Dr. Dave's Self-diagnosis

 I feel like this post has been percolating inside me smelling up the room and now it's time to pour it out. Percolating. Anyone remember those old coffee pots with the glass part at the top you could see the coffee bubbling up into? And the smell of it? 

Coffee wasn't a thing in my house growing up. My Mom never drank it and while we were young we only experienced that major part of Canadian culture when we went out. I recall one thing more than any other about my Mom's best friend when I was a kid - Verna Fletcher - and that was the smell of coffee that hit you like a bean bag (full of Columbian coffee beans) the second you entered the Fletcher home. I think the Fletchers had some of these 

Or some of these

to drink the coffee from. I actually don't remember seeing her without a coffee actually. I wonder if she had a problem... Things you just don't think of when you're a kid... 

Anyway, I think it might be the infrequency of that smell for so many years as a young kid that makes it so special to me now. I just brewed a cup in my Keurig and can smell it a little in my apartment. It's one of the better smells in life IMO. Popcorn, grass, bacon, old timey gasoline with no additives, lavender on the right person, KFC in the winter, Vick's Vapo Rub, freshly baked white bread in a paper bag, A535 on the rugby bus, cigarette smoke - but not just a burning cig - I mean the kind that has been inhaled then exhaled, campfire smoke on clothes days after the campfire... I could go on and on.

But that wasn't what I'd planned to blog about. I gotta try to avoid words like "percolate" or I might go off on a trundle like that again. I wonder if I've done this before. Off on a tangent and I haven't even started with the main topic. Maybe it's age. Tell me THAT wasn't revealed the second I talked about the percolator coffee pots! ha ha ha. I wonder if I could even buy one nowadays.

Nevertheless, the doctors, pharmacies, and general medicine supply chain in Ontario sure have a sweet thing going for themselves! Segue? What's that? I gotta believe it's the same in every province but since I'm here in Ontario I'll concentrate my stream of vituperation. 

I was living in Cheonan teaching at Gongju University there. I believe it was 2020. The Fam had come from Pyeongtaek to have a Sam Gyup Sal feast with me at a restaurant near my apartment in The Love House on the campus of Gongju U. Heather had been testing her blood sugar because it was low and she said we should use her equipment to test mine just for fun. My blood sugar level was 542 or something outrageous like that. So began my days as a conscious diabetic. I don't mean that I've ever been an UNconscious diabetic although I have since thought about a blackout or two that I blamed on alcohol which might have been attributed more accurately, or at least equally, to the diabetes. I mean that I was a diabetic for many years before I was aware of it. How many years, I couldn't say. 

Being employed in Korea while diabetic was a definite plus since basic health coverage made the cost negligible. Virtually everything was covered. YES all you misinformed people, it's MUCH cheaper to be a diabetic in Korea than in Canada - a country that has long been resting on free health care laurels that it no longer deserves. As a point of fact, I visited The Fam for 6 months in 2024 and I paid less for insulin other diabetic supplies in the USA than I do in Canada! THAT'S how bad things have gotten and THAT (finescally) is to be the meat of this post.

I've been getting my drugs and stuff since around April of this year from the pharmacy attached to the walk-in clinic where my doctor is here in Sarnia. I've been to that office a half dozen times or so and only seen this doctor of mine once. He doesn't work at his office I guess. I saw a young male intern, a rude, inattentive, obtuse doctor a few times, and most recently a young female intern. They all want to give me the meds I was on in Korea, or their Canadian versions, which is fine, but in the 6 years I've been treating my disease, I haven't made much progress. A few things have been tweaked, for example, I was on Metformin and it just made my guts go super garburator and give me emergency toilet sessions that I thought endangered the structural integrity of the porcelain fixtures upon which I was blasting out the said guts. I got a substitute that is better called Sitaglipton. It's much more expensive than Metformin. I thought maybe this is why it was readily substituted, but then the doctor (my new diabetes doctor Dr. Shetty) did the opposite. After 6 years of injecting insulin and juggling different meds, some of which I never needed such as the blood pressure medicine I got prescribed because of a flawed BP testing machine in Korea, which I finally put a stop to just a few days ago, I was prescribed this wonder drug called Taro-Gliclazide. 

To give you an idea (now using the western scale for blood sugar) I have been hovering around 10 for years. When my blood sugar goes over 10, like to 12, it's high. When it goes below 10, like to 9, it's good. I have never been in the 8's or 7's regularly. Since starting this Gliclazide I'm in the 7's and 6's! NORMAL blood sugar is 5.5 and 7.8 two hours after eating. I'm practically at a normal blood sugar level! Where was this drug for the last 6 years?

When I took the prescription to the pharmacist, you should have seen him! He asked if I was positive this is what Dr. Shetty prescribed. I said yeah why? He said it's strong stuff. I said so what does that mean, I've been on weak stuff all this time? He chuckled but I wasn't joking. 

As you know, I have the time that most folks don't to research things. I got online and found out a little bit of the history of this drug. First of all, we know who Banting and Best are, don't we? I'm sure it's not just because they're Canadian that I know they're the two dudes who isolated the hormone insulin. They knew the discovery was too valuable NOT to give to the world so they sold it to the University of Toronto for a buck if I remember correctly. Somehow it's now $120 for a box of 5 pens here in Ontario - the same province where it was GIVEN away! Again I am trying not to Google everything so I can maintain a little memory so I think it's pig insulin we get in those pens. 1921 the discovery was made and since then diabetics have been squirting pig hormone into our bodies. Nothing better has happened in science since then? 

Au contraire mes amis, in 1942 (in France) a guy named Marcel Janbon was researching typhoid fever and by accident discovered that a medicine he was using lowered patients' blood sugar dramatically. It was discovered a few years later that this medicine stimulated the pancreas to MAKE MORE INSULIN. Well DUH! This is exactly the drug we need for diabetes, isn't it? But we don't know Marcel Janbon, do we? Do you know what a sulphonylurea is? No. I think this might be because they're dirt cheap. Remember what I said a month's worth of insulin cost me? That's what a YEAR'S worth of this wonder drug costs. 

It doesn't work on type 1 diabetes because it requires a functioning pancreas, but instead of just squirting expensive pig hormone into my body, wouldn't it have been a good idea to see if Gliclazide or some other sulphonylurea worked? I wonder now if I had known about this drug and asked for it, maybe I could have been taking it all this time. And maybe I could have been paying less all this time. But since it's so cheap I guess the doctors hang on to those pills like manhole covers. Just a theory.

OOOORRRRR... since for 6 years I have also been complaining to my doctors about extreme reflux and stomach acid problems, you'd think that maybe one of them might have clued in to the connection between pancreatic digestive enzymes being destroyed by stomach acid and high blood sugar? There's a treatment called PERT Pancreatic Enzyme Replacement Therapy during which replacement enzymes are given through meds like Creon, and proton pump inhibitors like omeprazole or Prevacid (lansoprazole), which I plan to request from Shetty next time I see him next month, are used to make sure the stomach acid doesn't destroy the replacement enzymes. Now, Creon can be a couple thousand bucks a month so this makes me think that none of my doctors even thought about it as an option. Perhaps Shetty HAS thought about it and since he is the one who gave me the cheap pancreas stimulator, maybe he is leery of prescribing Creon because he knows I'm paying out of pocket. BUT, there are alternatives like Pancreaze or Pertzye that can cost... $154 a month. About the same as insulin. 

I requested a medicine for my reflux and Shetty prescribed rabeprazole, which just makes me shit 5 times a day, but I've heard from a few people who have found good reflux meds that they went through a few "prazoles" before they found the right one for THEM as well. 

So I'm thinking Pancreaze + Prevacid PERT treatment would be perfect for me. Or it might be worth a try. By the way, a month's worth of Prevacid is about 20 bux. Would I pay $174 a month to have normal blood sugar and be able to sleep lying down and go through a day without coughing 1500 times? Hell yes! Are Pancreaze and Prevacid pills that pharmacists hold on to like manhole covers? I guess we'll see when I go to see Dr. Shetty next month. And I wonder how the pharmacist will react if I manage to get the cheap drugs prescribed. Just as an aside, the same pharmacist who hesitated to give me the wonderdrug Gliclazide put my prescriptions together again for this month. I checked the bag of pills after paying and, what do you know, no Gliclazide. I asked him and he acted like he didn't know what it was. I told him to check what he'd given me last time. I didn't know the name of it at the time but I said if he showed me and I could smell it I'd recognize it. He showed me some that had no smell and then the right stuff and immediately I recognized it. Why hadn't he just given it to me? Why had he been reluctant the first time? Probably because it's so cheap. So I can just imagine what he'll be like if I end up doing the PERT. I may not even NEED the other drugs! What if I can stop using the Metformin replacement drug and the insulin? I hope to find out someday.

Should I be the one diagnosing my own health problems here? Especially now that I'm back in Canada where we are practically synonymous with stupendous healthcare? No! It's shameful that I am doing this. But that's the new Canada. If there's a way to do something cheaply you just can't expect the experts to tell you what that is. You gotta figure it out on yer own. 

Now, I fully expect Dr. Shetty to shoot down this idea when I suggest it to him. But if he doesn't and if it works, what does that say about doctors, pharmacists, and the whole medical profession here? This is going to be interesting folks...