diabetes: metformin

Showing posts with label metformin. Show all posts

Tuesday, 4 August 2009

Hypoglycemia symptoms without low blood sugar

In Type 2's who have had high BG for a long time, it is not uncommon to develop a high "set point". I have that, and a BG of say 90 will give me the mild shakes. 80 is downright scary until I test and verify it is at a safe level. This does not seem to be what is happening with you. How high were your BG readings before you started taking Metformin?

I would read between 110 and 145, most of the time. Not incredibly high, but I tended to not go low enough for enough time to offset the 145 level, so the average is high enough to raise my A1C. I haven't tested a lot since starting Metformin. I think I ought to start doing that.

Thursday, 23 July 2009

Most type 2 diabetics who take meds take metformin

>I am officially on Metformin, starting this morning. I have very little idea what this is going to do to me. Can someone tell me what Lactic acidosis is and how common is it with the use of Metformin? I am a tad nervous about starting this to say the least. What do I need to look out for?<

Most type 2 diabetics who take meds take metformin. Normally the docs start people out with a small amount every day and only gradually increase the dose, since metformin often causes diarrhea and nausea at first (symptoms usually go away in a week or two-- if not, make sure to tell the doc), but if you take it with food, it's usually not bad. Make sure you were given a prescription for the extended release form of the drug-- it's much easier on the insides. Metformin is not considered a hypoglycemic drug, since it doesn't stimulate the pancreas to release more insulin. Instead, it works primarily in two ways-- it helps the body's cells be more sensitive to what insulin there is available, and it works on the liver to keep it from dumping stored glucose into the bloodstream so readily. The overall effect should be a lowering of your blood glucose levels across the board. Lactic acidosis can be a rare but serious side effect of the drug. Go to www.google.com and enter lactic acidosis into their search engine; you'll be shown a few million websites where you can get all the info you want and need. It's important to have liver function tests done a couple times a year, just to check on things. LA caused by metformin is rare-- be aware of it, but you don't need to live in fear of it.

Friday, 10 July 2009

Answer about when to begin oral meds

She isn't on any oral meds or insulin. She is 74, a bit overweight, sedentary mostly, although she gets physical therapy 5 days a week and also attends a very light exercise class most days. The rest of the day, she mostly sits. She has congestive heart failure (which doesn't seem to be causing any trouble right now -- no water) and was diagnosed type 2 about 2 years ago.

She claims to be starving, mostly in the evenings. They're talking about increasing her anxiety medications to counter the problem. I talked to her today about what insulin resistant means and that the hunger could be very real and not psychological at all. Her blood sugar isn't so high that she's whonked out, but at 74, in the first stages of dementia, I think it's high enough that we just can't depend on her to control her diet enough to control her blood sugar. She says she wants to, she just feels compelled to eat. I mentioned this a few weeks ago and I know some of it might be psychological, but here's what I think: I think they need to start her on oral meds to get those numbers down and work from there. I think masking the hunger with some kind of anxiety drug is not the place to start -- try Metformin and see what happens? I talked to her about this today, at length. I don't know what her a1c is -- she doesn't know herself. But, I would think with a consistent average of about 160 for the last several months, that it should be high enough to consider some kind of additional help, at least until the numbers come down and stay down. Any thoughts? I know you're not doctors, so don't worry -- I just really don't know what to think.

Questions about when to begin oral meds

>While visiting my mom today, I checked her blood sugar log. She's checks twice a day, and it runs between 150 and 170 -- consistently, and for quite a while now.<

With only two checks a day (and I assume one of them is fasting), it's hard to know what's really happening. If she starts out at 150, for instance, her post-meal levels could be well into the 200s. Whatever, this is not a good situation. Yes, she's 74, but she could very well have 20+ more years of life ahead of her. With her permission, it'd be nice if you could have a phone conversation with her doc. He probably thinks her A1c is acceptable (if he's not ordering one at least once a year, that's malpractice, IMO), since she might be coming in at 7.0 or so. But her blood sugars are high enough to cause physical hunger, definitely. You're right-- to mask that with anti-anxiety meds sounds more like an effort just to keep her quiet than anything? You suspect dementia; has she been evaluated by an old-age specialist, a gerontologist? Yeah, metformin would seem to make a lot more sense than ativan or something. Can you consult with her doc?

Wednesday, 1 July 2009

Chromium Picolinate & Liver (or kidney?) tests with Metformin or Glipizide

I believe the instruction from the manufacturer or either Metformin or Glipizide (both of which I take) say your doctor should test your liver or kidneys (I forget which) every 6 months, or yearly. Anyone have thoughts or experience on that? Liver. Lactic acidosis can be a problem with metformin. From what I understand, it's rather rare, but it does happen, and it can be life-threatening. This is only one reason why all diabetics need ongoing check ups with their docs at least every six months, with accompanying bloodwork...read more

Has anyone had experience taking chromium picolinate to help lower blood sugar? What kind of results, with what dosage, and what brand? (The latter two can make all the difference in the first, of course. And there is a dose level, as with many helpful supplements, where it gets toxic.) I took Nature's Way - Blood Sugar with Gymnema when first diagnosed. I was on Metformin then so I was not worried about hypoglycemia. I know that many people are skeptical of these supplements. From my experience, I can say that this did help keep my sugars in good control. I took 6 capsules daily, 2 with breakfast, lunch and supper. If you are taking any hypoglycemic drugs you should talk to your doctor before taking such as the probability of going low is likely. Now I am on Prandin and as part of a test I took the supplement once along with the medicine and went really low. So my experience tells me that it does work.

Does Metformin Cause Weight Gain for Diabetic?

My mom said the first week or two she had stomach issues, after that her body got used to it. If you have been on it for longer than that, maybe you could ask for a lower dose? My experience has been weight loss. But I also have a question about metformin... has anyone experienced continued upset stomach and diarhrrea when taking it? I am on mg a day and my poor stomach is always upset. I'm on vacation now, but can't imagine what it will be like to feel this way all of the time when school is back in session...I just can't go running out of the classroom to the potty all the time!

Does Metformin Cause Weight Gain?

Metformin Side Effects for Diabetic

My mom said the first week or two she had stomach issues, after that her body got used to it. If you have been on it for longer than that, maybe you could ask for a lower dose?

I can't take more than 1000 mg a day. When I got bumped up to 1500, well, just forget it;I'm not willing to spend half the day in the bathroom. So some people can't take it at all, some can take the maximum dose very comfortably, some people have to make do on a lesser dose, but almost everyone seems to have at least some queasiness and diarrhea in the beginning and at any time the dosage is increased. Usually, if you're going to get used to it at all, a week or ten days later things start to ease. Usually. Definitely a YMMV thing.

Monday, 29 June 2009

Have you considered contacting the manufacturer of your Metformin?

I ask this because, about a month ago, we received letters that the manufacturer was doing a RECALL on our DIGOXIN because there were either too high or too low dosages of Digoxin in the pills. We were advised to return all our Digoxin and it was replaced with another prescription. I do not have a good feel for this, but it strikes me as unlikely it was the Metformin. I have often heard of cases of bad batches of drugs, but closer investigation almost always reveals something else going on. That is not to say it is impossible, but the generic drug makers are heavily regulated, and the liability for mistakes is so great, they tend to be mighty careful. I was DX'd in Feb of this year and have been working on getting my numbers in an optimal range. After about 3 weeks I did ok for a week or two then my numbers were higher (130-190 range for the most part). Last week I got a new bottle of metformin and my numbers have been in a much better range (109-121) pretty much immediately.

Pick up the phone on Monday AM and ask the pharmacist if they switched suppliers on you. By law, the active ingredient in metformin or metformin XR has to be the same as in the original Glucophage or Glucophage XR. But the various generic metformin manufacturers are allowed to play around with the so-called inert or inactive ingredients, which can definitely affect absorption rate, etc. This is one of the drawbacks of using the cheaper generic brands-- the pharmacists can fill your prescription with whatever generic brand they want, and switch you up at any time. If you like this one they gave you and want to continue it, just ask the pharmacist to always supply you with that particular generic-- AFAIK, any generic brand can be special ordered for anyone at the pharmacy's request, as long as it's still being manufactured. If there's been no change in supplier, maybe your old supply had been contaminated or changed somehow (heat, moisture, etc) or was simply past its expiration date.

BS numbers and Meds question in metformin or metformin XR

I was DX'd in Feb of this year and have been working on getting my numbers in an optimal range. After about 3 weeks I did ok for a week or two then my numbers were higher (130-190 range for the most part).Last week I got a new bottle of metformin and my numbers have been in a much better range (109-121) pretty much immediately. Pick up the phone on Monday AM and ask the pharmacist if they switched suppliers on you. By law, the active ingredient in metformin or metformin XR has to be the same as in the original Glucophage or Glucophage XR. But the various generic metformin manufacturers are allowed to play around with the so-called inert or inactive ingredients, which can definitely affect absorption rate, etc. This is one of the drawbacks of using the cheaper generic brands-- the pharmacists can fill your prescription with whatever generic brand they want, and switch you up at any time.

If you like this one they gave you and want to continue it, just ask the pharmacist to always supply you with that particular generic-- AFAIK, any generic brand can be special ordered for anyone at the pharmacy's request, as long as it's still being manufactured. If there's been no change in supplier, maybe your old supply had been contaminated or changed somehow (heat, moisture, etc) or was simply past its expiration date. Great info to know! Thank you so much for replying to me. I definitely know something has changed and it wasn't me. I am still seeing awesome numbers and it makes me feel good because I have struggled so much these last several weeks trying to figure out what I was doing wrong. Never crossed my mind it could be the meds. Do they have to document which manufacturer they filled your Rx with each time it's filled? Thanks again!

BS numbers and Meds question on Metformin

I am on metformin and every time I have to renew I always get the same pills and the exact size. I deal with a small town pharmacy also. I have been dealing with this pharmacy for over 25 years and have never had any problems with him. I get about 8 different medications per month and the only time i have any trouble is when he does not have the medication in stock but he will get the next day.

On Metformin, my pharmacy changed fairly frequently. Sometimes the pills were a different shape. I go to a small pharmacy in a country town, and the pharmacist would happily show me the bottle the stuff came in if I asked. I would expect any pharmacist to be cooperative, or it is time to find a different pharmacy.

I agree. I would feel the same way about a doctor or hospital who refused to show me my own medical records. All of us are entitled to ethical treatment, and that includes full disclosure about all procedures, medications, medical notes, and recommendations about our own treatment. There was a time, decades ago, when patients were treated like children in many cases, but those days should be long over by now.

Thursday, 25 June 2009

Talk To Your Doc About Getting Off The Metformin Altogether

I am not so sure about shooting insulin and being on Metformin also. It does not make a lot of sense to me. Talk to your doc about getting off the Metformin altogether. If he thinks it is better to stay on the Metformin, ask him why not start another oral antiglycemic in addition to Metformin rather than starting insulin at this point.

The cartridges cost the same as the disposable pen. We found out the pharmacist messed up and gave us the wrong things. It has finally been fixed and we are using the disposable pens as the dr ordered. One other thing is that the refills are not for the Solarstar but the OptiClick. The pen itself (for the refills) has to be gotten from you doctor. I did get to see the price on both and belive it or not they are the exact (to the penny) the same price. Both are 202.58. Shocked me. I do wish to appologize for the amount of time it has taken me to respond. I have been sick and so has my husband. I am also getting ready for a day trip tommorrow for possible Jury duty (over 2 hours away). And yes they can do that when it's the state grand jury.

Also on an update note: We found that the easiest way for him to get the insulin is in the very back of his arm. He can't reach that so I do give him his shot each night. The stomach burns, the legs are almost no fat at all and the sides of the arms are muscular. I don't mind helping him with this. He is up to 25 units of Lantus each night with an up in the Metformin to 2000 mg per day (that's the max right?). Anyway his numbers are still up there and the diet is also under tight control. He is allowed (by mutual agreement) one snack a day and one sweet treat a week provided he exercises daily. The once a week thing was his ideal but the exercise part was mine (he agreed to have only one a week if he did something to improve his numbers and I suggested exercise). I do believe he is gonna get there it's just taking longer than either of us expected. We were so naive as to think take a shot numbers are normal.

I use the disposable pens. How much less do the pens that use the cartridge cost. More specifically, not the reusable pen, but the little vials it uses? Looks like it would be cheaper.

Metformin-Insulin Combo for Diabetes

Metformin is popular because it works well, is generally well tolerated, hardly ever causes hypo episodes, and is a doctor's wet dream for easy patient management. It is not without risk, however. The relatively huge doses required (up to two grams daily) can damage kidneys or cause other problems. I still question the wisdom of not discontinuing it when insulin therapy is initiated. There are of course other opinions. Personally, I am glad to be off of Metformin after nearly a decade of using it. It contributed to my kidney problems at the very least, and may have been the principal cause.

>I am not so sure about shooting insulin and being on Metformin also. It does not make a lot of sense to me. Talk to your doc about getting off the Metformin altogether.<

Lots of us are on both insulin and metformin-- believe me, it's not an unusual combo of meds. After all, metformin is not a hypoglycemic, plus any drug that will help a type two be less insulin resistant as well as help keep the liver from doing those unfortunate glucose dumps quite so readily, well, when it works, it's very effective.
Anyone with normal kidney function is a good candidate for at least a trial course of metformin, if they can't get their glucose under control with just diet and exercise. In fact, from what I see, metformin seems to be the first go-to drug most docs are using these days. Naturally, careful, regular monitoring is necessary to make sure liver and kidney functions stay within normal limits.

The Combination of Metformin and Insulin Can Reduce The Weight Gain Typical for Insulin Alone

You are of course correct. I now see the combination of Metformin and insulin can reduce the weight gain typical for insulin alone. I know what you mean about multiple drugs. I am now taking a cocktail of drugs as a result of my recent bad bout with kidney failure, et all. I am not entirely happy with some of the drugs involved. I have even passed out from low blood pressure, the first time I ever fainted in 57 years of living, as far as I can recall. Nevertheless, I am glad I quit Metformin personally.

I still question the wisdom of not discontinuing it [metformin] when insulin therapy is initiated. There are of course other opinions. Well, my "opinion" is that I shouldn't have to take any of the sh**tty drugs I shove down my gullet every day. Sigh. Damned things... I KNOW they're poison, but... which disorder do I choose to not treat, and why? And when? Not even the so-called experts can tell me which of the many drugs I take is more apt to kill me than any other. Taking any kind of medication is a calculated risk, I'd say, just as is leaving any medical condition untreated, for that matter. A couple of years ago, I asked my endo about discontinuing the metformin-- I told her, "I don't think it does anything anyway." So she looked me up and down and said, "Go ahead. Don't take it anymore if you want. I think you'll see it DOES do something." So I did, I discontinued it, and within about 3-4 days, I found my blood sugars going up, my insulin requirements increasing, etc. Sigh, sigh, sigh. And yeah, I went back on it and am still on it.

When someone like me, who besides 1000 mg of metformin also takes 110 units of Lantus a day and upwards of 150 units of Humalog, decides they're not going to take metformin anymore, well.... I guess I should start buying those 100 unit syringes, huh? Or maybe see about switching to U-500 insulin, something my doc doesn't want me to do. See, this is why we can't make generalities about diabetes care-- each and every one of us here on the list has a different way of getting to where they need to be (close as possible, anyway), and when it comes to meds (like anything else), YMMV is never more true.

Wednesday, 17 June 2009

Metformin makes you more sensitive to the insulin you are taking

Don't get discouraged! Remember, you are not taking a fast-acting insulin yet for the food you are consuming. The fact that Dr. New told you to test only twice a day makes me feel uncomfortable. But since it's only until next week, I guess it's OK. Forget about testing with both your meters since you say the numbers are comparable. Use the one that your insurance covers the strips and keep the second one in reserve. Metformin makes you more sensitive to the insulin you are taking. 1000mg of metformin is still below the *minimun effective* dose of 1,500mg. Dr. is bringing the dose up slowly to save you from intestinal distress. I have read that 2,500 is the maximum dose so there is a long way to go.

Your added weight can be from edema (water retention). Lantus can cause some edema. You could ask about switching to Levemir if the weight gain continues. Are you exercising? Even a slow hour walk each day can make a difference. If you work in an elevator building, walk the stairs. BTW, I avoid cottage cheese which usually contains 4mg carbs per serving. I sure hope that Dr. New is redoing all your tests. Two weeks will be up in a flash. Hold tight, see what happens, and let us know how you're doing.

I'm not doing much exercising at all right now. Psoratic Arthritis in my hips and knees is acting up, so I'm spending too much time sitting here in my chair. I also work here at home, on the computer, so no stairs. We've got the pool heated up now and we'll be getting in for the first time tonight. I can swim without ending up in pain like the walking does to me.

This new doctor says he'll probably crank me up to 2500 mg of Metformin but I won't be hitting that high dose until the end of a month of working up to it. He wants new tests for me but we may wait 2 months for that. He likes the lab I used for the last tests so he got a copy of my results and my A1c is really 7.9. He says that isn't a number to panic over but it does need to come down. BUT he doesn't want to see me get down to the number 5. He wants me at 6.?. It's his opinion that getting your numbers (including daily BG numbers) down TOO low puts a person at risk for Hypo and that's just as dangerous as going too high. He says a diabetic has to work hard to keep themselves within a relatively narrow range to avoid highs and lows. Our bodies can't self-regulate very well to quickly correct those highs and lows.

Friday, 12 June 2009

Diabetes: The combination of Byetta and metformin is optimal for type 2 diabetics with weight to lose

IOW, metformin alone didn't affect appetite. Byetta alone didn't affect appetite. But metformin plus Byetta worked wonders. Has anyone else had a similar experience?

I started taking Byetta about two years ago and I experienced an immediate adjustment of my appestat. I eat only when I'm hungry and stop when my brain tells me I'm full even if it is in the middle of a bite of food. I will spit it out. I was exactly like that with food when I was a child and immediately recognized the feeling. I am one of those people who gained a ton of weight when I was using insulin to control my BG and Byetta has totally turned my life around. I've lost 65 pounds and still have another 60 to go which I have no doubt I'll be able to do. My doctor and I added Metformin after a month on Byetta mostly because I wasn't getting the great BG control that other people seem to get. I've been diabetic for over 30 years and still need about 20 units of Lantus at bedtime and 10 units of NPH in the middle of the night to keep my A1c a little under 6.0 . I think I would continue to lose weight on just Byetta but I agree that the combination of Byetta and metformin is optimal for type 2 diabetics with weight to lose. I think the combination ALLOWS me to lose weight but I also eat low carb and swim and do weight training three times a week. I lose very slowly and wouldn't be losing weight at all without making the effort. I do occasionally hit a plateau but have always been able to get the appetite suppression back, if that's even what it is. It feels very healthy and normal. I think all three things; Byetta, metformin and low carb eating help control my appetite. When I was using insulin alone my body was sending hunger signals ten minutes after I just finished a meal and that chemical imbalance has been repaired.

Wednesday, 10 June 2009

Diabetes: What's the name of this antibiotic?

Several antibiotics directly interfere with insulin uptake. This particular antibiotic has all sorts of warnings about adjusting insulin dose in the package liner notes. Dunno, just what it says. I've never heard about antibiotic affecting blood glucose before. I wonder if it's a warning along the lines of "if you're sick enough to need this medication, you might be sick enough that your blood sugar will be wonky, so keep a close eye on it". What's the name of this antibiotic?

This was one of the cephlosporins, Keflex I believe. I just looked at one web reference just now and did not see reference to the general effect on diabetes, but did see a mention of interaction with Metformin. The warning I have seen before was a caution that adjustment of diabetes medicine in general may be necessary.

Tuesday, 9 June 2009

Diabetes: Two weeks in loss to the Metformin

When first put on Metformin in January, I weighed 174 - my highest weight ever! Two weeks ago I was down to 162 (I attribute most of the loss to the Metformin, plus boyfriend has moved out of state for a few months and I eat healthier on my own, and two weeks before diagnosis I began a regular exercise program). Currently 5'4", 160 lb. (I used to be 5'5" LOL) I'm focusing more on nutrition and exercise and trying to not put much emphasis on the weight number, although I like seeing it go down. My goal at this point is 140 lb. and we'll see how that feels......

I discovered Leslie Sansone's DVDs on Walking at Home and have been using them consistently now for a month, six times a week, minimum 30 minutes each time. I enjoy them, work up a sweat, feel myself toning, know I'm burning calories. The moves are easy and I can't use any excuse like it's too hot out, too cold out, too late out... I know there's a honeymoon period and I will probably be tempted to slack off, but I do have a variety of her programs and really do like the way I feel when I accomplish them. I started with just one mile (plus warm up and cool down) and now usually do two....with a goal of completing a four or five mile program in one session..... one day!

Nutritionally I'm doing much better. The only real issue I have (and I can deal!) is the time it takes to prepare and record food. I'm basically a convenience food gal... grab and go, pop in the micro... and you don't get a lot of great nutrition that way. I've been doing a lot more salads, which - of course - means chopping and cutting and washing, etc. all the fresh goodies. I enjoy them....just sometimes feel like my life is about food now . Go to work, come home, exercise, eat, prep meals for next day, go to bed, go to work..... I am coming up with good solutions, tho.... cottage cheese and multigrain crackers is grab and go! Still got a ways to go, but I'm changing my ways and I'm doing it because I'M WORTH IT!!! (repeat after me, Marilyn.... I'm worth it!)

A week ago I had an ice cream binge...finished off that quart I couldn't justify throwing away....(... you HAVE to be able to laugh at yourself, right?!). Otherwise, I've been on track. This weekend I'm attending a convention. Fortunately it's in my city and I can go home at night. Before yesterday's opening I stopped at a restaurant and had a good, healthy salad. The convention offered a Nacho Fiesta mid-evening, and an ice cream social later at night. I skipped both, and had planned ahead by bringing snacks with me. I'm seeing how things I would have taken for granted prior to diagnosis are now red flags for me....interesting living in my old world with my new me.

Monday, 8 June 2009

Diabetes: To change from Janumet to Metformin and see if things improve

My DH is having a really rough time right now. He is having difficulty focusing, he has been really irritable lately, he is drinking alot more (water only), he is eating no stop and his numbers are soaring. He has been under alot of stress and we both are getting worried. Could this simply be a side effect? He takes Janumet 2 times 50/500 and glipizide 2 times 5 mg. He has taken Dualact and Actos both in the past and ended up with depression. At night he sweats all night long and will wake up several times a night. The Gastro dr said he might have Sleep Apnea and that he should be tested for that but not to run off to the gp for that (he has an appointment next month with the gp). Could this be causing the problem? Health wise he is going down hill. He had 4 small polyps removed on Friday. He's already had 2 surgeries in the last three years for abscess drainage (it was to the bone and came up both times overnight). He's really get frustrated (I can't blame him). He is on a pretty good diet plan. I keep him around 45 carbs per meal and that was starting to work. He gets 30 minutes of exercise a day with alternating between strength and cardio. I'm getting concerned because I really don't want him to have to go onto insulin. He doesn't like testing and he's only now taking this more seriously. I would be concerned about him taking the insulin on schedule. I know there are long acting ones but in his job he doesn't always get to eat at the same time. Somedays he doesn't eat at all (usually when he has to go to a job site) or he doesn't eat well. He has a fairly seditary job also (believe it or not he's behind a computer most days and eats while working). All of these I could see being a problem on insulin. Please shead some light. I know I'm not able to control this for him I just need to know that it will be alright and that it could be the meds that are causing this.
We are faxing a request to the dr to change from Janumet to Metformin and see if things improve. Just figured I'd see what you guys/gals say.

Saturday, 6 June 2009

Diabetes: Metformin question

I had noticed my BG was getting worse, and assumed I was loosing control with Metformin (failure of the oral anti-glycemic after years of use is common). I got to feeling really bad and lost all appetite, loosing quite a few pounds. I finally got in to see the endo (actually the nurse practitioner) and was told I was in acute Kidney failure. My creatinine was 3 or so and my BUN was 60, I believe.

I originally assumed I was a rare case of Metformin induced lactic acidosis, but the endo has waiverd on an opinion as to cause (perhaps due to malpractice concerns). Maybe the ACE inhibitor I was taking in a rather large dose or maybe the HCTZ diuretic. It is frustrating not to understand exactly what happened since that understanding would help with decisions as to what drug cocktail to use now. All the docs want to talk about is congestive heart failure, but in fact I did not pick up a fluid load until the nurse practitioner insisted on cold tukeying on all diuretics. Eventually, I was put on megadoses of diuretics and have last in the neighborhood of 50 ponds of (mostly) water in the last two weeks (I say mostly because I am sure I lost some real weight on hospital food).

Now as to your situation. Ketones in your urine infers poor glycemic control, I believe. Blood in the urine can mean a number of things, generally not good. Find out your BUN and Creatinine numbers as these are good indicators of Kidney function. It is generally accepted that a creatinine of 1.7 or 1.8 indicate about 50% kidney function, though that is a subjective number. I am running 2.0 or a little less which is good enough to live with for at least awhile. Of couse my kidneys are being asked to deal with temporary huge doses of diuretic, and that may improve a bit more when that is over.

Tuesday, 4 August 2009

Thursday, 23 July 2009

Friday, 10 July 2009

Wednesday, 1 July 2009

Monday, 29 June 2009

Thursday, 25 June 2009

Wednesday, 17 June 2009

Friday, 12 June 2009

Wednesday, 10 June 2009

Tuesday, 9 June 2009

Monday, 8 June 2009

Saturday, 6 June 2009

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