Brief Answer:
happy eyes!

Detailed Answer:
I've just been thinking about you over the past few days and trying to think whether I'd ever hear about any outcomes in your case.....so glad you wrote....

So you went to MEXICO to see a doctor? But you wouldn't come to CLEVELAND? ;)

Well, XXXX....I guess that tells me where I stand with YOU! HMMMMM?? XXXX!!

I know, I know....for you going to see a doctor in Mexico is about as time consuming and difficult as me going from where I live in the burbs to work at the hospital! HA!



Except, I don't need my PASSPORT.....I just have to pass metal detectors and bomb sniffing dogs! HAHA!

So, as predicted you are starting to turn around.....I knew you would....you just needed to get less strict with your dieting on a CONSISTENT BASIS and allow your body to get used to another SET POINT...if that makes sense.

Now, XXXX me this...(that's what XXXX would always say to XXXX...original 1960's series), are you still training and dieting the way you used to? And you had an MRI of what? And the doctor in Mexico was what type of doctor? I would've preferred you hooking up with an ENDOCRINOLOGO...may be, gastroenterologist but not both come gastroenterolo....true? How long did they run the GTT for? I would've held you for a 5 hr. test although you could probably get decent information after 3....I'd just want to keep your friendly company....nice patients are so hard to come by these days! HAHA! (Yes, I'm looking to score Brownie points for my critique! We DIE for those electronic STARS!....bottom line your GTT was demonstrating a trend toward insulin resistance...gotcha...

And yes, sure can be involved with brain fog.....but back when before you've come under better control I believe your brain fog was much more likely to have been due to simply a rapid LOWERING of your blood sugars AND possibly coupled to an inability to utilize the circulating glucose because of the resistance. What's the reason for the resistance? Anybody throw out any conditions or syndromes they thought you could possess?

And that's nice that your spells have moved off the IMMEDIATELY UPON EATING moment and readjusted themselves to AFTER DONE eating....at least that gives you time to recalibrate some things or at least get ready for the spell a little, I dunno...you tell me....

I'm not sure I understand the concept of the PANCREAS WORKING BETTER some days than others? I'm afraid that makes no sense to me.....organs of the body are like LAZY WORKERS or something! HA....."Today, I think I'll work my ass off......but tomorrow, we're gonna slack off a little....come on.....it's JUST TODAY....!" Uh uh....the body's organs must be working at 100% optimal capacity according to the game plan...24/7 (sorry, body organs and cells, "Like, ummm....yeah....YOU'RE SLAVES for the rest of this body's LIFE CYCLE! WORK! WORK! WORK! Full Capacity (cracking whip)...."Full steam ahead, every second of every minute of every day of every week of every month of every year, etc. etc.!" You get the picture, don't you? So unfortunately, I'm having a tough time believing that explanation as to why some days are better than others.....I'd be content in simply accepting the fact that metabolic "S***" happens".....you know what I mean? And not everyday is your blood sugar going to necessarily be as well regulated as another....but that has NOTHING to do with your pancreas more or less.....your organs have 1 point at which they tend to operate.....FULL ON when they're healthy and under normal LIVING circumstances.....

I believe your "insulin resistance" WAS UNMASKED by the strictness of your dieting...remember we talked a little about that? In other words, your body's been HYPERSENSITIZED in a way....(of course, it's a heckuva lot better now) and that's why there were these major swings of sugar....but it's getting better. It could take a very long time for things to settle back down.

So remember, insulin resistance really comes down to one important thing and everything basically flows from that 1 understanding...and basically what it is.....it's: Body tissues poorly utilize blood glucose as their primary target fuel....so that will DEFINITELY SLOW the Black Box in your cranium down, right? No can utilize glucose, yes? Well, then, here are the consequences, goofiness, brain fog, lethargy, fatigue, fainting/hear fainting, weakness, confusion.... etc. etc.

It sounds like things are definitely going in the right direction now compared to before except it's going to take some time for the entire system to ratchet itself back to normal. How did you develop this entity? Possible genetic links cannot be ruled out...

Do you have any lab results as well as the MRI films to upload for me to see?

What's your weight now and where are you trying to maintain? How about another pic to compare to the last one you took of you in competition...do you notice a difference in how you LOOK? If you're not competing...are you OK with that? Don't forget what I told you before....that I know I've got contacts with people here who can map out a regimen for you on what to eat and how much IF YOU still wanted to compete without suffering from taking in hollow calories. Are you HYDRATING ENOUGH? Remember, WATER is the fuel in which all calories are burned...and when doing these types of competitions it really becomes extremely important the ingestion of sufficient water so that things are not climbing uphill due to lack of substrate in which to carry out their biochemical "due diligence!"

Anyways, it's SO COOL to see you back and sending me messages....A strong girl abrazote! I'm very happy that things are improving....don't get impatient....it may take you months more to fully stabilize.

Ok my dear....write back with some answers, try and do some uploading of information if you can get it and scan it in....and let's figure some stuff out....

This query required 60 minutes to read, research, and compile an envoy to the patient.

P.S. Whatever happened with the doctor here in the states you were going to see, the endocrinologist? I guess he didn't impress! HA!

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Brief Answer:
No insulin RESISTANCE is demonstrated by your tests

Detailed Answer:
Hey there....thanks for your response and explanations as to why you chose Juarez compared to XXXXXXX ...you're forgiven :) One day I'll tell you a story of a patient who I sent from Mexicali on a train to Ciudad Juarez....I had all the best intentions when I put him (literally and ACTIVELY with the help of the ambulance driver who drove him to the station with me) on the train to send him to a better life....I hope that's how it turned out...actually, his ticket was 1 way all the way to Guadalajara...but I could never verify if he made it or not....I'm sure he's passed away...he was in his 70s then and that was 1990....anyhow...

I looked at your labs for the GTT and I have to say that I do not see why anybody would say there was any insulin RESISTANCE? There's a slight bump in the amount of measured insulin at 60 min. but it's only 4% above the upper limit of normal and glucose levels come down by about 50% after 60 min. and continue to go down by about another 6% over the next hour with insulin going down as well.

So where is the resistance? If you had resistance then, your serum glucose levels would be higher significantly higher after 60 min. and in the face of a large release...make sense? In other words, to use your numbers, serum insulin would be at say 77 while serum glucose would be hanging out at say, 150 or 160....or even about 167 which was the peak at 30 min. Those would be examples of insulin resistance. The fact, that your serum glucose is not entirely back to fasting levels doesn't concern me after 2 or 3 hrs. because they shouldn't necessarily be expected to go back exactly to starting levels....after you've had carbs you'll get a cortisol push as well which can keep a little extra carb content in the blood above fasting levels...this is because the body assumes that after awakening in the morning (and I'm assuming that's when this was done...though there's no hour of collection noted) the body is going to be busy during the day....therefore, it will keep a little extra carb content above fasting......

Another potential problem with this GTT is a little known detail that patients should be instructed not to restrict carbs in any specific way for at least several WEEKS prior to the test. Is that true in your case? Or were you still in a training and dieting mode which means you were very much limiting carb intake and had altered physical activities which could've altered these results. Actually, I don't think it's ultimately that important because I see your curves as pretty normal.

Here's the bottom line in your case....in my opinion your dieting and exercise activities were in the extreme range for what most people would do for a long time and I think as a result you unmasked a possible intolerance issue to large swings in glucose after a certain point that your body just said, "Sorry, no can take anymore" and that's I believe when you started experiencing the "brain fog" phenomenon that started this whole thing and the reason why you needed to start writing on this network. I don't think the endometrial polyp has anything to do with this whole thing. But if you have ovarian cysts then, that MAY have some relationship to the current problem.

As far as being able to continue training, following regimented diets in order to build muscle etc. I don't see a problem with that...but I think you have to now recognize that your body is telling you about some of its own intrinsic limits and forcing it to take in exactly this many grams of carbs, this many grams of fat, this many grams of protein..etc....know what I mean.

You can certainly diet in order to keep what would be considered IBW for you and train for the purpose of gaining strength and muscle if that's what you want but it has to be done within these new constraints. With all the genetic diabetes you've uncovered in your family....unfortunately, you're at risk for this problem and so your best hedge AGAINST coming down with it is to embrace and embody good dieting perspectives and ongoing exercise regimens.

I can't be too much more specific in what I'm telling I'm saying because I can't predict numbers since I'm a neurologist and not a nutritionist. That's why I want you to come to XXXXXXX and you can talk to someone well versed who is professional and works with professionals who understands how to mix things up with constraints such as what you have. Make sense.....I understand why you may not be able to come up here....but if you're going to go to Mexico then, you need to find someone other than a GP...and frankly I don't even know if just an endocrinologist would be the person for that job. An endocrinologist WOULD be who you want to see about what's going on with the ovarian cysts and to be able to counsel as to whether or not you should go on BC....but we need more of an exercise physiologist or an EXERCISE NUTRITIONIST (do they exist?) Are any of your professors capable of grasping this type of situation?

And you never told me what part of your body was MRI'ed. I'd want to make sure that nothing was up in the pituitary gland or pituitary hypothalamic axis if we're really going to rule out anything that could be working in the background with all these other numbers being normal and yet you feeling brain fogginess then, I think a head MRI is worthwhile. Just my thoughts though......

This query has required a total of 135 minutes to read, research, and compile an envoy to the patient.

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Brief Answer:
Symptoms definitely had to do with glycemic indices NOT insulin resistance

Detailed Answer:
So, just to be clear-- in my opinion your symptoms of lightheadedness, "brain fog", lethargy and whatever other symptoms you had that you could consider "slowing you down" after eating something were related to rapid changes in your blood sugar levels...but they had nothing to do with any problem of insulin RESISTANCE which I don't believe you suffer from based on your GTT numbers. I believe your sugars were dropping more dramatically due to a rapid rise in insulin release...but this was going on while you were having your most severe episodes. Since you've gotten off the strict dieting and strict training schedule and since you've gained some weight....things are starting to settle down. Your GTT numbers are now coming into normal range and that's why your symptoms are much better. I can't say why you're not 100% back to normal except to say that I'm wondering if your ovarian cysts could be playing a role in anything. But that hasn't been looked at yet. If that's not the explanation then, honestly I don't have any other GREAT ideas at this moment except to say I think we need a really good ENDOCRINE specialist involved who is going to really work on getting a good diagnosis and then, start working on a solution. I think TINCTURE of time may be your best solution so that you don't have to destabilize things using unnecessary drugs. I don't understand what the neurologist was really trying to say when telling you that he wouldn't be able to SEE VESTIBULAR NEURITIS.....nothing really to see unless he were looking for some type of vascular abnormality in the inner ear but then, again, symptoms would be much more constant rather than just occurring at meal times. Make sense? I know that your braces can cause BEAM ARTIFACT which can make it difficult to read everything on the film....are you getting the braces off any time soon? Also, did they do the MRI with gadolinium contrast or without? I would've sent you with a contrasted order but non-contrasted should still be interpretable...depending upon the BEAM ARTIFACT.

Don't worry...they weren't electrocuting in the MRI scanner....you were feeling the common symptoms of claustrophobia that many feel inside the MRI scanner. In the future if you cannot get yourself into the zone to go into the tube you should ask your ordering doc for an order of ATIVAN before going into the tube. For the time being you may not need another study since you will still have your braces, right? And that means the beam artifact will still be there.

If you could upload your images to a DROPBOX ACCOUNT and then, send me the link to the file then, I could look at all your images.

Yes, I think hormones could be involved....and that's why we need to define what's going on with respect to the ovaries and reported cysts. There's an entity called PCOS (polycystic ovarian syndrome) which can cause problems with blood sugars, excessive release of insulin, rapid lowering of glucose, and brain fog. That may make sense then, if you're saying that things get worse right around your period time as well.

BTW, what's your Vitamin D, D2, D3, and serum Magnesium levels these days?

Parasites have zero to do with this...but of course, in Mexico parasites are on every doctor's mind since it's so endemic there...but you live in the U.S. Nobody worries about parasites here....we don't eat Taquitos in the Street nearly as much! XXXX!

Not sure why your mom would want to think gallstones since I haven't heard you complain of anything that sounds like gallstones...and again if we simply pay attention to the history of how this all comes about and how it subsides we'll see that there is no correlation to something like a blocked or obstructed bile duct.

An ulcer could be present under ANY circumstance in anyone....but you'd only see them with an endoscopy. Personally, I don't think you need one. An ulcer can't cause these symptoms.

Antibiotics wouldn't have anything to do with this for all the obvious reasons:

1. You're not on them anymore
2. They typically don't cause nor are related to the symptoms of Brain Fog you're talking about
3. Your symptoms are focused around when you eat....no relationship with antibiotics that you no longer take and haven't for some time now.

Throwing the ball back to you chica...! XXXX....

This query has required a total of 173 minutes to read, research, and compile an envoy to the patient.

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Brief Answer:
Very good news that your head is "clean"

Detailed Answer:
I agree with you that I think it's terrific news that after the studies and hassles you went through getting the head imaging studies that nothing of an evil nature turned up inside the skull. I'm not sure about the zapping you felt but I'm wondering if it had anything to do with your braces on your teeth? That is, IF you are entirely unwilling to accept the more likely fact that you're probably JUST XXXX! XXXX....HA! Come on....of course, it's all PSYCHOLOGICAL.....admit it....you've finally FLIP-PED! XXXX....just teasing you my dear!

Seriously, I've had people with braces on their teeth tell me the same thing that when they turned the magnet on they felt something a little odd throughout their body.....so that's pretty cool, no? You're lucky the damn machine didn't just YANK your entire set of choppers out and just have them laying next to you in the tube! HA! I've had an MRI of my head in the past as well so I know what you went through.....that is a damn small crawl space isn't it? Feels like a torpedo tube...and the noise is what you get when you turn each magnet on and off. What ends up happening is that the machine has 3 magnets and they are all oriented at right angles to each other..that's what allows the machine to scan you thoroughly in 3D although it can only "draw" your picture in 2D. Every time they turn 1 magnet on and the other 2 off you get a BANGING SOUND which some people have a terrible time trying to deal with...which is why most places either give you a sedative or earplugs. I never needed either one...neither thing bothered me that much but you're right, I was looking forward to getting out....can't say as how I think something like an MRI machine would make it as a RIDE at either 6 Flags or Cedar Point! XXXX....

So, speaking of 6 Flags and Cedar Point....there's still time to come up to XXXXXXX and catch Cedar Point....come on....tell me you haven't been dying to go to CP? Everybody does....it's very very cool....and I'm sorry, YES it is way better than 6 Flags....been there and it's nice...don't get me wrong but if you've never compared it with CP then, you just don't know what an amusement park is all about. The only place that would possibly be better and I'm not even sure it's a totally fair comparison would be Disney....but that's it....so whaddya say?

So if you ever do get an MRI again, either request they do an OPEN scanner or have them give you just a tiny dose of Ativan or something like it so you'll relax...and then, just keep the towel on your face....you'll be fine! BTW, for the record, I think you look great these days even you're not heavy duty training anymore and even though I guess you took that pic in the locker room or bathroom.....I'm assuming that was the girls' side? HA! Where are the rest of the women man? Or were you on the guys side? XXXX....

If you want to try DROPBOX to see if you can upload your MR images that'll be cool and then, just give me the URL and I'll look at them....but if you were told they were absolutely normal then, you could also just upload a .pdf of the report....your call, I'm happy to look at the pics if you'd like. By the way, give me your exact height and weight nowadays as well...I don't think I have a precise BMI right now to compare with what you were before.

Let's see what your vitamin levels look like as well but I think the next major step for you is to figure out what the cysts on the ovaries are all about and try to correlate anything there with what's going on if you believe that symptoms are either more intense or get more noticeable around your period time....

Oh, one last thing before we close out this thread...I don't think I've asked this question before...but start keeping track of the following to see if there are any patterns....what would the intensity of your symptoms be like COMPARED to the GLYCEMIC INDEX of the food(s) you're eating at the time you feel a bit goofy? I don't think we've ever compared those 2 parameters yet. Glycemic Indices vs. Intensity of Zoning Symptoms. So, what we're trying to do is see if there are certain foods that you could possibly either eliminate, cut back on, or substitute for which are associated with when you feel your worst.

So, if you want to send me answers to those questions....or wait a minute till you get more information you can....then, you'll need to open a new thread since we've come to the end on this one. You can also wait till you've got a date for when you want to make the road trip up here so we can get you back into training and figure out the exact dietary regimen that's going to work for you!

STRESSES THE, true? XXXX!

I just know you'd love seeing XXXXXXX more than XXXXXXX TX--- but I understand, keep trying to find that green pasture down there.....IN THE DESERT! HA! Ustedes, Texanos---

This query has required a total of 211 minutes to read, research, and compile an envoy to the patient.

Please don't forget to CLOSE QUERY ON YOUR END and leave some written feedback and a HIGH STAR RATING....very important if you want them to throw me a big bag of peanuts and keep me going on this end! XXXX!

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