SemiAnnual Visit with My GP
Today was my semi annual visit with my GP. There were a few things he wanted to get done, and there was a lot I wanted to discuss.
He needed to go thru my "maintenance record", for vaccinations, next cycle colonoscopy, another EKG, and other routine stuff. Fun fun fun ...
Then, the discussion about my lab work results happened. You can see what I thought about them here. My questions about the BUN/CREATININE ratio were properly answered ("Do I care about these?" "Probably, almost certainly, not."). The discussion about blood CO2 levels was interesting. He said the test shows unusual numbers in a clinical setting (i.e. you're seriously ill), and generally has to do with the acidic condition of your body. That's over my current wage grade, and something I may do more homework on. He agreed that the radical improvement in my liver enzymes was evidence of defatting my liver. We didn't discuss my lipid panel much, other than to agree that the numbers were impressive, for me, and that was just fine. My HbA1c value got me much cred on what I wanted to do with drugs (see below), but he did say, whatever I was doing, keep doing that. As for the c-peptide result, he wrote the lab script for the next one, saying it's only one data point. But, it isn't a happy value.
There were 4 meds of interest for me: Acarbose, Lantus, Metformin, and Lisinopril.
Acarbose is a carbohydrate digestion delaying drug, moving the digestion from the stomach (where blood glucose goes into the bloodstream) to the intestines (where the carbs feed your gut bugs). I wanted it for 'spot use' - think, beer and pizza and BBQ parties. He agreed. The script is at Weggy's.
Lantus is being used at about 35 units per day, down from the original 80. He was impressed. We discussed insurance company and pharmacy reaction to my decreased dose, as well as what I intended to do further. It was good that my HbA1c value was at lifetime lows.
Metformin I want to stop taking, because of the impact it has on the results of exercise. I want all the help I can find to get that benefit. We discussed what will / may happen if I stop taking it. He agreed to my trying it out. I'll stop soon. That'll be interesting. Not sure how to further instrument me to see if I can tell what happens. This'll be one of those jump-first-fly-second things. We discussed using my road bike as a test bed. Any clues about measuring my endurance, please advise.
Lisinopril is blood pressure medicine, that I agreed to take a while back, because hell, let's maintain the Doc / Patient relationship. So my question was, if I take my BP measure, and they continue "normal", how will I ever know to be able to stop taking the drug? Two responses: If my BP numbers ever start being "low", that's a clue to stop. Second, current treatment of elderly (yes, ouch) diabetics is believed to indicate taking the drug, even without much if any evidence of high blood pressure. OK, I thought, this is not a hill I choose to fight over, so I agreed to keep taking it. And, resolve to do my homework on the topic. Perhaps it'll yield some insight into my BUN/CREATININE ratio understanding.
Last, but not least, I wanted a referral to a podiatrist. Some of the exercises I do, like 125 pound pull thrus, put a lot of pressure on my feet in various ways. And, it'll eventually be decent bike riding weather again, and my cleated shoes let me put a lot of pressure on my toes. I want to not f' them up. One more, I'm interested in learning the ways of medical oriented pedicures. And, am amused that my copay might be less than my retail pay for the work.
All in all, the visit went well, my relationship with my GP was improved, and I got everything I wanted from the conversation. Qualifies as a great visit !!
He needed to go thru my "maintenance record", for vaccinations, next cycle colonoscopy, another EKG, and other routine stuff. Fun fun fun ...
Then, the discussion about my lab work results happened. You can see what I thought about them here. My questions about the BUN/CREATININE ratio were properly answered ("Do I care about these?" "Probably, almost certainly, not."). The discussion about blood CO2 levels was interesting. He said the test shows unusual numbers in a clinical setting (i.e. you're seriously ill), and generally has to do with the acidic condition of your body. That's over my current wage grade, and something I may do more homework on. He agreed that the radical improvement in my liver enzymes was evidence of defatting my liver. We didn't discuss my lipid panel much, other than to agree that the numbers were impressive, for me, and that was just fine. My HbA1c value got me much cred on what I wanted to do with drugs (see below), but he did say, whatever I was doing, keep doing that. As for the c-peptide result, he wrote the lab script for the next one, saying it's only one data point. But, it isn't a happy value.
There were 4 meds of interest for me: Acarbose, Lantus, Metformin, and Lisinopril.
Acarbose is a carbohydrate digestion delaying drug, moving the digestion from the stomach (where blood glucose goes into the bloodstream) to the intestines (where the carbs feed your gut bugs). I wanted it for 'spot use' - think, beer and pizza and BBQ parties. He agreed. The script is at Weggy's.
Lantus is being used at about 35 units per day, down from the original 80. He was impressed. We discussed insurance company and pharmacy reaction to my decreased dose, as well as what I intended to do further. It was good that my HbA1c value was at lifetime lows.
Metformin I want to stop taking, because of the impact it has on the results of exercise. I want all the help I can find to get that benefit. We discussed what will / may happen if I stop taking it. He agreed to my trying it out. I'll stop soon. That'll be interesting. Not sure how to further instrument me to see if I can tell what happens. This'll be one of those jump-first-fly-second things. We discussed using my road bike as a test bed. Any clues about measuring my endurance, please advise.
Lisinopril is blood pressure medicine, that I agreed to take a while back, because hell, let's maintain the Doc / Patient relationship. So my question was, if I take my BP measure, and they continue "normal", how will I ever know to be able to stop taking the drug? Two responses: If my BP numbers ever start being "low", that's a clue to stop. Second, current treatment of elderly (yes, ouch) diabetics is believed to indicate taking the drug, even without much if any evidence of high blood pressure. OK, I thought, this is not a hill I choose to fight over, so I agreed to keep taking it. And, resolve to do my homework on the topic. Perhaps it'll yield some insight into my BUN/CREATININE ratio understanding.
Last, but not least, I wanted a referral to a podiatrist. Some of the exercises I do, like 125 pound pull thrus, put a lot of pressure on my feet in various ways. And, it'll eventually be decent bike riding weather again, and my cleated shoes let me put a lot of pressure on my toes. I want to not f' them up. One more, I'm interested in learning the ways of medical oriented pedicures. And, am amused that my copay might be less than my retail pay for the work.
All in all, the visit went well, my relationship with my GP was improved, and I got everything I wanted from the conversation. Qualifies as a great visit !!
Comments
I relatively recently forgot my daily dose one day. Unfortunately, it was the day before my semi-annual checkup. My blood pressure was higher than normal, somewhere around 10%. Three month check up to make sure that the missed dose was the cause had it back down to "normal" for me. If you have access to a reliable, repeatable blood pressure tester, you can run the experiment...
Good idea. Thank you.
I'll do it when my lab rat dance card is done with the weight loss diabetic stuff.
For now, I'm pretty booked.
rr