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Medical Forum / Diseases and Disorders / Diabetes / December 2006Finally getting round to this
Sorry for being missing a while but health issues dictated I took time for me! Alot of you have asked my medical history - well I got round to typing it up (Needed to for teaching student drs yesterday)! There are still BIG issues with the blood sugars even with Lantus now at 46units and rising fast! Ive swapped to opticlik pens due to the dose size (opticlik go to 80units) and much prefer them but still control hasnt been found! I am awaiting an urgent appointment with a diabetic consultant at our nearest major hospital (UK)! So for now I will elave you with the information below! Any comments welcome but please try to understand how complicated my care is with everything else I deal with! Personal details. Donna. 31yrs old. Medical conditions. Brittle asthma - type 1 - steroid dependent. Diabetes - type 2 - on insulin. Severe chronic chest pain. Migraine. Depression - steroid induced. Multiple anaphylactic allergies - carries adrenaline. Major bowel surgery 18 to 24tmhs ago. Allergies (anaphylaxis). Latex. Insect stings. Maxalon. Stemetil. Cyclizine. Haloperidol. Tramadol. Aspirin. Accolate. Amitriptyline. Zispin. Penicillin. Doxycycline. Fexofenadine. Cefalexin. Quinolones. Medications. Atrovent nebuliser - 500mcg - 1 every 6hrs. Phyllocontin continues M/R tablets - 2 twice daily. Terbutaline nebuliser - 5mg - 2 nebs (10mg) 4hrly + 1 neb as needed. Bricanyl turbohaler - 500mcg - only to use when neb is not practical. Terbutaline sulphate tablets - 5mg - 1 three times daily. Serevent accuhaler - 50mcg - 2 puffs twice daily. Flixotide accuhaler - 500mcgs - 2 puffs twice daily - up too 4 puffs twice daily when chest bad. Anapen adult injection - 300mcg - to use in severe asthma attacks and anaphylaxis. Betamethasone tablets - 500mcg - 12 tablets in morning - LONG TERM. Paracetamol tablets - 500mg - 2 every 4 to 6hrs. Ondansetron tablets - 4mg - 1 every 6hrs. Esomeprazole tablets - 20mg - 40mg in a morning. Sodium cromoglicate 2% eye drops - apply 4 to 6 times daily. Calcichew D3 forte tablets - 1 twice daily. Erythromycin ethyl succinate tablets - 500mg - 1 twice daily. Alendronic acid tablets - 5mg - 1 once a day. Naratriptan tablets - 2.5mg - use as directed. Dosulepin tablets - 75mg - 2 at night. Pseudoephedrine tablets - 60mg - 1 6hrly if required. Quinine tablets - 300mg - 1 at night. Dihydrocodeine tablets - 30mg - 2 tablets 4 to 6hrly. Ferrous sulphate tablets - 200mg - 1 three times a day. Hydroxyzine tablets - 25mg - 1 three times daily. Metformin M/R tablets - 500mg - 1 twice a day (three times a day IF tolerated). Lantus Opticlik cartridge injection - 100u/ml 3ml cartridge - dose as directed. One touch ultra test strips - as directed. One touch ultra soft lancets - as directed. Opticlik insulin pens - as directed. Ascensia autodisc test sensor discs - as directed. Penfine insulin pen needles - 31g 8mm - as directed. Sharpsbin - 1 litre >I am awaiting an urgent appointment with a diabetic consultant at our >nearest major hospital (UK)! If memory serves you've now been "trying to control" incredibly high blood glucose levels with basal insulin for over a month now. Time for you to go to private pay and see an endocrinologist now, because obviously National Health has written you off or they'd have put you on fast insulin when you first presented. Jm2c, mind. Cloudedbrains <donna_williamson"@" btopenworld.com> wrote: : Sorry for being missing a while but health issues dictated I took time for : me! : Alot of you have asked my medical history - well I got round to typing it up : (Needed to for teaching student drs yesterday)! : There are still BIG issues with the blood sugars even with Lantus now at : 46units and rising fast! : Ive swapped to opticlik pens due to the dose size (opticlik go to 80units) : and much prefer them but still control hasnt been found! : I am awaiting an urgent appointment with a diabetic consultant at our : nearest major hospital (UK)! : So for now I will elave you with the information below! : Any comments welcome but please try to understand how complicated my care is : with everything else I deal with! : Personal details. : Donna. : 31yrs old. : Medical conditions. : Brittle asthma - type 1 - steroid dependent. [quoted text clipped - 4 lines] : Multiple anaphylactic allergies - carries adrenaline. : Major bowel surgery 18 to 24tmhs ago. : Allergies (anaphylaxis). : Latex. [quoted text clipped - 13 lines] : Cefalexin. : Quinolones. : Medications. : Atrovent nebuliser - 500mcg - 1 every 6hrs. [quoted text clipped - 8 lines] : anaphylaxis. : Betamethasone tablets - 500mcg - 12 tablets in morning - LONG TERM. : Paracetamol tablets - 500mg - 2 every 4 to 6hrs. : Ondansetron tablets - 4mg - 1 every 6hrs. [quoted text clipped - 10 lines] : Ferrous sulphate tablets - 200mg - 1 three times a day. : Hydroxyzine tablets - 25mg - 1 three times daily. : Metformin M/R tablets - 500mg - 1 twice a day (three times a day IF : tolerated). [quoted text clipped - 6 lines] : Penfine insulin pen needles - 31g 8mm - as directed. : Sharpsbin - 1 litre My heart goes out to you. with al those meds every day, I wonder tht ou have time to write to us or do much else. I do hpe you get the bgs resolved soon, as they can't be helping with eithe ryour health or your stte of mind. I am glad to hear that you will be seeing the diabetic consultant ASAP . I assume that means some kind of endocrinologist. Please keep us informed as we do wish you well, een if some of us get a bit short. Wendy Cloudedbrains > wrote in message ... >Sorry for being missing a while but health issues dictated I took time for >me! [quoted text clipped - 82 lines] >Penfine insulin pen needles - 31g 8mm - as directed. >Sharpsbin - 1 litre I echo WoolyGooly's comments. Putting a T2 on a fairly high dose of Lantus is a wonderful idea. . . unless they have other issues. Looking at that list of meds, especially the blood sugar increasing meds, demonstrates to me that you have other issues. The simple T2 approaches aren't working and looking at the list of meds makes me think "Why would they expect the simple approach to work?" I think back about our poster, "Tony from Mexico" who had some problems and had to use prednisone. His Mexican docs immediately put him on maximum metformin plus a fast + slow insulins regime. Regards Old Al Thanks for the replys. The consultant in the UK is prob equivalent to your Endo's. Wendy - I learnt a while ago to take meds and nebulisers while doing other things - it becomes autonomous really. Al - I have reached my limit of putting up with this cr*p treatment I am getting - hence the consultant appointment being made top priority now. After speaking to the lead DSN yesterday evening - I made it clear I cant and wont put up with this anymore and demanded that if they cant sort it out to get permission from the consultant to do something at least till I see the consultant as given the time of year it will be a miracle if I get seen before new year now. I am trying my best to get on with this but you simply cant if the nurses wont do ought - which they firmly know now I wont take! Ive educated myself, learnt a h*ll of alot by myself and have researched the *steroid induced* side of this and I know what level of treatment I should be getting BUT actually getting the DSN's to listen and to get treatment startedis proving very difficult! Cloudedbrains wrote: > Ive educated myself, learnt a h*ll of alot by myself and have researched the > *steroid induced* side of this and I know what level of treatment I should > be getting BUT actually getting the DSN's to listen and to get treatment > startedis proving very difficult! YESSSSSSSS!!!!! You go! Susan >Thanks for the replys. >The consultant in the UK is prob equivalent to your Endo's. [quoted text clipped - 18 lines] >be getting BUT actually getting the DSN's to listen and to get treatment >startedis proving very difficult! Good luck. You know my opinion, so I won't add to the lectures. Thinking of you. Cheers, Alan, T2, Australia. d&e, metformin 1000mg, ezetrol 10mg Everything in Moderation - Except Laughter. -- http://loraldiabetes.blogspot.com/ http://loraltravel.blogspot.com/ latest: Pompeii, Amalfi, Bari > After speaking to the lead DSN yesterday evening - I made it clear I cant > and wont put up with this anymore and demanded that if they cant sort it > out to get permission from the consultant to do something at least till I > see the consultant as given the time of year it will be a miracle if I get > seen before new year now. Good for you, Donna! Nicky.  SignatureA1c 10.5/5.5/<6 T2 DX 05/2004 100ug Thyroxine 95/72/72Kg I got a letter today from the hospital! Have an appointment in just under 2wks time! With a consultant in endocrinology! I still think 2 weeks is too long to go without further treatment - so I am still going to push for more on monday when I call lead DSN! Cloudedbrains <donna_williamson"@" btopenworld.com> wrote: : I got a letter today from the hospital! : Have an appointment in just under 2wks time! : With a consultant in endocrinology! : I still think 2 weeks is too long to go without further treatment - so I am : still going to push for more on monday when I call lead DSN! That is owonderful news and I agree that the 2 weeks is too long, but much better than 1 year. I had spoken to my endo at my last visit in October about your case( of cousre without all the details of your complicated med regemin and he said yu shul dbe treated intenively with long and short iactin insulins to get thse screamingly high bgs down. I hope your endo reaches the same conclusion and bawls the heads off your current medical advisors. Please keep us informed of our progress and how the appointment goes. We all a concerned and worried for you. That is why we sometimes get smappish. Wendy > That is owonderful news and I agree that the 2 weeks is too long, but much > better than 1 year. [quoted text clipped - 10 lines] > > Wendy I have to admit my fbg's are better but sugars still go up all day and peak over 21mmol still at night but then drop again for the fasting! I've not slept properly for months with running the loo when sugars sky high or my chest kicking of with the sugars! My eyesight has deteriated and I have bad eyesight to start with! And I am frequently showing Ketones in urine now where I have always tested negative before! And basically I told lead DSN friday if she cant instigate more treament then she needs to get the consultant to OK more treatment till I see him! >I have to admit my fbg's are better but sugars still go up all day and peak >over 21mmol still at night but then drop again for the fasting! [quoted text clipped - 6 lines] >And basically I told lead DSN friday if she cant instigate more treament >then she needs to get the consultant to OK more treatment till I see him! Take all your records of home testing to the endo, and make sure your concern is clearly understood - and specifically ask for a review of your ENTIRE medication list for inter-actions and contra-acions (where one med may be interfering with the action of another med). Make sure your full medical situation is looked at - not just the diabetes, because there is no doubt that the medications from your other problems, such as the asthma, are affecting your diabetes. Cheers, Alan, T2, Australia. d&e, metformin 1000mg, ezetrol 10mg Everything in Moderation - Except Laughter. -- http://loraldiabetes.blogspot.com/ http://loraltravel.blogspot.com/ latest: Pompeii, Amalfi, Bari >I got a letter today from the hospital! > Have an appointment in just under 2wks time! > With a consultant in endocrinology! Cool! You'll get a full blood test as you walk in the door - and he'll be interested in your test logs, and your full med list. Have you Googled him? Most hospitals do bios of consultants, you can check his special interests. Do you have enough insulin to crank it up again a little before seeing him? Nicky. SignatureA1c 10.5/5.5/<6 T2 DX 05/2004 100ug Thyroxine 95/72/72Kg >>I got a letter today from the hospital! >> Have an appointment in just under 2wks time! [quoted text clipped - 7 lines] > Do you have enough insulin to crank it up again a little before seeing > him? Nicky I find out minday whether I get anymore insulin added in till I see him or not - lead DSN spoke to cons friday about it. I already know him as when I have been in with my brittle asthma I ended up on his ward several times when no beds on resp wards, also he looked after my mum for the 1st week when she was critically ill a few years back. I dont have ANY bloodtests done at hospital only7 my GP does mine herself(on admissions I have a central line inserted then bloods taken that way). He's already been told all about me anyway but we will see what happens when I see him and also what hes told lead DSN to do! Just thought I would let ya all know what the lead DSN has said today! After speaking to the cons on friday about me the consultant has told her as an interim measure till I see him to add in Novorapid (Flexpen) at tea-time! I'm going to be picking the prescription up tomorrow and am going to see lead DSN at 11am tomorrow also so she can talk me through it! I am just so relieved! But he also told the DSN that he thinks either mixed insulin twice a day or basal/bolus will be the way to go! Also when I goto the appt next week I am actually seeing the consultant NOT one of his juniors! Cloudedbrains <donna_williamson"@" btopenworld.com> wrote: : Just thought I would let ya all know what the lead DSN has said today! : After speaking to the cons on friday about me the consultant has told her as : an interim measure till I see him to add in Novorapid (Flexpen) at tea-time! : I'm going to be picking the prescription up tomorrow and am going to see : lead DSN at 11am tomorrow also so she can talk me through it! : I am just so relieved! : But he also told the DSN that he thinks either mixed insulin twice a day or : basal/bolus will be the way to go! : Also when I goto the appt next week I am actually seeing the consultant NOT : one of his juniors! Donna, This is great news. I am not on insulin , but from the comments of those who are, it looks like you have found the right person at last. Your pusing the DSN seems to have worked adn I am delighted for you. Here's hoping it finally begins to really deal with your high bg's . You should feeel ever so much better as the number start to really come down. Please keep us informed. Wendy Donna....... when you see the consultant, please make SURE you tell him that your Lantus dose is so high that you can't skip a meal without going hypo ! ! ! this is NOT how Lantus is supposed to work....... he will reduce your Lantus and have you take the rapid before each meal...... a FAR safer way to treat diabetes.... print this even, and ask him if i'm full of it! kate Signature> Just thought I would let ya all know what the lead DSN has said today! > [quoted text clipped - 11 lines] > Also when I goto the appt next week I am actually seeing the consultant NOT > one of his juniors! Thanks Kate. The lead DSN didnt say anything about Lantus dose today but will see what further she says tomorrow! A friend ran me down to get the new insulin today as it was done for me! The a blue disposeable pen with Novorapid written in an orange box! I am used to cartridges now so I hope can use these ok! > Donna....... when you see the consultant, please > make SURE you tell him that your Lantus dose is so [quoted text clipped - 9 lines] > kate > -- oh, ask for your NovoRapid in cartridges...... less to dispose of, and you are used to using a pen......... the NovoPen3 is a nice stainless steel finished pen........ it will stand out from the Lantus pen k > Thanks Kate. > The lead DSN didnt say anything about Lantus dose today but will see what [quoted text clipped - 16 lines] > > > > kate I'll have too see what she says later on. What I dont get is why I am scared that the next step is being taken now after 4 months of fighting for it! One thing I was thinking of in the early hours this morning was now I've got rapid acting that if I get a really high reading that wouldnt it be possible to bolus for it now? > oh, ask for your NovoRapid in cartridges...... > less to dispose of, and you are used to using a > pen......... the NovoPen3 is a nice stainless > steel finished pen........ it will stand out from > the Lantus pen > k Am so knackered - busy busy morning! I start my rapid acting Insulin at teatime today! They doing a set dose going up every 2/3 days! Tonight is 2units - as they obviously dont know how I will react and that they want me too stay on 46units of Lantus! Been warned I will have eyesight probs for a while as they need to titrate the dose upwards - then when got dose needed it will be 6 to 8 weeks before it settles! So been told to avoid cross-stitch or straining eyes - I am fed-up! But otherwise am OK! Very wheezy also as when went to appt they were having new floors done using a "LATEX" floor mixture - me is allergic badly to it! Got my appt done sooner though and they let me out a back way so didnt have to walk through it again! They are not sticking me on a true basal-bolus regime due to stomach issues that lead me to miss meals occassionally - but consultant will work out whats best! |
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