Sinuses and Sugars

Last Friday was a quite a day.

I started bright and early at Mercy South to repeat my oral glucose tolerance test. I haven't really talked about any of this on here, but a couple months ago I did my annual test and it came back borderline. I wasn't quite diabetic, based on those numbers, but was most definitely in a pre-diabetic gray area.

So we wanted to repeat the test, and I chose to do that last Friday. It took way longer than it should have, and I was there for almost 4 hours. I had just enough time to come home, eat something (since I hadn't had anything yet, save for the glucose beverage), and vest, and turn around and leave to go to my other appointment that day.

I had set up an appointment to go to an ENT. I've been having more sinus symptoms in the past months, and lately I felt I was clearing my throat constantly due to drainage. Sinus symptoms are very, very common in CF and I've been lucky to dodge any major issues until now.

The doctor was up in Saint Peters. My CF doctor, when I asked her about seeing an ENT, mentioned I could see one there or there was another doctor who everyone there had loved, but he left and was "in Wentzville." She was a smidge off on the towns, but close enough. I said "Oh, well that's out by me, I could go see him." So I set up my appointment with him.

Immediately during my visit, it was clear I made the right choice to see him, versus seeing any ol' ENT in town. He has dealt with CF patients before and knows the drill.

Long story short, we did a CT of my sinuses and turns out they're mostly blocked up. There is likely some infection going on, but not in the traditional sense of what people mean when they have a sinus infection. He told me that just like the CF lungs can't naturally clear out mucus, the same with the sinuses. I never thought about it, but that makes perfect sense. Anyways, we're trying to improve things in the meantime with rinses and an antibiotic, but most likely I will need sinus surgery. He said they typically try to tie in a sinus surgery after a hospitalization, since that's when you're feeling the best and, ideally, should be the most cleared out. Again, so glad I went to see him because not everyone would know about all that.

So it's a bummer, but probably a long time coming. I've read comments from other CFers who are 20 and have had like 13 sinus surgeries already. So with that kind of perspective, I've really lucked out. That being said, now that this is an issue for me, it probably won't be my only sinus surgery, and the doctor mentioned that too. He actually commented how lucky and rare it was for me to make it to 30 years old without needing sinus surgery.

So that's the sinus story. Not super fun.

The sugar story... is also not a great story.

I finally got my results Wednesday; my doctor and I had been playing phone tag. And they came back a little worse than last time. Last time, they were 103 and 201. This time, they were 111 and 209. For those who don't know, the first number is your "fasting" number, the second is taken two hours later after drinking the glucose. 100 or under is normal, 100-125 is considered pre-diabetic for the fasting number. On the 2-hour level, over 200 is considered diabetic. 140 or under is normal, that's where you want to be. And between 140 and 200 is pre-diabetic, which is where I've been. As you can see, for my test two months ago I really was right on the cusp, plus I was still trying to feel better and illness or infection can elevate the results. But since this second test was worse, it's safe to say that I am, indeed, diabetic. Not great news.

CF-related diabetes is its own beast. It's not like Type 1, it's not like Type 2, it's weird. I can't change what I eat because then I would lose weight, and since I already struggle with that, I need to keep eating just like I am. Cutting carbs is absolutely not advised. That being said, there may be a way to control it with diet in pairing carbs with proteins and fats, because those can counteract blood sugar spikes. So bring on the steak and bacon, haha.

Just like I sought out a specific ENT because of his experience with CF, I will be seeing an endocrinologist in Columbia because he has experience with CFRD.

So yeah... a lot of information for me to process. I'm really trying not to get too ahead of myself with the diabetes stuff, because I have no idea what the doctor will tell me. I don't know if I'll need insulin; I have to wait and see what he recommends. But it's hard. This is just more shit I have to worry about and fit into my day, which already feels jam packed. In trying to convince myself this isn't as bad as it seems, I'm trying to tell myself that we caught this early. Yes, I am past the diabetic threshold... but just barely. It's not like my sugars came back at 250 or something. Furthermore, I knew that the older I got, the higher my chances were that this would come up. 50% of adults with CF have CFRD. In addition to that, about 3-4 years ago we thought I had CFRD but turned out I didn't just yet, but it's not surprising things continued to trend this way.