Bright and early this morning, before I could slip into dishonesty, I volunteered to my diabetes specialist that I was depressed. Actually it was more like joining in conversation with her as she wondered aloud if any ‘black dogs’ were about.
There’s always something cathartic about admitting this after circular self-arguments about whether I am or am not. What’s with the shame? Jeez, I’ve been treated for major depression for over twenty-five years – what’s the big deal if I have a flare-up that meds, at least temporarily, don’t seem to be helping?
She asked if I had a friend I could talk to when I’m feeling down. Several came to mind.
Not unrelated, my diabetes is not controlled at this time (it would help if I did what I was told). I promised her I was already back on track and showing positive results. That’s true.
My weight is down about three kilograms. This is not good as my bony ass feels tremendous discomfort in typical meeting chairs. I can’t find a good cushion.
I’ll see my HIV doc on Friday when more of my blood test results will be revealed. I can’t say I’ll be surprised if there’s a problem.
Affirmation: I deserve to take the best possible care of myself.
While showing me a graph, with the trajectory of my health over the past few months, my endocrinologist remarked, “I wouldn’t have sold you life insurance in January!”
Point taken. It was a rough patch, to be sure.
CD-4 count: 400 (the same level as when I was first diagnosed HIV+); up from 270
Viral load: undetectable (no change)
A1C (blood sugar): 8 (above the ideal 7 but greatly improved from my insulin overdose episode)
Weight: up (I can’t remember either the former or current weight)
I’m still feeling a little wobbly on my legs so I’m using a cane, more often than not, and I have a walker to take with me to the grocery store for heavy loads.
All in all, I am shaping up nicely for spring!
First there was the pre-Christmas illness. Then, while in Perth, I went for only one walk – to the pharmacy – in a town which normally calls out for long walks. I even felt unsteady on my feet roaming around Mom’s big old house.
Mom, who has been using a walker herself for a year or so, suggested I check into getting myself a walker once I returned home.
I did. Yesterday. A walker from my community’s storage was made available to me. I took to it like the proverbial duck to water, although I’m a tad tall for it. I went out for some milk and bread, pushing/being pulled by my new friend, then walking the long way home to put some miles on it.
Last night, oblivious to what barriers I might encounter, I went to a meeting via the subway, folding and carrying the walker where necessary, happily taking the offered subway seat, then walking the several blocks from St. Clair station.
I am easing into it. There are walks which I can easily do without help, so it may surprise people when on other occasions I present with the walker.
It helps me walk. It gives me confidence. Why would I worry about what anyone thinks about me using it.
I spent the afternoon yesterday in the Emergency Department of Toronto’s Mount Sinai Hospital after a drug overdose, albeit accidental, when I tried to eliminate a “HI” reading on my glucose meter with two, then three times the recommended dosage of my insulin. It was lost on me that doubling and tripling up on a time release insulin formula was plunging it well beyond my control, rather than naively reining it in.
“Stop chasing the ‘HI,” quipped the ER doc after an uncomfortable stay, clearing me out with an IV, a cookie and some orange juice.
Thank you to staff of my housing co-op for providing me with a ride to, and a taxi from, Mount Sinai and to Ryan for staying with me pre-treatment.
In my ongoing quest to get to the bottom of my annoyingly reduced sleep, I received the results of a recent MRI of my brain when I visited my family doctor yesterday and the report was clearly not written for me to comprehend. Even my doctor was at a loss with some of the language but he concluded, “At least you don’t have a brain tumour,” which was more than I could deduce from this:
Clinical history: New onset central sleep apnea.
Multiple sequences were performed through the brain.
The splenium of the corpus callosum is absent and colpocephaly is present. There is a 1.2 cm gray matter heterotopia along the lateral wall of the trigone of the left lateral ventricle. There is thinning of the optic nerves, optic chiasm and optic tracts. The fornices are also quite thin. The mammillary bodies are small. The pineal is quite small. The entire ventricular system is larger than normal. There are mild microangiopathic changes in the hemispheric white matter. There is a prominent cisterna magna. There is mandibular hypoplasia. There is reversal of the cervical lordosis.
There are numerous developmental abnormalities of the brain as discussed. The predominant abnormality is colpocephaly with absence of the splenium of the corpus callosum. Of note is the presence of a gray matter heterotopia.
*****END OF REPORT*****
Some of the ‘abnormalities’ may stem from my prenatal and first couple of years of life. ” Hydrocephalus Arrested” is how my mother recalls the episode being summed up by doctors at Montreal Children’s Hospital. (Hydrocephalus is accumulation of too much cerebrospinal fluid in the brain.) Outwardly my head was disproportionately larger than my infant body, leading me to sitting up and tipping over, occasionally knocking my head. That it was “arrested” was of great relief to my parents because two children of two different cousins of my mother had been born with the same condition. One died, the other spent his shortened life in a wheelchair so one can understand how worried Mom and Dad would have been for me in my early months and years..
I’m guessing the brain’s way of retaining all its history may be partly responsible for the gobbledygook in the MRI report but I’d like to hear it from a neurologist’s mouth, rather than via the cryptic language quoted above.
Early this month I had electrodes taped to my head, neck, chest and legs, then I was wished a good night for a sleep study to see why suddenly, to me at least, I couldn’t get a decent night of shut-eye.
The results, which I received on Monday, showed that over the course of the six to seven hours that I slept, however intermittently, my breathing stopped briefly “like you were swimming underwater” hundreds of times.
This is apnea but not the most common type of respiratory apnea; mine is linked to the brain, which “forgets” to signal to breathe, and is known as central apnea.
The news flooded over me faster than I could think of questions but here’s what I know. I’ll be forming a very close relationship with oxygen each night, I am having a brain MRI this coming Monday at Women’s College Hospital, I go back to see the sleep doctor on August 29, then I meet with a neurologist on the third of September and with my family doctor the following day It’s the most intensive medical care schedule I have had for quite some time..
I’m a little nervous.
“How long have you been wasting?” the chiropodist asked me a couple of weeks ago as she updated a history on me.
The starkness of the verb, however accurate, stayed with me.
I’ve always been thin, I said, but my weight has been falling a bit since last fall.
Fast forward to preparations for a bone density test in Women’s College Hospital’s shiny new facilities today.
I stepped up onto an equally shiny, new, digital scale.
Weight: 122 lbs.(just over 55 kg)
On my worst weight dives I’ve never been below 130. Even at my usual 145 I’m off the BMI chart.
I’m accepting fattening dinner invitations.