And the Doctor Says...

After a LONG conversation with someone at Kaiser, I was given a new doctor and got an appointment. Today I got to meet him and was actually pleased. I'm not thrilled with him, but so far so good (and no bad stuff yet). He was very understanding and supportive of where I am and what I've been through.

Ironicially, the Physician's Assistant who made me so irritated also works for this doctor. She seemed puzzled that I was a "new patient" but that I looked familiar. Oh well.

Anyhow, after talking to him, he thinks that I have heat-induced migraines, which is not what I expected to hear, but actually makes sense to me. He prescribed medication for it that I'm to take at the onset of the migraine. One of them I can't take within 12 hours of taking my pain medication (which means I will probably never use it), but the other one is for the nausea (so maybe I can prevent myself from doing a technicolor display for the neighbors while on my front lawn).

I guess I'll have to wait and see how it works once I have need of it.

I also went walking with my friend. She's been so supportive and helpful through all of this and is rapidly filling a "hole" I've had in my life for several years of a close female friend that is there for me to lean on when I need it. I hadn't even realized how much I needed that.

Anyhow, while out hiking I got a rock in my shoe. Jokingly, I said, "Oh, I'd better take that out...being prediabetic and all, get a rock in my shoe, then I'll have to get my leg amputated." My friend seemed confused until I explained how having high blood sugar over time essentially disables the nervous system and immune system, so extremities lose sensation (not sensing things like rocks in shoes), wounds develop, and because of the weakened ability to heal, infection can set in and then get severe enough that limbs need to be amputated.

Stunned, she looked at me and said, "I thought you were joking, but you weren't kidding!"

I'm still struggling with the blood sugar, but both my naturopath and my new doctor have told me that by losing weight and staying active, I am actually doing the best things I can be doing for myself.

Oh, and I nearly forgot. My blood pressure, for the last couple of years, has consistently been around 125/85ish. Not terrible, but getting pretty close to worrisome (like 5 points higher and it would be worrisome). Oddly, every time I went to Kaiser, I was told, "Oh, your blood pressure is good." Every time I've thought, That's weird. Are they just surprised that for as big as I am, it's not higher, or do they actually consider that decent?

Today it was 85/60. That's actually quite low, but again, about 5 points away from concerning. Nonetheless, the nurse kind of freaked out. I was pleased though, because it was yet another sign that I'm on the right track, even if things are going slowly.

Best of all, the Kaiser scales show that I've now lost 30 pounds.

Still have a ways to go though.

Even Oregon's "Heat" Is Too Much For Me

After a long journey home (36 hours, door-to-door, only four hours sleep on the floor at JFK, which is the WORST airport I've been through, STILL), I was really looking forward to cooler weather and time to myself.

The dog suffered pretty badly while we were gone, unfortunately. She's allergic to fleas, which she'd contracted, so she scratched them to the point of a staph infection and developed a hotspot. I was embarrassed to take her into the vet, but the treated her well and at a pretty reasonable price (I LOVE our vet). She now has a shaved spot on her hind end, but at least is on her way to recovery.

More than I can say for myself. I went to the gym to do some choreography to music I had JUST cut. It wasn't that hot--right around 80 degrees. I was there for only a couple of hours and not even working that hard, but was not feeling well by time I was done. "Not feeling well" meaning I had to lie down in front of a fan and NOT MOVE or I felt like I was going to hurl.

I managed to cool down a bit and then it occurred to me that if I hopped in the car and cranked up the air conditioning, I might cool off much more quickly.

The cooling off worked.

The nausea did not go away.

Just when I was thinking I was going to make it home (I was pulling into the driveway), I was proved wrong.

If any of the neighbors saw me leaning over the bushes in my yard, they are probably wondering what type of issues I must have. I rather doubt that a severe reaction to heat is one of the things that would cross their mind.

I'm now much less worried about managing the physical events of the triathlon. I think I can complete them, but the shape I will be in afterward is a bit more concerning. Looks like driving home might not be an option.

Time Flies When You're Not Paying Attention To It

The past few days have seen very little formal exercise activity, although at least my pants are still getting looser.

I had another heat episode, and this time it wasn't even triggered by exercise. Despite drinking plenty of water (I drank even though I kind of had to force it down), I ended up with another good bout of heat exhaustion, narrowly missing a repeat performance of a public biohazard deposit.

It took 12 hours of sleep to drain the light-and-sound hurts headache and get over the must-be-within-10-degrees-of-horizontal-or-I'm-going-to-hurl stomachache.

And then we went out in the sun for another long day of walking around being tourists. I seriously debated staying behind, but I'm glad I didn't since I was only partly yucky feeling at the end of the day.

Then my dad left and we ended up with a day that felt like we still had jetlag--unable to get up before noon and dragging around the rest of the day.

Today we did more walking around, I got my last bit of shopping in, and now I'm wrapping things up to get ready to go home, where I will have two husband and child-free weeks and then things will go back to "normal."

Back to Retail Therapy--Shopping Is Exercise, Right?

Another later morning between jetlag and a very late Moroccan time schedule (staying up until 1:00 or 2:00 and then sleeping in past 10:00). After a not-terrible (diet-wise) breakfast at a cafe at 1:00 in the afternoon, we decided to try to get to the medina.

After a crazy journey there (five people in the back seat of a very small compact car, with someone we'd just met over breakfast and two people we didn't know at all), we got to the medina.

I got a bunch of shopping done for presents for friends and was pleased that I was even somewhat able to communicate this year.

"Communicate" being used loosely as at one point I wasn't sure if the guy was saying that he was impressed that an American was speaking French or laughing at how terrible the American spoke French. Considering my French skills, it was probably the latter. On the other hand, considering he was trying to impress a customer (as they usually do), there is a slight chance it was the former.

Or maybe I'm just trying to flatter myself and WANT to believe my dad when he tells me how impressed he is with my French.

Hmm. It's actually something I feel good about myself with right now, so I'll take it as a positive.

Not that I can quit studying.

Unfortunately, not much exercise got done, unless you count standing/walking around a medina for about four hours. While carrying pounds of three-year-old daughter and/or pounds of purchases.

It still felt like Ramadan as we didn't eat in the medina though and even had to wait awhile after getting back to my father-in-law's house.

I'm having a hard time relaxing on my "vacation" between issues with the dog, things coming up over email with my volunteer work back home, and not being able to control my diet or exercise plan very well.

Or maybe I'm just whining because of my control issues and I can't control anything here.

Nah.

Finally, Ramadan Is Over

I'm not sure if I had mentioned that it is (was) Ramadan, the holy month for Muslims, where they fast during daylight for a full month.

Which means that most restaurants are closed during the day and it's not very polite to eat or drink in public since 99% of the population is fasting. Well, except for young kids, elderly, sick/pregnant, and tourists.

This made today a big day for celebration and feasting since it is an official holiday.

There was a TON of food today. Except not so much of it was healthy. Cake for breakfast, sweet pastries for lunch. A nice meat dish, to be eaten with bread.

Not a veggie or fruit in sight.

I got glares as I raided the fridge for vegetables and did not partake of what was served, but I felt like I didn't have a choice.

Dad and I took a post-lunch walk down the promenade again. It seemed much shorter in the daytime and at a not-meandering pace. It was also ridiculously hotter and I went straight into the bathroom and turned the freezing-cold water on straight over my head.

In the evening, we again visited my mother-in-law, where sugared tea was served.

A hypoglycemic's dream.

A hyperglycemic's nightmare.

We got back very late and went to bed.

Hopefully tomorrow will be something more like moderation.

M...o...r...o...c...c...a...n Time

Our plans for today were to go to Rabat, visit the Medina, and be back early enough that I could for a walk. But being on Moroccan time, we left so late that things didn't quite go as planned. We were dropped off by a friend of the family in the middle of the city, and right as I got out of the car, I severely twisted my left ankle and did something else to my right foot, perhaps banged it on whatever my left foot twisted on; I'm not sure.

So I hopped around for a few moments and then recovered enough to limp around. We visited some tourist sites, then went to my husband's mom's house, where I iced both feet for awhile before we headed back to Temara.

I did get in a quick walk with my dad, against the advice of my in-laws, as it was near dark and they consider the "forest" a very unsafe place in the evening. I was relieved I at least got in SOME exercise, even though we were late for dinner.

My dad was very worried that we'd made some sort of faux pas, but with the blood sugar numbers I've been posting, I didn't really care as I need to regulate this somehow.

Then this evening I got bad news. Well, the news wasn't bad, but it could have been.

Essentially, I got a voice mail that someone had found my dog.

Which meant she was lost.

Which meant that the person we had looking after her...we didn't know what happened.

After about an hour of frantic phone calls (at $2.95/minute roaming charges), I arranged for one friend to pick her up, the original dogsitter to collect her, and several others who could fill in as "back-up" if the original housesitter couldn't, our doggie was back.

And so are levels of stress that had just started to melt away.

Getting to Work Out Is More Challenging than the Workout Itself

So being on Moroccan time is really making sticking to my workouts challenging. After my dad arrived and we all took jetlag catnaps, we ended up going down to the beach. It's too bad the water is SO polluted or it would be a perfect place for me to practice swimming in open water.

We sat on the beach instead, but by time we got back it was dark and time for dinner. Disappointed that I wasn't even going to get in a walk, I was trying to figure out what sort of strength-type training I could do, using my body as resistance (pushups, crunches, etc.) when I found out we were going for a walk on the "promenade."

Unfortunately, this was a walk where instead of being for exercise was more for socializing and enjoying each other's company. I explained to my dad that when we take a walk with family, it's usually more of a meander.

So my workout today was just a meander down the promenade. Not exactly what I had in mind when I brought my running shoes here.

Frustrated and Confused

So after checking my blood sugar for the past two days, I have ended up more stressed out and confused than anything. I did some research online and ended up with more questions than answers, although I did find out some of the more serious effects of diabetes that I hadn't already known.

I don't know if my testing strips (which expired two years ago) are terribly accurate, but I was hoping they would at least give me an accurate "range." If they are, then I'm worried, because with what I've been eating and doing in terms of walking and activity, then I'm really concerned about diabetes not being a "possible" issue, but being something that's already been occurring. In which case it's a good thing I've already started on this path.

Since I can't very well control what is served to me at meals, I'm trying to choose my portions and which dishes I eat as best I can. I'm also trying not to worry too much as even my naturopath said not to stress out while on vacation and to enjoy myself. Since I'm still working on the whole moderation thing, I'm trying to keep that in mind, knowing that I will probably have to be much more strict when I get home.

I did get in another dusty walk today, only got a little bit lost, but obviously, since I'm back online and updating this, I found my way back.

Now if I could just get to sleep in this heat, I would start feeling better.

Right Into the Groove

We woke up a little late this morning--it was a bit hard for me to get to sleep in all the heat, but not too late considering how tired I was yesterday and the jetlag.

Shortly after getting going in the morning, we made plans to go out with family for shopping. As is usual when we do this, it took ages to actually get going, but instead it was my fault for a change because I hadn't organized anything since arriving and had to do my daughter's hair, among other things.

We walked around for several hours in the shopping area. Not "exercise" so much, but it was tiring in the heat and carrying bags as we did end up doing some shopping.

When we got back, I immediately put on an old pair of shoes (pre-triathlon training shoes that hurt my feet sometimes) and went over to the park (which they call the "forest") and took a 50 minute walk, arriving back just in time for dinner.

I spent much of the walk still fuming about my Kaiser doctor and the way the PA handled the phone conversation. Also, I really missed my HEK friends and the park we usually walk in. I also wished I'd been able to find my walking meters before leaving. I haven't used them much lately, but I was hoping to be able to use them as a comparison.

I got back filthy as the trails are all dirt. Dirt that is a reddish color and the consistency of baking flour. I stepped into the shower and ran the nozzle over my legs and feet and scrubbed until it no longer ran brown down the drain.

Thank goodness I brought my old shoes and don't plan on taking them back home.

Back on Solid Ground

After about 36 hours of traveling, we're finally settled in at my father-in-law's home. I spent much of it miserable for one reason or another, mostly a lack of sleep.

Weirdly, once I got here, I couldn't sleep because of the heat and so got up to go socialize with my in-laws in my pathetic French. It's really fun though because I can tell that my Nintendo DS program has really helped my language skills and I'm actually confident that I can say things and it doesn't take as long for me to articulate them. Of course, I'm still horribly mangling the language, but I feel like I can communicate now.

That or they're just humoring me and smiling and nodding because it's our first day.

I had the brilliant idea of wearing flip flops while traveling. Easy off, easy on for security, comfort on the plane, etc. Great idea except that I never wear them otherwise so I blistered. I was worried they would hurt me on my walk that I planned for the evening just after dinner.

As a sample of how fatigued and unable to think I was at that point (I'd ended up being awake for nearly 60 hours, with only brief catnaps on the plane), let's look at some of the problems with my logic for planning a walk after dinner.

1) It is Ramadan, the Holy month for Muslims, where they fast from sunup to sundown, daily.

2) Iftar, which is the feast that breaks the fast, begins promptly at sunset.

3) Iftar, thus, is dinnertime.

4) Thus, dinnertime begins at sunset, so by time you are done eating, it is dark.

5) There is little or no lighting on the streets around here.

Which means that I could not go on a walk after dinner as I would be stumbling around in the dark either in an unlit forest I am unfamiliar with (where I'd planned to walk) or stumbling around in the near-dark on streets with potholes and drivers who aren't expecting to see someone walking down the street.

Hopefully some sleep will improve my critical thinking and planning skills and I will be more mentally functional tomorrow.

Into the Air

I was right. Zero sleep last night as I started actually putting things into suitcases after midnight and scrambled around until 2:00am, when our airport ride showed up.

When we got there, we found out that the check-in kiosks didn't even open until 4:00 am. That whole thing is a separate set of drama I'll chronicle elsewhere. The short version is that our travel started out with blood, sweat, and tears, and that was before we even got our boarding passes.

Sweat: me, of course, running around packing at the last minute (luggage total: 11 pieces for 3 people).

Tears: My daughter, after she got run over by a luggage cart. The guy couldn't see over his luggage and then SHOVED the cart again when it was stuck on her. My husband grabbed the cart and stopped him.

Blood: At first thought it was my daughter's as it was discovered on her pants post-luggage cart incident, but there was no broken skin. Later discovered my husband's hand was bleeding and he'd been holding her...great, those will be stained.

Then separate flights to New York and a very confusing change over at JFK. And I have to complain about this here. They have very few signs anywhere and thank goodness I could speak English to ask for instructions, and I had to do so three different times because it wasn't clear where I should go (I was directed outside to a "sidewalk" that was about 18" wide with potholes that then stopped and I had to walk on the street to get to another terminal--later found out there was a monorail, so why didn't they direct me to that?!)

Anyway, reconnected with the rest of the family at JFK, minutes before boarding.

The only sleep I got was on the floor at JFK.

Not On Any Track

Woke up at 10:30 this morning to the doorbell. I was sleeping in intentionally--getting ready for our trip and knowing I probably wouldn't sleep again (at least, not in a bed) until Sunday night. Oh well. It was a client I hadn't seen in two years, in desperate need of a massage.

Despite all the things on my to-do list, I booked him an appointment at 3:00.

I then began running around packing. Our house was already a disaster, so finding things was even harder than normal. It took me, no kidding, nearly two hours to find a specific piece of luggage that I wanted for the trip. I found it in a place that 1) I had walked by or stood next to a minimum of 10 times already, 2) when I put it there I remember thinking "the cats won't be able to pee on this here!", and 3) in plain sight.

I didn't even get to start packing. As usual, I was finishing up laundry, getting things together, trying to take care of a variety of last-minute details, and then giving a massage.

I ran errands, including picking up extra catfood and buying last-minute gifts.

Despite how exhausted I was, I didn't even start packing by midnight, and I know I'm not going to get to go to bed tonight before leaving.

Hadn't Realized It Has Been So Long...

...since I posted on here.

Fortunately, I have at least been busy, in all aspects of my life, and keeping up with "training" too. Training in quotes because I'm still more in weight loss mode of training than in preparation for a triathlon, but at least more active than I was before I started this whole thing.

Finally visited my naturopath awhile back and spoke to her about mercury poisoning as well as the other issues I'm having (aside my back). For example, the relatively little levels of exercise that seem to put me straight into heat exhaustion and the headaches that turn my stomach inside out and make me useless.

I had to go and get a bunch of bloodwork done, which after quite a bit of phone tag with Kaiser, was approved. Ironically, in the middle of that with me, my dad was complaining that it was easier and took less time to replace his lost driver's license at the DMV that it was to get an appointment to talk to his Kaiser doctor. Apparently I'm not alone in the craziness.

Today I got a call from the medical assistant for my doctor. Now, as history, I actually went in to them well over a year ago with my back issues. When I hadn't gotten off of the narcotic painkillers immediately, I had to go in for a visit to make sure I wasn't a drug addict. Federal law and all. I told them then that I didn't want to be on the painkillers, but that I couldn't function (meaning do things like lean over in the morning to put on my underpants) without significant pain. Furthermore, I figured some of my back issues are probably weight-related but that exercise hurt so much that I couldn't do enough to affect my weight. I.e., where I was when I started this blog.

As a reminder, when I started this, if I walked to the end of the block and back, I would have to lie down for awhile to deal with the pain. So yes, losing weight would probably help my back and when I mentioned this to the doctor, I got kind of a nod, but that was it.

I finally got in to see the physiatrist, who told me the same things all the other doctors have told me, with the exception of "you should try Pilates." Which I would love to do, if I had access, money, and childcare, so I will look into it. Anyway, when I got in to the physiatrist, they weighed me, as they do at all Kaiser visits. According to my last weigh-in from Kaiser, I'm down 12 pounds.

So I was a little surprised and annoyed at the phone call I got from the Physician's assistant. Basically, I was informed that all of my tests were normal with the exception of blood sugar, which showed up as "Level 3" which is "very concerning" because it means I am "prediabetic."

The PA then gave me a third-degree lecture on losing weight and changing my diet and starting a regular exercise program. When she paused for breath, I informed her that I had started a new exercise program in May, made fairly significant lifestyle changes that included diet and that I have already lost weight, and that since I had gestational diabetes, I am familiar with what I need to do.

The lecture continued, with her informing me that this is "extremely serious" and that I should consider seeing a nutritionist, and that I need to exercise a MINIMUM of 30 minutes, five times a day.

At which point I interrupted. "FIVE times a DAY?! Shouldn't that be a week?"

She said, "Oh, let me look...yes...the doctor wrote five times a day...hmmm...that does seem like a lot...maybe you are right...a week sounds more normal, but that is what the doctor wrote."

I told her that I was already exercising regularly, that I would continue, that I have changed my diet significantly (for the most part--I have my moments, but not like before), that I still had my blood sugar testing kit from pregnancy and that I could start tracking what I'm eating and doing and what my levels are so that I could make adjustments as needed.

At which point, the PA said, "The doctor didn't say to do that."

So I asked her, "Well, wouldn't it make sense for me to keep an eye on my blood sugar to make sure I'm doing okay?"

She repeated, "The doctor did NOT tell you to do that and I need to be clear on this. She did NOT tell you to test your blood sugar."

At which point I wanted to know what the harm was and she just repeated that the doctor hadn't told me to test.

THEN the PA told me to "check back in three months to see how it's going and if we need to, we'll refer you to a nutritionist then."

At this point I was so disgusted I gave up arguing, thanked her (I'm not sure why), and hung up.

I was SO ANGRY when I got off the phone.

Basically, they ignored me for a year. I made changes on my own and have started showing results. When a different doctor ordered tests, they were suddenly FREAKED OUT over one number enough to call and lecture me, telling me to make changes that I had already implemented and neglecting to notice the already-dropping weight on my chart.

THEN when I hopped right on board, agreeing that this is serious, I need to be responsible for my health, and volunteering to go the extra mile (testing blood sugar), I was told that my doctor didn't tell me to do that.

What the heck?

From my gestational diabetes during pregnancy, I know it is serious, and from the little bit of reading I've done, diabetes (or "prediabetes") isn't something to be taken lightly at all. The ramifications of long-term high blood sugar are significant, so waiting three months to "see how it goes" seems like the dumbest advice a doctor could give.

I think I'm done being "polite" to my doctor.

This is just icing on the cake of having an appointment canceled AFTER I've already arrived to it, having a different appointment take over an hour for two minutes of time with the doctor, having the doctor "refer" me to a physiatrist but then 1) not process the actual referral and then 2) question it when two months later I asked what the heck was going on. Now I get lectured and then when I jump on board to make changes am told not to do that much and "see how it goes."

Have I ever mentioned that this doctor can't make my patellar reflex trigger? On my hyper-sensitive knees that had reconstructive surgery?

I asked if I could switch doctors in the network, but since I don't know anyone who sees them, I could end up with someone even worse. I can't imagine that, but then I couldn't imagine this bologna either.