OMFG! Don't listen to any of that.
Don't listen to any of what?
You are already receiving excellent advice in this thread. I have very little to add, except it sounds like you are doing a great job of managing your D under very difficult circumstances. If you are severely under weight and dropping quickly, you just need to adjust your diet.
You sound very stressed out. Relax. Don't overthink things. It can be very intimidating and difficult to disobey someone in a position of authority. You are an adult. And for better or worse, ultimately responsible for your own health and decisions. Maybe it would help if you made a list of problems with her recommended treatment, data to back up your criticisms, references and explanations when necessary. Present them to her calmly and rationally. Best case scenario: you both learn something. Worst case: figure out how to work around her.
Oh sweetie, what a horrendous ordeal. What you've endured! So very sorry for the torment.
Hard to have trust in a medical system that didn't diagnose your hypothyroidism initially that caused you suffering & put you on a psychotropic med nightmare. I'm also hypothyroid (Hashimoto's) & walked around for decades feeling hideous because I was told I was borderline, it was nothing & therefore ignored. My symptoms meant nothing. All that counts to doctors are tests. Absurd. For one thing, the test ranges are wrong. For another, they weren't doing the correct tests. TSH was all that tested. Useless. I fought long & hard to finally get Free T3, Free T4 & Reverse T3 tested to prove I was seriously hypo. I was about to pay for the tests myself. Now, it's another battle to be put on natural dessicated thyroid, rather than Synthroid. Closed medical minds on that topic.
Understand your dilemma. Not the same situation as yours, but none of my doctors or CDE were supportive of LC. CDE gave me the usual brain starving myth. I've explained gluconeogenesis to several medical professionals. They've obviously never heard of it:) So, not surprised she's adamant. I know what works best for me & refuse to discuss it further with people reading from the same playbook issuing one-size-fits-all, incorrect advice. You know what work bests for you & no one can control what you eat.
I wouldn't take insufficient insulin doses either. Only you are responsible for your BG control. Please don't be concerned about "keeping the peace." It's your body & your life. Pointless to be a compliant patient.
I'm sorry to hear about all these troubles. It can be really frustrating navigating the health system. At least you have a team and they are practicing "integrative medicine." It is all too common for doctors to not communicate well and fight over control of various aspects of our health. My suggest is that you focus on getting an agreement on your treatment goals with your endo, not your NP. Her job is not to make treatment decisions, but to work with you to properly implement your treatment plan. And the key elements, your blood sugar targets, etc are things that you can appropriately move from her decision sphere to your endos decision spehere (or other doctor). Their decision will trump whatever she wants.
But in the end, you will likely have to accept that there will be some mismatch. You may have to make some short term compromises in order to get through this. If your team concludes you are refusing to comply you can end up with your NP complaining that your low blood sugar and carb starved brain are causing all the problems. This will be a distraction that you just don't need right now. So be willing to agree to moving your lower range from 70 to 80 or 90 if requested. You can eat whatever you want, they won't know the difference, they will just think you do great bolus calculations. Just nod your head, say thanks for the advice and move on.
So think about my suggestions and don't fret yourself over the short term. The important thing is to figure out what is wrong, get it fixed and get on with your life. Once you get on with your life, you won't have some NP all over your back with whacko advice and you can return to normal.
According to David Mendosa, the problem is that the brain's need for glucose is confused with a need specifically for carbohydrate.
http://www.mendosa.com/blog/?p=282
I see this repeated often and stated as fact. If anything, I've experienced improved cognitive function, since switching to a LC diet and stabilizing my BG levels.
I agree with Zoe that 100g/day is relatively LC. USRDA is 300g. But, I have noticed that once your body has adapted to 20-30/day, eating significantly more than this can really wreak havoc with your BG control.
Hey. dear friend. I had no idea you were doing such hard travelin' these days.
But I'm so pleased that you are getting such good advice from the community. We have so many knowledgeable and experienced people at TD - people I'd trust 100 times more than a NP who probably has some dumb_ss cookbook recipe for treating db. Makes me furious.
If I used 8 units to cover 30 gm cho, I'd be on the floor in no time. My normal dose would be about 3.
When I was in the hsp for my ruptured spleen, they wanted me to have juice when my bg was 80 too. In that instance, I think part of it was that they didn't want to bother having to come back to my room and retest in an hour.
......sigh. Stay strong sister. You are very intelligent and have dealt with the db long enough to know what's what.
Gee, Lots. I had no idea you have had so much trouble with the medical "experts." We know our bodies best and should listen to them before we listen to the experts. I was told when I was a patient in 2 hospitals ( for non-D related conditions), the medical professionals feel more comfortable when diabetics have high BG. Maybe your NP feels better when your fasting BG is over 120. I was told they panic when a D has a low BG. Low to them is anything under 70. Remind her that the reason you have no complications is because you do tight control. I will be anxious to hear how the appt. went today. Cat
Good advice, Sam.
Thinking of you, lotsofshots, and hoping that today went well for you. :)
My ratio is similar to bsc's, my boluses run from under 10% to (rarely) 20% on days when I treat myself. I feel great. You DO know yourself. All those 'rules' are guidelines, which we individualize to suit ourselves. She's having you start from square A, when you've already done all the tweaking.
I agree that 90 carbs a day won't hurt short term, except if it makes you feel crappy. Higher BG short term won't hurt either, with the same caveat.
Please also remember that stopping the drugs you were on cold turkey is VERY hard on your system. Why didn't they wean you? It can take 6 weeks or more for the withdrawal symptoms to abate, so don't think the sx are permanent yet!
Most of all... MEGA hugs to you my friend!
I'm glad things have worked out.
Cheers!
Like the kitty, I'm so happy for you. I deleted my comment that said to fire her. Your ability to be civil and at the same time doing what's best for yourself is the best way to go. Congratulations!
Fabulous!!! You stood your ground, did so calmly and reasonably (and with documentation!) and she heard you! She may not have acknowledged you were right, which I guess is too much to expect from some medical professionals, but hopefully she will think about the experience later and realize that some PWD's do indeed, know how to manage their own Diabetes. Congrats. I has a happee for you!
I'm so happy for you, lots! I actually got goosebumps when I read your update because I can just feel how things have turned around for you.
Have an absolutely wonderful day! :)
So glad your mind is clearing and you feel better,seems like she needs to read "Think like a Pancreas".
Lots- So glad things went well for you at your appt. You must have sounded clear minded and in control of your D regime, so she couldn't dispute what you said. Don't forget to join the chat this Friday. Gary Scheiner, author of "Think like a Pancreas" will be leading the chat. Glad things are so much better for you. Cat
OMG, I love LOL cats and LOL dogs. Your last post sounds... well, like lots! I haz a happee for you toooooo.
Lots=- BTW- the webchat is 1PM EDT.
Way to go, Lots! I'm so glad you stood your ground and did what you knew was right. Just curious why you are going to meet with the NP on the 13th? I thought the primary said to "forget the NP" - she has definitely proven herself incompetent!