I woke up early.
This isn’t like me. I usually stay up late writing and then sleep in. But the morning after the scrambled egg episode, I woke up bright and early and ravenously hungry.
This wasn’t like me either. As we covered earlier this week, I hate breakfast. I don’t usually have an appetite until noon. But this morning I was starving.
It was my fifth day on metformin. Day Five is when it’s supposed to really start to work. I was excited for it to work, because it’s a medication known for its beneficial effects on polycystic ovary syndrome– that’s why I was perscribed it even though I’m not diabetic. I certainly didn’t like the nausea and mild depression it was causing, and I didn’t like yesterday’s hunger attack, but I was ready to give it the old college try because it can prevent the blood sugar issues that occur with PCOS from turning into diabetes, and it’s been known to make you ovulate. I took the metformin with an enormous breakfast so that it wouldn’t give me low blood sugar again. I had a cup of coffee with butter and cream, some keto-friendly cream soup, a leftover hamburger patty and a side of cauliflower, and then I went to check my email.
Five minutes later I felt the “Charybdis” feeling I described yesterday once again: my stomach was full of food, yet I was starving. I munched a ketogenic cookie as I checked my facebook.
The next thing I knew, with the taste of the cookie still in my mouth, I was in agony. My jaw clenched. My skin instantly tightened into gooseflesh; I felt like I had been plunged into ice water, even though the living room was warm. Tremors ran up and down my arms. I was nail-spitting angry at nobody and horribly paranoid about nothing and ready to cry from depression all at once. And the hunger was unbearable. I would’ve run to the kitchen and eaten anything that wasn’t nailed down if I had been able to get up. I haven’t felt such a terrifying loss of control in the longest time: when I was in labor with Rose, perhaps, or further back, when I couldn’t stop throwing up from my bowel obstruction in 2007. Maybe it was just that paranoia, but I thought I was dying.
I was already on facebook, so I pecked out a description of my symptoms as a status; it took longer than usual with my hands shaking. Then I realized I ought to be calling the doctor’s office instead of summoning the peanut gallery, and fumbled with the touchscreen until I managed to get through to the doctor’s secretary. With maddening calm, the secretary wrote down my list of symptoms and the name of the medication I suspected was the cause. She promised to tell the doctor as soon as he finished the surgery he was currently performing.
I wanted to scream “HOLD THE PHONE TO THE DOCTOR’S EAR IN THE SURGICAL THEATER, I NEED HIM NOW!” but I couldn’t get words like that out.
The computer was still in front of me, so I saw a nurse friend had commented that I needed carbohydrates and fast. My first instinct in that hypoglycemic rage was to yell at her that I couldn’t eat carbohydrates, I was in ketosis on my doctor’s orders for my health. But I pulled myself off the sofa to the pantry. I poured myself an enormous, extremely messy bowl of the Boo Berry cereal Rosie had refused to finish because it was too sugary even for her. I found myself in the kitchen slopping milk on it, even though it would’ve made more sense to start eating it dry immediately. And I shoveled it in.
Rosie was right. Boo Berry is disgustingly sweet. I have hated the joyless dehydrated “marshmallows” they put in children’s cereal since I was a preschooler, but I ate them. I ate the purple nuggets with the unpleasant crunch and that sickly medicinal flavor that’s supposed to taste like fruit. I drank the mottled purple milk.
The agony disappeared as quickly as it had come on– all except for a little fatigue and some depression.
I got back on Facebook, where diabetic friends were commiserating about blood sugar free-falls like the one I’d just experienced. Friends with PCOS were commiserating about the horrors of Metformin which is supposed to be such a good medicine. Another nurse was weighing in with how inappropriate it was to put a patient with only slight insulin resistance on both the ketogenic diet and Metformin, the diet was plenty– and, she reminded me, the way ketosis can effect a glucose tolerance test result might mean I wasn’t even insulin resistant in the first place and the doctor should have ordered another test. A friend with a disabled daughter was giving me a pep talk on how one has to be assertive with doctors and not let them intimidate you. The nurse who’d warned me to eat carbs was telling me I could just skip my next metformin dose, no need to titrate the dose. And others were just expressing sympathy.
I woke Rosie up. We walked to the grocery store to get proper cereal I liked, stopping once to eat along the way because my blood sugar wasn’t done being dramatic yet. And for the rest of the day, when I felt my blood sugar crashing, I ate Koala Crisp.
The next day, Charybdis was gone forever. I only felt fatigue and body aches– fibromyalgia is comorbid with PCOS, and when I clench my muscles violently like that they are very tender and painful the next day. I went back to eating ketogenic food and trying to stay healthy, using the instructions my friends had given me.
The doctor’s office called me back at 4:30 in the afternoon, a day and a half after my emergency. I was so angry with them that I didn’t pick up the phone.
Why am I telling this story?
Well, first of all because I have wonderful friends who saved me and comforted me, and I want to thank them.
Secondly, just to remark that chronic illness is exhausting. Doctors are frustrating and can’t seem to do very much. Medicine is complicated and unpredictable. It’s lonely. It’s embarrassing.
And if you, the reader, are struggling with a chronic illness, I see you. You are a hero fighting a dreadful battle. You’re not alone. There are so many of us. I think we all must be courageous and strong, though it doesn’t feel like it. We are strong. We can find ways to help each other. We can carry one another’s crosses and get through this.
If you choose to take Metformin, do keep some good-tasting cereal in the house.
Image via Pixabay
Mary Pezzulo is the author of Meditations on the Way of the Cross and Stumbling into Grace: How We Meet God in Tiny Works of Mercy.
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