A Word of Warning

Most of my last few posts have been about me. Disappointing, isn't it? But then I can't write about you, since... Well, I'm not you.

I know. I'm brilliant like that.

There's an underlying cautionary tale in these posts about me dealing with one crisis after another. If you don't control your diabetes, you could be living a very similar lifestyle. This is different from me telling you about one specific problem in a post. This is the various complications attacking simultaneously. It's a diabetic blister that's followed by your dry, delicate skin tearing when you remove the wound dressing. While your coping with those wounds, even more appear because you unknowingly collide with a whole host of things with your lower legs. The reason you don't know it is because diabetic neuropathy has wrecked your nervous system. 

But why stop with a few open wounds on your lower legs when you can add a dental infection. It wasn't anything so dramatic at first. Just a bit of receding gums from constantly battling dehydration during hyperglycemia, and then the tiniest particle of food gets caught between one of your teeth and your gums. You somehow didn't feel it, and despite brushing your teeth regularly, you ended up with a little invader that thrives in the bacteria-rich environment of your mouth.

Now that you have several trouble spots that can become serious infections, your body goes bananas in its effort to fight. Reserves of sugar and naturally occurring steroids send your glucose skyrocketing, making it even harder to control.

And then, sneaking in under your radar, is something you're completely unaware of. All you did was take some ibuprofen to deal with the pain in your gums. Ibuprofen is an NSAID - Non-Steroidal Anti-Inflammatory Drug. Since your gums were swollen, taking an NSAID seemed like a smart thing to do. Heck, your doctor approved its use!

"So what, Rob? Ibuprofen - AKA Motrin - is an over-the-counter drug. It's no big deal, right?"

Under most circumstances, I'd agree immediately. But there's this little complication for diabetes known as Diabetic Nephropathy - AKA Diabetic Kidney Disease. Like just about every other complication, it boils down to high blood sugars altering the shape and functionality of microvascular vessels. 

Forgive my lack of proper structure, but I'm switching from what could happen to you to what's currently happening to me.

I've been lucky. Only once did I start showing signs of kidney failure in my lab work. But the next time I was tested for it, whatever damage that was supposedly happening was no longer apparent. So precautionary measures were taken. I was put on a very low dose of a drug commonly used to control blood pressure and protect against kidney damage.

Amidst my battle with gingivitis, I was a bit too distracted by the pain to really pay attention to it... but as the pain lessened, I noticed that my right leg was swollen. VERY swollen. Obviously it's water retention, but it's EXTREMELY sudden.

At this stage, while waiting for my PCP to get back to me, I'm going to make an educated guess. I could be completely wrong. Heck, I hope I am! But I could also be right, and that scares me silly.

Brace yourself. It's time for another list.

1. I can't take doses of ibuprofen higher than 400 mg. (Maximum strength is 800 mg.) Exceeding 400 mg. per dose makes my kidneys ache. Why? Because...
2. Ibuprofen can cause nephrotoxicity - poisoning of the kidneys. This isn't to say that this is a common risk, but people with existing kidney disease and heart disease should definitely consult their doctor.
3. About a year ago, a lab test came back with a cautionary flag. There was a trace of hematuria - blood in the urine not visible to the naked eye. This is NOT what they look for when testing for diabetic nephropathy, but in my semi-panicked brain, it could be a sign something was off. (They typically look for albumin, a blood protein your kidneys should not be filtering out.)
4. During my gingivitis adventure, I was taking 400 mg. of ibuprofen every eight hours. Regardless of the dose size, it would be taken every eight hours at the most. This, however, was more ibuprofen than I'd taken in a LONG time.

So, ummm... Did I damage my kidneys with an OTC during a completely different crisis?

Okay, let's all stop and take a deep breath. It's important to remember that I'M STILL NOT A DOCTOR! I'm fully capable of making myself paranoid, especially when "doing my own research on the internet." In fact, I'm sure if I dug deep enough, I could have myself diagnosed with "leg cancer" by the end of the day. This is why I'm constantly telling you to consult your doctor. I can only offer up so much information before I reach the limit of my knowledge.

As is my habit, it's time to add pictures to my post. I'm afraid I don't have a beautiful woman or silly joke this time around. No, what I have are a couple of pictures of the swelling in my leg.

Oy vey 1.

Oy Vey 2.

Maybe you can see it, maybe you can't. My leg is significantly larger until it reaches the discolored portion, where the swelling suddenly stops. And in the second picture, you get to see the scab of yet another leg wound.

The good news...? The site of the diabetic blister has healed up nicely, hasn't it?

Okay, readers. I'm off to stew in my paranoia and await word from my PCP. I'm more than likely going to need a lab workup to determine what's ACTUALLY happening. I'm also going to mourn my carb-free snacks, as the reason I was able to get away with them was my lack of water retention. "Alas, poor Pork Rinds. I knew them, Horatio. A snack of infinite yumminess." 🙁

EDIT: My PCP has gotten back to me. He agreed that NSAIDs can cause kidney troubles, and told me to stop using the ibuprofen, (which I already did), and cut down my salt content, (which I already did). If I don't see improvement soon, he'll order labs. Personally, I'd prefer he order them now, but as stated earlier, I'm not a doctor.