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Saturday, December 26, 2009

[Type-2-Diabetes] Digest Number 3840

Messages In This Digest (25 Messages)

Messages

1a.

Re: gastroparesis and glucose tablets

Posted by: "Jude" peridotjude@yahoo.com   peridotjude

Sat Dec 26, 2009 1:31 pm (PST)



--- In Type-2-Diabetes@yahoogroups.com, Holly Shaltz <holly@...> wrote:<snip> One thing I've seen is that it seems to take at least 25 minutes for any amount of glucose tablet to show up in my BG tests>>

Make sure to drink several swallows of water with the tablets, and chew them up as finely as possible. They can't affect the glucose level until they make it into the small intestine, and they can't get there until the stomach deems them dissolved enough and ready to go. So chew 'em up into a paste before swallowing, and drink at least a half cup of water along with. See it that makes a diff. If it doesn't, you might want to switch to a gel glucose supplement. It comes in a tube and you just squirt it in your mouth and swallow it. Some folks use prepared cake icing-frosting for this, but I doubt you want to go there, lol. A gel formulation might be more quickly recognized by the stomach as intestine-ready? Not sure. This is why people use OJ or milk or regular soda to counteract lows-- already in liquidform, need no prep by the stomach (or very little) to get into the intestine.

<snip> I don't seem to have any other symptoms of gastroparesis, but I certainly haven't been assessed in any way for it>>

There is a machine test for autonomic neuropathy. You get electrodes stuck to your chest and leg, as though for an EKG, and then you stand and breathe, lie down and breathe, etc, while a machine does some measurements. The results are reported as mild, moderate or severe.

I have moderate autonomic neuropathy, and I *know* I have gastroparesis because I get full so fast when I eat now, I had that violent reaction to Byetta, and I have lots of problems with GERD. You'd have to ask your doc about whether or not you have this going on.

Judy D.

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1b.

Re: gastroparesis and glucose tablets

Posted by: "Tiamat" tiamat99@comcast.net   lulamoon99

Sat Dec 26, 2009 4:06 pm (PST)



I do find the tabs slower than juice...so I keep small bottles of juice in fridge for the rare low. Juice is very fast but I do take the tabs with me when I go out [also rare] just in case.

Tia

----- "Holly Shaltz" <holly@shaltzfarm.com> wrote:

I've had some success using glucose tablets to
> control BG drops and rebounds due to exercise, but
> not as much as I'd like. I'm feeling somewhat
> woozy right now, though I never can tell if I
> overshot the amount I needed and accidently caused
> higher BGs than I want, or if I undershot and
> ended up with a liver dump causing higher BGs.
> Either way, the change is most unpleasant.
>
> One thing I've seen is that it seems to take at
> least 25 minutes for any amount of glucose tablet
>
_,_._,___
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2a.

Re: Endo(??)  refilled my Metformin at 1500 mg more than MAX dosage

Posted by: "Jude" peridotjude@yahoo.com   peridotjude

Sat Dec 26, 2009 1:35 pm (PST)



There was a time when 2000 mg a day was considered the max. Now I see it's commonly Rx'ed up to 2500 mg. It's not illegal or anything for a doc to prescribe any drug outside the common dosage guidelines, if he or she feels it's warranted, but it would have been a good idea to explain this to you if that was the case.

If I were you, I'd be deeply suspicious that there had been an error made. I also don't know why your pharmacist didn't question it (not sure how much they question things the docs phone in, but...) I certainly would not take more than 2500mg a day until I'd checked with the doc's office, but that's just me.

Judy D.

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2b.

Re: Endo(??)  refilled my Metformin at 1500 mg more than MAX dosage

Posted by: "Tiamat" tiamat99@comcast.net   lulamoon99

Sat Dec 26, 2009 4:13 pm (PST)



What is actually IN the bottle? Do the tablets say the unit amount?
Who made the error is second to what you should be taking...call the original doc immediately. Might be ok as is or might need new rx.

Tia

----- "brian cooper" <brianevans_99@yahoo.com> wrote:

I had just happened to hear or read a couple of days earlier that the MAX dosage for Metformin (regular, not any ER form) is 2500mg/day. So you can imagine my surprise when I found the latest prescription said 4000 mg.

,_._,___
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3a.

Re: why no insulin for type 2s

Posted by: "Kristy Sokoloski" sokokl@yahoo.com   sokokl

Sat Dec 26, 2009 1:44 pm (PST)



Jude,

Some doctors do have the time, but my point is (and having the RNs that work for them is fine as they are under the supervision of a doctor) that kind of teaching is not something that should be done by the CDE.  That goes beyond their job description.  And not only that it is unethical as well as illegal for them to be doing so to teach about insulin as that has to do with medicine being prescribed by a doctor.  A CDE's job is to strictly give general information about Diabetes such as about a little on wound care by bringing in experts on the subject if necessary, talk in general about the different meds as to what they are supposed to do for controlling the Diabetes, cholestrol but that's it.  Even if they are an RN that got the training in CDE that is all they can do.  They can't counsel on how to use the medication, or tell the patient which medicines may or may not be affecting why they have Diabetes.

I sat in on the classes provided by the CDE in this area and her nurse partner who is a wound care specialist when my mom went in 2003 so know what is supposed to be going on in those classes.

You said, "But that's no excuse for not even offering someone the opportunity. No one should decide in advance that any individual or group of individuals is unmotivated or too stupid or too far gone or too poor and/or disadvanted to learn. IMO, the patient should be offered the best solution to their problem first, and only when he proves incapable, for whatever reason, should therapy be dumbed down."

I agree that it's no excuse for not even offering someone the opportunity to learn, but remember that the person who doesn't think that anything is wrong with them doesn't think that it is an excuse.  I know some will say but that means that the person is in denial and wihle I would agree with that statement to some extent that person would not see it that way.

By saying that no one should be deciding in advance that any group of individuals are unmotivated, too stupid, too far gone, and/or disadvantaged to learn is quite correct.  I also agree that every patient should be offered the best solution to their problem first and then when being proved incapable for whatever reason should therapy be turned down, but again remember that the person who thinks that there's nothing wrong with them is going to think that you are forcing something on them that they don't want to do.  They are going to say, "but I have the right to live however I want to live and if it kills me oh well".

I know that this is a wrong attitude to take on the part of anyone in that situation because we want the best for our loved ones and our friends, but sometimes the only thing we can do is let them be.  As the expression says, "you can take a horse to water but you can't make them drink".  The same applies here.

This was something I have had to learn the hard way with my mom as I have been living around this disease for nearly 25 years of my life.  Even when my grandma (now deceased for nearly 10 years, and she was an RN at one time in her life) worried about her a lot.  She would try to force the issue to get my mom to take better care of herself and it caused many arguments.  I had to fight with my mom for over a year to get her to go to the Podiatrist to have them take care of her feet.   I had started to push her again on the issue when I had to start going to a Podiatrist for care of my own foot problems as connected to my Cerebral Palsy (mine is mild but creates different problems like for my feet).  She didn't figure she needed to go on a regular basis other than when she had a more common type of problem like the one time where she had a bone spur in her heel.  That doctor that took care of her a couple times knew she was Diabetic and did not push
her on the issue of caring for her feet.  I found out later that in his paperwork he had a thing that he expected his Diabetic patients to sign that said that they would follow through on letting him tend to their nails for filing, and trimming and tending to the calluses.  He never enforced it and I don't know why he did not with her.  Because if he had done so we would have found out about the neuropathy a lot sooner.

And then for her to go to my Podiatrist who then found something was really something. I am going to be interested to see how the Podiatrist reacts to those test results because he was very concerned as I said before.  As one of my friends said after I told her this a second opinion may be coming because the Podiatrist wanted the surgeon to do an angiogram on her to see more indepth what was going on as to why those pulses in her right foot were worse than on the left.

And what I meant by too late was the issue of more damage to her body.

If it had not been for a friend of ours years ago (this was back in the mid 80s where they did the urine testing at home) who talked mom in to doing a test with those urine strips we may not have known until much later or even at all that she was Diabetic.  Who knows.  Now if only I could get her to take all of this much more seriously but again it's her choice.  I can't make her do something that she doesn't want to do.

How we are all learning, and I learn from watching her how not to be if I ever end up being a statistic which I do not want to be so want to do all I can to take better care of myself now.

I will let you know what the Podiatrist has to say about all this when she goes back on the 5th.

Kristy :)

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3b.

what a CDE does

Posted by: "Jude" peridotjude@yahoo.com   peridotjude

Sat Dec 26, 2009 2:01 pm (PST)



--- In Type-2-Diabetes@yahoogroups.com, Kristy Sokoloski <sokokl@...> wrote: Some doctors do have the time, but my point is (and having the RNs that work for them is fine as they are under the supervision of a doctor) that kind of teaching is not something that should be done by the CDE.  That goes beyond their job description.  And not only that it is unethical as well as illegal for them to be doing so to teach about insulin as that has to do with medicine being prescribed by a doctor>>

Not all CDEs have the same background, since some of them are dietitians or pharmacists or social workers who have received CDE training and been certified. But certainly certified nurse (RN, LPN, NP) diabetes educators could meet one on one with patients and teach them how to manage the insulin the docs have prescribed, whether through injection or pump. The nurse CDEs are the backbone of the endo practice I patronize. I've met with them several times over the years for various reasons, including last year when my doc wanted me to start Byetta, so I met with a CDE to learn how to use the pen (I'd never used an insulin pen), how to dose myself, etc.

I think the CDE job description you're talking about is leading diabetic teaching classes, which of course would be tailored to a group, not to the individual needs of anyone.

And lastly, from the Joslin Clinic website:
<<<Diabetes Nurse Educators
Diabetes nurse educators provide excellent patient care, perform health and learning assessments, develop and update your individualized self-management education plan.
They will teach you management skills, including:
* blood glucose monitoring and how to handle sick days
* how to treat your diabetes when traveling across time zones
* how to recognize and treat low or high blood glucose
* how to begin an intensive diabetes program or use an insulin pump and other new technologies>>>

Judy D.

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3c.

Re: what a CDE does

Posted by: "Kristy Sokoloski" sokokl@yahoo.com   sokokl

Sat Dec 26, 2009 2:13 pm (PST)



Jude,

CDEs that have the appropriate backgrounds like with social work can only deal with those issues that their background is in such as if it is social work issues.

But a CDE, even if they are an RN can't give any kind of counsel on medication as to how to use it such as insulin.  If they are under the supervision of a doctor's practice I can see that being different since it is in the actual office.  The RN that worked for the endo my mom went to when she started to use insulin taught her how to do it.  But when it comes to teaching even on an individual basis the CDE even if they are an RN can not be teaching how to use, or manage the medication.  The other things you listed as part of what a CDE does they can do.  But not when it comes to the issue about meds as to how to work with them.

Daughter of Type 2 Insulin Dependent Diabetic,

Kristy :)

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3d.

Re: what a CDE does

Posted by: "Jude" peridotjude@yahoo.com   peridotjude

Sat Dec 26, 2009 4:25 pm (PST)



--- In Type-2-Diabetes@yahoogroups.com, Kristy Sokoloski <sokokl@...> wrote: <snip> when it comes to teaching even on an individual basis the CDE even if they are an RN cannot be teaching how to use, or manage the medication.  The other things you listed as part of what a CDE does they can do.  But not when it comes to the issue about meds as to how to work with them>>

Maybe we're beating a dead horse here, but... I think we're disagreeing on what the word "manage" means.

The doc's job is to diagnose (decide on a name/label for what ails his patient) and then to order treatment (tests, therapy, drugs, surgery, whatever combo of things needed to get the patient to a healthier place, hopefully). He explains his diagnosis to the patient and answers any questions, makes appropriate written notes in the chart, writes any orders for outside facilities if needed, and then hands the chart (and the patient) over to his staff.

At some point, the nurses and nurse CDEs sit down with the patients and explain the cause of their condition, treatment options, and any follow-up needed, answering more questions as needed. Then they show the patients how to carry out the doc's orders-- how (when, where, how much, etc) to take any prescribed meds, how to load up a syringe and inject insulin, how to use and maintain a pump, what side effects to look for, how to do glucose tests and interpret the results, how to treat highs and lows, etc. Naturally this is all done under the supervision of a doc, but alone with their patients in a treatment room, his well-trained staff are certainly capable of doing their jobs effectively, within the scope of the law, and in a responsible manner, keeping careful records for the doc's review and always using him as the go-to person to answer their questions, and if necessary as things develop to make med and treatment changes in the orders, etc.

Such is the nature and function of a good, well-oiled, effective medical team. The doc cannot do it all, and there's no reason why he should have to. His training is in diagnosis and ordering treatment; his staff's is to carry out those orders with the patients and keep him informed along the way, until the next time he can meet personally with the patient for a follow-up review.

So, no, the nurse CDE cannot prescribe meds or order different therapies, but she can certainly see that the doc's orders are put into motion and train the patient to do his part with his own self-care.

Judy D.

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3e.

Re: what a CDE does/Kristy

Posted by: "jm04161955" jm04161955@yahoo.com   jm04161955

Sat Dec 26, 2009 5:24 pm (PST)





--- In Type-2-Diabetes@yahoogroups.com, Kristy Sokoloski <sokokl@...> wrote:
> But a CDE, even if they are an RN can't give any kind of counsel on
> medication as to how to use it such as insulin. 

Kristy,

I'm sorry, but you're wrong. Both the CDEs I've seen and the CDEs that work in conjunction with the pump companies are the ones who make changes and adjustments to insulin doses based on the patient's current BG readings, and are VERY involved in a patient's pump start. I recently started the pump, and the CDE that I saw -- not an Animas CDE, as my friend had, but a CDE from one of the local diabetes centers here, who is certified as a pump trainer -- set my starting doses and took me step by step through the process of my basal verification testing and adjustments and my I:C ratios and correction ratios. The doctor had no part in it. And for my friend's pump start, the CDE came to her home and started her on a regimen that closely reflected her regimen on injections (MDI), and made changes as appropriate based on her readings at different times of the day.

For pumpers, it's very very rare that a doctor has any input into a pump start setup.

JoAnne

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3f.

Re: what a CDE does

Posted by: "Kristy Sokoloski" sokokl@yahoo.com   sokokl

Sat Dec 26, 2009 5:47 pm (PST)



Jude,

A CDE, regardless of their background can not explain to a patient the cause of their Diabetes or about the treatment options to manage their disease.  Only a doctor can do that. 

The doctor's job is to find the cause of the problem, diagnose the problem, design a treatment plan, and teach the patient on how to use the various treatments involved in that plan.  Teaching includes telling the patient how often to use it, explain the side effects of the treatment if any.  Not the staff unless he tells his nurse to do it (the teaching-see below), and definitely not a CDE.  But yes, teaching is definitely part of the physician's job. 

The CDEs can talk about the treatment of highs and lows, and about basic wound care as part of the general information about Diabetes bu that is it.

Any questions that the patient has about the cause of the condition,  treatment options if more are necessary, and further follow up or even more additional questions such as about how to carry out the doctor's orders as I said comes from the doctor directly.  Same with interpreting test results such as for glucose levels, only the doctor can do that.  No one else.   The doctor's nurse can show them how to draw up the insulin from the syringe and inject it, or to maintain the pump, but that's because they are in the office of the doctor.  Not the CDE, even if that CDE has an RN background.

Doing any of the other things that you mentioned is out of the boundaries of their job description.  And when they do it is unethical and it is also illegal.

Jude, it's ok if you don't agree with me.

Thank you for sharing your thoughts on this with me though.  I hope you have a good rest of the weekend.

Daughter of Type 2 Insulin Dependent Diabetic,

Kristy :)

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3g.

Re: what a CDE does/JoAnne

Posted by: "Kristy Sokoloski" sokokl@yahoo.com   sokokl

Sat Dec 26, 2009 5:54 pm (PST)



JoAnne,

Thank you for sharing with me even though I don't agree with you.   It's ok that you don't agree with me.

Daughter of Type 2 Insulin Dependent Diabetic,

Kristy :)

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3h.

Re: what a CDE does

Posted by: "AnaLog Services, Inc." analog@logwell.com   sydlevine

Sat Dec 26, 2009 7:12 pm (PST)



Of course they can talk about causation and treatment, That does not constitute the practice of medicine, or every high school biology / health teacher would be locked up. Of course in Tennessee where I was born and bred, we used to go after teachers for teaching evolution, but that is another kettle of fish.

----- Original Message -----
From: Kristy Sokoloski
To: Type-2-Diabetes@yahoogroups.com
Sent: Saturday, December 26, 2009 8:47 PM
Subject: Re: [Type-2-Diabetes] Re: what a CDE does

Jude,

A CDE, regardless of their background can not explain to a patient the cause of their Diabetes or about the treatment options to manage their disease. Only a doctor can do that.

The doctor's job is to find the cause of the problem, diagnose the problem, design a treatment plan, and teach the patient on how to use the various treatments involved in that plan. Teaching includes telling the patient how often to use it, explain the side effects of the treatment if any. Not the staff unless he tells his nurse to do it (the teaching-see below), and definitely not a CDE. But yes, teaching is definitely part of the physician's job.

The CDEs can talk about the treatment of highs and lows, and about basic wound care as part of the general information about Diabetes bu that is it.

Any questions that the patient has about the cause of the condition, treatment options if more are necessary, and further follow up or even more additional questions such as about how to carry out the doctor's orders as I said comes from the doctor directly. Same with interpreting test results such as for glucose levels, only the doctor can do that. No one else. The doctor's nurse can show them how to draw up the insulin from the syringe and inject it, or to maintain the pump, but that's because they are in the office of the doctor. Not the CDE, even if that CDE has an RN background.

Doing any of the other things that you mentioned is out of the boundaries of their job description. And when they do it is unethical and it is also illegal.

Jude, it's ok if you don't agree with me.

Thank you for sharing your thoughts on this with me though. I hope you have a good rest of the weekend.

Daughter of Type 2 Insulin Dependent Diabetic,

Kristy :)

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3i.

Re: what a CDE does

Posted by: "Jude" peridotjude@yahoo.com   peridotjude

Sat Dec 26, 2009 10:34 pm (PST)




The only thing I can think of is that the role of the CDE is legally defined differently in Kristy's state than it is in my own. This actually is possible.

For example, as a dental hygienist, I know that in some states, trained and certified RDHs are allowed to use local anesthesia (novocaine, etc) as part of the periodontal therapy they do with their patients. But not in my state. Maybe other paraprofessional roles are differently defined by different states; in fact, as I said, this is quite likely.

The things you say CDEs can and cannot do, Kristy, are absolutely not true about the CDEs I've seen in my endo's office.

Judy D.

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4a.

Re: Type 2 Diabetes, The Thirty-Third Year

Posted by: "Sandra" atc.sandra@cox.net   atcsandra

Sat Dec 26, 2009 1:45 pm (PST)



I would read it, Judy! It's only been two years since I was diagnosed but I
am only 47 and have a lot of living I plan to do. I have things I want to
accomplish. You are an inspiration to me that I can still be accomplishing
things 31 years from now when I have lived with the disease as long as you
have.

Sandra

-----Original Message-----
From: Type-2-Diabetes@yahoogroups.com
[mailto:Type-2-Diabetes@yahoogroups.com] On Behalf Of Holly Shaltz
Sent: Saturday, December 26, 2009 8:58 AM
To: Type-2-Diabetes@yahoogroups.com
Subject: Re: [Type-2-Diabetes] Re: Type 2 Diabetes, The Thirty-Third Year

Judy writes:

<< who in heaven's name would read it? >>

Heck, everyone! Well, everyone who's been a T2 for any length of time. We
*all* have challenges remaining motivated over time. And, with your sense
of humor, your unparalleled ability to write clearly, as well as your
personal experience, you'd be ideal to write such a book.

Go for it, Judy!

Holly in MI

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*** All information discussed on this list is not to be taken as medical
advice but the experience of each member based on discussions with their
doctors. ***

*** Please always consult with your doctor about what treatment options are
best for your situation. ***Yahoo! Groups Links

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5a.

Mental Difficulties

Posted by: "Tricia" psimmons1219@gmail.com   psimmons1219

Sat Dec 26, 2009 1:53 pm (PST)



Butch
Snip
If I may ask, are you on "beta blockers" for heart problems. I was put on them last winter trying to reduce a rapid heartbeat.
Snip

No Beta blockers. Last BP was 100/69 with resting heart rate of 65. No meds for heart.

My hubby is on massive doses of beta blockers because he had an aortic dissection (sort of like a tear in the aorta). His BP has to stay very low or he could have another.
He has what I call brain fog sometimes but it has gotten much better. He has been on the meds for about 9 years now.

Holly
I have never really had high glucoses. I have had more trouble with lows than highs. I had my sugar checked 4 months before my diagnosis and I was at an 80 after a meal of Mexican food. When I was diagnosed in January of this years I had a 200 fasting glucose and a 7.1 Hgb A1C. As far as I know I have only had one glucose in the 400 range and that was due to a major stressor and was down to normal in a few hours.

This is what my Hgb A1C values have been. They correlate pretty close to my averages on my meter. My meter average is around 10 points higher because I follow any highs I am having. High to me is over 110.
1-2009 7.1
3-2009 6.3
6-2009 5.7
9-2009 5.4
12-2009 5.3
Is this enough to cause me damage? I have been trying to find something that gives a a range for when your glucose level will cause you damage.

When I am low I am a bumbling idiot with a bad attitude!

Judy
Snip
IMO, anxiety can make it worse. The more you worry about it, the more you're apt to stutter around.

Perhaps thinking out what you're going to say before you open your mouth will help. If you're like me, you probably like to lead with your mouth-- your mouth opens, words come out, and then the brain engages. That works when you're young and with-it, but as we age and our mouths and words start to betray us, maybe it's time to slow down.
Snip

Bless you. This may really help me. I seem to get frustrated with my self immediately if I can not put my sentences together right off. My husband tells me to Slow Down. He is so patient with this new development. I am the one that is upset. I actually had to read a page 5 times the other day before I just put the book down. I read 3-5 books a week and I would be devastated to lose the ability to comprehend the written word.

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5b.

Re: Mental Difficulties

Posted by: "AnaLog Services, Inc." analog@logwell.com   sydlevine

Sat Dec 26, 2009 1:53 pm (PST)



Yeah, that too. There is a close tie between sleep apnea and congestive heart failure. Many diabetics have both.

----- Original Message -----
From: Jude
To: Type-2-Diabetes@yahoogroups.com
Sent: Saturday, December 26, 2009 4:09 PM
Subject: [Type-2-Diabetes] Re: Mental Difficulties

--- In Type-2-Diabetes@yahoogroups.com, "AnaLog Services, Inc." <analog@...> wrote: You weren't by chance also on statins (for high cholesterol), were you? And that sleeplessness combined with bad dreams sounds like heart failure related problems>>

Sleeplessness combined with bad dreams are also (two of many) symptoms of uncontrolled obstructive sleep apnea.
Judy D.

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5c.

Mental Difficulties

Posted by: "Tricia" psimmons1219@gmail.com   psimmons1219

Sat Dec 26, 2009 4:27 pm (PST)



larrydou38
Snip
Have you recently started a new medication? There are a number of good web sites Google Diabetes also keep in mind US Government web starter page and NIH web sites. Very few things happen with our bodies without a reason, your body or mind is reacting to something.
Good Luck with research
Snip

I have not started any new meds since this started.
These are the meds I take daily:
Metformin 1000 mg twice daily
Tricor for elevated triglycerides
Levothyroxine for decreased thyroid
Omeprazole for reflux
Methadone for pain
Lortab for pain
Vitamin D for severe decreased level
Niacin for elevated triglycerides

Diane
I went through menopause surgically at 19 years old. I have recently been told I had to come off my estrogen. I think the problem is now worse than it was but it started around November last year. I was diagnosed in January so I seemed to put the symptoms with the diabetes since they occurred so close together.

I would not be so worried if I was older but as I said earlier I just turned 41 a few days ago.

Snip
There are a slew of possible causes for this, most of them not related to diabetes. You don't mention your age, your medications, how long you've been diabetic and what other problems you have. All of these could be factors along with stress and an assortment of other things.

The fact that your blood sugars are normal rules out diabetes as the direct cause. However, long term diabetics do have a higher incidence of cerebrovascular disease producing decrease in intellectual function.

You need for your doctor to sort things out.

Ron
Snip

I have been diabetic for about 11-1/2 months and I am 41. I have several autoimmune problems. The worst is Crohn's disease. I am having a flare with my ileocecal valve right now so I have been really sick.
I have to see my doctor every month for my methadone but I have been going every 2 weeks since I have been so sick lately.

Tricia

> I have been struggling with a very embarrassing issue.
>
> I seem to be struggling with words. I have never stuttered or had problems putting sentences together before I was diabetic.
>
> I am so frustrated. There are several different problems I am having but I think they are all really the same thing.
>
> I can not find the word sometimes. I can list everything about the word but can not come up with the word I need. For example. The other day I was trying to say the word quilt. I could come up with sewing, fabric, my back room, you know that thing I spend lots of time doing....
>
> I will think I say one word but that is not the word that came out of my mouth. This one could really get me in trouble. I have been having trouble with my husbands name. My Ex died last week and he was on my mind while he was so sick the last few weeks. This has never ever happened to me before. I seem to be getting worse.
>
> I either stutter or pause for 45 seconds to a minute coming up with the thought I am trying to get across.
>
> I had a CT of the brain and the doctor said I did NOT have a stroke. I was wondering if this is from the diabetes.
>
> My glucose is not high. I have had lows but my ranges are fine right now. I have been between 80 and 120 the last 6 days and I have had lots of trouble.
>
> I do have other medical problems which seems to be really common in diabetes. Is there any information on diabetes and other medical problems and there associations.
>
> Thanks for your help. I am really scared. I turned 41 a few days ago and I am worried about what will happen as I get older.
>
> Tricia
>
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5d.

Re: Mental Difficulties

Posted by: "Holly Shaltz" holly@shaltzfarm.com   hollyshaltz

Sat Dec 26, 2009 4:51 pm (PST)



Tricia writes:

<< I have been trying to find something that gives
a a range for when your glucose level will cause
you damage.>>

It's hard to find that information, partly because
every body is different - yours might tolerate
non-normal BGs better than mine, for example.

I personally believe that BGs outside of what I
consider the *true* non-diabetic range are likely
to do damage. I consider the *true* non-diabetic
range to be virtually always under 100, not
fluctuating more than 10 points most of the time,
and an A1C of 4.2-4.6. This is based on a lot of
reading, culminating with Dr Bernstein's opinions,
which are based on decades of experience. Many
people disagree with this, or feel it's not
practical to achieve and maintain, or that most
diabetics wouldn't want to make the "sacrifices"
necessary over the long haul. Different strokes :)

Your A1C trending downward so wonderfully is
GREAT! Whether it will do, or undo, damage to
*your* body is hard to say. Dr Bernstein saw some
pretty awful complications reverse in his own
case, but I don't remember him mentioning
stuttering, having difficulty fishing a word out
of the brain, etc.

All we can do is work to achieve our BG goals, and
cross our fingers it will make a difference! My
memory also stinks - worse this year than ever
before. Things that happened years ago are
crystal clear. Things in the last 5 years I have
a real hard time remembering and placing. Things
in the last 5 minutes, well, let's just draw a
curtain over that because I can't remember! :) <sigh>

If you're used to being articulate and literate, I
think having these difficulties can be a real
bummer, more so maybe than a lot of other
complications. I have to remind myself they don't
make me any less intelligent and capable. I
ignore the stuttering when it hits. I poke fun at
myself when I can't find a word, and ask those I'm
talking to for help. I rely on my spellchecker
when writing, my dictionary to check meanings, my
thesaurus to fish out words. Like my BG meter,
these are just tools to help me cope with
diabetes, not measures of my worth or capability.
In many ways the hardest part is I learn a LOT
slower than I used to. But that's where I am
today, and I'll make the best of it :)

You're not alone in your frustrating challenges!
I hope that helps at least a little.

Hugs,

Holly in MI

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Messages in this topic (17)
5e.

Re: Mental Difficulties

Posted by: "AnaLog Services, Inc." analog@logwell.com   sydlevine

Sat Dec 26, 2009 7:11 pm (PST)



And one of the slew is the narcotics you are taking. Methadone and Lortabs would sure make me a bit forgetful...

----- Original Message -----
From: Tricia
To: Type-2-Diabetes@yahoogroups.com
Sent: Saturday, December 26, 2009 6:23 PM
Subject: [Type-2-Diabetes] Mental Difficulties

larrydou38
Snip
Have you recently started a new medication? There are a number of good web sites Google Diabetes also keep in mind US Government web starter page and NIH web sites. Very few things happen with our bodies without a reason, your body or mind is reacting to something.
Good Luck with research
Snip

I have not started any new meds since this started.
These are the meds I take daily:
Metformin 1000 mg twice daily
Tricor for elevated triglycerides
Levothyroxine for decreased thyroid
Omeprazole for reflux
Methadone for pain
Lortab for pain
Vitamin D for severe decreased level
Niacin for elevated triglycerides

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Messages in this topic (17)
6.1.

Re: OT religion "wears off"

Posted by: "Diane Moro" deemoro@gmail.com   signoradiana

Sat Dec 26, 2009 3:35 pm (PST)



In OA they used to call it "the pink cloud" syndrome. When you first got
abstinent, and you were feeling great because you were no longer eating crap
but good food and in moderation, then you begin to lose weight and have more
energy and you go to meetings all spouting how good you feel, wanting to
share this new found feeling, it's almost euphoric.
And the old timers in the rooms would look at us (and I at them when it was
my turn) and smile a knowing smile, bring us back to earth with the "pink
cloud".
And sure enough, the pink cloud always would wear off, for some people
sooner rather than later, but it always did in the long run.
I don't mean to say this is Holly's situation, not at all. But I do know
what Syd means. BTDT.

~diane

On Sat, Dec 26, 2009 at 1:29 PM, AnaLog Services, Inc.
<analog@logwell.com>wrote:

>
>
> Sure it is, and I do not mean to say it is a bad thing (whatever you call
> it). It does tend to wear off, but not always.
>
>
>
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Messages in this topic (66)
7.1.

Re: weight loss, but for how long?

Posted by: "Diane Moro" deemoro@gmail.com   signoradiana

Sat Dec 26, 2009 3:44 pm (PST)



No matter what Syd says, Ron, I have seen it work for me firsthand. I
suffered terrible debilitating panic attacks in my twenties to the point of
agoraphobia by the time I was 30...I began to see a therapist, worked with a
phobia clinic and within months I was a different person. I was taught
coping skills, and the talk therapy was extremely helpful. It was Crucial to
my period of adjustment after my divorce. It was not easy, sometimes
painful, but definitely taught me about myself in a way I never would have
grasped on my own. Sometimes it's a matter of perspective, and a good
therapist holds up a mirror. Invaluable.
Plus this time my insurance is covering it!
BTW, I haven't had a panic attack in over a decade.
~diane

On Sat, Dec 26, 2009 at 2:22 PM, ron42nm <ron42nm@gmail.com> wrote:

> Sorry, but that's not good enough. You don't really expect anyone to
> accept a statement like that just based on your say so, do you? If you are
> going to make a claim that studies support a position, you have to be
> willing to show those studies. Otherwise, people can make any
> unsubstantiated claims they want here and never have to prove them. That
> doesn't make for rational discourse. Meaningful discussion requires that
> members be able to document statements of fact. To paraphrase a great
> statesman and philosopher: you are entitled to your own opinion, but you are
> not entitled to your own facts. If you say you don't think therapy has any
> value, that is your opinion and you are entitled to it, and entitled to
> state it. However, if you say studies show therapy has no value, then you
> are making a statement of fact, which you are not entitled to make up. You
> have to prove it.
>
> Ron
>
>
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Messages in this topic (66)
8a.

Obesity & Exercise (Was Re: Diabetes Causes Obesity)

Posted by: "karenscribes" karenscribes@yahoo.com   karenscribes

Sat Dec 26, 2009 4:26 pm (PST)



"Eric Geffner" drgeff@yahoo.com wrote:

> I was always thin and full of energy, for years I had undiagnosed diabetes because the fasting test was being used and not the a1c. I overate BECAUSE of the diabetes. Who else would be CRAVING sugar when the meter read 575 ? (I had to buy one myself after three doctors told me I was not diabetic because by fasting number was 100-110... I am not an MD so figured it out too a while, but I was so-call prediabetic for many many years, I think even as a child I had some symptoms.>

This is my first post here. I have a similar experience. I was skinny as can be until 1991, when I had a child at almost 37. I now know that I'd had fasting numbers in the 100-110 range for quite some time before I became pregnant, as well as the several years thereafter, when I was diagnosed pre-diabetic. I just took their word for it that the tests had been "normal" and didn't think to ask what "normal" was. I was only diagnosed pre-diabetic in 2006, but I'm in the diabetic numbers now.

With the pregnancy, I gained around 35 pounds that I couldn't lose. I held that until about a year ago, and I now weigh 275 pounds. (I'm only 5'4".) I'm absolutely miserable. I have osteoarthritis in the hands and feet, and I also have sleep apnea. (Hi, Jude! I wondered where you went!) I've been tested for lupus a couple of times, but the ANA has come up short both times. My family doc thinks I have it, though. My body aches, and it's hard for me to move. I'm out of shape, so, of course, it doesn't take much to get me short of breath.

Up until the end of 2006, I'd been walking a couple miles a day. Then I had to have a colon resection, and I couldn't get myself back into walking. I know I need to get moving again. I'm having a hard time just walking through a grocery store. If it weren't for the fact that I'm a home-based transcriptionist, I wouldn't be able to earn a living.

Has anybody else been able to crawl out of this type of hole, get moving again, and lose the excess weight? Any feedback will be appreciated.

Thanks!

Karen C.

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Messages in this topic (3)
8b.

Re: Obesity & Exercise (Was Re: Diabetes Causes Obesity)

Posted by: "Diane Moro" deemoro@gmail.com   signoradiana

Sat Dec 26, 2009 4:43 pm (PST)



Karen, I pretty much crawl out of my hole every morning when I have to put
the game face on and go to work!
But seriously, I HATE to exercise, so I have had to pick things that I know
I love, like swimming, and yoga. At least I know I will stay with these.
Walking just for the sake of walking bores me to tears, literally. I would
so much rather be reading a book when I'm not working. I'm 55 and I am
aiming to retire in a few short years so I am itching to be done with work,
already!
Good luck to you, we each have to learn how to crawl out of our own holes.
Stick around, there is good info here.
~diane

On Sat, Dec 26, 2009 at 5:21 PM, karenscribes <karenscribes@yahoo.com>wrote:

>
>
>
> Has anybody else been able to crawl out of this type of hole, get moving
> again, and lose the excess weight? Any feedback will be appreciated.
>
> Thanks!
>
> Karen C.
>
>
>
> States
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8c.

Re: Obesity & Exercise (Was Re: Diabetes Causes Obesity)

Posted by: "Holly Shaltz" holly@shaltzfarm.com   hollyshaltz

Sat Dec 26, 2009 4:57 pm (PST)



Karen writes:

<<Has anybody else been able to crawl out of this
type of hole, get moving again, and lose the
excess weight? Any feedback will be appreciated.>>

Yes, by eating to my meter as I've posted ad
nauseum :) Like you, I hurt all over, all the
time. It still amazes me that my muscles don't
hurt at all now - my joints do, but oh well, can't
have it all!

In the beginning I could hardly walk because in
addition to the weight and pain I had an infection
on the skin of my legs, covering a large portion
of each. And I could hardly breathe, like you.
So I started small - VERY small, a walk of maybe
300 feet! By the end of 3 months I was doing 3/4
of a mile in 15 minutes, with hills involved, so
it improved remarkably quickly overall.

Can you get a referral to some sort of exercise
specialist who can get you started with safe
things you can do?

Good luck!

Holly in MI

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9.

Metformin Overdosing

Posted by: "brian cooper" brianevans_99@yahoo.com   brianevans_99

Sat Dec 26, 2009 7:12 pm (PST)



Analog,

Thanks for your suggestion about Walmart. As a matter of fact, when I called them, I asked if they didn't have computerized or other safeguards, and got a less than meaningful or satisfactory answer. I think I'll follow up with them again, in person.

But even with their goof in the first place (possibly), or chance to rectify the doc's goof, I think the probability that the error originated with the doctor gives me serious pause about her. There are plenty of ways in which she might treat me in the future that might not lend themselves to being caught by a pharmacy system--and if she is so "spacey" or careless in this case, can I take the chance that this is a unique, isolated case?

Thanks again,

Brian Cooper
__________________________________________________________

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