(The story in this post takes place between the days of June 4 and June 10, 2021, though most of it happened on June 4 and 5. I've posted it here as an "intermission" post because it deserves its own entry due to the length and detail necessary), and because it's not an overall fun story to tell.
As you may or may not know, Daisy and I are pretty hardcore about our health and about taking care of problems before they arise -- preventative care and all that. From the dentist to the dermatologist, from our primary care physician to our optometrist, my urologist, Daisy's lady-parts doctor and endocrinologist, etc -- we try to take care of ourselves and generally do a moderately decent job about scheduling regular appointments to get checked out and taken care of. Well, with the Covid-19 pandemic ongoing for the past year and a half, that threw a huge proverbial wrench into the works and we were forced to become, shall we say, lax on those regularly scheduled check-ups and appointments. It couldn't really be helped, the damn country shut down and routine non-emergency medical stuff basically went to the wayside after March 2020.
Now that the pandemic is dissipating and the majority of folks in the state/country are at least partially vaccinated, Daisy has taken it upon herself to begin scheduling us our appointments again for our various preventative care stuff. The first and most pressing is our yearly physical/bloodwork, which is what the bulk of this post will cover. We have an eye appointment next weekend to get our prescriptions updated and order new glasses as well, and next on the list after that is...well, we'll get to it here soon enough. Anyway, let's begin our tale.
Because I work overnights and Daisy works normal daytime business hours, it's generally really difficult to schedule a time for us to both go to the doctor for almost anything. I could schedule an appointment pretty much anywhere at any time, but if Daisy has the car across town at her office, that doesn't help much. Similarly, if Daisy wanted to schedule an appointment anywhere at any time, she would be going it alone as I am asleep at home all day every weekday because of my overnight working schedule. So, most of the time, we will schedule appointments together, back-to-back appointments where both of us go at the same time, on Friday mornings. Why Friday mornings? Because Fridays are weekdays and I don't work Friday nights, so I can spare a few extra hours in the morning/daytime hours to go to the doctor without having to worry about sleeping fast to be able to get up and work the overnight shift. So, almost every doctor's appointment of any sort over the past five years that I've been on overnights has been scheduled for early on Friday mornings -- early as in, before 8am usually, as Daisy still has to work on Fridays. Minimizing impact on her own work schedule is just as important to me as it is to minimize the impact on mine.
So, when she scheduled the appointments for Friday the 4th a few weeks ago, at 7:30 and 8am, I wasn't exactly fazed by it. I knew I'd be coming off a two-day work week where I'd take off an hour early on Friday morning in order to be able to get dressed and get there on time, I'd go to the appointment and then I'd come home and go to bed as per the usual. I've done it dozens of times before; it's no biggie -- I'm usually back home by a little after 9, eat a small/quick breakfast, and go to bed relatively at the same time as I normally would.
As per the usual on appointment day, I gave my work folks the heads up that I'd be out an hour earlier than usual as a hard stop, and went upstairs to get dressed (and do the online check-in process). Once Daisy was up and dressed as well, we drove to the doctor's office and were soon called back into the room together. We were weighed, our blood oxygen and temperatures were taken, and then we were taken back to the exam room.
My Vitals:
Blood pressure: 128/86 (this is pretty baseline/normal for me; I have never had high blood pressure despite my weight).
Temperature: 98.1 F
Pulse: 98 (that's a little high for me, but eh)
Weight: 357 lbs, 12 oz (this is pretty damn accurate, legit very close to what the scale at home tells me)
Oxygen saturation: 96%.
We waited in the exam room for about ten minutes.
At that point, a nurse came in, asked us some baseline questions, and took our blood pressures (which is where I got the figure above). She also told us that there was a medical student onsite today, and wanted to know if we were okay with the med student sitting in with our doctor during the actual physical.
"Sure," I said, after a quick glance at the wife to make sure she didn't mind. "The more the merrier, I guess."
"So I see here that you used to be [former doctor]'s patients," the nurse said. Not really a question, but a statement.
"Yes," I said. "Can you tell us what happened to her? Nobody we know seems to know anything about it."
Quick side-story here: our former doctor had been the "family doctor" of sorts for us as well as Daisy's parents (and probably her sisters, sometimes) since Daisy was fourteen years old. Daisy turns 33 this month. Aside from a single clinic visit in 2015 when I had Influenza-B pretty badly and had to see someone else, she has also been my primary care physician as well. All of us loved her; she was -- without question -- an amazing doctor, and the only doctor in my adult life I've ever been 100% comfortable with as her patient. About two months ago, we got a cryptic letter in the mail from our doctor's office saying that she was no longer employed by our primary care provider, effective immediately (letter was backdated, even); we would need to, basically, pick a new doctor the next time we scheduled appointments...and that was it. No cause, no "she's retiring," no "she's starting a private practice," nothing of the sort. No explanation whatsoever.
"Nobody's really told us much," the nurse said, "other than confirming that she is no longer practicing medicine."
"Really," I said, rather surprised. "That's concerning; we were pretty distraught to hear the news."
"A lot of her patients were," the nurse replied. "Including me; she was my primary care physician too."
There was a very quick, sad pause in the room for a moment before the nurse finished up her questionnaires for us and left the room, telling us our new doctor (who Daisy and her mother both have experience with; she was the doctor who diagnosed Mama's heart attack a few years back when it happened) would be in to see us in a few minutes.
We then sat there for another ten minutes before...the med student came in. Alone.
It was at that point I felt the mood/tone in the room change. When it comes to Daisy, I have a damn good "Spidey-sense," so to speak. It might be an empathy thing, it might be a "I just know my wife" thing, but I could immediately feel Daisy get irritated. Daisy wears a good mask, so it's not like she can't or didn't hide it very well, but I could feel it radiating off her.
"Hiiiii," the med student said, introducing herself. "I'm [name] and I'm studying under Dr. [name], thank you for letting me observe, I appreciate it."
We then went through the same exact list of questions and concerns we'd already given the nurse once before, in the same order, taking the same amount of time. It was a Groundhog Day-like exam room experience, during which I thought to myself are we being Punk'd? Are they testing us to see if we provide the same answers and ask the same questions?
This was another ten-to-fifteen minute ordeal before the med student left and said our nurse and doctor would be joining us again shortly to do the blood draws. Once the door latch clicked shut and Daisy and I were alone again, I could feel Daisy's rage rising as she whispered to me under her breath.
"This is bullshit," Daisy said. "It's a lie, it's a con; I hate letting the students observe because they're supposed to come in together with the doctor and they never do, they always come in first by themselves, and then waste more time because they go back and tell the doctor everything we told her, and then the doctor comes in and we do it all over again! We have to tell the same stories and ask the same goddamn questions to three different people three fucking times -- our hour is now up and we haven't even seen the goddamn doctor yet!"
She was seething, but she was right -- it was now 8:30, a full hour after we'd arrived, and we still hadn't seen our doctor, still hadn't gotten our blood drawn for our yearly bloodwork, still hadn't even gotten into the proverbial "meat and potatoes" of our entire visit.
A few minutes later, the first nurse arrived with her box of vials and needles, and said she'd do my blood draw first.
Now, here's where it gets interesting.
A fun fact that a lot of you may not know about me is that I hate getting my blood drawn. It's not that I'm afraid of needles (I once was, back in the day, but not now) and I can handle the pain of getting stuck -- it's the blood itself. I don't mind seeing other people's blood, and I'm not bothered by violence or gory movies or anything like that, but the second I see my own blood going down a tube into a vial, being sucked out of me -- forcibly removed from my body -- I...uh, have a tendency to...faint.
Look, goddammit, I'm not proud of it. And it doesn't happen every time. Just, uh, most of the time. I'd say something like 80% of the time, roughly. And I cannot control it. If they stick me once and get the blood they need, great -- generally I'll be fine. If they have to stick me more than once or stick me in multiple places, well, it's bravo six time. It is terrifying, and frankly it is embarrassing for a 38-year-old man to faint when he has his blood drawn.
Now, every year when we've had the physicals done up to this point, there used to be a RN there at the doctor's office named Derek, and Derek was awesome. He claimed to be the "fastest stick in the west," and could always find my vein to tap it and get the blood he needed from me really fast. He was quick, efficient, most of the time relatively painless, and he was great to work with.
Derek has since been promoted up to the local hospital (the one down the street from us, where I got my urology work done and where I'll go back to again soon, but I'm getting ahead of myself) and is no longer at our office. Instead, I was now stuck with a nurse who did not seem to...eh...be really experienced in tough blood draws.
I know I can be a tough blood draw, too. I am fat and have relatively thick skin, but I've found that if I drink a lot of water/fluids in the 12-24 hours before my blood draw, it is far easier to get a needle into me and to get blood out of me. As I had to fast for 12 hours before the bloodwork -- nothing but coffee and water allowed -- I drank two 16oz cups of coffee in the overnight and two full liters of seltzer water from my Sodastream. I figured this could only help.
For most people, it would. For this nurse lady, it didn't.
We have a plan when I get my blood drawn: Daisy stands next to me and holds my hand, and she keeps talking to me about something engaging to hold my attention while they take the blood, while during the entire time I am squeezing her fingers so hard I could break them if I'm not careful. Usually this gets me through it fine and we continue our doctor's visit normally once they take the blood.
Also -- they always take the blood out of the top of my hand. I have thick, visible veins there and even though apparently it's more painful (debatable, in my opinion) than the inside bend of the elbow, every time a doctor has tried to take blood from the inside bend of my elbow, I have fainted cold. Surprisingly, Daisy has not been there for those occasions -- it happened once when I was a teenager during a routine visit, it happened again when I had to get blood drawn for a TB test when I became a substitute teacher in Kansas (yeah, that happened, it's a story for another time) and it came very very close to happening (like 95% fainted) when they drew blood from that spot for my last STD test about ten years ago. So now, as a seasoned adult who knows this is a thing, I always tell the doctors about it in advance and request the butterfly needle on the top of the hand, also giving them warning that I might still pass out anyhow.
Back to the present, and Daisy is standing next to me and I'm squeezing her hand tightly when I tell you that I can tell that it feels like this nurse is literally fucking the top of my hand with this needle, over and over, trying to get into a vein to take the blood. I start sweating. This is generally the first sign that I'm about to faint. They lay me down on the exam table, propping me up a bit so my back doesn't wrench itself.
It is at this point when the actual doctor finally comes into the exam room, to see me looking like a mess and to see the nurse say "nope, can't get it out of the right hand, let's try the left hand." Doctor lady, who's probably about my age (hard to tell when she's wearing a mask) introduces herself to me while I'm halfway out of it and offers to help the nurse. Doctor lady takes me by the left hand, massages it a bit and says "right here," and bam, they're in and blood is flowing, with almost no pain whatsoever.
Daisy is talking to me about our garden to keep me occupied, and I am responding by helping to tell our doctor lady and nurse about all the things we're trying to grow, and I'm now squeezing Daisy's hand with my right hand, which has multiple puncture holes on it, no bandage, and is rapidly developing a bruise. I ask if blood is flowing -- meaning, if they're getting the tubes full of it that they need -- and all three of them reply "yes" in what sounds like in unison. I am still sweating and am starting to feel a little dizzy, but I am mostly okay. I look down at the vials and tube full of my blood. "Oh neat," I say, "this is cool, I can watch it." And then it hits me.
I am told, after I recover, that the color went completely out of me, and that I was as white as a sheet and sweat began pouring off me, drenching my head, neck, and the pretty wolf t-shirt I was wearing. I felt the sensation of something under my head/neck, and learned a few minutes later that it was a cold pack -- like an ice pack -- which I'll be damned if it didn't feel divine, because the room suddenly felt like it was 120 degrees. I vaguely felt the doctor lady leap into action, felt the needle get pulled out of me and a band-aid with gauze get taped to my hand, and she opened an alcohol swab to hold under my nose like smelling salts, telling me to breathe in through the nose, out through the mouth. Surprisingly, this helped.
I don't know how long I was down. I don't think I ever went full bravo six, but damn was it close. I ask for water -- I am barely able to speak. Doctor lady tells me I can have some once she sees some of the color come back to my face, as otherwise I'd probably vomit it up. I tell her I'm okay, she tells me something along the lines of "not yet you're not, keep smelling the alcohol swab." Throughout all of this I don't remember whether I still have a death grip on Daisy's hand or not. I tell her I'm fine again and can sit up and she again denies me this action until she sees some color return to my body. She grabs a paper towel from the dispenser and hands it to me, and I soak it with sweat off my forehead and face/neck area -- sweat that I didn't know was there.
"Why does this happen?" I ask her, while still pretty goddamn out of it.
She explains something about it being an autonomic response, like a reflex, that can't be controlled -- the body sucks all the blood within it into the vital organs and, well, you faint. I didn't understand her explanation, as I was, again, still out of it. Daisy would tell me later that the doctor lady sympathized with me as she said it sometimes happens to her too. I didn't catch that in her explanation of it.
A few minutes later I am able to sit up fully and am feeling groggy, but otherwise okay. I drink the water in the little paper cup like it is the nectar of the gods. I do not vomit. Five minutes or so after that, I'm 100% okay and answering her questions about while I'm there and about the topics I wanted to cover, which include getting off the testosterone because my balls are shrinking, and making sure my allopurinol is refilled/renewed for another year. She asks me about my gout and flare ups of it (very few and far between, and very mild when/if it happens) and questions me about my sleep habits and fatigue. She orders a urinalysis to make sure I don't have any blood in my pee still, and schedules not only a referral to the urologist for a semen analysis, but orders a sleep study for me to address the fatigue (more on this later).
I take the cup to the bathroom and ask the jabby-jabby needle nurse how much pee she needs in it, which sort of embarrasses her I think, but fuck it, I was recovering from a fainting spell and I needed an accurate answer. I go to the bathroom and fill the cup about halfway with pee, am like "eh, good enough," cap it and put it in the little door they have there to collect it.
It was now time to do Daisy's blood draw. At this point, it was nearing 10am, and we had been in the doctor's office a full 90 minutes longer than our expected one-hour appointment. I come back to the exam room to find the jabby-jabby needle nurse now rooting around in Daisy's veins, trying to find one to tap.
"I'm just not having great luck with blood draws today," she said.
"Perhaps it's our thick vegetarian and vegan skins," I mused, which did not seem to go over well with the nurse.
Daisy, who does not thankfully suffer from the same fainting affliction I do, went through three different nurses who jabbed her in multiple places six times and were never able to get a goddamn drop of blood. They're supposed to send you to the hospital's blood lab after three unsuccessful tries; Daisy told them to just keep going and maybe they'd get lucky with a thin vein. Remarkably, I could watch all of this with no issue -- after all, it wasn't my own blood this time.
This took the better part of a half hour. I texted my work friends, with whom I have a running group chat, to tell them that I was literally going into hour three of being in the doctor's office and I wish I was kidding.
They stuck Daisy over and over for what had to be close to 20 minutes before shrugging and saying yeah, she was just going to have to go over to the hospital's blood lab where they could try again. After that was decided, our visit wrapped up pretty quickly -- I guess there was nothing else to say or do -- and they gave us our "after visit summary" printouts and sent us on our way.
Daisy and I were back home fifteen minutes later, where I was finally able to eat something after my long fast...but Daisy could not, since she still had to go to the hospital down the street from her workplace and get the bloodwork done there. It made her...bitter...to watch me eat, to say the least. She changed into her work clothes and off she went. I finished eating and was in bed sometime after 11am, where I remained dead to the world until after 6pm that night.
However, this story doesn't end there.
Daisy was particularly interested in her bloodwork because she wanted to see if they could check for inflammation causes/factors/levels, as well as to see if she had a gluten or wheat allergy/sensitivity. To make sure she had a good bit of it in her system, the dinner we'd had the night before was pasta and garlic bread -- carby-carb-carbs, wheat, gluten, everything that would likely trigger inflammation in her so that she could give them a more accurate reading. The doctors actually said this was a fantastic idea. While I slept, she went to the hospital lab, they stuck her in the same place one of the nurses already had, and were able to get blood from her without any issue whatsoever -- an in-and-out trip. Imagine that, right?
Most of her labs were available that night in the MyChart system before she went to bed, and she found that there were zero markers whatsoever in her system for any sort of gluten/wheat sensitivity or inflammation -- everything was within normal parameters. This frankly shocked both of us, really. I know how inflamed this woman gets when she eats bread and pasta, yet...nothing.
"I think I screwed myself," she said, "by taking anti-inflammatories every day to where they likely built up in my system."
While that may be the case, that parameter came up as normal, as well as pretty much every other test result she had near-immediate access to.
Meanwhile, some of my own test results had become available as well -- some of the baseline ones, anyway. Uric acid levels are normal, testosterone in my bloodstream was low normal, but still well within the normal range, etc.
Here's what my printout said -- I'm going to list them all first, as an overview of sorts, then go through them one by one in detail. And even then, there is still more to discuss.
Instructions from [Brandon's new doctor]
We will check labs today and notify of results
Order placed for a home sleep test for evaluation of extreme daytime sleepiness
Check a uric acid level today and notify of results, continue to take allopurinol as prescribed and we will notify of any necessary medication changes
Advised to work on improving overall nutrition and increasing physical activity
For semen analysis, referral placed to urology
We will check a UA today to rule out any persistent blood in the urine due to previous hematuria
We will check testosterone today and notify of results, he would like to stop the testosterone cream. Discussed weaning off of this.
Mind you, there's some inaccuracies here on what I asked versus what was documented above, so let's go through these.
We will check labs today and notify of results
Several days later, I can say that almost all of my labs are normal. There's no blood in my pee, my uric acid levels and testosterone are decent and not a cause for concern. Basically, almost everything is where it should be and where it was expected to be. My cholesterol is a little higher than it was before, and my triglycerides are a fair amount higher than before. But, really, meh. If you think I'm leaving something out, I am, and I'll cover it below.
Order placed for a home sleep test for evaluation of extreme daytime sleepiness
The way this is phrased versus what I asked concerns/bothers me as a patient. For one, I work overnights -- of course I'm going to have "extreme daytime sleepiness." What I asked was what could be done about my fatigue, my near-constant "Brandon is always exhausted no matter how little or how much he sleeps" bullshit that I'm really rather sick of. I explained that yes, I do work a stressful overnight job, and yes, I do sleep 6-7 hours at most on most days -- with many days less than that. My concerns weren't "why am I tired," because duh, but "why do I never feel like I've gotten any real rest." The new doctor lady and her team added a Vitamin D test to my bloodwork, which showed me as slightly deficient (but higher than Daisy, so go figure) and said they wanted to rule out anemia and sleep apnea because of my weight, which okay, I'm fine with. As such, they ordered a sleep study -- the first test of which will be at home, and will rule out a number of different things, I guess. If anything pops up abnormal on it then I will indeed have to go in for a monitored sleep lab setting thing, per doctor's orders. I'm not really comfortable doing this, and really don't want to do it, but it is what it is. In the past few days since our appointments, the sleep lab has left me voicemails almost every morning to call and set it up. I'll also note that I've not been given any information on or any directions for this "home sleep test" at all, not a damn thing. From doing preliminary research it sounds like I have to wear a device with sensors and a mask, which...lemme tell ya, is gonna make it really hard for me to sleep period, let alone try to sleep comfortably when I have two of my three cats who love to cuddle up with me.
Check a uric acid level today and notify of results, continue to take allopurinol as prescribed and we will notify of any necessary medication changes
Gotcha, I'm fine there, see above.
Advised to work on improving overall nutrition and increasing physical activity
This one sort of bothers me too. Yes, I am fat. I have been fat my entire life. I'm also vegetarian, and while yes, I do like some "junk food," I eat relatively little and relatively cleanly the vast majority of the time. I take vitamins and supplements every day. I don't drink alcohol. I don't gorge myself on dumb shit (most of the time), I try to avoid a lot of sugars, I am conscious of and try to regulate my carb/bread intake at least a good chunk of the time, and I try to eat a lot of vegetables and some fruits. Anyone else who ate a diet like mine -- as I have said before -- would have weight melting off them and they'd feel like they were wasting away. As for "increasing physical activity," well, you try to do that when you work overnights five nights a week and suffer from chronic fatigue. A lot of the time, the only physical activity I have any energy for is being (mostly) awake and upright.
For semen analysis, referral placed to urology
Okay, so there's a little backstory to this one. Eventually, the wife and I want to have kids. Well, a kid at the very least. We're both getting older and Daisy is entering "geriatric pregnancy" territory were I to even knock her up at this point. After seven years of being married and yes, having regular, unprotected married sex, we do not have a child yet (obviously). Daisy has also had PCOS her entire life, which makes it near impossible for her to lose any real weight and keep it off, and also has the double bonus of making it near impossible to conceive a child. So, I mean, odds are stacked against us here in many ways already...but I have no idea what the health of my semen is. I've never had it checked, and I have been on testosterone therapy for probably a little over three years at this point, which (I've been told) can also make it much harder to conceive a child. So, before Daisy decides to go through any more analyses, invasive or otherwise, I have to go jerk it into a cup. Sorry to be crude, but I mean, that's what it is. I have yet to schedule this appointment.
We will check a UA today to rule out any persistent blood in the urine due to previous hematuria
"Hematuria" is literally "blood in the urine." I didn't have any; I'm good and clean.
We will check testosterone today and notify of results, he would like to stop the testosterone
cream. Discussed weaning off of this.
Mentioned above. My testosterone level was like 252 or something like that, which is in the lower, but still quite normal range, especially for a man of my age. Last time it was 400-something, which is the highest I've ever had it in all my testings. The testosterone isn't a "cream," either, it's a gel. It's literally hand sanitizer with testosterone in it, and I hate it. If I could just take a daily pill, I'd likely feel much better about it and more comfortable with it.
So, as mentioned before, I have been leaving something out this entire time, and that was the results of my blood glucose. For the past four years, my blood glucose has been very normal -- something like 80 at the lowest to 112 at the highest. 112 is a little high, but it's not "let's panic" high, and that reading was over two years ago (I've had lower results since then).
My reading on the morning of my physical -- after I'd fasted for 12 hours and after I'd drank a lot of water to get my blood flowing -- was 194. Which is crazy, sugar-attack bugshit high for no reason whatsoever.
I did not get this result until Monday, when the test was on Friday. Needless to say, 194 is nowhere near normal for me. I have never had high blood sugar before. I've always been normal -- so normal, in fact, that I'd never been given an A1C test to check for any sort of diabetes symptoms or what-have-you. Daisy would later tell me that she thinks they probably should have called for an A1C when my reading was 112 over two years ago, but as the next time around it was much lower and still in the normal range, that's probably why they didn't.
I didn't know what to do, honestly. I called Daisy upstairs once she got home from work, and I was panicking. There are many things that can artificially raise blood sugar, such as lack of sleep (check), stress (check check), and even some ways the test can be handled and processed that could give some skewed or otherwise inflated numbers. As my blood glucose had never been that high before, I had no clue what was causing it. My mind went to different factors -- we'd had spaghetti and garlic bread the night before for dinner, so there was possibly lots of carbs still in my body, etc. Nothing made sense. I was convinced it had to be a fluke, like they'd mixed up my labs with someone else's or some shit like that. I'm not a sugar guy, I don't like sweets and the bread I've been eating as of late is sprouted whole grain bread, which has the benefit of having a lower glycemic impact. While I have been drinking the full-sugar Pepsi Blue soda that Daisy was able to find for me, it's not like I was downing them like water -- it has taken me weeks to get through even two six-packs of them. It could be coming from stress and sleeplessness, sure, but to the extent where I'd hit 194? After fasting and drinking a ton of water? That was, to me, doubtful at best.
The doctor's office called Monday while I was asleep and told me they wanted me to come back in for the A1C test based solely on that glucose result alone -- I know this not only because they told me but because all of my other labs and bloodwork was normal, which is why the number stood out more than it normally would have; this is saying something. They were closed by the time I got up Monday night, but I called them back Tuesday morning once I got off work.
"Of course I'll come in for the A1C," I said. "I'd like to do it early in the morning if possible, but I've got basically any morning this week open. Can we try for Thursday?"
Please note, I picked Thursday because we were to have a utilities person come out to the house on Wednesday morning to check our indoor gas meter (apparently this is an inspection that needs to be done once every three years) and because Friday Daisy had off for more appointments of her own -- not to mention that I just wanted to get the A1C over with to prove conclusively one way or another whether I needed to be concerned or whether I could continue on with my normal life.
"We don't have any appointments on Thursday," she told me on the phone.
"Well, what do you have in the early mornings?"
"We can do it Wednesday morning if you'd like," she replied. "I have a 7:45 appointment open."
"Cool," I said, "book it."
I told Daisy this and she had to call the local utilities folks to push back the appointment window of the gas meter reading to a couple of hours later, but it was no big deal.
Tuesday night, I was frustrated and morose. I had to start fasting at 7:45pm, but I was determined to drive down the results of any retest and to get my baseline of normal back. For dinner I had a handful of Fritos, a few handfuls of trail mix, and a Monster lo-carb -- and that was it. In the overnight I drank 32oz of black coffee and this time downed three one-liter bottles of water -- not even flavored Sodastream water, but normal water. By the time the night was over, I was peeing every fifteen minutes and it was completely clear, with no yellow to it. I was primed. I had extra liquid in my blood/skin, and I didn't think there would be any problems getting blood. Moreover, I just wanted to settle the matter and go back to normal life. The week at work had already sucked, and I'd have two more nights to go (which would end up sucking as well, but eh). I'm not one to live with artificial anxiety; I wanted answers.
Of course, the A1C is another blood draw, so one of my biggest concerns was going all "bravo six" again. From my story above already, you know that wasn't something I was exactly looking forward to and wanted to avoid if at all possible. So, Wednesday morning I logged off work a little early, got dressed, woke the wife, and we went to the doctor's office.
We were called in very shortly after I arrived, and as this was a simple nurse visit (just for the blood) I was taken back into a tiny little room by a tiny little Latina nurse probably in her late 20s, one I'd never worked with before.
"We want the best stick possible," Daisy said, before I even had the chance. "He might faint."
"Oh no, then we're going to the bigger room," she said.
"I'm fine," I said, "I can do it here, it's no big deal."
"No, no, no," she said, "come with me, we're gonna lay you down, and I have a trick."
A trick?
I was then taken into another room with one of the uncomfortable exam table beds, and was propped up on it, leaning back at about a 60 degree angle -- not too far back, but leaning back. I went through my normal blood-draw spiel -- out of the hand, not the arm, Daisy stays and we talk, etc.
"I don't want you to faint," she said. "It creates a lot of paperwork."
"Paperwork for what?" I asked.
"Oh, like questionnaires, like what could you have done better to keep the patient from fainting and stuff like that, it's a mess."
Seriously? That's shitty.
"But...it's not your fault when patients faint..." I said.
"Well, regardless, I have a trick."
From her pocket, she produced -- and unwrapped -- an orange Tootsie Roll pop.
"Suck on this, savor it, and look away," she said.
I'll be goddamned if it didn't work.
She had to try twice, but she got the blood, a big vial of it, really quickly. It was almost painless. The Tootsie Roll pop was sweet, it was calming, it allowed me to focus on something else. 30 seconds later she was done and I was fine.
A lollipop. Jesus, it's like I'm six years old.
"This trick works for all ages," she said. "From kids to the elderly. I don't know why, but it does."
She was the best nurse I'd had there in ages. Sweet, funny and jovial, willing to make jokes and laugh and with a fantastic bedside manner. We were back home shortly after Daisy would've normally started work for the day. I broke my fast and got something to eat -- I don't remember what -- and ventured back upstairs. I heard the utilities person come a short time later, it was a girl apparently, who checked the gas meter for literally two minutes and left again, and went to bed shortly thereafter.
And then would come the waiting.
For those of you unfamiliar, a hemoglobin A1C test is a blood test that attempts to track your blood glucose over an average period of about three months, because (I guess) it can do that. You're assigned an average percentage value, upon which you are either considered normal, pre-diabetic, or diabetic. 4.5 to 5.6 is considered "normal," 5.7 to 6.4 is considered "pre-diabetic," and anything over 6.5 is considered diabetic. I can't remember the last time I had an A1C test done -- it was likely in high school or early college -- so 20 years ago now or more. It was just never something that came up. Despite my weight, I was always in pretty damn good health.
But diabetes does run in my family -- my mother has it (moderately), and my aunt, her sister, has it badly. I'm also not unfamiliar with it; Daisy's mother has it, and for years Daisy herself has been in the pre-diabetic range but has actively worked to take care of herself because she doesn't want to be full-on diabetic. When they just did her bloodwork, Daisy had worked herself back down to 5.7, which is the lowest end of the pre-diabetic range. With some further work she will likely not even qualify as that during her next blood draw.
When I got up in the afternoon, my test results weren't ready.
Throughout the entire night of work I kept checking my personal email on my phone to see if I'd gotten the message that the results were ready. I didn't. When my shift ended at 7, I came back upstairs to see that just then, the results were available in my online chart. I logged in, apprehensively pulled up the page, and opened the results to find...
8.5.
Fucking 8.5. Two full points above the range that would consider me diabetic.
I, apparently, have diabetes.
Diabetes that came out of the blue, with no prior warning signs or other indicators, no glucose in my urine, no high blood pressure or other problems (aside from the gout), diabetes that literally manifested itself out of nowhere over the course of the past eighteen months since my last physical, when the only thing that has changed about my life is the fact that I now work from home.
I was incredibly angry and frustrated. I still am angry and frustrated. I didn't know how to process it and still really don't. I've always been the person that has been the poster child for "look, you can be fat and still be healthy, still be normal" and now I can't be that person anymore, because boom, diabetes. Daisy was upset as well -- not at me, not because I have diabetes, but because the doctors didn't catch it sooner, never did the A1C tests sooner or regularly because of my weight, and for basically dropping this bomb out of me out of nowhere.
"Answer your phone when they call you," she said, "because I guarantee you're going to get a call."
Soon enough, I did.
"Your A1C is 8.5, which is unfortunately considered diabetic," the nurse said on the phone, telling me what I already knew. "So we've called in a prescription for Metformin for you to start taking twice a day with your meals, and you'll need to check your blood sugar periodically to try to monitor it..." she droned on.
I already knew everything she was telling me. Daisy is on Metformin not for diabetes, but for PCOS (because that really helps it, apparently) and I know the drill for the blood sugar checking with the meter and all that, Daisy does it a fair amount and her mother wears one of the monitors that periodically uploads her glucose level to an app on her phone, so it's not like I don't know these things.
"Your cholesterol and triglycerides were a little higher than normal too," she added, "so we need to monitor those things and maybe get you on medication for those if they don't improve..."
Yeah, I knew that too. I also know that I'm vegetarian and the only cholesterol-containing food I eat is cheese, which tells me that the cholesterol is likely more hereditary than it is physical. While I do like cheese, I'm sure I don't eat enough of it to significantly raise my cholesterol and triglycerides that much.
"[New doctor] wants you to come in again this week for a sit-down discussion of everything moving forward," the nurse continued, "no blood work or anything necessary, just a discussion--"
"No," I said.
"No?" the nurse replied, surprised.
"No," I said again. "Can't she just call me and give me the rundown? I already know a lot of what she's going to tell me, I have diabetic family members and know the ins and outs of checking blood and taking Metformin."
"Uh...well..." the nurse seemed genuinely surprised, like she wasn't expecting that answer at all.
It throws off my entire day to get off work, get dressed, go to the doctor, spend the time there that I need to spend there, and then come back home to finally go to bed hours later than normal. Most of the time I go to bed in the morning right after Daisy leaves for work or starts work (if she's working from home). I also can't keep making Daisy go in to work late because she needs the car to do that, and obviously if I'm going to the doctor's office in the morning, that requires use of the car.
"I guess we can set this up as a telemedicine appointment," the nurse said.
"Okay, I guess," I said. "Is that different than her just calling me?"
Whatever happened to the days where doctors would just call their patients to have a five-minute discussion with them?
The nurse got my details and said she'd call me back.
"I don't think I'm asking too much there, do you?" I asked Daisy once I hung up the phone. "Do I really need to go in there to sit down to have her lecture me about being fat and diabetic?"
"No," Daisy said, "you don't."
Again, Daisy is still mad they didn't catch this sooner too.
A few minutes later, the nurse called back. "Okay, we have the telemedicine appointment set up for Wednesday the 16th at 8am," she said. "Does that work for you?"
"Yes," I said, "that's fine."
"[New doctor] agreed to it this time but she absolutely wants to see you again in six weeks for another check-in and A1C," she added.
"As in, you want to set up that appointment now?"
She set up the appointment for the third week in July, somewhere thereabouts. I don't remember the exact date and frankly, at this point I do not give a single shit. I'm burnt out by doctor visits, I'm stressed and frustrated, and I really don't want to deal with anyone in the medical field more than absolutely necessary.
While I slept for the day, Daisy worked, went to pick up the Metformin (and my allopurinol refill) and brought it home for me.
"I warn you," she told me that evening, "never, ever take Metformin on an empty stomach. It will wreck your bowels."
Mind you, I've heard horror stories about Metformin before, and about how it can and does cause gastrointestinal distress. If you have a sensitive stomach, if you don't stay properly hydrated, if you eat a lot of wheat/breads, it will fuck you with #thepoops. I already have occasional intestinal distress anyway, and for a long time thought I had IBS, so this did not fill me with a lot of confidence. Metformin is also one of those drugs that you cannot drink any alcohol with (reports vary on this, but most resources say that it's a pretty bad idea) and apparently if you're on Metformin, eating a shit-ton of fiber is bad too -- which means that while bread was already a bad idea, dark breads are doubly bad for me.
"Read up on Metformin," my mother told me. "It's bad for you, and once you're on it you can never get off it."
Daisy and I rolled our collective eyes at this. My mother means well but her statements are patently false.
I took my first dose of it on Thursday night with a light dinner. I've taken a dose with every meal since. It is now Sunday. I have experienced zero side effects and have had 100% normal bowel movements and no gastrointestinal distress whatsoever. This simply amazed Daisy and her mother. If anything, I haven't felt sick to my stomach at all, nor have I had excess gas, indigestion, stomach/intestinal pain or gas pains, or anything since I've been on it. I've felt completely normal. Maybe, for me, the drug is simply doing its job.
In the interim since I've been diagnosed as diabetic, I've been taking a long, hard look at my lifestyle and diet. I have been eating a lot more breads and snacks lately -- that will now be heavily limited and eventually mostly stopped. I have begun watching carb levels and sugar levels in my foods much more closely now. Anything sweet and/or sugary or carby is pretty much off the table. It's the gardening season, so I'm going to be eating fresh vegetables now pretty much every day for the rest of the summer, and when I don't, I'll be eating steamed ones. Gone are most pastas and ramens, with the exception of some rare and appropriate times, and gone are the pizzas I'd order were I so inclined. Real cheeses, containing real cholesterol, are being phased out for vegan cheeses that do not have said cholesterol in them. I can't eat most cereals, I have to avoid most crackers, and basically most processed foods are pretty bad for me in general. I need to eat cleanly, I need to exercise more, I need to consistently be active, and I need to get (or try to get) consistent, restful sleep. Some of these things are (obviously) harder to do than others.
To her credit, Daisy is being wonderful about the entire situation. She told me she needed to get some groceries to help cook more diabetic-friendly meals, and I told her to do what she needed to do and get whatever ingredients she wanted, as she knows this stuff far better than I do. She responded by purchasing close to $250 of groceries on Friday night. We also plan to sign up for a new gym membership tomorrow at the gym down the street from our house so that we can start working out again four days a week (her idea for the "four days a week," not mine) now that the pandemic is basically over. It's summer now, so I'd also like to plan some more outdoor adventures for us on days where it's not ungodly hot, but what those adventures will be remains to be seen. Even working in the yard is active movement and more exercise than I'm regularly used to.
So, we shall see how it goes. Now, without any further ado, back to your scheduled posts.








