August 27, 2013

Is There a Best Way?

Part 1 of 2 parts

There are days when a topic says write about me and there are days when the thoughts just won't come together. I have about a dozen or more topics I want to write about if I could just put some thoughts on paper. Normally I start out on a yellow tablet and start outlining ideas for a blog, but sometimes it is easier to use the word processor and put ideas down and outline. Using either route, I put the points in the order I want and then start writing.

The last week was difficult in organizing anything and my last weeks blogs may reflect some of that. I sometimes force myself to write. While I have had a few excellent (in my mind) topics that I can outline, organize, and write about, it is often not wise to finalize them, but put them aside for some time and go back later and reread them. Then I sometimes rewrite much of the blog and schedule it for posting.. Some have surpassed my expectations for readership while some that I really liked and felt they were important, were rewarded with a poor number of reads, but this happens.

This is a blog that I had started back in 2010 and it has been in my hold file all this time. When I opened it this evening, the idea came to me that I have not written about what might be the best way to manage diabetes. Yes, I have skirted the edges and made some good points here and there, but I am hoping this gives some readers an idea to latch onto and possibly make it work for them. I have no idea of how many blogs this may encompass.

So I will start at diagnosis and work my way through what may work. Yes, I will use some of my previous blogs as they cover some of the points that should be important for everyone to learn. This is the first one covering the ideas and points everyone newly diagnosed should learn. The support group has tried to add other items to the list and after discussing them, we have set them aside as they did not fit the way we thought they would..

Now for some points to make sure you consider at diagnosis or shortly after diagnosis.

#1. Attempt to obtain your lab results at each doctor appointment. It is much easier to ask for them at each appointment than later when you may need them. Plus the doctor may make you wait 30 days which presently they can do legally. Plus this will help you track your health and provide good information if you need to change doctors,. Hopefully this won't be needed. The lab results will let you know if your doctor is checking the vitamins and mineral levels, thyroid condition, and many other vital tests. Blogs about some of the important tests are here and here.

#2. See your eye doctor for an eye examination. This is important to establish a baseline for the condition of you eyes. When most eye doctors are told you are newly diagnosed with type 2 diabetes, they will normally do a thorough eye exam and make many notes. This provides a base for future eye exams and they will check for retinopathy, cataracts, and other eye diseases.

#3. Set up that dental appointment! I know many people avoid this, but it is important so the dentist can check for periodontal disease which often can accompany diabetes. Better to establish a baseline here as well and have your teeth and gums taken care of to prevent future problems.

#4. Make sure you have a good pharmacist. A pharmacist can be a great asset for questions about medications. They can prevent medication conflicts. It is a good idea to ask the pharmacy if they would like a list of supplements you are taking as some supplements can have deadly conflicts with some medications. Most pharmacist are an excellent resource for knowledge on diabetes supplies and if not overly busy may be able to answer many questions about them. Some pharmacists are working into primary care.

#5. Check your insurance for supplies covered. Laugh if you want, but many people are not familiar with what supplies their insurance will reimburse. With the changes being made by the Centers for Medicare and Medicaid Services (CMS) changes have and are being limited. If you have the funds to buy what you chose, great. Otherwise you will need to consider what is reimbursed by your insurance, not great in many cases.

#6. Start reading and looking for material (books and newsletters) for self-education. Chances are as a type 2, that you will not have a certified diabetes educator available help educate you. Self-education may be your only option. Don't forget about some types of social media. Also see number 4 above.

#7. Do not be afraid to ask questions, of your doctor, and anyone with diabetes. Normally those of us that blog are able to answer some questions and if we are unable, we will refer you back to your doctor, or a source that should be able to answer your question. We will not answer certain questions that should be answered by your doctor. Only your doctor can answer some questions based on your tests and personal history. We may ask more questions to determine how best to suggest a solution based on our experiences.

#8. Another exam that needs to happen is a hearing test. This will also develop a baseline for future tests to determine if there is hearing loss happening. Small blood vessels in your inner ear can be damaged by high blood glucose levels and over time will rupture and cause hearing loss. It is important to maintain excellent blood glucose levels and blood pressure readings.

#9. Get an examination by a podiatrist. As a person with diabetes, this is important as atherosclerosis, problems with the large arteries in your legs need to be avoided and you need to be sure that you have someone to treat wounds, cuts, and other foot problems to avoid infections that may prevent healing and causing a need for an amputation of a toe or part of your foot or leg.

#10. Consider getting an appointment with an urologist or doctor specializing in kidney diseases. If you primary doctor is doing the necessary tests, this may not be necessary, but you may need a referral later to handle kidney disease, or nephropathy which is a complication of poorly managed diabetes.

#11. If you develop neuropathy, another complication of diabetes, you may need to see a neurologist. They can help with the pain and prescribe medications that can ease the pain. Only excellent diabetes management will prevent this from happening and outside of heart problems, is the most prevalent complication of diabetes. An important article appeared on August 15 about the risk of peripheral neuropathy occurs only with fluoroquinolones that are taken by mouth or by injection. This answered many questions for myself and another member of our group because we had neuropathy before we were diagnosed with diabetes. Now we understand the medicines that caused it. I would suggest that if you have neuropathy, and are diagnosed with pneumonia, do not let the doctor prescribe Levaquin as you will be put in extreme neuropathy pain. This is what happened to me about a year ago and the pain put me back in the emergency room.

There are always more tests and things to do, but this will provide items for thought and be a starting point.

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