Thursday, January 27, 2022

Health Topics

I haven't written a blog entry in ages, and mostly its because this is the next topic I need to address, and for a lot of reasons I've been reluctant to tackle it. First of all, there's nothing much wrong with me so no need to worry, but I've got several things going on that at least people that are around my age, more or less, might find interesting. They're things that happen to a lot of us as we age, yet I'm probably not alone in thinking that somehow I would be the exception! Wrong!

First of all I’ve manage to acquire a running injury. It’s my own fault, I felt it but tried to ignore it, until it became something that I couldn’t ignore any longer. I’ve strained my hamstring, by not giving my body enough time to recover after a 5k and that 10k trail race. As my PT says, hamstrings are tricky. I rested it, did a lot of PT, learned some new exercises to strengthen my glutes so that I won't overuse my hamstring. I'm back to running, but pretty slowly, and not a lot. My main goal at this point is to take it easy until mid-March when it will be time to start training for the San Francisco Marathon, in person, finally!

Secondly, over the past few years I’ve started having more and more difficulty with urinary incontinence. It’s one of those things that nobody likes to talk about. I feel embarrassed even writing about it, but I’m SURE I’m not alone. You only have to walk down the incontinence aisle at any grocery or pharmacy to know that it’s a pretty common problem! But I tended to think that only REALLY old men and women had that problem, not relatively "young" seniors like me. 

Last year I went to a pelvic floor therapist and she taught me how to do bladder training, which I did last year. Basically you gradually train your body to hold urine longer, very gradually. I did it over a period of several months and got a lot better. But then I got lazy and gradually things became problematic again. I tried to do the bladder training again, but this time it didn’t work. 

So earlier this fall I went to see a urinary gynecologist. I had no idea there even was such a thing! He diagnosed me with a prolapsed uterus AND bladder, so no wonder I couldn’t hold my pee-pee sometimes! He fitted me with a pessary, a rubber ring that fits inside my vagina and holds my organs in place.  If it sounds a little medieval that’s because they’ve been around in one fashion or another since the 15th century!

I’m gradually getting used to it. On the positive side, it really works. I haven’t had an accident since I got it. On the negative side, it’s no fun to put it in and take it out, and I can’t seem to poop with it in, so I’m taking it out at least once a day. But it really is a minor miracle for me. I've had it now for over 3 months and its transformed my life. I don't have to wear a pad, and I don't have to structure my every activity around the possibility that I might have to pee at any second. 

The third thing is the weirdest, and I guess potentially the most serious. When I had the blood work done for my annual physical my blood glucose levels were elevated and my kidney function has deteriorated somewhat. So my doctor ordered another test, to check my A1C levels, which is the test for diabetes. I was a 6. 5 or lower is normal, 7 is diabetic, so I’m classified as pre-diabetic. But weird, huh? I’m not overweight, in fact I’m about the thinnest I’ve ever been, and that’s without watching what I eat at all. And obviously I get plenty of exercise. My doctor was a little puzzled, said it might be genetic. But there’s no diabetes in my family, I don’t think.

So I googled “thin, fit and pre-diabetic” and came up with something called LADA, latent autoimmune diabetes in adults. I asked my doctor about it and she had me tested for it. I'm using a glucose monitor, and and I've gone to an endocrinologist and a dietician. This may seem like overkill for an A1C of 6, but since I don’t fit the Type 2 diabetes profile, and these results are new, it’s better to get a jump on it. If it was LADA, it’s treated differently than T2 diabetes, since it will slowly over time progress to type 1 as your pancreas quits working. But if I can manage it properly maybe I’ll die of something else before that ever happens! The additional blood work determined that I probably don't have LADA, although they can't say that with 100% certainty, since the tests for it are still being developed.

The endocrinologist basically just wants me to watch it and keep testing my blood glucose levels. I had my A1C tested again at the beginning of the month and it hadn't changed. This might be concerning, since I've also started taking metformin, the standard drug used to lower blood sugar. I'm going to see him again next week, so we'll see what he thinks.

I had my appointment with the dietician last week and that was interesting too. She gave me a lot of information about what foods to eat, and which ones to avoid. I'm not any good at making dramatic changes in my life, so I'm trying to focus on one dietary change at a time. But I seem to really love the things, like carbs and sugar, that aren't good for me, and struggle to find substitutes that soothe my cravings. More healthy protein helps, to a point, and so do smaller amounts of more complex carbs. Its going to be a long journey, though, I can see that right now.

The endocrinologist also said that I should go see a phrenologist about my kidney function, so off I went to yet another specialist. The kidney doc was an old guy with a bow tie, and decades of experience in the field. He asked me all sorts of questions, looking for any possible reason why my kidneys weren't functioning as they should be. He sent me for an ultrasound, which came back normal. And he had me do a disgusting test, where you collect ALL your urine in a jug for 24 hours and then send it off to a lab. I did it, but it was pretty annoying.

The 24 urine collection, however, is the definitive test to check your globular filtration rate, which is the real test of how your kidneys are doing, and after all that, my kidney's are just fine! My creatinine levels are a little high, which is what started this whole thing, but he said that was probably because I've got a lot more muscle mass than your average 69 year old woman, so I fall outside the normal range. 

So. After months of doctors and tests, my hamstring is slowly improving, I'm still pre-diabetic, and my kidneys are probably just fine. But I'm getting old, there's no way to get around that. Our bodies don't last forever, and someday mine will stop functioning, just like everyone else's. Its a strange thought. We somehow can't quite imagine our own death, even though we might try. An even stranger thought is that except for my hamstring, even 20 years ago I wouldn't have had any idea there was anything going on with my blood sugar or my kidney function. I guess I'm glad I know, so I can be proactive, and take care of things, yet at the same time it seems a bit like overkill at this point, since nothing is really wrong, yet. 

As I said earlier in this entry, its quite likely that something else will kill me before my blood sugar or my kidneys get their chance. I guess I'm okay with that. I'm not ready to go just yet. I've got grandchildren to play with, afghans to crochet, more baby quilts to make, at least a few more marathons to run! If I'm anything like my mother I won't want to give up on life until the very last moment. That's ok with me.


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