Nurse Practitioner’s Appt This Afternoon

I had a brief meeting with my nurse practitioner this afternoon. Even though it was only half an hour, we discussed a lot of things. First we made concrete plans for me to start the topiramate. Like I said before, I would need to be on the injectible birth control for two weeks before I could start it. That would be next Thursday, but I proposed I won’t start with the topiramate until the Sunday after that, July 4. That way, I won’t be just starting out when I go to Lobith on July 3. This was okay with my nurse practitioner and he’d make sure the pharmacy would get it ready on time.

Next, we discussed my bloodwork results. In the part that measures metabolic health, nothing worrisome was found. I asked about my kidney function and first my nurse practitioner said that unless your estimated GFR is below 60, it’s no reason to worry yet. Mine was 81. He checked my previous lab results. My estimated GFR was 71 in 2019 and 82 in 2020, so there’s not a clear decrease either.

He also complimented me on my cholesterol level, which was completely normal. Of course, there is only so much you can do about high cholesterol, but apparently I’m doing what I need to. It probably helps that I don’t drink and try to eat a relatively healthy diet.

Then the other page showed my blood level for my antipsychotic aripiprazole and its active metabolite. These were quite high. This means that side effects may outweigh the effectivness of the medication. While I don’t experience any major side effects, we will try to lower my aripiprazole dose in the not-too-distant future. That’s been a long-time wish for me anyway.

Then we got to discuss my crisis last week and my conversations with my husband. My husband had suggested I might have dependent personality disorder and I eventually thought he was right. Of course, in my mind, this led to all kinds of additional conclusions that my husband hadn’t mentioned, like my not having trauma-related issues and my not even being autistic and my being one giant manipulator.

My nurse practitioner said that DPD rarely if ever goes alone and that he wonders whether it even is a valid diagnosis. It is according to DSM-5, of course. He added that this is one of the most negative diagnoses to give someone. My nurse practitioner obviously didn’t mean my husband, as he didn’t really try to diagnose me at all, just wanted to give me food for thought. We will further discuss my issues with dependency in the future.

Overall, it was a good appt. As my nurse practitioner hadn’t read the E-mails we (meaning my inner people) had sent him over the weekend, we didn’t go into those specifically. Those E-mails had included a lot of self-loathing and self-doubt, including about our possible DID. I did explain about the dependency issue, like I said above. He also made sure I’m no longer in actual crisis. I confirmed this. This means I no longer need more frequent contact with the mental health team than I normally have.

June 2021 Health and Wellness Update

I am feeling kind of worried about my health lately. To get myself a more realistic picture of how I’m doing, I thought I’d do a health and wellness check-in. I am hoping I can make this a monthly habit.

Firstly, the reason I am worried is one abnormal result on the annual bloodwork I had done last week. I get an annual blood test for fasting glucose, cholesterol and other indicators of metabolic syndrome. This is because I take psychiatric medications that can influence this. Last year, my mental health agency ordered it, but this year, my care facility’s physician did. This means I could see my results in the patient portal for my GP surgery that same evening.

The good news is my fasting glucose, cholesterol and triglycerides were all within the normal range. The one thing that wasn’t, is an estimate of kidney function. It should be above 90 and was 81. Because it is an estimate, one abnormal blood test doesn’t say anything. I may need to be retested in a few months.

I looked up what to do about decreased kidney function, hoping to find that if I drank plenty of water, I could get it back to normal. I’m still not sure that’s the case. I mean, I try to drink at least two liters of fluid each day, but can’t figure out whether that should be enough. Other than that, I do try to watch my salt intake more closely. That’s pretty hard, of course – harder than drinking more water.

I do worry that I might not be able to tolerate the topiramate though, because if I remember correctly, that medication is eliminated through the kidneys. I’m not sure though and will leave this to the doctors to decide.

Like I said though, all my other results were within the normal range. My fasting blood glucose was 4.3. It should be between 4 and 6 and was 4.2 the last time, but I’m not drawing conclusions about it increasing as of yet.

Today, I did send off a urine sample for checking for a UTI, because I’ve been having lower abdominal pain. It came back alright. My staff will likely call for an appointment for me to see the doctor, as the pain is still pretty intense.

As for some good news though, I stepped onto the scale this morning and am back at my average weight for the past six months or so. My weight usually goes up or down a few pounds. I’m now 72.1kg, which means 2kg to lose for a BMI under 30. I am unlikely to reach that goal, but it’s okay.

As my husband reminded me when I told him about the abnormal blood result, small steps go a long way. I am already trying to cut back on my snacking on the weekend. I also make sure to eat enough veg and fruit. I mean, the meal delivery company isn’t great on putting veg in its pasta and rice dishes, which I eat most days. However, I make sure to eat some cucumber, tomatoes or raw bell pepper with each lunch. For the upcoming month, I’ve also selected some potato dishes from the meal menu, since they usually are richer in veg.

My husband also pointed out that I get enough physical activity. I could go on the elliptical more often, but my walking is pretty good already.

I did feel a little depressed when my husband told me that it’s obvious that I’m not as healthy as the average woman in her thirties. Then again, he reminded me that I turned the tide on my weight gain in 2018 and am healthier in some ways than I was before. Besides, a century ago I wouldn’t have lived past infancy. That put things into perspective.