Health Matters
More check-ups
Seven months from initial diagnosis..............
I've had another diabetic check up - my second major one. And whoopee, my readings are 'excellent' according to my diabetic nurse.
This is a breakthrough, she's actually said something positive about my efforts.
Blood sugars are down and very nearly ideal, kidneys, eyes etc. seem fine.
I suspected everything would be OK on this front so I'm happy to have it confirmed. What concerns me more, and has done for the last few months is the vascular appoinment a few days hence.......
To reiterate - I have peripheral arterial disease (P.A.D.) It's an incurable condition where basically my outer extremities are knackered or getting knackered - particularly below the waist at this point. My aorta is blocked behind my belly-button so there's no arterial blood flow down to the old legs. There is some blood getting through. It's found another way there. How? I've no idea, but I'm grateful that it has. I think I've made some'collateral' blood vessels. Spare, new ones in effect, but I'm not 100% sure. I've had the symptoms for five years or more but it was when I was TOLD there was something wrong I started feeling poorly! Before that I'd put any discomfort down to a bit of rheumatism due to advancing years (back, hip, legs).
I saw my surgeon earlier today. (Sounds pompous eh, my surgeon?). Vascular specialist anyway. He was actually pretty complementary considering the nature of the blockage, which is total. Something he pointed out twice in case I'd missed it first time. He said that I was really doing very well considering. I have relative normality of movement and lack of pain, plus a lack of dead bits lower down. It's stark stuff isn't it? For a guy who played sports to a fairy decent standard, it's a shock. If I had to run for a bus these days, I'd miss it.
The consultation was in the out-patients department of the local hospital. The walk from the car park to Suite 6 involves a climb of approximately 3000 metres! It was actually much less, but due to the precipitious nature of the landscape, it felt a long way! I'm glad we're half an hour early, I've got time to recover. I sit on the examination couch without trousers and socks (half sit / half lie actually, it's a very unnatural and uncomfortable position). I'm pretty sure they have installed ultra-violet lights in the ceiling because my thighs are much more mottled blue than usual. I've had a bit of this mottling for five years or more but it seems to have flared up as a special treat for my vascular man.
He examines my feet which are 'cool' and tests my pulses in feet and groin, neither of which he comments on.
So what's caused all this? Well, smoking in younger years with little doubt. Also poor diet and possibly excess booze. I've put all these to rights now, but too late?? (Except the red wine which I partake in sensible quantities for therapeutic purposes. And less sensible quantities for escape purposes).
He tells me much the same as he did last time - only this time it seems to be sinking in! He say that the only treatment options are the drug therapy I'm currently on (aspirin, a statin and a 'blood vessel dilator') or major surgery which carries a 4 / 5% mortality risk. Not very encouraging news. He indicated that because of the surgical risk they only really operate when things get critical. I am an unsuitable case for either stents or angioplasty so it's bypass surgery or nothing.
What is encouraging is that I can still walk plenty without too much discomfort, particularly on the flat. Uphill can be a bit of a struggle when back, hips, thighs and calves get a bit sore. I'm also working at renovating another house which entails long hours doing all sorts of jobs, some of which require heavy lifting. I'm working for myself so if I do get too sore I can take a breather for a couple of minutes and gaze, bewildered at the half-built pile of rubble around me.
The specialist says I MUST keep taking the tablets and keep exercising. Those are the two crucial things. The other important bit is eating well and managing my diabetes closely to keep my blood sugars in as good a shape as I can. I show him the results of my most recent blood tests (done as part of my diabetes management programme) – which are very good, largely because of a low cholesterol / high fat / high wine diet. He mumbles a bit but doesn't appear as impressed as me.
Then he signs me off. There is nothing more he can do at this stage. He tells me that I am in much the same condition as when he last saw me nearly four months ago and that is good. He tells me that I'm doing pretty much all I can for myself and, in effect, praises my efforts. Only come back, he says, if you have a problem.
What he really means is, come back WHEN you have a problem. This disease is not curable and it is progressive. How quickly it progresses is partly down to how much I look after myself and how lucky I am.
I briefly visited self-help internet sites relating to my P.A.D. condition. Very depressing places those I can tell you. Some people on the sites are in a real mess - I can only hope that these are the few very worst cases come for some succour. I read that up to 10% of us will have some degree of vascular disease as we 'mature'. I believe that the most commonly recognized form is CVD (coronary vascular disease). I also believe that many problems can be avoided or alleviated by living a healthy life-style – good diet, weight control and plenty of exercise for example. Indeed a healthy regime may well PREVENT many conditions, including vascular problems and type 2 diabetes – my twin towers.
I've not got all the information about my condition, I'm not brave enough to look too deep. But I know enough to realize it's quite serious. I've been very averse to taking statins as directed by my diabetic team (GP and nurse) to control my cholesterol level. I did research that pretty thoroughly when diagnosed as T2 Diabetic and found that the statin / cholesterol conundrum was basically a massive, money-spinning, ill-advised mess. But I do take a statin to help stabilize the plaque which is my blockage. It may prevent bits breaking off and clogging up my heart or brain – enough incentive there I think.
What do I do with the information that I am not indestructible?
When I stand at the bar chatting with my brother and his wife I'm the same normal, dumb animal as ever. Nothing appears to be out of sync physically or mentally. When I walk the dog early morning up the hill in the park I get a bit sore but that soon passes. My son in law (step son in law actually – in fact, not even that, they aren't married yet!) has just started a local walking group. After his wife and two little sons, trekking seems to be the love of his life. I wish I was able to join them on some hill walks, but I can't. No matter, I've done plenty of hill walking in my life. Plenty of all sorts of physical things, including many sports and our boating adventures. I'm glad I did them when I could.
If I'd not done so much I would have been very frustrated and angry now having had my diagnosis.
In other words, what I'm saying is don't hang about, do it now. I'm talking to you! You never know what's round the bend.
Mentally it's another challenge. I've not got a terminal illness but I have got something which may gradually deteriorate to a point where it becomes life-threatening. It's a peculiar suspended state and one that, if I think too deeply about it, gives me the wobbles. It's early on in the whole process for me. At the moment, particularly during daylight hours, it's easy to shunt it to the back of my mind because there are alternative stimuli. At night it's a bit different when I wake up with a start and all is quiet. I don't mean to sound dramatic here, but it is what it is. The middle of the night can be a pretty frightening place. Goodness only knows what it's like for someone with real problems!
We have had a pretty varied life and have made the fun happen – though some people put it down to luck. It's not luck, it's doing what you want within the parameters you're offered. I think we've made the most of things generally. But now we have a new beginning. The beginning of the end if you will and we must try and make the most of what's to come.
Today was quite an important day in my life.
Today it dawned on me that I had discovered the means of my death - at least in all likelihood.
It's a bit surreal because there's no definitive time scale. It could be a relatively long time, it could be later today.
I state again that I've written all this to help / warn people about getting into the same mess as me.
You can prevent problems or at least delay them till you're into your late 90s!
Next: Two years on