lonely
 

now that i am back to taking the regular amount of medication, i don't seem to be angry but brother am i lonely. a close friend invited me to lunch on sunday but i felt too tired to go so i said no even though i love her company.
i have been going for short walks practically everyday with Robert and his dog Mickey...superdog Mickey whom I love....except for last friday and this friday my cleaning woman Maria who i care for comes twice a week. Robert told me to get an echocardiogram. He thinks i should have made more progress with my exercise with him and the shortness of breath. He already went through the procedure of having two stents put into his heart. He now walks four miles a day and carries heavy stuff. brother am i scared about that. i changed my insurance yesterday in case i need the procedure. I called the woman whom i met on the bus but didn't leave my number. she has it but hasn't called me back. I will call her again after the holidays next week and see what happens. I wish i were in love with somebody but whenever i was in love with somebody it was always a very poor choice and brought unsurmountable problems and pain
bobby

Ekg?
 

Dear Bobby,
I think it is wonderful that you and Robert are walking. He is a good friend. Walking is wonderful with a good companion.

I need to think about this some more.
=-=-=-=
For right now I can say that you do not need to be scared or listen to suggestions from Robert. He can't diagnose you. And maybe he is concerned only because of his own heart issues. Having said that, you do have good access to medical care for tests.

I have EKGs regularly because I am on Verapamil. The tests they do in offices seem to be unreliable. The techs have to do them again and again because the machine is not responding right. Eventually they get a good enough reading to show the doc. Even in the hospital when I went in with chest pains about 5 years ago the doc had to do a series of EKGs over my 24 hour stay. One test (even on good equipment) was not enough. I guess I a saying that an EKG is not going to give a definite answer.
My cleaning lady got a stress test when she turned 50. (She passed she told us :) ) A stress test is an example of a reliable test.
Have your mdoc do a cardiac work up on you if you want.


M.

ohhhh
 

Dear sweet Bobby.

Hear Mari's words.

i appreciate your being scared, but maybe you can reframe your friend Robert's concerns as being more a projection of what he went through, and at the same time an expression of caring... FOR YOU. every individual has their own situation. "progress" is relative, and can be slower or faster. Robert is not on your meds, has a different basic physical situation, and is a man. did you know that men build up muscle mass and lose fat faster than women? it is point blank easier (faster) for them to get into shape.

You are doing great walking with him and Mickey the wonderdog. i am so proud of you. Please be proud of yourself with me. :)

fwiw... i understand your kind of lonely... firsthand. :(

:heartthrob:

love

~ waves ~

an ekg is different from an echocardiogram but both are non evasive. I skipped this afternoon's walk because I am slightly nauseated and chilled and it is freezing out.
I forgot if I wrote that the magnesium and melatonin really appear to be working. I am not longer getting just three hours of sleep. last night i think i got about six hours of interrupted sleep. I wonder if this continues how long it will take for me to catch up on sleep. I also started taking calcium which i should have been doing all along since I am taking metformin.
this thing about loneliness is a real b@tch-i don't know how to deal with it and i have never known how to deal with it. i keep on telling myself that i am part of God and i am not really alone and have never been alone because of that.
Mari I don't know what to say about your husband. His behavior appears to keep away his depression....i think in the past you wrote that he doesn't experience depression. I would chose hoarding over depression any day.
Real estate is still so bad and even though you just moved I wonder if you can look for another place and let him have his own room to fill to the ceiling if need be.
Bobby

echo / electro - cardiograms
 

i think i had always been confused about this... for anyone else who is confused... i looked this up and an EKG (or ECG) is an electrocardiogram. Also, an echocardiogram is sometimes called a cardiac ultrasound.

For more extensive info:

http://www.heartsite.com/html/ekg.html

http://www.heartsite.com/html/echocardiogram.html

thanks for clearing that up, Bobby. :)

~ waves ~

Dear Bobby... some thoughts
 

you mentioned about the sleep, but you hadn't started the calcium yet.

6 hours is decent... i hope it gets you feeling better. i also hope the calcium doesn't interfere with the magnesium (depends on amount and timing). often the intestine tells the tale... i hope this isn't a TMI sort of thing for you... if you get constipated - could be too much calcium, the opposite - too much magnesium. the overall intake (food and supplements) of Ca:Mg should be 2:1, respectively. Since you are taking supplements i would probably have both tested each time you get labs if possible, or every 3 months if your labs are more frequent than that.

i think what you are telling yourself is certainly positive. i am not sure that it will wipe out the feelings. not being alone does not correspond to not feeling lonely unfortunately. and we as humans long for human company. think about it... in Genesis, woman was created to keep man company. we can abstract the "which sex came first" out if you want, but the bottom line is, two were needed. and also think about how we are as animals. we are "normally" made so that procreation requires a mate. it only follows that the instinct to find/have a mate be there within us. in that light your loneliness seems natural.

possibly take it on a moment to moment basis, and not as a life sentence. i try to do that. :o but trying to fight it squelch it out with being a part of God ... i don't think will work 100%. certainly feeling close to God can help you to bear such loneliness, but i don't think this can annihilate it. because it is a different type of being alone. it is not even a bipolar thing. it is the human condition. :o

so what i am saying is this: i think that if instead of mentally trying to "eliminate" or discount the loneliness you feel... you rely on your relationship with the divine to help you bear it, the feelings can be attenuated. Conversely, i think that fighting it head-on, trying to squelch it out, can actually exacerbate this loneliness.

love,

~ waves ~

I messed up
 

Dear Waves and Bobby,

I am sorry that I messed up and confused those two tests.

I had the echocardiogram when I was in the hospital in July. In my head I called it a sonogram.

M.

lol Mari
 

but if you hadn't posted as you did, lil' miss waves here never would have realized they were different! (for all the stuff i know... this i didn't! ;))

so, thank you.

~ waves ~

stuff
 

Dear Bobby,

In the past, times of anxiety for him went along with buying binges.

Since we moved here in August, he has had no buying binges. I'm glad about that. He is more relaxed here. I'm trying to like it here. He loves it. That is good.

He can go to very light depression but more likely to run "up" mood wise. He also has a great deal anxiety that I haven't mapped yet. Perhaps the anxiety runs with the depression. So he is good now.

My role since we met is to help him with the anxiety. Apparently I calm him and I know that he calms me.

I appreciate your post about him.
M.

lonely
 

Dear Bobby,

Does it help to go out and be around people even if you are alone?
That used to work for me for awhile.

I wonder if improved sleep can help with the loneliness -- sounds like a stupid formula (Sorry if that did not make sense). What I mean is that perhaps in some way the sleep might be looking up for you now and maybe other things will start looking up for you too.

M.

I'll write a lot more later. I really appreciated yours and Mari's posts. I have trouble sleeping last night again. rats. I have pernicious anemia ....vitamin 12 deficiency and I take metformin for diabetes two....I started taking the calcium but i just realized i am only taking 600 and should take two capsules which i will start today


I’m not aware of any particular campaign on the part of Bristol Myers to inform physicians on the potential risk of B12 deficiency with metformin use. However, there is mention of this risk in the package insert for Glucophage/Glucophage XR, and it’s recommended in the PI that those at risk for deficiency be screened at 2-3 year intervals. Apparently testing for methylmalonic acid (MMA)over blood B12 levels is recommended by some, but it’s use is still somewhat controversial in the medical community. One theory is that metformin may interfere with B12 absorption; however, it appears that supplementation with 1000-1200 mg of calcium can limit this interference with B12 absorption. As I mentioned in my posting, it’s important for anyone taking metformin, particularly long-term, to talk to his or her healthcare provider about the potential risk for B12 deficiency and the steps one can take to prevent this from happening.

Hey, thanks for all the info in this thread !! :hug:

Bobby, I too think the walking is awesome, and, I think it can only be good for you... You know, the excercise, the sun light... Good ! :)

About your heart exam, I'm praying everything will be alright... Try not to stress and don't be scared.


Take care !! :hug:

hi bobby,
2 things come to mind.
you may know this but it is better to seperate your calcium into 2 doses 12 hours apart if you can manage that, half the day you are not eating or trying to sleep so your body needs it most during those times. I have two forms of calcium, pills and chews depending on my mood.
There is a test that can determine quickly if you have any plaque build up in you coranary arteries. it is called a calcium heart screen. it costs $100 and takes 5 minutes to run it is like a little cat scan of your heart. totally noninvasive. only one hospital in my town had the right equipment to take the test but it was worth every penny for peace of mind.
I think many of us would be friends in real life if we could...I would love to come visit you some day....
(((HUGS))))
bizi

Dear Bobby,

thanks for the extended information re: the actual amounts of Ca and the specific relationship to metformin i.e. B12 malabsorption. i am a bit concerned because the information regarding supplementation is not very multifaceted in a nutritional sense... this is a complex issue.

first, Vitamin D. i'll bet the studies on supplementing with calcium to increase B12 absorption were done on people who were NOT taking extra vitamin D. and most people are way low - even the standard requirements are too low, according to the newer information in the vid Mrs D posted for us some time ago. You ARE taking vitamin D, recently increased to 8000mg. this alone will increase your calcium levels! which by extension should promote the b12 absorption ... (possibly without need for extra calcium.)

taking extra calcium does not imply it should not be balanced with magnesium. taking 1200 mg extra calcium would probably be best if 600 mg Magnesium went with it. if you stick with the 600 mg Calcium daily, that still requires an added 300 mg magnesium, to maintain a 2:1 ratio.

- How much extra magnesium are you taking?

- Do your calcium tabs have any Mg or other nutrients incorporated?

There are the nutritional unknowns, in this too. your diet could be more deficient in one or in the other. And the supplementation needs to reflect that.

Excess (unbalanced) calcium can be detrimental... can cause other problems like kidney stones for instance. Also, if the magnesium was helping you sleep, adding 600mg of calcium might have thrown off the balance... and put you back where you started.

All of this is why i suggested testing the mineral levels.

As for the frequency, the reason i suggested 3 months is only because it takes that long for the plasma levels of vit D dose to stabilize when one changes the dosage. so if you test your minerals now, because you just upped your vit D, they should be tested again in about 3 months. after that less frequently is probably adequate unless you change your supplements.

i hope this helps. talking to doctors... i'd recommend enlisting the help of a nutritionist rather than a GP for this.

i really see a rather limited of mindset in the recommendation to supplement with calcium to offset metformin issues. it seems likely the real point is to increase calcium levels... and as it is, even with the metformin, yours may now be adequate due to your vitamin D supplementation.

:hug:

~ waves ~

calcium
 

Dear Bobby,
You already know so I am posting for others.
If one does take calcium, it is better absorbed if one takes vitamin C (or fruit) with it.
Iron supplements interfere with Calcium -- best to take them at different times.
http://www.niams.nih.gov/Health_Info...lcium_supp.asp

Lots of people are taking this med for blood sugar control (brand names Glucophage, Glucophage XR, Fortamet, Riomet, Glumetza, and others).
I wonder how many doctors are testing for B12.


M.

loneliness
 

Dear Bobby,

I wish you felt better about your tdoc. Do you have a social worker?
Maybe you can find activities that will bring you to other people.
Have you considered something like that?
M.

are you sure that extra vitamin d would be an adequate substitute for all that calcium. I think now a lot of doctors are aware of people's deficiency in vitamin d and having their clients take supplements. I don't know if there is a raise in pernicious anemia since metformin has been on the market.It is alll so confusing
Love
Bobby
I just ordered 1200 miligrams of magenium. last nite i didn't sleep

hi there
 

Dear Bobby,

sorry if my post was a mess.

Sure? no. there is no way i can calculate to what degree the vit d increases your level. but also when one takes heavy supplementation, the body tends to absorb it less. also Ca supplements are less absorbed if not combined with Mg, Vit D (which you take plenty of) also C and E and b complex are important for utilization. so the reason for those figures - the 1000-1200 is possibly they are bombarding the body due to inefficient absorption. and a recommendation to take such a mineral in isolation just doesn't make sense because it doesn't work in isolation.

the vitamin D however is a big factor, and in the amount you take it i am sure it raises levels a good bit. how much i really can't say. that's why it would be good to have your levels checked. do you perhaps have an old lab that has that data on it, to compare with?

yes but typical supplementation is not at 8000 IU... some "high dose" supps are at 1000 IU... also Vit D is not mentioned with that recommendation to pump up the calcium when taking glucophage which makes me think the people studied were NOT on Vit D supps or it would be mentioned... vit D was probably not even taken into consideration. some docs still consider 200 IU as supplementation ... you are taking FORTY TIMES that! (old RDA was 200... i think the RDA has been upped but not past 1000 that i know of)

that is an interesting question. i don't know either.

Oh dear. :( I hope increasing the Mg helps with that.

A bit of concern here, because 1200mg would quite skew the Ca:Mg ratio (1:1 if you are taking 1200mg Ca). Since you weren't sleeping you might need some extra Mg - more than a 1:2 ratio, but... these are some heavy dosages... i would go up slowly perhaps...

How much were you already taking for sleep? (before starting the calcium)

and yes, i agree with you it is like a cat chasing its tail isn't it. this goes up so that goes up but if you add the other thing then the first goes down and ... :eek::eek::eek: :(

I am sorry you have to deal with all of this. Have you been to a nutritionist before... can you get a referal if not?

love

~ waves ~

vitamin D - reference intake values, from NIH
 

i found the site of the National Institute of Health, Office of Dietary Supplements...

here is the table showing the current Reference Intake (replaces the old "RDA") for Vitamin D:

http://ods.od.nih.gov/factsheets/vitamind.asp#h2

for your age group, Bobby, it would be 400 IU... nowhere near what you are taking... the newer research on the benefits of higher vitamin D serum levels have not yet been integrated - still considered new/experimental studies.

Also, fyi...

Vitamin and Mineral Supplements - Fact Sheets

~ waves ~

Dear Bobby,
 

Here is the journal you already read perhaps about the interaction of Metaformin / B12 / Calcium.
I does not mention Vit D. That would be helpful.
(Sorry that I am talking to myself. I am trying to figure this out.)
=-=-=-=-=-=-=-=-
http://care.diabetesjournals.org/con.../1227.abstract
I am looking for something about how much calcium to take if you are supplementing with vit D and I can't find anything. But what Waves says makes sense to me -- that you do not need as much Calcium if you are taking Vit D. If I find such an article, I'll get back to you.

http://www.vivo.colostate.edu/hbooks.../vitamind.html
I think many docs are not interested in working this out for us.
Perhaps a nutritionist might be able to help. I've never been to a nutritionist for myself but I went to a session with a friend andt the nutritionist was wrong about carbs for diabetics (still giving the old gov recommendations that were wrong according to LOTS of published materials)
A pharmacist might be a good at this. --especially since you are dealing with the metaformin/ B 12/ calcium question.


M.

=-=-=

I started a study a diabetes when I got engaged at 19 to a man with diabetes 1. After that other people came into my life who had diabetes and I kept learning about it for a while. I've taken a break from the study of diabetes but I remember some of what I was reading over those years.

thanks for trying....i have been spending a lot of time researching and coming up with zilch on that matter. I just came up with another thing that metformin does about storing one of the supplements in the liver...i think magnesium. intuitively i think the numbers for vitamin d are way off...we used to spend so much time outside and thus manufactured so much vitamin d.
now forget it.
last night i got another good night's sleep. so many of my problems now may be related to for over a year getting 3 hours sleep in a 24 hour period. I am still really irritable...I am also reading how these deficiencies can cause muscle weakness. That might explain part of my trouble walking even little distances.
Bobby

I didn't bother to read it because it is so way off. I did read one study where people were given the equivalent of possibly 20,000 to 40,000 of vitamin d and they thought it did help with depression and it didn't mention anything about toxicity. I also can't remember how much the body can manufacture
vitamin d in twenty minutes of sunlight but it is probably at least five times 400
Bobby

right. exactly. and in the glucophage studies if any vit d was used, chances are it was in these "way off" official doses... ie, negligible compared to what you take. i was NOT trying to suggest you are taking too much vit D. i was only providing a REFERENCE to what i stated in my previous post... and before that regarding the likelyhood that your calcium levels could be a good bit higher just from the level of Vit D you take, EVEN if the folks in the studies were taking supps - the piddly way off doses.

i am sorry if my posts have been confusing. it seems that way. :( i'm really sorry. you have enough on your hands as it is. hopefully Mari's posts are less confusing.

I have always remembered the fat soluable vitamins from a nutrition class:
ADEK
these are the only ones that are stored and can become toxic in too large of doses....all the rest of the vitamins simply pass thru our system using what we need and then passing the rest.
albeit I don't know what those amounts are and could be different individually. Sorry.
bizi

from the vitamin D thread...
 

Bobby - re Vitamin D causing calcium increase....

the above is from the Vitamin D thread (which i just bumped up). In it are many other references/info also. (you probably know hypercalcemia means too high calcium serum level.)

just thinking about you today.
((((HUGS))))
bizi

thanks so much. i am really depressed. have a therapist's appointment this morning...she isn't supportive..will try to respond later=i am feeling so much pressure
thanks again
bobby

good luck with your therapists appointment, hate to hear that she is unsupportive, right away want to tell you to get someone else who is!
But this may not be possible...don't know.
((((HUGS))))
I am sorry that you are so depressed wish I could take that away from you.
bizi

Dear Bobby
 

i hope your therapist appointment went ok. i am so sorry she is so unsupportive. i wonder what would happen if you opened a discussion on types of therapy with her - maybe inquire about what approaches she tends to use and drop a few for her to pick from ... mention "supportive therapy" what i am really wondering is what if you told her flat out that one of the things you currently require from therapy is emotional support.

one of my therapists from the past who also did interpretive type therapy and did a lot of work with kids also did supportive therapy with me she was a real treasure. she was so funny too ... she had kids toys in her "office" which was actually a little shed out in her yard set up sort of like a single-room mini-cottage / play-room inside. it was a bit like being in wonderland. but, i digress...

...amongst the toys she had some clay. she noticed early on i was biting my cuticles and after a couple vain attempts at stopping me by observing it out loud, she instead took to just handing me a piece of clay at the start of the session... i took to fiddling with that the whole time instead of biting or picking my cuticles.

other than that small intervention, which worked - i could have put the clay down, but i liked squishing and molding - she didn't try to mess with me/boss me much... she would listen to me a lot, tried to help me home in on my feelings, and gave me encouragement on things i expressed a need or wish to do. i was really depressed and anxious when i started seeing her and i needed that.

i wish you could get that. i don't know if it is something one can ask a therapist for. it may be worth a try. but i don't know this woman.

anyway let us know how things went when you can. i hope you are ok.

love,

~ waves ~

thank you so much Bizi...i told her point blank a few times yesterday that i wanted her to be supportive and that is what i wanted her to be. now i think she might be around seventy. she is overweight and has blonde hair and wears a lot of costume jewelry...always dresses well and youthfully but in keeping with a mature woman. I find her sexy. I guess i should tell her. SHE IS SO COMFORTABLE IN HER OWN SKIN. yesterday i told her i was so upset about weight and my eating was out of control. she said i could go to a diet doctor and he would give me pills. Some do give topamax which i am on. I said to her if it were so easy why are there so many obese people....i told her i might try weight watchers. she said to try to control yourself. i said that medications also help you gain weight and can increase your appetite.
SHE DIDN'T KNOW THAT...SHE SAID THERE WAS NO CAUSE BETWEEN DIABETES AND PSYCHIATRIC MEDICATION. I SAID THERE WERE LAWSUITS BECAUSE THERE WERE. She wasn't phased with this new found information. She didn't seem disturbed that she could be wrong.
I told her that I stopped taking wakes with Robert and Mickey because he kept telling me that my doctors with their medication had destroyed me.
She started saying that it was my choice whether to go to see Dr. Moussavian and my other doctor and her. For most of the session she didn't get it that i already told Robert was going to stop walking until i saw the doctor. IT ALL SEEMED SURREALISTIC. I was raising my voice and becoming more and more irritable and agitated. AS LONG AS I WANT TO SEE DR MOUSSAVIAN I HAVE TO SEE HER
bobby

your therapist sounded wonderful. i can't do what you recommend with mine.
she is like a bull. at least she didn't mention bath this time or rather shower.
love
bobby

Dear Bobby,

some time ago you mentioned something about she might go into retirement soon... but if she is 70 and still working i wouldn't count on how soon. she might enjoy it ... the therapist i told you about was kinda elderly, definitely past retirement, and i suspect she just did it because she enjoyed her work.

i don't like how this woman said well it's up to you if you want to continue to see Dr. M and her... almost sounds like a threat well screw that. if they have other therapists, maybe it's time to ditch her... i never like recommending this but it seems like you've tried to confront her with the issues to no avail.

maybe you could tell Dr. M how you've tried to get on with her and that you two are just not on the same plane, and tell him you need someone different. if need be you could cite some of the examples you have posted here.

what a relief she didn't get into the shower bit. but still... there just seem so many things wrong with this picture. you said she is like a bull - aggressive. seems to me you could use someone gentle. and the ignorance on psychiatric meds ... i mean, she may not have openly admitted her ignorance and many don't. she could still be receptive to what you said - or NOT. it might be easier for her to just think you are being defensive. you should not have to be up for battle every time you go to therapy. that sucks royally.

can you ask Dr. M... about seeing someone different? he knows you. i bet he will understand.

love

~ waves ~

Dear Bobby,
I can't write much of a note write note -- have to be somewhere.

I think that Robert and Mickey have been helpful and important to you.
Can you talk to Robert when you are not walking (and maybe he is in a listening mode) to respect you and your decisions? He seems a little over focused on your situation. Ask him to back off the the sake of the friendship.
Maybe he will listen.

I hope you find some peace.
The people who could be helping you are not being very helpful.

M.

I am afraid. Robert doesnt owe me anything and he gives to me a lot more than I can give to him. He is also into analyzing me and when i wrote him that i didn't want to take walks til after i saw the doctor he wrote me back about how my father destroyed my self esteem. I am afraid that Robert might be bipolar as he has recently told me he has always suffered from depression and anxiety and is extremely bright. He can't seem to let go.
He is just making me feel a lot worse. I have to face everyday the toll the medications have taken on my body but i know my depressions and anxiety and agitation would be much worse. Robert doesn't seem to care about that.
Now the drive to start smoking again is harder and harder. Thank God I can't afford it. I am feeling so isolated. The only thing that seems to make me feel better is when I think of my dead Snowball and Hammy and Morgy and PUmpu and Tui. I miss Snowy so much. He suffered so much with chronic health conditions that I am glad for him that he died. He was such a treasure and he seems for the most part to be the only thing that can break through right now with my feelings.
Bobby

I don't think it will work. He already changed me once. I will give him some examples like the magic pill to lose weight and that antipsychotics don't cause you to gain weight. I feel as if I am being punished. maybe they all
sh#t there except for dr moussavian. it is mostly a drug clinic.
today i was so out of it
Bobby
I just called the woman i adopted snowy from and told her if she ever comes across another kitty cat sort of like snowball to let me know

Dear Bobby
 

i'm sorry you are having such a hard time with Robert as well. Try not to worry about giving-getting having to be equal. Friendship is about reciprocity, but reciprocity does not imply keeping even scales? It doesn't sound like he realizes the way he is trying to help is actually hurting. I can't think of a good "positive" way to communicate that to him now. Like, a non-critical way, you know? If i think of something i will post. maybe someone else can think of something.

If you decide to talk to Dr. M, besides telling him what isn't working with your current therapist (and yes examples might be good), i would then state explicitly what your needs are from a therapist. it might help him pick out a good (or at least better) match for you.

i am glad you are looking into getting another kitty. :hug::hug::hug:

love
w.

Dear Bobby,
it is awful being not understood.
YOu must feel frustrated/disappointed with robert.
how old is he? he sounds young.,,,,maybe I am completely wrong on this but maybe he thinks what he is saying is helping you.
It clearly is not.
Could you talk to him about this? YOu guys are friends right?
have you shared with him that your therapist is being non supportive and give him examples of what you want from her....HIM....maybe he would get the hint or do you think he is a two by four kind of guy?
(((((HUGS)))))
bizi

robert is very young in spirit but is at least my age if not older. He looks great and does not at all look his age. He walks four miles a day. He just doesn't get it and doesn't realize that now I am seriously agitated and irritable and mildly depressed and somewhat numb. I just feel more isolated.
Bobby

I don't think there is much of a selection at the clinic so I doubt that Dr.M
will change me. I now have to face that I might have to leave him.
Bobby

Dear Bobby,

This is sad to hear -- that you would leave him because of the awful therapist.

Talk to him some more before you make any decisions.

M.