Probably Bronchitis

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.

Heading Back to the Doctor

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.

Hypoglycemia Rejected By Some Doctors?

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

Finally Made it to the Doctor

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?

Anxiety Could Be Related To Hypoglycemia

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!