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Medical Forum / Diseases and Disorders / Diabetes / October 2005Mom's diabetes - input needed
I've posted here on a semi-regular basis and I credit the advice I got here, particularly Jennifer's advice for the newly diagnosed, with the excellent control I've had. My question, though, is regarding my mom, who was diagnosed a little more than a year ago. She is 77, an incorrigible smoker, and doesn't take very good care of herself. When she was diagnosed her a1c was 6.4. She lives with us, and I was able to exercise considerable influence over her diet and that got her down to 5.7 at her first follow-up. I should add that she goes to the same Dr. that I go to. He's a nice guy but my own control is not based on anything he has done. My Mom went to visit my sister in NY and my sister became concerned that my Mom was unhappy because she can't eat the way she wants. So she called Mom's Dr. and together they decided that at her age and with her smoking there isn't any real point on her restricting her diet - that if a less restricted diet results in higher blood sugars he can give her a pill for that. My concern is that she has never been overweight and I wonder if her problem is not so much insulin resistance as lack of sufficient insulin production. And that giving her a pill, metformin, for example, might not do it because IR isn't her problem. And that in short order we will be looking at her needing to inject insulin. This concerns me, as she is simply not capable of adhering to a regime of insulin injections with the kind of diligence it requires. Since she is alone most of the day, if she goes hypo it could kill her. Since I've basically been taken out of the picture on her diet she has gone hog wild. I did urge her to get a meter and test and she got one. We spent an evening going over how to use it, but she has basically done nothing with it. I suspect that the readings she has gotten were high because she won't talk about them. So I need to know if my fears are exaggerated or if I am right to be concerned. Any input on this is welcome. Rich > I've posted here on a semi-regular basis and I credit the advice I got > here, particularly Jennifer's advice for the newly diagnosed, with the [quoted text clipped - 42 lines] >ways to help where they can. Why don't you talk to your sister, or your >Doctor, they may be able to help you with your concerns Kay Rich, I haven't posted here in quite awhile but may be doing so shortly as I am prediabetic right now. This is just my story and what I witnessed, but wanted to share as I also had concerns with my mom. My parents both passed away 3 years ago and my mom had type 2 diabetes. She always had such amazing willpower and did a great job with her diet and glucose control and exercising. She had some complications from 30 years of having diabetes, but overall was doing well. When she had health problems that landed her in the hospital and then from there assisted living and then more care, my brother let his doctor care for her (GP, not an endocrinologist, and as I wasn't in the same city I didn't have much say). The nursing/rehab center first told me that glucoses of 200 were fine, as she had enough other stuff to deal with. I of course questioned the logic but fortunately she wasn't there long. My brother's doctor was like your mom's in a way, as he brought up the "quality of life" issue and that a "little higher" glucose was ok as she had enough other problems and a little enjoyment was ok, and that her other problems were more serious so glucose control should take a back seat. I let it go, though I was uneasy with that philosophy. At that point, life wasn't anything real special for her as she was in a wheelchair and living in a home with other people who needed care and rarely got out unless we took her somewhere when visiting. Then she started getting toe infections that wouldn't heal and she ended up with a bypass on one foot and amputation of a toe on the other.....which of course didn't heal and she was back for amputation of more toes a couple of weeks later....which of course didn't heal....and she was sent to another hospital for hyperbaric oxygen treatments. It wasn't helping much either, and they contemplated more surgery. She was there for weeks dealing with it all and eventually succombed from her medical problems. I know that if I were older, I might view the quality of life issue differently, but seeing what she went through and the pain and depression, after being so careful for so many years and maintaining a good quality of life because of good glucose control, I would definitely do things differently if I had the chance again. She went through a lot that last year that I really feel could have been prevented if she had had a doctor that was on top of things and believed in the importance of glucose control. It's something I will always regret! I wish you the best in coming to terms with your mom's situation and finding a good compromise for you both. It isn't easy on either side of the fence! Darcy Johnson Let me speak to the "quality of life" issue. I'm 77 and have had diabetes for over 15 years, a quadruple by-pass, a herniated disc which gives me a backache pretty constantly, and now have some arthritis. Plus conrneal dystrophy which bugs me...... ....... OK. I can walk. I have all my limbs. I have no unhealed sores. I read constantly. (The TV is a bit blurry and I grab a magnifying glass sometimes but what the h___.) As my doctor says "at your age you expect to run marathons?" I do expect to read, go to work, enjoy my grandchildren, play with my dog, dig in my garden, harvest my avocados, (and lemons at the moment), and fret about the budget......which has nothing to do with diabetes. GOOD CONTROL. GOOD MEDICATIONS. GOOD DIET. Any stupid doctor who refused to treat what I've got on the theory that my "quality of life" deserves to be lousy just because I'm 77 CAN DROP DEAD HIMSELF. (Or herself as the case may be.) Or live in a wheelchair with amputations. Or_________pick any nasty complication you think is worse. On the other hand, there are old people in denial. Fat, self-indulgent, lazy. I do NOT blame it all, or even mostly, on the medical profession. There is one horrible truth in the examples given: SOME PEOPLE REFUSE TO HELP THEMSELVES. If you are dealing with parents who will not face their problems, there is not a lot you can do AND STOP BLAMING YOURSELF. If my 5 kids, all in their 40s, tried to change my life style, they wouldn't have much success. I am responsible for ME. My children are not. It is good that you care but you canNOT force a parent to do your bidding, no matter how helpful it would be. I say that as a parent and grandparent; got the authority to speak for that. Much as my kids love me, and they do, they cannot dictate to me and if I indulge, refuse to face problems, deny an illness, IT IS NOT THEIR FAULT, IT IS MINE. Love, suggest, and cry to yourself if it doesn't work. But do not blame yourself. Nan, Type 2 since 1990 or so. > Let me speak to the "quality of life" issue. I'm 77 and have had > diabetes for over 15 years, a quadruple by-pass, a herniated disc which [quoted text clipped - 36 lines] > > Nan, Type 2 since 1990 or so. Great, Thank you for your view. My Dad is 94 , has had diabetes for40 years, worked out insulin for himself his Dr said it was a different way to figure it, but it works and he is one of his best controlled diabetic he has. His only diabetic loss is hearing, and while seriously slowing down he still lovesjust waking up and finding himself still alive, and has said to me, ' even with the ageing and physical problems, do enjoy what life you can hang ontoas long as you can.." Kay > Let me speak to the "quality of life" issue. I'm 77 and have had > diabetes for over 15 years, ....... > As my doctor says "at your age you > expect to run marathons?" There are people older than that who would say "hell, yes -- and I have one planned this month" -- so age is not per se a reason you can't do something. I don't do marathons, but I have done 10 milers (actually, due to the security scare & resulting sudden course change, the recent Army ten miler was 11+!). Doctor better not tell me that I'm too old to keep that up -- I'm only 61 but there's no telling how long I'll be able or want to keep doing this. And when 10mi is too much, there's always limiting myself to 10k, or 5 mi, or even just 5k races, if I want to keep running & racing. My mother is 85 & in good health. She still rides her bicycle -- not just around the block, either, but further afield -- though not long distances, & she no longer puts in the car & goes out beyond the burbs to ride. Coming home from downtown is, btw, *uphill*. She also walks a lot. Don't tell *her* she's "too old for all that"! (when she was moving into the retirement home a couple of years ago, she hit them with a new question -- "where can I keep my bicycle?") > GOOD CONTROL. GOOD MEDICATIONS. GOOD DIET. Any stupid doctor who > refused to treat what I've got on the theory that my "quality of life".... I don't think the OP was a case of the doctor refusing to treat, but rather a patient not cooperating & a doctor trying to find some way to treat around the denials, find something that might do some good that the patient will actually cooperate with. > SOME PEOPLE REFUSE TO HELP THEMSELVES. And it's so frustrating for all concerned to see that happen. bj > I've posted here on a semi-regular basis and I credit the advice I got here, > particularly Jennifer's advice for the newly diagnosed, with the excellent [quoted text clipped - 33 lines] > > Rich Your concern is understandable though one can not help someone who does not want to be helped. In Christ's love and service forevermore, Andrew -- Andrew B. Chung, MD/PhD Board-Certified Cardiologist ** Suggested Reading: (1) http://makeashorterlink.com/?G1D5217EA (2) http://makeashorterlink.com/?W13A4250B (3) http://makeashorterlink.com/?X1C62661A (4) http://makeashorterlink.com/?U1E13130A (5) http://makeashorterlink.com/?K6F72510A (6) http://makeashorterlink.com/?I24E5151A (7) http://makeashorterlink.com/?I22222129 >>I've posted here on a semi-regular basis and I credit the advice I got here, >>particularly Jennifer's advice for the newly diagnosed, with the excellent [quoted text clipped - 12 lines] >>Dr. and together they decided that at her age and with her smoking there isn't >><snip> > Your concern is understandable though one can not help someone who does > not want to be helped. > > In Christ's love and service forevermore, > > Andrew for those who don't know ANY advice from the Chung should be ignored >> I've posted here on a semi-regular basis and I credit the advice I got >> here, [quoted text clipped - 54 lines] > Your concern is understandable though one can not help someone who does > not want to be helped. What a c.nt you are In Christ's love my f.cking arse. It's in your WON self love that you revel. |
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