Wednesday, June 28, 2017

Internal Medicine June 2017

I arrived to Internal Medicine clinic feeling like death. I had the usual labs, plus a few extra. I'm waiting on the extra results, but my stat labs looked good with the exception of my chloride levels being too high. That is undoubtedly due to being on so much potassium chloride. Dr. B didn't seem concerned about it; he was just glad to see everything else in normal range again, including my kidney function which has improved significantly on my current medication regimen. He noted amiloride, and I agree it is the drug that brought my filter rate out of the danger zone.

Much of my family is diabetic, but my blood sugar is a champ in spite of being overweight. I haven't reached the point of "obese" and hopefully won't, but it is a constant worry with failing muscles and a protein/fat diet. It is more frustrating than I can express that I cannot exercise without catastrophe. My doctor is less worried about my weight than I am, and he circled my blood sugar as if to say "look at this fabulous number", so it was good news overall.

The two biggest problems right now is the muscular dystrophy and my incredibly antagonistic digestive system. I'm a wreck head to toe with weakness and severe pain. My bowels are at a halt most days. I can't lie down without choking. I feel like I'm on fire, and I feel like I'm smothering. My acid reflux disease is uncontrolled even with the most aggressive prescription-strength medications - I have tried nearly all of them. Dr. B has tested me for digestive cancer in the past, and he said he will probably do another h.pylori urea breathing test in a couple of weeks. Erosive esophagitis and gastroparesis can be serious in a variety of ways. We decided to try Protonix and Amitiza again to see if things improve. If I don't see results in two weeks, he wants me back in the lab. So far, the meds aren't working.

He didn't send the social worker in to ask me questions this time, and I'm glad. I was feeling badly enough as it is, and having a hard time keeping it together through the nurse's repeated mistakes with my pharmacy. Thankfully, I made it out of there without getting too angry. Some days, I feel like I handle things pretty well...above average. Other days, I definitely don't. Not even close. Last time I was in the hospital (2014), the doctor told me I was acting completely normal concerning my circumstances, including my moments of frustration and cursing, so I'm trying not to overanalyze my ability to cope, or lack thereof. It's a 24/7/365 job just to survive and perform basic functions of living. I honestly want no part of it, but I'm here doing the best I can.

I'll update my medication list in the sidebar soon.

Next appointments: Probably testing for h.pylori in two weeks, but otherwise Internal Medicine and Muscular Dystrophy clinic are in October

Edit Note 6/29/17: Send-off tests came back. I need to continue my high dosage of Vitamin D, as 150,000 IU a week is only bringing me into borderline low-normal range. Magnesium and Phosphorus were fine.

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