Getting Rid of Plantar Fasciitis

I’m really sick of my feet hurting.

I recently stopped taking Meloxicam, which is an excellent NSAID that helped me get through walking in THREE 5k’s within a week of each other the beginning of September.  But I was having all sorts of weird gastro-intestinal issues, so I started phasing things out that weren’t needed in the hopes of getting my intestines and stomach back to reasonable performance. My gut has settled down quite a bit over the past couple of weeks, so maybe it was just a prescription drug cocktail problem (of my taking Meloxicam on top of Metformin everyday) and not the dreaded gluten allergy/celiacs issue. Jury is still out on that one, and I’ve done nothing yet to pursue testing that possibility.  One thing at a time, people.

Back to my current pains…last weekend, I was limping along after sitting down too long (joints get cold, stretch the inflamed fascia back out, pain ensues), and I mentioned my foot pain to a family member who’s in her 60s and has had foot problems as well. She said, “Oh, plantar fasciitis? Well, at least that will go away.”

I very quickly corrected her. I’ve had plantar fasciitis since 2005. Closing in on 9 years now. I’ve done a plethora of treatments – shoe orthotics, physical therapy, night splints, tens unit stimulation, cortisone shots, acupuncture, NSAIDs, pain creams, lost weight, never go barefoot, never wear shoes without arch support, and my wonderful husband gives me a foot massage almost every night. My. Feet. Still. Hurt. And hurt terribly 80-90% of the time. Even worse when I over-work them by walking a lot or being on my feet for too-long stretches.  I don’t think it’s going away anytime soon. Is it because they always stay inflamed because I have such crappy circulation in my feet and they can never seem to heal? Is this one of those “stupid diabetes” things?

The sad thing is, I want to exercise more, and my favorite forms of exercise involve walking and hiking. I’d love to someday actually *run* some 5k’s instead of walking them. Sure, I know I could do an exercise bike, or go swimming, but they are just not my favorite, and it’s tough to get motivated to do something you really don’t enjoy, when that will take valuable time away that you could spend with your family, your friends, or doing 8,000,000 other things that you’d like to do.Stupid feet.

I’m still up in the air about subjecting my feet (and blood supply) to the questionable PRP – Platelets Rich Plasma treatment that my podiatrist has mentioned. But really, I’ve sort of run out of options. Staying on NSAIDs indefinitely is NOT feasible, even though my feet felt the best they have in years for the 2 months I was taking Meloxicam. Granted, I still had *some* pain, but it was on a scale of 2 or 3 instead of 8 or 9.  Having pain every-single-day, on top of dealing with diabetes crap, really wears me down (despite the demeanor of happiness and positivism that I try to keep up as a good front for the people around me. I don’t want to be a Debbie downer.)

I’ve taken the stance that no matter what, I just have to keep on going. But I would love to hear from other diabetics that have had issues with plantar fasciitis – and even moreso, would love to hear from those who have suffered with it for years but then finally found relief. Please, someone, tell me the secret!

A Post of Gastronomic Poop-portion

I’m sort of embarrassed to be writing about this (and trust me, it takes a LOT to embarrass me!) but I’m thinking I need to go to the doctor about my poop. There, I said it.

Poop has become a common word around my house, it’s just, we usually talk about my daughter’s poop – considering she has been potty training for a couple of months now (“Yay, you pooped in the potty!!!!), and even as a baby, pooping was a very important occurrence to track. I cannot tell you how many times I’ve talked about poop over the past 2.5 years, and just last night, during a wonderful home-made stir-fry dinner, I talked about poop with my neighbors, and a girl I’d literally just met. No topic is taboo over dinner, apparently. None of us were grossed out. Poop-talk is that common.

This always makes me giggle

You can have your own jelly bean pooping bear! (click on image to go to site from whence said photo came)

But my own personal poop? Not that common. I’m lucky if I poop a couple times a week on average. However, in the past 3-4 months or so, I’ve noticed an alarming change in my poop cycles. I’ve been going more often, and they are usually not pleasant. They are not the bastions of solidity that I am used to. They are odd colors and consistencies. They are many times urgently required to happen, if you know what I mean.

I’ve asked my endocrinologist about it, as well as my OB/gyn. Neither of them seemed particularly concerned. I’m taking Metformin, and that supposedly has the side-effect of stomach upset. But I’ve been taking that for years now, and these poop problems just started a few months ago.

This past weekend, I had a new side effect: feeling nauseous after eating lunch, and then an overwhelming fatigue that hit me like a Mack truck – so hard that I was forced to take a mid-day nap (I have NEVER been a napper, except for when pregnant, and no, I’m definitely not pregnant) and I slept for 4 hours. Even after the nap, I was still dragging, went to bed at my usual hour, and slept for 8 hours. A humongous “thanks” goes out to my husband for taking over kid-duty 100% and letting me get as much sleep as I did.

Yesterday and today I haven’t felt quite as tired as all that, but I’m still not back to normal. Poops are still weird and gross. The nausea doesn’t occur after every meal, but it seems to be barely there maybe 1 or 2 meals out of the day. I am refusing to do internet searches on symptoms, because I don’t want to self-diagnose myself with the worst case scenario. Could this be something diabetes-complication-related? Maybe. But I’m not going to blame the big D until I know more.

All this poop-talk just to say: I think it’s time I found myself a good gastroenterologist.

Me and My Metformin

(I can’t help thinking I should make up a song with lyrics about “Me and My Metformin” set to the tune of this classic Sesame Street video: http://www.youtube.com/watch?v=sgkYHhG18uc  It was one of my favorite memories from childhood, and shaped my attitude around good dental hygiene, I’m sure.)

As I’ve mentioned before, I started taking Metformin a few months after I had a baby because I was having crazy issues with spiking blood sugars after breakfast that nothing else seemed to fix. Metformin is usually a drug given to Type 2 diabetics, but it appears I have Type 2 tendencies with regards to insulin resistance, even though I am most definitely a Type 1. Best of both worlds. Yay.

What I failed to mention was, it was my OB/Gyn who prescribed it for me. I was seeing my endocrinologist on a regular basis (every 3 months, baby!), but he had never brought it up as something that might help my continuing saga of insulin resistance, nor as something that may have helped with fertility issues. My OB/Gyn started me out on a pretty aggressive dose – 500mg of the extended release pills, twice per day. (I did inform my endo that I was taking it at my next appointment, and he was fine with it.)

Metformin

Metformin (Photo credit: Wikipedia)

Imagine my surprise when our little girl was 6 months old, I had been taking Metformin for about 2 months, and I suddenly realized one night that I was pregnant. (Of course, I had not gone back on birth control after having my daughter – it took such extraordinary measures for me to get pregnant with her, there was NO WAY it was happening naturally. Right?) Several pregnancy tests later confirmed it. We were over the moon with joy, called the OB/Gyn and made the proverbial 8 weeks check-in appointment.

I don’t think I can discuss this right now, but in short, I had a miscarriage. That is not the focus of today’s post, and I just can’t bring up those emotions today. The point is: I believe the Metformin at least “helped” in my ability to get pregnant on my own. Also, having recently had a baby, I’m sure that was a contributing factor to kick-starting my reproductive system. If Metformin could help me have a child on my own someday, we were destined to have a long and prosperous friendship.

My relationship with Metformin has gradually changed over the last (almost) 2 years that I have been taking it. About a year ago, I felt like it wasn’t  as effective as it had been when I first started taking it. I was getting strange overnight blood sugar spikes-and-hanging-out-for-hours in the 200s for no good reason. LOTS of them. On a whim, I tried cutting out the 2nd dose of Metformin that I was taking in the evening at dinner time. (My theory was that the Metformin was possibly lowering my sugar just enough to where my liver wanted to take back control and crank out some extra sugar to get me through the night.)  Magic happened! My sugars regulated back to overnight happy places between 90-120.

Things have been great with Metformin over the past year  (A1c’s have been consistently in the 5.9-6.3 range) until recently, when the dreaded post-breakfast blood sugar spikes have started up again. A couple of days ago, I tested another theory and didn’t take the Metformin at all. I had a TERRIFIC blood sugar day, with numbers on my Dexcom showing between 65-140 for an entire 24 hour period. No-hitter day!!!

…and then yesterday I tried not taking it again (see below.) Looks like I’ve got some work* to do with me & my Metformin. Dexcom Sans Metformin, Day 2(*Post Update -the “work” is what Scott mentions in his comment to this post – it’s tough to be patient and realize that ANYTHING could be causing weird blood sugar issues, and a couple of days of numbers isn’t really a good litmus test when you’re working on a theory. Oh, and I mention this in the About section, but ya’ll know, I am NOT a doctor or medical professional of any sort, so please don’t change your medications and what-not without consulting your own medical team of experts.)

UPDATE as of 5/29/2014 – A year later, and I am still taking Metformin daily. Not sure what that weird hiccup was, but taking Metformin out of my daily regimen of diabetes management was not in the cards. Overall, it’s been a “good” diabetes year. My A1Cs have been below 7, and while there are always the occasional WTH high or low sugar days, I feel like I’ve been swimming along, and swimming well. Let’s keep that up.

Trust Me, I’m a Type 1

Since I broached the topic of weight issues yesterday, it’s only fair that I set the stage now for many blog posts to come. It’s been almost 19 years since my diagnosis as Type 1, and I’ve gone from a healthy and comfortable weight in my roaring 20s, to being an honestly overweight 40 year old. I accept that true lack of diligence on my part has added extra pounds. For those of you who have not yet made this transition – our lives and our bodies change dramatically in those 2 decades between 20 and 40. Consider yourself warned.

I don’t want to point the blame at anything but myself for this steady weight gain that I’ve had over the years, but let’s be rational and look at what has changed for me in 20 years, and what has helped contribute to my current state of unacceptable BMI:

…at age 20, I took Accutane to get rid of the awful cystic acne that plagued me since the beginning of puberty. You are required to go on birth control pills while taking it (because it WILL cause birth defects), and my ob/gyn recommended I stay on them to help retain my fertility (I’m sure I will tell more jokes about this later. Looking at the side effects, did accutane cause my diabetes?? A question  to ponder in another post….)

That horse was HUGE!

Ahh, the roaring 20s!

…I took said birth control pills for 15 years. There is conflicting information about whether or not birth control pills make you gain weight. I personally believe that anything that synthetically whacks out your normal hormonal system is bound to have some adverse systemic effect.  Most women report an average of 5 pounds gained each year on birth control. You do the math.

…once I got out of college, I got a job. Sitting down in front of a computer all day. It took more effort to exercise than ever before, and thus, exercise fell by the wayside in lieu of making money to pay off college loans, and spending time outside of work socializing with friends and dating.

…over the years, I’ve become more insulin-resistant, very much like a Type 2. I have taken Metformin since having a baby to help with some crazy sugar spikes, and slightly reduce my insulin requirements. As we all know, more insulin = more weight gain. (more thoughts on Metformin in future posts…)

…I got married at last when I was 35. I was happy and eating out a lot more than ever before. (But yay, I have an awesome husband! He loves me no matter what I look like, and has supported me more than I ever dreamed was possible.)

…and we started trying to have a baby. I had fertility issues. I took crazy amounts of fertility drugs for 3 years, went through several rounds of IVF. Stress. Emotional roller coasters. More weight.

…after much heartbreak and hope, I had a baby! Add on baby weight. (This weight I carry as a badge of honor. I freaking had a BABY!! I will gladly gain that weight again if I can ever have another. )

The good news is, I love my life, and I love all the people in it. I wouldn’t trade the years of struggle with my weight if it meant I wouldn’t have my friends and family that I have now in my life.

I recognize that there are lots of factors that led me to the place I am today – having to work hard to get back to some semblance of that healthy and comfortable weight of my roaring 20s. Most of the people who meet me today and who never knew me in the olden days are a little surprised, and probably think I am lying when I say I’m a Type 1 diabetic. They think that because I’m overweight now, I must be Type 2, right? But I know plenty of thin Type 2’s. And through my ever-growing circle of diabetic friends, I’m meeting more and more overweight Type 1’s. I wish people weren’t so quick to judge. I wish more people were educated about diabetes in general. I wish they would trust me when I say, “I’m a Type 1.”

I tend to crop pics now so you don't see as much of my body. But here, you can certainly see my happiness :)

I tend to crop pics now so you don’t see as much of my currently overweight body. But here, you can certainly see all  my joy and happiness 🙂