Interesting conversation with a doctor

[Sheryl]

I question the pre-diabetes diagnosis esp given the low Hb1ac and based on a single blood glucose....especially one taken when you were feeling "shaky". Stress of any kind will cause a temporary surge in blood sugar.

Also pre-diabetes does not cause the symptoms you describe.

These sound rather like what you experienced before your recent cardiac arrest...which I also have some doubts about in terms of whether the cause was fully explained and adddressed. While septic shock can cause arrest it does not usually do so suddenly in someone who was still ambulatory, rather it is usually a more gradual and obvious deterioration

I am concerned that there may be something else going on and suggest you see a good cardiologist. Bring with you both the recent lab results, records from your recent hospitilization and also the lab results from the check up you mention where you were told everything was "fine".

You could be having some sort of arrythmia (abnormal heart rhythm).

Another possible explanation would be effects of medications but would need to know what exactly you are taking.

A good cardiologist at Bumrungrad if you want to stay there is Dr. Visuit

[nongsung]

I wasn't shaky after the fasting sugar and two weeks ago I was monitored for 24hrs and my heart showed no abnormalities. But now, when I'm shaky sugar fixes me up every time (that looks like diabetics related to me). And shaky/dizzy/sweaty/cold hands/feet happens mostly in the early morning but around midday I'm mostly fine.

Late afternoon I go for my daily walk with no problems whatsoever.

I'm not on any medication at the moment but was treated with Metronidazole & Ceftriaxone two weeks ago by IV.

[nongsung]

Some details regarding my Cardiac arrest. At home I had serious diarhea, more than 10 times, pure yellowish water. It came out with unbelievable force. I tried to replenish with ORS drinks but ran out of drinks when I reached the hospital. I had to wait for my turn and in the meantime went to the toilet at least 6 more times in 20 minutes or so. I was very thirsty and weaker by the minute and the last 3 toilet visits my wife had to support me because I was so dizzy could hardly walk. For me, that's detoriation.

The last visit to the toilet was by wheelchair (could'nt walk anymore) and was the one when the lights went out. Seriously dehydrated and lost an enormous amount of fluid and therefore blood pressure... that's when my heart gave up. Rhythm came back after half a minute or so but only 30bpm. 10 quick pumps and the normal rhythm returned.

For me, that explanation given by the doctors is a plausible one and exactly how it felt but I could be wrong.

I should have asked for something to drink but I thought 'I'm in the hospital now so I'm going to be fine' and that was kind of stupid. Can't blame my wife who helped me going to the toilet, registering my as a patient, asking nurses if they could speedup because I was really sick at that point. She did her best we just did not think about getting some fluid in...

 

@Sheryl: it's always difficult to describe exactly wat happened but I value your input highly. Being a non-English speaker can complicate matters.

Edited February 8, 2017 by nongsung

[nongsung]

To give as much info as I can: during the shaky/dizzy spells my heart rate is around 77bpm and I do not experience an abnormal hart rhythm. Having these spells do not make me feel anxious, I take them as they occur in the knowing that a glucose drink will fix me up eventually. What I'm going to do is to buy a glucose check-kit today to monitor the glucose levels myself to see if there is any relation between feeling like shit/feeling fine and glucose levels. 

[Hedghog]

1 hour ago, nongsung said:

I wasn't shaky after the fasting sugar and two weeks ago I was monitored for 24hrs and my heart showed no abnormalities. But now, when I'm shaky sugar fixes me up every time (that looks like diabetics related to me). And shaky/dizzy/sweaty/cold hands/feet happens mostly in the early morning but around midday I'm mostly fine.

Late afternoon I go for my daily walk with no problems whatsoever.

I'm not on any medication at the moment but was treated with Metronidazole & Ceftriaxone two weeks ago by IV.

The symptoms you describe,are not of pre diabetes.

Most people show no symptoms at all.

I was diagnosed through blood tests relating to an illness,that can cause Pre diabetes/Diabetes.

Pre diabetes is a warning it doesn't mean you will develop Diabetes,if the under lying problem is addressed.

 

[nongsung]

This is what I found on the web (my symptoms are in italics):

Do You Have These Pre Diabetes Symptoms?
The more yes answers you have, the more likely you have prediabetes.

A constant feeling of being tired. No matter how much you sleep, or exercise to gain strength, you feel fatigued.
 
Frequent bouts of depression for no reason. You’ll be fine, and then you feel sad all of a sudden, without any cause.
 
Unexplained weight gain. Your eating habits haven't changed, but suddenly you've put on 10 pounds. In addition, you are having difficulty losing it, even when you exercise and eat less.
 
Blurred vision that seems to be worsening, and trouble seeing at night.
 
Headaches and a sore throat that comes and goes.
 

Dizzy spells, and a feeling of being lightheaded sometimes, especially after having sweets. (This indicates reactive hypoglycemia.)

Breathing issues during sleep; you may have been diagnosed with sleep apnea.
 
Digestive issues. You get frequent stomach aches and are constantly dealing with gas pain, bloating and stool issues, cycling between diarrhea and constipation.
 
Heartburn which may be worse during the night. You may have gotten a diagnosis of Gastroesophageal Reflux Disease (GERD).
 
A groggy, sleepy feeling after meals, even when you have plenty of rest. You may fallen asleep at your desk at work, or during a meeting.
 
The dentist tells you that have gingivitis, even though you brush and floss every day. You often wake up with a nasty taste in your mouth, even though you brush before bed.
 
You have elevated blood pressure and blood tests indicate you have high triglyceride levels, and low HDL cholesterol levels.
 
After every meal, you really crave something sweet, even if you are already feeling full.
 
Frequent yeast infections, and cuts or bruises you get don’t seem to heal quickly.
 
Constant hunger, no matter how much you eat. You often think, "How can I be hungry? I just ate!"
 
Constant joint aches, and muscle and joint stiffness when you wake up in the morning. You may even have been diagnosed with some form of arthritis.
 
Your feet burn and your toes feel numb when you stand for long periods of time.
 
Swollen ankles, and a general feeling of puffiness or water retention, especially if you sit for long periods of time.
 
If you don’t eat, you get really grumpy. You may also feel nauseous and shaky.
 
Waking up in middle of the night with your heart pounding. Often you also feel nauseated or cold. It happens more often if you've been eating high sugar meals. This again indicates hypoglycemia or low blood sugar.

 

And all these symptoms just started last week, suddenly...

[Hedghog]

In my previous post.

I was referring to the attached quote.

With the above extensive list,pre diabetes is a given.

But still the question remains.

What is the underlying cause.

That is what you are being invstigated for presently.

If the route cause can be identified,then the pre diabetes can also be reversed.

[nongsung]

14 minutes ago, Hedghog said:

In my previous post.

I was referring to the attached quote.

With the above extensive list,pre diabetes is a given.

But still the question remains.

What is the underlying cause.

That is what you are being invstigated for presently.

If the route cause can be identified,then the pre diabetes can also be reversed.

Thanks HH,

For now we assume that a combination of a colonscopy, an e-coli infection and strong anti-biotics have taken toll on my system. First approach is to diet & excercise in order to lower Cholesterol and hopefully improve the (pre)diabetes symptoms as well.

It will be closely monitored by the hospital, bloodtests again next week.

If the symptoms continue then further investigation will be done (that's what my doctor just told me this morning).

Thanks for the valuable input!

[SaintLouisBlues]

12 minutes ago, nongsung said:

Thanks HH,

For now we assume that a combination of a colonscopy, an e-coli infection and strong anti-biotics have taken toll on my system. First approach is to diet & excercise in order to lower Cholesterol and hopefully improve the (pre)diabetes symptoms as well.

It will be closely monitored by the hospital, bloodtests again next week.

If the symptoms continue then further investigation will be done (that's what my doctor just told me this morning).

Thanks for the valuable input!

The best advice I received from a dietician is to divide the amount food on my plate in half and only eat one half. You might need to start on 3/4 rather than 1/2, but basically your stomach gets used to a certain amount and you need to train it to expect less. Somewhere between 1/4 and 1/3 of the "usual" Western portion is all that's required

[nongsung]

That is what I like about a forum like TV. Valuable information, alternative possible reasons for my symptoms, open discussion without flaming, food for thought and sound advice. You guys are the max!

Thanks!

[Sheryl]

Ignore the website list of "symptoms" of pre-diabetes (which looks to me lijke it was patched together from various websites, some of them not even talking about diabetes but rather about  its opposite, hypoglycemia. )

 

Pre-diabetes in fact has no particular symptoms.

 

Neither pre-diabetes nor diabetes causes the shakiness relieved by food that you describe, that is rather likely related to low blood sugar. (Of curse, that in turn can be a side effect of diabetic medications but you aren't on any).

 

Be careful that in dieting to reduce your lipids you do not worsen what seems to be symptoms of hypoglycemia. In particular, be sure not to go too long between meals. They don't have to be large meals, but you need to take in something at regular enough intervals that you don't get dizzy or shaky. Preferrably something other than processed carbs, while processed carbs give a quick initial boost that is followed by a precipitous drop in blood sugar later.

 

If this keeps up, might be worth seeing an endocrinologist

 

 

[nongsung]

1 hour ago, Sheryl said:

Ignore the website list of "symptoms" of pre-diabetes (which looks to me lijke it was patched together from various websites, some of them not even talking about diabetes but rather about  its opposite, hypoglycemia. )

 

Pre-diabetes in fact has no particular symptoms.

 

Neither pre-diabetes nor diabetes causes the shakiness relieved by food that you describe, that is rather likely related to low blood sugar. (Of curse, that in turn can be a side effect of diabetic medications but you aren't on any).

 

Be careful that in dieting to reduce your lipids you do not worsen what seems to be symptoms of hypoglycemia. In particular, be sure not to go too long between meals. They don't have to be large meals, but you need to take in something at regular enough intervals that you don't get dizzy or shaky. Preferrably something other than processed carbs, while processed carbs give a quick initial boost that is followed by a precipitous drop in blood sugar later.

 

If this keeps up, might be worth seeing an endocrinologist

 

 

That makes sense to me Sheryl!

it feels like a hypo and yes, I switched to small meals every 2,3 hours. Be it a banana, some crackers or rice with fish. That would explain why, after a waking up, I feel so shitty (could well be hypo). It takes food and drinks to fix me up and afterwards I'm ok. Maybe important to know that I was a sugar junkie all my life and recently I have cut that out completely. In the hospital they advised me to do that.

[Sheryl]

Very likely then that this is related to the withdrawal of the sugar intake your body was used to.

 

Eat more often and also try a high protein meal with healthy fats just before bedtime...fat slows the digestive process so this will help maintain your blood sugar through the night, then eat immediately upon awakening.

 

 

[nongsung]

An update:
Little over a week ago I had an appointment with the doctor who treated me
while I was admitted. He happens to be an endocrinologist, just what I
needed. My food was not properly processed, yellowish very soft stools, cramps,

dizziness/shakiness, feeling very weak and that all sounded very familiar to him.
Guts were working overtime and he gave me some medication before and after food.
The dizziness/shakiness was most probably caused by the nerves vagus, something
that connects guts & brain. Since day one all my symptoms eased, stool got better and

a bit more firm, no undigested food in stool en started to gain a little bit of weight
that I lost over the last 2 months. Day by day my energy got better and tomorrow I
have an appointment with him again. The only thing that's still there is the dizziness/shakiness

but, as I have found out, is always connected to having to visit the toilet.
Once stool is out of my system the symptoms disappear. How I was able to stop it by taking sugar

is beyond me, it's the urge of going to the bathroom.
By reporting my experience with colonoscopy and the health-scare when I passed out it's only fair

to keep you all updated.

I will stop posting on this subject once my symptoms are cured/solved.

Thanks for listening in!

 

[Sheryl]

OP as you required a course of heavy duty antibiotics your gut flora will have been affected. Probiotic may help and certainly can't hurt. Large pharmacies wilo have; ask for Infloran or Bioflor.

[al007]

6 hours ago, nongsung said:

 

I will stop posting on this subject once my symptoms are cured/solved.

 

 

Do not stop too soon thats how we all learn

 

good luck and hope your recovery continues

[nongsung]

23 minutes ago, al007 said:

Do not stop too soon thats how we all learn

 

good luck and hope your recovery continues

Yep, my road to recovery is a kind of voyage to (for me) unknown places. Never struggled with my health until I came to Thailand. I've learned a lot about myself, my wife, family, friends far & close. I was dependent for care (the wife) and that has made me humble. Mind you, when I was in the hospital I was in diapers and my loving wife changed them! 62 yo and in diapers?

She never complained once, I'm looking with different eyes to her now. I also learned a lot from the valuable input from the TV members and (stubborn as I am) learned to embrace that and use it to my advantage. Although scary and very frightning my near death experience has made me a better person. The story continues...

[nongsung]

3 hours ago, FredGallaher said:

I have   a couple of comments. My first comment is to find and trust good professional. Sheryl can point you in the right direction. Self diagnosis is not good advice.

That being said I have a couple of comments. First a parasite that Thais tolerate for the most part, Giardia usually causes intermittent diarrhe

I am currently being treated my an endicronologist and my symptoms, although not gone 100%, have eased.

If for some reason I need a second opinion I will not hesitate to ask Sheryl if she can recommend one. If you have read my posts I'm not self-diagnosing, I follow doctors orders!

Guardia is not very likely since I was treated for parasites aggressively when I was admitted. It could however have survived. I'll talk with the doctor about it later today.