3 December 2024
The morning started early (3:30 am) but finished late (7:00 am). Somewhere in there I managed to get back to sleep. No breakfast and no coffee this morning so I was dragging a little on 5 hours of sleep.
I left a little after 8 am to have blood drawn on Stirling in Hollywood. I was not used to Joel’s car. First, I couldn’t unlock the door. I was afraid I would break the key off in the lock but with a little jiggling, I got the door open. Then I had trouble getting the key in the ignition to work. More jiggling. It finally started.
I didn’t park it in the garage (the body was too long) and I had to run the windows up and down and the windshield washers to clear the dew and fogged glass. The windows are power windows and the car is old and the buttons were a little sensitive. For a while there, I thought I was going to have to drive all the way with the front windows down.
They finally reacted to the power buttons and I was able to raise them. Then the windshield wipers started up on their own. Joel had warned me about this. I pulled into the blood draw place with windshield wipers beating time with me and Bobby McGee.
There was a line of 4 people waiting to get their blood drawn but the line moved quickly with two phlebotomists. The one drawing my blood asked if I drank plenty of water before coming. I said no. He said I needed to do that. That was interesting because I remember one time when the nurse told me to only drink enough water to take my meds in the morning. Next blood draw I’ll drink water, water and more water if it makes it easier on them to find a vein. I was back home by 9 am and had breakfast and coffee.
My next appointment is 2:30 with Dr. Jellinger. I plan on napping until 1 pm and then getting ready to head out. More windshield wipers.
4:57 pm
OK, I’m officially depressed. He did put me on insulin (14 units). I also now have a CGM (continuous glucose monitor) – FreeStyle Libre 3. I’m sure I’ll knock it off my arm at least 3 times a day.
I’ve tried to stay off insulin. I never wanted to go on it. I remember how difficult it was to regulate for people when I was a kid. The CGM will monitor my glucose 24/14. It has to be replaced every 14 days. I’ll use a pen device with insulin preloaded. I’ll dial the needed amount on the pen and inject in the region around the lower abdomen (2 fingers away from the belly button) every night at bedtime. I no longer have to do daily finger sticks. I do have to stay on the Metformin.
I’ve been promised I will love this system. Supposedly you never feel the needle go in. However, Farah has been on insulin for 40 years and she told me she gets an itchy rash around the injection sites.
I’m to self regulate the insulin in 3 unit increments. My target goal is 90-115 for glucose. I’ll adjust the insulin dose based on the readings of the CGM. I’ll check the readings on my iPhone. If my glucose level drops too low, the phone will notify me with an alarm and wake me if asleep.
Dr. Jellinger said this was not necessarily a lifelong association with insulin. I might become a candidate for Ozempic or I might go back on Jardiance. He continues to be concerned about heart failure/heart disease because of the Herceptin infusions. That’s the number 1 and 2 side effects of the monoclonal antibody. However, he was pleased with the echocardiogram. He was concerned that the left ventricular ejection fraction was 56% which puts me in the category for heart failure. That and I have a high calcium score showing calcification in the heart.
We discussed whether diabetes has any effect on my neuropathy and it may have some. He’s not so sure my neuropathy will be permanent and wants to hear what the neurologist says tomorrow. He does say Gabapentin is often used to treat neuropathy in diabetics. I’ll possibly know more tomorrow.
He pretty much believes my fatigue and weakness and edema of the calves and feet are due to the Herceptin. I need to ask Dr. Velez if that gets better. Otherwise, I’m looking at an entire year in compression socks and blue funks.
I’m to notify Farah at the end of one week on how things are going with the insulin. I have an appointment with Dr. Jellinger on February 28th for a review.
Stay tuned!
