Category: Health & Wellness

Neuropathy Attack 20230917

Photo by Pixabay on Pexels.com

This one is pretty bad. It started this morning as I was lying on my front in bed checking my phone. The pain point this time is right under the left inner ankle bone. Typically, the initial pain intensity is pretty low, and it slowly builds. This time, the first attack was about a six out of ten, and it has gotten more intense over the past six hours. My entire leg is numb after each attack and the frequency is still increasing. I have taken two Tylenol PM caplets, but they made no difference, and I have been unable to take a nap. Now my entire left foot is numb and experiencing pain in multiple places, albeit not as intense as the main ankle pain point.

Diabetes. The curse that keeps cursing.

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It is 12:45 am on Monday, September 18, and the neuropathy attacks are still happening. Luckily, they stopped for about six hours while I drove to LAX to pick up my sister, but resumed when I got home.

Weight Update 20230916

There is officially one week left in the SPR program. When I started the program, I weighed 245.8 pounds. This morning, I was 222.4 pounds, or a loss of 23.4 pounds in 68 days. Although many coworkers said they noticed a visual difference, I do not really feel any different. My pants do feel much looser though. When I was down to below 180 pounds, I had to purchase pants with a lower waist size. For the longest time, I wore size 38 waist pants but ended up buying a 36 waist sized pair of Levi’s jeans. Then I started gaining weight and when I started the SPR program, size 38 waist pants were very tight again. Now I think I am somewhere between 36 and 38. I need to find that one pair of size 36 waist jeans to see if I can fit again.

With one more week left in the program, I am hoping to lose 2.4 pounds more so I can come in at 100 kg or less.

COVID-19 Resurgence?

I did not think I would write another post about COVID-19, yet here we are again. I have not heard much news about COVID after China imploded from the sudden end to their zero-COVID policy. However, it does look like there is a slight increase in cases in the US. Here is Orange County data for new cases:

New cases for all time
New cases for last twelve months

From the top chart, the number of new cases seems flat when compared to the past spikes in cases. If you zoom in to the past twelve months, there is a rise in cases since the summer. Will that continue, flatten out, or even decrease? I heard there may be a new vaccine out in September. Is this rise due to the long wait since the last approved booster?

Additionally, it has become harder to find COVID data. I used to use occovid.com or the New York Times page. I believe occovid.com has been shut down, or at least I cannot connect to the site anymore. The previous NYT COVID page stopped updating in March 2023, and the new page needs a login.

SPR Weight Loss

Last November, I signed up for a program called Omada through my online pharmacy. I posted about it here. The goal was to eat healthy and exercise to lose weight. I believe I posted a few things the first week, then promptly ignored the rest of the emails. I kept weighing myself and the mobile connected scale kept track. Here is my weight history. The original goal was probably lose 5% of my weight.

I started the SPR program on July 10th, which is the last high spike before the large drop. In three weeks, I have lost twelve pounds or about four pounds a week. My first goal was actually 200 pounds so if I keep losing weight at the same rate, I may be able to hit the forty-pound weight loss goal. Likely the weight loss will slow but I would be happy if I lost another fifteen pounds. That would bring me to 215 pounds or thirty off my high.

As for the program, I am still having issues with my burned fingers, and now my fistula is hurting. I can still feel the “thrill” a bit, but I cannot hear the fistula anymore. I hope it is temporary; I do not want to visit the vascular surgeon at this point post-transplant.

Hearing Loss

I just got back from my sister’s house. Only my younger niece was home, and she said there was something beeping. She could not locate the source, so my sister called me to go and take a look. When I got there, I could not hear any beeping. My niece said that it was high pitched and soft. My sister also said she could hear it over the phone. I finally noticed a display in the fridge that showed alarm and flashing 0°F for the freezer. I managed to turn off the unheard alarm, but noticed the freezer items were not very cold.

I have noticed that I am having more trouble understanding female coworkers. Usually, certain words or phrases are either muffled or too soft. I did notice that other people seem to have few problems understanding the same conversation. I think I do have high frequency hearing loss since this happens less when I listen to male voices. I am unsure why I am getting this since I am not usually near loud sound sources.

Maybe it is age based. Getting old sucks.

Apple Health Export

I reconnected all my health providers to Apple Health again this morning. I think the connections are time-limited, so you need to reauthorize access periodically. It took a long time to update. I also noticed an “export to PDF” option so I let my iPhone generate the report for all lab results from everywhere for all time. The result was a 616-page PDF. 😱

SPR Low Blood Sugar

I posted about two weeks ago about a low blood sugar event while driving to my friends’ house. Well, after starting the SPR program, the problem is getting worse. Overall, it is good that my blood sugar is averaging much lower, but the extreme lows are scary. I received a critical low blood sugar warning Thursday on the way to work:

The reading actually got down to 53 on a prior scan. That is really low. I was brought to the ER when my blood sugar dropped to below 40 post-heart transplant. I mentioned this to my nephrologist yesterday and she said I should taper down my Toujeo insulin shot until my morning blood glucose is over 100.

After fighting high blood sugar, especially after the kidney transplant, it is refreshing to see a consistently normal blood sugar reading, especially with less insulin shots.

The Six Pack Revolution

I signed up for the SPR Signature program, which starts today. My sister and her partner did the program in March and saw great results. The program is really intense as there is a specific set of food that you can eat, and you need to prepare meals and snacks yourself. Since my sister offered to help prep meals, I decided to try the program. After transplant, my weight dipped down to about 180 pounds but have since increased to 240 pounds. I have not increased my weight since the beginning of the year but have not been able to lose any either.

Since this is the first day, I do not have much to post yet. I have been getting several hypoglycemic events just today so maybe I need to adjust my insulin intake. The exercises have been difficult, and my quads are aching right now from some pre-course workouts. Today was also kind of easy with food since I am at home. I need to start packing for tomorrow’s full day in the office.

Now I need to go and walk/run 1 km to complete the first fitness challenge. I also need to go to the market to get some fruits and vegetables.

Ozempic Shortage

If you live in the United States, you probably have seen this commercial:

Ozempic is used to lower blood glucose levels for type II diabetic patients. Evidently, the active ingredient is also used in obesity medication. Not surprisingly, one of the side effects of Ozempic is weight loss.

As I mentioned in a previous post about my endocrinologist appointment, my A1C was high at 8.1. The doctor modified my insulin dosages and prescribed a “smart” insulin pen. She also said she wanted to start me on Ozempic, but there is a shortage because non-diabetic people are using it to lose weight. WTF? Even my neighbor talked about the drug saying it is great for losing a few pounds without any side-effects. I was being polite, but I call bullshit on the “totally safe” comment. Just pay attention to the ad above as the narrator lists out the side-effects.

What a fucked-up world. You got a bunch of narcissistic assholes using an anti-diabetic drug to lose a few pounds, while patients that need the medication cannot get it. My doctor said we should wait for Ozempic since she did not want to modify all my medications to include it, then have it be unavailable at the pharmacy. Unless you have a medical obesity problem, just watch your diet, and do regular exercise to lose weight.

Endocrinologist and InPen

I had an appointment with my endocrinologist. I was a bit worried since she is fairly stern, and my A1C result sucked. I was supposed to see her last year but due to getting COVID and general procrastination, I did not see her until last week. Overall, the appointment went okay, partially because it was remote. However, she did adjust my insulin schedule, and prescribed an intelligent insulin pen called InPen. It is made by Medtronic and connects via Bluetooth to a mobile app. You are supposed to input your blood glucose reading and it will tell you how many units to inject. It does connect to a few continuous glucose monitors, but not the Libre 2 I am using.

I picked up the pen from my local pharmacy, but I am still waiting for the insulin cartridges to come. I still have several boxes of the old insulin pen so I will keep using those.

The pen casing feels like very light aluminum, and I like the deep blue color. Since Medicare paid 100%, I do not know how much the pen costs. I was able to connect it to the iOS app on my iPhone 12, and it is already notifying me to shoot up.

As for the endocrinologist, I have a follow-up meeting in one month and also in four months.

UCLA Appointment Postponed

I had a call schedule with UCLA Transplant Center about the Natera Prospera program. I was asked to join a study post-transplant, and this is the first time the sponsoring doctor has scheduled an appointment to talk about it. Here is a description from Natera’s website:

Covered by Medicare, Prospera is a transplant rejection assessment test that uses a simple blood draw to evaluate the risk of rejection of a transplanted kidney.

Through the use of advanced cell-free DNA technology, Prospera increases a provider’s ability to identify otherwise undetected rejection that might lead to kidney loss. Catching transplant rejection as soon as possible can help providers develop a treatment plan to best protect the donated kidney.

https://www.natera.com/organ-health/prospera-organ-transplantation-assessment/

I think it is informative that the first sentence tells patients that Medicare covers the cost of the test. Since Medicare coverage only lasts three years after the kidney transplant, maybe that is the topic of discussion today.

Anyway, I joined the call at 9:55 am for a 10:00 am call. I then waited for twenty minutes before another doctor called me on the phone saying the doctor I was supposed to speak with was delayed and we needed to postpone it to 11:45 am. Doctors are busy people so I totaly understand last minute schedule changes. I just wish they would have called me earlier, so I did not have to sit in front of my iPhone waiting for twenty-fine minutes.

Low Blood Sugar in Traffic

Today, as I was driving to a friend’s house in Laguna Beach, I had a low blood sugar event while stuck in traffic. Since there is only one road from Irvine to Laguna Beach (other than Pacific Coast Highway), there is often traffic backup on weekends. My Tesla’s GPS initially said 45 minutes of driving, but that stretched to one hour and twenty minutes while I was on my way.

Somewhere on route 133, between the 405 and the 73, I started feeling faint. It felt like low blood sugar, but I did not shoot my Humalog dose yet. Since I have a continuous glucose monitor (CGM), I scanned the sensor, and it said my blood sugar was down to sixty-eight.

Luckily, I had some glucose pills in my car. I am not sure what would of happened if my blood sugar dropped further. It took another 30 minutes to get to my friend’s house. It must suck to live in Laguna Beach if there is traffic like this each weekend.

Neuropathy 20230529

So, after having the pain point move around all weekend and losing two nights of sleep, I took a nap in the late morning and got up at 1:00 pm. As soon as I woke up, the pain started up again in yet another location. This time the pain is happening on my right foot insole, and it is very painful. Each attack also leaves the entire foot numb as well. I messed up my ugly feet diagram so I will need to find another one to mark the pain attack locations.

This sucks. It seems like each time there is a holiday, I end up at home and exhausted due to an intense neuropathy attack. This current one has been happening for about four hours and is getting worse.

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Th make matters worse, I have not really eaten anyt5hing since lunch yesterday. It was an AYCE shabu place, but I really did not eat that much. With the CGM readings spiking after every minor bite of food, I have been trying to not eat anything to see if I can get the readings lower, but now I am feeling really hungry.

This is from the Libre 2 app. The only thing I have had today was a small protein shake at 8:00 am.

CGM Sensor Roller Coaster

Speaking of continuous glucose monitors, yesterday’s readings were like a wild roller-coaster ride. Here is the chart from the Libre 2 iOS app:

Let me narrate what happened today. Since I was meeting my friend for lunch at an AYCE shabu place, I did not really eat lunch nor dinner the day before. I had some neuropathy pain, so I was up until 4:00 am. I did not eat anything, so my blood sugar stayed around 160. When I finally fell asleep, the levels started to drop. At around 11:00 am, I left for the restaurant after injecting the morning and pre-meal insulin doses.

At the restaurant, even though we were eating for 30 minutes, I started to feel the signs of hypoglycemia. The reading was 60 so I quickly drank some sugared soda. My blood sugar stabilized but then started shooting up. I did not eat that much for an AYCE place, and it was mostly beef, vegetables, and fish balls. Anyway, we stopped eating around 1:00 am but my blood sugar kept rising. By the time I got home, it was approaching 300 so I took another insulin shot. I then took a long nap during which time my blood sugar dropped to around 180 then back up to over 300. I was sleeping so I did not eat anything. Was I still digesting food from hours ago? This random rise in blood sugar also happens occasionally during mornings. The readings would slowly rise during the last three hours of sleep even though I have not eaten anything for six to nine hours.

Another Bad Libre 2 Sensor

I had another Libre 2 continuous glucose monitor (CGM) sensor fail on me. The sensor was only two days old; they cost $100 and are supposed to last fourteen days. I made a good scan at around 7:00 pm, took a nap, and tried to scan at 11:00 pm and got an error message to replace the sensor.

I do not remember hitting anything with it. I have banged into doorframes before, but previous sensors always kept working. Since my pharmacy only gave me six sensors per prescription, I need all of them to last their full duration before getting another refill.

Last time this happened, I filled out a form online and Abbott sent me a replacement sensor. I went online, found a slightly different webpage, and reported the error. Unbeknownst to me, the form was for Abbott Australia. I just received an email notifying me about that fact, and that they are unable to help me. Ugh. I got back online, found the right webform, and filled it out again. Hopefully I will get an answer on Tuesday.

Neuropathy Weekend 20230528

My feet have been hurting all weekend. It is actually worse than that. My left big toe (#1) started hurting Thursday during the day. The attacks were pretty far apart, and the pain was not very intense. It was still bothersome, and I did not sleep well for a few days. Then the pain shifted to the toes in my right foot (#2) Friday night and was also very intermittent. The pain seemed more diffuse as I could not even pinpoint which toe was hurting.

Because of #2, I could not sleep last night until around 4:00 am. I was up moving some furniture and computers around in my home office. I finally fell asleep and just woke up 20 minutes ago. As soon as I woke up, my right big toe (#3) started hurting. The pain is spread out across the entire toe and the attacks are still minutes apart. In addition, each attack lasts about 3 to 5 seconds, which causes a lot of numbness as well. I am heading out to lunch with a friend; it would totally suck if this was just the beginning of another 24 hour painfest.

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Ugh, the pain jumped back to area #2 last night as I was trying to fall asleep, and I ended up awake all night. I am so tired. Luckily today is a holiday so I do not have to work.

Pandemic Over?

The World Health Organization (WHO) released a statement saying that the COVID emergency is over.

The WHO Director-General concurs with the advice offered by the Committee regarding the ongoing COVID-19 pandemic. He determines that COVID-19 is now an established and ongoing health issue which no longer constitutes a public health emergency of international concern (PHEIC).

https://www.who.int/news/item/05-05-2023-statement-on-the-fifteenth-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-coronavirus-disease-(covid-19)-pandemic

The logic is that hospitalizations and deaths due to COVID are low enough that it is no longer an emergency but a daily fact of life. Does that mean the most virulent strains are relatively harmless? Are recent mutations not as dangerous as previous strains like delta and omicron? Locally, I do not see many people wearing masks, even in healthcare settings, and the FDA/CDC has not approved the next vaccine booster for immunocompromised people

Per the WHO, there are still active cases and deaths from COVID, but just not like the past three years. This is data for the US:

Without context, the chart is just a visual aid. However, it represents three years of everyone’s lives, 765 million cases, and seven million deaths worldwide. I am sure the numbers are higher, mainly due to China’s fake numbers and underreporting by many other countries. That means on average, one out of ten people were infected, and one out of 100 people infected died.

Neuropathy 20230507

I have been telling people that I get peripheral neuropathy attacks monthly but since I have been marking pain points on a diagram, it has been happening weekly.

This one is a bit strange. I am supposed to go to church this morning since two brothers in our group are getting baptized. However, I was dreaming my foot was hurting while at church. I ended up sitting in a back room and did not see anything. When I woke up about twenty minutes ago, the marked location on my left foot was only sore. Soon, however, the real pain started. Was I experiencing the first few attacks while asleep and my brain converted that to a dream? Or was it something like PTSD since any nerve twitch will trigger a feeling of dread? I wish I understood the immediate triggers because it is literally random at this point.

Neuropathy 20230501

Ugh, another peripheral neuropathy attack. The timing is terrible this time since I am visiting a software vendor this afternoon. That is going to suck if the attack continues until then.

This time the apparent pain point is on the outside bottom of my right foot as marked above. Interestingly, I can push hard on my calf muscle and trigger pain or numbness in my foot. However, I could not find the location that matches the current pain point. Instead, I am just making my foot number overall.

I hope this attack ends soon so I will not have to hobble around the software vendor’s office later this afternoon. I have been trying to sleep since 11:00 pm. It is now almost 3:00 am and I have not slept at all, and I am very tired.