Slice of Chaotic Life

The daily life of a celibate middle-aged man.

Archive for April, 2012

Not the sugar, evidently

Posted by Itlandm on April 30, 2012

So today I destroyed my own beautiful hypothesis that lack of sugar is what makes me tired. I bought a new blood sugar measuring device. Thanks to some grotesque logic of the market, you can get the starter kit quite cheaply (99 NOK, or close enough to $20), but buying needles and test strips later is expensive. It is entirely possible that it would be cheaper to just buy new starter packs each time, destroying the environment in the process. -_-

Be that as it may, I tested my blood sugar after I came home from work. It showed 6.1 mmol/l, or 110 mg/dl for my American friends (who are more likely to have blood sugar problems anyway). I walked for an hour without eating or drinking anything except a glass of water and a lick of salt. When I stopped (from a beginning headache, which disappeared shortly) my blood sugar was 6.3 mmol/l, or 113.5 mg/dl. In other words, an hour of energetic walking had raised my blood sugar marginally.

At work, I eat yogurt from time to time, approximately a liter (a quarter of a gallon) over the course of the workday. I also drink a little Pepsi from time to time, about two glasses over the course of the workday. I was not big on large meals even before the current condition of my intestines. So it seems reasonable that my body pretty much has removed any excess sugar an hour after I leave work, and just above 6 (or 110) is more or less my natural level, which I will keep unless I drink one of those glucose solutions again or, on the other hand, work to exhaustion. I guess it really is true that the blood sugar is not low until you start going jelly-like in the knees. This is extremely rare for me, although last time I moved it actually happened.

In any case, this blood sugar is harmless. It is above average, but most people are either above or below average, obviously. It is unlikely to have any effect whatsoever on my health. Other things require more attention. And even then, as they say: “It is the one you don’t see that gets you.” Evidently the sugar is not that one.

EDIT: Looking back, I realize I never said it was a lack of sugar. Rather I said that maybe the liver was adding some signal molecules when giving up sugar. Perhaps it is a kind of warning, like a beep-beep when your fuel is getting low. That would certainly be consistent with the observation.


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Failed experiment

Posted by Itlandm on April 29, 2012

I have a circuit that I can walk energetically and it takes just over half an hour. So I decided to follow up on the previous two days of experimenting by walking one round, drinking a glass of Pepsi, walking another round and so on until I got tired anyway. That way I would find out how much of the tiredness came from lack of sugar, if that is what does it. Actually it could be the water, or the tiny amount of caffeine, or even the short break. But anyway, I would find out how far I could walk on Pepsi.

This did not come to pass. When I stopped by after the first half hour, my digestion was too upset to drink Pepsi. And after ten minutes of the second round, my pulse approached 130 instead of 120, so I stopped and went home.

Perhaps it is the water after all. I still absorb only part of the liquid I ingest, to put it delicately. It is enough for daily life, work and even moderate exercise. I am not getting dehydrated (dried out) like you can get from cholera, dysentery and many other diseases that settle in the digestive tract. So I have mostly stopped whining, but that does not mean I am getting better. It is still the same as when I was still taking the clindamycine. I could probably live out the rest of my natural lifespan on yogurt and probiotic milk drink, and a little salt and vitamins. Not the most exciting diet, but it is alright. And realistically I don’t think this will last all that long. But for now, I better show respect for my digestion.

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Walking experiment

Posted by Itlandm on April 28, 2012

So today I followed up my idea from yesterday. I walked the same route as yesterday, at roughly the same brisk pace, but I brought with me a bottle with about 2 dl of Pepsi, which would contain 20 grams (0.7 ounces) of cane sugar. (This is European Pepsi – American Pepsi probably uses corn syrup, except for Pepsi Throwback – not sure how easily available that is. Corn syrup is for some reason treated differently by the body, even though the sucrose in cane sugar is a molecular fusion of glucose and fructose, the two ingredients in corn syrup.)

At 50 minutes (out of 80) I stopped and slowly drank the Pepsi, to which I had added a little water before leaving home. (It is strong and fizzy for me in its pure form.) This may have taken as much as 5 minutes, as I waited between each mouthful for my pulse to come back down. Swallowing causes my pulse to go up briefly by 20-30 bpm, I assume this is a human trait but I have never heard of it elsewhere.

When I resumed my walk, my pulse was actually marginally higher than yesterday at the same stretch, and I was breathing more deeply. But this is almost certainly because I was walking faster. The feeling of heavy feet had disappeared! So evidently the body has three different modes in this regard. 1: The muscles use their own storage of glucose. Walking fast is easy, pulse is relatively low. 2: The muscles transfer sugar from the liver. Walking fast is harder, pulse is relatively high. 3: The muscles transfer sugar from the digestive tract. Walking fast is easy, pulse is higher than in mode 1.  This implies that the feeling of heavy feet is somehow triggered by the liver, releasing some kind of signal molecules when it supplies sugar at a fairly rapid speed. I doubt the caffeine level in a full glass of Pepsi is enough to play a role, but I may want to test that some day with a non-caffeinated drink.

I don’t think you can stay in the fat-burning zone endlessly just by adding Pepsi whenever you tire. There is probably a limit. But that limit is not one I am likely to reach. There are people who actually run marathon, I don’t even walk marathon. Even last summer before the ambulance episode, I rarely walked fast for more than two hours. If the stress test on Wednesday shows that I can safely run, I may need to bring a lot more Pepsi though. ^_^

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Back to walking

Posted by Itlandm on April 27, 2012

I try to get my body back in normal shape before the stress test of my heart next week. Yesterday I walked about an hour, and the same the day before when I wore the portable EKG and a blood pressure monitor. Today I upped to 1 hour 20 minutes, which was around the normal range before I started getting the palpitations and the tachycardia episodes.

There were no irregularities this time either. But after around 45 minutes, my leg muscles must have run out of glycogen or something: My legs became heavy and my pulse went up. Not to alarming levels, but I kept a pulse of around 120 on flat terrain from then on, simply by walking without hurry. I don’t mean ambling, but walking as if you know you are not late for something. Usually I would need to walk unnaturally fast to get to 120, some days even run a few steps now and then.  On the other hand I was not winded at all, so the extra blood flow was presumably for sugar rather than for oxygen.

As I mentioned over in my less personal blog, even in the fat-burning zone you burn 40% sugar. When the muscles run out of their own sugar storage, they have to get it from the blood, so the heart works harder to bring more blood from the liver (where there is a large central glycogen storage) to the muscles.

I have an old blood sugar measurement device from 2005, but I don’t have the strips for it. This type has strips that expire in 75 days, and are ridiculously expensive. Since most people don’t pay them themselves, this is unlikely to change. But today I wish I could measure my blood sugar. You see, I have a hypothesis.

I am diagnosed with “pre-diabetes”, as my blood sugar level is higher than normal but not high enough to do organ damage (except possibly in the retina of the eye, but even then usually if the blood pressure is correspondingly high). Normally this develops into actual diabetes. What I wonder is whether this higher level has become “normal” for me and my heart reacts with palpitations when it falls to lower levels, which are normal levels for others. When normal people have their blood sugar fall to lower levels (for them), palpitations are normal. So I’d like to see whether my liver tries to keep my blood sugar at the higher level or whether it waits until normal human levels before adding more sugar to the blood.

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No stresstest today!

Posted by Itlandm on April 26, 2012

Was a bit of a misunderstanding – the stress test of my heart is on May 2nd, when I have the appointment with the actual cardiologist. This is probably for the best, although nurses here in Norway has a similar amount of education as an engineer. They earn about the same too, but only if they work nights or weekends.

Be that as it may, today was uneventful. Thank the Light for that. I am adding a small amount of fiber in my diet, will see how that goes. Also walked for almost an hour. Did not want to tire myself out while my body is still finishing off (I hope!) the infection. And especially with the poor sleep of last night, when the blood pressure measuring device squeezed my arm really hard once an hour. I am not used to being squeezed in my sleep, obviously! ^_^

The place where the pressure device pressed against my skin for a day and a night are itching like mad still, but the red stripes have gone down. And in perspective, that was a pretty small thing.

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Holter monitor!

Posted by Itlandm on April 25, 2012

Despite my conviction yesterday that I was oh so sick, I actually went to work (a little delayed) and also went to the heart specialist and had the Holter monitor (portable EKG machine) fastened. Together with it, and more disturbing, is a blood pressure monitor. Every half hour of the day (and every hour of the night, the nurse said) a shark bites my upper arm for a little while. Or so it feels. I have usually had a moderate blood pressure, but with the prediabetes I think it may be higher than ideal now. I am sure they will find out. And I am also sure there won’t be much deep sleep tonight.

Still, this is a grand improvement from how I felt yesterday. I still have the diarrhea, but it seems mostly harmless. I took an hour’s walk after work, not much less than usual.  (Actually I took two shorter rounds of half an hour each, so as to not get stranded somewhere far from home.) I felt no heart palpitations at all, but then I hardly ever do the first day after some days of rest. (Well, rest – I have been to work as usual, but by “rest” I mean “not walking fast for an hour or more after work each day”.)

Tomorrow I am scheduled for a workout test of the heart. It is probably the safest place except a hospital to do such a test, but I am still wary. I have not exercised hard since grade school, because of the asthma. I have an inhaler but I don’t use it, I just slow down before I get winded. I have not actually been winded for more than 40 years, I think. So I am bringing my asthma inhaler and hope they have a heart starter nearby as well. Still, this is a unique opportunity to learn whether I can continue to exercise, and perhaps more intensely than now. But I’m still going to try to explain the situation, and if they think it is too risky I am not going to insist.


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The diarrhea begins

Posted by Itlandm on April 24, 2012

So far, it does not have the severity of a C. Difficile takeover. But yeah, unappetizing liquid at unexpected times. The timing could just barely have been more precise: Tomorrow is the day I should put on the wearable heart monitor. I am planning to call them and ask to cancel that. (Tomorrow morning, as it was too late today.) I was hoping to walk my usual route in the hills with the monitor on; as it looks now, I will not walk very far from the bathroom. While I am sure it would be interesting to have my heart and blood pressure monitored while sleeping, going to the bathroom and trying to rehydrate, that is not really what I was thinking of!

On the bright side, the swelling in my face was gone already yesterday. My tooth is still lose and I suspect that its movements are irritating the wound, but there is really nothing I can do about that. I will stop taking clindamycin when I have developed serious diarrhea, as requested by the accompanying leaflet. If the diarrhea keeps getting worse, I should next consult a doctor. (Provided there isn’t a month’s wait this time? There is no clause for that in the product sheet.)

So far I have eaten just yogurt and the probiotic milk drink, as I have done since the cure started. But I should probably add some cooked water and salt if this continues.

Edit later in the evening: Now that the antibiotic has been out of my body for some hours, there is definitely some pressure building in my face again, although slowly.  You’d think it would not come back once it was gone. At some point the immune system should be able to deal with it: This is not some kind of new superbug, to the best of my knowledge, it was contained for several months before the surgery with no symptoms except a loose tooth!

Well, at least perhaps someone will read this and take my warning to not have oral surgery unless your life is on the line.


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Clindamycin day

Posted by Itlandm on April 22, 2012

Yesterday late in the afternoon was when I cracked my first capsule of Dalacin (clindamycin), a broad-spectrum antibiotic. The reason why I was prescribed this was that the infection had been inside the bone, and the bacteria that can lodge there are anaerobe (they do not need oxygen to live). Penicillin has little or no effect on these. On the other hand, clindamycin is a pretty extreme measure, as it kills pretty nearly every bacterium there is except hospital bacteria with resistence, and a few strange creatures like the infamous C. Difficile, destroyer of intestines.

So, a day and some hours later… nothing much has changed.  I still have a slight swelling. I wish I had taken pictures before the whole thing began so I could compare, but to me it looks like I have a small pouch on my right lower jaw as well, that is slightly larger than the left. But the difference is so small, I may need to ask a few coworkers whether they can see it or whether it is just a trick of my imagination. It certainly feels like there is a swelling, and it is periodically tender, but I have to wonder whether this is a sparrow I am hunting with a cannon.

My body temperature follows the usual curve, only a bit later in the days now that it is weekend. There are short periods of feeling cold and stiff and unwell, but no more than an hour or so. These seem to have no relation to when I take the antibiotic. Once the temperature reaches 37.5C, it stops and gradually slides back down over several hours.

My appetite is pretty much shot, but there is still no queasiness or diarrhea. I drink a probiotic milk drink with my clindamycin along with the requested amount of water, and a little yogurt. That is pretty much all I can get myself to eat. But that is the least of anyone’s worries, since I have enough fat to last me through weeks of undereating. While I am not technically overweight, I am much closer to that than to underweight. It feels strange to not spend a noticeable part of the weekend exercising, though. But one is not supposed to do that with an infection, I read once in my youth. Perhaps I should ask the universal wisdom of the Internet whether this still applies?

The Internet says yes, exercise diverts resources that your immune systems should have used, so take it easy. No need to stay in bed unless your body decides so on its own, but don’t challenge it in any way. Also: “I just had oral surgery for a bone graft about 7 weeks ago and found that the antibiotic, which was Clindamycin, made my muscle ache some” says one athlete. So, it might have limited itself.

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Another day, another hurdle

Posted by Itlandm on April 21, 2012

The after-effects of the dental surgery unfold in slow motion. Which is better than fast motion, but still disturbing. The small swelling on my upper jaw has diminished, but there is now a small swelling on the side of my lower jaw (still on the right side). So basically the swelling seems to be “sagging” down. I assume there is some kind of lymph node or something there that has had an influx of the bacteria.

Finally accepting that I may need the clindamycin after all, I took one capsule. The product sheet said to swallow it whole, but it is far too large for that. I can barely swallow mustard seeds! Ever since I was a child, I have chewed everything three times as long as the people around me, because if I don’t, the food sticks in my throat and I have to try to cough it up. I am not sure whether I have a really small opening or this is just an acquired reflex of some kind. But antibiotics are kind of moot if I choke, so I bit it through and washed it down with a glass of water. Afterwards I drank some more water and a probiotic milk drink, in the hope of dodging the Chlostridium Difficile. (Bacterium which tends to cause horrifying and even life-threatening intestinal infections in clindamycin users. It runs wild because the broad-spectrum drug kills every other bacterium in the gut, most of which are friendly.)

Can you chew clindamycine? Random person on the Internet says: “It’s can be done but it’s not recommended because Clindamycin irritates the lining of the stomach and intestines and cause an upset stomach (that’s why it has the capsule.) They do have a liquid form called Cleocin which may help if you or the person you’re prescribing the medication to has a hard time swallowing pills. Hope this helps.”

Why am I not surprised? I have been bothered by acid reflux and stomach pains off and on for years, to the point where my doctor recommends not taking aspirin (or rather the equivalent in Norwegian, of course). I also providentially forgot to replace my anti-acid chewing tablets. DRAMA! On your Internet NOW!

OK, at least I know which of the alternatives is Scylla and which is Charybdis. I am now on my way from Charybdis (the all at once whirlpool) to Scylla (the blow-by-blow reef).  Wish me luck! I am not going to give up until I look down on my dead body. Actually, if that comes to pass as some people say, that’s probably just the beginning. But I won’t be able to blog from there, so keep me in your prayers for your future edutainment!

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Mixed health signals

Posted by Itlandm on April 20, 2012

I actually wrote an open letter to my body on Google+ about its mixed signals. On one hand, this morning the pain was gone; my pulse was back to normal (for me, that means low); and there was no hint of fever. I felt fine, to the point that I might have been tempted to take a long walk if not for one detail: There is a small bulge on my face, on the right side (where the dental surgery was). It is only visible near the nose, fairly straight up from where I had the surgery, but is tender a bit further. Also, the pressure in it felt stronger later in the day, and my right eye has been leaking a couple times. So something was definitely going on.

Around 8PM, things began to change rapidly. I started to feel cold, even though the room temperature was the same. Soon I was shivering. My pulse naturally went up, although not racing. I also began feeling generally unwell.  This lasted for about an hour. By the time I stopped shivering, my temperature was 37.5 C, which is actually similar to what I have after work. (I stayed home from work today.) Usually my temperature gradually falls back to 37C before bedtime.



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