Controlling Type II Diabetic Blood Sugar
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midwesterner85 wrote: »@nvsmomketo DKA (diabetic ketoacidosis) is not a form of ketosis. It is different than ketosis.
Yes, blood ketones are elevated in both ketosis and DKA (much more elevated in DKA), but that is basically where the similarities end. DKA will kill someone very painfully, it will lead to vomiting, dehydration, multiple organ failure, and perhaps even heart attack (due to pH imbalances). DKA is deadly, and is a medical emergency... if someone is in DKA, they need to get to the nearest emergency room.
Having said that, I will agree and repeat that it is extremely unlikely that a type 2 with BG's in the 150's would be in DKA.
I agree. DKA is not usually a factor for T2 diabetics. It is only a possibililty if they have burned out all of their Beta cells in their pancreas, and are no longer able to make insulin so they are just as dependent on insulin shots as a T1 diabetic is.
Ketosis is not dangerous at all. I am in ketosis all the time from eating a diet very low in carbs.0 -
nvsmomketo wrote: »midwesterner85 wrote: »@nvsmomketo DKA (diabetic ketoacidosis) is not a form of ketosis. It is different than ketosis.
Yes, blood ketones are elevated in both ketosis and DKA (much more elevated in DKA), but that is basically where the similarities end. DKA will kill someone very painfully, it will lead to vomiting, dehydration, multiple organ failure, and perhaps even heart attack (due to pH imbalances). DKA is deadly, and is a medical emergency... if someone is in DKA, they need to get to the nearest emergency room.
Having said that, I will agree and repeat that it is extremely unlikely that a type 2 with BG's in the 150's would be in DKA.
I agree. DKA is not usually a factor for T2 diabetics. It is only a possibililty if they have burned out all of their Beta cells in their pancreas, and are no longer able to make insulin so they are just as dependent on insulin shots as a T1 diabetic is.
Ketosis is not dangerous at all. I am in ketosis all the time from eating a diet very low in carbs.
Right - ketosis is not dangerous. Ketoacidosis / DKA is deadly. I know this both from a textbook standpoint and from experience... I am a type 1 diabetic and I nearly died from DKA once.0 -
Yikes! 0 -
caroldavison332 wrote: »On Diabetes.org. (thanks for the referral). It said oatmeal (and oranges) was a diabetes super food. Conflicting information is confusing.
What about whole vs skim milk? I frequenly put all kinds of things on my food list to compare them. There doesn't seem to be much difference in the two, and I read that we should have WHOLE milk products 3 times daily to loose weight.
There are no superfoods. Whole milk and others have similar levels of sugars but different levels of fat. They are not essential for weight loss.0 -
caroldavison332 wrote: »DAM5412 i got oatmeal and oranges off of the diabetes 10 super foods page. I also read that I"m supposed to limit myself to 180 carbs per day. I'm averaging 136. My blood sugar was 159 at noon, five hours after eating. Your assumptions are condescending and offensive.
Aggekik-no the Dr said twice a day. She also said to aim for blood sugar 126. Am I keeping a dairy recording what? I'm reading diabetics.org about what to eat. yes I know when to take meds, test, and no one said anything about ketones. What constitutes an emergency?
You need to count carbs per meal, not just per day. 180 carbs in 6 meals is very different than 180 carbs in one meal. If I remember correctly, it is about 40-60 grams of carbs per meal, but it can vary so it will take trial and error.
Fiber (so oatmeal and oranges too) are good, but you still need to track the carbs in these foods. So, portions matter.
160 blood sugar 5 hours after eating is pretty much fasting, so it is not good in general. It would be ok 1-2 hours after a meal, not 5 hours. So, you have a problem there and need to figure out what to do. You need a diet plan, and possibly adjusted medication until the dietary changes kick in.
In general, testing twice per day sounds fine, but you need to keep a diary. It is different fasting, 1 hour after meal, 2 hours after meal etc. Usually you measure a few times per day in the beginning at least, but at specific times. So, if one day you measure e.g. fasting and 2 hours after dinner, next day it can be 1 hour after breakfast and then 1 hour after lunch and so on, so you can see the big picture in a few weeks. And you need to also track what you have been eating, to know what caused spikes and what worked, plus keep track of medication, in case something needs adjustement. It is just the first adjustment, and then you get into a routine and the whole thing gets much easier.
And you need to find the time to exercise. I know how hard it is with work, and if to save time it means to completely change your life, like moving closer to work, or starting to look for a different job, or dropping other activities, or sacrificing lunch break to walk etc, it is definitely worth it.0 -
nvsmomketo wrote: »midwesterner85 wrote: »@nvsmomketo DKA (diabetic ketoacidosis) is not a form of ketosis. It is different than ketosis.
Yes, blood ketones are elevated in both ketosis and DKA (much more elevated in DKA), but that is basically where the similarities end. DKA will kill someone very painfully, it will lead to vomiting, dehydration, multiple organ failure, and perhaps even heart attack (due to pH imbalances). DKA is deadly, and is a medical emergency... if someone is in DKA, they need to get to the nearest emergency room.
Having said that, I will agree and repeat that it is extremely unlikely that a type 2 with BG's in the 150's would be in DKA.
I agree. DKA is not usually a factor for T2 diabetics. It is only a possibililty if they have burned out all of their Beta cells in their pancreas, and are no longer able to make insulin so they are just as dependent on insulin shots as a T1 diabetic is.
Ketosis is not dangerous at all. I am in ketosis all the time from eating a diet very low in carbs.
With numbers in the 150s, she is not in danger, but the first post was mentioning 450s spikes, which is a completely different story, especially if it was not just a one off.
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Please just follow what your doctor, dietitian and diabetes nurse says THEN go from there. Write down all your questions for when you go.0
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My neice had gestational T2 diabetes that lingered months after her child birth.
He doctor out her on what we refer to as LCHF. Low carb high fat.
For me, I was borderline T2 based on A1C. Doing LCHF eliminated that problem and also substantially lowered my cholesterol and triglycerides. in 2009 my trig was 311. Last year it was 51.0 -
Whole milk is fabulous.caroldavison332 wrote: »On Diabetes.org. (thanks for the referral). It said oatmeal (and oranges) was a diabetes super food. Conflicting information is confusing.
What about whole vs skim milk? I frequenly put all kinds of things on my food list to compare them. There doesn't seem to be much difference in the two, and I read that we should have WHOLE milk products 3 times daily to loose weight.
Drink that. It does not have an special weight losing properties but it is a good source of protein.
Diabetes.org and similar sites are 100% wrong. They are one of those "feel good / lets be happy without making changes" sites.
It is true that the advice will feel complicated in the beginning. The best advice you have gotten here is to start testing and recording your own blood sugars yourself so that you can see what foods bring up your blood sugar and which foods help keep it steady.
I am happy that you are trashing the oatmeal. Learn to love vegetables cooked in whatever oil you like and meat/eggs/fish/nuts/dairy.
There are apps that will help you see patterns.
http://www.healthline.com/health-slideshow/top-iphone-android-apps-diabetes#120 -
The essence of what DAM is saying is that carbohydrates are the food that raises blood sugar. You can continue to eat them and fix the blood sugar with drugs or you can minimize carbs and minimize blood sugar through dietary changes.
I understand that carbs raise blood sugar. Diabetes.org or com said oatmeal and orgagnes are super foods and to get down to 60 per meal. I'm averaging 139 daily so I am well within the limit. Right?0 -
nvsmomketo wrote: »caroldavison332 wrote: »On Diabetes.org. (thanks for the referral). It said oatmeal (and oranges) was a diabetes super food. Conflicting information is confusing.
What about whole vs skim milk? I frequenly put all kinds of things on my food list to compare them. There doesn't seem to be much difference in the two, and I read that we should have WHOLE milk products 3 times daily to loose weight.
There is a LOT of conflicting theories out there.
For a few decades the ADA was recommending a diet low in fats which meant it was high in carbs. Many doctors still follow this model, and many diabetics have success with weight loss and blood sugar control on it.
The newer thoughts is that controlling your carb intake will better control your blood glucose levels. This makes sense to me since fats won't raise your blood glucose but carbs do. A low carb high fat diet (LCHF) will lower your blood glucose and not cause large BG spikes. BG levels will drop further as your body adapts to the LCHF diet AND as weight is lost.
If you follow the older theory, you would want skim milk. If you follow the more recent theories, you would use heavy (whipping) cream and only dilute it with water if it was too thick for you to use - cream has fewer milk sugars (lactose) than skim milk. I don't drink milk, but I definitely prefer cream in my coffee to skim.
Dr Bernstein's Diabetes Solution spells a LCHF diet out very clearly. He is a diabetic (T1) doctor who believes most diabetics should be able to normalize their blood glucose as much as possible by diet... That's normalized compared to an average person and not just "good for a diabetic".
Get the book and see it it makes sense for you. Not everyone likes the idea of LCHF but I love it.
Here is an example of my day on a (very) LCHF diet: yesterday I ate coffee with coconut cream, 3 bacons, 1 egg, 1 burger patty with artichoke and asiago dip, celery, cucs, and yellow pepper (not in large amounts), 2 pepperello sticks, salmon covered in a primevera sauce with mushroom, shrimp, red pepper, and cheese.
It took me about 2 weeks to get used to eating this way, and I was tired and headachy during that time, but now I feel better than before I started, my appetite is greatly diminished, I've lost 15 pounds in the first 40 odd days (a lot since I only need to lose 20-30 more), and my blood sugar is at the low end of normal ( I was prediabetic though so my BG probably improved faster than yours may).
LCHF worked well for me, but it isn't for everyone. Best wishes.
I'm definatley going to try to do this by diet. Thanks for the info.0 -
but taking meds and exercsiing my heiney off, literally! in the meantime. I FEEL better than I have in theree months.0
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Don't you have detailed instructions from your dr? If not, get an appointment ASAP. In the meantime, try diabetes.org. Read carefully, they have very detailed instructions and can help you learn how to plan meals and snacks and count carbs. It is not as simple as avoiding sugar. You need to count and balance all carbs throughout the day (not eliminate them, but eat them in small amounts at a time), make sure you are eating enough protein, limit total calories, add physical activity. In general, vegetables and protein are your friends but make sure to not overdo it in fat as calories can add up.
Please correct me if I'm wrong, but don't you need to do these eating gymnastics to eat just enough carbs to match the dosage of drugs given to address the high blood sugar caused by the level of carbs you are eating?
No one has advised me on this. I will see the diabetic nurse and the educator august 7. In the meantime I read under 60 carbs per meal. I average 139 daily.0 -
Here's what my doctor tells me to do: Be very moderate with carbs, AND never eat a carb without also eating a protein. Don't eat a whole banana at once, just half at a time, due to the high glycemic index. I am controlling my blood sugar without meds which seems to be a thing doctors like nowadays especially if the person is prediabetic rather than full on diabetic. So in cases like this the "gymnastics" really are necessary. But they become a habit and so you don't feel overburdened by these things for long. Lean meats and nonstarchy veggies are your friends. I had to learn to limit fruit, which really makes me sad, but... it is what it is. I now treat fruits as a dessert item consumed after I've eaten my protein rather than as a standalone snack option. Snacks have become things like a boiled egg or string cheese. The doctor I see also advocates the MyPlate method of portioning: 1/4 of your plate is lean protein, 1/4 is carbs, and 1/2 is various nonstarchy vegetables. Maybe salad, maybe spinach, whatever you like veggie wise. Then a piece of fruit is dessert. Like say half a banana, a clementine, a cup worth of grapes.
love this! exactly what I needed to know about combing foods. So I should have an egg with my oatmeal. and nuts with my orange. I've mostly been eating veggie soups and Dr Joel fuhrmans bitter greens, beans, onions, mushrooms, berries and seeds salads. I sprinkle a teaspoon of peanuts on to better absorb the vitamins.0 -
caroldavison332 wrote: »The essence of what DAM is saying is that carbohydrates are the food that raises blood sugar. You can continue to eat them and fix the blood sugar with drugs or you can minimize carbs and minimize blood sugar through dietary changes.
I understand that carbs raise blood sugar. Diabetes.org or com said oatmeal and orgagnes are super foods and to get down to 60 per meal. I'm averaging 139 daily so I am well within the limit. Right?
OK, let's talk about oatmeal, since you seem stuck on that. There was a study done in Atlanta, GA with 2 groups - a group of diabetics and a group of non-diabetics. They fed both groups oatmeal. Both groups saw quick rises in BG. The non-diabetic group topped out in the 180's on average. The diabetic group had BG's rise above 200 on average. The non-diabetic group was down to 130's within 2 hours. The diabetic group was down to 150's in 2 hours.
Oatmeal is carbs, so it raises blood sugar (net carbs* convert 100% to glucose). Diabetics have trouble with reacting to rising blood sugar, so they go higher and stay higher with the same foods.
Oatmeal is not helpful because it has such high carb content.
*Net carbs = Total carbs - fiber - (0.5 X sugar alcohols)0 -
Patttience wrote: »You are getting conflicting advice because not everyone agrees on what is best for diabetics. The low carbers think all carbs are bad except vegetables. This is not the traditional or mainstream view. I think low carb is alright but I don't think you need to be as radical as many suggest.
Oatmeal should be ok because it is a slow digest and if you are not overeating it should be ok. But include protein in the meal you eat it. Milk (whole milk) is good but i find an egg as well is better.
I would not recommend for breakfast eggs and bacon. I do not think bacon is good on any level for anyone. And certainly the pigs live lives of hell in order to you to have a bit of pleasure.
I would recommend oatmeal + milk
and wholegrain toast and a boiled egg with some butter.
and some fresh fruit.
I would also avoid completely fruit juice. It is liquid sugar. If you don't like the oatmeal, is it because you have not added any salt to it. But you do'nt have to eat oatmeal.
You can have fried tomatos,onions and mushrooms on wholegrain toast.
Anyway include lots of fresh vegetables in your diet. These the best thing and also legumes. Get into the habit of eating legumes often - every day, more than once if you can. These are brilliant foods but unfortunately not many in the west living on junk food diets learnt how prepare them into delicious recipes. So the quick and easy way is to make salads with bean mixes, or hummus. A serving size of beans for me is about half a cup. Its probably the same for most people really.
Pattience-who ovedos OATMEAL? I'm eating it commando. It tastes like and is the consistency of mortar! I'll try adding salt. I'll plan meals ahead and will try oatmeal w milk or oatmeal w egg or eat w toast to find the most bang for my buck. BUt again diabetes.org or com said oats (and oranges) were a superfood.
I never did drink fruit juice-i think of it as liquid sugar. I eat oranges because I want the vitamin c and because they are portable in my backpack.
I eat hugh salads of beans, collards, kale, watercress, mustand, onion, mushroom, berries and seeds for lunch every day. I saw the light in that ER!0 -
Thanks for the keytones info. My dr didn't mention it so I'm not worried about it at this time. My friend also warned me not to eat too few carbs or I would retain sugar. I believe that I am safe at this time iwth 139.0
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Looked into the oatmeal-egg, egg-bread, oatmeal-milk thing. WIll be having yummy open faced egg salad to sandwiches.
You know how they say to use avacadoes instead of mayo? How is the taste/consistentcy if you mash the avacados?0 -
caroldavison332 wrote: »Thanks for the keytones info. My dr didn't mention it so I'm not worried about it at this time. My friend also warned me not to eat too few carbs or I would retain sugar. I believe that I am safe at this time iwth 139.
No, you will not retain sugar by not eating any. But, when you are medicated and do not adjust your meds to a low carb diet, or try fasting for hours, then you might end up with a hypoglycemic epeisode which can have you pass out. It depends on your meds and your plan. Especially if you are on insuline, you need at first to follow instructions religiously about what to do based on your numbers.0 -
Whole milk is fabulous.caroldavison332 wrote: »On Diabetes.org. (thanks for the referral). It said oatmeal (and oranges) was a diabetes super food. Conflicting information is confusing.
What about whole vs skim milk? I frequenly put all kinds of things on my food list to compare them. There doesn't seem to be much difference in the two, and I read that we should have WHOLE milk products 3 times daily to loose weight. Drink that. It does not have an special weight losing properties but it is a good source of protein.
Diabetes.org and similar sites are 100% wrong. They are one of those "feel good / lets be happy without making changes" sites.
It is true that the advice will feel complicated in the beginning. The best advice you have gotten here is to start testing and recording your own blood sugars yourself so that you can see what foods bring up your blood sugar and which foods help keep it steady.
I am happy that you are trashing the oatmeal. Learn to love vegetables cooked in whatever oil you like and meat/eggs/fish/nuts/dairy.
There are apps that will help you see patterns.
http://www.healthline.com/health-slideshow/top-iphone-android-apps-diabetes#12
diabetes.org is the site of the american diabetes association and gives pretty much the advice every diabetes specialist gives. It is about major lifestyle changes, that work for millions of people. It is not pro ketosis or pro high fat, so it does not appeal to this crowd, but it is not advice given by a random blogger or a random internet poster either.0 -
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caroldavison332 wrote: »On Diabetes.org. (thanks for the referral). It said oatmeal (and oranges) was a diabetes super food. Conflicting information is confusing.
What about whole vs skim milk? I frequenly put all kinds of things on my food list to compare them. There doesn't seem to be much difference in the two, and I read that we should have WHOLE milk products 3 times daily to loose weight.
you're getting conflicting information because there are quite a few rando, low carb zealots around here...go talk to your dietitian rather than a bunch of random internet strangers.
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Going to assume you're already working an Endo. They should give you a referral to a dietician who can walk you through diet and carb control - how many carbs max to eat at each meal and snack. That helps a lot with meal planning. Imagine how much easier it is if you know 15 carbs at breakfast and snacks and 40 to 70 for lunch and dinner. Helps drive your food choices.
When having a snack, make sure you're pairing a protein with a carb - in other words don't just eat an apple. Combine an apple with a low fat cheese stick for example or PB2 protein powder. It slows down the impact of the sugar in the fruit to your bloodstream.
Ask about medications like Metformin that help your body use the insulin you do make.
Keep up whatever exercise you're doing now.
If your doctor recommends it, get a meter like Accuchek and check fasting and post-prandial (meal) every day.
I've had diabetes for 19 years (type 1) & this is great advice.0 -
caroldavison332 wrote: »Thanks for the keytones info. My dr didn't mention it so I'm not worried about it at this time. My friend also warned me not to eat too few carbs or I would retain sugar. I believe that I am safe at this time iwth 139.
As another said, that is false. You will not retain sugar if you eat too few carbs. It isn't possible.caroldavison332 wrote: »Looked into the oatmeal-egg, egg-bread, oatmeal-milk thing. WIll be having yummy open faced egg salad to sandwiches.
You know how they say to use avacadoes instead of mayo? How is the taste/consistentcy if you mash the avacados?
I think that you should use the mayo if you want it. As long as it isn't a low-fat version of mayo, there should be almost no sugars in it - quite safe for blood sugar.
Avocados are great too. Mashed avocados is the start of a guacomole, which is really nice on meats.
Now the bread on a sandwich is something that will affect your blood glucose. One slice of whole wheat bread is around 40g of carbs - two slices is 80g. That's almost 3/4 of your daily alotment and over your 60g of carbs limit that your doctor suggested, even more if you add veggies to your sandwich.
One slice of bread, or no bread, will have less of an impact on your blood glucose levels.0 -
I don't use lot fat low sugar anything because I think of them as chemical sheep storms.
Diabetes.org said limit to 60 carbs per meal or 180 a DAY. I average 139. I eat lots of veggies but not many starchy ones. I track those on food account.
"What does one slice of bread, or no bread, will have less of an impact on your blood glucose levels" mean?0 -
Also a slice of toasted rye or wheat bread is 15 grams of carbs. Where are you getting this 40?0
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caroldavison332 wrote: »I don't use lot fat low sugar anything because I think of them as chemical sheep storms.
Diabetes.org said limit to 60 carbs per meal or 180 a DAY. I average 139. I eat lots of veggies but not many starchy ones. I track those on food account.
"What does one slice of bread, or no bread, will have less of an impact on your blood glucose levels" mean?
Whatever comes first, not one or the other. 60 carbs max per meal, 180 carbs max per day. Not 60 carbs at e.g. 10 meals or 180 carbs all in one meal. And whether 60 is fine depends on each person. You try it, check your levels. If you get above recommendation, keep lowering until you get some balance.0 -
caroldavison332 wrote: »I don't use lot fat low sugar anything because I think of them as chemical sheep storms.
Diabetes.org said limit to 60 carbs per meal or 180 a DAY. I average 139. I eat lots of veggies but not many starchy ones. I track those on food account.
"What does one slice of bread, or no bread, will have less of an impact on your blood glucose levels" mean?
By that I meant that eating less carbs (ie. eating one slice of bread compared to eating two slices of bread) or eating no carbs (ie. no bread) will cause less of a blood glucose rise than two slices of bread would.
Carbohydrate rich foods (baked goods like bread, muffins tortilla), noodles, rice, corn, potatoes and added sugars will cause your blood glucose to rise more than other foods. These are the foods that will make you blood glucose harder to control. They will cause a spike in your blood glucose that will last a couple of hours - not good for a diabetic.
Meat, high fat dairy like cream or cheese, nuts, coconut, and fats will not cause a blood sugar spike (unless you eat a LOTof meat). Veggies will cause a small rise in your blood glucose, higher if you eat a lot of veggies. Fruit often has a lot of sugar, except berries, so eating fruit will also raise your blood glucose.
Best wishes0 -
Just remember everyone is an individual and certain starches and complex carbs still trigger spikes. Some people can eat whole wheat pasta (in proper portion combined with a protein) and be fine and others can have a spike. Testing is key. Follow your doctor's instructions on when to test and stick to it. You can also use the notes section of the food journal to track you blood sugar readings. It will help you see what foods are better for you.
Great advice.
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Hi caroldavison332
I've been a type 1 diabetic for 22 years, while our conditions are different, many of the control aspects are the same. Try not to get overloaded with information, you'll learn what you need to do as time goes on. There is no need to go too in depth at the beginning, as you see your doctors/specialists, they'll explain what you need to know. That will give you a good information platform to build on if you wish to learn more about it.
Keep in mind that everyone's body needs sugar, it's unavoidable, at the core, it's our fuel.
You have a few goals regarding your condition. Weight loss, I know that seems like stating the obvious but it's more about how effective your medication will be. Insulin resistance is a pain but the more weight you can shed the more you can turn that around. (the less cells your body needs to fuel, the more manageable it will be until your body can handle it on its own)
Take care when exercising though, you DO NOT want to be exercising when your blood sugars are high. It's not good for you, cells do not function quite as they should when they glucose level is too high. If you have a high blood sugar level, let it settle down a bit first before heavily exercising. When your sugars drop into a more acceptable range you'll find you have more energy and exercise will come easier, when your sugars are high, you may feel a bit lethargic, have a gritty/burning sensation in your muscles, you may also feel a little sick. Sorry it's quite difficult to describe some of the sensations but you'll soon get used to the symptoms of a high blood glucose level, especially if you are looking for them.
When it comes to your diet, you can't completely avoid sugars, nor should you. Our cells are fuelled by glucose but glucose in its raw form is what we try to avoid. Carbohydrates are totally fine, they are broken down into glucose. It's expected that roughly 45% of our sugars should come from carbs. Its what kind of carbs that really make the difference. We are working to keep a glucose concentration level as low as possible so the goal is to allow sugar into our system as slowly as possible so your blood stream does not become overloaded too quickly. The resistance to insulin means it will take more time for the glucose to be absorbed so the more slowly the glucose is deposited into the bloodstream, the more stable and less concentrated it is. What you want to stick to whenever possible is slow digesting carbs. It take's more time for these to be digested into glucose. Simply the longer it takes your body to break down a carbohydrate into glucose, the better it is for you. A handy thing about this for diabetics is it gives a slow, steady energy supply as it digests. So if you have oats for breakfast, as it is slowly digesting and releasing its glucose into your bloodstream, your medication and your own insulin will instruct your body's cells to absorb it (at a rate it can handle). This will keep your blood glucose levels stable until your next meal. If on the other hand you have fruit for breakfast, containing a lot of fructose, which is much easier for your body to break down, it will enter the blood stream far quicker causing your glucose levels to rocket up.
Look out for the different sugars in food, like lactose in milk and fructose in fruit. There are a good few different sugar molecules and our body can process most of them.
Ketoacidosis has been mentioned but you should't have to worry about this. It is normally caused by a lack of insulin in the system. However when the body cannot absorb glucose into it's cells to use it will eventually start breaking down fat (then muscle tissue) to get to the glucose in the structures. This doesn't sound too bad considering weight loss is a goal. Unfortunately when this happens toxic chemicals called ketones are left in the system as a by-product of the process. Your doctor would've asked for a urine specimen when you were diagnosed, this is to check for ketones amongst other things.
Overall, take your time, stick to slow digesting carbs as much whenever you can, steer clear of anything that is sweet (can't make it easy for your body to get to the sugars) and keep up the exercise and if you are concerned about anything, talk to your doctor.
I'm sorry to hear about your situation, I hope you get everything under control soon 0
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