My Second Visit To My Endocrinologist

I went to see my endocrinologist(diabetes specialist) yesterday afternoon. I was a little late on my appointment because I had a previous engagement somewhere else in Cranford, New Jersey – about forty minutes ride from the doctor’s office. The persistent onslaught of rain in the afternoon also added the delay of my arrival. But, anyway, when I arrived at the doctor’s office, a number of people had been waiting in line ahead of me, so I just had to wait for another thirty minutes before I saw my doctor.

When I met my doctor, she was very cordial as ever. Her secretary took some blood sample from me to test my sugar. She took my blood Pressure and had my weight taken too. I was happy because everything seemed to be in order. My doctor asked me how I was. She examined the result of my blood test, and she was glad to know that my A1C has gone down dramatically since my first initial test. But she challenged me if I could bring it down even some more. My A1C reading of 7.3 is still relatively high if what is normal is 6.9 or below. She wanted to prescribe another pill but I told her that I would like to continue taking my current medications for now, if it was possible. She was agreeable with the idea. But she said, she would like to evaluate me after six weeks. If nothing has changed with my sugar level after that, then she told me to consider taking the other pill. I told her that I had no problem with the arrangement.

I raised to her the issue of taking me off from insulin. But looking at the result of my blood test, she said she was not ready to take me off from insulin yet. “Let’s see what happens after six weeks,” she said. I felt a little dismayed because I still have to continue taking shots of insulin. But I understood what she was saying. She told me as well to continue checking my sugar regularly, especially two hours after meals. I could not say no. What else can I do but follow my doctor’s order if I want to feel and get better.

I told my doctor about my problem of constipation. For this, she told me to see my nutritionist as soon as possible. The truth is, I haven’t seen a nutritionist since I was diagnosed with my illness. So I immediately made an appointment with a nutritionist for this coming Friday. For my constipation, my doctor also told me to eat fruits which are high in fiber and calcium and Vitamin B. I noted down some of the fruits which she mentioned that I should consider eating.

My doctor also examined my foot. For the past week, I had been feeling some discomfort and little pain on one of my left foot fingers. She gave me a prescription to see a podiatrist as soon as possible. She also recommended an eye check-up as part of the precautionary measures that I need to do. I told her that I would be seeing an eye specialist in the coming weeks.

In general, there was nothing very peculiar or out of the ordinary with my doctor’s visit. My doctor wanted to see me again after six weeks. In the meantime, I just have to do what I was asked to do. But I need to continue my diet and my regimen of regular exercise. I promised myself not to be complacent or get lax about these. Diet and exercise are now part of my daily routine.

Stress Management

I was told by my doctor that one of the causes of diabetes is stress. I was surprised when I was told about this because I could not figure out initially how stress has something to do with this illness. But, on second thought, I realized that maybe they are right in saying that stress can cause diabetes. How is this so? Well, as we all know, stress is how our body’s responding to all kinds of demands. Scientists tell us that when people feel stressed by something going on around them, their bodies react by releasing some kind of chemicals into the blood. These chemicals give people more energy and strength, which can be a good thing if their stress is caused by physical danger. But this can also be a bad thing, if their stress is in response to something emotional and there is no outlet for this extra energy and strength. Stress can affect both our bodies and minds. As we all know, people under large amounts of stress can become tired, sick, and unable to concentrate or think clearly. Sometimes they can even suffer mental breakdowns. In a similar way, when one is under stress, and certain chemicals are released into the blood, the blood sugar shoots up as well. It becomes a necessary consequence. And just consider a person, for example, who is experiencing a large amount of stress, not just once, but all the time. What happens then to his/her blood sugar? We can easily conclude its tragic effect and consequences on the person. That is why, stress management is very important in the treatment of this illness.

As we all know, there are many things that can cause stress – from physical , emotional to psychological causes. Identifying what may be causing our stress is I think the first step in learning how to better deal with our stress.

I have read somewhere that there are many kinds of stress. There is such as thing as survival stress, internal stress, environmental stress, and stress caused by fatigue and work. Let me define and clarify each of them.

What is survival stress? Survival stress is a common response to danger in all people and animals. When you are afraid that someone or something may physically hurt you, your body naturally responds with a burst of energy so that you will be better able to survive the dangerous situation or escape it all together. This is survival stress.

Internal stress has something to do about worrying about something but of which you can do nothing about. This often happens when we worry about things we can't control or put ourselves in situations we know will cause us stress. Some people become addicted to the kind of hurried, tense, lifestyle that results from being under stress. They even look for stressful situations and feel stress about things that aren't stressful.

Environmental stress has something to do with the noise around us, crowd, and pressure from work or family. As said, identifying these environmental stresses and learning to avoid them or deal with them will help lower our stress level.

The stress that results from fatigue and work are the common stress that all of us experience in one way or the other. This kind of stress builds up over a long time and can take a hard toll on our bodies. It can be caused by working too much or too hard at our job(s), school, or home. It can also be caused by not knowing how to manage our time well or how to take time out for rest and relaxation. This can be one of the hardest kinds of stress to avoid because many people feel this is out of their control. If we are in this kind of situation and environment, what are our options?

Since I was diagnosed with my illness, I have tried as much as possible to avoid all forms of stress – whether physical or emotional stress. Of course, the first thing I had to do was to change a bit my lifestyle. If before I was so engrossed with my task and work, now I find time to relax and exercise. I found out that after doing some form of regular exercise, I feel so great, mentally and physically. If not exercising, I find time to just sit and relax in the park, read a good book, or just lay down beneath the trees and just enjoy the afternoon breeze. As much as possible, I try to avoid negative thoughts and feelings. I always try my best to think positive, whatever the circumstances maybe.

If you are suffering from diabetes, or other similar illness, try to avoid any form of stress. It's good for our physical, emotional and mental well-being.

People Who Needs People

One of the greatest pleasures that we can have in this world is when we have families, true friends and acquaintances that we can really trust and depend on. In the first place, we need other people in order to exist and survive. We are not isolated individuals. We exist with others. That is why we are called social beings. Our nature and existence are interdependent with other individuals. Therefore, to think that we can live alone by ourselves and exist alone by ourselves is essentially a fallacious statement and a mistaken identity.

When I was diagnosed with my illness, I was so overwhelmed with the outpouring of love and concern by many friends and acquaintances. I never really thought and imagined that so many people had been praying for me and extending their support. My trials and sufferings became much lighter to carry knowing that I have a family, many friends and acquaintances who are ready to help and support me in this journey of my life. In spite of my illness, I could say that I am so lucky in so many ways that I have these family and friends whom I can depend on, not only when everything is right, but most especially when I am facing some trials and difficulties. In times like this, the support from family, friends and other people is very important.

As I begin to look back into my life now, I can identify a number of people who had been there for me all the way, in good times and in not so good times. People who were always ready to share with me the so called ‘burdens’ of life. People who have not ran away from me when I was in difficulty, or when I was facing some problems or trials. People who cried with me when I was in pain, and who laughed with me when I was feeling some excitement and joy. People who were ready to correct me when I was not doing right, and who affirmed me when I have reached some success. These are the people we can trust and depend on. We need people like them to hang on, be able to share our dreams with, our successes, our pains and even our failures. When we are sick, the pain of loneliness and fear of the unknown can sometimes be overwhelming. It’s good for us if we have families who love and care for us and whom we can readily depend on. But, for some people who are ill or in crisis situations, they are left alone by themselves to face their own survival. In situation like this, the pain of loneliness can sometimes be even more difficult to face than the physical ailment itself. That is why, for people who are affected with diabetes, or some similar illness, we are always encouraged to form or join some kind of support group. This support group can be very helpful not only in terms of our psychological and moral balancing of ourselves, but also for social and spiritual support. Yes, we need other people to help us in this journey. Without the support of families and friends, our world is simply darn, lonely and dark.

Let us be thankful if we have a loving family and good friends we can count on. For those who are living alone facing their own survival, we pray that they will not feel deserted. May God’s loving presence be felt by them as they face this very difficult journey of their life.

My Blood Sugar Test is Promising

I had my doctor’s appointment yesterday where I got the results of my blood test. Among other things, my A1C has gone down quite dramatically to an acceptable level – from 11 to 7.3. Although the American Diabetes Association (ADA) declares that what is really acceptable & normal should be at least 6.9 or below, my A1C reading of 7.3 does not really reflect a 3-month span, since I was only diagnosed last March 9. The truth is, this is only a 2-month reading, according to my doctor, and yet it has shown a dramatic change already. My doctor was saying that if this is how low my A1C reading has become in a span only of two months, he was hopeful that it could still go down maybe even below 6, after another month. My doctor was happy about the results. I felt happy too about myself and what I have accomplished.

My doctor was curious how I was able to lower down my A1C in so short a time. I simply told him that the key to my initial success was nothing but diet and exercise, and of course, taking my regular medications. Due to my dieting and regular exercise, I have lost at least 16 pounds already. Before I was diagnosed with this illness, I weighed 190 lbs. Now I only weigh 174 lbs (as per the doctor’s weighing scale). My personal weighing scale however does give me a different reading of 170 lbs. But I still want to lose some more weight. I intend to lose another 20 lbs in the coming months. That is one of my goals now.

My triglyceride has come down dramatically too, from over 300 to 160. My bad cholesterol is down, which is very good, but so is my good cholesterol, which is causing me a bit of concern. My doctor is intending to prescribe me a pill to help raise my good cholesterol.

The blood test shows that my kidney, heart and other vital organs seem to be in order and functioning well. My blood pressure is excellent, according to my doctor. Over all, my doctor was happy about the results.

The only concern I have at the moment is in regard to my constipation. I told my doctor that I have had constipation for more than two weeks already, and I really don’t know what’s causing it. In fact, I should not have any problem about constipation because I am taking in Metformin for my diabetes, and this can even cause diarrhea as a side effect. Also, I should not have this problem because I am drinking a lot of water too. A few days ago, I also started taking in Metamucil, a fiber supplement, which is very effective in treating occasional constipation and restoring regularity of vowel movement. But, as of this time, I still have the same problem. For this, my doctor has prescribed me a new pill to take- it’s called Amitiza. I have to take two capsules daily, with food. Well, let’s see what happens. In the meantime, he has made some kind of arrangement that I should get a colonoscopy, to see if there is any problem related to this. I still have to make an appointment with a specialist on this.

So, this is where I stand at the moment. In the meantime, I am hoping that when I see my endocrinologist in a few days, I could ask her that I be taken off from insulin already, if it is possible. My appointment with my cardiologist is also upcoming in a few weeks.

What Happens After Tomorrow?

Last Saturday, I had my first blood test taken since I was hospitalized about three months ago. The day before my doctor’s appointment, the doctor’s secretary called me up and reminded me about my doctor’s appointment the following day. Also, she instructed me about not taking anything after midnight of that day in preparation for my blood test the following day. During the night before my doctor’s appointment, I felt so restless and anxious. I was thinking about the blood test that I had to do the following day and I was anxious about the possible results. I know that in the course of three months, I have somehow managed to regulate my blood sugar at an acceptable level. My readings had been relatively low and promising. My blood sugar had not gone up more than 150, which was good. In spite of this, however, I still felt some anxiety within myself that I could not really explain. I knew that this blood test was important because, for the first time, I would come to know if my AIC has really gone down or not. They say that the day-to-day reading of blood sugar level is not really important. What matters really is the AIC count. Through the reading of the AIC, the doctors will be able to determine and evaluate the consistency of how high or low my blood sugar is within a span of three months. For now, I just hope for the best.

What happens after tomorrow? A question I ask myself recurrently nowadays. Some days I find myself in a relatively good mood, at some other days I feel terribly bad. My feeling is sometimes likened to a roller-coaster. I have my own good days and bad days. Maybe it’s just the way it is. Of course, I don’t want to simply set excuses that I have this roller coaster mood due to my illness. I know for a fact that there are other things which are contributing to my sets of moods. But, I need to deal with it more maturely and rationally. I cannot let my mood swings overpower my capacity to enjoy a happy and fulfilling life. Whether you are suffering from some form of illness or not, all of us have our own sets of moods and behavior patterns. However, what is important is being able to understand the causes of your behavior, and be able to accept and deal with it in a mature way.

Today I am going back to see my doctor to get the results of my blood test the other day. I am hoping that my AIC has gone down to an acceptable level. If my blood test shows that my sugar is now regulated, my doctor would hopefully ask me to discontinue the use of insulin. I pray and hope that I get a positive results from my blood test.

But, as I always say, I take one day at a time. Everything has a reason and a purpose. Right now, I put everything in God’s hands. He knows best what is good for me. I have to believe and trust in His mercy and love.

Just a Glimpse

I went to the park this afternoon to do my usual exercise. The weather was very good and accommodating. Although the heat of the sun was glaring hard, the soft breeze coming from the north, facing Passaic river, neutralized the heat. I saw a number of people, mostly elderly, walking around the park with the usual ease and momentum. Some of them, with portable chairs, just sat together under the trees, reading newspapers, or conversing with one another. A number of cars were parked at some corners, and I saw some men taking a nap inside their cars. What a nice day to relax, if not a good place to take some rest and find some respite.

I started my exercise regimen by riding my bike around the park. I started slow, then with gradual speed. I rode my bike around the park five times without slowing down or letting up. I felt a little tired and weak in the beginning. After a while, however, I gained some momentum, and my strength was becoming steady. While exercising, there were times when I wanted to slow down and stop and simply take a rest. But, my determination to exercise has kept me going. I didn’t want to be lax with my exercise regimen. This is something I have and must do. I have to put it in my head that in order for me to regulate my blood sugar, I need to watch my diet and do exercise regularly. There is no other way. Diet and exercise, as I was told, are the keys to my success in my battle against diabetes.

After the fifth lap, I slowed down my bike and went to take some drinks from inside my car. An elderly lady, who parked her car near mine, came out from her car when she saw me. She said hello and then we started engaging in some conversations. She told me that she just came out from work and she went to the park to relax. Gauging from the uniform she was wearing, she must have been working in some hospital or medical institution. After she said hello, she immediately said that she could never ride a bike like I did. Well, looking at her physique, she was a big lady. So I was not surprised at all when she said that she could never ride a bike. Our conversation started off with exercising and the need to care of our health. “Health is wealth,” she said. Then she mentioned about her friend who is filthy rich and yet she is dying of brain tumor. “What good is our riches if we are not healthy,” she added. I nodded my head in affirmation. Then she asked me if I had been going to the park and exercising regularly. Yes, I told her. I had been exercising quite religiously since I was diagnosed with diabetes more than two months ago. Then she mentioned to me that she too had diabetes. It had been seven years ago since she was diagnosed with the same illness. She warned me about the complications of diabetes. “It’s a silent killer,” she said. Then she was ranting off about the effects of diabetes, and how this sickness can kill people. I stood there listening to her as if I didn’t know anything about this sickness. What surprised me was, she was telling me all these negative things about diabetes and yet she herself, according to what she was telling me, was apparently not taking care of herself too. She said to me that she was eating all that she wanted to eat. “I am now sixty two years old and I really don’t care anymore,” she said. I said to myself, this woman was warning me about the complications of diabetes, if not regulated, and yet she was not taking care of herself as she should. What an irony that was.

Before I started my car and headed home, I stopped for a while and reflected about my exchanges with this woman. I know that there are people out there, who may be suffering the same sickness as I am, but who take their sickness so lightly. The woman was right when she said that this sickness is a silent killer. Therefore, we cannot be complacent on our guard, or take this lightly. And much worse, to think that we can just do anything we want as before, especially in terms of not watching our diet and not exercising. Some reason out, ‘we take our medications regularly so there should not be any problem.’ But this is exactly the problem. For me, this could be the worse attitude we may have. If you are afflicted with this sickness, and you continue the same path as you used to tread on before you were diagnosed—I can bet that sooner or later you will find yourself in a position where there is nothing left but regrets.

I left the park with a heavy heart for this woman. I know that I am in the same boat as she was. The only difference between us is that –I know what I am treading on, and I intend to do everything possible, not only to be well informed about this sickness but also to do what are necessary to treat this illness and keep them.

Two Days of Respite

Last Thursday, May 1st, I visited a long time friend whom I haven’t seen for a while. It was such a nice opportunity for me to go away for awhile and have a nice respite for myself. My friend just arrived into this country more than two months ago. I was so delighted that we could be together again after more than ten years of not seeing each other. Well, except in a few, rare occasions that we met sometime in between. My friend and I are buddies since high school. We were classmates for more than fourteen years. In so many ways, we share the same vision and aspirations in life. Yes, indeed, it was a nice time to be together again with my friend and share some old memories together.

I stayed in my friend’s place for two days, Thursday and Friday. Another buddy who was with us in Rome joined us too. The three of us had a nice time sharing some laughter’s and funny experiences together. But more importantly, the quality time that we spent together, although limited, was indeed memorable.

Since I came to the US more than ten years ago, I haven’t had the luxury to find some respite for myself, except on some, rare occasions when I was home for my summer vacation. That is why, to be with the company of old friends was a rare commodity. In my own experience, life in this country is so much different from the way I was reared up in my own native land. First and foremost, I missed the company of old friends whom I used to hang with quite frequently. When I came into the country, I had to learn how to live by myself independently. I had no friends or acquaintances to depend on. I just had to trust my instinct and learn the law of survival of the fittest. Secondly, the routine of daily work can sometimes be sickening. Here in this country, you have to learn how to go along with the flow. Life here, they say, is always on the go. We are almost always in a rat race. Everyone is always busy with something. People hardly have time for themselves. They are always catching up with something. That is why, you hardly find people here who know how to relax and have a good time. I missed those times back home when I could sit down at the end of the day, sat in my rocking chair, and drink a cold bottle of beer. I missed those times when I could go around in the neighborhood, and just sit in the company of the men, who were just happy conversing with one another, relaxing after a day’s work in the farm. I missed those times when I could go home and my mom had always a hot meal ready for me. Oh, well, those were some good times and memories that I will never trade in with anything, even in exchange of any material luxury or comfort. That is why, seeing my old buddies after a long time, brought back memories of the old times.

I think it is important that in order for us to keep our sanity, we need to retreat once in a while, take some days off from the routine of daily grind, and find a place where we could be alone and find some respite. The demands of daily life can sometimes be overwhelming. That is why, we read so much in psychology about “having my own space,” or in spiritual language, “going for some retreats or recollections” to recollect and rejuvenate oneself. Man’s value is not simply equated with work. He is a social and spiritual being too.

Going away for two days was certainly rejuvenating for me. It was not just an opportunity to see and meet old friends, but it was also something I needed for myself. I promised myself to find some extra ‘space’ for myself like this once in a while. I know it is a luxury, but I think it is also good for my on-going treatment for my illness.