Cortisone shots tomorrow

I know this is going to be late in asking…but I am just now thinking about it.

I have been working VERY hard at getting my BG’s numbers down to a controlled state. I’ve succeed for the last three weeks to have a very good daily number and my A1C is 6.2…

Enter the other dragon in my life ---- arthritis of the knee ---- tomorrow I go for a SYNVISC injection in one knee, and a cortisone injection in the same knee, possibly both. Cortisone makes my BS’s go up for about two days if I do only one…if I do both it will be a week of 200’s+ and that’s working on it with exercise and lots of water. I don’t necessarily have to do both, but I do feel better, have less stress, less pain, and am in a better place to manage and control t hings. Yet, the numbers are scary and I don’t really want to go up again.

What would you do…on a scale from 1 - 10 with 1 being no pain and 10 being cut my leg off — I am a 4 in one knee and a 9 in the other…

Your quality of life as well as your attitude toward dealing with your D is parallel to how you feel. If you hurt that badly you probably aren’t in the mood to be as attentive to your D as you need to be in order to maintain your current BG values. So, having said that, I would go for the shots, if they help. With less pain and the subsequent distraction, you can then deal better with the ramifications of the steroids and maintain your BG better through the increase due to the medications. That’s my two cents! YMMV!

Two questions: what is your diabetes management method (diet and exercise only, pills, insulin, insulin and pills)? Is the doctor who gives you the shots the same one who manages your diabetes?

If you are on pills or insulin, you might want to ask the doctor who manages your diabetes whether you need to increase the dosage for the week, or whether it’s ok to let your sugars run high for that week. If it’s the same doctor who manages both your knees and your diabetes, you can ask when you see him/her for the shots. You might want to mention this to the knee doctor anyway: he may know other patients with similar issues and may be able to give you some ideas for managing.

tmana, thanks for the ideas. My primary care physician and I have been through this cortisone thing many times, and have worked out a plan. No, my ortho doc handles the knees and arthritis, he is aware and concerned about the affects of the cortisone, but until I succumb to having a total knee replacement…which doesn’t cure the arthri, this is the best method. Synvisc is like an artificial sponge that they put in between your two joints so they don’t rub on each other. the relief is amazing, and yes It does cause me to not have to deal with two things at one time…and not bother with the one that isn’t screaming for help…the D.

I manage my D with pills, diet and exercise daily. The exercise actually helps with arthri also, and for about two days I get relief, but depending on the weather (I know it sounds funny, but it’s true the weather does affect arthri.)
relief may be minimal with exercise. We are all in contact with each other, so that no one is left in the dark. That was one of the things I demanded when putting together my team…cooperation and communication.

Judith, thanks for the ideas…truly. I live in the boonies, 200 miles from any major area of medical specialties, so the kinds of help is not available here, and the price is prohibitive. Cortisone is something that I’m not excited about, but it works for me…I am deathly afraid of surgery and have avoided it for 9 years or more…but my turn is coming…and I know it. So if I can make it through the winter, we’ll look seriously at a knee replacement in the spring…no crutches or walkers for me on South Dakota’s frozen tundra with ice and snow.

Well, the shot is done, and I’ll have a synvisc in three weeks. AND we talked about surgery in April. I can feel the panic coming on already…probably over the fact that I finally gave up…and said enough is enough.

I’ll have bouts of terror and fear until we get there, so please be patient with me. I am a devout coward when it comes to surgery. A woman had two knees done, at the same time, last year here, and they got so infected that they had to be removed completely. Scared the bejabbers out of me. I have to realize that I have the best docs, and they listen to me, and take my ideas and concerns in to consideration. Just really don’t want to do this at all.

I see you have decided to go with knee replacement - I’d like to encourage you, if I can. My father-in-law had his knee replaced a little over a year ago - he was 85 at the time. He has done very well and his doctor is trying to convince him to get the other knee done. If he can do it, anyone can. He is in good health, of course, but still 85 years old! Don’t be afraid as that will not help you or your glucose levels.

It’s hard to say what you can do about your blood glucose numbers, but if your health care team is fully aware of this and they aren’t concerned, then there isn’t much else for you to do. I think tmana asked all the right questions, because if you were on insulin this could indeed be adjusted during that time. Best of luck to you.

NO insulin. At least not yet. Diet, Exercise and meds is controlling it just fine.

I’m more worried about the after surgery than surgery itself. I have very little help at home, and for six weeks, I’ll be on my own while dh is at work…three times a week for PT after two weeks of everyday. AND I have two beagles who are very rambunous how do I get them to understand that I can’t play for awhile, and who will go down the 4 steps to let them out…pain is a big factor. But I met a woman at the clinic yesterday who is about my age, weight and physical problems, we are going to talk about them and how she worked through them…that will be a big boost.

Surgery won’t be until spring, so I have lots of time to work through things.

Well, three days after the shot, my sugars are up — I mean way up. My FBS was 312 — granted I ate like a banchee yesterday and didn’t realize that this was going to happen…forgot all about it. So now, I am drinking water like crazy and that seems to help.

But I can walk, my emotions are in check, the quality of my life is much better right now. AND I know that these high numbers will be over in two more days. I have a blood test on Monday…and we’ll know if there was any damage done with the last two injections.

I sucked it up and scheduled the knee surgery, even though I hate the idea, but I’ve fought the battle for 12 years, and that’s long enough to be in constant pain.

I just feel very defeated, as I wanted to beat this thing…but it isn’t in my cards, I guess.

Cathy,you have to consider the short term increase in your BG against the longer term relief from the pain. I’m been in the same situation 3x’s. I always opted for the cortisone. Best to you. PS , Your BG will return to normal,it will take time but relieving the pain is worth it. Sorry this reply is late Good luck with the surgery .Pete

Peter, thanks so much, that is exactly what I did. The pain had gotten to the point, where all I wanted to do was sit, and not get out of the house, do exercises (which are terrific for arthritis) or anything else. My sugars did go up, but are just beginning to come down. I made some very unhealthy food choices during the last week, so that didn’t help either. But am back on track.

Surgery may not be able to happen, although I am ready for it. My husband can’t afford to take time off for a week to be home with me…help me move around, get to PT for that first week, etc. So now I am having to reconsider it…crumb buns…just when I make up my mind, everything goes to pot. Keep thinking positive thoughts for me, and maybe something can be worked out.

thanks again,

NEWS FLASH: Well, after years and months and weeks of putting things off with my knees…I won’t be able to have surgery after all in the spring. Dh’s job won’t allow him to take off five days — unpaid ---- and we can’t afford to not have his paycheck. So I checked with the docs today, bawling because I didn’t want to have the pain back. We are going to work on some PT – yea, more exercise — and a different method of pain control. Less meds, more physical activity and maybe braces for the time being. The braces will keep my knees steady and warm, and buy us some time to work out a plan. But this last dose of cortison really messed with my blood sugars worse than it has ever done before, so I think that’s it for that plan … at least for awhile. Just pray we can find something that will work, cause I’ve got a lot of living left inside of me.

I wish you all the best,Cathy. Hopefully, the PT and braces will give you some relief. Do take care. Oh,.guess where I.m headed today. I’m to see my ortho man for a cotisone shot. Can you believe it?There goes my BG levels.Pete

Cathy, I just went thru the same thing but I’d do it again. My sugars were in the 200’s for almost 2 weeks but my knee feels great right know. The last shot I got lasted over a year till it reall started hurting again. I’d rather do the elevated BS and get rid of the pain. My Endo declined to give me any short term meds and said to ride it out … and so I did. Actually has a semi low today @ 72 before dinner. So it will level out and the A1c will go up but the knee will feel better.
Take care, Joanne