April, part 1- Health, fitness, and doctors
While I’m not sure that anybody has read this blog twice, I feel I should apologize for not blogging for the past few weeks.
*AHEM* I apologize for not blogging the last few weeks. Thanks.
April included some new wrinkles for my training:
- Fewer short support runs (not good)
- My first “speed” workouts in years (good at the time, but…)
- Bad news from my doctor (not good)
Let’s take the last one first. I had my regular 6-month checkup scheduled for 9:15 on April 11th. I had bloodwork done in a lab on the 4th. On the 9th, my doctor’s assistant called to let me know how concerned my doctor was with the results. She asked if I could schedule an appointment to see the doctor to discuss these results. Um, how about 9:15 on Friday the 11th, the appointment I already made? We agreed to keep the appointment that precipitated the bloodwork in the first place. This gave me the opportunity to stew about the appointment for two days.
My current doctor took over the practice from my previous one when he retired last September. The previous one was sanguine, not at all an alarmist, and more than happy to let me be a partner in my own care. While he was sure that running was crazy, he was pleased that I was exercising. Under his care I managed to finish a marathon, a half-marathon, several 5-mile races, and countless training runs. However, we went round and round on medications for treating my general metabolic disorders, including Type II diabetes, high cholesterol, and borderline (high-normal) high blood pressure. As we added drugs to combat each I gained about 5 pounds. After two years of treatment all my numbers were excellent except the one between my feet on the scale. I’d gone from 180 pounds to at least 205. I felt terrible, looked flabby, and I made an emotional decision instead of a rational one. In February 2003, I let all my prescripitions expire without consulting my doctor.
It went well at first. I lost 10 pounds the first month, then 10 more over the next two months. I felt better, I looked good, I had more energy than I’d had in a while. I ran 10 miles in 100 minutes for the first time in years. If I could go back to the doctor as a fitter person with no symptoms of diabetes, perhaps we could find another course. Instead, I never called the doctor. Who calls their doctor to say, “I’m really healthy. Can I have a checkup?” I still didn’t call when I started to get some neuropathy (nerve pain) in my hands in the fall of 2003. By Christmas, my hands were so numb that my shoes would not stay tied- I couldn’t pull the laces tight enough. On New Year’s Day 2004, the pain exploded beyond what ibuprofen could mask.
For those unfamiliar with neuropathy, the problem is that there are no outward visible signs. There is only pain in the nerves. Before, the pain was severe but localized, usually started from a benign touch, then it faded over minutes. On a scale of 1 to 10, the worst it had been was a 4 or 5. This new pain was about 8 on the pain scale. I could barely sleep or eat. It felt like my hands were being squeezed in a vise, burned, and frozen, all at the same time, all the time. The pain crept up my forearms into my elbows. If it got any worse, I would have gone to the emergency room for morphine. That’s my 9. 10 on my pain scale is unconscious.
My old doctor saw me two days later. I explained to him what I’d done and the colossal amount of pain I was in. I sat there with my hands curling into claws and waited for a lecture. Instead he filled out new scrips for my old drugs, plus one for Tylenol laced with a mild narcotic to ease my pain enough to let me function by day and sleep at night. And when he left he shook my hand gently, looked me right in the eye, sternly but without malice and said, “Don’t stop taking your meds again.” I said, “Yes, doctor”. We never spoke of the whole thing again. The neuropathy cleared very slowly. I was unable to play bass guitar for months. I took 6 “special” Tylenols a day, the max, at first, and i didn’t get back to zero per day until July of that year. It’s hard to tell if there is pemanent nerve damage; if so, it’s minimal.
I tell you all this to point out that I miss my previous doctor, that the pain of shingles or shin splints is no big deal compared to that bout of neuropathy (even a hip pointer and a briefly dislocated knee were minor in comparison), and that I’m not screwing around with my health. Now I have to prove how serious I am about my health and fitness to this new doctor.
At my April 11th appointment, my current doctor, whom I have seen only twice before, told me my numbers (fasting blood sugar, hemoglobin A1c, cholesterol, and triglycerides) were all elevated. Not crazy high (untreated, my triglycerides have been in the thousands), but enough to make him wonder why everything went up. I told him it was likely linked to my lack of exercise while I had shingles, well documented in this blog, a concern I voiced during the shingles diagnosis. Then, he switched my cholesterol medication and told me to come back in two months instead of the usual six months with another round of lab workbeforehand.
I find this situation aggravating. Not the least of which because I have to write this long post that has not talked about running hardly at all (runs like no?). There is pain in my left shoulder which is either left over from the previous shingles attack or the precursor to a new one. Moments ago, I took my blood sugar reading. It’s 200. Every condition I have is related to stress. Much of my stress comes from managing these conditions. My doctor is asking me if I fasted before my lab work was done, like I don’t know any better. I don’t blame him for doubting me. I just hope it’s the last time he has to doubt me.
Doctors like to keep things normal. What’s normal? I’m going to try to run 12 miles or more tomorrow. Is that normal? I never smoked. I haven’t had a drink in seven years. Is that normal? If I do things one way, my blood sugar is in the “normal” range; when I do the same things again, they’re out of that range. Is that normal? I just wrote a thousand words that no one else may ever read. That ain’t normal.
I’m going to chill out now. April, part 2 will be along shortly to discuss my running both for and in spite of my health during April.
Tags: April, diabetes, doctor, fitness, frustration, health, neuropathy, normal, pain scale, running, shingles, weight
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