Now that you've left that state of denial and are in touch with your dr there are others to get on your team. Beside your dr a CDE (Certified Diabetes Educator) is vital in helping you manage your disease. There's more then a notion to live with disease and a CDE can lead you through the curves and twist that the Diabetes journey will take you...wishing the best in learning how to manage your D.
Good luck on your doctor's appointment. Remember your PCP has only a very limited knowledge of D and will probably be unable to help you on the complexities of clarifying diagnosis. But he will be able to help you stabilize and get on the track until your Endo appointment. If he gives you flack just let him know you are there because you are now ready to take control. Please don't resist his suggestions if he suggests you start insulin, because he will be giving you good advice.
Also, since you have some time until your endo appointment you might want to get Using Insulin by John Walsh or Think Like a Pancreas by Gary scheiner.
Endo's often book their schedule full months ahead with their "regular" diabetic patients. But stuff happens, schedules change and often there are openings. I have had very good luck being put on the waiting list. I've had instances where I have been told to wait 3 months and then been called to come in that week. If you are flexible, just ask to be put on the waiting list for the next opening.
i'm very confused why you're not even checking your blood sugars? can you not go and get a cheap meter and test, that's you responsibility to do this, no? you can avoid being hospitalized by taking whatever meds are Rx'd to you and checking your blood sugars and managing this disease, cause no one else is gonna do it. go get a meter and test.
i don't think it's true type 1 DKA. DKA happens quickly and usually t1's don't have 75 lbs to lose. one can certainly feel very ill when BG's are too high but if it was DKA it wouldn't be lasting this long, it would be near fatal at this point, by now, as it is with type 1's....you're either in DKA and it happens quickly or you're not, one doesn't stay DKA for months. DKA will kill you if you don't get medical attention and treat it. go get a meter!
I'll close out this discussion thread with an update.
Had my doctor's appointment this past week Wednesday. So glad I went ahead and did that. I 'd almost switched docs when I couldn't contact their office immediately, but **VERY** glad I stuck with him as he spent THREE HOURS with me.
Unheard of, right? Best doc everrrrr.
So I got to ask him all of my questions, about DKA, about foamy urine being an infection, about the bit of neuropathy on the tip of my left big toe, about meds - everything. Learned SO much, he explained the mechanism behind how the meds work. It was great.
THE DREADED LABS
My BG was 567!!!!!! (I explained that I had been binging all week with an ice cream soda the night before, sweet tea, and pizza).
My A1C was 15. (Which I'd told him before the labs came back is what they'd be).
My urine test showed ketones, which he explained and I'll be researching more all day today.
MEDS
He put me on (daymit) Victoza, and made me take the first dose right there. Also gave me a prescription for Metformin, and another something for cholesteral (210).
I'm on day 3 of the Victoza, and each night I'm all ready for headaches, nausea, etc. but nothing so far. I think, perhaps, the initial dosage of "just 3 clicks" is really too tiny to cause any side effects. Of course, I'm PRAYING that I won't have any, but that's why I'm taking it at night. If I get sick it can't be at the office.
I still have no BG test strips though. Either the doc sent in the wrong Rx or the pharmacy got it wrong. All they have is the Rx for the Ultra One Touch *kit* -- but I already have the meter so I don't need the kit. The pharmacist said I could by the strips out of pocket ($75) or buy the kit ($69) -- but The Kit doesn't even have strips. So I'm waiting for a prescription for just strips to get to the pharmacy.
THANKS EVERYONE
So... just thanks so much to all of you guys. For being there. For being firm. For being strangers I could open up to. For being gentle, yet still scary enough for me to take action.
I wish each one of you magical healing, and the self-discipline to overcome any diabetes-related hurdles you might have.
Abrazos!
You will be amazed at how much better you feel once your blood sugar has been brought down to a normal level. It won’t take long before you are enjoying the benefits of taking proper care of yourself. Best of luck with it all.
On bg test strips... if you cannot afford to pay OTC for OneTouch brand, you can buy a store brand meter with matching test strips cheaply at many places. OTC, no prescription needed. Cost per strip is much much less. And tracking your bg's is very very important.
Typical store-brand glucose meters:
http://www.walmart.com/ip/ReliOn-Ultima-Blood-Glucose-Monitor/3555238
http://www.walgreens.com/store/c/walgreens-trueresult-blood-glucose...
http://www.cvs.com/shop/product-detail/CVS-TRUE2go-Glucose-Test-Met...
I want to second what Cinderfella says, You will feel so much better once you gain control. There may be bumps in the road such as lows that aren't actually lows and maybe a set back or two but the important thing is to stay with it.
Not all that take Victoza have the bad side effects and even for those that do it usually go away after a while.
Please remember that the important thing is to get it under control no matter what it takes. If you treatment plan means a stronger response down the road please don't resist, There is no shame in being T2 and none in doing what you have to do to win.
Congratulations again on your positive attitude, that's half the battle IMHO. If you are going to do "Eat to your Meter" you will need to make an investment in strips in order to fine tune your diet. If insurance or your Dr. will not give you enough the best thing to do is to buy your strips from one of the inexpensive sources others have listed. This is not a forever thing and you can gradually cut back after you have identified the problem foods and your numbers start to fall in line. Then you can save the detailed testing for trying out new foods or when your numbers go wonky.
For me the unpleasant side effects of Victoza started to get better quickly, and my numbers got so much better that it was a strong incentive to keep taking it. I'm at about 1.5 years in and I have no side effects, however it is also not quite as effective either.
Stemwinder is correct in that you may not feel better right away as your body is not used to more normal sugars. I had moments for at least 6 months where I felt bad only to find good numbers when I tested. Another thing I learned is that if you low carb make sure you're are getting enough salt. When the body burns fat for energy instead of carbs the kidneys excrete more sodium. Lack of sodium made me feel quite light headed and unable to concentrate.
Here's a couple of groups here on tuD you might find useful. The Low Carb Recipe Swap group is a great source of interesting low carb recipes. The Bernstein Group has a lot of experienced low carbers who can answer your questions as they arise. Also some good recipes are posted there from time to time. Finally you might find the Victoza Group to be of interest.
Really? I didn't know that! I may do that today because it's now the weekend and I'm still not able to test.
Granted, with a BG over 500, and only on the super-starter low dosages I'm sure my blood sugar is still crazy high. But I really wanted to start tracking numbers from the onset of starting all these meds.
Thanks Tim!
I'm telling you, feeling better in just 1 area is the *ONLY* thing keeping me pushing forward with the meds.
For the past 3 nights at 8pm (The Medicine Hour) I find myself bursting into tears when taking the Victoza, because all I can think of is, "... so this is how the thyroid cancer / pancreatitis/ renal failure begins". I'm praying over the meds, and just a wreck.
I know in my head everything has a side effect. My doc even told me on last week's visit, "If you read the side effects of aspirin you'd never take it again. Get over it". (In a nice way; he's awesome).
But I've been so lucky in the past having had great health, and never ever had to deal with this "side effects" crap. I used to watch tv commercials and just laugh at the crazy long list of side effects at the end saying, "Why on EARTH would anyone TAKE that medication knowing it caused all of those side effects? What idiots." Yeah, now I'm one of them. Tradeoffs SUCK.
But what pushes me forward is(1) you guys & your insights, warnings and encouragement, and (2) just the thought of being able to do things I can't do now, (go to fairs & big events where there's no restroom, or take long walks 'cos I can't make it back to the restroom, or stop needing to hide how much water I'm drinking when I visit family (never told them about the diabetes), or just no longer having to gauge EVERY thing I do based upon, "How far will I be from a bathroom?"!!).
Last night was the first of the next higher dose of Victoza (6 clicks)... I might have had a super mega ultra TINY bit of nausea, so still no side effects. At least there's that!
Love u guys to pieces.
Hopefully yours!
Thanks BadMoonT2!
I'm glad to hear about the side effects subsiding. A little bummed though that it seems to have stopped being quite as effective for you? Are you taking other meds to compensate? I'm just worried that JUST at the 1-2 year mark when I'm finally sorta comfortable it will not work as well/ body gets de-sensitized. So then do you change meds? How do you deal with it not being as effective?
Yes, I joined the Victoza group yesterday and spent the day watching tons of videos about how Victoza is 97% similar to natural GLP1, which lives in our beta cells, and how it binds to the GLP1 receptors on our beta cells, stimulating them to deliver insulin.
And stuff!
I really appreciate the carb sites because I am still **MASSIVELY** failing on the food front, especially with what the heck to snack on. Yesterday was a colossal WRECK. I had 4 Pepperidge Farm strawberry cookies, a 1/2 a cup of 2% milk, a bowl of Uncle Julios corn chips, AND a scoop of Haagen Dazs ice cream.
My hubby and I just do-NOT-cook. EVER. We've always eaten out; just our lifestyle in the past. So we are having a tough time getting food in the house. We bought chicken breasts, and ground turkey, and brown rice yesterday. I cannot begin to tell you how unappetizing that sounds to me.
So I've started a Pinterest board to gather recipies, and also found a few other sites. Honestly, though, I can't even get my head around all of these recipies because I... there is NO way... I just can't see how I can squeeze cooking into my routine. I can't do it after work during the week because I'm just TOO busy and TOO exhausted. (Yes, I hear myself). So then I'm thinking I need to steal some time away from other things on the weekend and start cooking things for the week ahead.
And why the Sam Hill hasn't some savvy entrepreneur taken advantage of this marketing niche? I can't be the only one who'd be willing to pay for someone to make these meals.
Yeah - this is clearly where things are going to be toughest. Sweardagod, I've been on this "What should I/can't I/can I eat" train since the diagnosis. Holy cow I'm sick of thinking about it.
Wait, I just felt a hunger pang. Lemme go get a bean and some water. Yum. 8-P
Hi Angie. For me, even though Victoza is not quite as effective my A1C is still 5.8 so no time to panic. However my guiding principal is do whatever it takes to keep my blood sugar numbers in range. This means giving up foods that my meter says are hurting me. For me it means no grains, no sweets, no beans, no fruit, all I might add were former favorites.
This also means that if and when my numbers deteriorate, I will move on to insulin. No guilt, no beating myself up, if this is what is required so be it. The blood sugars you had from your last Dr. visit were like mine before diagnosis, my A1C was 13.1. There is no doubt that numbers like these mean a shorter life span and diminished quality of life, so I do what I have to do.
For me your snacks are all off my list of things I can eat. What kind of meter readings did you get from eating them? For me good readings are a positive reinforcement that help me keep on the straight and narrow.
I decided to Google "Low Carb Snacks" here is the first site that came up. It has a whole page listing lots of good alternatives. I would suggest searching the internet and compiling a list of things you might like and then stocking your kitchen with them.
I think fast acting carbs are addictive, there are physiological reasons for this. I went cold turkey and eliminated them all at once. The advantage is that the cravings soon disappear. Others advocate a gradual tapering off, you will have to make your own choice on this. Then you will have to design a diet you can stay on because it is interesting and satisfying. This is a change you will have to live with for the rest of your life, so it must be sustainable.
I can't help you much with eating out as it is something I have not mastered. I find it easier to prepare most of my meals from scratch with fresh ingredients. Perhaps some low carbers who eat out often can help you with this.
This is all very tough, make no mistake. But this site is full of people who have followed this road, they made the necessary changes and will tell you it's worth it. Keep your eye on the prize, this is doable.
please don't worry about side effects, because the 'side effects' of uncontrolled blood sugars, frankly, are 100%+ worse. I'm very surprised your endo did not give you a shot of insulin to get your blood sugars down but maybe because you're type 2, that's what they do? please see if you can see a CDE or dietitian and get some help with your diet, food, etc...you have options here, including changing your diet, you have some control. dig in deep, try to put things into perspective. if you change the way you're eating, for a type 2, that's half the battle. stay strong and focus on feeling better. :)
I was over on the DiabetesMine website to day and saw a quote (again!) that is very powerful:
NEWS FLASH: Well-managed diabetes is the leading cause of...
One side effect from managing your Diabetes is not having to be concerned about where or how far you are from the restroom :).
It is very important that you go see an endocrinologist!
There are several reasons for this.
1. Internists aren't kept up to date on the latest information concerning diabetes, Type 1 OR Type 2. Especially when you're on more than one medication, you really need someone who knows the disease well to manage it.
2. Your internist sounds wonderful--truly one of a kind. I don't know very many doctors who would spend so much time with ONE patient. But--almost any endocrinologist would've put you on insulin temporarily to bring your BG down. I know the idea sounds scary, but really high blood sugars are dangerous in and of themselves. Just the fact that you've been going to the bathroom all the time is a good enough reason--the dehydration from a blood sugar that high is terrible.
I shadowed my endocrinologist for a week one summer. Even though he's one of the most conservative doctors I've ever met when it comes to meds, he didn't hesitate putting a newly-diagnosed T2 on insulin for a week or two until her blood sugar went down. He insisted that she'd come off of it as soon as her blood sugar was below 200, and we both believed him. And her blood sugar was "only" about 400 at the time.
3. If you needed glasses, your internist could tell you. He could even tell you approximately how bad your vision is. But he wouldn't EVER try to prescribe you glasses. It should be the same for diabetes. Internists aren't trained in endocrinology and even the best self-taught physician still doesn't have board certification in endocrinology. There are so many variables in diabetes, and it's so complex, that an endocrinologist is a good idea.
For now, stick with what your internist has prescribed. Keep watching what you're eating (and YES, it definitely gets easier!). But also make an appt with an endocrinologist.
More importantly for the short term, if you experience any symptoms of severe dehydration, you should go to the ER immediately. These include your skin being abnormally dry, your eyes looking "sunken", no tears when you cry, and a very fast heart rate.
Y'know, I'm so glad I kept this post open. Good advice!
Yes, you're right. My internist did initially want to put me on insulin last week, but I BEGGED him not to, so he relented. I think only to get me to take SOMETHING -- since a year ago I completely refused to take anything and didn't show up for over a year when he prescribed something I didn't like! LOL, such a coward I am.
Before seeing him last Wednesday though, I'd located a local endo with very strong patient ratings who is very close to home when I wasn't able to get to my internist initially. I didn't schedule an appointment with the endo cause I couldn't get in to see him until March 30th (1 month from now).
I'm going to go ahead and get in to see the new endo too, if for no other reason than to supplement and get a 2nd opion.
Yeah! Recipies and cooking are DEFinetly my next hurdle. Baby steps, but I AM encouraged by the sheer volume and variety of recipies. I'll check out the snacks link you posted in a bit. Hardest for me in the quest for low carb/healthy snacks I don't do "fake" food. No fake fats, short ingredient lists with no/minimal multi-syllable names, no Splenda or other new sugars. I've taken to snacking on raw cucumber slices, nuts & raisens, etc. so I've just got to establish the habit of keeping those groceries on hand and at work. Otherwise I end up grabbing chips and a Pepsi! 8-O
Perfect analogy about "prescribing glasses" -- I SEE your point exactly. Ha.
I absolutely agree with Bad Moon that carbs (and sweets most of all!) are addictive, both physiologically and psychologically. Some people can limit them greatly and do well with occasional treat. Others like me, do much better cutting them out. I haven't eaten sugar in 18 years and don't miss it at all. The physiological cravings disappear fairly quickly. If you test a couple hours after you eat the sweets you mentioned you will see how destructive they are on your blood sugar! As for "what the heck can I eat?" I have to say as a vegetarian I am always surprised that omnivores find it difficult to limit carbs. Really any type of meat or fish and any types of vegies are extremely low carb! You say you bought chicken breasts, ground turkey and brown rice and found it all very unappealing. If you are trying to lose weight that is one thing, but for limiting carbs for D management, you can eat any kind of meat or fish. Brown rice is better than white for some people but for some of us it's still impossible; so if you don't like it, why bother? And where are the vegies? I am a vegetarian and a foodie, so I do cook intricate dishes but I also rarely use fake food. Even without being interested in complex cooking you can find things that you enjoy to eat with a little effort and changing your way of thinking. Cheese, nuts, nut butters are all low carb and good snacks if you need to snack. (Old fashioned D thinking was we needed to eat lots of snacks, you really don't unless you're hungry). Find things you like to eat and things you like to drink. Find ways to cook your foods that make them tasty without adding carbs. Don't confuse low fat with low carb. You don't need to lower your fat and many of us find that even for weight loss low carb is more effective.Don't eat cucumber slices and dream of ice cream; find things you enjoy eating. If you prefer eating out go to actual restaurants, not fast food joints and order fresh food such as meat, fish, seafood, salads, vegies. You can eat small amounts of fruits, some easier than others, and when you stop sugar fruit will taste delightfully sweet.
And finally, please stop considering insulin a punishment and a fate worse than death. It isn't and you will adjust to it easily. If it allows you to eat healthy and feel better, and get your blood sugar down, then listen to your doctor and take the plunge.