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Practice makes near perfect at bedtime

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October 22, 2016
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The weather outside has been relatively mild the past couple of weeks -- but you'd hardly know it from looking at me. I've been fairly consistently wearing base layers underneath my short-sleeved workshirts, multiple layers of polar fleece indoors, consuming more commercially-made soup than is good for me, drinking copious amounts of coffee, and still feeling chilled and unable to warm up.


Lest you think it's all in my head, my hands have been turning blackish from my fingernails to my knuckles -- and my toes, likewise. It's not the first autumn that I've had to deal with these issues, but it seems ridiculous that I should have to wear base layers designed to be worn for outdoor winter sports (these garments actually come with warnings to not wear them in conditions over 55 degrees Fahrenheit!) indoors just to keep from constantly shivering, yawning, and doing everything else that suggests I'm running borderline hypothermic.


Worse yet, as near as I can tell this year, it's happening at normal (or for me, slightly elevated) body temperatures.


And as far as I can tell, there's no medical rhyme or reason for it.


I can tell you when I started having inappropriate sensations of being chilled, the environmental circumstances that I believe led to these responses, and under what conditions they occur -- but try as we may, my doctor and I have not been able to figure out why. I do believe the symptoms are worse when my blood glucose levels are higher than my usual range, but because of the lack of circulation in my fingertips, my meter will tell me I'm borderline low to low. Meanwhile, my body will react to the thermal stress by raising my blood pressure -- sometimes dangerously high -- and if I try to "ride it out", I will observe a glycemic response consistent with a stress-related glycogen release. And if I'm under enough of a thermal barrier to try to normalize, by the time I feel comfortably warmed up, I'm sweating.


We've tested for Raynaud's Syndrome, lupus, Leiden Factor V, and a number of other conditions, all of which have come back negative. We've tested my female hormone levels, which reveal only that I'm in the middle of those changes that are appropriate for my age and stage of life. We do know that I have chronic venous insufficiency in my legs, which plays a factor in my calves swelling up (unless I wear compression hose) and my toes feeling cold, but the only thing my doctor can come up with for my fingers getting as black as my toes is, "the diabetes". And try as I can, I am unable to find anything in the medical literature (other than menopause-related hot flashes) discussing metabolic and/or pathological conditions that might affect one's ability to regulate one's body temperature (or one's sense of thermal comfort).


At one time, I remember reading of elderly people who needed sweaters when the local environment dropped below 80F, and who died of hypothermia in the oddest of ambient conditions. As my body's ability to regulate its temperature declines, I sometimes worry that I might one day add to those statistics.


Just one more thing to have to keep track of.


(My "normal" is 97.4F-97.9F; I start feeling feverish or acting strange when I drop below 97.0F. Lately, I've been running more like 98.2F.)

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