It's not Cushing's, I'm just fat.

Well, this month has been a busy one. The first weekend of March, our roommates moved out and headed down to their own home in Georgia. They’re also Navy, so moving frequently and losing good friends isn’t something new to either of us, but I don’t think we realized how much we would miss them after they left. We managed to find a new roommate shortly after they left, but we’d like our old ones back please and thank you.

Since March 1, I have been to 5 job interviews and 1 “shadowing interview”, none of which have panned out (yet). I still have a job, but getting a job with more stability and work would be nice. Not having to do more 1099s every year would be nice too.

I finally saw my endocrinologist after having some massive snafus with the scheduling at the diabetes clinic. I last saw my endo in March of 2015. Three months after I saw him, I began seeing the OB-GYN specialist and I saw her 4 times in a matter of 3 months (I talked about that in my last post). I had an appointment scheduled to see my endo again in October, but since it was the same week that I was doing a lot of traveling and going to my best friend’s wedding, I had to reschedule. My rescheduled appointment was for President’s Day, February 15^th, not ideal, but it was the earliest I could get. We got a “snow storm” which accumulated about 2 inches of slush, so naturally, the clinic was closed. I didn’t get a call notifying me of the closure until I had already gotten into the parking lot of the clinic. Why you call a patient 10 minutes before their appointment to let them know their appointment had been canceled is beyond me. I got a call from the clinic to reschedule my appointment later that afternoon and was rescheduled for April 5^th. Not pleased about the long wait, but it is what it is, so I took it. March 11^th, I got an email from the clinic’s appointment app that my appointment on April 5^th was canceled. No phone call to let me know, no “we’ll call you to reschedule”, nothing. I was mad. I called the clinic and explained what happened. They told me I could get a new appointment in June. Unacceptable. I haven’t seen my endocrinologist since March of 2015 and I needed to see him like yesterday. I needed blood drawn for labs, something I normally have done 3 or 4 times a year. I needed to know what my A1c, cholesterol, thyroid and Vit D levels were. I asked to be put on the cancellation list and the woman on the phone asked if I wanted to be put on the short-notice cancellation list for people who live close to the clinic. I said yes, do that. Hung up phone with an appointment scheduled for June. Wrote and sent a scathing email to my diabetes nurse and pump support group coordinator, as she is sort of the liaison between patients and the clinic. About 5 minutes after I hit “send”, I get an email from the appointment app that I have an appointment on Monday, March 14^th at 11:40 AM to see my endocrinologist. Finally glad to have an appointment in the month of March, I send another email to the nurse, apologizing for my hostility in the last email and ending this one with an equal amount of hostility about why the damn appointment people couldn’t just call me about the new appointment. Talk about frustrating.

Anywho, I finally got to see my endocrinologist. After discussing my A1c of 6.8, which was a TOTAL surprise, but a good one, he mentioned he would like to take my blood pressure again. It was high when I got my vitals taken by the MA (150/84), so he wanted to see if that was just a random thing or if my blood pressure was now, actually high. He took my blood pressure and it had come down, minimally. He asked me if I had stretch marks on my abdomen or legs. He asked if I had a “hump” between my shoulders. Then he told me he was concerned about my rapid weight gain (upon weigh-in before seeing him, my weight was at an all-time high of 220 pounds. This time last year, I weighed 204. The last time I weighed under 180 was in 2012. Yeah, those are painful and shameful number to put out there, so I hope y’all appreciate this), my high blood pressure and the fact that I have Type 1. All of those things put together made him think I may have Cushing ’s disease. He told me I would need to do a 24-hour free urine test to see what my cortisol levels are. I chuckled when he told me he was concerned I might have Cushing’s because being a life-long horse person, I know exactly what Cushing’s is…..in horses. I know what it does to them, I know what the symptoms are, I know what the treatment options can be. But people? Sure I’d heard of it, but I didn’t know anyone with it, nor what the treatment was. It would just be my luck to have the additional auto immune disease that horses also get.

Little sidebar tid bit…horses cannot get diabetes, contrary to what some may have thought. Horses however, CAN end up with Insulin Resistance, a metabolic disorder characterized by a loss of insulin sensitivity at the cellular level. Google “Insulin Resistance in horses” (like I just did) and the first few pages to pop up in that search include information on Equine Cushing’s, Insulin Resistance, Equine Metabolic Syndrome, etc. Is it coincidence that I have been doing horsey things for longer than I’ve had diabetes and yet, here I am, living with potentially one or two auto immune diseases that horses also (sort of) get?

Anyway, back to the original point. Cushing’s disease is a condition in which the pituitary gland releases too much adrenocorticotropic hormone (ACTH). The pituitary gland is an organ of the endocrine system, much like the pancreas. ACTH stimulates production and release of cortisol, a stress hormone. Too much ACTH causes the adrenal glands to make too much cortisol. Cortisol controls the body's use of carbohydrates, fats, and proteins and also helps reduce the immune system's response to swelling (inflammation). Too much cortisol and you end up with fatty deposits, moon face, acne or skin infections, bone pain or tenderness, weak muscles, mental changes, fatigue, headache and more. It’s a bowl full of fun. Typically, surgery is the main treatment, especially if there is a tumor pressing on the pituitary gland.  If I wasn’t stressed about life in general before, I sure as shit was now!

Fast forward to the end of last week, Saturday I think it was. I woke up to an email from the clinic with the results from my urine test. My cortisol range is “normal”. So, apparently, I just have “exogenous obesity”. Excellent -_-. 

Friday, while I was at work I had a pretty uneventful day, well, work related. Shortly after lunch, I starting getting this acute, stabbing pain in my stomach, right where my lungs/rib cage meet up with my stomach. If I sat or bent over in a particular way, the pain would get worse, but it wasn’t unbearable. I WebMD’d the symptom (since I had no other symptoms) and of course I thought I had pancreatitis. WebMD is the worst thing ever. I decided to just wait it out, see if the symptom would go away on its own. I called my mom, who’s a nurse, to ask her advice and see if she thought I should go to the ER. Since she was visiting my brother in New Hampshire, she never got my texts. Hubby and I went out to a movie and all was fine for the most part. On our way out of the theater, I bent over to pick something up off the floor and the stabbing pain came back and I almost fell over it hurt so bad. I have a pretty high pain tolerance, so this was alarming. Breathing hurt, deep breaths were almost impossible. When we got home, I took an Aleve and some Pepto and went to bed, hoping it was just gas. Woke up Saturday and immediately felt OK and thought to myself, ok, maybe it WAS just gas. Then I yawned. Nope. Stabbing pain is still in same spot, not as painful, but definitely still there. Husband asked me if I thought I should go to the ER. I said I’d rather wait til I got in touch with my mom. I texted my brother to ask mom to call me. When she finally did, I explained my symptoms and she was concerned enough to tell me to go to the ER since random stomach pain with no other symptoms is odd, but concerning. Maybe they’d take some scans or blood work. Husband and I went to the ER and it was eerily quiet. But, I suppose a navy hospital on a weekend afternoon around lunch time wouldn’t be super busy anyway. Got checked in to the ER, waited about 5 minutes before a corpsman came out to bring me to a room. The first nurse came in shortly thereafter to take my blood pressure, temp and pulse. She asked for my symptoms and a couple other questions. She asked when I had my last menstrual cycle. I told her that I had just started my cycle that morning. Nurse leaves and another nurse comes in about 10 minutes later to take vitals again since my blood pressure was high. Blood pressure a little more normal now, so nurse leaves and sends doctor in. Doc asks about symptoms and does a very quick exam, palpating my abdomen to see if anything was inflamed, which it wasn’t. No blood work done, no xrays, no peeing in a cup. Doc told me there wasn’t much else to do but wait it out. Since I had no other symptoms (no aches, no temp, nothing out of the ordinary), they didn’t see it necessary to do any tests. Told me if pain persisted or got worse to come back and to follow up with my PCP and endo. Doc left to get my release paperwork and was gone for about 10, 15 minutes. In that time frame, I managed to vomit in the sink in the exam room because my cramps from my period were so bad. I wasn’t nauseous, but the pain was just THAT bad that it made me vomit. This is nothing new to me. I’d been dealing with cramps this bad since I was in high school. Some months aren’t that bad, while others are almost debilitating. I wish there was some sort of pattern and I also wish I had started tracking my pain specifics earlier than I did (I started tracking pain specifics like location, where on pain scale, etc last year). My husband was a little scared that I just randomly puked with no notice, but that’s how it is with me. It just…..happens. I promised him I was fine and that it was due to my cramps. We left the hospital and I spent the remainder of the day on the couch trying not to die.

At the end of February, I had purchased some inexpensive ovulation tests off amazon on the recommendation of a friend and had high hopes for them helping us make a baby this month. Self doubt runs rampant with me, so of course I felt like I messed up the tests or did them wrong or that something is generally wrong with me when only one line (the control) would show up, or the control line would show up and a second line would just barely be there. I also need to be consistent with these tests because my ovulation "schedule" may not be the typical text book 14 days after the last day of your menstrual cycle. For all I know, I could ovulate immediately AFTER my period is over. or right before i get it. I am wondering if I have PCOS, which will make it hard, if not impossible to get pregnant, and with my weight being what it is, it wouldn't surprise me if that's whats wrong with me. 

So, long story short, no December baby for us, at least not this year. In a way, we dodged a bullet that we had previously talked about. Both hubby’s and my birthday are in December, his 7 days from Christmas and mine is 6 days before his. We feared having a baby in December would financially stress us out to the max, so there was a time where we even discussed not trying to make a baby during the month of March. When I got my period in February, I asked him if he wanted to try anyway and he said yes, so we did. We were both sure that because we didn’t want a December baby, that it would just happen anyway, but it didn’t.

August is still 5 long months away and I know plenty can happen in that time, but I still wish I could just talk to my doc about getting started with fertility testing sooner. I also need to bring it up with my mom. Apparently she had her “tubes blown” at some point before I was born (I think), as she brought it up when I was talking to her on the phone after my ER visit. I don’t know why I have such an issue about talking to my mom about fertility, but we’ve never talked about it. I guess I wanted a baby announcement to be a complete and total surprise to my parents and by asking my mom about her fertility, that just kinda ruins the surprise that we’re even trying. Since my husband and I have been married for 5 years now, I’m sure many in our family think we have just decided to not have kids. Not many have asked me (or him that I know of) when we plan to have a baby, so maybe they’re putting two and two together. Who knows. All I know is that I can’t look at my friend’s baby pictures, baby shows, science shows about babies or even pictures of people I don’t even know having babies because they all make me cry. I don’t even know where the tears come from, they just appear and I have a hard time explaining them to my husband. I know my problems are a drop in the bucket compared to some, but it’s still really frustrating to try to get something done for 8 months and have nothing to show for it.