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Medical Forum / Diseases and Disorders / Diabetes / November 2007

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I'm pretty f.cking depressed

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Jackie Patti - 20 Nov 2007 17:00 GMT
OK, last week, my readings went wonky for no particular reason.  Since I
was trying to get a thorough set of readings for my endo appointment
tomorrow, I was somewhat perturbed.

I was also getting weaker and less able to do things and it just started
to seem like I was going backwards.  By the end of the week, I started
getting depressed - feeling like my recovery was stalled.

Probably just a bug, but it was discouraging.

So yesterday, I had an appointment with a gynecologist and it just blew
me away completly and I am now having a meltdown.  Males can quit
reading here if they are easily squicked.  ;)

I'm overdue for a Pap and a mammogram, but the main reason I was going
in was cause I had an ultrasound back in August and they saw
adenomyosis, which is endometrial tissue growing into the uterine wall.

The main reason I had the ultrasound was cause I had a period in July, 3
years after my last period and I'm therefore presumably postmenopausal
so not supposed to have periods.  Frankly, I thought the internist was
overreacting, I had the CABG in June and figured my body had just
generically been shocked or something.  I didn't think a period was a
big deal, in fact, I didn't even mention it to the internsit, Steve did.

After the ultrasound, I looked up adenomyosis and it said it didn't need
treatment if it was asymptomatic so I didn't think it mattered much and
wasn't hurrying about it.

The gyn says it's a big deal.  Says the internist was negligent in just
doing an ultrasound, that I need an endometrial biopsy.  He says that
the main reason women don't die of uterine cancer is because they know
to check after the one primary symptom, which is unexpected bleeding.

I had cervical issues in my thirties.  I had a bad Pap smear, a bad
follow-up biopsy, then a LEEP surgery in a doctor's office with a bit of
cervix removed.  The following year, I had a repeat, bad Pap, bad
biopsy, outpatient surgery through a hospital gyn clinic with a bit more
cervix removed.  At the time, I was been told it was HPV-caused cancer.

My new gyn says it wasn't cancer, says if it was cancer, they'd have
done a hysterectomy.  I distinctly remember being told it was cancer,
when I freaked out about the second surgery, one nurse told me I'd *die*
without it.  So I dunno what the hell that means.

I also remember the biopsies hurt like hell.  I'd been told they
wouldn't and that I could drive myself.  Since I was a single mom of a
small child, I went ahead and did so.  I barely got myself home and
then spent several days in bed in pain due to cramps.  So the biopsy
wasn't nearly as "not a big deal" as they had said.

I have this biopsy scheduled for Dec 17th.  It's an endometrial biopsy,
which I presume means they are going through the cervix to get some
stuff from the uterus itself.   I can't see how it'd be *less* of a
problem than a cervical biopsy, so expect I shouldn't try to drive
myself.  Since Steve is on the road, I guess I'll take a cab.  No big
deal.

Unless I fail the biopsy, in which case this guy is gonna wanna yank my
innards out.  That should really jumpstart my recovery, having another
major surgery.

I am starting to believe that I'll never feel good again.

The gyn also said it was very unusual for them to see adenomyosis on an
ultrasound so he wants the report.  He also wants me to track down the
old medical records from when I did or didn't have cervical cancer,
which was almost 15 years ago in another state.

I know doctors who overdo hysterectomies are a possible problem, so
dunno if this guy is right or not.  I know I can Google and learn gobs.

OK, I already knew about diabetes.  I learned about insulin when I first
got home from the hospital.  Then I read and studied up on heart
disease.  Then I began reading about endocrine disorders and I'm not
done with that study yet.  Right now, my overwhelming feeling is that I
do NOT want to learn about uterine cancer.

I left the gyn's office and went for an unscheduled grocery shopping.  I
bought all frozen crap: cheese sticks, breaded chicken strips, pizza
rolls and garlic bread, decided that stuff didn't look unhealthy enough,
so added a Pepperidge Farm chocolate farm layer cake.  I had a big pity
binge for myself last night.  There's still gobs of leftover junk here;
I could start my own chapter of the ADA.  ;)

I haven't decided anything for today yet - if I'm going to keep being
stupid or get back on track.  I've been up for 4 hours and haven't
eaten, measured my bg, bp or temperature, taken any Lantus, or my other
meds, nada.  I just had a cup of coffee and several phone conversations
with hubby.  I've missed the Y and ought to grocery shop for
Thanksgiving too today, but am not feeling much like it.

I haven't begun calling around to track down all these medical records
yet either.  I'm not entirely sure if I give a damn.  My body seems
damned determined to f.ck me over, no matter what I do, so I'm not sure
if I wanna fight anymore.

I told hubby if I am gonna die any damned way, I want to go out on a
diet of hot fudge sundaes washed down with coffee with *extra* caffeine
while chain-smoking and no one had better dare bring a vegetable
anywhere near me.

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Susan - 20 Nov 2007 17:40 GMT
x--archive: yes

> OK, last week, my readings went wonky for no particular reason.  Since I
> was trying to get a thorough set of readings for my endo appointment
[quoted text clipped - 96 lines]
> while chain-smoking and no one had better dare bring a vegetable
> anywhere near me.

Drop the "poor me" crap and back away from the fridge!

You're probably going to live, you realize, and have complications of
these choices on top of everything else.

Just when you think you have a perfectly good excuse to indulge, you
find out you're NOT DYING YET.

I mean it, knock it OFF!

I mean that in the sweetest, most supportive way, of course.  ;-)

Susan
Jackie Patti - 21 Nov 2007 12:25 GMT
I have a two-hour endo appointment today to get to the bottom of
everything endo-wise.  There's really nothing to do but what is right in
front of me, so... I'll do that.

Yesterday, I read a novel - an author I like who always makes me feel
hopeful.  I basically decided I shouldn't read or think about medical
stuff.  Figured it'd make me feel better and it did for the time I was
reading anyways.  I had a meltdown at bedtime, but with four cats to
cuddle, crying isn't so bad.  ;)

Today, fbg is 144 - so bingeing didn't kill me.  Probably comes from
deciding breaded chicken strips and cheese and crackers were binge
foods; I don't binge well.  ;)

Steve is delivering in Pittsburgh this morning, and they do their
damndest to get drivers home for Thanksgiving and Christmas, so he may
well be home this evening and if not, by morning.  He is pretty aware
that he is coming home to help me rather than to have a holiday.  The
turkey is already thawed, so we'll throw it in the oven regardless, even
Steve could do that.  ;)  I bought champagne too, so maybe I'll get
drunk at some point this weekend.

I'm not scared of dying, per se.  I know that's a given whether it's
next year, a decade from now, four decades from now - I'm gonna die.
Being scared of that is something I've lived with since the heart attack.

What I'm *really* scared of is of being sick until then, of never
feeling good again.  I'm scared of never being able to have a garden
again.  Of never being able to hold a job again.  I'm scared that no
matter WHAT I do, another damned thing will come along, that I'll never
really recover, just go from illness to illness - that I'll just be an
invalid from here on out.

I also have this weird feeling that every different doctor who gets a
hold of me is going to find something else wrong.  Right now, I have an
internist, a gynecologist, a cardiologist and an endocrinologist.  This
is just an insane number of doctors; used to be I didn't see a doctor at
all for years at a time.  I feel... that I don't want any more
specialists; they'll just find something else wrong.  Somehow, it won't
hurt if I just don't know about it.

And yeah, Michelle, I'm scared of doctors doing any damned thing to me
unless I know all about it and approve.  I don't know of any way to
determine the difference between a good doctor and a quack short of
learning a lot of what they know myself.  But I am just flatout not
gonna look into uterine issues until after the biopsy.  If this guy
wants to yank chunks of my innards out, first thing I'll do is ask for a
second opinion, which will give me some time to do some reading and
decide what the hell to do.  For now, I'm just not gonna think about it.

And I'm postponing the mammogram until January.  It's gonna hurt way too
much with my chest still being sore from the surgery.  If they wanna
find something wrong with my boobs, they're gonna hafta wait as I don't
have time to have a problem there right now!

The weird thing is how like preparing *chicken* the whole thing seems.
Splitting my breastbone for the bypass struck me as something I am
familair with primarily from cutting up whole chickens.  The potential
hysterectomy seems like gutting me.  Boy, have they got the order of
things wrong!

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Susan - 21 Nov 2007 14:46 GMT
> I'm not scared of dying, per se.  I know that's a given whether it's
> next year, a decade from now, four decades from now - I'm gonna die.
[quoted text clipped - 6 lines]
> really recover, just go from illness to illness - that I'll just be an
> invalid from here on out.

I so hear you, and I've lived with thoughts like this for a long time,
especially this past couple of years.  I've decided that it's just not
true, as long as I believe in my wellness.  If it turns out to *be*
true, at least I'll live as a person who plans her life as a well one,
works for me so far.

> I also have this weird feeling that every different doctor who gets a
> hold of me is going to find something else wrong.  Right now, I have an
[quoted text clipped - 3 lines]
> specialists; they'll just find something else wrong.  Somehow, it won't
> hurt if I just don't know about it.

Me too.

> And yeah, Michelle, I'm scared of doctors doing any damned thing to me
> unless I know all about it and approve.  I don't know of any way to
[quoted text clipped - 4 lines]
> second opinion, which will give me some time to do some reading and
> decide what the hell to do.  For now, I'm just not gonna think about it.

Good plan!

> And I'm postponing the mammogram until January.  It's gonna hurt way too
> much with my chest still being sore from the surgery.  If they wanna
[quoted text clipped - 6 lines]
> hysterectomy seems like gutting me.  Boy, have they got the order of
> things wrong!

There are some docs who, if it's not actual cancer, will do myomectomy.
 Very time consuming and bloody, but keeps your organs intact.
Honestly, though, if it's just abnormal, not urgent, getting your
endocrine stuff under control may handle it.

Glad you're a Bad Binger.  ;-)

Susan
Jackie Patti - 21 Nov 2007 17:01 GMT
>> I'm not scared of dying, per se.  I know that's a given whether it's
>> next year, a decade from now, four decades from now - I'm gonna die.
[quoted text clipped - 9 lines]
> I so hear you, and I've lived with thoughts like this for a long time,
> especially this past couple of years.  

Yeah, I don't know how you deal with it, Susan.

Reading that Cushing's group is seriously depressing stuff - the
testing, then the sugeries, and sometimes that still not being a cure.

You can do everything right and still lose.  That's the feeling that's
driving me batty.

> I've decided that it's just not
> true, as long as I believe in my wellness.  If it turns out to *be*
> true, at least I'll live as a person who plans her life as a well one,
> works for me so far.

I need to get that tattoo'd on me or something.

Right now, I'm just gonna write this cause I *need* to believe in it...
my thinking has been, as I get healthier and improve the IR and perhaps
with some help from the Symlin, I'll be able to get off insulin in a
year or so.

And THEN I want to put everything in storage and give up this house and
just drive for a year and put piles of money in the bank.  If we both
drive, we can save a pile of money and buy land outright without a
mortgage in a year or two.

And then I shall have my garden, and when I improve the soil, it will be
improved FOREVER.  And I want to build a greenhouse so I have a garden
all year.  And have chickens again cause they turn carbs into eggs.  ;)
 And I want a cow, cause I like cows, and want my own - and silly as it
sounds, when I had my heart attack, that is what hit me as my biggest
regret, that I had never had a cow.  And to make yogurt and various
cheeses.  And just be a boring old fart who spends most of her time with
plants and animals and teaching kewl stuff to visiting nieces and nephews.

And I'll be DAMNED if I'm gonna be too sick to do that!

> There are some docs who, if it's not actual cancer, will do myomectomy.
>  Very time consuming and bloody, but keeps your organs intact. Honestly,
> though, if it's just abnormal, not urgent, getting your endocrine stuff
> under control may handle it.
>
> Glad you're a Bad Binger.  ;-)

I have no taste for sweets anymore, the layer cake was gross so I threw
it out.

When you eat flax and organic everything regularly, breaded chicken
strips and a cheeseball with crackers seem like awfully "naughty" foods.

Makes it rough to really binge properly - I probably CAN'T actually go
out on hot fudge sundaes.  Maybe I could manage a potato and pasta orgy
though.  ;)

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Susan - 21 Nov 2007 18:07 GMT
> Yeah, I don't know how you deal with it, Susan.

Same way anyone else does, by doing everything I can, and remaining
grateful for the abundant good fortune in my life.

> Reading that Cushing's group is seriously depressing stuff - the
> testing, then the sugeries, and sometimes that still not being a cure.
>
> You can do everything right and still lose.  That's the feeling that's
> driving me batty.

Yep.  I'm not so sure I'd have the surgery; I may *need* the extra
hormones unless resistance is addressed.

>> I've decided that it's just not true, as long as I believe in my
>> wellness.  If it turns out to *be* true, at least I'll live as a
>> person who plans her life as a well one, works for me so far.
>
> I need to get that tattoo'd on me or something.

Alternatively, on a piece of paper stuck to the fridge???   ;-P

> Right now, I'm just gonna write this cause I *need* to believe in it...
> my thinking has been, as I get healthier and improve the IR and perhaps
> with some help from the Symlin, I'll be able to get off insulin in a
> year or so.

Always hope for the best and plan for the worst.  Afer you've made your
plan, stop thinking about the worst entirely.

> And THEN I want to put everything in storage and give up this house and
> just drive for a year and put piles of money in the bank.  If we both
> drive, we can save a pile of money and buy land outright without a
> mortgage in a year or two.

That's a great plan.

> And then I shall have my garden, and when I improve the soil, it will be
> improved FOREVER.  And I want to build a greenhouse so I have a garden
[quoted text clipped - 6 lines]
>
> And I'll be DAMNED if I'm gonna be too sick to do that!

Exactly!

> I have no taste for sweets anymore, the layer cake was gross so I threw
> it out.

I'm the same way.  I'll make exceptions for extraordinary desserts with
Precose, but not for ordinary dreck.

> When you eat flax and organic everything regularly, breaded chicken
> strips and a cheeseball with crackers seem like awfully "naughty" foods.

They seem kind of rancid, greasy and pasty, no?

> Makes it rough to really binge properly - I probably CAN'T actually go
> out on hot fudge sundaes.  Maybe I could manage a potato and pasta orgy
> though.  ;)

Whereas I'd go out on a float made of Boule d' neige...

Susan
sally - 21 Nov 2007 23:13 GMT
> >> I'm not scared of dying, per se.  I know that's a given whether it's
> >> next year, a decade from now, four decades from now - I'm gonna die.
[quoted text clipped - 6 lines]
> >> never really recover, just go from illness to illness - that I'll just
> >> be an invalid from here on out.

Hi Jackie, I am so sorry to hear about your problems. I have enjoyed
reading your posts for the last 2 or 3 months and have found lots of
great information in them. I sincerely hope that you can come to terms
with the situation and make the best of it. I have not been in your
position so don't know how I would react but I imagine it would be much
the same. My thoughts an prayers are with you at this time.
I hope that you can enjoy your Thanksgiving with your husband and find
something to be thankful for. You sure have had your share of troubles
lately. It makes me more aware of how lucky I am to only be diagnosed
with early onset diabetes and nothing else at the moment and reading
about others trials makes me more intent on taking care of the diabetes.
Take care and best wishes for the upcoming tests.
Michelle C. - 22 Nov 2007 17:28 GMT
> Yesterday, I read a novel - an author I like who always makes me feel
> hopeful.  I basically decided I shouldn't read or think about medical
> stuff.  Figured it'd make me feel better and it did for the time I was
> reading anyways.  I had a meltdown at bedtime, but with four cats to
> cuddle, crying isn't so bad.  ;)

Hi Jackie,
Good for you!  So what did you read?  I'm an avid reader myself.  :-)

snipped but read in full

> I'm not scared of dying, per se.  I know that's a given whether it's
> next year, a decade from now, four decades from now - I'm gonna die.
[quoted text clipped - 6 lines]
> really recover, just go from illness to illness - that I'll just be an
> invalid from here on out.

I think that is something we all fear--hence our participation in the
newsgroup in order to control diabetes.  Personally, I believe quality
of life is more important than quantity of life.  The trick is in
determining what actions are going to get what, and that's where
information is your best ally.  I know the road since the bypass has
been very tough, but it sounds to me that you have been making
definite progress.  Except for the fact that you have to investigate
this new issue, physically you are in the same place that you were
before you discovered you'd have to deal with it, and that has been a
progressively more positve place.  Don't forget that.

> I also have this weird feeling that every different doctor who gets a
> hold of me is going to find something else wrong.  Right now, I have an
[quoted text clipped - 3 lines]
> specialists; they'll just find something else wrong.  Somehow, it won't
> hurt if I just don't know about it.

While I would never give advice about what a person should or should
not do in regards to health, here's my perspective, both as a patient
and a medical lab tech.  Doctors get the issue of quality of life
mixed up with quantity of life--they tend to think they are same
thing.  (Patients, and families of patients often mix these issues up
as well.)  Doctors also tend to look for problems because it's their
job to cure them--but sometimes the problems and cures really aren't
that important to quality of life.  Here's an example:  I worked for
an internist, a smart, compassionate guy, but also very thorough,
sometimes too thorough.  We had a 90 year old lady who was amazing--
sharp, no major physical infirmities, lived by herself.  The only
issue that was developing in regard to her health was the onset of
lymphocytic leukemia.  Her white count was 20,000+ and the greatest
percentage of cell types were lymphocytes.  The thing about this type
of leukemia is that it develops very slowly.  Anyway, the internist
wanted to do a bone marrow on her and she wouldn't allow it.  It
perturbed him to no end.  I asked him if he had the bone marrow test
if he could begin treating her.  He told me that no, he couldn't treat
her until her white count reached 50,000.  So I followed up with the
question about why the bone marrow test was so important.  He replied,
"Well, I just want to know!"  Okay, this internist was a good guy and
he helped a lot of people, but obviously he forgot that quality of
this patient's life was more important than his need to know.  (I
later talked to another physician I'd worked for before--an old guy
with a more "country doctor" attitude--about the incident.  He told me
the internist was being ridiculous, that at her age, the patient was
more likely to die of something else before her leukemia became bad
enough to require treatment.)   My point is that one needs to be very
careful to sort all of this out.  So while I wouldn't give advice
about what to do in regards to health, I will offer this:  Try to
determine what the doctor's motivation is in the advice they give
because sometimes they really don't know themselves--even the good
ones.

> And yeah, Michelle, I'm scared of doctors doing any damned thing to me
> unless I know all about it and approve.  I don't know of any way to
[quoted text clipped - 4 lines]
> second opinion, which will give me some time to do some reading and
> decide what the hell to do.  For now, I'm just not gonna think about it.

I think that's smart.  And like I said, I have the same issue with
doctors.

> And I'm postponing the mammogram until January.  It's gonna hurt way too
> much with my chest still being sore from the surgery.  If they wanna
> find something wrong with my boobs, they're gonna hafta wait as I don't
> have time to have a problem there right now!

Very smart!  Just do your self breast exams.  If I had a lump, I'd
definitely get it checked out--in fact I had a cyst, and I got it
checked out--but I personally wonder about the wisdom of radiated my
breasts every year as recommended.

> The weird thing is how like preparing *chicken* the whole thing seems.
> Splitting my breastbone for the bypass struck me as something I am
> familair with primarily from cutting up whole chickens.  The potential
> hysterectomy seems like gutting me.  Boy, have they got the order of
> things wrong!

LOL!  That's so bad, all I can do is laugh.

Best regards,
Michelle C., T2
diet & exercise

> --http://www.ornery-geeks.org/consulting/
Alan S - 22 Nov 2007 23:01 GMT
>While I would never give advice about what a person should or should
>not do in regards to health, here's my perspective, both as a patient
[quoted text clipped - 29 lines]
>because sometimes they really don't know themselves--even the good
>ones.
<snip>

Hi Michelle

I understand your point and I would certainly agree with
your view that a 90yo in her position should not have the
BMA. An initial BMA can be very important in correct
diagnosis and assessing correct treatment regardless of the
white count, although other less intrusive methods may also
be possible these days. But I certainly wouldn't support it
in geriatric circumstances.

However, for others of a different age be aware that while
some CLL patients do move very slowly, some don't.

One reason I am taking a sabbatical from the management team
of the ACOR CLL list next year is that, while I am one of
those lucky ones "more likely to die of something else
before my leukemia became bad enough to require treatment",
I have said goodbye to too many on that list lately. Some
were only diagnosed a year or two ago.

While I'm on the subject, I'll put in a plug for any cancer
patients who are not aware of the ACOR lists:
http://www.acor.org/

And, just in case there are other CLLers reading here, a
great blog by a British haemotologist for CLL patients:
http://mutated-unmuated.blogspot.com/

Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com
Psyllium, Fibre, Muesli and Nuts
Michelle C. - 23 Nov 2007 18:07 GMT
> On Thu, 22 Nov 2007 09:28:55 -0800 (PST), "Michelle C."
>
[quoted text clipped - 61 lines]
> And, just in case there are other CLLers reading here, a
> great blog by a British haemotologist for CLL patients:http://mutated-unmuated.blogspot.com/

Hi Alan,

I'm sorry you're losing friends to the cursed CLL.  You bring up some
very important points.

I think what we're both saying is that each case is unique, and all
factors must be taken into consideration--age, aggressiveness of the
disease, and the patient's personal philosophy about what constitutes
quality of life.  Doctors, even terrific ones, are human and they tend
to form "policies/philosophies" in order to make their jobs easier,
which are sometimes in conflict with what is important to the
patient.  In the case of the internist I mentioned above, he was
always very thorough.  This was a "policy" that served him and his
patients well overall.  However, it prevented him from seeing that in
this 90 year old lady's case, it wasn't appropriate.  And that's where
we as patients need to be on the ball.

From way up here in the US, you've always impressed me as being very
informed, able to get to the crux of the matter, and well in tune with
what you personally believe is important.  I know you are always going
to be your own best advocate.  Unfortunately, many people do not even
know where to begin.  I imagine most of us here on ASD can remember
when we were confused and bombarded by too much information too fast.
We learned to research, sort data, network, etc.  Some people never
get to that point.

In Jackie's case, where she has several issues going on all at once,
it's really tricky, although I know she's going to do well at getting
the information she needs to make informed decisions.  She has a
particularly remarkable knack.

Alan, I certainly wish you a long and comfortable life.  ASD needs
your wisdom.

Best regards,
Michelle C., T2
diet & exercise

> Cheers, Alan, T2, Australia.
> d&e, metformin 1500mg, ezetrol 10mg
[quoted text clipped - 3 lines]
>
> - Show quoted text -
Alan S - 23 Nov 2007 23:19 GMT
>> On Thu, 22 Nov 2007 09:28:55 -0800 (PST), "Michelle C."
>>
[quoted text clipped - 99 lines]
>Michelle C., T2
>diet & exercise

Thanks Michelle.

Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com
Psyllium, Fibre, Muesli and Nuts
Cheri - 20 Nov 2007 18:33 GMT
Jackie, I'm sorry. You definitely seem to have an awful lot on your
plate (including that junk food plate right now...little bit of humor
there), but in all seriousness I hope your biopsy turns out well, and
is not as painful as the last time. I also hope that you're able to
get back on track, because sometimes the "I don't give a damn"
attitude, makes the depression worse. It's really true what Gilda
Radner used to say..."It's always somethin." May your "somethin" be
good. Take care.

Cheri

Jackie Patti wrote in message
<47431279$0$27061$470ef3ce@news.pa.net>...
>OK, last week, my readings went wonky for no particular reason.  Since I
>was trying to get a thorough set of readings for my endo appointment
[quoted text clipped - 97 lines]
>while chain-smoking and no one had better dare bring a vegetable
>anywhere near me.
William Wagner - 20 Nov 2007 18:46 GMT
Hang in here Jacki.  Depression is a major side effect of heart
disease and it looks like diabetes  may also have this problem.  Perhaps
all major chronic problems do.

Bill

"General health status was lower, body mass index higher, and insulin
treatment more frequent; history of prior coronary heart disease was
less frequent. They were more likely to indicate depression and
hopelessness and to identify costs as a barrier to self-care; less
likely to report trust in their regular physician; and more likely to
smoke cigarettes and be physically inactive."

From below.

....................................

Understanding the Gap Between Good Processes of Diabetes Care and Poor
Intermediate Outcomes: Translating Research Into Action for Diabetes
(TRIAD).
Selby JV, Swain BE, Gerzoff RB, Karter AJ, Waitzfelder BE, Brown AF,
Ackermann RT, Duru OK, Ferrara A, Herman W, Marrero DG, Caputo D,
Narayan KM; for the TRIAD Study Group.
From the *Division of Research, Kaiser Permanente Medical Care Program,
Northern California, Oakland, California; ÝDivision of Diabetes
Translation, Centers for Disease Control and Prevention (CDC), Atlanta,
Georgia; ýPacific Health Research Institute, Honolulu, Hawaii;
§Department of Medicine, David Geffen School of Medicine, University of
California, Los Angeles, Los Angeles, California; ¶Department of
Medicine, Indiana University School of Medicine, Indianapolis, Indiana;
?School of Medicine, University of Michigan, Ann Arbor, Michigan;
**University of Medicine and Dentistry of New Jersey, Center for
Continuing and Outreach Education, Newark, New Jersey; ÝÝRollins School
of Public Health, Emory University, Atlanta, Georgia; ýýfor a list of
the TRIAD Study Group, see .
BACKGROUND:: Performance of diabetes clinical care processes has
improved recently, but control of hemoglobin A1c (A1c) and other
vascular disease risk factors has improved more slowly. OBJECTIVES:: To
identify patient factors associated with control of vascular disease
risk factors among diabetes patients receiving recommended care
processes. POPULATION:: Managed care enrollees who participated in the
TRIAD (Translating Research into Action for Diabetes) Study and received
at least 5 of 7 recommended care processes during the 12 months before
the second survey (2002-2003). METHODS:: Comparison of 1003 patients
with good control of A1c (<8%), systolic blood pressure (<140 mm Hg) and
LDL-cholesterol (<130 mg/dL) versus 812 patients with poor control for
at least 2 of these factors. RESULTS:: Poorly controlled patients were
younger, more frequently female, African American, with lower education
and income (P < 0.001 for each). General health status was lower, body
mass index higher, and insulin treatment more frequent; history of prior
coronary heart disease was less frequent. They were more likely to
indicate depression and hopelessness and to identify costs as a barrier
to self-care; less likely to report trust in their regular physician;
and more likely to smoke cigarettes and be physically inactive.
Adjusting for demographic and clinical variables, concerns about costs,
low trust in one's physician, current smoking, and physical inactivity
remained associated with poor control. However, inclusion of these 4
variables in a single model did not diminish associations of
race/ethnicity or education with control. CONCLUSIONS:: Clinical,
socioeconomic, psychosocial, and behavioral factors were independently
associated with poor control. However, these factors did not fully
explain observed racial and socioeconomic disparities in control.
PMID: 18007164 [PubMed - as supplied by publisher]

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krom - 20 Nov 2007 19:45 GMT
Sorry jackie <cyber hug>
My advice would be say lump it to turkey day..order chinese and rent a movie
and relax.
Me ..i love to cook so that would de-stress me but if its work for u forget
it this year..its not a law..lol.
I hope and sure it will be ok.
As far as testign etc take a day off but dont go nuts with food or you'll
just feel worse and who needs that?
Take your meds...if your not gonna eat much take less and just eat when your
hungry and if you feel icky make hubby test you..

:-)

KROM

> OK, last week, my readings went wonky for no particular reason.  Since I
> was trying to get a thorough set of readings for my endo appointment
[quoted text clipped - 96 lines]
> chain-smoking and no one had better dare bring a vegetable anywhere near
> me.
Michelle C. - 20 Nov 2007 20:07 GMT
> OK, last week, my readings went wonky for no particular reason.  Since I
> was trying to get a thorough set of readings for my endo appointment
[quoted text clipped - 99 lines]
>
> --http://www.ornery-geeks.org/consulting/

Jackie,

You may correct me if I'm wrong, but I keep getting these vibes that
what you really, really HATE is being at the mercy of the medical
profession.  How do I know?  Because I do too.  Nothing makes me feel
more defeated than the fear I might have to rely on someone who isn't
going to be competent--not to mention that a lot of medical procedures
are just plain undignified.  Hell, I was a medical lab technologist,
so I know that to the people who perform said procedures it really
isn't any big deal, but if I have to go to the doctor, I get the worst
case of white coat syndrome.  Logic just doesn't work here.

Now, having said that, get the test.  If you know what you're dealing
with, you're going to feel better.  It might not be a big deal.  And
even if it something that the doctor thinks requires surgery, it
doesn't mean you have to go along with him/her.

In other words, don't suicide on chocolate fudge until you've got the
facts.

Best regards,
Michelle C., T2
diet & exercise
Jackie Patti - 21 Nov 2007 12:36 GMT
> You may correct me if I'm wrong, but I keep getting these vibes that
> what you really, really HATE is being at the mercy of the medical
> profession.  How do I know?  Because I do too.  Nothing makes me feel
> more defeated than the fear I might have to rely on someone who isn't
> going to be competent--not to mention that a lot of medical procedures
> are just plain undignified.  

Oh yeah, seeing a gyn always leaves me feeling someone should've bought
me dinner first.  ;)  This guy wasn't too bad though; he had decent
bedside manner.  He actually spoke to you in an office first, while you
were dressed, instead of deciding to get all chatty with his hand up
inside!  ;)  Still... flowers would've been nice.  ;)

Eh... the undiginified bit is... I'm so over all that.

It's not knowing if they're competent or not.  I've dealt with
incompetence at rather high levels so don't have much faith in
credentials.  The first PhD awarded from my lab in grad school was given
to a woman who didn't understand chemistry as well as my then 5-yr-old
daughter, so credentials don't mean much to me.

I had no choice about the bypass as I was too stoned to learn about
heart disease rapidly.  I had to just trust the surgeon and that was not
easy for me to do.  She didn't kill me, so it worked out.

I really expected with the gyn to be told it was no big deal, given a
Pap and a slip for a mammogram, and sent on my way.  So it was a
disappointing visit.

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Michelle C. - 22 Nov 2007 17:39 GMT
> > You may correct me if I'm wrong, but I keep getting these vibes that
> > what you really, really HATE is being at the mercy of the medical
[quoted text clipped - 10 lines]
>
> Eh... the undiginified bit is... I'm so over all that.

Oh yeah, me too!  In fact, I'm so weirded out by it, I try to find a
female doctor if I can.

> It's not knowing if they're competent or not.  I've dealt with
> incompetence at rather high levels so don't have much faith in
> credentials.  The first PhD awarded from my lab in grad school was given
> to a woman who didn't understand chemistry as well as my then 5-yr-old
> daughter, so credentials don't mean much to me.

Yep, there are idiots in every profession and doctors are no
exception.

> I had no choice about the bypass as I was too stoned to learn about
> heart disease rapidly.  I had to just trust the surgeon and that was not
> easy for me to do.  She didn't kill me, so it worked out.

And we're all glad it did.  Jackie, I really enjoy your posts--full of
dry humor, honesty, and a lot of knowledge.

Best regards,
Michelle C., T2
diet & exercise

> I really expected with the gyn to be told it was no big deal, given a
> Pap and a slip for a mammogram, and sent on my way.  So it was a
> disappointing visit.
>
> --http://www.ornery-geeks.org/consulting/
Michelle C. - 22 Nov 2007 19:43 GMT
> > > You may correct me if I'm wrong, but I keep getting these vibes that
> > > what you really, really HATE is being at the mercy of the medical
[quoted text clipped - 10 lines]
>
> > Eh... the undiginified bit is... I'm so over all that.

DUH--Missed this line--just read the preceding paragraph.  Obviously,
I'm not over it.  ;-)

> Oh yeah, me too!  In fact, I'm so weirded out by it, I try to find a
> female doctor if I can.

> Best regards,
> Michelle C., T2
> diet & exercise
Jackie Patti - 23 Nov 2007 15:58 GMT
>>> Eh... the undiginified bit is... I'm so over all that.
>
> DUH--Missed this line--just read the preceding paragraph.  Obviously,
> I'm not over it.  ;-)
>> Oh yeah, me too!  In fact, I'm so weirded out by it, I try to find a
>> female doctor if I can.

Someday I'm gonna get the nerve to ask one of them *why* they wanted to
be a gynecologist.

Maybe I'll feel better about it all, but maybe I won't.  ;)

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Alice Faber - 23 Nov 2007 16:08 GMT
> >>> Eh... the undiginified bit is... I'm so over all that.
> >
[quoted text clipped - 7 lines]
>
> Maybe I'll feel better about it all, but maybe I won't.  ;)

Every time I hear of a male gynecologist, I remember the boy in my sixth
grade class who announced that he wanted to be a gynecologist so he'd
get to look at lots of naked women. I know (hope) he grew up, but
still...

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"[xxx] has very definite opinions, and does not suffer fools lightly.
This, apparently, upsets the fools."
    ---BB cuts to the pith of a flame-fest

Michelle C. - 23 Nov 2007 18:09 GMT
> >>> Eh... the undiginified bit is... I'm so over all that.
>
[quoted text clipped - 9 lines]
>
> --http://www.ornery-geeks.org/consulting/

Oh my, that is a hysterical thought!  If you ever get the nerve to
ask, tell us what s/he says.

Best regards,
Michelle C., T2
diet & exercise
Julie Bove - 20 Nov 2007 20:52 GMT
> OK, last week, my readings went wonky for no particular reason.  Since I
> was trying to get a thorough set of readings for my endo appointment
> tomorrow, I was somewhat perturbed.

<snipped but read>

Sorry to hear that.
W. Baker - 20 Nov 2007 20:54 GMT
: OK, last week, my readings went wonky for no particular reason.  Since I
: was trying to get a thorough set of readings for my endo appointment
: tomorrow, I was somewhat perturbed.

: I was also getting weaker and less able to do things and it just started
: to seem like I was going backwards.  By the end of the week, I started
: getting depressed - feeling like my recovery was stalled.

: Probably just a bug, but it was discouraging.

: So yesterday, I had an appointment with a gynecologist and it just blew
: me away completly and I am now having a meltdown.  Males can quit
: reading here if they are easily squicked.  ;)

: I'm overdue for a Pap and a mammogram, but the main reason I was going
: in was cause I had an ultrasound back in August and they saw
: adenomyosis, which is endometrial tissue growing into the uterine wall.

: The main reason I had the ultrasound was cause I had a period in July, 3
: years after my last period and I'm therefore presumably postmenopausal
: so not supposed to have periods.  Frankly, I thought the internist was
: overreacting, I had the CABG in June and figured my body had just
: generically been shocked or something.  I didn't think a period was a
: big deal, in fact, I didn't even mention it to the internsit, Steve did.

: After the ultrasound, I looked up adenomyosis and it said it didn't need
: treatment if it was asymptomatic so I didn't think it mattered much and
: wasn't hurrying about it.

: The gyn says it's a big deal.  Says the internist was negligent in just
: doing an ultrasound, that I need an endometrial biopsy.  He says that
: the main reason women don't die of uterine cancer is because they know
: to check after the one primary symptom, which is unexpected bleeding.

: I had cervical issues in my thirties.  I had a bad Pap smear, a bad
: follow-up biopsy, then a LEEP surgery in a doctor's office with a bit of
: cervix removed.  The following year, I had a repeat, bad Pap, bad
: biopsy, outpatient surgery through a hospital gyn clinic with a bit more
: cervix removed.  At the time, I was been told it was HPV-caused cancer.

: My new gyn says it wasn't cancer, says if it was cancer, they'd have
: done a hysterectomy.  I distinctly remember being told it was cancer,
: when I freaked out about the second surgery, one nurse told me I'd *die*
: without it.  So I dunno what the hell that means.

: I also remember the biopsies hurt like hell.  I'd been told they
: wouldn't and that I could drive myself.  Since I was a single mom of a
: small child, I went ahead and did so.  I barely got myself home and
: then spent several days in bed in pain due to cramps.  So the biopsy
: wasn't nearly as "not a big deal" as they had said.

: I have this biopsy scheduled for Dec 17th.  It's an endometrial biopsy,
: which I presume means they are going through the cervix to get some
: stuff from the uterus itself.   I can't see how it'd be *less* of a
: problem than a cervical biopsy, so expect I shouldn't try to drive
: myself.  Since Steve is on the road, I guess I'll take a cab.  No big
: deal.

: Unless I fail the biopsy, in which case this guy is gonna wanna yank my
: innards out.  That should really jumpstart my recovery, having another
: major surgery.

: I am starting to believe that I'll never feel good again.

: The gyn also said it was very unusual for them to see adenomyosis on an
: ultrasound so he wants the report.  He also wants me to track down the
: old medical records from when I did or didn't have cervical cancer,
: which was almost 15 years ago in another state.

: I know doctors who overdo hysterectomies are a possible problem, so
: dunno if this guy is right or not.  I know I can Google and learn gobs.

: OK, I already knew about diabetes.  I learned about insulin when I first
: got home from the hospital.  Then I read and studied up on heart
: disease.  Then I began reading about endocrine disorders and I'm not
: done with that study yet.  Right now, my overwhelming feeling is that I
: do NOT want to learn about uterine cancer.

: I left the gyn's office and went for an unscheduled grocery shopping.  I
: bought all frozen crap: cheese sticks, breaded chicken strips, pizza
: rolls and garlic bread, decided that stuff didn't look unhealthy enough,
: so added a Pepperidge Farm chocolate farm layer cake.  I had a big pity
: binge for myself last night.  There's still gobs of leftover junk here;
: I could start my own chapter of the ADA.  ;)

: I haven't decided anything for today yet - if I'm going to keep being
: stupid or get back on track.  I've been up for 4 hours and haven't
: eaten, measured my bg, bp or temperature, taken any Lantus, or my other
: meds, nada.  I just had a cup of coffee and several phone conversations
: with hubby.  I've missed the Y and ought to grocery shop for
: Thanksgiving too today, but am not feeling much like it.

: I haven't begun calling around to track down all these medical records
: yet either.  I'm not entirely sure if I give a damn.  My body seems
: damned determined to f.ck me over, no matter what I do, so I'm not sure
: if I wanna fight anymore.

: I told hubby if I am gonna die any damned way, I want to go out on a
: diet of hot fudge sundaes washed down with coffee with *extra* caffeine
: while chain-smoking and no one had better dare bring a vegetable
: anywhere near me.

jacki,

i can't help you much with your many issue, but I can say, dump on us here
as much as you need to.  That is what friends are for.  others may be
along with actual advice, but I do have smypathy for ou.  

When is Steve gettign home?  I think ou shoul n't be alone right now, but
need some kind of shoulder to cry on.  have ou any friends nearby or other
family to lean on pysically till Steve gets home?

Wendy
antmeeter@yahoo.com - 20 Nov 2007 22:38 GMT
> OK, last week, my readings went wonky for no particular reason.  Since I
> was trying to get a thorough set of readings for my endo appointment
> tomorrow, I was somewhat perturbed.

<Crumple>

'Sound like you're having a rough week and sorry for that.  One thing
that helps me get
through tough times is to remember this: a century ago I wouldn't have
lived this long,
this well, or this "rich" (relatively speaking).  You have conditions
for which there are
largely remedies. A hundred years ago, you would have been finished a
long time
ago.  I try to be mindful of this and use my "extra" time well.

All The Best
ant
Alan S - 20 Nov 2007 22:51 GMT
<snipped but read>

Hi Jackie

I can't offer anything but the thought that someone cares
from half a world away. And I know you're too strong to give
in to a pity party. You will overcome and you will make the
right decisions.

Best wishes.

Cheers, Alan, T2, Australia.
Oleg Lego - 20 Nov 2007 23:19 GMT
>I told hubby if I am gonna die any damned way, I want to go out on a
>diet of hot fudge sundaes washed down with coffee with *extra* caffeine
>while chain-smoking and no one had better dare bring a vegetable
>anywhere near me.

Bummer, Jackie.

Hang in there, though, and try to get back on track, just in case
you'll be around for the next few decades, m'kay?

Signature

Larry, T2, Saskatchewan, Canada.
DX 24 Aug 07. D&E
Metformin 2000mg, Ramipril, Simvastatin
Last A1c 8.1 (at DX)

Nicky - 20 Nov 2007 23:21 GMT
>I'm overdue for a Pap and a mammogram, but the main reason I was going
>in was cause I had an ultrasound back in August and they saw
>adenomyosis, which is endometrial tissue growing into the uterine wall.

Jeez. Glad they caught it. And I don't like the thought of that thing
being in you and not fully identified - so although the biopsy thing
is a total pain, I'm glad you're getting it done!

I'll think about you on the 17th; sending you good vibes...

Nicky.
T2 dx 05/04 + underactive thyroid
D&E, 100ug thyroxine
Last A1c 5.6%  BMI 25
Gantlet - 20 Nov 2007 23:34 GMT
> I told hubby if I am gonna die any damned way, I want to go out on a diet
> of hot fudge sundaes washed down with coffee with *extra* caffeine while
> chain-smoking

Sounds like the advice on the ADA's page. :).

Just make sure you use your meter to make sure you get healthy amounts  of
hot fudge
coffee and smokes :).

but seriously doing what you said would be a gamble.  you may first
end up with diabetic complications much worse than anything
you already have experienced -  before what ever it is that you are afraid
of dieing of.

when things get tough the tough get going.

Over? Did you say "over"? Nothing is over until we decide it is! Was it over
when the Germans bombed Pearl Harbor? Hell no!
And it isn't over now. 'Cause when the goin' gets tough...
[thinks hard]
the tough get goin'! Who's with me? Let's go!
[runs out, alone; then returns]

I hope everything works out for the best and you get your mind at a pleasant
place.

Signature

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www.TomsDiabeticDiary.com

Chat in peace with other diabetes at the American Diabetes Associations Web
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Information You Can "Trust" From Your American Diabetes Association
www.diabetes.org

Information on Specific Types of Fat.
http://www.diabetes.org/nutrition-and-recipes/nutrition/foodlabel/specific-fats.jsp

Cheri - 21 Nov 2007 00:18 GMT
Gantlet wrote in message ...

>Over? Did you say "over"? Nothing is over until we decide it is! Was it over
>when the Germans bombed Pearl Harbor? Hell no!

Exactly when did the Germans bomb Pearl Harbor though? Just curious.
Happy Thanksgiving to you and your wife Tom. :-)

Cheri
Kurt - 21 Nov 2007 00:44 GMT
> Gantlet wrote in message ...
> >Over? Did you say "over"? Nothing is over until we decide it is! Was
> it over
> >when the Germans bombed Pearl Harbor? Hell no!
>
> Exactly when did the Germans bomb Pearl Harbor though?

Hey Cheri, have you ever seen the movie "Animal House" with John
Belushi?  If not, rent it this weekend.  It's quite funny...and you
may just have the answer to the question you posed to Tom.

Kurt
P.S. After reading about your planned laid back Thanksgiving plans I
got real jealous. :)
Cheri - 21 Nov 2007 01:21 GMT
Kurt wrote in message <2a96fd0e-29e5-4e1f-b128-

Hey Cheri, have you ever seen the movie "Animal House" with John
Belushi?  If not, rent it this weekend.  It's quite funny...and you
may just have the answer to the question you posed to Tom.

Kurt
P.S. After reading about your planned laid back Thanksgiving plans I
got real jealous. :)

____________________________

No, I've never seen that movie, but I heard it was gross, with a lot
of man/child bathroom humor etc. I did really like JB though. I
thought he was great in Continental Divide, and Blues Brothers. BTW, I
am pretty jealous of your Thanksgiving plans too. I have a feeling you
have great parties. Me, I have a very small house, and at Christmas
there will be 20, that's way more than this house can handle, but
somehow we manage. :-)

Cheri
Gantlet - 21 Nov 2007 16:21 GMT
On Nov 20, 4:18?pm, "Cheri" <gserviceatinreachdotcom> wrote:
> Gantlet wrote in message ...
> >Over? Did you say "over"? Nothing is over until we decide it is! Was
> it over
> >when the Germans bombed Pearl Harbor? Hell no!
>
> Exactly when did the Germans bomb Pearl Harbor though?

Hey Cheri, have you ever seen the movie "Animal House" with John
Belushi?  If not, rent it this weekend.  It's quite funny...and you
may just have the answer to the question you posed to Tom.

Kurt
P.S. After reading about your planned laid back Thanksgiving plans I
got real jealous. :)

I dont know about the recommendation Kurt.
I will still watch the movie but the real magic it holds is that I seen it
when I was younger.
I can still remember watching it with my 5 room mates in a 3 story house
that was very much like
animal house.  the back door was never even attached and the top floor was
off limits to those still able
to walk and their was always a party going on.  I moved in when I was about
16 years old.  good people
I miss them all especially those that didnt make it this far.

Signature

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Information on Specific Types of Fat.
http://www.diabetes.org/nutrition-and-recipes/nutrition/foodlabel/specific-fats.jsp

Jackie Patti - 21 Nov 2007 17:30 GMT
> I can still remember watching it with my 5 room mates in a 3 story house
> that was very much like
[quoted text clipped - 3 lines]
> 16 years old.  good people
> I miss them all especially those that didnt make it this far.

My husband lived in a place like that for years when he was young...
they called it Hawthorne House.  Far as I can tell, it was one big party.

He says you couldn't ever have a cold beer.  If someone walked in with a
case, everyone snagged their share and hid it in their bedroom closets.
 You couldn't leave beer in the fridge or it'd disappear.

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Gantlet - 21 Nov 2007 16:17 GMT
> Gantlet wrote in message ...
>
[quoted text clipped - 6 lines]
>
> Cheri

when someone is depressed the first thing I try to make them do is smile
and everytime I think about Bluto from the movie animal house I smile.
http://www.survivinggrady.com/bluto.jpg

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Tom

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Information You Can "Trust" From Your American Diabetes Association
www.diabetes.org

Information on Specific Types of Fat.
http://www.diabetes.org/nutrition-and-recipes/nutrition/foodlabel/specific-fats.jsp

Gantlet - 21 Nov 2007 16:23 GMT
>> Gantlet wrote in message ...
>>
[quoted text clipped - 10 lines]
> and everytime I think about Bluto from the movie animal house I smile.
> http://www.survivinggrady.com/bluto.jpg

lol... that is supposed to be.

when someone is depressed the first thing I try to do is make them smile.
Jackie Patti - 21 Nov 2007 12:04 GMT
>> I told hubby if I am gonna die any damned way, I want to go out on a diet
>> of hot fudge sundaes washed down with coffee with *extra* caffeine while
>> chain-smoking
>
> Sounds like the advice on the ADA's page. :).

I forgot about the orgy... it can't all be food.  ;)

They're gonna *hate* me at the hospice.  ;)

> I hope everything works out for the best and you get your mind at a pleasant
> place.

Thanks for the support, Tom.

Signature

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Gantlet - 21 Nov 2007 16:35 GMT
>>> I told hubby if I am gonna die any damned way, I want to go out on a
>>> diet of hot fudge sundaes washed down with coffee with *extra* caffeine
[quoted text clipped - 3 lines]
>
> I forgot about the orgy... it can't all be food.  ;)

we like to use the word - toga party. it helps when inviting guests.

> They're gonna *hate* me at the hospice.  ;)

I am sure they will. :)

>> I hope everything works out for the best and you get your mind at a
>> pleasant place.
>
> Thanks for the support, Tom.
Kurt - 21 Nov 2007 00:42 GMT
> I told hubby if I am gonna die any damned way, I want to go out on a
> diet of hot fudge sundaes washed down with coffee with *extra* caffeine
> while chain-smoking and no one had better dare bring a vegetable
> anywhere near me.

Sorry to hear you got stuck riding the emotional roller coaster in
Diabetesland.  Plus the other things you're going through all add to
the scary ride.  This disease, compounded with other problems, can be
a pretty big burden to carry and unfortunately there are days like the
one you seem to be going through.  But the one constant thing I hear
from diabetics I meet in person is, if they are in pretty good
control, they feel they are much healthier than if they would never
have gotten diabetes.  That is to say that the disease has motivated
them to want to achieve the best health possible and it is something
they do every day in a proactive manner.  Yes, there are bad days but
try to remember all the other days when you are on top of things.
That's got to count for something...and it should!

Hope things turn around for you.

Kurt
zob - 21 Nov 2007 01:53 GMT
>I told hubby if I am gonna die any damned way, I want to go out on a
>diet of hot fudge sundaes washed down with coffee with *extra* caffeine
>while chain-smoking and no one had better dare bring a vegetable
>anywhere near me.

You're on this earth for a reason, kiddo.  Do you know that since my
heart attack and angioplasty lastmonth that you are the only person
that I've spoken with that has been able to relate to what I went
through and give me helpful advice?  

 I know how you feel though; after going through a major stoke 10
years ago, working a stressful job, never getting ahead financially
because of medical bills, losing most of my lifelong friends because I
wasn't able to go out and do the things we used to do together ... and
then to have this latest medical crisis set me back again even
further... it would be easy to just give up.  But I'm not put together
that way.  I get mad, and fight my way though.  The older ayou get
though, the harder it gets to do that.  You get tired, and tired of
fighting, I understand.

Everybody is different.  As for me, if given only these choices, I'd
rather adapt and adjust to the changes and have a long life rather
than give up and die early.  There are still too many things that I
want to see, do and experience while I'm here.  It may not be the same
things that I thought I'd do 10 or 15 years ago, but it really is
amazing how we can adapt to lifestyle changes when we really want to
or have to.

You hang in there.  Ths sun will come out tomorrow.
Evelyn Ruut - 21 Nov 2007 02:09 GMT
> OK, last week, my readings went wonky for no particular reason.  Since I
> was trying to get a thorough set of readings for my endo appointment
[quoted text clipped - 96 lines]
> chain-smoking and no one had better dare bring a vegetable anywhere near
> me.

Jackie,

I am overdue for a pap myself, and getting ready to finally go in a week or
so.   A couple of years after I had my last period I suddenly got a period
too.   OB/Gyn went nuts wanting to do all that same stuff yours recommended
calling it "post menopausal bleeding".   I ignored him and didn't do it.
Guess what?  Nothing happened.   That was over 13 years ago.   Hormones are
a funny thing.   They can and sometimes do go wacky.    It turned out that
mine did that one time, and it was just a fluke.   I am not advising you or
anything like that... follow your own instincts.  It is probably better to
go and find nothing, than to not go and have it turn into something serious.
Anyway, hugs to you and I hope it turns out to be nothing at all.

Signature

Best Regards,

Evelyn

RodS - 21 Nov 2007 04:52 GMT
Jackie can I give you a great Australian word for times like this

*BUGGA*

Now repeat a few times, then have whatever you want to eat for the day
but take yer pills and tomorrow's another day. Hey you have a hubby and
kids now who is gunner wash all them clothes and iron them and well you
see what I mean. Do you do windows? Now seeing as I haven't given up
smoking yet I'll blow some smoke in your general direction yer east of
me right? I have a problem tho seeing as you're still in yesterday for
me you gota tell me what time you gunner be awake.

  (- -)
=m=(_)=m=
RodS T2
Australia

<all read but some not understood> I am male after all :-)

> I told hubby if I am gonna die any damned way, I want to go out on a
> diet of hot fudge sundaes washed down with coffee with *extra* caffeine
> while chain-smoking and no one had better dare bring a vegetable
> anywhere near me.
Alan S - 21 Nov 2007 06:17 GMT
>Jackie can I give you a great Australian word for times like this
>
[quoted text clipped - 6 lines]
>smoking yet I'll blow some smoke in your general direction yer east of
>me right?

I'll pretend I didn't read that:-(

> I have a problem tho seeing as you're still in yesterday for
>me you gota tell me what time you gunner be awake.
[quoted text clipped - 3 lines]
>RodS T2
>Australia

This may clarify Rod's meaning a little:

http://www.youtube.com/watch?v=O-Y3AsZ19Hc

or (not a good copy, I'd appreciate a link to a good one)
http://www.youtube.com/watch?v=OwWMDpGrf0o

My favourite ads:-)

Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com
Psyllium, Fibre, Muesli and Nuts
RodS - 21 Nov 2007 07:34 GMT
>> Jackie can I give you a great Australian word for times like this
>>
[quoted text clipped - 6 lines]
> or (not a good copy, I'd appreciate a link to a good one)
> http://www.youtube.com/watch?v=OwWMDpGrf0o

That's the one I was thinking of, I love the dog :-)

> My favourite ads:-)
>
[quoted text clipped - 4 lines]
> http://loraldiabetes.blogspot.com
> Psyllium, Fibre, Muesli and Nuts
Frank t2 - 22 Nov 2007 00:34 GMT
"Alan S" <loralgtweightandcarbs@gmail.com> a écrit  ...

>>Jackie can I give you a great Australian word for times like this
>>
[quoted text clipped - 25 lines]
>
> My favourite ads:-)

Bugger ........... Alan ....

You missed this one (probly the first ?)

http://www.youtube.com/watch?v=gypURd_IGE0&feature=related
Alan S - 22 Nov 2007 01:53 GMT
>"Alan S" <loralgtweightandcarbs@gmail.com> a écrit  ...
>>
[quoted text clipped - 33 lines]
>
>http://www.youtube.com/watch?v=gypURd_IGE0&feature=related

To be honest, I don't recall it. Possibly not shown in my
area, which didn't have many Maccas at that time.

Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com
Psyllium, Fibre, Muesli and Nuts
Nick Cramer - 21 Nov 2007 05:54 GMT
> OK, last week, my readings went wonky for no particular reason.  Since I
> was trying to get a thorough set of readings for my endo appointment
> tomorrow, I was somewhat perturbed.
[ . . . ]

Hi, Jackie. Doesn't sound like you've been dealt the best hand at the
table!

Attitude is the best weapon in your arsenal. Everbody gets in a funk once
ina while. Snap out of it! f.ck it! I'm gonna die with my boots on and
they'll have to pry my gun from my cold, dead fingers!

Knowledge is power. Check on the gyn's record. If you end up trusting him,
follow his advice. If not, find another one, but don't go doctor shopping
in hopes of finding one who tells you what you want to hear. Track down
those medical records. Research uterine cancer. Take your meds on time.
Check you BG, BP and temp. Keep records. This is a game you want to win!

Take care,

Signature

Nick. Support severely wounded and disabled Veterans and their families!
I've known US vets who served as far back as the Spanish American War. They
are all my heroes! Thank a Veteran and Support Our Troops. You are not
forgotten. Thanks ! !             ~Semper Fi~

hemyd - 21 Nov 2007 06:55 GMT
> OK, last week, my readings went wonky for no particular reason.  Since I
> was trying to get a thorough set of readings for my endo appointment
[quoted text clipped - 96 lines]
> chain-smoking and no one had better dare bring a vegetable anywhere near
> me.

Jacki,

I wish I could offer some constructive advice other than offer sympathy. I
had my wife Linette read your post. Her words:
"you had crap doctors before, but you might have good ones now. Do what's
necessary. Maybe have the hysterectomy and be done with it (again - my
wife's words)" I agree with other posters - don't commit suicide by eating
just yet. Don't toss it all in. It's not a nice way to go.

I am hoping Quentin Grady reads this. I am hoping he provides some input,
even if he's unfamilliar with your problems, as indeed I am.

Henry Mydlarz (with apologies if I said something wrong or insensitive).
Andy - 21 Nov 2007 11:35 GMT
> I am starting to believe that I'll never feel good again.

Jackie,

Like others, i can't really speak much to what you're going through. But
we're here and we certainly don't want to see you feel bad. So, chin up
and bugga (whatever that means :) and remember that a path of a thousand
steps is formed by placing one stone at a time. Nothing is too big to
handle if you just take it step by step.

A
Signature

Andy
T2 dx 7/2007; D&E, 500mg Metformin 1/day
DX A1C: 13.2%, no new A1C yet,  BMI 31 (and dropping)

Argue for your limitations and you get to keep them.

Loretta Eisenberg - 21 Nov 2007 15:17 GMT
Jackie, you certainly are being wrung out to drive.  I am so sorry that
you are feeling depressed amongst your physical ailments

There is nothing I can say that will make you feel better, but I will
keep you in my prayers.

Here is what I just found that works for me.  My plate is also full but
I decided to learn how to knit.  When a person is knitting the only part
of the brain that is really functioning is concentration on the
stitches.  I has taken away a lot of stress for me.

I am lucky I found knitting.  

I hope you can find something that helps you

Loretta
Jackie Patti - 21 Nov 2007 16:43 GMT
The endo appointment went well.  It was a two-hour appointment!  They
love my records and think my control is great and are massively
impressed with me.  ;)

They're testing me for antibodies as they do think I may have T1 also.
I told them about my no-insulin experiment a while back, that I do think
my pancreas is still somewhat functional.  Their main reason for being
suspicious is that I developed T2 too young, but they also don't like
that I have thyroid antibodies.

They also took blood to run thyroid and adrenal panels.  And I've got an
ACTH test scheduled too as the endo said that'd be most indicative of
nonclassical CAH.  Given that I had thought that myself, I was
relatively impressed.

They checked my feet thoroughly.  Felt up my liver as I feel something
weird in there every so often.  Took very kewl pictures of my retinas to
send out to an opthamologist.

They gave me a new meter and a script for about a bazillion strips!
They said a *minimum* of 6 times a day and they'd write the script
however I want as I can test as much as I like.  Woohoo!  I HAVE A
DOCTOR THAT ACTUALLY WANTS ME TO TEST MY BLOOD GLUCOSE!

I have a script for Symlin too - they thought that was a great idea for
me.  They said I was an ideal candidate since I already test so much.

They also suggested I was a good candidate for a pump.  They had a
brochure about the OmniPod pump.  It's a *much* simpler pump than all
the inserts and such with normal pumps, plus it's waterproof.  You just
sort of stick the pump on and you never even *see* the needle and it has
a separate remote control where you can adjust the insulin and get your
bg readings!  Cheaper than regular pumps too, it costs around $800 and
my insurance would cover it.  They basically said they'd prescribe it
anytime I want, let them know.  They also have a "camp" coming up in May
to teach people to use it if I want to go.  Or anytime before or after,
they think if I want it, I should have it.  I told them I'll Google and
get back to them on it.  I'll probably talk myself into it rapidly, as
with the Symlin I'll be up to 8 shots a day, not including finger-poking.

I have an appointment with a nutritionist.  I told them upfront that I
wasn't gonna be gungho about the nutrionist if they were gonna push an
ADA diet at me, that I low-carb.  They're kewl with that.

I had it suggested during conversations there with the nurse
practitioner and the educator who was telling me about the pump that
maybe I should go to medical school.  ;)

They wrote me three-month scripts for the Symlin, Lantus and Novolog
(switching from Humalog since it's non formulary with my insurance) with
a year's worth of refilles.  The only disagreement we had was in my pile
of scripts, someone snuck a script for Zocor in there.  I told them I
won't have it filled until someone does research about how statins
effect endogenous steroid synthesis.  That's one of the times I got told
I should be a doctor.  ;)

Hell, the cardiologist is OK with me not being on a statin.  My LDL is
59!  I can't see the statin at this point.

But I'm really too busy being impressed to be terribly annoyed over the
one thing.  This is the most thorough anyone has ever looked at diabetes
- and after YEARS of being sort of semi-accused of being a bit anal
about the whole thing, it's darned nice to have someone think I'm doing
mostly the right stuff.

I have to go in for lipid and metabolic panel on Friday; internist had
already prescribed that.

And I have another appointment with the endo in two weeks once all the
blood work is back and to see how the Symlin is working.

Apparently, having a doctor pat me on the head and tell me I'm a good
girl has greatly improved my mood.  ;)

That and just deciding to postpone all the worry about gynecological
stuff.  I'm not going to think about that until I have to.  I have
decided my previous thinking, that it is nothing, is probably accurate.

I talked to Steve afterwards and he was dispatched straight home from
the Pittsburgh delivery, so he'll be here in a few hours.  I have time
enough to get grocery shopping done and drop off my scripts.

Our Thanksgiving menu: turkey, gravy, mashed potatoes (for him), roasted
green beans, pumpkin custard (for me), pumpkin pie (for him), sugar-free
whipped cream, champagne.

If I need to binge later, the turkey is a 20-pounder so that should keep
me busy.  ;)

Signature

http://www.ornery-geeks.org/consulting/

Susan - 21 Nov 2007 17:48 GMT
> Apparently, having a doctor pat me on the head and tell me I'm a good
> girl has greatly improved my mood.  ;)
[quoted text clipped - 13 lines]
> If I need to binge later, the turkey is a 20-pounder so that should keep
> me busy.  ;)

Jackie, thank goodness for all the good news and brighter perspective!

One caveat: make sure you familiarize yourself with ACTH testing, which
should be at 4 pm, preferably, but can also be run at 8 a.m.  No one
ever does it right unless you bring them the Mayo or Labcorp procedure,
they're not familiar with it.

It must be drawn into a chilled tube, the last one drawn so it doesn't
sit there, placed *immediately* into a refrigerated centrifuge, then
frozen right away.  If there's no refrigerated centrifuge, they should
only spin it for 7 minutes, then freeze immediately.

ACTH is secreted in brief pulses, and lasts only minutes in the
bloodstream, so getting it captured is quite a crapshoot, requiring many
tests, or around the clock testing the way Ludlam does it at Swedish in
Seattle.

Good luck, sounds like you have good allies, though Zocor for someone
with LDL of 59 is a scary mistake, you're not likely to let anything
like that slip by you.

Happy Thanksgiving!

Susan

P.S.  I had numerous cervical and uterine abnormalities and biopsies in
the past, and no cancers, so there!
Jackie Patti - 21 Nov 2007 18:07 GMT
> ACTH is secreted in brief pulses, and lasts only minutes in the
> bloodstream, so getting it captured is quite a crapshoot, requiring many
> tests, or around the clock testing the way Ludlam does it at Swedish in
> Seattle.

No, it's the other one... where they give you ACTH and measure your
cortisol afterwards.

That's why it made sense to me, to see if my adrenals are working
properly since I suspect CAH.  If it is nonclassical CAH, my ACTH should
be normal, but my response should be weak.

> Good luck, sounds like you have good allies, though Zocor for someone
> with LDL of 59 is a scary mistake, you're not likely to let anything
> like that slip by you.

Heh.  They just want *everyone* on the damned statins.  I swear.

> Happy Thanksgiving!

You too!

> P.S.  I had numerous cervical and uterine abnormalities and biopsies in
> the past, and no cancers, so there!

I've heard that from a number of folks and am starting to think like I
did originally... so I had a period.  Big deal.

As if having my chest split open wasn't a bit of a shock to the system.
  Whatever.

Signature

http://www.ornery-geeks.org/consulting/

Susan - 21 Nov 2007 18:12 GMT
>> ACTH is secreted in brief pulses, and lasts only minutes in the
>> bloodstream, so getting it captured is quite a crapshoot, requiring
[quoted text clipped - 3 lines]
> No, it's the other one... where they give you ACTH and measure your
> cortisol afterwards.

> That's why it made sense to me, to see if my adrenals are working
> properly since I suspect CAH.  If it is nonclassical CAH, my ACTH should
> be normal, but my response should be weak.

But it doesn't tell you that; I have some abstracts I'll send you.  My
results on that test were perfectly normal because it tested my adrenal
reserve, but I had almost no daily adrenal function at the time, my a.m.
cortisol was 1.5 and I was clammy, weak, nauseated and desquamating.
It's a lousy test of actual adrenal *function.*

>> Good luck, sounds like you have good allies, though Zocor for someone
>> with LDL of 59 is a scary mistake, you're not likely to let anything
>> like that slip by you.
>
> Heh.  They just want *everyone* on the damned statins.  I swear.

The fact that they can rx such a potentially harmful drug to someone
with adrenal probs and *before* testing, suggests you have to be very
vigilant with them, that's a big, BIG oversight.

> I've heard that from a number of folks and am starting to think like I
> did originally... so I had a period.  Big deal.
>
> As if having my chest split open wasn't a bit of a shock to the system.
>   Whatever.

Welp, it's always something, eh?

Susan
Jackie Patti - 22 Nov 2007 11:42 GMT
> But it doesn't tell you that; I have some abstracts I'll send you.  My
> results on that test were perfectly normal because it tested my adrenal
> reserve, but I had almost no daily adrenal function at the time, my a.m.
> cortisol was 1.5 and I was clammy, weak, nauseated and desquamating.
> It's a lousy test of actual adrenal *function.*

You know, I'm not actually sure what test they're doing.  I had *seven*
pages of printed notes prior to this appointment, so I didn't get
everything entirely clear.  Good thing I'm going back in two weeks.

Meanwhile, I will pick up the Symlin tomorrow and start experimenting
with that.  It occured to me today that... they "forgot" to tell me to
cut my insulin bolus in half.

Granted, I mentioned I'd already read the full prescribing info, so they
may have assumed I already knew about it.  But given that's the primary
"side effect" of Symlin, hypos due to not cutting the insulin dose,
seems like someone should've mentioned it, eh?

I do think I've fallen into the hands of some pretty clueful folks at
this endo's office, but one still has to pay attention.

>>> Good luck, sounds like you have good allies, though Zocor for someone
>>> with LDL of 59 is a scary mistake, you're not likely to let anything
[quoted text clipped - 5 lines]
> with adrenal probs and *before* testing, suggests you have to be very
> vigilant with them, that's a big, BIG oversight.

Yup.

Though sometimes I think it'd be easier to be a more trusting patient
than I am.  ;)

>> I've heard that from a number of folks and am starting to think like I
>> did originally... so I had a period.  Big deal.
[quoted text clipped - 3 lines]
>
> Welp, it's always something, eh?

For now, it's not something I'm thinking about.  I'm gonna keep focusing
on the endo stuff.  Symlin first.  Maybe thyroid or cortisol later.  A
potentially kewl new toy if I go to a pump.

One thing at a time ought to keep me from getting overwhelmed.

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Susan - 22 Nov 2007 15:24 GMT
> You know, I'm not actually sure what test they're doing.  I had *seven*
> pages of printed notes prior to this appointment, so I didn't get
> everything entirely clear.  Good thing I'm going back in two weeks.

It's likely an ACTH or corticotripin stim test, and mine was normal
while I was in severe adrenal crisis:

: J Clin Endocrinol Metab 1996 Jan;81(1):285-90 Related Articles, Books,
LinkOut

The potential for serious consequences from misinterpreting normal
responses to the rapid adrenocorticotropin test.

Streeten DH, Anderson GH Jr, Bonaventura MM

Department of Medicine, State University of New York Health Science
Center, Syracuse 13210, USA.

Despite unequivocal published evidence that patients with subnormal
hypothalamic-pituitary-adrenal (HPA) function may respond normally to
ACTH, such normal results are still considered reliable indications of
unimpaired HPA function. This view was tested in four patients with
clinical features suggesting corticotropin deficiency, in whom
cosyntropin (0.25 mg, i.v.) raised serum cortisol above 560 nmol/L (20
micrograms/dL) at 1 h. All four patients had subnormal responses to
metyrapone and excellent persistent improvement during subsequent
glucocorticoid therapy. Serum cortisol concentrations 1 h after
cosyntropin treatment in these patients closely resembled cortisol
concentrations 1 h after uncomplicated cholecystectomy in six other
patients. However, the rapid ACTH test in the patients with
hypopituitarism failed to indicate whether more prolonged stimulation by
ACTH or their endogenous stress would stimulate the normal continuing
rise in serum cortisol, which reached 1358 +/- 170 nmol/L (+/- SE) 5 h
after the incision in the cholecystectomized patients. As the three
hypocorticotropic patients who were recognizably stressed had unstressed
serum cortisol levels despite persistent adrenocortical reserve (shown
by their ACTH responses) and recovered during glucocorticoid therapy,
the ACTH test, if interpreted to indicate normal HPA function, would
probably have had disastrous consequences. We conclude that a normal
response to the rapid ACTH test can be dangerously misleading,
particularly in incomplete ACTH deficiency states.

Comments:
Comment in: J Clin Endocrinol Metab 1996 Nov;81(11):4176

PMID: 8550765, UI: 96142001

And this:

: J Endocrinol Invest 1982 Jul-Aug;5(4):259-61 Related Articles, Books

Plasma cortisol response to ACTH does not accurately indicate the state
of hypothalamic-pituitary-adrenal axis.

Reschini E, Catania A, Giustina G

The hypothalamic-pituitary-adrenal function was studied in 55 patients
with various pituitary disorders. In particular, the consistency between
the responses of plasma cortisol to exogenous ACTH and to insulin
hypoglycemia was investigated in 5 patients in whom cortisol response to
insulin was absent; four of these patients showed a cortisol response to
ACTH of variable degree. These 4 patients had surgical or functional
hypothalamus-pituitary disconnection and showed a preserved cortisol
response to lysine va