There was one thing that John Stimac would never do, and that was yell or get mean with you. He was the owner of The Market Street Pharmacy that now in its spot is some icky looking restaurant with a Monkey in title. It was one of the last Mom and Pop Pharmacies in Seattle before he retired and closed shop.
Now that I have a lot of prescriptions because of this whole Insulin Resistance, Metabolic Syndrome, PCOS stuff, I am using the QFC just a block down from me at the moment. Some sort of wires got crossed on my last doc visit.
Someone did not call in and order more refills on some of my prescriptions. So two of them had no refills when I called on Monday night to get them refilled. The automated thing asked me if I wanted the pharmacy to contact the Doctor to get them authorized. I said yes. It told me to call back two days later to confirm the prescriptions were being filled.
So I called today. They had not been filled. In fact, they had not even made contact with the doctor. They had faxed the request and had not heard back. What if they had not received the fax? I run out of pills after tomorrow. Might not be a big deal to you, but my Doc's office is only open Monday through Thursday.
So I explain the situation. They get the Pharmacist on the phone. He gets all mad and grumpy with me. I tell him I would have done something if I had known there was a problem with getting in contact with the doctor. But no one contacted me. I told him I was a teacher in back to work meetings and prep the last two days and was only following directions. He finally acquiesced and is going to give me an emergency prescription through Tuesday, but he basically threatened me and demanded the doc get a hold of him after the holiday.The nurse at my doc's office has several frantic emails from me. He is great and I know will take care of it. The nurse probably thinks I am kinda freakzoid now too.
This is all lamesauce.
Showing posts with label Health. Show all posts
Showing posts with label Health. Show all posts
Thursday, August 30, 2012
Friday, June 15, 2012
12 Week Check up! Insulin Resistance Factor
Tuesday was my 12 week checkup, but 'all things work' has consumed my time. First piece of news is that nothing is bad. And that is really good news. So here is the updated list of info after 12 weeks of treatment:
- My Cortisol is much lower (this is good)- This improves metabolism a tiny bit, but also helps reduce excess fluid retention.
-Reproductive hormones look OK, but still need to monitor in next few months and watch for PCOS.
-Fasting Glucose best yet and average glucose in normal range (no where near pre-diabetes). This is very very good!
-Vitamin D is getting much better
-B12 and K are very good
-iron levels are much better
-Thyroid is good
- Blood Pressure is a little better
-Insulin resistance is very strong. Test results are showing a need for aggressive medication to untangle the kinks in metabolic machinery. (This is the not so good part of the results).
First, let's go back and investigate Insulin Resistance because people have no clue what it is all about (and don't worry, I will attach my resource links as endnotes because I don't plagiarize). Wikipedia gives us a nice overview. It is a physiological illness where insulin (a hormone) is less effective at lower blood sugar levels. Seems simple on the surface, but how is it different than diabetes? Well Type 2 deals with insulin deficiency (which if insulin resistance is left untreated over time can turn into Type 2 Diabetes, and Type 1 deals with the body not being about to produce insulin.
Marcelle Pick (OB/GYN NP) also has a nice explanation of Insulin Resistance. She talks about if insulin spikes too often by high carbs than your cells and brain will prevent and decrease the amount of insulin receptors. And then "eventually, this prevents glucose from getting into your cells, leading to high blood sugar and depriving your cells of the energy they need to function. This is why many women with insulin resistance experience carbohydrate cravings, fatigue and weight-gain — their cells are literally starving for energy, even when plenty of glucose is available in the blood" (Women to Women). Unfortunately, what she fails to address is other factors that can cause insulin resistance besides just having a lifestyle of unhealthy food and no exercise. Doctors have known for over 20 years there are also genetic factors, environmental factors, and even lack of food, and extreme exercise factors that can cause insulin resistance. Maybe I will save the stuff I have been told about starvation and your mind choosing not to burn energy, but to store fat for a later blog. I hope that helps with insulin resistance.
So what is on the docket for my next 6 weeks (18 weeks of treatment)?
1). Step up treatment approach for insulin resistance
-Add Topiramate (have an interesting story on this drug and Pharmaceuticals and diet pills from the 1970s for a later time).
-This helps lower a NPY neurotransmitter that signals starvation and directly slows the metabolism.
2). Keep increase Victoza to maximum dosage in next 2 weeks. This is the hardest to do because every increase causes nausea for me until my body is used to it.
3). Keep my Metformin the same until Victoza to maximum level then 1 week later start adding in a morning dose.
4). Reduce B12 from 3,000 IU to 2,000 IU daily
5). Reduce Vitamin K from 4,000 IU to 3,000 IU daily
6). Don't change anything else. So keep taking a multi-vitamin, 10,000 IU of Vitamin D, 1,200 IU Omega 3, prescription Iron supplement, Blood Pressure med, and Thyroid Med daily.
Phew.
And modifications will probably happen again. Most of the 6 week checkups are to find out what is working and what needs modification. While the Victoza is definitely helping with my digestion of food, if we can't get it to start helping the insulin resistance, we have another med I will have to try. Breaking the insulin resistance is what is going to be the trickiest, but is what will start having me loose weight (which I know some people are waiting for with bated breath).
It is funny. When someone has a broken arm and is in a cast, no one ever states, "well, it doesn't look like it is being fixed," or right after it is taken out of the cast someone usually does not bellow out, "Oh my, your arm does not look that healthy!" But something my doctor and I talked about is how to deal with naysayers who don't believe I am sick. It is hard when my only improvement has been internally and not externally. Even though I have said from day one that this will take 3-4 years to work out, they think they will see some kind of miracle weight loss over night. This is not the first time my doc has had this conversation. It is one she has had to have time and time again with her metabolic syndrome patients that have obesity as a symptom. Believe it or not, she has metabolic syndrome patients that are not obese, but have a symptoms I thankfully do not have: high cholesterol and clogged arteries. And that is something to be thankful for!
Until next time... when I will have lots of funny tales and anecdotes,
Capt Mel
http://en.wikipedia.org/wiki/Insulin_resistance
http://en.wikipedia.org/wiki/Diabetes_mellitus
http://www.womentowomen.com/insulinresistance/default.aspx
- My Cortisol is much lower (this is good)- This improves metabolism a tiny bit, but also helps reduce excess fluid retention.
-Reproductive hormones look OK, but still need to monitor in next few months and watch for PCOS.
-Fasting Glucose best yet and average glucose in normal range (no where near pre-diabetes). This is very very good!
-Vitamin D is getting much better
-B12 and K are very good
-iron levels are much better
-Thyroid is good
- Blood Pressure is a little better
-Insulin resistance is very strong. Test results are showing a need for aggressive medication to untangle the kinks in metabolic machinery. (This is the not so good part of the results).
First, let's go back and investigate Insulin Resistance because people have no clue what it is all about (and don't worry, I will attach my resource links as endnotes because I don't plagiarize). Wikipedia gives us a nice overview. It is a physiological illness where insulin (a hormone) is less effective at lower blood sugar levels. Seems simple on the surface, but how is it different than diabetes? Well Type 2 deals with insulin deficiency (which if insulin resistance is left untreated over time can turn into Type 2 Diabetes, and Type 1 deals with the body not being about to produce insulin.
Marcelle Pick (OB/GYN NP) also has a nice explanation of Insulin Resistance. She talks about if insulin spikes too often by high carbs than your cells and brain will prevent and decrease the amount of insulin receptors. And then "eventually, this prevents glucose from getting into your cells, leading to high blood sugar and depriving your cells of the energy they need to function. This is why many women with insulin resistance experience carbohydrate cravings, fatigue and weight-gain — their cells are literally starving for energy, even when plenty of glucose is available in the blood" (Women to Women). Unfortunately, what she fails to address is other factors that can cause insulin resistance besides just having a lifestyle of unhealthy food and no exercise. Doctors have known for over 20 years there are also genetic factors, environmental factors, and even lack of food, and extreme exercise factors that can cause insulin resistance. Maybe I will save the stuff I have been told about starvation and your mind choosing not to burn energy, but to store fat for a later blog. I hope that helps with insulin resistance.
So what is on the docket for my next 6 weeks (18 weeks of treatment)?
1). Step up treatment approach for insulin resistance
-Add Topiramate (have an interesting story on this drug and Pharmaceuticals and diet pills from the 1970s for a later time).
-This helps lower a NPY neurotransmitter that signals starvation and directly slows the metabolism.
2). Keep increase Victoza to maximum dosage in next 2 weeks. This is the hardest to do because every increase causes nausea for me until my body is used to it.
3). Keep my Metformin the same until Victoza to maximum level then 1 week later start adding in a morning dose.
4). Reduce B12 from 3,000 IU to 2,000 IU daily
5). Reduce Vitamin K from 4,000 IU to 3,000 IU daily
6). Don't change anything else. So keep taking a multi-vitamin, 10,000 IU of Vitamin D, 1,200 IU Omega 3, prescription Iron supplement, Blood Pressure med, and Thyroid Med daily.
Phew.
And modifications will probably happen again. Most of the 6 week checkups are to find out what is working and what needs modification. While the Victoza is definitely helping with my digestion of food, if we can't get it to start helping the insulin resistance, we have another med I will have to try. Breaking the insulin resistance is what is going to be the trickiest, but is what will start having me loose weight (which I know some people are waiting for with bated breath).
It is funny. When someone has a broken arm and is in a cast, no one ever states, "well, it doesn't look like it is being fixed," or right after it is taken out of the cast someone usually does not bellow out, "Oh my, your arm does not look that healthy!" But something my doctor and I talked about is how to deal with naysayers who don't believe I am sick. It is hard when my only improvement has been internally and not externally. Even though I have said from day one that this will take 3-4 years to work out, they think they will see some kind of miracle weight loss over night. This is not the first time my doc has had this conversation. It is one she has had to have time and time again with her metabolic syndrome patients that have obesity as a symptom. Believe it or not, she has metabolic syndrome patients that are not obese, but have a symptoms I thankfully do not have: high cholesterol and clogged arteries. And that is something to be thankful for!
Until next time... when I will have lots of funny tales and anecdotes,
Capt Mel
http://en.wikipedia.org/wiki/Insulin_resistance
http://en.wikipedia.org/wiki/Diabetes_mellitus
http://www.womentowomen.com/insulinresistance/default.aspx
Monday, May 7, 2012
A Different Kind of Journey
Recently, I have had many acquaintances and co-workers give me a sheepish look and very quietly and politely ask if I have a life threatening illness and if I am going to die. I know some of them are just nosy, but many others are truly concerned.
And then I wonder if a person can be labeled as nosy if you are not trying to keep a secret. I digress.
In the past 5 months, I have been given such a different outlook on my life. An outlook that is amazing, scary, hopeful, and depressing all at the same time. And about what!? Weight. Hence the title of the blog: Weighing In. If you or anyone you know has ever made the following statements, this is the blog for you:
I have thought or said out loud many of these statements and more. This is my story on the struggle of weight loss, and this should be the path people take before they start fad diets, extreme exercise, or gastric bypass surgery. It is a long and complicated story, but I will start with the most recent history.
In June of 2011, I trained and completed my first official 1/2 marathon. My goal was under 4 hours and I made that goal. In the fall, a few of my friends wanted to do their first 1/2 marathons and I agreed to join them. We started training together. It was during this time, I had my annual physical and my doctor gave me that 'I have something very serious to say' look.
You see, I had gained another 30 pounds over the last year. And after all this exercise and training I was doing. She really wanted me to start seeing a nutritionist. In the next two months, I completed my second 1/2 marathon (again just under 4 hours) and started to see a nutritionist.
My nutritionist was horrified at my eating. And not how much I was eating, but how little. She put me on a plan. I told her right there I would gain more weight. No matter how much she talked about carbs being a log that keeps the fire going and protein being the kindling, I knew that with that much food (eating every 3-4 hours) would equal weight gain and not weight loss. We tried this for two months and those were exactly the results. More weight gain. I thought all hope was lost, but she was only encouraged. She then sent me to my current doctor who specializes in metabolic disorders (among other things).
At my first meeting, I laid everything out on the table. And surprisingly, the doctor had even more questions about my life. She was 99.9% sure I had a whole score of things wrong, but I was not to worry because with treatment, it was guaranteed I could get back to a normal weight and have a healthier life. I was scheduled for my first blood test. Here were the results:
For too long, all people have heard from the general population and media is that obesity is a three pronged approach: Eat Less, Eat Healthy, and Exercise More. But what happens when that doesn't work? In fact, 95% of all people who decide to try and lose weight by eating less and exercising more will fail to keep it off long term. Doesn't that tell you something is not working? It does. And many doctors know about it. It has been known for over 20 years. I have a hypothesis on why we don't know about it. First, it would ruin the weight loss industry. Second, it costs money to fix this problem.
Here is some outside reading until I write next time.
http://www.nytimes.com/2012/04/18/health/research/pairing-of-food-deserts-and-obesity-challenged-in-studies.html?_r=1&src=tp
http://www.weightymatters.ca/2012/04/biggest-loser-destroys-participants.html
So, I welcome you all in joining me on my journey and discover where I have been and where I am going!
Capt Mel
And then I wonder if a person can be labeled as nosy if you are not trying to keep a secret. I digress.
In the past 5 months, I have been given such a different outlook on my life. An outlook that is amazing, scary, hopeful, and depressing all at the same time. And about what!? Weight. Hence the title of the blog: Weighing In. If you or anyone you know has ever made the following statements, this is the blog for you:
- When I look at a hamburger, I gain five pounds.
- If I could work out 4 hours a day, I would not have any weight problems.
- I believe that people think I go home and eat buckets of ice cream every night.
- I wish I could eat like other people. If I do, I gain lots of weight.
- Eating less and exercising more is not giving me any results.
- I wish I had a new body. What I want to do in my mind, is hindered by my size.
- I exercise more than anyone I know, but I am still the largest.
I have thought or said out loud many of these statements and more. This is my story on the struggle of weight loss, and this should be the path people take before they start fad diets, extreme exercise, or gastric bypass surgery. It is a long and complicated story, but I will start with the most recent history.
In June of 2011, I trained and completed my first official 1/2 marathon. My goal was under 4 hours and I made that goal. In the fall, a few of my friends wanted to do their first 1/2 marathons and I agreed to join them. We started training together. It was during this time, I had my annual physical and my doctor gave me that 'I have something very serious to say' look.
You see, I had gained another 30 pounds over the last year. And after all this exercise and training I was doing. She really wanted me to start seeing a nutritionist. In the next two months, I completed my second 1/2 marathon (again just under 4 hours) and started to see a nutritionist.
My nutritionist was horrified at my eating. And not how much I was eating, but how little. She put me on a plan. I told her right there I would gain more weight. No matter how much she talked about carbs being a log that keeps the fire going and protein being the kindling, I knew that with that much food (eating every 3-4 hours) would equal weight gain and not weight loss. We tried this for two months and those were exactly the results. More weight gain. I thought all hope was lost, but she was only encouraged. She then sent me to my current doctor who specializes in metabolic disorders (among other things).
At my first meeting, I laid everything out on the table. And surprisingly, the doctor had even more questions about my life. She was 99.9% sure I had a whole score of things wrong, but I was not to worry because with treatment, it was guaranteed I could get back to a normal weight and have a healthier life. I was scheduled for my first blood test. Here were the results:
- Cortisol High
- Leptin lower than predicted
- Insulin resistance (genetic, but reversible)
- Average Glucose over 3 months elevated (pre-diabetic levels)
- 2 of 3 components of Metabolic Syndrome
- Seems to be no Poly-Cystic Ovarian Syndrome (PCOS) but birth control could be masking it.
- Thyroid is low
- Vitamin D is low
- Vitamin B12 low
- Vitamin K and Zinc ok for now
For too long, all people have heard from the general population and media is that obesity is a three pronged approach: Eat Less, Eat Healthy, and Exercise More. But what happens when that doesn't work? In fact, 95% of all people who decide to try and lose weight by eating less and exercising more will fail to keep it off long term. Doesn't that tell you something is not working? It does. And many doctors know about it. It has been known for over 20 years. I have a hypothesis on why we don't know about it. First, it would ruin the weight loss industry. Second, it costs money to fix this problem.
Here is some outside reading until I write next time.
http://www.nytimes.com/2012/04/18/health/research/pairing-of-food-deserts-and-obesity-challenged-in-studies.html?_r=1&src=tp
http://www.weightymatters.ca/2012/04/biggest-loser-destroys-participants.html
So, I welcome you all in joining me on my journey and discover where I have been and where I am going!
Capt Mel
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