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October 26, 2016
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Confusion Troubleshooting

Every morning, I weigh myself, check my blood pressure, and test my blood glucose. The latter two measurements are checked on various occasions throughout the day -- moreso the glucose than the pressure, even though my only prescription medications are for my blood pressure rather than my blood glucose. There is a range for each that I consider "safe". When the ambient temperature drops, Raynaud's kicks in, and with it, the risk of hypothermia. Unfortunately, three of those parameters -- blood pressure, blood glucose, and body temperature --have a common symptom when they drop below the safety zone. That symptom is shakiness.


If I'm at home, it's easy enough to test each of these levels to try to figure out the cause of the symptom. Usually, low temperature will cause my blood glucose and blood pressure measurements to rise somewhat and will cause me to feel sleepy; low blood glucose will give me headaches or shorten my temper; low blood pressure will make me lightheaded (and maybe a bit faint or dizzy). It might be simple if these symptoms were only associated with low numbers. Unfortunately, they're not: stress-related rises in blood pressure will make me shaky and lightheaded; glucose spikes will give sharp headaches. It might also be simple if it were always convenient and in the front of my mind to test all three whenever I'm shaky.


Obviously, it's not. Most of us are familiar with blood glucose testing in public; some of us also have portable wrist cuffs for pressure monitoring. Most of us don't carry around thermometers, nor do we feel comfortable using them in public. And testing -- anything -- is the furthest thing from my mind if I'm trying to do something else that is attention-intensive -- such as holding my own in informal debate.


These past few days, I've been having difficulty recalling a number of idiomatic phrases -- the sort of stuff that's part of what I consider a "normal" vocabulary, not the "twenty-dollar words" I've been known to toss around as if they fell out of the penny gumball machines. I've gone halfway through the turn of phrase and miss the exit ramp, stuck on the freeway of not-quite-aphasia. While I can write off the occasional miss as normal-but-annoying, on Sunday night I was an absolute mess. I kept not-remembering the words to phrase cogent sociopolitical questions in an intricate conversation with friends -- right in the middle of Panera's. (And yes, these friends toss also around terms like "sociopolitical ramifications" as if they dropped out of the gumball machine -- at least in this sort of conversation.) I was chilled, and while the shakiness was of the sort I tend to associate with low blood glucose, I knew I had eaten enough that this would not be an issue (which was proved by a fingerstick of 118). For at least an hour, I was struggling to express conceptual ideas while I was trying to stop from shaking, feeling as disconnected from my intellect as if I were drunk or drugged. I felt myself arguing as a grade-schooler, repeating the same question twenty times because it didn't come out right, and so I kept getting answers to the wrong questions.


The really scary part of this is that there is a very strong tendency towards Alzheimer's disease in my father's mother's family, and a lesser tendency in my mother's father's family. While what I've seen does not suggest early onset Alzheimer's, the fear of losing my ability to communicate is never far from me.


It wasn't until after we left the premises and I warmed up a bit that I realized I was probably running borderline hypothermic.


It's only the middle of September. I'm fearful this is going to be a looonnnnnngggg winter.

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