Thursday, September 21, 2017

Adjusting the system

I had my quarterly check-up on Tuesday, and the results were basically good. There were some adjustments however, including some that should improve things further. Well, that’s the plan, anyway.

I had blood tests this time, and the bottom line is that there’s still a problem. Basically, my HDL (“good”) cholesterol is still too low, though it’s up very slightly. My diet and exercise levels are basically unchanged, so the slight improvement is possibly down to choosing foods that raise HDL, including taking fish oil capsules, something I started taking again only a couple months ago, gradually increasing the dosage.

On the other hand, my Cholesterol/HDL ratio is unchanged, and still too high. The reason it’s unchanged is that my cholesterol and triglyceride levels were up slightly. The test this time was non-fasting, wheras the previous one in March was fasting, and this may account for some of the differences. My next tests will be fasting, so it should be clearer where things stand.

I asked the doctor to change my beta blocker tablet because I felt very tired nearly all the time, and that’s one of the side effects of the drug I was on. When I say “tired”, I mean that I might do something and have to sit down and rest for anywhere from 15 minutes to and hour or so, depending on what I’d been doing. This made me unable to make any progress on some of the last projects organising the house, especially my office: I just didn’t have it in me.

The new drug, Atenolol, is similar to the old one, and has similar side effects, so we’ll see how I tolerate it. This is one of those situations where there are other drugs that would be good for me, but they’re not presently funded by Pharmac, so to qualify for them I have to try every other drug available first and if they all are bad then my doctor can apply to the Ministry for special permission to get the drug. The difference is paying $5 for a prescription or unsubsidised market rates (no idea how much that would be, but obviously a lot more).

The other change was that the doctor doubled my allopurinol dose (to 100mg) because my urate levels are still too high. If I hadn’t had gout attacks, my urate levels would be in the normal range (though upper end), however, I need to have them toward the lower end. Some people, the doctor told me, are taking 600mg a day, though she doesn’t think I’ll need anything like that. The point is to prevent attacks, and I have still been having small ones, so clearly the increase in dosage was needed.

Other than that, things were good: Blood pressure is still well-controlled, weight is still down from August of last year (meaning I’ve maintained the weight loss), and apart from the tiredness, I feel okay physically. It’s just that the tiredness does kind of dominate things. Still, in a few weeks I should know if the new drug is any sort of improvement or not.

And that’s the update on where things are: Basically good, with a few adjustments to things. I can live with that—literally.

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