Not Good Doctor's visit
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| Sat, 01-31-2004 - 12:14am |
I am so glad that I can finally post because I need your support as much as you need mine.
I went to the doctor for my regular appointment and things didn't turn out so well. Unfortunately my A1c has been rising above acceptible norms. He increased all my meds back in October and I started exercising and managed to lose 6 pounds over the holidays. But my A1C didn't come down and so he told me today to think about either going on actos or insulin. I have to tell him on Monday. '
While I know that diabetes is a progressive disease that I have had for almost 15 years I have been trying so hard to keep from having to go on insulin. I know I am not a failure but is sure feels like it. I did tell my doctor that I would only go on Lantus. I normally have elevated liver enzymes and so I don't want to go on actos. Plus the main complaint with actos is weight gain and I certainly don't want to gain any weight. I also don't want to deal with NPH insulin because it causes hypoglycemia. So I am trying to get over my tears and get my arms around this new wrinkle in my disease. I have a new diabetic to counsel at church (remember I am also a parish nurse) and I have to put on a brave face fer her.
Hugs to everybody,
Mary Frances
cl-maryfrances40

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Michelle,
I called the doctor's office in tears again yesterday. I talked to his receptionist whom I know from going to this office for years. I guess she told him I was upset! Anyway he told me not to be so upset that this was just a different way of treating type 2 diabetes!
I agreed to go on the insulin. The curve that he threw me yesterday was that he was thinking of stopping all my oral meds and covering my blood sugar with insulin.
He was to have one of the nurses call me today to set up an appointment and I asked that she call me at work. Of course she called me at home and so I only got her message when I got home! I will call her tomorrow. There is a CDE in this practice that I know and have worked with before and hopefully I will be able to see her again. If not I have her email address and I can write to her. This is a research clinic and so there are several CDE's in the practice. I have been really lucky to have been referred to this clinic. I get top notch care there so ultimately I will be fine when I get over the shock and disappointment of all this.
Thanks for your support and caring,
Mary Frances
cl-maryfrances40
Thank you Marsha for your supportive comments.
I can talk about this now without bursting into tears which shows a lot of progress. I guess I was just bargening with my disease. I am not really looking forward to this but I will make it work. Maybe down the road I will get an insulin pump. Now that would be a really new experience for me.
One day my nephew came into my office when we were seeing patients and we were having computer problems which he was going to fix. The next thing I know I hear him saying "She's going to kill me!" I asked why and he explained that he had fixed the problem and then accidentally erased the system off my hard disk. I had to have the files rebuilt and my data recaptured. That took several days. I had no way to make patient appointments or have any idea which patient was coming in to be seen. I really did want to kill him! But for sure I didn't. He just never worked on the office computer again.
So you can't live with them and you can't live without them!
I am so sorry to hear of your news. I hope you find the right meds to make your numbers go down and help you feel better real soon. Let us know what you decide - we are all pulling for you!!
Jennifer
You know we are all pulling for you!
Biggest Hugs -
Diane
I lost weight and then they give me a pill (avandia) and I gain it back. I truly enjoy my exercise time it helps me to relax and my husband joins me.
Please explain to me why most diabetics and professional view insulin so negatively.I truly don't understand.
Hi and welcome to the board. You aren't being sassy. You have just had a different experience than most of us. It harder to manage your life if you have to be constantly checking your blood sugar levels and giving yourself insulin before every meal and bedtime. The oral medications are easier to live with but that obviously wasn't an option in your case. Also having to go from oral medications onto insulin means that your disease is getting worse and you need to change your treatment regieme.
I have refused to go on NPH insulin because of the peaks and valleys that it causes in your blood sugar levels. I have also refused to go on actos or avandia for exactly your experience. The most common complaint with these two medications from patients is weight gain. I weight nearly 50 pounds less than when I was diagnosed and I don't want to gain one ounce of it back!
Do you carbo count? If you do you may be able to prevent the highs and lows of your blood sugar readings. But if you are on NPH insulin and if your insulin hasn't been changed since you were diagnosed, that is probably what you are on, there isn't much that you can do about it.
I will be going on Lantus which is a basal insulin, and has been on the market about 5 years. Then if the doctor takes me off my oral meds, which he is talking about doing, I will most like be on Lispro, which is a quick acting and short acting insulin. You take it about 15 minutes before you eat and its action peaks in one hour. Regular insulin
Love,
Morgan
I haven't been able to log onto the diabetes board for a couple of days. I'm glad to hear that you are getting used to the idea of insulin. I cried for a couple of days, too, when I had to go for my appointment and when I got the news.
I am taking Lantus at night and I take Novilog before each meal. I"ve been taking insulin for a little of over a month, and each day it gets a bit easier. I'm still adjusting. Still having some ups and downs. Tonight I forgot to take insulin before dinner and had to remember mid-bite that I'd forgotten. Oops.
It is inconvenient, but what has lifted for me is a sense that I am not "doing a good job." I felt very guilty the last few months before taking insulin that I was somehow "bad" because my blood sugar numbers were not where they should be despite great efforts to exercise daily and to count carbs. I'd get into a cycle of a high bs# in the a.m., I"d feel discouraged, make poor choices, not test because I didn't want to fail....I don't feel the guilt I used to feel those last few months now that I"m on insulin.
The weight gain is an issue with me, and I've put on a few pounds this month because my body is using the energy I'm taking in. I, too, don't want to gain any more weight, and I'm still working this part out. I could use some insight from other insulin users about how they manage with the weight gain moving from oral meds to insulin.
At any rate, I am thinking of you and want to offer support as you walk thru this change. It felt so weird and scary at first, but 5 weeks out, it is part of my daily life. One step at a time...
Alison
I thought you would find it interesting what I am going to be doing.
I am going to join, if I pass the lab tests, a level 4 study on the use of Lantus in type 2 diabetics who's A1C is above 7. It's called the GOT study and it will be looking at the incidence of hypoglycemia dosing algorithms. There are five arms to the study. The treatment goals are to get the average blood sugar 80, 90, 100, 110 or 120. I know the 80 arm is already filled (thank goodness!). I don't know which arm I will be assigned to but I do know that I will receive Lantus, a new meter and a calculator called AL-CAL. I have no idea about this calculator. I have been told based upon the numbers in the calculator my doseage of Lantus maybe changed on a weekly basis until I meet the treatment goals. I will start with 10 units. I may also have to stop taking the glucophage for the duration of the study. They are also going to run a C-Peptide test on me but for some reason they are not going to give my doctor the results. The study lasts 7 months and perhaps at the end they will give him the results. I start next Thursday.
This is the 6th study I have been in, so I am an old pro at studies. But I was surprised that this was a 4th level study as I thought they only went through three levels. I was also surprised to learn that I only need to check my blood sugar once per day except on certain days when I will need to check 2 hours after eating breakfast, lunch and dinner. Iwill be using an Accu chek Advantage instead on my Accu Check compact. I fell like why do I need another meter! But this what always happens with these studies.
So I will keep you informed about how all this goes.
Mary Frances
cl-maryfrances40
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