Author Topic: A lost stray is returning ...  (Read 356 times)

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Offline nellie

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A lost stray is returning ...
« on: 18 October 2017, 04:08:53 PM »
... and here I am.

I joined his forum when I was first diagnosed and was very well-controlled by diet alone at first. THen there was a series of big personal events and my control went AWOL. One of the events was a move to a new area and a new GP practice. I got off to a bad start with the DN at the new surgery and got told basically to do 'do what I say, eat what I say and let me prescribe any medication I think will work'. It didn't fit very well with me when she started to explain in words of one syllable what DM is, despite her knowing I'm a retired nurse.

I was put onto Metformin which had no effect at all. I tried to keep to my VLCHF diet with a 'treat' once a week (rotated between a piece of cake, small portion of chips or an ice-cream on Sundays). My BG kept on going up and up. I also started to find keeping the carbs so low nauseating - I've been craving an occasional baked potato or 'proper' sandwich with a slice of wholemeal bread instead of just a slice of cheese for lunch.

I saw Nursey Nightshade  :nursey: again 2 days ago and was amazed at the difference in attitude. I've been bad and instead of having the potato I craved, I've denied myself it but lost control when I was at WI meetings with all that cake ... And when my husband had chocolate in the house, I ate it and bought more while he was at work to replace it. I know from past experience that if I have a tiny bit of what I crave, I'm okay but if I resist it, I eat anything in sight for days. Okay - confession over.

Nursey has give me a meter and strips and wants me to test - this after telling me that I 'shouldn't be testing at home because it's no good for you' a year ago. I'm still on Metformin (500mg tds) with added Trajenta. She's also said we should be aiming at a pre-breakfast level of between 5 and 6, which is a considerable improvement on the 'less than 9.5' she wanted last year. Her last suggestion was that if Trajenta doesn't give a good result, we'll try short-term insulin to get the BG down so we can then see how much pancreatic function I still have.

I feel so much better - I feel as though the local NHS Trust has finally come into the 21st century. I've added a bit more 'allowable' carb to my diet in the form of porridge for breakfast and one piece of fruit as part of lunch. I'm happy with this level and the biscuit cravings have gone. I know how stupid I was but it was so scary arriving here and being told that there'd be no support for my chosen way of taking some control of my condition - I got into the rut of thinking if the NHS didn't care, why should I because they were seemingly on track to kill me anyway.

Back to trying to get my control back, although my new GP has suggested diet alone won't be enough now as my pancreas may have less to give. Going to be trying hard now, back to testing, head out of the sand and keeping a food diary until I get some stability back. Thanks for reading xxx

Offline Pattidevans

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Re: A lost stray is returning ...
« Reply #1 on: 18 October 2017, 07:50:10 PM »
Hi Nellie and welcome back into the fold!

Well, where to start.. I note you say that although you are on Metformin, which you say has had no affect at all and then later you mention that you are in fact on only 500mg.  The lowest effective dose of Metformin is thought to be 1500mg per day and the optimum dose is 2000mg per day.  I take 2000mg per day as well as insulin as I put weight on and had IR as well as being T1.  I won't go into the long story, but I stopped the metformin for about 6 months last year, piled on 9lbs and my insulin doses went up accordingly.  I went back on it, fortunately lost the 9lbs and noticed a huge difference in insulin needs.  So it may be that it would be beneficial for you to be on a higher dose.

I wonder what caused Nursie Nightshade's change of heart?  It seems like a 360 degree change of attitude... how odd... are you sure it's the same nurse LOL!  Or perhaps she's had some training?

At least now you have a meter and strips you can see what's what.  Have you tried testing before and at 1 hour after the porridge?  Just a thought....

Your GP may well be right about your pancreas, you can only try and see how you get on with Trajenta.  As to insulin on a temporary basis, that's quite advanced thinking on the part of your nurse.  Nothing to be afraid of.

Glad to hear you are feeling better!

Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline nytquill17

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Re: A lost stray is returning ...
« Reply #2 on: 18 October 2017, 10:40:31 PM »
Nice to see you again!

I just want to say that it doesn't sound to me as if you've been very bad at all, in fact it sounds like you've been stellar! The odd slip-up is only human, and you've been sticking to your diet far better than, say, I stick to mine! ;)

If you've been generally that disciplined about diet and your BGs are still going up, then I very much doubt that an occasional chocolate bar or piece of cake is the culprit here. It does sound like you're not on enough Metformin, like Patti says, and also it may just be that your pancreas is on its last legs. And again, for someone who has been so disciplined about diet overall, it's highly unlikely that it's anything you've done that caused it to give up - it sounds like it was just going to go no matter what you did.

I only mention this because - as your experience shows - morale is so very important to how we care for ourselves! So it's important to think critically about any guilt or self-blame we internalize, however small. Sometimes it's warranted, but often it isn't and we've fallen victim to diabetes perfectionism instead!
T1 DX 1995
Levemir + Novorapid
 
  ~-~-~-~
"If you can't ride, can you fall?"
"I suppose anyone can fall," said Shasta.
"I mean can you fall and get up again without crying, and mount again and fall again and yet not be afraid of falling?"
"I - I'll try," said Shasta.
  ~C.S. Lewis, The Horse and His Boy
  ~-~-~-~
"There is no answer; seek it lovingly."

Offline Pattidevans

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Re: A lost stray is returning ...
« Reply #3 on: 19 October 2017, 12:05:54 AM »
Apologies, I said nothing about your slip... what I should have said was what Nyt said... do not beat yourself up.  Not worth it and after all you are only human and VLCHF is a hard discipline.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline colette3

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Re: A lost stray is returning ...
« Reply #4 on: 19 October 2017, 01:09:51 PM »
I was to see NN in November.  I remember being absolutely gobsmacked when she declared she did not want me to be at 45 (last year's HbAic).  Spoke to my doctor on one of my visits for the tonsillitis and said I did not want a 30 minute appointment after an HbA1c.  Sort of suggested that I had coped quite well with my diabetes up to now and that I didn't need a half an hour chat about my test result.  Doc told me that 45 was very good but that instructions were now favouring higher numbers!!  Said quite honestly I don't really understand some of the advice being given to people with Diabetes nowadays.  With a fbc my doctor snuck in a HbA1c and its 52.  Bad I know but with nearly 6 weeks of illness I wouldn't expect better.  Once glands went down then bgs went down.  In the ambulance (another post) my sugars were 5.1 which I think was amazing bearing in mind I was shaking like a leaf from shock.  The body is a weird thing, isn't it.

Offline Alan

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Re: A lost stray is returning ...
« Reply #5 on: 19 October 2017, 11:51:31 PM »
... and here I am.

I joined his forum when I was first diagnosed and was very well-controlled by diet alone at first.

Welcome back :). I read it all but snipped to comment on a couple of points.

Quote
Nursey has give me a meter and strips and wants me to test - this after telling me that I 'shouldn't be testing at home because it's no good for you' a year ago.

I read that several times to be sure. Did you not have a meter before? Really? I know they have been discouraging testing by type 2s in the UK but that staggered me.

Quote
Back to trying to get my control back, although my new GP has suggested diet alone won't be enough now as my pancreas may have less to give.

May?? Have you been tested for insulin production or c-peptide?

To help you take control again I know you will have read this last time you were here but now that you have a meter it may make more sense (click on it): Test, Review, Adjust.
Cheers, Alan, T2, Australia.
--
Everything in Moderation - Except Laughter.
There is nothing I could eat I like more than my eyes.
Type 2 Diabetes - A Personal Journey (latest: Small New York Baked Low Carb Cheesecake)
Born Under a Wandering Star (Latest:Dambulla, Sigiriya and Polonuwarra, Sri Lanka)

Offline nellie

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Re: A lost stray is returning ...
« Reply #6 on: 21 October 2017, 01:51:37 PM »
THanks for the encouraging words, everyone.

Alan - yes, I did have a meter but I had to buy it myself and pay for the strips. If I mentioned that I was testing at home, I got a lecture about ho there was no need for T2s to test, we didn't understand what we were seeing, blah blah  :banghead:  My old practice in the Midlands eventually agreed that testing was the way to go for T2s but still wouldn't or couldn't issue meters unless we were on insulin. I still have my meter and use it but can't do the intensive testing I did when first diagnosed because I'm now retired and on a much smaller income.

I'm surprised my pancreas has got anything left to give, quite frankly. I apparently showed severely raised BGs during my pregnancy with my daughter but nothing was said at me at the time. Or at any time until 2013 (I think it was) when I was diagnosed. Not even in 1999 when I was doing a return to practice nursing course and we were testing each other and I threw up a result of 12.something 2 hours after a cheese salad lunch and I saw my GP the next day, begging to be tested. I was told to stop lying about what I'd eaten for lunch and stop wasting the doctor's time! When I got to the stage of thinking I was going to die, I again begged to be tested and was then asked why I hadn't sought help earlier. I could give myslf a nasty headache with all the  :banghead:.

I feel very let down by the NHS. There have been tell-tale signs for years and years - the regular skin infections, cellulitis that incapacitated me for weeks at a time following the slightest scratch to my legs to name but 2. I've learned that one of the major causes of cartiledge destruction is uncontrolled hyperglycaemia - I've had both knees replaced because of osteoarthritis. But the worst of it is that at least 3 doctors along the way told me that they hated having nurses as patients because 'you think you know the answers and are constantly asking to be tested when there's clearly nothing wrong'. That's not  :banghead:, that's ground for either murder of spontanous combustion.

Sorry for the rant but I've had the T2 depression for 2 long and today's anger is helping me climb back out of it. Today's anger burns.

Offline Alan

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    • Type 2 Diabetes - A Personal Journey
Re: A lost stray is returning ...
« Reply #7 on: 21 October 2017, 10:29:41 PM »
THanks for the encouraging words, everyone.

Alan - yes, I did have a meter but I had to buy it myself and pay for the strips.

I snipped for brevity but read it all. As an outsider looking in I'll say nothing about the NHS, just sympathise. Did they ever do the extra testing for T1?

Quote
I still have my meter and use it but can't do the intensive testing I did when first diagnosed because I'm now retired and on a much smaller income.

This may help: Testing on a Budget
Cheers, Alan, T2, Australia.
--
Everything in Moderation - Except Laughter.
There is nothing I could eat I like more than my eyes.
Type 2 Diabetes - A Personal Journey (latest: Small New York Baked Low Carb Cheesecake)
Born Under a Wandering Star (Latest:Dambulla, Sigiriya and Polonuwarra, Sri Lanka)

Offline Pattidevans

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Re: A lost stray is returning ...
« Reply #8 on: 22 October 2017, 02:11:06 PM »
Nellie


What a bloody awful saga.  I hope things improve a lot from here on in!  Sounds like they are starting to from what you've said.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline Dr DeEath

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Re: A lost stray is returning ...
« Reply #9 on: 24 October 2017, 01:39:03 PM »
Earlier this year I lent a friend my spare meter and gave him some of my strips. Despite glucose readings (not going to be caught out by BAGs again) showing his levels going up despite increasing doses of metformin and being atypical (just slightly overweight) the insistence was that he was Type II. After collapsing he has been diagnosed Type 1.5 and feels far far better now he is on insulin.
T1 for over 50 years.  MDI on Porcine insulin.  Lisinopril and Atorvastatin.

Offline Pattidevans

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Re: A lost stray is returning ...
« Reply #10 on: 24 October 2017, 01:53:42 PM »
Quote
not going to be caught out by BAGs again
What, or who are BAGs?
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans