Numbers Have Genders

Well, they do when it comes to test results.

The health management organization to which I belong lets me log on to their portal and see all of my test results. For this data gal, that's like being given the keys to the candy store! While some candies are sweet, others are tart, and still others leave a downright bitter taste in your mouth.

I was looking through the list of my pre-op labs, and noticed that the results of a test for my Kidney function, 51, fell into the mild to moderate Kidney damage zone. I decided that, although I could panic, I wouldn't, at least, not yet. Because, I got people in high places with all sorts of esoteric knowledge. I sent my buddy, who just so happens to be a practicing Nephrologist, aka Kidney doctor, a hey, "is this bad?" text. I figured that she'd set me on the path to calm or drop-kick me to the fast track to panic, accordingly.

Her initial response of "eGFR usually underestimates renal function in women" was both calming and disturbing. Calming because I took that to mean that the results, couple with my creatinine values, were okay for me, because I'm a woman. Disturbing because why wasn't the fact that I'm a woman reflected in the results? Why wasn't I given results based on my biology? How many other tests have results scaled for men but not women, and how is this male-focused scaling affecting the quality of healthcare women receive?

While the above questions go far beyond the scope of a personal health blog focused on PCOS, Insulin Resistance, Hursuitism, and the host of symptomology I've mentioned throughout many of my topics, those very questions cause me concern as to the confidence the medical profession truly has when it comes to treating women in general, and me specifically. I admit that my looming hysterectomy, which takes place on Monday, is causing me not a little angst; but maybe, some of that angst wouldn't exist if things like tests and their results were based on my biology versus that of some other sex.

With today's technology, it's a pretty simple thing to check a box to filter results by sex. Why is the medical profession lagging so far behind in gathering, standardizing, utilizing, and reporting sex-based tests?

Symptomology 101

Throughout these posts, I have mentioned symptoms and associated many of those symptoms with possible root causes. I've made dramatic lifestyle changes and I'm experiencing either a resolution of or a decrease in the intensity of my symptoms.

I call that success!

I decided to take a moment to celebrate my successes and speculate on which life change may have contributed to the improvement of symptoms.

Acne
Significant changes in not only what I eat, but when and how much I eat have contributed to completely clearing up acne breakouts. I'm positive that going dairy free, and eliminating potatoes, rice, and white flour, have contributed to eliminating this particular malady.

Excessive Sweating
While I haven't found the off switch for this lovely symptom, it is greatly reduced. I've noticed that the onset is usually when my blood sugar levels are high that I'm particularly susceptible to sweating. Further, when I'm exercising my sweating is within acceptable limits, so long as I drink plenty of water before, during, and after an activity. I'm fairly sure that eliminating caffeine and drinking buckets of water have been key to alleviating this fun symptom.

Assorted
Some of the following symptoms I know are addressed by using a CPAP. Others depend on my blood sugar levels, amount of daily excercise, and my stress levels. Still, significant improvements overall.

• Anxiety reduced
• Depression reduced
• Daytime fatigue reduced
• Forgetfulness reduced
• Lack of energy during the day reduced
• Loud snoring gone!
• Mood changes reduced
• Morning headaches reduced
• Sleepiness reduced
• Slower reaction time reduced
• Restless sleep reduced
• Recurrent awakenings reduced
• Insomnia reduced
• Vision problems reduced
• Waking up with a very sore or dry throat gone!
• Waking up with a choking or gasping sensation gone!

Related Links

• How lifestyle, daily routine affect blood sugar
• Patient information: Diabetes mellitus type 2: Alcohol, exercise, and medical care (Beyond the Basics)
• Pre-Diabetes&Lifestyle Changes to Prevent Type 2 Diabetes

Medication Configuration

In an effort to corral the volume of insulin stampeding through my veins, my endocrinologist put me on Metformin. Seems reasonable, and as I had done my research before the formal diagnosis, I wasn't surprised or overly concerned. The dosage seemed appropriate, 500 mg the first week, and then increase to 1,000 mg.

The first week went well. I didn't notice any particular challenge. By the end of the second week, I'd had an anxiety attack and a racing pulse. This anxiety attack didn't feel like a rhinocerose tap dancing on my chest, as prior episodes had. This one felt like a flight response; I wanted to bolt, run as quickly as my heartbeat suggested. For those who don't know me, I'm not a runner. In fact, I'm built for comfort, not for speed. But, I digress.

Just for the heck of it, I purchased a blood pressure monitor. I chose the easy, wrist unit. Up until now, my systolic (the top number) was generally below 119, and my diastolic (bottom number) generally below 79. After a couple of week tracking my blood pressure, I noticed that I was averaging 136/81, which falls into the pre-hypertension range. Ack! Now, how fair is that? I mean, I've made significant lifestyle and diet changes, my blood pressure should be trotting, not racing! Deep breath, okay, I'm done ranting, for the moment, anyway.

I chatted with my Family Practitioner about my blood pressure, and showed him the report from the Glucose Buddy app I use for tracking. Because the clinic's computer system was down, my doctor wasn't able to compare my current information to my historical data. He mentioned that my weight will have an effect on my blood pressure, and asked if I wanted to go on medication to address this. Uh, no. I didn't want to go on another medication until I felt confident that I could pinpoint the underlying issue. Both the doctor and I were happy that I declined.

If I'd been on my toes, I would have pointed out that I weigh less now than I did when I was in his office a few months ago. Why was my blood pressure good then and pre-hypertensive now? If I'd had my problem-solving hat on, I would have asked what changed? However, it was late in the day, I accepted what I was told, and merrily went on my way. But a nagging doubt kept needling my brain. It simply didn't feel right to dismiss my high blood pressure as a result of my weight. I knew that there was more to it than that.

That night I pondered the visit with my doctor before I fell asleep sleep. During the night, some mental filing occurred, along with a bit of cross-referencing and voilà! Magic happened. So, all those things that I wished I had thought about above crystallized, and with that clarity came possibilities and more questions. At my first opportunity, I searched for connections between Metformin and increased blood pressure. I looked at studies and read through documented Metformin side effects. I also found instances on various social media platforms and forums where someone noted the same Metformin/increased blood pressure symptom as I. Somehow, finding real people experiencing the same side effects that I have somehow put me at ease.

Putting it all together

What changed? I introduced a new medication into my body. Shortly after, I increased the dosage of that medication. It was when I increased the dosage that I became symptomatic. A ha!

After discussing it with my doctor, I decrease my nightly dosage to 500 mg. After all, I want to use the lowest dosage possible in which I can achieve the maximum therapeutic level without aggravating or incurring undesirable symptoms.

Updates

Date	Details
10/8/2014	My blood pressure is now below 117/74 and my blood sugar is still low and normal, but now my heart rate is whacked. I'm going to reduce my nightly dose to 250 mg, and see what happens. Check back here for an update. -Kat
10/21/2014	I nixed the Metformin all together. What can I say? My blood pressure is good, but my heart rate is still kind of erratic and tends to run high. Not sure what this means. At least it gives me something to talk about with my endocrinologist next month -Kat

Related Links

• Blood pressure chart: What your reading means
• Metformin
• PCOS: Insulin and Metformin
• Review: could Metformin cause Blood pressure increased (High blood pressure)?

Personal Data Collection

Sifting through data can be enlightening. Going through the process of collecting data can be arduous and, at times, a drag. Yet I needed to quickly learn what improved my symptoms and what made them worse. There is only one way for me to gain the kind of insight necessary to achieve my goal of lessening the intensity and duration of my symptoms, and that way is keeping records.

I'm very much into technology and as I always carry my smart phone, I saw no reason why I couldn't find apps to aid me in record keeping. 

First things first, I downloaded the My Symptoms food diary and symptoms app. Within a few days of record keeping, I began to see patterns emerge. I could pinpoint correlations between activities or foods and how my body responded. Specifically, I wanted to minimize or eliminate completely the excessive sweating symptom - that one drives me nuts!

Not long after, I received a blood testing kit (glucose meter). After grumbling a bit at having to use two separate apps to track my personal data, I downloaded the Glucose Buddy app. That was a huge eye opener for me. It was through tracking my blood glucose levels at the onset of any symptom that I made a huge leap in understanding what was happening to my body and what I needed to do to minimize a symptom's intensity and duration. 

While the My Symptoms app gave me correlations and insights, it didn't give me calories or a breakdown of fat, proteins, and carbohydrates. I also wanted a running total of the number of calories I burned while exercising. More data with which to fine tune the positive changes I'm incorporating into my life. 

I was referred to SparkPeople to track my foods and fitness by the facilitator of a pre-diabetes class I attended. Wow! Neat program that links an online interface with apps. So, I can do the bulk of my entries, or define frequently used entries, online, and then enter updates in real time via my smart phone. Pretty nifty. Further, you can sign up for various types of support and network with others who have faced or are facing similar issues to ones with which you may be dealing. I choose not to be quite so connected, as my goal isn't to lose weight, per se, but to be symptom free. Loosing weight just so happens to be a benefit of my goal. 

I track everything, even the three squares of Ghirardelli Dark Chocolate with Hazelnuts that somehow slipped from my fingers into my mouth. Yeah, if I'm not honest with myself and track everything that passes my lips, tracking doesn't help. 

It does take a bit of time and trial-and-error to find the tools that work best for you. I can assure you that becoming an expert on you, your body, and your health is well worth the investment. 

Related Links

• Quantified Self (This is a little over-the-top. The one below is well worth viewing.)
• Show me the data -- becoming an expert in yourself

System Flush

Research cited by the New York Times shows when your body is dehydrated, your kidneys go all Chicken Little on you. No, the sky isn't falling, yet those panicked kidneys retain water and release a hormone that raises blood sugar. For those of us who are tasked with driving our glucose levels down, it makes sense to do what it takes to keep our kidneys from pushing the panic button and releasing that pesky hormone. Fear not, Chicken Little kidneys, we know of a magical elixir that will bath you into calm bliss: Water.

Water dilutes the blood and flushes out glucose, among other things, from your bloodstream. Evidence suggests that drinking as little as .5 to 1 liter, or 17 to 34 ounces, will help you with attaining homeostasis. I drink a lot of water. On good days, my water consumption goes beyond 2 liters, or over 64 ounces. On other days, I stay in the range noted above. I drink water about .5 liter or 16 oz and eat a small protein/carb duo to stave off my blood sugar spike as soon as I get out of bed in the morning. I'm happy to report that this small change has greatly reduced the excessive sweating symptom I talked about in the One Hot Mama and Reverse Symptomology posts.

By chance I ran across a post in a forum that offered a suggestion for when blood sugar levels spike. My signs of hyperglycemia may include:

• Excessive sweating
• Fatigue (weak, tired feeling)
• Headaches
• Difficulty concentrating
• Increased thirst
• Frequent urination
• Decreased vision

When I experience any or a combination of the above, I flush out the sugar by drinking 16 ounce water quickly. I wait five minutes and drink another 8 ounce glass of water. Soon after, I'll pee, and my blood sugar levels start to decline. I keep drinking through out the day, as well. Keeping well hydrated has kept me cool and comfortable for several weeks now.

I'm thinking I'm on to something.

Related Links

• Does drinking lots of water and staying well hydrated help with keeping blood sugar levels at a more normal level?
• Does Drinking Water Bring High Glucose Levels Down?
• Five Simple Ways to Lower Your Blood Sugar
• Ways to lower your blood sugar quickly

Resistance Is Futile

Insulin resistance is when your body produces insulin, but the cells in your body have become resistant to that insulin and are unable to use it effectively. Insulin resistance may be part of the metabolic syndrome, has been associated with higher risk of developing heart disease, and precedes the development of type 2 diabetes. My symptoms include lethargy, hunger, and brain fog. These symptoms can easily be written off as a reaction to stress, which is pretty much what I did.  

Diseases or conditions associated with insulin resistance include:

• Obesity
• Type 2 diabetes
• High blood pressure
• Abnormal cholesterol levels
• Heart disease
• Polycystic ovary syndrome

Because insulin is one of the major hormones, it’s impossible for your body to balance its minor hormones (for example, estrogen, progesterone and testosterone) until your insulin metabolism is balanced first. 

Related Links

• Insulin Resistance and Diabetes
• National Diabetes Information Clearinghouse

One Hot Mama

I began having hot flashes when I turned 32. That seems young, doesn't it? I thought so too, at first, until I realized that I began menstruating when I was nine. Young, I know, right? Anyway, I remember having a few night sweat episodes after the birth of my youngest, but nothing like the drenchings that began around 40. 

I thought that I was experiencing peri-menopause. You know, all those things that we once

heard word-of-mouth, doctors thought women were crazy and referred us to mental health specialists? Thanks to the magic of the interwebs, our collective voices are heard. Turns out, we're women and things like mood swings, headaches, night

sweats, and hot flashes are part an parcel of being female. I know, sucks, right? It's easy to collect these symptoms together and label them "the change of life," except, of course, when we just accept the easy collective reality we might miss the exceptions and individual symptoms that might belong to another, more challenging collective reality. 

So, here's the thing: excessive sweating, hot flashes, and night sweats can be peri-menopausal, or they can be something else entirely. If I knew then what I know now, I would have insisted on a complete hormonal panel blood test be ordered often and frequently. The whole kit-and-caboodle. 

In fact, when my daughters begin their first annual girly parts exams, I will insist that they get hormonal panels done, too. Period. 



Similar topics: 

• Reverse Symptomology
• System Flush

Related Links

• Excessive sweating: Symptom
• Hyperhidrosis
• Sweat