Specialists -- Ha!
Mon., February 12, 11:18 AM
This tired business is getting on my nerves -- really. I'm often too tired to read diaries, and that truly is annoying. Being the person I am, I have been analyzing it. Could be mental -- oh, yeah. But it could also be physical. One thing I know for sure is that, when you have uncovered a lot of causes, none of them is the root problem and you have to dig deeper.
I went to sleep around eleven the other night and slept right through till seven the next morning. So what, you say? Well, I had taken a two-hour nap that afternoon, and I needed another the next day.
So I have mentioned fatigue to my doctors, because there is always a possibility there is something I haven't noticed. In addition, it could be a reaction to one of the medications I take. (Including Ar1m1dex, which has not been in use that long and is showing some unpublished side effects.) Both my primary physician and my oncologist cite a low red cell count. They know I have HHT but, y'know, they have never seen one of my major nosebleeds in progress. I'm not sure they believe me. I have spent more than twenty years knowing that, if I increase iron in my diet, there will be more nosebleeds.
It was at this point that I remembered something one of my high school teachers said: "As you pursue higher education, you learn more and more about less and less." He was talking about master's and doctoral degrees, but it is even more true about medical specialities.
Personally, I am a generalist in a world of specialists. I know only a little bit about a lot of different things. The one subject on which I may be a specialist is the reaction of my own body. Get the specialists to believe me.
So my regular doctor sent me for endoscopies, not looking for cancer this time, but for internal bleeding. I think I would have known if that were happening. In any case, there was not a sign of it. A couple of months later, I had to explain to the oncology staff that, no, I wouldn't do an occult blood test because I had clean endoscopies, both upper and lower. (Unfortunately, since the HIPPAA privacy laws went into effect, specialists do not automatically inform the other doctors.)
The oncologist and I got into the old discussion about red cells and taking iron, and he quoted a rather low reading, even for me. No, I would not take iron pills; I would try to eat more eggs and meat. He seemed surprised. How about spinach?
I answered, quite honestly, that I like spinach and eat it a lot. But I almost laughed; he's an oncologist, not a nutritionist. I did not tell him that nutritionists have some reservations about spinach as a source of minerals because its oxalic acid content hinders absorption. Why would he know that? I'm not a nutritionist either, but I remembered something I was told.
Doctor suggested a liquid iron tonic, which appealed to me a little more because you can control the amount of liquid. Have I got a story for him this time! I tried one teaspoon, just a third of the recommended dosage. My nose bled. I waited a couple of days and tried again. Same thing. I ate several foods high in iron as well as some peanut butter, all on the same day. Guess what. But I have an idea that peanut butter might be a better remedy, even if the doctor doesn t know that beans and peanuts are a better source of iron than spinach. Ahem.
In any case, I have addressed one possible physical cause of being tired. It may be a contributor, but I don't think it's the major cause. The mental stuff may be more interesting.
Some time ago, when I was still in chemotherapy, I asked the oncologist whether it could be affecting my eyesight. (I shouldn't pick on him; he is one of the best oncologists in New England. But gee!) He thought it might be an effect of my diabetes, which is under good control. So I asked the eye doctor; he said chemo dries out your eyes and gave me some [useless] eyedrops. They were both wrong. Specialists! I think it was merely coincidental that my eye problems worsened at that time, but I'm the only one who knows it. My mental reaction to it is another story entirely.
Maybe I could sign up for a course in hypochondria. I could earn an easy A.
