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Practice makes near perfect at bedtime

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October 25, 2016
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Numbers and Mumbers

Last Tuesday was my quarterly doctor visit. We'd pretty much settled on a quarterly schedule back at the time I was diagnosed, and it's only varied when I've needed to see the doctor for another reason (or because I had a bad reaction to a pharmaceutical), or when I've been uninsured (or had so high a deductible that I couldn't afford to make an appointment), and for a year or two somewhere in the middle that everything was running swimmingly without prescription pharmaceuticals, we'd switched things back to semi-annually.


The blessed (or is that "blasted"?) heat has been keeping my blood pressure in the "prehypertensive" range which, while it seems nice medically, may be too low based on recent research reviewed by Diabetes in Control and the momentary bouts of what would appear to be orthostatic hypotension (although I don't have a pressure cuff with me to document it) during my workday. That I tend to have periods of stubbornly high blood pressure (especially in cold weather) suggests the calcium channel blocker (diltiazem) is necessary, but the leg swelling (which could as easily be due to my job and to the weather) might argue against it. We've made a note to check again in October, when (hopefully) we won't be in the middle of a heat wave.


We discussed the ongoing pain issues, and concluded that the lower-back and hip pain is probably related to standing still/stiffly, since riding in the drops (stretching out my back and glutes) seems to alleviate it somewhat. We didn't get a chance to discuss the pseudosprain question. In any case, my doctor is absolutely convinced that my neuropathy issues are caused by having lived with diabetes for 11 years, and not a factor of standing on my feet all day, spending hours typing frantically at the computer, peripheral cirulation issues, or anything like that.


Meanwhile, having read a blog post that suggests that metformin might adversely affect Vitamin B-12 absorption, and that B-12 malabsorption might contribute to neuropathy put the issue on my radar. Finding another article in my archive that suggests B-12 defiicencies might also be behind cognitive issues (a different article on the topic may be found here, suggested I discuss things with my doctor. We did a B-12 test in addition to the other bloodwork (it came back normal).


The July numbers are slightly improved over the May ones, though not quite at where I'd like to be: A1c of 6.0 (my goal is under 5.7), my total cholesterol is 184 (goal is under 150), my HDL is fine at 66, and my LDL is at 97 (new standards suggest it should be under 70 for PWD, but I suspect that's just a ploy to put everybody on statins). I'm a bit concerned that my triglycerides have gone up to 104 (I'd like to keep them under 100), but that may be the result of too much white flour in my diet. As you may note, my goals are stricter than most (and for the most part, they are my own, based on what I've read in the medical literature and my own personal circumstances and risk factors). That said, my evening lows (and crazy eating patterns, based on my schedule) suggest that there are a crapton of highs out there which I'm not capturing, and I need to devote some attention to bringing things back into line.

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