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Apr. 30th, 2008 04:29 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
urocyonI haven't been in front of the keyboard much in a while--mostly haven't felt like it, being sick and tired from (and of) the metformin. Yesterday was pretty bad, but today seems to be making up for it. Thank goodness things frequently work out that way.
Yesterday I was thoroughly fed up, and finally thought to try to find more info on side effects. (Don't know why I hadn't done this before, possibly out of "this will surely go away soon" denial.) Apparently, it's not at all unusual for GI symptoms to continue, no matter what pharmaceutical reps have the doctors believe. (Medscape is erratic in wanting a login, so here's a saved version.) This is not too surprising, considering how it works on the GI system--that certainly explains why the symptoms kick in within half an hour of taking the stuff. That's even without all the anecdotal evidence. Judging by other people's experiences, the lightheadedness, dizziness, and headaches are probably more direct side effects, rather than the hypoglycemic symptoms I started out assuming. It also seems that the fatigue, brain fog, general lack of energy, and some muscular pains are likely coming from B vitamin depletion--and my stores of some were just getting reestablished, from the celiac. Pretty much the same reason in both cases, but it hadn't occurred to me; maybe I should blame the brain fog. :)
On the brighter side, I did run across a lot of tips for making the side effects liveable, mainly from one PCOS forum. Some of the eating advice I'd figured out already. I'd discovered that I do need to eat every couple of hours, in small quantities, and make sure I eat something before I even finish my coffee in the morning (particularly fun, since I'm just not hungry for a few hours). If I wait until I'm starting to feel low, that's the rest of the day gone; ditto for eating very much at a time, or much in the way of carbs without tons of fiber, or much not-very-saturated fat. Yesterday, I think I got so sick from (a) waiting a couple of hours to eat, while carrying buckets of fish water in the meantime, and (b) extending some leftover goulash with too much pasta. I was glad to see some other tips on food timing and content, including taking the pills in the middle of the meal and preferably with some milk or yogurt too (if the lactose content isn't enough sugar to cause a problem). I'm seeing an awful lot of veggies and fruits--which the metformin hasn't hated, so far--in the near future, and I already tend to consume 8+ servings. I'm also going to try harder to remember to take a B complex, and hope that some of it gets absorbed, along with the magnesium supplement on top of all the legumes we've been eating lately.
As a side note, the advice I ran across--along with personal experience--makes me very glad indeed that I knew enough not to follow the diet recommended by the NHS. Besides throwing in lots of outdated "eggs are horrible, don't eat nuts, margarine is great" cholesterol-lowering advice, the handouts I got made absolutely no distinction between Type 1 and Type 2. If I were being "good" by their definition, and eating even more starchy carbs than the food pyramid suggests, I'd be about dead from the meds before now--and wondering why it was happening, in spite of my "goodness". It's particularly inappropriate, given that metformin is the most prescribed drug for Type 2, with its method of action. I only wish I were surprised at the quality of advice. :/ Unfortunately, a lot of people seem to have more trust in medical professionals, and don't do much if any research for themselves.
The metformin hasn't been very fun so far, but it still looks like the best option. Something that actually reduces the insulin resistance, rather than pumping more insulin into a wonky system, makes a lot more sense. Just seeing some assurance that things can be managed so that the effects are tolerable has given me more hope. Knowing that there's something, short of going off the meds, that I can do to help the complete lack of energy is particularly welcome. With any luck, quality of life will be looking up before too long.
That reminds me, I really do need to get over my phone phobia* long enough to call for a remedial massage appointment. The knotted up shoulder and chest muscles from that job have proven a more lingering and aggravating problem than the lower back injury. It keeps feeling like I've been trying to fly, with implausible angel-type wings, attached behind my arms. Wearing a bra really aggravates this, since I could tell at the time that doing such strenuous, repetitive work with restricted/awkward movements from a bra was causing a lot of the problem. They're unpleasant enough, at the best of times, but I'm still not entirely comfortable bucking that particular deranged social mandate. Some sports massage from someone who knows what they're doing should work wonders, though, so I really ought to make myself get on the phone soon.
* I'm still wondering about the feasibility of using TTY and/or relay; just the CAPD, which helps make me nervous since I can't understand the other end of the conversation at least half the time, constitutes a legitimate reason. The little television/DVDs I watch have been so much more enjoyable since it occurred to me to turn on the closed captioning.
Yesterday I was thoroughly fed up, and finally thought to try to find more info on side effects. (Don't know why I hadn't done this before, possibly out of "this will surely go away soon" denial.) Apparently, it's not at all unusual for GI symptoms to continue, no matter what pharmaceutical reps have the doctors believe. (Medscape is erratic in wanting a login, so here's a saved version.) This is not too surprising, considering how it works on the GI system--that certainly explains why the symptoms kick in within half an hour of taking the stuff. That's even without all the anecdotal evidence. Judging by other people's experiences, the lightheadedness, dizziness, and headaches are probably more direct side effects, rather than the hypoglycemic symptoms I started out assuming. It also seems that the fatigue, brain fog, general lack of energy, and some muscular pains are likely coming from B vitamin depletion--and my stores of some were just getting reestablished, from the celiac. Pretty much the same reason in both cases, but it hadn't occurred to me; maybe I should blame the brain fog. :)
On the brighter side, I did run across a lot of tips for making the side effects liveable, mainly from one PCOS forum. Some of the eating advice I'd figured out already. I'd discovered that I do need to eat every couple of hours, in small quantities, and make sure I eat something before I even finish my coffee in the morning (particularly fun, since I'm just not hungry for a few hours). If I wait until I'm starting to feel low, that's the rest of the day gone; ditto for eating very much at a time, or much in the way of carbs without tons of fiber, or much not-very-saturated fat. Yesterday, I think I got so sick from (a) waiting a couple of hours to eat, while carrying buckets of fish water in the meantime, and (b) extending some leftover goulash with too much pasta. I was glad to see some other tips on food timing and content, including taking the pills in the middle of the meal and preferably with some milk or yogurt too (if the lactose content isn't enough sugar to cause a problem). I'm seeing an awful lot of veggies and fruits--which the metformin hasn't hated, so far--in the near future, and I already tend to consume 8+ servings. I'm also going to try harder to remember to take a B complex, and hope that some of it gets absorbed, along with the magnesium supplement on top of all the legumes we've been eating lately.
As a side note, the advice I ran across--along with personal experience--makes me very glad indeed that I knew enough not to follow the diet recommended by the NHS. Besides throwing in lots of outdated "eggs are horrible, don't eat nuts, margarine is great" cholesterol-lowering advice, the handouts I got made absolutely no distinction between Type 1 and Type 2. If I were being "good" by their definition, and eating even more starchy carbs than the food pyramid suggests, I'd be about dead from the meds before now--and wondering why it was happening, in spite of my "goodness". It's particularly inappropriate, given that metformin is the most prescribed drug for Type 2, with its method of action. I only wish I were surprised at the quality of advice. :/ Unfortunately, a lot of people seem to have more trust in medical professionals, and don't do much if any research for themselves.
The metformin hasn't been very fun so far, but it still looks like the best option. Something that actually reduces the insulin resistance, rather than pumping more insulin into a wonky system, makes a lot more sense. Just seeing some assurance that things can be managed so that the effects are tolerable has given me more hope. Knowing that there's something, short of going off the meds, that I can do to help the complete lack of energy is particularly welcome. With any luck, quality of life will be looking up before too long.
That reminds me, I really do need to get over my phone phobia* long enough to call for a remedial massage appointment. The knotted up shoulder and chest muscles from that job have proven a more lingering and aggravating problem than the lower back injury. It keeps feeling like I've been trying to fly, with implausible angel-type wings, attached behind my arms. Wearing a bra really aggravates this, since I could tell at the time that doing such strenuous, repetitive work with restricted/awkward movements from a bra was causing a lot of the problem. They're unpleasant enough, at the best of times, but I'm still not entirely comfortable bucking that particular deranged social mandate. Some sports massage from someone who knows what they're doing should work wonders, though, so I really ought to make myself get on the phone soon.
* I'm still wondering about the feasibility of using TTY and/or relay; just the CAPD, which helps make me nervous since I can't understand the other end of the conversation at least half the time, constitutes a legitimate reason. The little television/DVDs I watch have been so much more enjoyable since it occurred to me to turn on the closed captioning.