Monday, June 12, 2017


A manta ray 

In earlier posts I’ve talked about aging and well-being in terms of a huge flat sea creature, like a manta ray, that swims past just under the water I’m standing in so that it seems just a shadow, then disappears.  I went for a check up last summer, taking with me a little prepared document I made for the doctor.  Since I’m managing Diabetes 2, some of the time better than others, I’m fussy and don’t want to forget.  This is new. As a young person I almost recklessly took all kinds of risks.  (Never pregnancy.)  But I’m finding that today’s checkups are surface.  Docs no longer take your temp nor even ask to take your clothes off and look at your body, even here in melanoma country.  They don't ask for pee.  They just send in a blood sample, a standard “panel.”  You could do it by mail if you had the access.

In fact, the “free” checkup for Medicare turns out to be product research and promotion: insomnia, incontinence, falls, laxatives, painkillers.  There’s a pill for that.   And the blood tests are not free.  No “checkup” has revealed anything.  In fact, though I’ve been taking Metformin for years now, no one has said anything about the side effects since the beginning and I’m not sure it was even on the blood panels I took, though regular tests are recommended.

The problem is called “lactic acidosis.”  “Stop taking metformin and get medical help right away if you develop any of the following symptoms of lactic acidosis: unusual tiredness, dizziness, severe drowsiness, chills, blue/cold skin, muscle pain, fast/difficult breathing, slow/irregular heartbeat, stomach pain with nausea, vomiting, or diarrhea.”

Last night I had every symptom except vomiting.  Dr. Computer was at hand but not reassuring:

FDA Warning: Lactic Acidosis Warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects.

Lactic acidosis is a rare but serious side effect of this drug. In this condition, lactic acid builds up in your blood. This is a medical emergency that requires treatment in the hospital. Lactic acidosis is fatal in about half of people who develop it. You should stop taking this drug and call your doctor right away or go to the emergency room if you have signs of lactic acidosis.” 

I’m thirty miles from the nearest hospital, a hundred miles from Great Falls.  It was 3AM, high wind, Friday night (party night), and I’ve been meaning to get my taillight fixed — but I did recently use my VISA for enough basic repairs to drive safely again.  (I haven’t been for a while — bad tires, worn hoses.)  This outlay was on purpose because of the possible need to get somewhere without an ambulance.  Does one call an ambulance for being tired and sleepy with cold feet at 3AM?

There’s no one in the house to discuss all this, so I was my own advocate.  First, I asked why I wasn’t reacting to these symptoms until they were this intense.  Partly denial, partly consciousness of people suffering far more serious problems than mine, partly because of lack of experience with bad health, partly because I’ve been interpreting all this as aging.  Partly because I do NOT trust doctors anymore, much less the New Age nurse practitioners who are substituted now.

Second, I asked why I was drifting in terms of diet.  I don’t eat foods with sugar — black coffee, no jam, never pastry or potato chips.  But my amounts are off.  I called up some diabetic and weight loss diets and saw that I’m eating double and triple the amounts stipulated.  I eat the right stuff, just too much of it.  Elizabeth Taylor’s personal diet was to eat all the same things — just half as much.   Hmmm.  

Why do I overeat?  Partly as a reassurance — I’m following the Trump/Russia hearings closely and they are unsettling.  My neighbors have lately become worrisome.  Some old friends, not here, are at the edge or already dead.  The house has serious problems.  The yard is a jungle.  Pretty standard.

Beyond that, I really fear hunger.  My mother told about her childhood when sometimes they only had home-baked bread with applesauce on it.  They did have a cow and chickens, but they were living on a prune orchard and I didn’t hear much about gardening.  That grandfather was a master builder, which meant he had to travel to his contractor locations.  That grandmother died of cancer in her fifties.  Maybe that’s what planted the notion that losing weight meant one had cancer, so the (unreasonable) protection was being a little fat.  (It was one of the few ideas my mother-in-law and I shared.)

I’ve calculated that if SSI were suspended or the infrastructure of food delivery were interrupted, I have enough fat to last three weeks, assuming I have water.  My father constantly expected WWIII.  (His idea of food hoarding was cases of Wheaties and peanut butter.)  He was very overweight, which I attribute to heredity (Scots, from centuries of surviving on little food of dubious content) as well as a concussion as he entered middle age which seems to have disordered his system, both emotional and metabolic.  (They are meshed.)  For most of his work life he was on the road, a drummer for a wholesale cooperative in rural areas where every event is a competition in fine baking and one never sits down to talk without something to eat on the table.

Knowing all that doesn’t necessarily help.  The REAL CULPRIT is what you’re looking at:  my computer keyboarding.  I sit too much.  They say now that sitting is more deadly than sugar.  In spite of roaming grizzlies and glaring streetlights, I went out and walked around the block.  It helped.  I used to walk daily in spite of wind and ice, but then I fell a couple of times and started being short of breath.

I only drive for groceries and the laundromat.  ($3.50 a coin tub now, but I’m afraid buying a washing machine would overwhelm my malfunctioning sewer system.)  This is not a “food desert” because we have a single town store, but it’s a monopoly and you know what that means.  High prices but also mostly stocking what the owner family eats.  One whole aisle of wine, but recently a very welcome freezer of veggies.

Left alone, I would live on bread, cheese and coffee.  When I was traveling, I used to eat huge breakfasts in cafés, but now all I want is a toaster waffle I can carry around without syrup or butter.  No more can I eat what I want.  I resent having to use valuable thinking and writing time planning food.  

On the bright side, I discovered who will deliver cat food by the case for less money than the county stores even when the roads are bad.  I figure if things get REALLY dire, I could always eat the cats.  They don’t require refrigeration.  (Must I mark this as a joke?)

But the bottom line is that I think I need to know MUCH more about Lactic Acidosis because I may be flirting in and out the edges of it.  Maybe for many years.  That Manta Ray, Devil Fish, cruising around my heels.  First clues are “using aspirin”, which interacts with Metformin (I had no idea), and inadequately controlled diabetes.  I’ll start there.  And walk.


Nancy said...

Very sorry you are dealing with this. I hope you are able to find the medical care you need.

Mary Strachan Scriver said...

Been to the doc. I like her. She was reassuring -- which is not necessarily reassuring -- but we took a blood draw and will consider the results. No worries.

Prairie Mary

Nancy said...

Oh, good. It makes all the difference to have a doctor you like and trust.

anne harris said...

that is good news about the doc!