I've Been Spayed

Once I made the decision, it was easy to schedule the surgery. I chose the traditional method rather than the laparoscopic, because the procedure was a shorter duration, and I had already decided whom I wanted as my surgeon. 

The hospital and staff treated me well from the moment I was admitted. The prep part went smoothly, and I was under sedation quickly and easily. Then I woke up. I chatted and joked with the nurse, who was administering morphine to keep my pain levels manageable. Pain was okay with the meds, as long as I didn't laugh or breathe too deeply. I had no sense of time, so I'm not sure how long I stayed in the recovery room. At some point, I was transferred to the room in which I'd stay the next two nights. I didn't like the moving part, especially when the gurney went over thresholds. I'm not going to sugar coat it, it hurt like hell, with a side of barbed wire. The gentleman who was stuck with transporting me felt awful for torturing me, and gave me time after crossing each of the nine threshold to breath through the pain.

My nurses were outstanding.  I was up and walking in no time, and they were with me every step of the way. I was given lots of advice before surgery, and I want to share the hints and tricks that worked best for me. The best advice was to suck it up, and stretch out. Don't give in to clutching a pillow to your tummy. When it's time to walk, stand up straight and breathe through the pain.  I took the "suck it up" advice, and I know the intensity and duration of pain was greatly reduced because of it. Essentially, it's like ripping off a band aid. You can go slowly, and prolong the pain, or you can rip it off and get it over with. I chose the latter.

Things I enjoyed doing before surgery were unpleasant for a while after surgery. Laughing, taking deep, cleansing breaths, going from laying down to sitting to standing, and vice versa. Each day, the pain lessened and it wasn't long before I was driving. I am not ashamed to sat how painful navigating speed bumps were. Yes, I drove slowly and cautiously in general, and I crawled over speed bumps in particular. I loved being mobile, but I was careful to follow another piece of advice: don't do too much too quickly. I was (mostly) pretty careful about not overdoing it.

I was struck with a stark reality about 1/2 through my recovery: there's an empty spot in my body cavity. I felt all sorts of things, depression, fear, and incomplete, for a while. I was expecting it, so I knew what these feeling were when they crashed over me. I was worried for a while that I wouldn't be able to enjoy an active sex life as I had before. I was afraid that I had mutilated my body and would no long experience orgasm as I once did. I can assure you, that fear is groundless. My missing parts and pieces do not in any way reduce my sexual appetite or the ability to experience pleasure.

There are a lot of articles and information out on the interwebs, but I'm not going to link to any of them, as I didn't find the concerns they raised either true or helpful. My hysterectomy experience went well, and I achieved the desired results: I no longer have uterine pain from fibroids.

I take a daily estrogen supplement, and I am free of menopausal symptoms. All in all, I consider my hysterectomy a success.

Medication Experimentation

I got to thinking that what I experienced as anxiety and depression was actually the effects of insulin resistance. I felt that I had enough personal data and supporting evidence to warrant a decrease in Cymbalta, which I have been taking for about eight years. I was at the maximum daily dosage of 120 mg. I chatted with my doctor about cutting the dosage in half. He supported my decision to try decreasing my dosage and we agreed that I would take 90 mg for 14 days and then 60 mg after that. I'm happy to report that I'm doing quite well on the current dosage. Perhaps in the next year or so I can wean off of Cymbalta completely. With my doctor's permission, of course.

A month or so ago, my endocrinologist put me on Spironolactone for Hirsutism. While the literature states that it takes a few months for noticeable effects, I've already seeing a few. For example, my skin and hair is not as oily. I need lotion now when I didn't prior; however, I love the various lotions I've purchased, and using them makes me feel feminine and girly.  I no longer need to wash my hair every day, every other day works out well. 

Fewer meds and feeling better is a great way to start this new year. 

Related Links

• Spironolactone 

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)?