Sunday 15 September 2013

Hypoglycemia and Hepatotoxicity, or Excuses Excuses

I'm afraid that, despite how long it's been since my last post, this will probably be a short one. I've been going through some health issues that have prevented me from writing. To start I have been in a lot of pain, so I've been spending a lot of time lying down which is much less painful on my hip joints than sitting up. Anyone who has been following my blog knows that I am awaiting surgery for labral hip tear injuries, as well as joints that have become misshapen and need to be re-shaped surgically.

In addition to this I started experiencing near-constant low blood sugar issues, which can be very debilitating. Now, for those who don't know, hypoglycemia (literally translated as low blood sugar) is not a disease in and of itself. It's always caused by something, and there are numerous things that can cause it. Many diabetics experience it because insulin levels are very difficult to control, and too much insulin causes low blood sugar. I'm not diabetic, however, so the reasons I'm experiencing low blood sugar have been unknown. Through my own research, and after discussing it with a nurse at my doctor's office, the current determination is that my liver function is impaired because I'm ingesting too much Tylenol (acetaminophen). The dosage of gabapentin (a neuropathic pain reliever, rather than a narcotic) prescribed by my doctor at my last visit was too low, so I had to continue with my Tylenol Ones.

I have not been experiencing symptoms of hepatotoxicity per se, but generally a fair bit of damage is done before the symptoms become clear. Generally the liver swells up and there will be tenderness to the touch that can be completely missed. I know because I've been through it before. I was sent to the hospital a few years ago, very suddenly I might add, having had no symptoms of liver impairment. My family doctor discovered the swelling of my liver upon examination when we discussed my Tylenol intake. Of course, considering my general level of pain even on a good day, I'd never notice a tender liver even if I got slapped in the face with it. Thankfully no one chose my liver to do that with, however. A couple of pokes from my doctor was enough to tell me there was an issue.

The joyful note to this is that the liver is the one organ that can regenerate itself quite nicely. Once you've stopped poisoning it, it's content to get on with rebuilding itself. In fact, partial liver transplants have become the thing nowadays. They can put a piece of a liver into someone and it will grow into a full liver. The donor who loses a piece of theirs, will actually grow it back. Wonderful organ. It has to do with stem cells, and the identical mechanism that is used by salamanders when they grow back a tail or limb. Science is currently looking into ways for us to regenerate our other organs, which will be a step in the right direction rather than having to do transplants. Unless you have a faulty liver to begin with, there's quite a bit of damage you can do to your own before you hit a point of no return. Since no one has any idea where that point is, however, it's not advisable to push it. Believe me, the feelings of having your liver not working properly, and the symptoms of low blood sugar, are nothing that anyone wants to experience on a daily basis.

So, what are those feelings and symptoms? Well, with low blood sugar there's blurred vision, full-body tremors, sweating, headaches, etc. Those are the mild and moderate symptoms. Severe ones include seizures, coma and death. Not a state I recommend to anyone. Impaired liver function, before you get to the jaundice and swelling and bloated abdomen, are things like nausea and exhaustion. You can imagine that I don't spend my days in a state of comfort right now.

All's well that ends well, however, as I've got my follow-up appointment on Tuesday at 10 AM. I'll get the increased dose of gabapentin and have acetaminophen out of my life for good. I still have to take some of it until then, but I've cut it back drastically. Taking it makes me feel pretty sick now, so it's a toss-up with juggling the pain issues. I can't take NSAIDs at all, so aspirin and its ilk are out of the question for me. The even better news is that I will likely have my first surgery scheduled pretty soon, and that means I'm on the road to no longer needing pain relief at all, which is exactly where I dream of being. My life awaits!!

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