Tag Archives: Diabetes

The Kidney Update

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Yesterday, was not a fun day. I had to have some blood drawn for a thyroid test my doctor ordered. I also had to leave a urine sample for something called a micro albumin test. Originally, the urine sample was going to have to be sent to a lab to be analyzed, because the machine that the clinic has to perform that particular test was not working. However, today it was working properly.

The lady who took had to stick me for the blood sample had only graduated from school two weeks ago. My veins scared her. She made me wait until there was no one else needing blood drawn, so she could spend a great deal of time on me. It worked. She took her time and was able to hit a vein, on the first try, in the back of one of my hands. While I was waiting for her to get through everyone else, I went over to where I needed to pee in a cup.

I had a special urine test done called a microalbumin test. Webmd explains what microalbumin is, as well as the test much better than I could.

A microalbumin test checks urine for the presence of a protein called albumin. Albumin is normally found in the blood and filtered by the kidneys. When the kidneys  are working properly, albumin is not present in the urine. But when the kidneys are damaged, small amounts of albumin leak into the urine. This condition is called microalbuminuria.

My microalbummin level was significantly higher than it was the last time I had this test done. That means the kidney damage has progressed.

I am not sure what happens from here. I go to a free clinic and it looks like they have no appointments available until at least the beginning of August, but it is hard to tell because the appointment desk did not have their August calendar quite yet.

I am trying to not be worried. So far the results have been mixed. I know worrying will not do me any good, so when I do start I try to redirect my thinking.

Busy, Busy, Busy

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I have had a very busy week. This session of the school semester is winding down, and I had a couple of big projects due. I worked a lot at my writing job. I had an appointment with my counselor, group, and an appointment with my psychiatrist. I went to the diabetes clinic – part of the free clinic I go to – on Thursday. Also, I have not been feeling well.

The class that I had to take for my first session of the Summer semester was something called “Skills for Success”. It has turned out to be something completely different than I thought it was going to be. I had to assess my learning style, figure out if I had external or internal locus of control, determine if I was a lifelong learner (and figure out what I needed to do to become one), and develop critical thinking skills. I have learned a lot about myself from the class assignments.

Because the time zone for the class is different than mine, I have until 2 in the morning my time to turn assignments in. I have never been late or even pushed that deadline, until Tuesday. I had not felt well all day, and when I sat down to do an assignment I fell asleep. I woke up about an hour or so before the deadline had passed. Unfortunately, my head must have been on the “W”. When I woke up, the screen was full of “W’s” and all the work I had done was gone. I took a screen shot…

I retyped everything, and it looked like I was going to make the deadline, and then…I fell asleep again! I did finally get the assignment turned in, about an hour late. The instructor could have deducted points from it since it was late. That is school policy. However, he chose not to.

Things went really well at the mental health center. I have qualified for another six month of services, and the psychiatrist is pleased with how I am doing. I do not have to see her again until the end of September. She did ask me to bring her some pictures from Alaska.

For the last few weeks my feet have been swelling…

For the last few days, I have felt totally exhausted, no matter how much sleep I get. When I went to the diabetes clinic I mentioned it the doctor. He did a routine test, and told me that I have kidney damage. He said that would explain the swelling, and could be why I have been feeling so run down. However, he has order some tests for my kidneys, as well as a thyroid test. I have had several thyroid tests over the last few years, it is common when you have a mental health issue, so my gut tells me that is not the problem, but I could be wrong.

This is how the doctor at the free clinic wrote the prescription for my depression medication…

My Voice Mail To Depression

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For day seven of the WEGO Health’s Health Activist Writer’s Month Challenge the prompt is:

Leave your condition a text or voice mail. Check in with your health by pretending you are leaving a quick note. Bonus points if you find a way to record it in audio form too!

Below you will see the audio file that contains the recording of my voice mail, underneath that is a written copy of what I said.

depression voice mail

Hey depression,

I thought I would check in with you real quick and see how things were going. I know it has been a difficult few months for us, but I wanted you to know save draft how much I really appreciate you letting me be the one in control -most days. Let’s keep up the good work and I’ll check in again with you soon.

So Much Better!

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As much as I did not want to, I went to the University Hospital of Augusta’s Emergency Room Monday night. I am so glad that I did! I did not have to wait long before I was taken back into the Emergency Department and the nurses started treating me as soon as I was settled. Every one of the staff I encountered was very nice, professional and efficient. My dad is the one who drove me there, and despite my efforts to kick him out – so he could go home and rest – he stayed.

Before the doctor saw me – even before respiratory had a chance to show up – a nurse administered a breathing treatment, my vitals were assessed, blood was drawn, an IV was started, and I was giving Solu-Medrol (Steroids) through the IV. I was very impressed with how quickly they started to implement procedures to make me feel better. Not long after all of those things were done, I was taken to x-ray and some chest x-rays were taken. Having chest x-rays when you are short of breath, wheezing and have chest tightness are normal. It is the way a doctor can determine if your symptems are being caused by either pneumonia or bronchitis.

After I came back from x-ray – nothing wrong showed up in the x-rays that were taken – I was given another breathing treatment. I was feeling rather discouraged and thinking that I might have to be admitted. I just did not feel as if my breathing was any better. My oxygen saturation levels were still acceptable, however, in an asthmatic those numbers can be misleading. In every asthma flare I have had, my oxygen levels have always stayed within acceptable levels. At the stage of the flare I am usually in when I seek help, my biggest problem is not that I cannot get air in, it is trying to expel the used up air. The stuff with all the carbon dioxide in it. That is why things like a peak flow meter are a must have for asthmatics. They are a simple device that we can use to get an idea of how much our lungs are able to clean themselves out when they exhale.

My dad was great! It seemed like it was taking so long for me to feel better, and it was getting very late. My father gets up very early for work, and I knew he was getting tired. Every once in a while he would doze off – while watching a football game – in one of those hard hospital chairs. He did leave the room – it sort of looked like he was running – when the nurse who started my IV had to stick me more than once to get the IV started. Dad hates that part. My mother and I are hard sticks and he knows that sometimes it can take a great many attempts to get IV’s started on us. At one point, he wandered off and came back with a bag of ruffles – cheddar and sour cream flavor. After he ate those he dozed off again. I was messing around with my phone and started to hear a rustling sound. When I looked up, dad was pulling a decent sized bag of Reeses Pieces out of his back pocket. He had gotten those out of the snack machine too.

Knowing that I could be there for a long time, I kept trying to get dad to leave. I told him I could call him whenever I was discharged, and that way he might be able to get some decent sleep at the house. No matter how much I tried to convince him I was fine in the ER by myself he would not leave. After a while, I gave up. I thought I was stubborn, my dad is definitely more stubborn than I am. I did think it was very sweet and considerate of him to want to stay there with me.

When my breathing started to improve, it was like it happened instantly. Once second I was chugging away – wheezing and miserable – the next second my chest felt less tight, there was barely any wheeze, and my agitation – from having to work so hard to breathe – had gone away. Shortly after that, a nurse and the doctor came in with some discharge papers and a prescription for prednisone (oral steroids).  I can honestly say, that when I left that emergency room I felt better than I had in several days.

I am still feeling better. I still have a slight wheeze, but it may take me going through the whole course of my oral steroids before that improves. Or, if things do not get better, then I might have to go back to that ER and get some more IV steroids. I am okay with either way it plays out. The care I received there was very good.

As a diabetic, steroids cause me problems. They raise my blood glucose levels extremely high. Yesterday, my morning reading was close to 500. I quickly gave myself an insulin injection, and upped my dose of long lasting insulin last night. My morning blood glucose reading was much better this morning, 169. That was before I took my dose of oral steroids, so I am sure it will go up from there, but it does appear as if I am doing a fairly decent job keeping my blood glucose levels close to normal.

Yesterday afternoon, I went to Babys R Us, with my daughter in law. It may have been too much walking too soon. I got very short of breath, and my mother picked me up so I could go back to the house and rest.  I also did some Wii Sword Fighting with my daughter. That was not the wisest decision I have ever made.

As I write this, I can feel my wheeze picking back up. I am not totally surprised. I half expected this to happen. Very often I need several days worth of IV steroids to stop an asthma flare. I will keep taking the oral steroids and if things are still like this when I finish the taper, then I will let a doctor look at me again.

Asthma really plays a huge role in my mental health. When you cannot breath properly, it makes you extremely anxious, and agitated. Not too mention, days and days of working so hard to breathe, really can bring your mood down. I work very hard during times like this to find positives, as well as things to laugh about so that my mood can stay up beat. I am not always successful, but at least I always try.

One of my favorite Asthma Sites is Breathin Stephen. If want to learn more about Asthma and how it affects a person, I suggest taking a look at his blog.

My Depression And Diabetes Cycle

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Asking me which came first, my depression or my diabetes, is kind of like asking that age old question about the chicken and the egg. I think in the grand scheme of things it does not really matter which came first. All that really matters is that I have both. What I find true for me is that both illnesses seem to feed off of each other. When my blood glucose levels are out of control, the physical effects make me feel depressed, and when I feel depressed I have a hard time managing my diabetes. On the flip side, treating my depression can – and has – made my diabetes worse, and managing my diabetes is sometimes a depressing process.

Before I began treatment for my depression, I was not managing my diabetes like I was supposed to. A lot of the time, I was not bothering to check my blood glucose levels and would inject myself with an arbitrary amount of insulin. Anyone with diabetes knows what kind of trouble trouble this can lead to. Blood glucose levels bottoming out. More than once I found myself in an intensive care bed because of doing this. When I was not injecting myself with too much insulin, I was not bothering to inject myself at all. It was rare that my blood glucose levels were where they were supposed to be. Due to my mismanagement, they were either way too high or way too low. I believe how these extremes made me feel physically added to my mental health decline.

After I began depression treatment – and I mentally started feeling better – I was no longer so carefree about checking my blood glucose levels. I tested myself four to six times a day, and strictly followed my insulin dosing directions. I was feeling better all the way around. Then I had an asthma flare that resulted in me being admitted to the hospital and placed on IV steroids. All those steroids sent my blood glucose levels soaring. The doctor treating me in the hospital became very concerned about the levels and gave the nurses instructions to give me insulin injections every four hours. When I was released from the hospital, I had to continue the every four hour injection schedule until I was no longer taking oral steroids. Even at night there was no relief from this schedule. It did not take long for all these extra injections to begin to get to me. I felt the return of some of my depression symptoms.

With the return of some of my depression symptoms, my diabetes management was affected. I actually went through a stage of rebellion. I made choices to not see the doctor who was treating me for my diabetes, and did not schedule the blood work that he had ordered. I wish now that I had not allowed my depression symptoms to affect my diabetes management. In some ways, I paid a heavy price for my period of rebellion.

Many depression medications have the potential to raise blood glucose levels. This happens because antidepressants can inhibit the production of insulin in a person’s body. This can lead to a Type II Diabetes diagnosis for some people, or make it difficult or impossible for many diabetics to properly manage their diabetes. Another reason this happens is that many anti-depressants cause intense feelings of hunger – especially for carbohydrates – leading to weight gain. This weight gain can increase a person’s risk for developing Type II Diabetes and it can also hinder proper management of diabetes.

My poor choices to not see my medical doctor – and to not have the blood work I was supposed to –  left my doctors in the dark about how the depression medications were affecting me physically. They had no idea how bad my blood glucose levels were getting, and I was not going to tell them. All I cared about at the time, was being able to keep taking the antidepressant that had worked so well on my brain. The nurse – that was supposed to monitor things like this – left the mental health treatment center I go to, making it very easy to continue hiding what was going on.

All of my poor decisions caught up to me on the day that I fainted and woke up with my face firmly planted on asphalt. The day after that happened, I had to go to the mental health treatment center. My face looked bad and caught the attention of the new nurse. After a quick exam – in which she discovered that my blood glucose was over 400 – she made me go to the emergency room. When I arrived there I was treated with IV insulin and also for dehydration. The doctor told me that the dehydration had probably been caused by the massive sweating my anti-depressant caused as well as from my extremely high blood glucose levels. That trip to the emergency room was a wake up call for me. I realized that no matter how much I wanted to continue taking the depression medication that had worked so well, I could not any longer.

I got my blood work done, saw my medical doctor, and made my psychiatrist aware of what was happening to me physically. My psychiatrist had me discontinue the antidepressant that was causing the high glucose readings, and we are now in the process of finding a new one. Since discontinuing that medication I have felt better than I have in a long time. It is a shame that it took a face plant to jump start me into action.

This whole process has served as a stark reminder that my mental health is directly affected by my physical health and that my physical health is affected by my mental health. If there is a lesson that can be learned from my experience, it is that ignoring one aspect of your health for the sake of another can be detrimental to all aspects of your health.

The Pay Off

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With having to withdraw from Effexor, and trying to find a new anti-depressant, the last few weeks have been challenging. When the withdrawal process began, I was angry and physically felt awful. I was angry because I was having to stop taking a medication that had helped my mental health so much. Physically, I felt so bad because of what Effexor had been doing to my body and the effects of the withdrawal process.

There were times during that process when I did not think that what I was going through was worth it. I felt like I was unraveling mentally. The withdrawal process was worse than I had imagined it would be. I became difficult to be around, and did not want to be around anyone.

Slowly, I started to feel better. In fact, I felt better than I had in months. I did not feel like I had to struggle everyday to stay awake and move. I became more active, taking walks and spending more time outside. My blood pressure was become lower and so were my blood glucose readings.

The real pay off for all that I have gone through these last few weeks came on Thursday. I had an appointment with my medical doctor. The last time I spoke with him he was worried, very worried about my health. This time he was pleased with what he saw. Although my blood glucose readings are not within target range yet, they are considerable lower than they used to be. He took a reading while I was in his office and it was 188. My blood pressure was 140/90, last time I was there it was 186/129. I have even lost some weight. It made me feel happy to be able to go into the doctor’s office and hear good news, and not see a look of worry on everyone’s faces.

I feel good mentally and physically. All of the uncomfortableness of the last few weeks has been worth it. I even learned a few things about myself. I learned that even in a basically unmedicated state I am in much better mental health than I was last year. I learned that I am stronger than I gave myself credit for. I also learned to have a greater appreciation for all that I have gained over the last year and a half.

Depression, Diabetes And Autumn…A New Beginning?

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I like Autumn. I like the smells, sounds and the feel of Autumn. I have always looked at Autumn as a time of new beginnings. It gives me a sense of renewal. I think it is because it heralds the end of Summer, and welcomes in the cooler, crisper temperatures.

This year, in particular, I have really been looking forward to Autumn.  Summer has been really hard on me.  Diabetes makes my internal thermometer a little off on a good day, throw in Effexor – antidepressant – and I spent most of this Summer sweating.  I do not mean a slight glistening of my brow.  I am talking about a full on sweat pouring off my face and body almost constantly.  Once I got heated up that way, even if I went into a cold room, it took hours and hours for me to feel cool again.  I was changing clothes a minimum of three times a day, and my hair never seemed to get dry.

This is the Summer that I had my first fainting spell, which ended in a face plant on the road in front of my parent’s house. It is also the Summer that I was treated for dehydration for the first time in my life. This has just been a miserable summer.

It is now officially Autumn.  I have been able to detect a slight cooling of the air at night and it is not nearly as humid during the day as it has been.  From here on out, it will quickly become cooler, leaving a refreshed feeling in me and in the environment around me.

Just as it is time for the Seasons to change, it is a time for my depression treatment to change.  A new beginning.  It was this time last year that an appropriate drug mix was found for my depression.  It is at this time a new drug mix needs to be found.

I have really enjoyed being able to think clearly, and for my brain to feel and function better.  That is what Effexor has done for me.  Unfortunately, the side effects of Effexor have done many things to me.

From the beginning of my relationship with Effexor there have been struggles.  At first it caused me to have a flat affect – my face did/could not express the emotion I felt and my emotional response was dampened internally. The next thing that it affected was my sex life.  My already low libido basically went away. Then it began to raise my blood sugar.  That was hard to identify in the beginning, because of two asthma attacks – one in December and one in February – that required me to be on steroids. Steroids drastically increase blood sugar levels. Then Effexor started messing with my blood pressure, raising it to extremely high levels.   As I previously mentioned, my body’s ability to control its own temperature was also affected by it.

After looking at my blood test results yesterday, my Psychiatrist was extremely concerned.  She said she was, “sorry, but you absolutely cannot take Effexor another day.” She also said “I do not even know how you are functioning right now”

Which leads me to a confession.  There have been days that I have barely been able to function.  Those are the days when I tell people, I am not feeling well, because I do not want to tell anyone just how awful I feel.  High blood sugar makes you feel so completely horrible.

Withdrawing from Effexor could be be bad, or it might not be.  Right now, I feel extremely, horribly fatigued. No matter how difficult or easy the withdrawal turns out to be, it is something I must go through.  As my mother pointed out “Being happy does not do you any good if you are dead”.  As dire as her statement sounds, that is where my physical health is heading due to the side effects that I am experiencing because of the Effexor.

This new beginning, this new Season in my life, will offer me a chance, once again, to be healthier.  New beginnings are not alway meant to be easy.  I believe if they are easy, then people do not get as much benefit out of the process. One thing I will do, is keep trying to get through each day as best as I can, and only take it one day at a time. I will also keep in mind, that no matter how rotten I feel now, it will not last forever, and once I get through the process I will probably feel better than I did before it began.

The Impact Of Physical Illness On Mental Health – Mental Health Awareness

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I believe that my physical illnesses contributed to the poor state of mind I had, as well as developing Clinical Depression, and an Anxiety Disorder. I went from being a relatively healthy person to someone who physically feels rotten much of the time. Also, several of the medications I am on to treat the diabetes and the asthma have been shown to directly affect your brain and lead to depression, especially, if you are already prone to depression or anxiety.  My counselor calls it co-morbidity.

I believe I have a better attitude and outlook about my physical illnesses. When I was in the hospital for my asthma in February,  I was not down in the dumps like I would have been before. Being there on my fortieth birthday did not bother me. I even kept blogging while I was there. I would have the nebulizer in my mouth, for a breathing treatment, and I would be blogging away at the same time. I also think my depression medications help counter how my other medications might affect my brain chemistry.

The Impact of Physical Illness on Mental Health


There is one particular aspect of  mental health that is still not widely discussed.  It is the impact that physical illness has on a person’s mental health.  Mental health workers easily recognize this fact, everyday they see patients with a multitude of physical and mental issues.  Unfortunately, few outside the mental health field see the correlation.

One way to put it in perspective is to think about how you feel when you have a cold.  Obviously, you have a stuffy nose, runny eyes, a fever, and you just feel physically awful.  How about the mental aspect of it?  Many people get cranky, and a bit irritable.   Very often it goes deeper than that.  Many people feel “blue” or “down in the dumps” when they have a cold.  I know I get really whiny when I have a cold.  The good thing is we know that a cold is not going to last very long, most of the time, and soon we will be back to feeling like ourselves.

Now think about this, what if the cold turned into a long term illness?  How do you think that would affect your mental health?  Most people, no matter how mild or serious the illness is, experience a wide range of emotions.  Emotions like anger, sadness, and worry.  We feel like we have no control and that our bodies have let us down.  We feel lonely, and even though there probably have been millions of other people with the same illness, we feel as if no one really understands what we are going through.

From a mental health perspective, when it comes to a chronic or long-term illness, anxiety and depression are the biggest concerns.  Many times these mental health issues  are  over-looked and left untreated.  Which can be very dangerous from both a mental health perspective, it can lead to suicide, and from a physical health perspective, it can delay healing.

Doctors are becoming more aware of how physical illnesses can affect mental health and attempt to be on the look out for the signs and symptoms of anxiety and depression.  However, their best source of information about how you are doing mentally, is from you.  Your doctor will not be aware that you are having any mental health issues if you are not open and honest with them about what is going on in your life and how you are feeling.

Why are depression and anxiety more likely to happen when you have a physical illness?

  • People become depressed and anxious when they are stressed for any reason.  Being ill is stressful.
  • Some drug treatments, such as steroids, affect the way the brain works and can directly cause anxiety and depression.
  • Some physical illness, such as an under-active thyroid, affect the way the brain works and can directly cause anxiety and depression.

You are more likely to experience severe anxiety and depression when you are physically ill if:

  • You have been anxious or depressed before.
  • You do not have family or friends you can talk to about your illness.
  • You are female (women report more anxiety and depression than men).
  • You have other problems or stresses going on in your life at the same time.
  • You are in a lot of pain.
  • Your illness is life threatening.
  • Your illness has left you incapable of taking care of yourself.