I've gone through and read lots here on steroids. Dr has said it's a very small amount and wrote down all info for my endo appt on Wed.
Trying to decide what to do next...here's background.
I fell in January and broke thumb and wrist. Now after healing and pt thumb and connecting area of wrist (De Quervain's tenosynovitis)and thumb are still a major problem.
I'm on a pump for 1 month and start CGM Thursday.
It is my right thumb, lots of pain, hard to move, cannot hold anything, having a hard time signing (ASL), because of limited thumb movement AND the second language in our home is ASL (America Sign Language). I have severe hearing loss and ASL is super important to our family.
Dr has said either the steriod injection or surgery would be next course of action since we've tried all conservative. Surgery would be outpatient, awake with relaxation meds. approx 6-8 stitches, 10 days in a splint and a bit of pt after. Has anyone had the steroid injection in thumb, know it'll be different for eveyone, but how long was bg up?
Any suggestions on what to talk to my endo about this week? Any planning or prep ideas?
THANKS!!!
Kelley
I've had many steroid injections over the years, and I used to go super high and stay up there for at least three days. A few years back, however, my rheumatologist came up with a protocol to prevent the highs. Immediately upon getting the shot, I set a temp basal for about 125% of my regular basal. I test in one hour, and if I'm starting to go up, I'll increase the temp basal to 130%. I've never needed to go higher than that, but as they say, your mileage may vary. I keep the temp basal set at the increased rate for two full 24 hour periods (don't forget to re-set before bedtime), and then I usually decrease it to about 115% for the next day, and then back to normal. This has worked for me quite well. Also, I don't usually have to increase the boluses, unless I eat a high-carb meal (which I especially try to avoid after a steroid shot).
As my rheumatologist and my endocrinologist have said, it's much easier to prevent the high than it is to get it back down once you've gone high from the steroids. When I finally had carpal tunnel surgery, the (very stupid) anesthetist, who KNEW I was diabetic and had watched me test myself just before I went into the OR, decided it'd be a good idea to help prevent any post-surgery pain by giving me some steroid medication. No one told me, and I ended up with bg's in the high 300's for two days! To say I was pissed was putting it mildly, but I have to give credit where it's due...the hospital called the day after surgery to see how I was doing (that's when I found out about the steroids), and they ended up having the Chief of Surgery call me to find out about my pump protocol for managing bg's with steroids. He also said that everyone would be re-educated about steroids and diabetes, and no one would ever be given a steroid again without their knowledge.
Without a pump, there's not much you can do to manage the steroid high, but the pump makes it possible to have a steroid shot and keep your bg's under good control.
Ruth - thanks for how you've made it work. Gives me a good idea what to expect. I'll see what my endo has planned. I do think being on the pump and cgm will make it more managable.
