Diabetes, not me

DianaCox

Bad Cop
Joined
Dec 30, 2013
Messages
6,343
Location
San Jose
My non-compliant, poorly eating, smoking, gonna be 70 at the end of this month, was-always-strong-as-a-horse husband Charles has been increasingly ill over the last several months. I kept telling him to go see our PCP, but he kept putting it off, assuming it was mostly the result of his medications for cirrhosis (in particular diuretics) making him have to pee every hour or so, and disrupting his sleep, and he was sure his body would "get used to them" soon. In the meantime, he was eating even more poorly than usual - mostly carby comfort foods - and his muscles started wasting away.

In June, his borderline pre-diabetes finally crossed the line to diabetic (no surprise - his mother was a type 2 diabetic for many years, and died of non-alcoholic steatohepatitis (NASH)) with a fasting blood glucose of 130, A1C of 6.5. PCP added an oral sulfonylurea. Then things went bad with my father, and the PCP disappeared for about 2 months, changing practices for the THIRD time since we moved here. We finally got an appointment with him at his new practice in mid-October and checked in with him. He added a couple of meds for Charles to try to minimize the nighttime peeing.

Less than a week later, Charles fell in the house while I was out shopping. He'd been feeling dizzy from time to time, but now his left arm was spasming multiple times a day and had no strength. I got him to go see the PCP again, and he ordered a pill for muscle spasms, and a fasting bloodwork panel, which Charles did the next day, Thursday the 28th. He was also concerned about the arm spasms and weakness might have been from a "mini-stroke" and also referred him to a neurologist.

I want to add that we were supposed to leave for California on the 26th, but our RV has a problem that is taking FOR-F'ING EVER to diagnose and fix - we still have no ETA for this. My son was supposed to fly to Phoenix on the 24th to travel back to CA with us, as we were going to make a stop at the Grand Canyon, which he had never been to - I wanted to spend some concentrated time with my son, whom I have barely seen in 5+ years, and not at all in 2 years, but also wanted him along because Charles' had physically deteriorated so much over the summer and could use help getting the house ready to leave for over a month, as well as loading the RV. So Charles fell the day my son was supposed to have arrived, but we had already canceled his ticket because the RV wasn't (and still isn't) in condition for a long trip.

Charles’ bloodwork came back the next morning (Friday), which I can see on our portal. Fasting glucose 444; A1C off the chart at ">15.5" - WTF? How could things go south that fast?

The PCP never called on Friday, despite messages being left, and his new practice had NO after-hours contact information, and I want to say here that Liz spent HOURS talking me through getting him a glucose meter, telling me how and when to use it, how to get Charles to eat until he could get more info from the PCP, and sending educational links. I would have gone crazy(er) without her help.

The PCP called on Monday, and put him on Lantus (long-acting insulin), as well as salt and Gatorade Zero for his low electrolytes. I also decided (with Liz's help) that he needed to get in to see an endocrinologist, and managed to squeeze the local highly rated endo who wasn't taking new patients to see him the next day. She prescribed short acting Novolog 3 times a day in addition to the Lantus.

In the meantime, he has been surprisingly cooperative about changing his crap diet - he has been pretty steadfast in refusing most fish and chicken, and that's mostly what he's been eating for over a week now. No bread/pastries has been killer for him, but he's having veggie snacks and liking it.

His average glucose is slowly going down, He's had a few measurements under 200 the last couple of days, and he is already feeling a fair bit better. He had the neurologist appointment this morning, and although he's got some tests to run, he doesn't think it was a stroke. He will (FINALLY) see a podiatrist next week, and I got him in to radiology to do a precautionary CT he's been putting off to make sure the incidentally discovered abdominal aortic aneurysm really is small and doesn't need treatment at this time. And he's down to just a few cigs/day. He will be doing specialty labs tomorrow to determine what kind of diabetes it is (i.e., not autoimmune or T1).

I hope he's been scared straight. If it's T2 and he can't get it under control right away, I'm already thinking Hermosillo is just a few hundred miles from here.

Oh, and I guess I'm going to lose a few pounds (which I very much need to do) if I'm going to cook keto for both of us.
 
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Diana, I’m just glad y’all weren’t on the road. It wasn’t safe for him to drive with those levels. And I’m glad I could be of help. I was just paying it forward from those who helped me decades ago.
To be honest, the RV problem was a blessing in disguise. I would have insisted that we stick to the schedule without us having ANY idea that he was that sick. And it could have been a disaster.
 
Yikes! This could have been a real disaster. I'm so glad Charles has you to push for his medical care (and sorry that it's necessary for someone to push just to get care for a not rare problem) and glad he's starting to get better now. Having his diabetes under control should make a big difference in his quality of life.
 
On the other hand, he is no longer hypertensive - he has ceased both meds for HTN, and he was taking a daily aspirin which has been stopped (he used to clot REALLY fast and his father died from an embolism after hip surgery) because the liver disease makes his blood clot slower. A little good from the bad of his evolving health issues.
 
On the other hand, he is no longer hypertensive - he has ceased both meds for HTN, and he was taking a daily aspirin which has been stopped (he used to clot REALLY fast and his father died from an embolism after hip surgery) because the liver disease makes his blood clot slower. A little good from the bad of his evolving health issues.
Well crap! I am very sorry. I hope things get better fast!
 
Wow!

[I’d write more, but I’m pooped. My caregiver MrSue has a hip that’s gone south. Not only can he not do the things he usually does for me (like help me cook or with laundry), I am suddenly doing all of those things w/out his help AND several of “his” tasks (assistant chef, doing dishes), too. I do not appreciate this turn of events and hurt everywhere.

Also, like most husbands in mortal pain, he can be a snippy little asshole. So Celebrex helps a lot, with his pain and my feelings, but may kill him, given he’s 69 yo w/ a hx of silent stroke and MI. But if he DOESN’T take SOMETHING to relieve the pain and keeps flaming out, I may put him out of his misery. He’s not opposed to hip replacement surgery, but would like to defer to closer to post-pandemic times.]

Well, Diana, I guess we’ve both got no choice other than keeping them alive and functioning as well as possible.

ETA…I wrote a lot.
 
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Well, Diana, I guess we’ve both got no choice other than keeping them alive and functioning as well as possible.
He’s the RV driver* - assuming we ever get it back from the shop. Otherwise, I’d consider putting him out of MY misery.

(*And cat barf-cleaner-upper, and spider killer, and tall person for top shelves. But he also used to be the jar opener, but he can’t even open his Gatorade bottle, so now I’m the opener.)
 
He’s the RV driver* - assuming we ever get it back from the shop. Otherwise, I’d consider putting him out of MY misery.

(*And cat barf-cleaner-upper, and spider killer, and tall person for top shelves. But he also used to be the jar opener, but he can’t even open his Gatorade bottle, so now I’m the opener.)

We have similar jar opening issues.
 
How scary! Wishing Charles the best of health from here on out. And wishing happiness to may Charles, MrSue and their respective lovely partners!
 
Wishing good health for Charles and Mr Sue, and patience for their wives.
 
Interesting - his fasting/before meal blood sugars have been going down slowly - still not normal, but nothing has been tweaked yet - still on his starting doses. I guess the burden of glucose in his body is getting "drained" slowly.

All are either before food or before bed. And before the Novolog of course.
11/12:
7:12 AM: 138
2:34 PM: 216
6:54 PM: 180
11:22 PM: 194

11/13;
8:49 AM: 180
1:18 PM: 193
6:27 PM: 126
11:14 PM: 141

11/14:
8:40 AM: 151
12:22 PM: 137
6:47 PM: 129

Don't have the results from the specialized tests yet, but on Thursday, his fasting blood sugar at Labcorp was 166, and his kidney function numbers, which were also alarming when his FBG was 444, was really good. Only his sodium was still a little low. So making progress.

Heard back from the vascular surgeon - the possible abdominal aortic aneurysm isn't an aneurysm - yet. His aorta has an enlarged bore and needs to be looked at yearly.

Neurologist doesn't think he had a stroke. He had a nerve conduction test on Friday (OW) but the guy wants to see his MRI results (will be done this coming Tuesday) first before discussing.

Tomorrow he sees the podiatrist. I hope that doc does something for his funky feet - at least helps him get rid of the toenail fungus that I keep worrying will become systemic with his other health complications.

He still hasn't even made an appointment with the prosthedontist to get his implant-supported dentures cleaned in two years. I'll start bugging him about that next week.

He's scheduled for a Moh's procedure in December for another small basal cell cancer, this time on his cheek. I'd been asking him to have it looked at for a long time.

At his discretion, his retinologist is willing to do a procedure on one of his eyes to clear up a blob in his vitreous - blood from a retinal tear years ago, and epiretinal membrane from that tear, that "smears" his vision. I'm guessing he'll wait on that one. It would likely cause the early cataract in that eye to worsen within a year, and then require another surgery for that. (I'm contemplating a similar procedure because of a huge floater that won't go away, and an early cataract, and REALLY looking forward to getting a lens implant that would make my nearsighted vision good, but I'm also a little leery of doing it before it really does bother me - even through I'm sure I'll be happy with the result, I really don't NEED the procedure yet, and it's not zero risk.)

We're getting his lifetime of Medicare taxes back up-front.
 

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