September 11, 2013

How Did You Handle Your Diabetes Diagnosis?

This is a question I receive in emails almost every month and I have my answer that I copy and paste in a return email. I will share it now.

First, I let people know that I was in the hospital when I received my diagnosis. I had been operated on to balloon out several arteries and had a stent implanted in one artery. As such, I had no room to become angry about the diagnosis. All I could do was let the nurses do their injections of insulin and follow their instructions if I was not able to eat enough, which was quite often.

When I was awake the first day, the hospital diabetes educator came around and introduced me to the testing supplies and how to test. She only had the equipment that my insurance would cover and of course told me that I would be given prescriptions for everything when I was discharged from the hospital. Since all the pharmacies would be closed when I was to be discharged, I was able to have her obtain my test strips and oral medications that the doctor had prescribed. She was very polite and took time to explain what the two medications were and how they would work for me.

What she all but ordered me to eat was whole grain foods and very lean meats (low fat of course). Little did I know then what problems this would cause. My son was able to come home to be able to transport me from the hospital. The next day I was able to fill the rest of my prescriptions. I was very fortunate that my pharmacist was watching my prescriptions and even then told me not to use the alcohol pads for cleaning my fingers. She said I should keep some around for times when I could not wash my hands, but that would always be the best to prevent cracked skin and very painful blood glucose testing. Since this was late October, I followed her directions.

Since I was still working, I did take the extra test strips at my expense. The pharmacist also showed me where to test on the sides of my fingers and explained that there was less nerves so I would have less pain. The pharmacist also suggested that I set up a log to track my blood glucose readings and the time. She also asked if a food log had been explained to me and I said no. She asked if I had a scale. I told her about my scale which could weigh in grams and ounces, could be zeroed for the container (called tare weight) and she commented that with that I was ahead of the game. She was becoming busy then and told me to write down questions and come back another day. She concluded that if she had time she would answer them for me then, or take them and answer them for me and I could pick them up another day.

Since my son had to get back to his work and schooling, he left the following day leaving me to my own devices. A couple of days later, I drove to the health food store and I needed a refill of my daily multivitamin. Since I knew the owner and knew that she had diabetes, I felt she would be able to answer a few questions. She did ask which medications I was taking and wondered why I had not been given one of the sulfonylureas. I said I was allergic to them so she moved on to research them. I told her I was not looking for a natural medication.

She said that she did not know of any that would help diabetes as she had tried several after her diagnosis and had only received short time help. She explained that once her body replenished what she was short of, the effects stopped. She did write down what to research myself and the tests to ask the doctor to do, to see if I was in the normal or low range. Then we talked about nutrition and the fact that I should reduce the number of carbohydrates and whole grains to get better results with the medications I was taking.

Her advice brought me out of the upper 200's to the upper 100's for blood glucose readings even though I kept reducing the number of grams of carbohydrates. So the next appointment in January the doctor and I had a good discussion about insulin. Since I had been researching it, he set me up with another doctor to establish the starting dosage for each insulin and she told me how to adjust (titrate) the amount of insulin based on my blood glucose readings for a correction and the number of carbohydrates I would be eating for that meal. She covered the readings I should be trying for and that it could take some time to get there.

She also covered hypoglycemia and having glucose tablets available for use. Then she started handing me sheet upon sheet covering the symptoms of hypoglycemia, hyperglycemia, and getting my baseline eye examination, dental examination, and set me up for a follow-up appointment with her and my primary doctor for making further corrections. With this I was off and running and managing my diabetes. Instead of A1c's in the upper 7's, my next was just above 6.0%.

I soon discovered that all the goals were what the American Diabetes Association recommended and further discussions with the owner of the health food store and my pharmacist taught me that it was better to set goals less that the ADA recommendations. I was reading Gretchen Becker's book The First Year - Type 2 Diabetes by then and I had found the website for David Mendosa.

Over the next few years, I did a lot of reading and researching on the internet. I had my first denial about three years after diagnosis and a bout of minor depression about the same time. Like most people, I have made bad mistakes, but I am happy to say that I have learned by making these mistakes.

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