Part Two

Yesterday I began a critical review of my current health situation, with a view to improve my future results by making some new decisions based on the current facts and trends.

Current Symptoms

Here is a recap of the situation as I see it now. I am taking the symptoms I listed yesterday and discussing each of them in the context of my current method of dealing with them, and/or discussing the cause of each of them as best I can, given that I’m not a doctor or scientist trained in this.

• Frequent urination – especially at night, interrupting my sleep.

The whole issue of urination and bladder control is interconnected with so many of my other underlying issues so it’s probably a good place to start.

Problems with urination are a little bit like the canary in a mine that warns of trouble. One of my earliest indicators that I had a problem, (and it might be diabetes) was having a need to urinate frequently, both during the day and at night. This started in my thirties, almost thirty-five years ago.

Diagnoses of the problems with my urination were complicated by a discovery, in my thirties, that I suffer from a relatively mild form of spina bifida, which despite it not being debilitating does have some significant neurological effects on my lower body, including sexual response and bladder control. This wasn’t great news to hear when I was only in my thirties, but everything the doctor told me about the possible side effects of spinal bifida occulta has surfaced from time to time since then.

Like many other men with any problems with their genitals and urinary systems, including urination or sexual performance, I generally tried to ignore the problem as much as possible. After discussing the potential effects of the problem with my lower spinal column with the back specialist I tended to ascribe any problems to the back and nervous system, including periodic difficulties with both urination and sexual performance.

In the spring of 1985, when I was 32 years old, I also exacerbated the problem, by choosing to undergo a vasectomy, without understanding in advance that the operation could have unintended side effects. Unlike what I had expected, the operation resulted in swelling of my prostate and my testes and an infection in my urethra and bladder. For more than a year I suffered severe pain from both urination and sexual expression, and my soreness persisted for several years before fading away completely. A prescription was given to me to reduce the swelling of my prostate, but it took some time to take effect, and as it was significantly swollen, there were physical effects on both sexual function and urination.

As one might expect, given the pain, there were also emotional effects and a significant impact on my intimate life, in ways I would not have normally expected.

My reasons for having a vasectomy still seem as valid today, as they were at the time, however, part of the decision to go for it turned out to be less true than it is in most cases. My medical results included significant pain, reduced enjoyment of life, and a much higher level of anxiety about the whole subject than was probably warranted.

The argument for having a vasectomy is that it is generally considered a relatively benign surgical procedure, done in the doctor’s office as a day surgery. For a woman to have sterilization surgery is much more invasive, not to mention that it results in huge hormonal changes. My wife and I both thought a vasectomy would be less problematic, and we were probably right, despite how frustrating and painful it turned out to be.

It continues today, as so I suppose I’m used to it. However, continuing declines in muscles and nerves is also contributing to further problems, which require a certain fastidiousness to avoid embarrassment because of weakness in bladder control. It’s not promising for the future, because if it continues to decline I can see a future including adult diapers. It may be already as bad as it is going to get, at least that’s my current hope.

So my problems with sexual function and urination really started then, and it was only somewhat later that I realized that my need to urinate more frequently as I was getting old might have a relationship to diabetes.

• Poor sleep – several things wake me up at night, variously including frequent urination, frequent cramps in my feet and calves, pain my shoulders and hips, dry mouth and nasal congestion, sleep apnea, hay fever, and difficulties breathing.

I’m not sure that I’m doing this analysis in the right order, but this is the order I listed my symptoms yesterday, so I will follow this list and get to the underlying stuff as it comes.

I have a lot of trouble sleeping through the night. I have a CPAP machine to help me deal with my sleep apnea, with which I have been having problems. The problems with the CPAP machine aren’t really with the machine itself, but with on again off again sinusitis that makes it almost impossible to sleep with the device forcing me to breath through my nose. So when I’m congested I don’t put it on. So it doesn’t do anything if I don’t use it.

So one of the new decisions I’m making as I do this analysis is to start using the damned CPAP every night possible. When I was using it, it did improve my blood sugars and I suppose it improved my sleep, although I didn’t feel much more rested then that I do now. In other words I’m still exhausted most days, regardless of the CPAP.

The problem with cramping in my legs and feet is another thing that wakes me up in the middle of the night fairly frequently, although not every night. When it first started up a few months ago, I asked a doctor and she advised me to use Magnesium and Calcium together to help. I started taking them every day, and my cramps in my calf muscles has been reduced to once or twice a month, instead of every night. However, this remedy has not improved the cramping in the arches of my feet, or the muscles in my toes.

Other body pain and neuropathic pain are also problematic in getting a decent night’s sleep. Arthritis and rotator cup problems wake me at various times in the night, and make it difficult to get back to sleep. Neuropathic pain which is merely irritating during daylight hours seems far more painful when I am at rest. Ergo, more interrupted sleep and more pain.

• Chronic pain during waking hours – moderate to severe pain in my feet, neuropathic pain as well as mechanical distress, including pain caused by walking on supersensitive soles of my feet, as well as my toes. 

I am taking Gabapentin, an anti-seizure medication which has shown to help with neuropathic pain. It may be providing me with some relief from the neuropathic pain, but the benefits are still uncertain to me. Would the neuropathic pain be worse if I were to wean off of Gabapentin, due to the numerou side effects cited in the literature?

Also… periodic moderate pain in my back and shoulders, and more serious pain in my lower back and hips when walking more that 1,000 to 2,000 steps.

Various types of chronic pain plague my waking moments, including arthritis in my hands, shoulders, hips and legs. Tendonitis has my hands bound up with pain. Inflation combines with ongoing pain.

Persistent breathing problems – mild to severe asthma on a continuing basis, almost always somewhat symptomatic but much worse when exercising or physically stressed.  Sometimes exacerbated by emotional stress or conflict. Of all my symptoms my breathing problems are the most intrusive, making ordinary activities difficult or impossible. I am currently taking three separate inhalers to remediate the asthma and borderline COPD. All of them have side effects which make my sinus and throat problems worse, and while they help me breathe, they make my singing voice harsh.

Chronic physical exhaustion and fatigue – comes and goes during the day but is worse during periods of relative inactivity (sense of exhaustion) and during periods of exercise (weakness and muscle fatigue).

Addressing these symptoms is something I haven’t really been able to address, yet.

To close the blog for the day, I’ve decided to stop here and pick it again tomorrow or Friday. All of this thinking is making my head hurt, but I realize that I haven’t really given enough thought to the role of the many drugs in my system, and how their many potential side effects may be effecting me.