Well, I Guess It's Give & Take...

Firstly, I can't believe that I've gained almost 8kgs since my heart bypass!

8 bloody kilograms!!!

Gah!

My weight has always been maintained at a (classified number which if I have to tell you, I will have to kill you after that. By telling you really bad jokes) and imagine my fright when I went on the weighing machine (which measures your height and your BMI too) at the hospital and this machine churned out the piece of paper.

Darn!

Well, I've always read that if you are on insulin regime, there's a high chance that you will gain weight. Here's some information on why and, more importantly, what you can do -

http://www.mayoclinic.com/health/insulin-and-weight-gain/DA00139

So, I guess I gotta stock up on fruits and healthy bites, and more importantly I've got to start using that punching bag and go to the gym man!

Well, honestly after being on insulin and the prescribed medication regularly, I feel that my body is slowly but surely sort of mending itself and I feel better bit by bit, day by day.

A few days ago, I had to go to the National Eye Centre.

Now, let me tell you - I really dread having to go there and have the nerves in my eyes burned away by laser.

It's really, really painful and I never fail to shed a tear or two, and curse and swear at my father and the faulty genes I inherited. Hahaha!!! (I'm laughing at the swearing and cursing)

BUT imagine my relief when I went there this time, despite having to wait for hours and hours among all those old people accompanied by their domestic helpers and their children, the doctor says my eyes are fine.

That means no laser!

Woohooooooo!!!!!!!

Well, I attribute this to good sugar control. You see, if a diabetic's blood sugar is not well controlled, diabetic retinopathy will result.

The lack of oxygen in the retina causes fragile, new blood vessels to grow along the retina and in the clear, gel-like vitreous humour that fills the inside of the eye. Without timely treatment, these new blood vessels can bleed, cloud vision, and destroy the retina.

Read more about this here.

So, I am thankful that for now, my eyes are stable.

I really can't imagine if one day goes really bad, like this.

Normal vision

The same view with diabetic retinopathy.

So, I guess I have to really, really take control of my blood sugar in order to control my life and delay further any onsets of complications.

I'm still trying to figure out how to manage my insulin therapy and food intake. It seems like I am hungry all the time despite eating whenever I am hungry. I know the reason for this is because I am on Mixtard - a mixture of fast acting and delayed reaction insulin injected twice a day, in the morning and in the evening.

So, the morning dosage is for breakfast, lunch and tea while the evening is for dinner and supper.

The tricky thing now is that I don't really know when the delayed reaction insulin will kick in. If, say I was so engrossed in work or whatever in the evening and manage to only inject my insulin at 9pm and have dinner, then sleep by 12am - I will definitely wake up at 3 or 4am when the delayed reaction insulin kicks in, and that's what I am having difficulty with.

Because I will wake up with the shivers because my blood sugar is low due to the insulin, my instinct will eat and drink to get my blood sugar up to a 'normal' level again.

I don't really know how to describe the feeling to you but I will feel that I have to eat a lot of things so that I won't feel so miserable with the low insulin anymore. And most of the time, I will eat more than I should.

So, the only thing I can do about this problem is to really stick to a strict mealtime plan.

It's really easier said than done, especially when sometimes I have to go out and meet clients and the meetings will drag and I can only eat after the discussion is over.

Well, I guess it can't be helped sometimes.

C'est la vie. =)

Pitter Patter

Yup, you guessed it.

This post is about feet. My feet in particular.

I bought some health socks that I chanced upon at the polyclinic last Monday but I think I may have bought the wrong one. =(

Yes, I have been worrying about my feet for some time now because of the new but not exactly good experiences I have been having with them.

First, there is neuropathic pain. Secondly, I think I am losing a bit of sensation on them. Thirdly, I have been having cold feet which I've not had before. No, it's not nervousness but rather the nerves. Get the joke? No? Nevermind...

It has a lot to do with blood circulation, I would say.

The easiest way to see whether enough blood is circulating to your extremities is to see how fast things are growing. Fortunately, my hair still grows quite fast but that's because I think a lot, so that explains all that hair. And when I had debridement to my right hand the other day, and the surgeon removed some nerves there, a fingernail there did not grow at all for weeks. 

Unfortunately, the nails on my feet have been growing very slowly lately, and my left foot is still a little bit swollen.

Doesn't help too that the graft wound on my calf is taking forever to heal, and that is a worrying sign indeed.

So, that's why I bought those darn socks but today I realized that although it was marked as a medical sock and I presumed there was 35% of the silver X-static fiber - apparently I was wrong and I think I may been misled by the information put up at the polyclinic.

The one I bought (MS04-MGL) only has 14% of the silver fiber and I only realized it after reading it on the official website and after retrieving the box from my rubbish bin. I did not read the fine print at the back of the box where it is stated, apparently. =P

But anyway, good news is I got it at a discounted price of S$32 (website price is S$39.95) and the silver fiber apparently works and it has sort of cleared the eczema on my feet.

This is due to the fact that according to the website -

X-Static® offers both anti-microbial and anti-odor performance by inhibiting growth of bacteria and fungi, and it neutralizes ammonia and denatured proteins. Bacteria are only one cause of body odor. Ammonia and denatured proteins are also significant contributors to odor. Incredibly, both ammonia and denatured proteins bind most readily to silver.

Because silver is on the outside of the fiber, X-Static® allows for immediate binding with ammonia and denatured proteins – resulting in instant odor reduction.

Well, I guess I have to buy the one meant for diabetic foot care because it is supposed to promote blood circulation and that's my primary objective ya.

It is way more expensive at almost S$70 but I guess I don't exactly have a choice if I still want to walk around with my own feet for a long time. It'll certainly be worth if, if it helps to prevent any complications to my feet.

Obviously I can't just rely on the socks alone but it has got lots to do with having a tight control on my blood sugar, washing my feet carefully and inspecting them for anomalies every single day without fail and to go to the doctor at the first sign of infection, and to not walk barefoot anywhere, even in the house.

It is really depressing to see those amputees being wheeled around at the hospital, and it scared me silly last Saturday when my father said he just received news that my auntie's husband also had just got one of his feet amputated due to diabetes. =(

So, for now my strategy would be trying my best to improve my blood circulation and of course the first step is to make sure I have enough exercise, and this is important for circulation and general health. I will try to walk as much as possible whenever I feel fine, and in the long run maybe I should go for acupressure and acupuncture sessions at the TCM shop. So, Marko - we will discuss about this ya?

Pray for me.

=)

I Can't Believe I Am Actually Entertaining Thoughts Of It

In a futile attempt last night to reset my body clock and sleep early, I ended up with only 3 hours of sleep. It was an epic fail, to say the least.

Man, that sounds especially fatalistic (not even sure if this is the correct word) to someone who's usually optimistic like me.

I couldn't sleep the whole night, no matter what I did, and finally settled down roughly at 7.30am after an hour of music and an hour of computer gaming (yes, I actually ran out of ideas). I thought music could calm me down and gaming would wear me out but I think I slept due to the fact I've been sleeping at roughly 6am for the past few days. It was just my circadian rhythm. It was late by one and a half hours today due to the brain stimulation due to the music and gaming.

So, I should be sleeping right now you say?

That's what I thought too but nooooo.... pain in my legs had to wake me up at 10.30am just now and it's the darn neuropathic pain again, the sort of pain which will go on like forever, attacking a particular, random area, coming every few seconds. No matter what I do, there's no way I can close my eyes and drift to sleep when this kind of pain comes.

So here I am, typing this stupid entry (I will go back to editing Jacqueline's wedding photographs after this) because it is of the rare times I feel defeated and wishing for all this to end.

Yes, I was actually entertaining thoughts of suicide the past hour.

=(

A Time & A Place For Everything

Ok, I am actually talking about the need for regularity and an almost regimented lifestyle, for me at least. =(

Anyways, good news at the polyclinic just now. I did not need to see the doctor and was instructed (by the queue number generating machine, no less) to head straight for the dressing room. I wish 'dressing room' here referred to the ones you find at boutiques 'cos I love to shop but no such luck today... 

Within 15 minutes (when usually the wait is usually more than an hour to just see a polyclinic doctor), my number beeped and I was relieved to see the nurse who attended to me before. She's nice and friendly and gentle. =P

"It looks good!" she said, almost sounding like she was complementing on something I was wearing or a dish that's presented well, as she peers into my graft wound, which yes, looked much better than it looked last Friday. There was a little bit of slough left and the redness was gone. I don't even know what a slough is honestly, and asked the nurse to spell it out for me (http://medical.merriam-webster.com/medical/slough). There is still some throbbing pain though, I told the nurse, albeit not as much painful as it was on Saturday evening.

"Have you been avoiding chicken?" she suddenly asked.

The question took me by surprise because Jacqueline was just telling me last week that I should be avoiding chicken but I thought it was some old wives' tale because she added the word 'traditionally', plus the fact that I was served chicken regularly at the hospital after my bypass. 

And I've been eating chicken almost every day.

The friendly nurse chuckled a bit when I told her that, and she added that I wasn't supposed to eat egg yolks too, and anything that's yellow.

Anything that's yellow?

????!!!!

Looking at my blank face, she assured me the last bit was a joke and asked me "My joke funny or not?".

"A bit lah." I said, in all honesty.

And she burst out laughing.

Hmmm...

Anyway, back to the topic of regularity - I have decided it is best to try my darndest to do everything ie. sleep, wake up, eat and work and do them at the same time, every single day, whenever I can.

I am actually sold on the belief that good health has a lot to do with regular sleeping and diet patterns, on the basis that the internal body clock governs the way your vital organs function.

Extracted from http://www.rense.com/general3/heed.htm

SUNDAY (HealthSCOUT) - If you ignore your body's natural clock by working and playing at any time of the day or night, you could set a time bomb for illness, injury and even death, sleep experts say.   "If you don't listen to your body, you will pay the price," says Dr. Harvey Moldofsky, director of the Centre for Sleep and Chronobiology at the University of Toronto.   And the price of ignoring your natural sleep patterns can range from aches and pains to heart disease to chronic fatigue syndrome. A regular bedtime can be as important to your health as stopping smoking or cutting back on saturated fat, says an article in the June 3 issue of New Scientist.   Your biological clock, nestled in the hypothalamus region of your brain, controls what time you eat and rest, the rhythmic surge of hormones, changes in body temperature, immune system activity and a host of other body functions.   Different people have different sleep patterns. Some are morning people while others are nocturnal creatures. Problems arise when you ignore your natural body rhythms to meet the demands of work or family, says the article.   "People who restrict their sleep or are engaged in shift work where sleep becomes fragmented and disturbed are at risk for cardiovascular disease. This has been shown in nurses who have been engaged in shift work over a long period of time. They show an increased risk for heart attacks," Moldofsky says.   Sleep debt can also contribute to depression, and lost sleep creates dangers at work and on the roads, he says.   "Sleep deprivation results in impairment in people's capabilities to operate in their usual, expected way, and they would not necessarily know that they are impaired," Moldofsky says.   "There are a lot of those people in the industrialized Western world who are restricting their sleep time, and consequently are impaired in their thinking and their ability to remain alert, and this could conceivably result in harm to themselves or others," Moldofsky says.

Wow... this for me, will be one hell of a change in lifestyle because I am practically used to working throughout the night, when I need to, and compensate by sleeping an average of 5 hours in the day.

You see, I am doing creative work and try as I might - I don't find the daytime conducive at all for this type of work I am doing. Only when night falls, and with it comes peace and quiet, will I find myself thinking more clearly, and able to focus on the work that needed to be done.

Besides, sometimes I need to meet my clients in town, and so have to do that in the day, and sometimes that can stretch from morning to evening, especially if I needed to run errands and do a little shopping. So, by the time I got back home, it's usually dinner if I did not eat outside, then rest for a while before I settle down to work on the project(s) that needed to be started on.

Oh well.. it's either my health or my professional life now.

Time to hit the papers and surf the Employment Section!

=)

Pain, Pain & More Terrible Pain

Oh my God, I am at wits' ends I tell you.

Just a few days ago, I could not even get to sleep for two whole nights because of the pain.

I did have a few random episodes some time last year but I don't remember them to be as unbearable as this time.

It's not helping too, that one of the graft wounds on my calf is not healing properly. In fact, I think it is infected because the surrounding area of the wound has reddened, and it feels warm to the touch, and since I came back from a day at the beach yesterday - I've been writhing in pain, shooting pain that comes every few seconds on the wound site.

It started with pus oozing out about a month ago and I went to the polyclinic to have it looked and they said it did not look too bad, and thus gave me a week's course of antibiotics (Amoxicillin 500mg twice a day) and then it seemed to clear up after a while but now, for some reason, it came back again.

I am suspecting my circulation is still not that good. That explains why the other graft wounds have healed nicely but the last one on the calf has not, because it is further down, far from where my heart is pumping blood.

I have another appointment at the polyclicnic tomorrow afternoon, and I suspect they will have me go to the A&E department asap, and I am kind of praying for that so that I can be warded and have this wound healed in a better environment, in the hospital. Maybe should ask the doctor about HBOT (Hyperbaric Oxygen Therapy http://en.wikipedia.org/wiki/HBOT). Shall remind myself to do that.

Anyway, back to the issue of unbearable pain - it is basically neuropathic pain due to my diabetes. The nerves are basically damaged due to prolonged periods of uncontrolled, high blood sugar, over a period of time. So, for my case, I have had this unfortunate condition for about 20 years now, since I was 13, and there were times in my life when I neglected my health totally, for some reason, and now I am paying the price.

The neuropathic pain that I am experiencing is not totally excruciating but it's painful enough to prevent me from sleeping altogether. The worst thing is that it seems to occur in random places in my feet and hands. The other day, I could not sleep for two days when the pain started to attack my left foot, coming in short bursts every three or four seconds, continuously. Can you imagine the torture of non-stop pain that you can do little about, in the middle of the night, over a weekend? Nothing helped. I took my regular Tramadol, and Paracetemol but there wasn't any relief at all. 

I was basically in tears.

Then yesterday, my hands started to get affected, and I had to massage my hands throughout the whole journey in the car, when we were on our way to the beach.

It's hard when you can tell people you are in pain but there is no visual indication to accompany your suffering. My hands and feet look fine. So, although you wished people understand your pain, you can't do anything when there are no lesions or cuts or whatever. For me, I don't really expect people to understand what I am going through because there is no way in hell they can unless they go through the same exact thing that I do, and feel the same exact pain that I am feeling, but I do wish that sometimes people can emphatize. =(

In fact, I worry a lot constantly. Although generally, I tend to be positive and try to always see things on the bright side, I really can't help worry about my own future, honestly.

People have always seen me as smiling and laughing, and generally enjoying life but I attribute that as a defense mechanism that I have developed, to give a false impression that everything's normal and that I am a normal, average Joe. More than a few people were very surprised when I told them the whole story of what I am going through now, and what I have gone through since I was barely a teenager.

And I worry about being worried, because it adds to the stress, and stress is definitely NOT GOOD for diabetics, and heart disease patients. Already I am undergoing lots of stress trying to manage the pain, going through a regimented life to keep myself alive, losing some sleep constantly, and suffering side-effects from the current arsenal of medicine that I have to consume a few times a day, most probably for life.

Couple that with having to constantly remind myself about my diet, my need for exercise, my need to work to pay for all these specialist consultations and expensive medicine and medical tests - oh my... 

Oh my...

The only thing that works to help alleviate the pain a bit now is to keep myself occupied - be it playing Operation 7 on the net, or walking about, or cooking and cleaning, or attending to the two stoopid cats. When your brain is occupied with an activity, the pain seems to be much more bearable, almost negligible, like background noise. Something that you know is there but doesn't really bother you if you don't let it.

Well, I console myself constantly by telling myself that the best way is to know what is happening, find out what you can do about it, and arm yourself with all the knowledge you can get about what you are going through, and what possibly awaits, if I don't take care of myself.

Afterall, they say prevention is better than cure.

So, I will do my very best to prevent more complications from this unfortunate condition that I have to bear for life.

So yes, I'll just grin and bear the pain for now, though I hope I can get some relief in the future, like Neurontin (http://en.wikipedia.org/wiki/Neurontin) or something.

=)

A Life Less Ordinary

That's my right hand when they first opened the bandage up for cleaning, after I had to go for a debridement due to an infection I got from having an IV drip plug.

Cool right? I could see right through my skin and down to the cartilage.

Hahahaha!!!

Now, I've a got a 3 inch centipede looking scar on that hand and some loss of sensation on my ring finger.

Damn!

Anyway, it's 8 days to D day.

No, I am not talking about the US presidential election (according to SNL, Obama will win definitely) but my triple CABG lah! Kekeke...

According to Wikipedia -

Coronary artery bypass surgery, also coronary artery bypass graft surgery, and colloquially heart bypass or bypass surgery is a surgical procedure performed to relieve angina and reduce the risk of death from coronary artery disease. Arteries or veins from elsewhere in the patient's body are grafted to the coronary arteries to bypass atherosclerotic narrowings and improve the blood supply to the coronary circulation supplying the myocardium (heart muscle). This surgery is usually performed with the heart stopped, necessitating the usage of cardiopulmonary bypass; techniques are available to perform CABG on a beating heart, so-called "off-pump" surgery.

Triple Cabbage
Huh? Bypass?! What happened? I thought only old people have to go for bypass?

SHHH!!! You ignorant people! Go and take a number and join the line! I'll answer you when it's your turn. Hehehe..

There are still many, MANY people who have very simplistic views about A LOT of things, so it's forgivable. =P

Well, I too once blamed my poor father for my poor health, asking why I inherited a defective gene and all that.

BUT I have learnt, that a lot of times, people with Type I Diabetes may get it due to a multitude of reasons.

My best guess is -

1) I was predisposed to it genetically

2) I was an overweight child and

3) I must have been exposed to some bacteria or virus that made my immune system attack various cells in my body, including insulin-producing cells.

A Turning Point
I can still remember vividly, when I was barely in my pre-teens, a blockheaded 13 year old still reveling in street soccer and hanging out with the boys. I didn't care about studying, managed to scrape through PSLE with a pathetic 226 average, and struggling through Secondary 2 (or was it Sec 1?)

Suddenly, I was losing weight rapidly (more than 20 kg I remember), not eating lunch at the school canteen, was constantly craving for fruits and ice-cream (basically sweet stuff), urinating frequently, and falling asleep as soon as I reached home from school.

Then my father got worried and brought me to SGH (I think) and the doctors said if I was brought in two days later, it'd have 2 days been too late.

??!!!!

ps Do you know that there so thousands of children, some as young as TWO, in the world who have Type I diabetes and have to be injected with insulin everyday like I do?

Moving On
Sometimes it is sad to know that people are not really educated about their own-selves, their own bodies, their own existences.

It's sadder to know that people continue to live in ignorance though.

I must admit, that the human body is an extremely complex mechanism, a design of mind-boggling physical and mental structure. A human organism is very advanced indeed.

The human adult alone has about 10 trillion cells in its body.

It's really tough to also know that diabetes, particularly Type I diabetes, has a lot of complications accompanying it, more so if it's poorly controlled.

All these complications arise from events that happen at the cellular level, a lot of it hard to control because you don't even know what's going on. Some complications only show symptoms when a particular organ is down to its last 40% in function, like kidney disease.

I mean, if you don't study medicine, how would you know these kind of things?! =(

So, a lot of people rely on hearsay, from the mouths of equally-blissfully ignorant people, and form dangerously simplistic ideas about life, and its dramatic tragedies.

THANK GOD FOR THE INTERNET..

... and Wikipedia, of course! =)

Well, even the doctors can be wrong sometimes. I was initially diagnosed as having Type II diabetes and was given metformin, but I guess they performed some albumin or C-peptide test and subsequently I was put on an insulin regime.

I Will Prevail
Well, I am coping better with the thought of having to undergo 6 hours of an open heart operation, thanks to all my wonderful friends and family who have assured me that everything's going to be all right.

I know I am still extremely worried about my current stage of CKD (Chronic Kidney Disease). It is currently Stage III, as in borderline kidney function. Read more about the renal function here...

I am definitely NOT looking forward to having to go for a dialysis of some sort maybe 3 years down the road.

Contrary to popular belief, a kidney transplant is not really the way to go either.

You'll have a really hard time with your immune system trying to fight and reject the new organs, anti-rejection drugs will cause you to fall sick more often and more easily and you have to take these blardy expensive drugs for the rest of your life, and a typical lifespan of a transplanted kidney is said to be 5 years.

Right now, the kidneys don't feel too good. In fact, I have been worried since the renal doctors ordered a coronary angiogram to find out why my heart ECHO shows only 25% LEVF function. In fact, the latest creatinine level in my body was an alarming 267 μmol/L (110 is the normal level for a healthy adult male), after the angiogram. I hope my kidneys don't give out soon. The contrast agent (iodine in this case) used in angiograms have a high risk of rendering the kidneys totally non-functional, and permanently. =(

Well, yes I know the only way to go is to have a positive and healthy mind, to go on a strict diet of healthy food and to exercise but I am currently finding it extremely hard to balance a positive mindset while knowing all these facts about my conditions.

And I still have to contend with people blaming government bodies and pharmaceutical companies teaming up to bleed money, huge amounts of money from the sick public, and rejecting new applications for new studies into new therapies that may hinder these corporations from making more and more money! Gosh! Read more about this here..

Ok, ok, everybody dies. That I know.

The thing is, I am not afraid of dying.

If I die, I will no longer have to bear all this pain and worry and mental stress, and I will know for sure if Elvis is dead or still alive somewhere out there in Vegas and performing to unsuspecting audiences. Hahahahaha!!!

But it will be really nice to still continue to live, be with friends, share my experience, be a living example to many people, while hopefully be in better health that now.

With new and promising experimental treatments on the horizon, like the Islet Cell Transplantation, I really hope to contribute to society by taking part in these clinical trials, all in the hope of cure and prevention of diseases in the human race.

So, there.. I am not in a quest for immortality but it'd be really nice to live long enough to travel and see more of our beautiful earth, meet more nice people (not only pretty girls ok) and make new friends.

Sure I wont be able to eat as much wonderful food but life will be too irresistible for me to compromise for just food!

=)