At the age of 62 I'm a newby with diabetes. When I am around others who are living with the disease for long periods like you I can only be thankful to God that I got this far and I am humbled for whining at times. I was diagnosed with Type 2 diabetes on August 2, 2005. The doctor had not told me that my blood work was bad, it had been for over a year. The A1C was slightly over 6 for over a year, Fasting Glucose was 129, then 139 and in August they went to 6.9 and 149. The doctor more or less offhandedly said something about needing to do something about my diabetes like it was something I should know about. I responded that nobody had told me I had it. His response, "There isn't any doubt about it. You have it. I don't know what makes you think you don't."
I was kinda stunned. He hadn't told me I had anything, he hadn't shared what the blood tests meant. I'm a techie, study lots of things but had never taken the time to look at this. One of the things that is now leading me to seek another physician is this attitude of not telling the patient what is happening. The only thing he ever seemed concerned about in previous visits was my blood pressure (I'm on meds for that) and the HDL that was a little low. Had he explained that the 6.1 and 6.2 A1C's combined with the FBS going up were not good and in fact shared that with me I would have been concerned. I did see one blood test slip until I threw a shoe with the nurse three months before that. Most didn't look bad. I failed to check what the numbers I didn't recognize meant.
I had gone through a diabetes concern by a previous doctor on diabetes about 30 years ago (I'm 62) and had a 3 hour glucose tolerance test which was negative. That was based on a father and grandfather who were diabetic and a chance comment about being thirsty. I kinda bagged diabetes as a "not worry about". I keep informed on a lot of things but diabetes was not on my home-study list. My brother in law was type 1 and died of heart failure at 42. I learned some from him. Over the years I've saved two people from insulin shock, one I worked with, one who was in a hotel lobby, because I recognized the symptoms as likely that and was right. Both took insulin and then didn't eat for some time. Both were in the "looking like they were really drunk and dazed" stage. Neither were 100% coherent. Both had difficulty thinking through questions that needed a yes or no answer, in fact they were having problems with specific yes and no questions. The man in the hotel staggered to the desk at about 7 AM and the desk clerk couldn't understand him. This was a long stay place, the Residence Inn and I had talked to him several times. I had her ask him if he was diabetic, after some real thought he said yes. Did he take his insulin this morning. He nodded yes. Did he eat, the answer was no. The gal was working with me in an office. I had my back to her and asked a question about work. After repeating the question several times I turned and realized she was there but looking a little dazed. I ran through the questions, was she diabetic, did she take insulin, did she eat. Two yes answers and no time got to the problem. We got her some orange juice and them called her husband to take her to the hospital. I knew the disease from that standpoint.
But if you had asked me what blood sugar levels were good on July 1 of this year I couldn't have given a good answer. And I had no idea an A1C even was a blood test for diabetes.
I see the complaints by the medical profession that 2/3 of the diabetics are not diagnosed. Let me tell them how to find at least a significant portion of the problem. LOOK IN THE MIRROR. I GOT NO HELP INITIALLY. I am not sure my primary care (possibly soon to be ex-primary care) is any more competent to handle diabetes management than he is to do brain surgery. And I am becoming convinced this is not an unusual case.
When he sprung this on me I was told to get a meter, come back in to have the nurse show me how to use it, then test a couple times a day. That is very close to the actual wording. I asked the nurse what meter. The response was see what your medical insurance will cover. I called the medical insurance carrier. They told me they would pay for what ever the doctor wrote for. I called the doctor back and got no additional help from the nursing staff. I visited the local Walmart pharmacy and actually got some help. I'm using the Ascensia Contour (was free) but from what I see there are lots of good meters. I made a nurse appointment (Thirty nine dollars) and took the meter to the doctors office. I got little if anything out of that visit. The nurse didn't know how to use the meter. She did show me how to load the lancet, something I could have figured out on my own. They wrote me a prescription wrong, for disks rather than strips for the meter - fortunately I looked before I left the pharmacy and saw they were the Ascensia disks not the strips. This is incomprehensible to me because I gave her the sample bottle of strips to write the prescription and it clearly had “strips” rather than “disks”..
Now I see the game plan and it isn't pretty. They wanted me to log the results for 3 months and come back to let him tell me what to do. I was playing with getting worse and damaging my body so he could have me come back and manage my condition. The doctor has to fix the problem. The more I think of that the more I get angry. The nurse did mention that there is a diabetes management class here that might be good and gave me a brochure. I almost threw it away. It looked like a good way for the medical profession to make money. They really need to improve that brochure, something I mentioned to them in their evaluation. They apparently spent good money developing a great program, which is good. But they need to improve the PR to get people in. There are people out there who need the help they offer. This has been one of two bright spots in all of this, the other ironically was the Walmart Pharmacy! I am sure the medical profession would not be happy with this evaluation.
After about 2 weeks of frustration I settled down to testing on 8/14, still not sure what I was doing. By Labor day I was even more frustrated. I had glucose levels all over the place. Half of them were over 160 which means I was headed for a higher A1C than before - which I still didn't even know about. One day at work I went outside very frustrated. One of my coworkers was there smoking. I don't smoke, I go out to walk at times. If they can smoke for 10 minutes a couple times a day I can walk for 20 minutes. (OK, I'll fess up, I didn't exercise every day till this happened.) He asked me how things were going, he had heard some of what was happening. I responded that I was ready to throw the meter and strips away and just let things go. I didn't feel sick so I couldn't be that bad. I would wait till I got bad enough to worry about it. He looked at me and said, "If you want to go blind, loose a leg, have a heart attack, have a stroke, ruin your kidneys, go ahead." I responded, "I like you too." He then told me that he couldn't stop me if I wanted to destroy myself but if I wanted some help to avoid it he would try. He is a 4 year type 2. He shared some things with me for a few minutes and we talked a couple more times over the next week. By mid September I was running 30% bad points.
At that point my coworker told me I should look for a class, he had given me about as much as he could. By then his help had built him enough credibility that I would have done almost anything he suggested. I signed up for the course and took it in October.
The portions of it that I expected to have the least value were in fact the best. I actually found a dietician that I like. She tells me I need 3 snacks a day. Well, there are other things she was right about too. And I am sure I am not eating exactly like she suggests but I am getting closer. I have only had 3 bad days in the last 45. One was not realizing some ham I was eating had been soaked in a sugar sauce. That got me to 215 about 2 hours later. One was just plain stupidity at a buffet – that got me a 285. The other one was a miscount of grams of carbs that got me to 201. I have a BA in Math and I can't even keep track of the carbs in what I eat which is simple addition. I can understand why this is difficult for others.
The November 1 blood tests came back. Fasting blood sugar a high 120 but well below the 149 of three months before. The A1C which would have been impacted by the bad days of August and the not good ones of September was 6.1, equal to the value of a year before and just within range. I'm not on meds so it is pretty hard for me to get low enough to be in jeopardy. The dietician who taught the class who is diabetic said that her husband knows when she has a low sugar, she gets grouchy. It's exactly how I would describe it when I get below 90. My meter seems to be reading a little high - I did a test when I had my last lab work (120) and it read 132 so that may be 82 not 92. But to maintain the control I have to have over 28 carbs a meal and but less than 37.
Copyright 2005 Ralph Brandt The author can be contacted at Ralph.brandt@suscom.net
Kimberly Advent Site Owner