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Tuesday, March 27, 2007

Alternatives to dropsy...and other thoughts...

Prolegomena: Everyone has their own standards for what should or should not be posted on blogs -- not in terms of what is right or what is wrong, but rather as a matter of "taste". Some blogs are too personal, some are too rhetorical, some are too cute, etc.

On this site I have tried to strike a balance between commentary and observations, and I suspect it has gotten too personal at times -- especially when I address my maladies. But I try to do so as a form of observation rather than complaint or play for sympathy. If anything, I go for the content and laugh more than the pity. For me this stuff is pretty interesting in general, and I share it in the sense of awe (mostly positive) about how we deal with "disease" through medication. So here is the latest set of "observations":

A couple of days ago I posted my comments on a self-diagnosis of recent lethargic behavior, and I shared my sense that this was somehow related to a particular medication (metformin). Besides writing, I also left a message for my endocrinologist about my concerns, and yesterday she responded by effectively dismissing my idea that the Glucophage was the cause of my sleepiness and erratic, low body temperature. Her question: how were my blood sugar numbers holding up? My answer was that overall -- on the average -- pretty damn good. They vary considerably, but all within a decent and acceptable range. If that is the case, she argues, then my sleepiness and related problem are not tied to my glycemic problems and therefore it ain't the medication (paraphrasing, of course). I am still not convinced, but I defer....

However, she was concerned that I (and those around me) was still "suffering" from the gastrointestinal side effects -- and she suggested that I temporarily drop the metformin (if I wished) until our scheduled visit in a couple of weeks. In its place she wanted me to double my dosage of another anti-diabetes medication I am taking (Glucotrol -- or actually its equivalent, Glipizide). I decided to go with that advice, not only because I am a bit tired of the general discomfort from the "side effect" but also doing so can be a monitored check on my suspicions about Glucophage.

Now, what is interesting about the Glipizide (classed as a sulfonylurea drug) is that it works differently. While I understood Glucophage to effectively reduce insulin production by the liver, Glipizide seems to increase its production by the pancreas while also lowering the liver production. By now I am baffled about all these tradeoffs. but if I understand it at all, the point is to get some moderate balance of blood sugar levels over a 24 hour period. One of the problems with this regimen is that I might now be more susceptible to hypoglycemia -- and I really have to watch out as well for weight gain and edema (a new word I have found for plain old bloatedness -- the alternative was 'dropsy', which is just not that inviting). But since I am already taking Glipizide (10 mg) each morning, the shock to the system of doubling up might not be as bad.

And what is my general observation from all this: between my neurotic personality and access to the web, I am quickly turning into a hypochondriac....

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Comments on "Alternatives to dropsy...and other thoughts..."


Anonymous Ciarán said ... (4:50 PM) : 

Good news on the hypochondria front: hypochondria's psychoanalytical definition is that you think you have a disease hitherto unknown to humankind.

In which case you're common-or-garden neurotic!

Have you tried sleeping more????


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