Ally-gator Scratching for Answers

A few weeks ago, I attended some follow-up appointments at Mass General Hospital (MGH) in an effort to identify allergies that may be triggering an inflammatory response in my body.  In other words, #JustSayNoToKetones, random fevers, crappy BGs, and the typical symptoms of a type 1 diabetic’s response to the dreaded “normal person sick” (NPS).  A WordPress glitch is not allowing me to link to content tonight, but the background to my MGH visit can be found by searching for the blog post “Sleuthing” on verylightnosugar.com.

In April, a scratch test confirmed what we already knew.  I am allergic to the following culprits.  Do not let their pleading-innocent faces fool you in their mugshots!

 

 

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 #WhoMe? #TootsieWithTheGoodFur

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#FreeAceDog

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’16 Bonnie & Clyde

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Scratch test and shoe game

We scheduled more intensive allergy patch testing in June, in which potential household irritants are temporarily placed on the skin to elicit reactions and identify allergy triggers.  I visited MGH on Tuesday, Thursday, and Friday, logging hundreds of miles on my car and refreshing my memory on just how difficult Boston traffic is in the summer.  I averaged 2 hours on the way there and 3 hours on the way back to Rhode Island due to traffic.

On Tuesday, a nurse placed the patches on my back.  She carefully explained each step in order to keep me calm and informed.

“Now I am going to clean the area… Now I am going to dry off the area… Now I am going to place the patch.  It’s like a big sticker… Now I am going to secure the sites with tape… Now I am going to draw around the sites with marker so we can track the reactions and the locations… You may feel a little itchy… Do not get the sites wet or super sweaty… Try not to scratch so we can examine things clearly when you come in again… Call us with any problems…”

“That’s it?  I’m free to go?!”

And off I went for 48 hours of fun.

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I’ve always wanted to say that a crocodile, an alligator, a Great White Shark, a mountain lion, or a bear bit me.  Seize the day, folks.

The sites were a little itchy, but nothing unbearable.  In true diabetes form, my skin was more agitated by the medical tape than anything else.  Eventually I could tell that a baseball cap and perfume overload were not going to cut it; I needed to wash my hair without getting my back wet.

The first attempt in the kitchen sink resulted in me inadvertently mopping the floor with my soaking wet hair.  I moved on to the shower, my back carefully padded with towels and sweatshirts to avoid contact with water, which would jeopardize the test results.  I craned my neck into the stream of water and scrubbed as best I could.  The next day resulted in a “hat day” as well, my hair a total Punky Brewster disaster.  Shout out to the Betes On Tap crew for sitting next to the smelly girl at happy hour.  You are good for the soul.  🙂

On Thursday, I returned to MGH for the patch removal.  A nurse gently peeled off the tape and then the patches, always cognizant of how much her patient was flinching in the background.  The skin is understandably angry after all of that, so a 20-minute waiting period takes place before the sites are examined to allow the skin to cool down.  One of my top ten favorite healthcare interactions of all time resulted:

“Try not to scratch, okay?  I’ll be back soon.”  -Nurse

“Okay.” -Me

*Frantically scratches back as nurse leaves the room*

20 minutes later:

Nurse, lifting patient’s shirt: “Did you scratch…?”

“No…..I mean, yes!” -Me

Now I know how Tootsie and Ace feel: guilty as charged.

Further examination revealed some irritation to certain patches.  The nurse bid me farewell with strict instructions not to scratch at home.

On Friday, I met with the doctor.  The skin irritation had quieted down at that point, and she did not believe that I was reacting to the patches we tested.  Further testing of a wider range of patches was recommended.  TBD what that will reveal… But at least I’ll know how to wash my hair better for the next time.

We also did a penicillin test, which involved scratch testing of the skin, shots, and eventual ingestion of penicillin.  Being a healthcare nerd, I know that penicillin allergies are often misdiagnosed or that patients will outgrow the allergies, and I was hopeful that the one time I broke out in hives and ran to the bathroom every few hours while taking penicillin in college would be a fluke.  It was.  Your girl is free to take the antibiotic again, which is nice to know in case of any serious infections in the future.  Now to update my MedicAlert bracelet!  I will bask in the glory of removing a medical jewelry condition rather than adding one this time around!

I took everything in stride the week of the appointments, mostly because of the superb care I was so blessed to receive at MGH.  The appointments ran on time; I was seen by an expert in the field; the nurses were considerate and thorough; the receptionists were friendly; a volunteer greeter walked me to the elevator I needed; just wow.  From the moment I stepped foot in the main lobby at MGH, I was treated respectfully.  I was not just a patient.  I was a human being.  Just like everyone else in the building.  This is a welcome change from some of my experiences at other facilities, and I urge those clinics (you know who you are) to take a page out of MGH’s book.  There is a reason why MGH is repeatedly numero uno.

The following week, exhaustion and burnout reared their ugly heads, and I was just… done.  Done with diabetes, with healthcare, with publicly sharing my health story, with traffic, with pretty much everything.  I wanted my privacy and my identity back- to not submit myself to one more needle poke or to being a patient incessantly pingpong-ing around the healthcare system.  Alas, after lots of sleep and lots of time spent in good company, I can see the light more clearly this week.  I am extremely fortunate to live near Boston and to receive topnotch care.  It is okay to be tired.  But I have to keep going, not allowing health woes to take over; rather, to know that I am trying.  We all do this because we have to.

Goodnight.  Don’t let the scratch tests bite.

-Ally-gator

 

 

 

*My condolences to those mourning the loss of friends and family members from the diabetic online community this week.  I hope that this blog post provided some comic relief, but on a more serious note please know that you are all in my thoughts and prayers. 

#weneedacure

 

 

 

 

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Sleuthing

This week I exhaled and sent an email to my doctor, the opening line reading, “Today was so hard.”

It is unlike me to show that much vulnerability upfront, but I was exhausted. And, if I am being totally honest, the past few months have been so hard.

Please trust me that this is more than the typical “diabetes rollercoaster” term used to describe the highs and the lows inherent to living with diabetes. Heck, it has been the diabetes “Tower of Terror.” Blood sugars were thrown into the spiraling abyss of lows in early 2016, only to ricochet back up into the stratosphere, seemingly unscathed by my defensive insulin jousts this spring.

For most of my life, I have known this truth: There is a “great unknown” affecting my diabetes. As a young child, I would be fine one minute, building couch cushion forts with my siblings, and the next minute I would be covered head-to-toe in a rash.

I recall being about eight years old and lifting my shirt to see large, circular patterns of hives all over my abdomen. My limited reference point at that time was the worst case scenario discussed in Catholic grammar school. This was clearly modern day leprosy in a suburb north of Boston! I tipped my head back and screamed at the top of my lungs.

Mom reassured me that although hives are unpleasant, I was not dying. This outbreak was no match for an Aveeno oatmeal bath. Do they still sell that stuff?! Magic!

I developed blistering rashes on my hands and fingers, an itchy-then-painful contact reaction. Contact with what? We still do not know. Anything and everything could be the trigger. As an adult, this occurs less frequently, but still happens from time to time.

There are other vague symptoms much like those described in this articulate New Yorker piece: low-grade fevers, allergies, stuffy nose, scratchy throat- that general sense of feeling run down but not sure exactly what is wrong. All of these factors send my blood sugar (and ketones) soaring, due to the obvious biological response to inflammation/bodily threats.

While you may be reading this and thinking, “So what?,” I assure you that I have spent years asking the same. In acute instances, this stuff seems trivial. But long-term, the sum of the symptoms is messing with my overall health. I have worked so hard to rewrite my diabetes management with multiple daily injections, to push the limits of my anxiety and to experience more freedom as a result, and to play by the diabetes “rules”.  Therefore, I will not allow this undefined immuno-gobbledygook to strip me of my health and dignity.

Because no doctor has time in a half hour appointment slot to put all of these puzzle pieces together, the puzzle has laid strewn across the table, unfinished, for decades now. Perhaps it is seeing the CGM graphs with more yellow (“high”) than I would like to publicly admit, perhaps it is the struggle to get through adult responsibilities each day when feeling like a fatigued zombie, or perhaps now is simply the right time.

Whatever it is, I am ready to connect the dots, with the help of a qualified healthcare team. We will become the Sleuths of 2016, our magnifying glasses polished to uncover clues along the way. Inspector Gadget and Harriet the Spy will have nothing on Boston physicians- I guarantee it!

In a few weeks, I will attend my first appointment with a renowned immunologist at a Boston hospital. The receptionist forewarned me that an allergy scratch test is imminent, and friends in the autoimmune world recounted lots of blood draws. Although my symptoms may not meet a diagnosis standard, they still exist. While my hope is that the doctor’s investigatory work rule outs any major problem, I also fear not having a real answer. Actually, I mostly fear not having a course of action.

Best case scenario: It’s not modern day leprosy, I’ll live, and this is how we’re going to treat this immuno-gobbledygook so that it no longer wreaks havoc on my blood sugar. The End. Happily ever after. Puzzle fully pieced together into a picturesque Thomas Kinkade image.

Then I will send my doctor an email, the opening line reading: “Today was so good!”