Non-fatal medical news

[pameladean]

On April 26th I went to the doctor for a regular checkup and lab work. My blood sugar came back elevated to the point where I was diagnosed with type 2 diabetes. This diagnosis triggered a huge number of Get this test, Get that exam, Here have a glucometer, No you don't have to start on metformin right away but you might need it so get ready, Take these four three-hour diabetes education classes, Talk with a diabetes education nurse (she was fabulous), Check your blood sugar first thing in the morning and two hours after beginning to eat your largest meal of the day, Hmmm given those numbers try exercising for 15 minutes an hour after eating dinner. I haven't seen a nutritionist yet but it's on the list.

I am not exactly surprised. Numbers have been creeping up for years despite periodic attempts to expel added sugars from my diet or at least be mindful of where they were and approach them with caution; both my grandfathers were diabetic. However, I am considerably more thrown for a loop than I would have expected.

In 2002 I was diagnosed with hypertension in the ER. Those numbers made everybody's eyes very large and caused them to rush around with heart monitors and ask me a lot of questions. Eventually they ruled out things that would kill me at once and sent me off with a prescription for a beta blocker and instructions to go find a primary care practitioner at the clinic. Nine months later, after trying about twenty drugs in various combinations, my PCP sent me off to a nephrologist to make sure my kidneys weren't turning the wrong kinds of cartwheels. In the regular clinic, my BP numbers made everybody get very quiet and look at me as if I were about to keel over. In the nephrologist's office, the nurse assigned to handle me addressed me as "young lady" (I was 49) and said, "We have patients with much worse numbers than that, and on more medications. We'll fix you up." They did, too; there was nothing wrong with my kidneys and they found a combination of meds that worked.

Similarly, while my blood sugar was sneaking up on the scary invisible line, everybody was very sober. Once it leapt over, suddenly my doctor was very cheery. "Oh, I've got patients with much worse numbers than that, and those are very hard to get down. You can get yours down."

I'm not sure if this is more reassuring or unnerving. Anyway, I've been sulking and dithering and sitting on the news, and I decided that it was time to stop that. Plenty of people live with diabetes. The new regimen and the knowledge that there are more changes to come are making it hard for me to work, but I will try to get over myself.

Pamela

Comments

[ritaxis.livejournal.com]

So my attitude is that if we live long enough, we all get type 2 diabetes. Also: there's a continuum between pre-diabetes and type 2 diabetes. The thing is, anything below 6.5 A1c and there's no evidence of neuropathy whatever (meaning you won't go blind from it). So if you've crept over the line to 6.5, your goal is just to get back down to below it, right?

As for the daily blood sugar tests--I found it a lot easier to stay on top of it when I had gestational diabetes because of all that feedback. I got into testing my sugars several times a day just for the hell of it, watching my sugars go up and down was entertaining and I felt like I learned more about the overall pattern than if I had just followed the directions. After a while all those finger pokes got to me and I fell back to the recommended pattern, but by then I had a pretty good idea of what my ,blood sugar was doing and I was able to hit my marks and ,my kids were normal sized and everything.

I'm still hanging around 6.3. Formerly I had dropped it to 6.1 for a while but currently I can't be bothered as long as it stays below 6.5. I imagine that after I have finished with all the cancer nonsense and I'm back "normal" or something like it, I will buckle down a little. especially if it turns out I've gotten a bump from the steroid they give with the cancer meds, which I don't think seems to be the case yet.

Anyway, all that babbling was by way of saying, hang in there. You can do this, it's just a wee bit more attention than you want to pay to your body, but it shouldn't interfere with your work too much.

[pameladean]

I'm at 7.2 and Minnesota standards of care want me to be below 7. I would much prefer to be somewhat lower, especially with the information about neuropathy that you provide. I'll ask my doctor or the diabetes nurse about this when I see one of them next.

I am not a fan of poking my finger and I am painfully aware that I'm paying for the lancets and test strips. Fortunately, for the moment the after-dinner pokes are providing a fair amount of information as I go through my usual recipes and find them either not so bad or, well, so bad.

Thank you very much for your kindness and encouragement.

P.

[asakiyume.livejournal.com]

Funny about the bifurcated response of the doctors... maybe it's like going from being at the top of one level of schooling and then crossing over into being at the bottom of the new level. You were on dangerous grounds for a person who didn't have diabetes, but for a person **with** diabetes, you've got not-much to worry about. Heck--you almost don't have it!

But I don't mean to make light. It's no fun at all to be subject to all those tests and consultations, and to have to take more medicine and restrict your diet further. I hope things even out and that it doesn't involve too much unpleasant change.

[pameladean]

Sorry, I answered you as a top-level comment. Not quite tracking, perhaps.

P.

[pameladean]

All right, the comment to you got pushed so far down I'm just redoing it. Your making-light paragraph is exactly how it felt. Really quite strange.

Thank you very much for your sympathy.

P.

[jenett]

I hit the official diagnosis point last year (slowly creeping up, and in my case, I'm convinced really really not helped by the last nine months in the previous job and the serious stress on my body.)

My doctor, weirdly, does not want me doing regular blood testing: I am on metformin (if you do decide to do it, I recommend the XR version, which has fewer side effects for a lot of people: I have about a week of adjustment when we up dose, but it's all 'this is mildly tedious' not worse than that, and then it settles down.)

I am about to go in for this quarter's round of blood work (which includes the A1c, but also the other stuff we monitor) and then we may do some more talkin,g but yeah.

(I also see a nutritionist at my practice, and she's great and the first one I've met who has actually gotten the other chronic stuff and not needed it explained to her umpteen times) but it's also why I have been working on taking up swimming.

[pameladean]

Comment above deleted because it was supposed to go to asakiyume. Let us try this again.

I'm not sure I'd have to do regular testing on metformin, but they wanted a baseline of fasting and after-large-meal readings while we figured out exactly how to deal with this.

Thanks very much for the information about metformin. I'm on so many meds already that I'm deeply reluctant to take any more, but it might be the best thing.

P.

[jenett]

That makes sense.

(I think mine crept up so gradually that my doctor's doing "See what happens with medicating for current lifestyle, and what that does" since that is a lot more sustainable for some people, including me, since my ability to get exercise reliably is limited by other factors a lot. And diet choices also somewhat complicated by other things and the fact that I am still reliably exhausted enough that food prep is complicated more often than I want to be.)

Anyway, I was at 7.5, was at 7.2 last time we tested in April, and hoping it'll be down below 7 this time, with changes I'm not having a hard time keeping up with.

[pameladean]

I think choosing medication over difficult regimentation is entirely sane, and am glad your doctor thinks so too. I'm very glad your number is coming down with easy enough changes. I hope to report the same soon.

And yes, I wouldn't be a bit surprised if the stress of that job played a part in the creeping upwards.

P.

[jimhines.livejournal.com]

Welcome to Team Diabetes!

My sense is that it's one of those things the doctors would really prefer to keep people away from. But there's so much more they can do to treat and manage it these days, too. So they try really hard to avoid that line, but once it's crossed, there are a lot of good options.

The biggest thing is not to ignore it. Which I suspect you know, but I've seen what happened with a family friend who made that choice, so I'm a little paranoid.

Anyway, I'll stop babbling. But I've had type 1 for 18 years now, so if you want to talk or ask questions or just have a joint complaint session about pancreases not doing their job, just say the word.

[pameladean]

Thank you, I think. No, seriously, thanks. I am always tempted to ignore health things, but the clinic is actually not going to let me. I think they'd hold my BP meds hostage or something if I tried.

And thanks SO much for the offer of a gripe session and a listening ear. I'm sure I'll be taking you up on it.

P.

[jimhines.livejournal.com]

Type 2 in particular is sneaky that way. It's easier to neglect, because the complications are often slower and more long-term.

I'm glad you've got a clinic team working to keep you healthy. Whether you like it or not ;-)

[sartorias.livejournal.com]

Oh, argh. I don't think there is anything wrong, whatsoever, with wanting our bodies to quietly do their jobs and not kick in the traces like this.

The docs seem odd, but then I've been hearing so much about medical weirdness lately, it's like one more hitch in the MD giddyap.

I hope things smooth out for you ASAP.

[pameladean]

That's it exactly. I mean, things used to work all right, what is all this rebellion? I think we both know about that.

As someone suggested above, I think the doctors are pleased to be able to Do Something. Just urging people to exercise or watch their diets without much effect must be frustrating.

Thanks, I hope so too!

P.

[kalmn.livejournal.com]

Thank you for starting with the very most important piece of information. I am super glad it's non fatal!

[pameladean]

Me too! And you are welcome. So many of us have become jumpy about medical stuff, I hate to make it worse.

P.

[mizkit.livejournal.com]

I got nothin' useful, just love and support from afar. <3

[pameladean]

That's a whole, whole lot. Thanks.

P.

[lcohen]

well that sucks, but at least it sucks in a way where there's lots to be done rather than that "sitting there helplessly" way that things sometimes suck. i hope that you find things that work well and easily for you and that your favoritest recipes are usable or usable with minor modifications.

*hugs if you'd like them*

[pameladean]

Yes, yes I would. Thanks.

P.

[inlaterdays.livejournal.com]

So sorry to hear about the diabetes diagnosis. You sound like you are holding up extremely well, but it must be scary. I hope you are able to get your numbers down and I'm glad that you were able to get your BP regulated.

[pameladean]

Thank you. I will do updates, and with luck it will be as easy as the doctor implied, if annoying.

P.

[seekerval.livejournal.com]

Sorry to read that your life just got more complicated, Pamela. Here's hoping it all settles into something relatively easy to deal with and wishing you much better luck as the weeks move along. Take care, dear lady.

[pameladean]

Thanks, Val. Of course you know that I wish you the same.

P.

[seekerval.livejournal.com]

Certainly I do.

[lblanchard.livejournal.com]

Oh, my. I hope you're able to settle into a routine with as little discomfort and annoyance as possible.

[pameladean]

I hate routine, but I'd better get used to it. Thanks.

P.

[firecat]

Welcome to the club none of us want to be members of. And it's normal to be thrown for a loop when you get your Official Membership Card.

And it's OK to take some time getting used to it all. A few weeks or months of an A1c in the 7's is very unlikely to cause complications.

I've had type 2 for 18 years and would be happy to answer more questions and/or recommend my favorite mailing list and Facebook groups.

[pameladean]

Thank you, I appreciate it. I'm not on Facebook, but am interested in the mailing list; not right now, but maybe soon.

P.

[thanate.livejournal.com]

I had the gestational version and found the constant blood testing and feeling like I wasn't allowed to eat *food* to be the most stressful thing about the whole pregnancy experience, but I think the ultimate shake-down results of how I relate to food several years after are probably good. The nutritionist I talked to through my healthcare was genuinely terrible (oversimplifying how food works & not understanding my questions) but fortunately I had other people to ask-- if you get a chance to chat with blairmacg at 4th St, she was the one who gave me a page-worth of bullet points that kept me from going nuts. :)

Good luck!

[mizzlaurajean.livejournal.com]

My grandfather use to say "If you live long enough you get everything." And he certainly did and lived through it -aneurysms, heart attacks, cancer, depression, major arterial reroutes, gout, high cholesterol and BP, removal of gallbladder, and tonsils, and type 2 diabetes. I know I'm forgetting somethings. I've got several of the warning signs for diabetes so I always make them screen me and I've got it coming at me from both sides of the family. I have considered it with some dread even though it is manageable it is I imagine a big change in how one thinks about and pays attention to their food all the time for forever.

Anyway I'm glad its not fatal.

[skylarker.livejournal.com]

So sorry to hear the scary diagnosis! I hope the cheery doctor is correct about getting your numbers down.