Analysis of Blood Test

Today, I started with the concerns in my blood test. I put my skillset to use and with a more than perfunctory use of Google, I've come up with what I think is going on.

The next step, of course, is to formulate and enact a plan on how to get the numbers into the right areas and become a more healthy person (well, at least physically).

Understanding, I believe is going to be paramount in this. I need to understand exactly what is going on in my body and how it is working. I need to clearly understand what's going into my body so I can ensure that I am preventing what I can. I need to understand that want is not an option.

The line in my mind has seemingly been drawn and I need to adhere to it.

Onward...

Test Name	My Result	Acceptable Range	Complications
Hemoglobin A1c	9.0 H	<=5.6 (%)	Diabetes II
Glucose	132  H	65 - 99 (mg/dL)	Diabetes II
Magnesium	1.7	1.7 - 2.4 (mg/dL)	Diabetes II/Kidney issues-Nephropathy
Vitamin D, 25-Hydroxy, Total	21.8  L	30.1 - 100.0 (ng/mL)	Need to be outdoors more/Kidney issues-Nephropathy
Microalbumin, Urine, Normalized	137  H	<=29 (mg/g creat)	Microalbuminuria/Kidney issues-Nephropathy
WBC	7.2	4.0 - 11.0 (k/mm3)	White Blood Cells
RBC	4.83	4.30 - 6.00 (m/mm3)	Red Blood Cells
Hemoglobin	12.9  L	13.0 - 18.0 (g/dL)	Total amount of the oxygen-carrying protein in the blood.
Hematocrit	40.5	40.0 - 53.0 (%)	Percentage of total blood volume that are red blood cells.
MCH	26.7  L	27.0 - 34.0 (pg)	Calculation of the average amount of hemoglobin inside a single red blood cell.
MCHC	31.9	31.0 - 37.0 (g/dL)	Calculation of the average concentration of hemoglobin inside a single red blood cell.
Specific Gravity, Urine	1.007	1.005 - 1.030	Microalbuminuria/Kidney issues-Nephropathy
pH, Urine	5.5	5.0 - 8.0	Acidic. Need more fruits/vegetables/Kidney issues-Nephropathy
HDL Cholesterol	37  L	>=40 (mg/dL)	Obesity/Lack of Exercise

Yes, there is work to be done.

Blood Test Results from 08-27-16

I'm still Diabetic.

Some of the results here are not surprising, but I do have to look some things up and review what I'm doing to battle the disease. Significant changes need to happen or my body is going to start to shut down critical systems without my permission.

I'm not at all pleased with the results, but I'm also not shocked about them either. I need to undo years of practices and rethink the solutions on what I thought was working.

So... onward.

Test Name	My Result	Acceptable Range
Hemoglobin A1c	9.0 H	<=5.6 (%)
Estimated Average Glucose (eAG)	212	Not Established
Glucose	132  H	65 - 99 (mg/dL)
Urea Nitrogen (BUN)	20	8 - 25 (mg/dL)
Creatinine	1.1	0.60 - 1.50 (mg/dL)
GFR Estimated (Non-African American)	80	>=61 (mL/min/1.73m2)
GFR Estimated (African American)	93	>=61 (mL/min/1.73m2)
BUN/Creatinine Ratio	18.2	10.0 - 28.0
Sodium	138	135 - 145 (mmol/L)
Potassium	4.9	3.5 - 5.2 (mmol/L)
Chloride	101	96 - 110 (mmol/L)
Carbon Dioxide (CO2)	26	19 - 31 (mmol/L)
Anion Gap	11	4 - 18
Calcium	9.6	8.7 - 10.5 (mg/dL)
TSH High Sensitivity	1.79	0.45 - 4.50 (mU/L)
Magnesium	1.7	1.7 - 2.4 (mg/dL)
Vitamin D 25-Hydroxy Total	21.8  L	30.1 - 100.0 (ng/mL)
Creatinine Urine Random	41	Not Established (mg/dL)
Microalbumin Urine Random	56	Not Established (mg/L)
Microalbumin Urine Normalized	137  H	<=29 (mg/g creat)
Vitamin B12	391	243 - 894 (pg/mL)
WBC	7.2	4.0 - 11.0 (k/mm3)
RBC	4.83	4.30 - 6.00 (m/mm3)
Hemoglobin	12.9  L	13.0 - 18.0 (g/dL)
Hematocrit	40.5	40.0 - 53.0 (%)
MCV	84	78 - 100 (fL)
MCH	26.7  L	27.0 - 34.0 (pg)
MCHC	31.9	31.0 - 37.0 (g/dL)
Platelet Count	387	130 - 450 (k/mm3)
RDW(sd)	40.9	38.0 - 49.0 (fL)
RDW(cv)	13.5	11.0 - 15.0 (%)
MPV	9.3	7.5 - 14.0 (fL)
Segmented Neutrophils	63	40 - 85 (%)
Lymphocytes	25	10 - 45 (%)
Monocytes	7	3 - 15 (%)
Eosinophils	3	0 - 7 (%)
Basophils	1	0 - 2 (%)
Absolute Neutrophil	4.6	1.6 - 9.3 (k/uL)
Absolute Lymphocyte	1.8	0.6 - 5.5 (k/uL)
Absolute Monocyte	0.5	0.1 - 1.6 (k/uL)
Absolute Eosinophil	0.2	0.0 - 0.7 (k/uL)
Absolute Basophil	0.1	0.0 - 0.2 (k/uL)
Immature Granulocytes	0	0 - 1 (%)
Absolute Immature Granulocytes	0	0.0 - 0.1 (k/uL)
Color Urine	Normal	Normal
Clarity Urine	Clear	Clear
Specific Gravity Urine	1.007	1.005 - 1.030
Leukocyte Esterase Urine Qualitative	Negative	Negative
Nitrite Urine Qualitative	Negative	Negative
pH Urine	5.5	5.0 - 8.0
Blood Urine Qualitative	Negative	Negative
Glucose Urine Qualitative	Negative	Negative (mg/dL)
Ketones Urine Qualitative	Negative	Negative
Urobilinogen Urine Qualitative	Normal	Normal (EU/dL)
Bilirubin Urine Qualitative	Negative	Negative
Protein Urine Qualitative	Negative	Negative (mg/dL)
Cholesterol	127	<=199 (mg/dL)
Triglyceride	94	<=149 (mg/dL)
Cholesterol/HDL Ratio	3.4	<=4.9
HDL Cholesterol	37  L	>=40 (mg/dL)
Non-HDL Cholesterol	90	<=159 (mg/dL)
LDL Cholesterol Calculated	71	<=129 (mg/dL)
VLDL Cholesterol	19	<=29 (mg/dL)

As I mentioned above, I need to do some more research, but based on the Microalbumin test above, my kidneys are passing protein through my urine. This possibly means I'm eating more protein than I'm using or that I need to adjust my diet to decrease the amount of meats and increase more vegetables and grains. It's really a Catch-22 situation.

Gods know that I don't need my kidneys to fail too.

At this point, I have to absorb what is useful and store the rest for analysis. I have to keep moving forward and not let this bog me down. Knowledge is power.

My overall takeaway is this:

• Eat more greens
• Reduce fatty and processed meats
• Exercise more

And finally...

My A1c has dropped by .07 points in 6 months!

I know I need to do more, but I'm not going to begrudge a small amount of success.

Better Living Through Modern Chemistry

Glucophage/Glucophage XR (metformin hydrochloride):
Biguanide; decreases hepatic (of or related to the liver) glucose production and intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization.

Glucotrol (glipizide):
Sulfonylurea (2nd generation); lowers blood glucose acutely by stimulating insulin release from pancreatic β cells (beta cells store and release insulin).

Cymbalta (duloxetine):
Selective SNRI; not established. believed to be related to potentiation of serotonergic (liberating, activated by, or involving serotonin in the transmission of nerve impulses) and noradrenergic (liberating, activated by, or involving norepinephrine in the transmission of nerve impulses) activity in the CNS (Central Nervous System).

Lipitor (atorvastatin calcium):
HMG-CoA reductase inhibitor; inhibits conversion of HMG-CoA (3-hydroxy-3-methylglutaryl-coenzyme A) to mevalonate (precursor of sterols, including cholesterol).

Prinivil (lisinopril):
ACE (angiotensin-converting-enzyme) inhibitor; decreases plasma angiotensin II, which leads to decreased vasopressor activity and decreased aldosterone secretion.

Chlorthalidone (chlorthalidone):
Monosulfamyl diuretic; not established. Acts on the cortical diluting segment of the ascending limb of Henle's loop of the nephron (the basic structural and functional unit of the kidney) and produces diuresis with increased excretion of sodium and chloride.

Trulicity (dulaglutide):
Glucagon-like peptide-1 receptor agonist; increases intracellular cAMP (cyclic adenosine monophosphate) in β cells (beta cells store and release insulin), leading to glucose-dependent insulin release. Also decreases glucagon secretion and slows gastric emptying.

Lantus (insulin glargine):
Insulin glargine; regulates glucose metabolism. Lowers blood glucose by stimulating peripheral glucose uptake and by inhibiting hepatic (of or related to the liver) glucose production. Inhibits lipolysis (the breakdown of fats by hydrolysis to release fatty acids) and proteolysis (the breakdown of proteins or peptides into amino acids by the action of enzymes), and enhances protein synthesis.

Putting in the Work

I take various medications in order to manage my Diabetes (6 oral and 2 subcutaneous). I also try to watch what I eat and am working to change my mental model on exercise. I also take time to breathe and consider what is happening in my life. I need to know what is causing me stress and how to address it at any given time. Well, all of us do, really.

My go to method for handling the stress in my life was to binge eat, feel guilty, and then fall into a spiral. With the onset of my Diabetes, this was a problem. Carbohydrates metabolize into sugar. Sugars are my problem – one of many.

When I think of Diabetes in general, I feel fear (which leads to anger, which leads to hate, which leads to suffering). I’m told that the pain of it all is inevitable, but suffering is optional. I’m also told that the only way to resolution is through.

You see, the obstacle is the pathway to success. Today’s results show that I’m on the right path and doing the right things.

It’s not just a matter of taking the medications, eating right, and exercising (body, mind, and spirit). It’s also having a strategy of when to take the meds, how much of what to eat, and making the time for what I’m going to call functional motivation.

A simple change in when I take my evening medications over the last two days have yielded incredible results. I’m within the range of where I’m supposed to be. I’ve not been overeating because I am recognizing boredom versus hunger. If I have a bad result, I know it’s going to be temporary as I work to get back on track.

I may get stuck in a mood of desperation. It is likely to happen more sooner than later. I’ll be in that dark place where I feel pitiful and my ego takes over. This is where I have to rely upon my training and education rather than reacting.

Having Diabetes (or any other chronic condition) can be taxing (emotionally, physically, mentally, FINANCIALLY!), and will have unique challenges to each individual. For me, I have to keep going on this particular pathway until something better is developed or discovered.

It is up to me to put in the work in order to maintain and improve my skillset in handling the disease. It is just like everything else we’ve all gone through. It takes work to be better.

I can do it.

I am worth the work.

Diabetic First

It’s been a couple of days without an insight or piece of fiction. My meager hit count is affected if I do not post something at least daily.

Such is the way of the internet and groups and tribes.

I’m finding that I need to focus on some things outside of this digital realm that I seem to inhabit. I need to be out in the real world to deal with meat problems. I need to ensure that the body I’m riding in lasts for a good bit longer than expected. In short, I need to refocus my work and handle my Diabetes.

I don’t know what that’s going to do to my fledgling career as an independent writer. I don’t know what my refocus is going to do at all. I have hopes though. I have hopes that I will find a way to keep going. I have hopes that I will become healthier in body, mind, and spirit. I have hopes that I will not be dead in 10 years.

Diabetes is a disease of attrition. It’s a slow death. It kills a kidney, then perhaps an eye. Maybe it’ll take a toe, then the foot, and so on.

Mentally, I’m ill prepared to keep a fight like that going on. Physically, I’ve been letting it happen for far too long. It’s been six and a half years since I was diagnosed. All that’s happened is I’ve been exposed to a litany of medications and have gained about 25 pounds(ish). I’ve dieted, and half-heartedly exercised. I’ve started, stopped, started, and stopped again for a variety of reasons.

The important factor here is that it is my body and my disease. Many are like me, but this one is mine.

What I mean to say is that Diabetes affects people differently. Each of us has different symptomologies and different physiologies. Each of us can do different things to battle the disease with different results. The one thing that is the same across the board is that we have to put our health first.

This is not always easy. My current battle is about the self and convincing myself that I am worth it.

The scotoma I’m having is the step where the exercise is not a chore – it’s a choice. It’s a decision to live versus sitting in decay (literally). It has to become part of the overall plan to establish that I am worth the work I’m putting in at the gym.

It’s not always going to be tight pants and uncomfortable shirts. It’s not always going to be seven pills in the morning, three at dinner, and a nighttime shot in the gut. It’s not always going to be the finger twitches and tingling. It’s not always going to be the overwhelming urge to eat.

Nothing is permanent. Darkness comes and then the light of dawn follows. The afternoon wanes and then twilight falls. It is cyclic.

The fact of the matter is that the disease I’m fighting comes with baggage. There are mental issues that destroy confidence. There are chemical issues that cause hunger. There are neurological issues that cause pain. The wavelengths of each of these vary.

Some days are better than others. Some days I can see the ego for what it is. I can see it crying over there in the corner about strapping on the sneakers and getting to the gym. Some days the whiney bitch wins. I can hear the pleas and mews for something to binge on. I can feel the rumbling in my gut. Well, what I think is rumbling, anyway. Mostly it’s boredom.

It’s now that I need to focus on, not the past failures or future successes. What can I do at this moment to ensure my success? What is it that needs to change in this instant? What is in my sphere of control in my immediate surroundings?

I know all of this sounds too familiar and formulaic. That’s because it is. The issues I’ve been facing is that I let myself get off script. I succumb to the soft and lumpy ego instead of understanding that in 15 minutes, that crybaby will probably forget what it wanted.

So, yeah, reinstating the fact that I am Diabetic first – all else has to become secondary.