Blood Test Results

Last Friday, on my much-needed day off, I headed over to the naturopath for my follow-up appointment.

I went in full of questions and left full of things to think about.

First of all, I got my blood work results back. After complaining about fatigue, I had been sent for the following blood tests:
- iron
- ferritin (think of ferritin like my iron stores)
- vitamin d
- vitamin b12
- thyroid

Being low in any of these things can result in fatigue so it was worth checking out. I figured I'd be low in iron, low in ferritin and wouldn't have been surprised to find out everything else was low too.

Instead, my iron was fine, my ferritin was fine, my vitamin d was fine, my thyroid was fine and my B12 levels were the highest he's ever seen in someone who is not getting B12 injections.

Well wasn't that nice to hear on a cold Friday morning in November? I asked if I was too high and he said no. Just higher than he is used to seeing. I asked how that was possible since I don't take extra B12 or do anything special to try to get it in my diet. He said I might just be absorbing it really well from my VEGA powder or my multivitamin. Whatever the reason, the blood results were fine which means I have a few less things to worry about.

He then told me that he thinks he figured out that weird thing that happens in my ears when I run. He said it was called 'exercise-induced eustachian tube disfunction'. A long name to be sure but it's not dangerous or problematic. On the other hand, there isn't much we can do to prevent it from happening either. It happens when I run for over an hour and goes away when I stop running. If I start up again, it comes back almost immediately. In my body's struggle to deal with it, it also affects my breathing and I find myself gasping for breath for a few minutes once I do stop.

(For the record, I googled it when I went home and read all about it. Sounds exactly like what I am struggling with. My GP, diabetes doc and my ear nose and throat specialist couldn't figure it out - I'm impressed my naturopath did and that he did it so quickly.)

So I have a diagnosis for my ears and confirmation that my blood test results were good. So what's up with the fatigue you ask?

Here's where things took a turn and I left the appointment with a lot to think about.

"Eustachian Tube Disfunction can sometimes be related to food allergies. So can unexplained fatigue. You're probably not going to want to hear this but I'm going to recommend you try an elimination diet to see if you have any food allergies."

What??!?

He talked about the four most common food allergies (dairy, wheat, eggs and soy) and suggested that, ideally, I would eliminate all of them from my diet for six weeks and then reintroduce them one at a time. "If you're not willing to do that, at least try wheat and dairy."

Bleh!

I drove home and thought about it. I told Doug what the doctor suggested and we talked about it. I thought about it some more.

Pros: if I really do have a food allergy, doing this might help me identify it, make changes to my diet and feel better overall. Not that I feel bad - I just have ears that plug up on long runs and I personally think I'm more tired than I should be given the amount of sleep I get.

Cons: I turn my diet upside down for six weeks. Just in time for Christmas. I wouldn't be able to eat out (easily anyway), I'd have to rethink every meal I eat, I'd be the most annoying dinner guest ever (did I mention Christmas is coming?) and I'd be pretty annoying to live with because every meal would potentially involve two meals and a lot of discussion to ensure all my allergens are avoided. And for what? I have no other reasons to think I have food allergy so it could all be for not.

I did think about doing it after Christmas but we're traveling in February, spending a week with friends, and doing things throughout the year that would never make it easy to find a six-week chunk of time where I can eat every meal at home without too much fuss.

Don't get me wrong. If I had a legitimate food allergy, I'd make all the dietary changes I needed to make to be healthy. But, because all of this is hypothetical, I'm really hesitant.

So, after a weekend of thought, I emailed my naturopath. I said I would continue with everything else he recommended, I'd increase my veggie intake, perhaps cut down, when reasonable, on my wheat, soy, eggs and dairy but I would not be doing the elimination diet at this time.

I felt both relieved and disappointed as I hit 'send'. I also felt like a tiny bit like a jerk since I went to him for advice but didn't take it. It is, however, my life and, ultimately, I need to make the choices that make the most sense for all involved.

So I did.

A Naturopath Report

Last night, after work, I headed down to a small little house with a sign out from that, among other things, confirmed that I was at the right place.

For better or for worse, I was about to head into my first naturopath appointment.

I wasn't sure what to expect but I had some pretty good ideas of what I did and did not want.

I did not want to be told to dramatically change my diet, to give up sugar (wouldn't that be a neat trick for a type 1?), red wine, chocolate, my morning coffee etc etc.

I did not want to be told that I need to take a bunch of weird smelling herbs and tinctures at every meal to balance my chakras or realign my feng shui.

I did want someone who understood type 1 diabetes, the challenges of eating properly to fuel all the activity I do. I wanted someone who would listen to my list of issues (fatigue, ear plugging weirdness, lower than ideal bone density) and work me me to see if there are things I can do feel a little better, a little more energized and a little less prone to breaking.

Guess what?

I got it!

We chatted for an hour and a half and didn't even get to everything. He had obviously done his homework and asked intelligent questions about diabetes, continuous glucose monitors, insulin usage etc. He even laughed at my subtle diabetes jokes that only people who get it would laugh at.

He listened to my concerns and suggested some blood tests based on what I said. I was handed a requisition form to have my ferritin tested, my B12 levels, vitamin D and thyroid. Things I have either never had tested or haven't been checked for in years.

He thought I might have difficulty absorbing minerals (iron, calcium etc) and suggested a digestive enzyme test for a few days. He gave me some samples to try and I am to report back at my next appointment as to how things felt.

He suggested a tablespoon of fish oil in my breakfast shake which is an antioxidant and will help reduce inflammation. He promised that it doesn't taste like fish. "More like lemons" he insisted.

He suggested vitamin K2. Vitamin D helps the body absorb calcium but Vitamin K2 is important in helping get the calcium from the blood into the bones. "Like how insulin gets sugar from my blood to my muscles?" I asked. "Exactly!" was the response.

Finally, he suggested Vitamin C with bioflavenoids. It's an antioxidant, improves collagen production (which helps strengthen bones) and improves immune function.

That was about the point when I asked for tips re when to take what. Iron shouldn't be taken with anything else other than vitamin C. Calcium and Vitamin D should be taken together - ideally not at meals. Vitamin K2 should be taken with a meal. It gets tricky.

We talked about what to take when. I got my blood work form. I booked a follow-up appointment in a few weeks and I promised to email a week's worth of food diary info. "Everything I eat and drink? Even Dex 4s and 3am fig newtons?" I asked.

"Everything" he said.

Right-o.

The only thing that didn't get resolved? My ear plugging thing. I described it, he asked a ton of questions. At the end, he was just as perplexed as every other doctor I've spoken to.

"Let me do some more research" he said.

Next appointment is November 22nd. Stay tuned for blood work results and a report on how well my digestive enzymes are doing.

If You Ignore It, Sometimes It Goes Away

Some people deal with things by not dealing with them.

They go shopping to forget about the fact that they are in debt.

That sort of thing.

I try not to do that sort of thing.

Dealing with things head on is my strategy of choice for most things.

On Saturday night, I was folding my running clothes that just came out of the laundry when it occurred to me that I had not thought about my foot all day.

That may not be odd for most of you. Feet really aren't that fascinating. I'm sure a lot of people did not think about their feet on Friday.

But it is odd for me.

Odd because I have only recently recovered from a stress fracture in my foot. I am hyper-sensitive to anything to do with it now. I think about my foot when I get out of bed in the morning. When I decide what shoes to wear. And certainly I think about it during runs.

I pay attention to how it's feeling. Is there pain? Are there aches? Is it stiff?

On Saturday morning, I ran 20k. And on Saturday night I realized that I had not paid attention to my foot when I woke up. When I got ready for my run. When I ran for 2+ hours. When I stretched and when I showered. I also didn't think about it during the afternoon golf game that Doug and I played.

I only thought about it when I saw my running clothes after dinner.

Why was my foot ignored all day?

Because I was paying extremely close attention to my ears. After the annoying ear-plugging session that happened on a long run a week earlier, I was super-focused on figuring out the cause and finding ways of stopping it from happening again.

I drank tons of water on Thursday and Friday in an attempt to ward off dehydration. I drank before my run. I made myself drink every 10-15 minutes during my run. And I focused all of my attention on my ears. Did they plug up? Both ears at the same time? When did it start? How bad did it get? What was my heart rate and blood sugar when they started plugging? Etc etc etc.

Which meant my foot was completely ignored and able to go for a run without constant supervision...for the first time since May.

Turn out that not dealing with a problem is sometimes a very effective way of dealing with it.

For the record:
- my ears plugged up a bit but didn't get nearly as bad as the week before
- my foot didn't hurt at all during or after the run
- my blood sugar was 4.8 before I started. I ate a banana and a GU gel and did not bolus for it. I also didn't change my basal rate. I was 14.4 at 7.5k, 10.6 at 15k and 6.5 at 20k.
- my heart rate hovered around 165 bpm which is 85% of my max
- I tried a new anti-chafing product and did not chafe at all...except in the one spot I forgot to apply it. Sigh.