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Discussion Starter · #1 ·
When I introduced myself, I indicated that I was very reckless with my health as a twentysomething, and that this had something to do with developing diabetes issues as relatively early as I did. Some regulars thought I was being a bit hard on myself in that regard. They could be right about that, because I am certainly no expert in the disease-process of type 2 diabetes. But one thing about which I'm pretty sure, my old bad habits certainly haven't helped my diabetes self-care.

This is especially true with regard to my kidney-health. While blood-sugar control is the paramount issue of being a diabetic of the second type, recent events have taught me that as a diabetic, the most vulnerable organ in your body is probably your kidneys. And my moral Achilles-heal of stimulant-abuse has recently been causing me to experience acute kidney dysfunction. The two stimulants I have tended to abuse are caffeine and pseudoephedrine. In particular, my nightly pseudoephedrine dose has been something that my online research has recently informed me is a common kidney-stresser.

You might be wondering how I could continue to indulge these substances whose synergistic effect is not unlike amphetamines or "speed" and that reek serious havoc on your blood-pressure, which is another issue diabetics need to closely monitor. I was a caffeine-user from the get-go in my late teens, but I added pseudoephedrine to the mix during the period of my life I have come to refer to as my "Kurt Cobain Years". Kurt Cobain was the lead singer of the "grunge" rock-band Nirvana whose issues with low self-esteem and drug-abuse motivated him to take his own life in the early part of 1994. My KCY were a four-year period roughly chronologically centered upon the month of Mr. Cobain's self-inflicted demise. I was in a downhill slide during this period, and it was then that I turned abusing my health into something of a dysfunctional art-form. It was also during this period that I was guzzling entire pitchers of high fructose corn syrup sodapop that I got for free at the restaurant jobs I was working.

As I got older and became less self-destructive, I wanted to give up the sudafed, but being somewhat congestion-prone, I discovered I had become dependent upon it to remain decongested. It wasn't an extreme and serious congestion I would experience without sudafed, but it was usually a light, dryish congestion in one nostril that I would experience at night, and this made it more difficult to get back to sleep. (You would think it would have more readily occured to me that my stimulant-abuse wasn't exactly conducive to getting sleep, but such is the psychology of addiction.) For that reason, I lacked the mettle to toss the sudafed into the dumpster once and for all.

And then starting shortly before the most recent Winter Holidays, I started retaining water. Of course, there was the weight-gain and the blood-pressure that just wouldn't come down, but the scariest symptom was the increased potency of what I have come to call "food-hangovers". I work a second-shift schedule these days, and that schedule determines the my idiosyncratic eating schedule. What that means in particular is that I eat my final meal shortly before retiring for the night. As soon as I started developing other diabetes symptoms, whenever I ate too much and then immediately went to bed (easy to do when diabetes makes you so very tired after work), I would feel a very harshly heavy-bleary-cloudy feeling in my brain all day the next day. It was easy to avoid this problem if I knew what was foolish for me to do with regard to my final-meal-eating/ retiring habits. I now realize that this situation was the result of the kidney-impairment common to all diabetics. This situation became a lot more severe this past December, and it accompanied the water-retention symptoms. I can manage it so that it isn't terribly debilitating, but my poor brain has been feeling rather like it has been "under water" this entire time. And that certainly hasn't helped my caffeine-reduction project either.

So starting today, I am doing what I should have done much earlier and throwing away the pseudoephedrine. If I have to endure some congestion for a while, then I am just going to have to "tough it". And once I am free of the synergistic effect of caffeine and sudafed, I'm hoping that at some point I'll be able to entirely ditch the caffeine too. Another thing I am doing to help my kidneys is reduce my dietary sodium intake by more than two grams.
 

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Good advice, OC; thanks. Pseudoephedrine is part of my past too, but not nearly as strong as oxymetazoline. The quickest thing to waken me is a stuffy nose & during the six years I've been on CPAP, it seemed an even more important issue to keep upper respiration flowing smoothly. I hated to take sudafed at night because I thought it would keep me awake, so I used oxymetazoline nasal spray every night for at least 25-30 years. Only since last November have I come off it & been able to sleep without anything to help.

Whenever I need a new CPAP machine, it'll come with a humidifier and I hope that will help even more. Rhinitis has bedeviled me most of my life & with spring pollens coming thicker with each new day, we're going to find out over the next couple of months, just what kind of stuff I'm made of in staying away from decongestants.
 

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Thanks for posting this -- I too am a formerly HEAVY user of sudafed.

Now I just finished using it to prevent secondary sinusitis from a cold.

I will be looking further!
 

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Discussion Starter · #4 ·
Thanks for posting this -- I too am a formerly HEAVY user of sudafed.

Now I just finished using it to prevent secondary sinusitis from a cold.

I will be looking further!
Probably no commonly-available substance is more of a highway to an early heart-attack than pseudoephedrine, because raising your blood pressure is what it's designed to do by constricting your blood vessels.

And speaking of the kidney issues, if just plain old pseudoephedrine is that bad for your kidneys, I have to think that crystal methamphetamine use, with all those obnoxiously caustic inorganic chemical stimulants, is like hitting your kidneys with a baseball bat every time! That may go a long way towards explaining why "crank" users end up looking so very terrible after so relatively short a time using this illegal drug. :eek:
 

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Discussion Starter · #5 ·
As much as I hate to admit it, it wasn't until relatively recently that I developed the mettle to start seriously tackling this problem. I started doing so during hay-fever season, so I have been staying off the pseudoephedrine with the help of Flo-Nase prescribed by my doctor and "Breathe-Right" nasal strips. Here's a hint for buying store-brand equivalents of the nasal strips: If the store-brand is 35% or more cheaper than the name-brand strips sold at the same place, the adhesive will be inadequate. If it is only 25% or less cheaper than the actual "Breathe-Right" sold at the same place, then the adhesive will be adequate to the task. (I'll probably be buying the Walgreens or CVS store-brand of these.) You Get What You Pay For!

In researching my nasal congestion issues, I have arrived at the conclusion that the situation is caused by either "vasomotor rhinitis" (which has a neurogenic cause) or more likely as a side-effect of my very severe gastroesophogal reflux disease (GERD). It may not be a coincidence that I am more easily controlling my pseudophedrine/ congestion issues now that I am partially treating my GERD with Omeprazole. I can't use Famotidine (Pepcid) because my bathroom scale told me Famotidine almost certainly makes my water-retention problem rather worse. But I know my GERD must be very severe because you are only supposed to use Omeprazole (in a two-week treatment regimen) once every four months, and I have to use it every two months. And in between treatment regimens, the first month is a lot better than the second month. Given the way I viciously beat the living snot out of my stomach lining during my reckless and irresponsible youth (I wonder what kind of health problems Kurt Cobain would be experiencing by now had he not taken his own life?), only having the stomach of Superman could have spared me from developing very severe GERD.

So at my next doctor appointment, I'm going to have to discuss treatment options for my GERD, and the very thought fills me with profound alienation and frustration because I know (through my amazing county-fair psychic-reader powers, of course) my doctor will blame my GERD on my weight. Just like my nasal congestion was because of my weight. (Never mind the fact that I couldn't find boo about excess weight causing nasal congestion in my investigation online.) But if I can get some kind of prescription for controlling my GERD better, I'm hoping I can experience improvement in dealing with my kidney dysfunction. After all, it's attacks of GERD in the night making the kidney dysfunction (known as "acute tubular necrosis", if my self-diagnosis is correct) related fatigue and bleariness much worse that has a lot to do with my needing way more caffeine to function than is really good for me.

Such a hole into which I've dug myself with my bad choices as an existentially insane kid!
 

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I should bring up my experience with nasal steroids. NEVER AGAIN.

Not my blood sugar, but a severe local reaction -- the epithelium completely peeled out of the inside of my poor nose. It itched like hell!!!

I had accepted a free sample from my internist who (along with my pediatrician as a CHILD!) tells me AT EVERY APPT, my nose is congested and inflamed. And offers me samples. Even when I am on Claritin. No clue what to do, I do not like having that inflammation, but it is localized per my hs-CRP, at least. And I am NOT getting rid of my cats, clearly ....
 

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Discussion Starter · #7 ·
Well, every medicine produces bad reactions for at least some people, and I'm glad I'm not one of them in the case of nasal steroids!
 

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I use Ayr's Nasal Rinse and it keeps my nose and sinuses clear. It's especially good during the Spring and Fall! I haven't had a sinus infection in the four years I've used it and no colds at all during that time. I averaged 4 or more a year all my life until then. My nose stopped up, then sore throat, then bronchitis and asthma. That and Spiriva have been miracles for me!
 

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Discussion Starter · #10 ·
[Fred from YouTube]Oh my garnet, AAAAIIIIEEEE!!!![/FFYT] Well, I just realized why my kidneys have been behaving the way they have. My stimulant-abuse problems certainly don't help and probably contribute to making the situation worse. But the real reason I've been experiencing this debilitating situation is that I am experiencing a very rare side-effect of the blood-pressure medication Losartan, also known as Cozaar. This should not be construed as a indictment of Losartan because I am one of those unfortunate people who is highly prone to rare and extreme side-effects. When I was six years old, Ritalin turned me into a horrendous emotional basket-case who wouldn't eat and wouldn't sleep. :(

How do I know this? Well, I really should have suspected this considering the unspeakably and indescribably horrible experience I had on Lisinopril. I finally had to tell my doctor that I would literally rather die than ever take one more Lisinopril tablet. I began to suspect it wasn't just the stimulants that were causing my problems when no matter how virtuously I tried to behave, the situation with my kidneys would kick the ability to get control of my caffeine-abuse just right out of my reach. (Anything from goopy bleariness upon rising to downright headachey "yuck".) But a website called Side-Effects Hub verified my suspicions by informing me that impaired kidney-function is a rare side-effect of Losartan. :mad:

I didn't consider it could be the Losartan because I was fine for the first five months. I wish it would have occured to me that I read while researching Lisinopril side-effects that you can start having severe side-effects after taking a medication without problems for years (though I suspect this is relatively rare). And also, I was strongly predisposed to blame my problems with OTC stimulants because one of my favorite codependent pastimes of late, especially since my diagnosis, has been beating the holy crap out of myself for what a loser, failure, and disappointment I turned out to be. I guess the fellow posters here who said I was being too hard on myself had a point, because not only did my failure to realize what my problem truly was result in a year of bleary debilitation, but also the water retention and accompanying high blood pressure might have killed me if it weren't for the fact that I still retain some of the cardiovascular resilience of youth at the age of 44. (Always having recognized the importance of getting at least some daily exercize likely has something to do with that.) It's pretty amazing that this is what it took to get me to resolve to beat up on myself at least a little bit less. (Just in time for New Years, donchaknow hey!) :D

The medication I'll be trying now is the beta-blocker Metaprolol. I think the ACE inhibitors and ARBs didn't work for me exactly because they are supposed to protect your kidneys. I suspect that my kidneys don't take kindly at all to having their functioning altered in any way and have told me in no uncertain terms that I had better leave them alone or else pay the price! :eek:
 
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