frais de l'hôpital

Here's a reminder of yesterday's numbers:

BP: 89/70 (kinda low; I did a double-take when I saw this)
pulse: 68
fasting glucose: 111 (still not where it should be—under 100)
estimated A1c: 7.33 (it'll probably be higher at the hospital)
weight: 113 kg (249.1 lbs.)

And here are this morning's numbers (measured at home):

BP: 154/106 (what the hell is that all about??)
pulse: 54 (unnaturally low for me)
fasting glucose: 63 (way low, and why I was tired and dizzy—hypoglycemia)
estimated A1c: 7.28
weight: 113.5 kg (250.2 lbs.)

And finally, here are the hospital's "official" numbers:

BP: 113/53 (still kinda low, but better than before I went to the hospital)
pulse: 68 (what it was yesterday)
fasting glucose: 71 (still too low)
"official" A1c: 7.3
weight: ??? (didn't see what the hospital scale said)

My appointment was at 10:40 a.m.; I'm normally supposed to be at the hospital two hours in advance to give a blood and urine sample, but I got there around 8:50 a.m. As before, my QR code didn't work for entry into the hospital, so a staffer buzzed me in. The staffers see me only once every few months, so I don't feel too bad about bothering them, and I'm sure they've forgotten all about me by the end of the day. As I usually do, I marched straight over to the 채혈실/chaehyeol-shil (phlebotomy room, where you present your arm and give three or so tubes' worth of blood samples), went to the special restroom where you piss into a special cup and place your urine sample in a window in a corner of the men's room, which is where unseen elves take your urine sample and do something arcane with it, like measure your urine glucose and other things kidney- and bladder-related. After giving my samples, I immediately went to the hospital bakery/snack area, where I bought a salad, a blueberry muffin, some apple juice, and some water. I didn't want to faint from low blood sugar.

I have no idea why my BP had shot up this morning compared to yesterday morning. I do, however, know why my blood pressure went down in the two hours between my home measurements this morning and my hospital measurements: I strategically took an extra hit of my meds while I was eating at the hospital. (Yes, the medical center is not even a kilometer's walk away, but I normally cab over and walk back, partly because I'm a lazy bastard, and partly because the pharmacy where I pick up my meds is at the halfway point between the hospital and my place—too short a distance to justify a cab.) That hit predictably brought the BP right back down, but I still can't think of why it had risen like that. I normally get stressed about going to the hospital, but over the past year, my BP has reflected that less and less, so I'm not sure that stress is the problem. Maybe I'm getting used to the visits.

My BP yesterday was alarmingly low, and today's post-medicine-hit diastolic number (53) was still alarmingly low. Blood sugar was also unnaturally low: it was 63 this morning, before I took that extra hit of meds, but it was measured at 71 at the hospital, despite my having eaten nothing at that point (the hospital asks you to fast the day before you give a blood sample; I'm usually ravenous after I submit my blood, hence the aforementioned restorative meal—a literal breaking of my fast). This could possibly mean there's a small difference in calibration between my home measuring device and the hospital's mysterious apparatus; it could also mean that something happened to my blood sugar during the intervening two hours. That said, an 8-point difference isn't huge.

The doc, however, saw the low blood sugar and advised me to hold back on the insulin (which I never wanted anyway); I received a ten-pen prescription all the same to last me until the end of September. Otherwise, none of my prescription meds were changed in strength or quantity, so I guess the "good" news is steady as she goes. I need to try harder to get off the meds completely, but I suspect that, with heart failure being a now-permanent feature of my life, I will never be meds-free. No one to blame but myself, and maybe also my genes (there's a history of early death on both sides of my family*).

My next appointment is with the cardio doc in July. Today's diabetes doc will see me again, as I said, in September. I'm not sure how much I like the idea of going back to the hospital every two months instead of every four months; I'll talk to my cardio doc about scheduling to see whether he can see me again in September as well. That might be too soon for his taste, though: normally, the interval is at least three calendar months long.

Today's trip to the pharmacy saw me get refills of my diabetes-related meds, plus my insulin pens. I think I have enough heart medicine to last me until July. That's the other reason why I'd like to go back to having both appointments on the same day: it's easier to see when each of my meds will run out. Ah, well... life is rarely simple.

Speaking of "not simple"—today there was a new thing, at least to me: I was told that, every six months, I have to stop by a certain desk to show my ID and confirm that I am who I say I am. I'd never heard of this before; either that, or I'd been misunderstanding something for years. Luckily, I bumbled around a bit and found the proper desk on my first try: lucky guess. The friendly guy looked at me, looked at my ID, and made a note. That was it. Just an extra bit of bullshit bureaucracy to keep us bogged down, to keep us thinking that life is complicated.

Anyway, I can now breathe easy for almost two months, but I will have to try to get my A1c down during that time. An A1c below 6 would be nice. Guess that's up to me.

__________

*Let's run down the list of early deaths, shall we? Mom's dad died in his 50s of a heart attack. Mom used to tell us the sad story of having to wrap winding sheets around his body before burial. Mom's mom died in her 60s (I think) from various causes, including a genetic condition: an upside-down stomach that made digestion painful and kept her from weighing more than 70 pounds. (Was it really 70 pounds? Mom was pulling on memories from her young girlhood, so who knows?) Mom herself died of brain cancer at age 66. Dad's parents were both alcoholics who died, in their 50s or early 60s, of heart attacks probably brought on by drinking. Dad himself, a teetotaler, nevertheless had a heart attack in 2006, when he was 64 (possibly for reasons of heredity, which may explain my own heart attack last year), and while I haven't talked to him since 2010, I assume he's still alive because, well, because of Murphy's Law. Only the good die young, they say. That would explain Dad's longevity, and my aunt's (imo, Mom's big sister): Imo was an unpleasantly combative person who resented having to take care of Mom when they had two sick parents during the Korean War. She's apparently losing her marbles now and doesn't even remember that her little sister had died. Mom, meanwhile, used to tearfully tell us a lot of stories from that horrific time in her life. She never totally got over it—the war, the abuse from her sister—not that I blame her.