"stalled" and discouraged

On Mon, 31 May 2004 02:24:28 GMT, (The Queen of Cans
and Jars) wrote:

Damsel in dis Dress wrote:

I guess I'm a really bad person.

most of the best people are.

(((((Carol)))))

Thank you so much. It's weird. The people I spend the most time with love
me very much. It's the people I never see who don't like me. So many
people live in the past, choosing to remember only the stormy days before I
got my medications dialed in. To them, I'm just this raving lunatic that
they have to put up with on holidays. That isn't the person that the
people who actually know me see.

I live in the past somewhat, too. I remember when my daughter loved her
mommy.

Carol
--
Fasting BG 182
227/223/150 (official weigh-day: Thursday)
Bernstein 5/25/2004
Diabetes Dx 5/15/2001
Diet, Exercise, Oral Medication

Jackie,

Three thoughts come to mind. I took metformin for 6 months as a trial
for PCOS in 2000.

My lactic acid levels did rise, but that wasnt until the end of the 6
month trial. Have you been tested for it since you got tired?

Metformin depletes vitamin b12. Have you been tested for it?

I have reoccurring ebstein barr disease. Ebstein Barr is a form of
mono, that most people in the USA have had once in their lifetime.
Once they get it, it stays in their system for the rest of their life
as a form of immunity. Some unlucky people, get this disease over and
over.

Within a month of starting metformin, I was extremely exhausted and
had mine checked again. I was in full form of Ebstein Barr. 4 years
later, my doctor tried talking me into trying metiformin again. By
month 2, I was exhausted and also tested positive for Ebstein Barr.

I have had Ebstein Barr in 2000 and 2004, both times immediately after
starting metformin. In the 1990's I would get Ebstein Barr about
every 2 years. So did metformin somehow stress my body so bad, it
sent me into Ebstein Barr or was it just 'time' for me to get it
again. I honestly dont know, but I do know I wont be experimenting
with metformin again.

essense



I considered that and thought about stopping it. But exhaustion
really
| isn't a known side effect of metformin, except in cases of lactic
| acidosis. The notion that I have some "new" unreported side effect
for
| a drug that's been in use this long seems fairly unlikely.

Jackie,

It sounds to me like your problem may not be insulin resistance. Perhaps it
is failing beta cells. This is more common with people with Type 2 than
most family doctors realize.

If that's the case, Metformin won't help since you may not be all that
insulin resistant so metformin's action is irrelevant. The reason that you
liver is pumping out the glucose is because your natural basal insulin level
is too low to suppress gluconeogenesis. Since you are low carbing and have
depleted glycogen stores, the liver is making that glucose out of muscle
tissue. This could make you feel like crap.

The answer for control is probably nightly basal insulin injections, which
can give your failing beta cells a rest and eventually lead to some recovery
of function.

Many doctors still believe that all type 2s are insulin resistant. But a lot
of current research shows that many have failing beta cells. If failing
cells are the problem basal insulin is the answer.

You'll probably need to see a young endocrinologist who is up to date with
research to get this prescribed.

Hope you can get this straightened out!

- Jenny - Low Carbing for 4 years. At goal for weight. Type 2 diabetes,
hba1c 5.4.
Cut the carbs to respond to my email address!

Low carb facts and figures, my weight-loss photos, tips, recipes,
strategies for dealing with diabetes and more at
http://www.geocities.com/jenny_the_bean/

Looking for help controlling your blood sugar?
Visit http://www.alt-support-diabetes.org/...0Diagnosed.htm



"Jackie Patti" wrote in message
...
No, it's not weight loss I've been stalled on... I'm wanting blood
glucose readings to get lower, not scale readings.

Background info on blood glucose readings: Normal non-diabetic blood
sugar runs around 80-90 (I measured my non-diabetic hubby after a big
giant piece of chocolate cake and his highest spike was 97). Bernstein
wants his patients in normal ranges, aiming at 85 round the clock. I
would be quite happy myself to see my fbg in the 100 range, with a 140
at one-hour and 120 at 2-hour after meals - that's sort of my immediate
goal. 3 months of low-carbing got me down to 140-160 regularly, which
is OK compared to uncontrolled diabetes numbers (my last cheat that
included pasta ran me up to 358). But I started on metformin to try to
get my numbers down. Doctor started me on 500 mg, worked up to twice a
day, and my numbers fell about 20, to the 120-140 range. I requested a
dosage increase as that was not good enough to hit my goals.

Metformin has two modes of action... it reduces insulin resistance,
meaning your cells manage to take in more glucose than usual, meaning
your body doesn't have to make so damned much insulin to lower bg. It
also supresses the liver, which makes glocose out of amino acids if it
thinks you don't have enough, so less glucose gets dumped into the blood
to begin with.

So I've been working the dosage increases the past couple weeks and it
has been really rough. I've been increasing my metformin dosage
gradually... from 500 mg 2x/day to my current 850 mg 3x/day which is the
maximum dose. I've played with taking doses at various times as well,
but have seen very little improvement, fasting blood glucose running in
the 140-150 range and post meal values in the 140-160 range, nothing
below 140 at all. Might as well not be on the meds at all... I got this
much out of low-carbing.

Also, I've felt like crap. Every dosage increase of metformin gives me
the squirts for a few days until I adjust to it, which is defintely not
fun. I have tried to stabilize the GI effects for several days before
increasing the dosage, just to give myself a bit of a break. Yes, the
scale shows improvement, but I know that's not *real* improvement...
empty intestines would more than account for the scale loss I'm seeing...

The whole thing has been really discouraging. For me, bg is the main
measure of my success at low-carbing and exercising and all. I measure
my weight now and then, and see lifting improvements at the gym, but I
consider my meter to show my *real* progress. And there just hasn't
been any; higher dosages of metformin are doing less than the original
dose was doing.

Further, I have been *exhausted* for several weeks now. I mean, I'm
sleeping 8-10 hours at a shot, twice a day. Get up, sit down to work on
the computer (I'm a programmer), and feel like going back to bed in an
hour. The tiniest amounts of physical movement, like getting up to get
a drink, or reaching across to put my seat belt on, take huge amounts of
motivation - I'm just so, so tired.

All the "feel good" benefits of low-carbing are gone. I feel awful.
I've only made it to the gym twice in the past couple weeks, once just
floated around in the pool (hardly could count as "swimming") and once
did an upper body workout, after which I slept for 10 hours.

My food intake has deceased tremendously because it takes too much
energy to fix food. And I'm too wiped to think about going grocery
shopping to pick up some no-prep kind of food. Still my bg hadn't gone
below 140 in weeks. The body makes virtually no glucose from fat, so it
*must* be making it from protein, and given that I'm barely eating,
that's got to be body muscle turning into these high blood sugars.
Which means some of my weight loss is likely muscle loss.

But *how* can I be doing that when metformin supresses the ability of
the liver to turn protein into glucose to begin with?

Where the hell is the sugar coming from? I see right here on my meter
that I've got plenty of sugar in my blood.

I *know* metformin increases the cell's ability to use that fuel, so how
can I be so frigging exhausted? My cells should be "eating" more than
they have in years. I should feel *more* energetic, I should be
sleeping *less*, I should be doing *great*.

I spent many hours the other night reading on diabetes again. Got
myself all worked up. Maybe I'm dehydrated, maybe I have too much iron,
maybe I need more electrolytes, maybe my magensium is low, maybe my
leptin levels are screwed up, maybe I have cortisol issues, maybe my
thyroid is screwed up, maybe, maybe, maybe... too damned many variables.

Maybe I should just become a frigging hypochondriac and have scores of
different things wrong with me and live the rest of my life obsessing
over my damned meter. Might as well eat a frigging chocolate bar and
have some damned crackers with my cheese since my damned blood sugar
won't go down any way. Major pity party, though I *didn't* eat crap.

I spent the day after that basically angry at everyone who isn't
diabetic. ****ing *******s get to have normal blood sugar without all
this damned work. **** them and **** their blood glucose readings,
lucky *******s. People who can eat chocolate cake and stay below 100...
BAH! Don't have to frigging poke their damned fingers over and over
again, just get to be frigging normal. *******s, all of them.

I forgot to get a copy of my blood work last time I was at the doctor,
so called them up to ask what my results had been after my evening of
research into all the ways I could be ****ed up. Just asked the nurse
if anything was outside of the lab normal ranges... and no, you're fine,
wait... except for this high white blood count.

I'm SICK? Someone could've *mentioned* that I was sick.

You know, I *really* couldn't tell. Do I have a fever? How the heck do
I know, I am perimenopausal, I have hot flashes. Do I have GI symptoms?
How the heck do I know, I'm adjusting metformin dosages which causes
that. The only symptom I had was being unbelievably tired (which I was
beating myself up for "laziness" and "lack of motivation") and the high
bg readings (which can be caused by infection).

I'm freaking out over a complete inability to get my blood glucose down,
imagining all sorts of things that might be "wrong" with me, and it
turns out I'm just sick.

Sheesh.

So... today my fbg was 128, lower than it's been in weeks. Couple hours
later, it's 126. I'm still exhausted, though not quite so badly. So I
guess I'm on the mend. I may have to titrate the metformin back down as
I get better, we'll see how it goes.

And I'll stop hating all you non-diabetics now.

--
As you accelerate your food, it takes exponentially more and more energy
to increase its velocity, until you hit a limit at C. This energy has
to come from somewhere; in this case, from the food's nutritional value.
Thus, the faster the food is, the worse it gets.
-- Mark Hughes, comprehending the taste of fast food

Damsel in dis Dress wrote:

I don't have the oomph to respond to your whole letter. MAJOR stress right
now. All of my blood relatives disowned me in one fell swoop yesterday. I
guess I'm a really bad person. (In my family, you're *bad* if you express
to someone that they have hurt you in any way, don'tcha know)

We have something else in common then. I have nada to do with the
family I was born into. My dad was the only decent member of my family
and he died over a decade ago. Some members I have not spoken to in a
couple years, others over a decade. Messing with me was somewhat
forgiveable, but messing with my daughter is not - so they're all
written off.

Luckily, I have really great inlaws that make me feel part of the
family. We spend all holidays with them and I just pretty much ignore
my own family. Works for me.

--
As you accelerate your food, it takes exponentially more and more energy
to increase its velocity, until you hit a limit at C. This energy has
to come from somewhere; in this case, from the food's nutritional value.
Thus, the faster the food is, the worse it gets.
-- Mark Hughes, comprehending the taste of fast food

Update:

I woke up from my nap yesterday with a bg of 100 - lowest of the year!
Ate some more hamburger, bell pepper and onion and found my 1-hour at
107, my 2-hour at 116. Was at 116 before bed, then 131 this morning
(which is close to my best fbg... I have high bg in the morning).

So apparently, my "stall" is broken. I feel much better today, though a
bit tired, though nothing like the past few weeks. I plan to get a
web-site finished and some light gardening done today and limit napping.
I think I'll be back at the Y and 100% by tomorrow.

Yes Virginia, the woosh fairy visits diabetics too.

I'd be willing to bet that my white blood count is down next time I go
in; I think I've just been sick. Just bad timing for it to happen when
I'm testing so much and trying to work out my dosage and such.

As for my doctor... I have no insurance and go to a clinic where I have
a young general practioner. He has a clue though, was highly approving
of a low-carb diet and exercise. He's also highly approving of me
knowing more about my disease than he does. We have a little mutual
admiration society going on, "Gosh, I wish all doctors were like you!"
and "Gosh, I wish all my patients were like you!"

Anyway, he *isn't* terribly knowledgeable about diabetes, but I can't
afford expertise at this point. I basically have to go in with a good
idea of what to ask for to begin with. Last visit, he basically gave me
a pile of sample metformin and told me to go ahead and work out my own
dosage so he could write the script.

I have made a big decision that sort of scares me though - I am going to
ask him during my next visit for training in giving insulin shots as I
think I'm going to need insulin to control bg when sick.

Anyway, it appears insulin is in my future, so might as well "get over"
the fear of the whole thing before I need to. I'll probably feel better
once I have this under my belt.

Still have to "work" on the fasting numbers, but seeing stuff that
*makes sense* on my meter has greatly encouraged me.

--
As you accelerate your food, it takes exponentially more and more energy
to increase its velocity, until you hit a limit at C. This energy has
to come from somewhere; in this case, from the food's nutritional value.
Thus, the faster the food is, the worse it gets.
-- Mark Hughes, comprehending the taste of fast food

On Mon, 31 May 2004 10:48:00 -0400, Jackie Patti wrote:

We have something else in common then. I have nada to do with the
family I was born into. My dad was the only decent member of my family
and he died over a decade ago. Some members I have not spoken to in a
couple years, others over a decade. Messing with me was somewhat
forgiveable, but messing with my daughter is not - so they're all
written off.

Luckily, I have really great inlaws that make me feel part of the
family. We spend all holidays with them and I just pretty much ignore
my own family. Works for me.

Hi Jackie. Sorry to hear that we're in the same relationship boat. And
we're both such swell people when we get away from Those People.

In this case, I finally got tired of my daughter's abuse, and wrote her a
letter .... which she forwarded to the entire world. I miss the sweet
little girl that she was, but not the greedy, selfish monster that she's
become. A person can only take so much before they have to say, "Stop!"

Crash and I are both orphans. He's also estranged from one brother, and
the other one uses him for his computer expertise, but that's the only time
we ever hear from him.

It's just Crash, his daughter (and mine, in a very special way), her
boyfriend, and a couple of Crash's long-time friends. That's it.

I'm so glad that I have my various internet families, as well. Lots of
brothers and sisters, and a mom or two from asdlc.

And great IRC friends, originally culled from rec.food.cooking. We get
together once a year and make enough food to serve several armies twice,
and still have leftovers. This time, I'll be the only low-carber. I see
orange cookies (which are low-carb, JC G) in my future.

Anyone interested in attending a cook-in in southern Minnesota in about a
month? Write, and I'll give you details.

Carol
--
Fasting BG 172
227/223/150 (official weigh-day: Thursday)
Bernstein 5/25/2004
Diabetes Dx 5/15/2001
Diet, Exercise, Oral Medication

On Mon, 31 May 2004 11:08:55 -0400, Jackie Patti wrote:

I woke up from my nap yesterday with a bg of 100 - lowest of the year!
Ate some more hamburger, bell pepper and onion and found my 1-hour at
107, my 2-hour at 116. Was at 116 before bed, then 131 this morning
(which is close to my best fbg... I have high bg in the morning).

Whoo-hoooooo! That is wonderful news! Good for you!

Carol
--
Fasting BG 172
227/223/150 (official weigh-day: Thursday)
Bernstein 5/25/2004
Diabetes Dx 5/15/2001
Diet, Exercise, Oral Medication

The Queen of Cans and Jars wrote:
Damsel in dis Dress wrote:

I guess I'm a really bad person.
most of the best people are.


You know? I don't always see your point of view, but
when I do, I really enjoy it.

Hugs to Carol, too.

April.
Put out the cat.
--
"Things that try to look like things often do look more
like things than things. Well known fact."
Esmerelda Weatherwax (Pratchett 1988)

On Mon, 31 May 2004 14:32:32 -0600, April Goodwin-Smith
wrote:

The Queen of Cans and Jars wrote:
Damsel in dis Dress wrote:

I guess I'm a really bad person.
most of the best people are.

You know? I don't always see your point of view, but
when I do, I really enjoy it.

Hugs to Carol, too.

Thanks, April. It's been a tough weekend, but I've had a lot of loving
support here at home, and with so many of you from the newsgroup. It feels
good to be cared about. :-)

Carol
--
Fasting BG 172
227/223/150 (official weigh-day: Thursday)
Bernstein 5/25/2004
Diabetes Dx 5/15/2001
Diet, Exercise, Oral Medication

Damsel in dis Dress wrote:

On Mon, 31 May 2004 02:24:28 GMT, (The Queen of Cans
and Jars) wrote:

Damsel in dis Dress wrote:

I guess I'm a really bad person.

most of the best people are.

(((((Carol)))))

Thank you so much. It's weird. The people I spend the most time with love
me very much. It's the people I never see who don't like me. So many
people live in the past, choosing to remember only the stormy days before I
got my medications dialed in. To them, I'm just this raving lunatic that
they have to put up with on holidays. That isn't the person that the
people who actually know me see.

I live in the past somewhat, too. I remember when my daughter loved her
mommy.

i'm sorry that your family are asshats, but i'm glad you have others who
care. you're not alone, and that's the really important thing.