Family Doctor
MomS...@webtv.net
share feelings and frustration. As I've mentioned before, I'm a 68 year
old female who was diagnosed with type 2 over 2 years ago. I've been
faithfully following my diet, and carbo counting. For a long time, I've
done fairly good, without meds or insulin...more or less just plain
grit. I'm afraid that my luck is running out. I've been having almost
constant readings an hour and half to two hours after meals and bedtime
of 160's up to 199. I've noticed that I can no longer able to eat the
same foods I used to. No cereal, and almost no kind of carbos. I saw
my dr. yesterday, and after some discussion, realized that he falls
painfully short of knowing what the present day treatment and diagnosis
of diabetes is. Like most family practioners in small towns, he is
rushed to and over capacity. When I showed him where I had been testing
more often after meals, he asked me where I got the idea to do that? I
told him from the ADA handbook and that I also read the diabetes forums
on the internet. He also asked me what it said about the acceptable
readings were, etc. That's when the light began to dawn. The only time
I had a HbA1c test was last May, and then, only because the nurse
suggested it. He didn't seem very concerned when he looked at my
logbook, and saw the readings that are beginning to get higher and
higher in the last 2 weeks. I had 192 after a light supper last night
and 179 at bedtime. My test in May was good, but I would have some real
highs, but plunged down low at times , so I guess that accounted for it.
Anyway, he seems to think that I have to have a high of over 126 when I
first get up in the morning, before I would need medication. The thing
is, from the start of my diagnosis, I would sometimes have lows in the
mornings that were almost hypoglycemic. Over time, that has gradually
increased, but only slowly. I had a reading of 114 yesterday morning,
and that's high for me. He had me to have the blood tests this morning,
and will start me on glcophage if necessary. Meantime, my food intake
is becoming more narrow in order to keep the count normal if possible.
I'm no longer able to eat the proper food to stay reasonably healthy.
I have neuropathy in my feet, and have noticed that the higher the
count, the worse the needles and pins. I know that my numbers are very
low compared to a lot of you, but somehow, I feel that I'm being denied
the proper care. I've called the entire area to see if there are any
specialists, and there isn't any in our area. If things keep
escalating at the rate they are, we're going to see about going to a dr.
in a larger city 3 hours away. Thanks for letting me rant....my family
sympathyizes but it would help if they would get better educated! My
husband is slowly catching on....especially when meal time comes, and I
stand in the kitchen and say what can I fix that I can eat,too, duh!!
MOM
Jan Robin
your activity level in your post -- has your exercise program, or even your
daily activity, changed?
I ask because I have observed that exercise is the single biggest impact on
my bG levels. (I'm 44, 40 lb+, T2, using metformin in addition to diet and
exercise.) It doesn't seem to matter if I have 45 g carbs or 60 -- I'll be
high if I haven't been exercising, and right on if I have. When I'm not
active, I can even be high (for me, high is 190ish) after a 30 g meal.
It's different for everyone, I know ...
I hope you have success in educating your doc or finding someone who can
help you better.
Jan
Carol Schwaderer Dickinson
expreience with knowing as much or more than a doctor in other areas
like
non-classic dwarfism connections to mental illness. I think its a big
clue when a doctor asks what you know, that the doctor may not be up to
speed and you need to at least check in with a specialist. I also think
its a good sign when your doctor asks. A lot will just pretend they know
or get mad that you are trying to educate yourself.
If I were in your situation, I would ask the doctor for a referral to a
specialist. With a referral you'll hopefully get to see the right
specialist and your doctor may be willing to work with that specialist
or be the local eyes and ears in a cooperative effort to get you better
care locally.
This did happen with my son. With the growth hormone problem there was a
private practitioner I didn't particularly care for, but he did 99% of
the care for kids like my son. He practices both in Alaska and
Washington. All records of Alaska kids were also reviewed by a team of
doctors that met once a month in Washington, so there was review.
Because our son is also eskimo and entitled to services through the
Indian Health servies, he was also reviewed twice a year by an Air Force
specialist. SO we had 2 reviewer situations even though primary care was
through a general pediatrician. In addition the mental health issues
were primarily treated by an Indian Health Service psychiatrist, but he
worked also with a specialist employed by the State of Alaska, because I
forced him to do so. The specialist was very interested in up to date
reserach but had no time to keep up. At his requrest, I did the reserach
at the medical library, getting copies, requesting papers, contacting
research groups.
All the reserach I gathered was shared and all of us learned together.
I'm sure the doctors understood more than I did when I was reading for
them, but it can work out to be a very beneficial thing for a patient
when a doctor wants to know what you learned and where you learned it.
Carol Dickinson
Type II, 7 days and counting
Jude Crouch
> Hi, I've posted a couple of times before, and appreciate being able to
> share feelings and frustration. As I've mentioned before, I'm a 68 year
> old female who was diagnosed with type 2 over 2 years ago. I've been
> faithfully following my diet, and carbo counting. For a long time, I've
> done fairly good, without meds or insulin...more or less just plain
> grit. I'm afraid that my luck is running out. I've been having almost
> constant readings an hour and half to two hours after meals and bedtime
> of 160's up to 199. I've noticed that I can no longer able to eat the
> same foods I used to. No cereal, and almost no kind of carbos.
We sometimes have to realize that we can't control our bG's without
meidcation (oral or insulin).
>...I saw
> my dr. yesterday, and after some discussion, realized that he falls
> painfully short of knowing what the present day treatment and diagnosis
> of diabetes is. Like most family practioners in small towns, he is
> rushed to and over capacity. When I showed him where I had been testing
> more often after meals, he asked me where I got the idea to do that? I
> told him from the ADA handbook and that I also read the diabetes forums
> on the internet. He also asked me what it said about the acceptable
> readings were, etc. That's when the light began to dawn. The only time
> I had a HbA1c test was last May, and then, only because the nurse
> suggested it. He didn't seem very concerned when he looked at my
> logbook, and saw the readings that are beginning to get higher and
> higher in the last 2 weeks. I had 192 after a light supper last night
> and 179 at bedtime. My test in May was good, but I would have some real
> highs, but plunged down low at times , so I guess that accounted for it.
> Anyway, he seems to think that I have to have a high of over 126 when I
> first get up in the morning, before I would need medication.
The conventional wisdom is that you should maintain near non-diabetic
meter readings thruout the day. If you can't do that with diet and
exercise alone, medication is advised. The early morning reading only
judges whether you are having dawn phenomonon or not. (non diabetics
also have dawn phenomonon)
> ...The thing
> is, from the start of my diagnosis, I would sometimes have lows in the
> mornings that were almost hypoglycemic. Over time, that has gradually
> increased, but only slowly. I had a reading of 114 yesterday morning,
> and that's high for me. He had me to have the blood tests this morning,
> and will start me on glcophage if necessary. Meantime, my food intake
> is becoming more narrow in order to keep the count normal if possible.
> I'm no longer able to eat the proper food to stay reasonably healthy.
There's no reason a diabetic has to be on a starvation diet. If you
cannot eat to satisfy you, there is another reason to start medications.
I can't advise what would be best for you, but please review the types
of oral medications that treat high bG: <http://www.diabetes.org/ada/c30c.asp>
And insisst on enough time to understand his answer. It's your right.
> I have neuropathy in my feet, and have noticed that the higher the
> count, the worse the needles and pins. I know that my numbers are very
> low compared to a lot of you, but somehow, I feel that I'm being denied
> the proper care.
Each of us are different, so I might have a problem at 220, others
may have a problem at 180. It is very individual. But it is real
nonetheless.
> ...I've called the entire area to see if there are any
> specialists, and there isn't any in our area. If things keep
> escalating at the rate they are, we're going to see about going to a dr.
> in a larger city 3 hours away.
Sometimes that is necessary, I'm sorry to say. I'd advise that
you look thru the American Diabetes Association site, print out what
you think is necessary, and bring it with you when you have your
appointment. Follow up with a phone call. (www.diabetes.org)
> ...Thanks for letting me rant....my family
> sympathyizes but it would help if they would get better educated! My
> husband is slowly catching on....especially when meal time comes, and I
> stand in the kitchen and say what can I fix that I can eat,too, duh!!
> MOM
Anyone who signs as MOM gets my heart. I wish you luck with the
doctor situation, but don't be afraid to ask more questions.
Jude
--
Jude Crouch (jcr...@pobox.com) - Computing since 1967!
Crouch Enterprises - Telecom, Internet & Unix Consulting
Oak Park, IL 708-848-0134 URL: http://www.pobox.com/~jcrouch
MomS...@webtv.net
nuts, after all! As you might realize, there are a few, especially
older doctors out there who just don't keep up. I have 2 physician
soninlaws who both practice away from this area, and I'd like to believe
they do. You might ask why I don't discuss my situation with
them.....well....one is a OB Gyn, and the other one is sometimes
remote....he doesn't really want to treat family, and we try not to ever
bombard him with medical questions when we do see him, although he did
tell my daughter that the 190's wasn't that bad. In all fairness to
him, he's a great dr. but is a director of a prompt care facility which
is open 7 days a week, and refers to specialists when there is something
that needs that kind of care. They have changed standards of diagnosis
and treatment so quickly over the last few years, that I'm sure it is
difficult to keep abreast. To me, that is even more important that each
of us have to keep informed, no matter what our medical condition is.
By the way, I really feel yucky today, and had a 192 reading 2 hours
after lunch that consisted of a bowl of tomato soup, 4 crackers and a
serving of sugarfree jello. My husband and I both have a respiratory
infection right now being treated with antibiotics, and I know that
illlnesses can make a change, also after being on inderal for years ,
the dr. has changed my medication because they have on hold right now
the manufacture of the inderal la. It is one of the beta blockers that
can be a factor in increases of blood sugar, and we'll see what happens
down the line. Thanks for the encouragement. MOM, grandma and
greatgrandma!!