactive hypoglycemia, it can prove beneficial for patients to eat small, frequent meals (as often as every 3 hours) and avoid foods high in sugar.  In fasting hypoglycemia, blood sugar falls between meals, after overnight fasts, or after exercise.  It is typically diagnosed by doing a fasting glucose test in which the patient doesn’t eat or drink for at least 24 hrs.  If blood sugar levels are below 50 mg/dl, the patient is said to have hypoglycemia.  For some patients, symptoms may not be present until levels fall far below this amount, while others may experience symptoms with levels slightly above this amount. 

The causes of fasting hypoglycemia include medications, alcohol, critical illnesses, hormonal deficiencies, certain types of tumors, and certain conditions that occur in infancy and childhood.  For fasting hypoglycemia, treatment is aimed at the underlying condition.

Now, I was diagnosed with fasting hypoglycemia in 1991 and, as far as we know, I’ve been able to manage it pretty well.  The biggest complications I’ve had occurred during pregnancy when morning sickness was working against my efforts to keep food in my system.  Throughout the years, there have been many changes in how my hypoglycemia occurs.  There have been periods of time when I could go 12 hours without eating before symptoms would appear.  There have also been times when I’ve only gone 5 hours and symptoms appeared.  Even the level of sugar required for the onset of symptoms has varied.  For the most part, when I start feeling shaky and weak, my levels have been in the lower 50s.  There have been times, however, that I’ve had an onset of symptoms and my levels were in the mid-60s. 

Having been told about this problem, I’ve been able to avoid any real “crisis,” as I know to simply drink or eat something with sugar in it.  There have been a few times that it hit so quickly that I wasn’t “with it” enough to know what had happened.  I remember one time lying in bed feeling God-awful and when my boyfriend (now husband) showed up to spend the afternoon with me, I tried to make him leave!  And when he suggested testing my sugar, I almost went to blows with him.  I was mad at the world and just didn’t want to be touched or even talked to!  Luckily, he won the battle and my sugar had fallen so low that my crappy home monitor just said LOW and it was designed to read a level as low as 45.  But that’s the thing with hypoglycemia… if it hits fast, you sometimes are so “out of your head” that you don’t think about it.  And although you quickly recover with even a half a glass of juice, it leaves your body feeling extremely fatigued and even achy at times.  Needless to say, I’VE LEARNED TO EAT and EAT OFTEN!  And you can forget about pulling a drunk!  Not only does my sugar drop, it drops really quickly and is hard to maintain the following day.  Where one glass of juice can bring it into normal range on the norm, after drinking it can take two or three.  What’s more, the periods in which it happens are shorter.  It has dropped from 70 to 51 in as little as 3 hrs!  Again, this is needless to say, but I DON’T DRINK ALCOHOL!  Ok… I’ve done it and just bit the bullet the next day, but it has to be for a VERY good cause, ha, ha.

So that’s my little “getting to know you” for hypoglycemia.  If you think you may have this, don’t hesitate to ask a doctor to test you!  And if you have been diagnosed, don’t let a physician tell you it isn’t real or isn’t serious! 

Here are some links that I’ve stolen some of the above information from:

 http://diabetes.niddk.nih.gov/dm/pubs/hypoglycemia/index.htm

http://www.diabetes.org/type-1-diabetes/hypoglycemia.jsp

http://www.diabetes.org/type-1-diabetes/hypoglycemia.jsp

Yesterday, I had about had my fill of feeling the way I’ve been feeling and decided to try getting seen at an urgent care clinic here in town.  Not knowing how I’m going to feel from one day to the next, trying to “schedule” an appointment can be quite difficult and at least at urgent care, you don’t have to have one… just walk right in.   Getting a busy signal when I tried to call my regular doctor was the deciding factor, you could say.  So I expelled what energy I had on getting a shower and actually “doing” my hair and off I went. 

When  I arrived, the waiting room was packed.  I sat there for 30 minutes (palpitations, rapid pulse, shaking, and weakness in full force) before they ever called me up to give me the new patient forms to fill out.   After another prolonged wait, I was called back to the desk at which time they told me, “We’ve had two traumas come in and it is going to be about a 3 hr. wait.”  Sitting there waiting was going to make matters worse, so I took my co-pay back and went home!  I called my doctor and finally got through, so they sat me up an appointment for today, but not with my regular doctor (or PA, actually).  I was torn… I don’t like having to recount my history because, let’s face it, it is a lengthy one, but I needed to be seen ASAP.  Besides, she would have my file right there.

As I walked in the door, another patient was standing at the counter and I heard the receptionist say, “We’ve had an emergency and it is going to be a bit of a wait.”  I nearly crapped my pants!  Not this again!  When I checked in, she didn’t say anything, so I was hoping it was just for one doctor and that I’d still be seen in a timely fashion.  Thankfully, I was right.

The new doctor was pleasant enough and had a great sense of humor.  I’m racking my brain at the moment to remember everything we talked about, but I was having some “issues” and I just can’t remember everything clearly.  It seems like even physical activity can start up some anxiety-like stuff and I was still trying to get “settled” after a short simple walk from the parking lot to the office door.

We talked a lot about the symptoms of anxiety and it certainly goes along with what I’ve been experiencing.  I brought up the fact that I have hypoglycemia and didn’t much care for what she had to say about that.  She said that some doctors don’t buy into the whole “hypoglycemia” thing.  HUH?  Don’t “buy into it?”  Did I miss something somewhere about this being a “made up” condition?  I know there are two different types of hypoglycemia and perhaps that is where the confusion comes in, but fasting hypoglycemia is not something to be taken lightly and certainly not something that should be dismissed.  Now she didn’t come right out and say she was one of those doctors who didn’t buy into, but that’s what her comments that followed her statement suggested.  I explained to her that my type of hypoglycemia came with the same risks and symptoms of those experienced by insulin-overdosed diabetics.  She seemed surprised to learn that when my sugar was dangerously low, I would become altered and such.  She did a lot of head nodding, but I just got the feeling that she had her ideals about it and I had mine.  So let’s hope this isn’t related to hypoglycemia cause I doubt she will ever feel inclined to investigate it further.

She directed me back onto the subject of anxiety and that’s pretty much the “working theory” we have now for me.  I know next to nothing about anxiety, so I’m game for trying anything at this point.  I think I am more open to her opinions and suggestions because she was right about a lot of my traits and personality quirks and it is those very things that could be causing a lot of this anxiety stuff.  For instance, she talked about always putting myself last and that’s very accurate, but that’s just what a “mom” does, in my mind.  She also said I had a “boot strap mentality” in that I handle tough situations by “pulling it all up by the boot straps and just getting on with things.”  Here again, I see that as a very good way of getting through the “hard stuff,” not wallowing in it things or getting mired down by them, but she portrayed it in a very negative way, so maybe that’s not the best way to handle things?  I don’t know… maybe I am “managing” my life the wrong way and it is catching up to me?

So here’s the game plan, for now… she prescribed me a medication I can’t even recall the name of and since it was phoned in, I’ve not had it in hand at this time, but it is supposed to be similar to Valium or Xanax in that it provides quick relief to anxiety symptoms.  As she thinks my “anxiety” has been a long-term issue despite only having these profound symptoms in recent weeks, she also wants me to start on Effexor.  Also, she wants me to join a Yoga class and do that three times a week as well as walking every day.  Yoga we sort of agreed on because I like “stretching” and it does help with some of the stiffness in the short term, but actually going to a class isn’t in the cards right now.  I’m supposed to be avoiding stress, right?  Well, having to scrounge up the money to buy clothes to “work out” in (simply don’t have workout attire suitable for public) is going to be near impossible and leave me stressing about what doesn’t get paid because of it, actually doing Yoga in front of other SKINNIER people is going to make me more anxious, and then there’s having to find someone to watch my son three times a week while I attend this class.  There’s a “Yoga for Beginners” thing on one of the On Demand channels, so I figure I’ll start doing that and it will be a happy compromise.  As for the walking… well… I’ll have to figure something out.  I didn’t feel like explaining to her that walking in cold weather was a huge no-no for me and starting something I can’t do consistently sets me up for feelings of failure.  Gosh… there’s a lot of stress that goes along with just having someone tell me to exercise!  If I have a string of good days and I’m cramming in all the activities I’ve been missing, I get “you’re over-doing it.”  If I’m not exercising because I’m in a flare or have the serious fatigue (the sort that makes me ill) I get “you need to exercise more.”  I would like to see all them try to EXERCISE around this body’s schedule and to do so without making three or more of my symptoms worse!  I just had a funny thought… if the walking is supposed to get my heart rate up and do some aerobic stuff for me… why not just forget the meds and I can experience rapid pulse and heavy breathing in the comfort of my own bed up to five times a day for 30 minutes each time!  HE HE HE HE  OH…. and I meet with their psychiatrist in two weeks for an evaluation.  Wonder how that’s going to go?

She gave me a long speech about giving the medicine time to work and I feel that came from having had to stop the Cymbalta and Lexapro before.  She was quite insistent that I call if I have any problems and made certain that I understood there were going to be some “side effects” of sorts, but that it would all pass in time and, given the chance to work, it would all be worth it.   She was kind of comical when she’s explaining all of this stuff, by the way.  “If you have a headache, take Tylenol!  DUH!  If you get diarrhea, well… you have that anyway…”, ha, ha.

While what she was saying was humorous, I couldn’t get past feeling she saw my quitting the meds before as a failure on my part.  Like I gave up too easy.  I know better.  The decision to stop the meds was far from easy.  Those were supposed to be my “miracle cure,” ya know!  I was barely functioning when I started them and after several weeks of taking them, things went from bad to worse.  I was having a lot of problems with the neuropathy at the time and the medication just magnified it all.  My feet were burning and hurting so badly that I just wanted to chop them off!  Unless you’ve experienced nerve pain, words just can’t describe it.  And the fatigue turned into fatigue AND extreme sleepiness.  My doctor at the time said that some people did experience a worsening of symptoms on the medication and he didn’t feel continuing it was going to make any difference (meaning it wasn’t likely to just improve with time) so he changed me over to Lexapro.  Stopping that one was an easy decision because it was causing bleeding.  Nose bleeds… mysterious bruising… bleeding gums when I brushed… a bleed in one of my ovaries… damn skippy I’m going to stop taking them!  By the time I survived all of that, I was already over my “flare” and didn’t feel the need to try anything else that could possibly just add to my problems.  Now, did I take the time to tell the new doctor all of this?  NOPE!  I didn’t see where it really mattered, in the grand scheme of things, and Lord knows doctors don’t much like to debate such issues.  After all, it was only my overwhelming need for understanding and approval that was at issue.

I think all my bad experiences with doctors has scarred me for life, seriously.  I over analyze everything they say now.  And I say this because I’m about to vent about something else she said that didn’t sit well with me, ha, ha.  She made it clear that she was going to “go the distance” with me and wasn’t going to just drop the ball.  Hmmmm…. where have I heard that before?  Oh… I know… FROM EVERY DOCTOR I’VE EVER SEEN!   With the way this “illness” is, there just aren’t answers and eventually, they all get tired of hitting dead ends and we go from “going to do all that I can” to “going to do as little as necessary to pacify my patient.”  Along the way, I have had some big “wins” so I guess in the end, each of them has accomplished something.  The neurologist did fix the nerve pain in my shoulder and I have regained full use of my right arm as well as the burning and pain in my feet and hands.  That’s a major WIN!  The cardiologist proved to me that my heart is perfectly healthy and that’s one less thing I’ve had to worry about.  The trip to the rheumatologist prompted my call to NIH where I learned my eosinophilia is still quite a ways from being something to really worry about and more importantly WHY it is nothing to worry about just yet.  So I guess that I am getting somewhere.  It has just been an excruciatingly slow and painful ride.

I just read over all this (correcting 500 misspellings) and realize how much anxiety there is now with doctor visits alone.  I’m clearly on the defensive and probably had no reason to be today.  Further proof that I have a real problem here or justifiable considering the history?

My web research has thrown me another curve ball!  Fasting hypoglycemia, the kind that I have, can cause severe anxiety symptoms even when blood sugar levels are normal.  I wish I could say more, but this stuff is just WAY over my head.  I’ve had so many other things going on that I haven’t been able to even pick a day I can try and get a doctor appointment, but I’m going to make that a mission tomorrow.  Well, today… ha, ha.  I’ve been reading so much that my eyeballs hurt, but this anxiety/hypoglycemia stuff is so fascinating!