March 7, 2013

You Have Diabetes – What to Do. - Part 4

Part 4 of 4 Parts

The doctor handed A.J. some pamphlets on injecting and where to inject. Then he pulled out a syringe and demonstrated filling it and how to read the scale. They covered the injection sites and the reasons for not injecting the short acting insulin near the long acting and the problems this could cause. I commented that was how I got two of my hypoglycemia episodes and that I make sure I have a set routine to avoid this. The doctor asked if he had figured out how to count carbohydrates and he answered not completely and he still had a lot to learn.

Then A.J. said that we would be stopping by the bookstore afterwards and if they did not have the ones on the list, he would be ordering them online. The doctor asked to see the list and said I must have had something to do with it and we both laughed. He said he would like to add Dr. Bernstein's book "Diabetes Solution" to the list, saying it was primarily for type 1 people but he should still consider it because of the insulin and some of the discussions. I said I agreed and once he had finished it, then maybe I could borrow it. The doctor quipped I should have already read it. I said I had not and that I was still rereading Joslin's Diabetes Deskbook. The doctor asked me if I would be loaning it to my friend, and I said sure, if he was into heavy reading.

Next, the discussion turned to me being a peer mentor for him, and I said that I thought I already was. The doctor laughed and said, in working with him to reset goals and work for good diabetes management. I said sure, and that he would probably be brought into our informal peer-to-peer group for more discussions. The doctor talked to him about being able to afford to lose at most 12 to 15 pounds to be at ideal weight for his frame size and height. He said that exercise would be in his best interest especially in starting out. He emphasized the insulin could cause an increase in weight to start as it would mean more effective utilization of the carbohydrates. I suggested that they discuss carbohydrate reduction at the start until he had adjusted to the insulin. A.J. asked what we were talking about, so some time was spent on carb counting. The doctor requested that I would discuss most of this and at the next appointment the lab results would be available for several vitamin and mineral tests to set a baseline and do any adjusting at that time if supplements were needed.

Next the doctor covered getting his eyes tested for a baseline for retinopathy, but not to get new glasses, if he wore them. He said no glasses yet, but that he would get the eye exam and we would talk about it on the way home. I said we would also talk about a dental check up for him to avoid periodontal problems related to diabetes. At that point we were done and the doctor took us out to the reception desk and told them to schedule him in six weeks. After this, we headed for the bookstore. They had only one of the books and it was determined that it was better to order all of them online.

He drove home and we talked some more about his eye exam and getting a dental appointment. He asked about the group I had mentioned and I said he would be invited to the next one if he wasn't working or that several of us could get together in an evening or a Saturday for a discussion. I mentioned everyone in the group and he said he knew three of them, but had not realized they had diabetes. Now he was excited to get together with the group. He said he had heard of two others, but had not met them that he could remember. He did comment when he let me out that he appreciated my having made him change doctors and he felt very good about how he was treated and included in the decisions. He was surprised about the thoroughness and that fact that lab results were the same day instead of doing it a week before. He said that made the trip worth it even though it was farther to this doctor.

We set a time to meet online for his meter testing and injection of the Novolog before the evening meal. Then we set a second time for the Lantus. We discussed the advantages of where he started and discussed several of the routines he could use. He asked good questions and I think he did very well and felt comfortable after he had completed it. I told him to call if he had questions later and he recorded his meter readings and time of injections. We have talked about food logs, daily health logs, and testing more often to learn how the foods react and raise blood glucose levels.

He is another computer geek and has set up a database for his meter readings, food log, lab test results and other information he wants to track. He says that in general it is much easier than he had envisioned and that occasionally he does feel a little pain when testing and injecting, but is nothing he can't live with. We have continued with emails and I enjoy answering his questions.

These four blogs are what I do in situations where I can help people. I have another person that is on what I believe the verge of developing diabetes and from his lab results he is very much at risk. He has asked that I not write about his experiences. A.J. has said to write about it since I am not using his real name. He feels that if relating his experience will help others, this needs to be done. Thank you, A.J.

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