Doctors, please listen

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I am in chronic pain. I have always been in some amount of pain. It’s become increasingly unbearable over the past 25 years. It’s not just all in my head.

I have always been overweight. I have always had high cholesterol. I have always had high triglycerides. No amount of chiding me about “diet” and “exercise” will change that. I am not lying to you about my dietary habits. I am not constantly shoveling down huge quantities of fast food. I exercise when I can, as much as I can. I mostly cook for myself, and I cook healthy foods.

The thing I eat the most of is salad!

There is probably a link between high triglycerides and fibromyalgia. There is a lot of evidence supporting that. But correlation is not causation. Given my lifestyle and dietary habits it seems unlikely that it’s the triglycerides causing the fibromyalgia. It’s probably the other way around, or there’s a common cause to both that has not yet been identified.

Treating me like a FUCKING CHILD WHO DOESN’T KNOW MY OWN BODY isn’t how to get me to feel better. Instead of just assuming that I don’t understand nutrition and don’t understand exercise and that I’m eating too much and drinking and smoking all the time, maybe. FUCKING. just FUCKING. LISTEN to me.

I promise that I am not lying about these things. I want to get better. It’s why I’m fucking coming to you.

While we’re at it, yes, I have sleep apnea of some sort, but three sleep studies have had conflicting results and either way, CPAP wasn’t helpful, and my most recent sleep study did not support the ongoing use of it. It wasn’t my choice to stop using it, it was AN ACTUAL FUCKING SLEEP DOCTOR who told me to stop using it and who stopped authorizing the refresh of the equipment. Which, you know. Requires a prescription. From a doctor. And I monitor my oxygen and heart rate most nights, and the metrics show that any breathing pauses are brief. And no I don’t want to be having them either! But chiding me for not using a CPAP that I’m not authorized to have isn’t. FUCKING. Helpful.

(And even if I did have obstructive apnea, most signs point to obstructive apnea causing weight gain, not the other way around.)

I am well aware that my lab results are troublesome. I am doing what I can. Don’t infantilize me and assume that I don’t understand that High Numbers Are Bad.

And yes I’ve tried statins and they just make me unable to move at all because of excruciating pain, and the same thing happened with fenofibrate. I’d be taking them if I could! I actually do want to get better! I am not making excuses! I am not being stubborn! It’s not like I have some sort of secret hatred of being on medication. Some people have a weird sense of pride about not taking meds, about seeing them as a failure. I don’t.

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Heart schmeart

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Today I had a followup appointment with the cardiologist following the incident. He said that most of the lab results from the ER were good, but there’s a slight concern from my EKG, and of course he’s concerned about my high cholesterol and triglycerides (as well as borderline A1C), as well as with my family history.

For diagnostics, he’s having me do a treadmill stress test in a couple weeks, and also get an echocardiogram to measure the thing the EKG indicated as a potential issue.

For cholesterol and triglycerides, I told him about my history with statins and fenofibrate causing massive systemic pain problems and muscle failure symptoms, so he’s putting me on Repatha, which is a rather interesting treatment option that involves a biweekly injection of monoclonal antibodies, and which shouldn’t have any bad health effects.

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Reconditioning

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So, a few hours after I posted that last entry, I woke up in bed feeling a squeezing in my chest, pain in my jaw, and a few other heart attack symptoms. I got out of bed, did my best to calm my nerves, and called 911.

The EMTs evaluated me and said they didn’t see anything wrong offhand but my blood pressure was extremely elevated and with my medical history they felt that it would be best if I went to the ER. So, I let them convince me to go in the ambulance, which will probably cost me quite a lot.

At the hospital they did a bunch of work-ups, including blood tests for heart attack markers and a chest X-ray, and nothing turned up. Out of an abundance of caution they put me on an IV saline drip and gave me some aspirin in preparation for whatever other tests might have been necessary.

Within half an hour I was feeling totally fine, and my BP and heart rate returned to their usual levels.

So, I’m pretty sure I was just dehydrated.

I’m not looking forward to the bill, but I’m glad that I’m not dying. The ER nurse recommended that I convince my doctor to refer me to a cardiologist (like I’ve been wanting for quite some time anyway).

Anyway, I guess this is a good reminder to stay hydrated, gosh darnit. One can of seltzer and a decaf cappuccino per day isn’t enough to live on.

Deconditioning

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For the last few days I’ve been feeling anxious and having an elevated heart rate. That’s not just subjective, that’s what my heckin' Apple Watch has recorded. I keep on waking up in the middle of the night with a pounding heart, too. It’s hard to tell if it’s anxiety raising my heart rate or the other way around, but either way, something’s got to change.

The last few months I’ve been particularly sedentary due to a bunch of things (mostly chronic pain but also generally just feeling Meh and not wanting to do anything) and time has been slipping away from me very quickly.

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Estradiol, patch form

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Back in November of 2017 I had a pulmonary embolism, the result of a DVT which was the result of a combination of risk factors. At the time that it occurred, the insistence from the hematologist was that I’d have to cease the use of estradiol entirely, and this led to the worst month of physical and mental health that I can remember. I was basically going through menopause. A month later, a different hematologist said there was no reason I couldn’t keep taking estradiol, especially since I was on a course of warfarin to clear up remaining clot.

A couple years after that I had another minor DVT, and this led to needing to be on blood thinners, so now I take Xarelto daily, and likely will for the rest of my life.

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Kegels (PSA)

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So, be honest: do you know what kegels are?

Last night I found out that most people I know had never heard of them or, if they had, didn’t know what they were. They’re a pretty good thing to know about though!

In short: they’re a pelvic floor exercise. And they’re very worth doing.

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GERDing my loins

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I used to have pretty bad issues with GERD back in the day, which I ended up successfully treating through a change in diet and habits, namely not eating after 9 PM and pretty much eliminating mint from my diet (aside from the occasional treat). But lately I’ve been having GERD issues again, and for the past few days in particular have been waking up in the middle of the night with acid in my throat and, often, rather loud noises of bubbling through my body, which I assume are peristalsis with gas bubbles or something.

This has been pretty badly affecting my sleep and making my fatigue way, way worse than usual. Ugh.

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Bleh

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Since a couple folks have asked, I’m still the same as the other day, which is to say, tired, with a mild cough and pretty bad fatigue. I’m actually able to get some work done, though.

Also, yesterday I finally got a positive COVID test, although the T line was extremely faint. But at least now I know these tests aren’t completely worthless, even if it only told me what I already knew and well in retrospect.

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