Diabetes Self-Management Blog

Greetings from an inpatient rehab unit somewhere in the Great American Midwest! I checked in last Wednesday evening after the Hanukkah candles had been lit and dinner (provided by a friend) eaten.

When last heard from, I was frustrated because the in-network home health-care place hadn’t managed to get certification from my insurance company to begin therapy. I decided I’d had it and called the medical director for the inpatient place, which hadn’t had a bed available when I was discharged from the hospital after surgery for a below-the-knee amputation.

I don’t remember if I called him on Monday or Tuesday evening: I just know it didn’t take long. I should also probably explain that I know him socially. I even made the challah for his sons’ bar mitzvot.

The goal here is to build my upper body strength, to strengthen my legs, and to learn to adapt to my new “normal.” I know I am getting stronger, because I no longer slide along my transfer board. Instead, I move along the board by standing up, then sitting back down further along the board. It also keeps the board from invading my underwear. I can also use the knee on my right (whole) leg to bend and straighten to some extent. I also have osteoarthritis in my knees, which complicates matter further.

And, man, do they work you here! I just keep trying to think of goals. A short-term goal is to be able to stand for a certain amount of time and to pivot on my one foot. We’re aiming for three minutes of standing. So far, I’ve made it to 1:08. It’s a start.

I need upper body strength and the use of certain muscles in my legs to successfully wear a prosthesis. My goal is to have a prosthesis and be able to use it at least minimally when my friend and I take her 4-year-old grandson to Disney’s Animal Kingdom and on a 4-night Disney cruise to the Bahamas in February.

My theory is that we need to set goals and not just do something because it’s good for us. Yes, it’s good for us, but it’s even more fun to have something to look forward to. As far as I’m concerned, you can’t get much better than sitting in a comfy recliner at home and taking a trip to Disney with a 4-year-old.

A really short-term goal is to figure out how to stop going low in the middle of the night. I was “blaming” it all on the fact that infection is gone and I’m on antibiotics. I forgot about what activity can do to your blood glucose. Last night, I had to go to the bathroom and called for help. (Somebody has to stand by while you transfer from bed to scooter and from scooter to toilet, etc.)

My continuous glucose monitor said I was 78 mg/dl and dropping. A finger stick said I was 32 mg/dl. I did another finger stick. That one said I was 32 mg/dl. OK, then…

Finished with what I set out to do in the bathroom, I began the slide back to my scooter. Then the sweat began to pour off my body. I moved back over onto the toilet. Where I sat while the nurse and the tech pushed sugar on me. “Soda? Juice? Yogurt or pudding? Cookies? Graham crackers?”

This morning (with a blood glucose of 134 mg/dl), I asked my nurse what she thought about my low.

“I just wish it hadn’t happened while you were on the toilet,” she said.

All in all, it’s been a positive experience. I wish more people recognized the importance of education when your world has been turned upside down, whether with a chronic condition like diabetes, or with a life-altering experience such as having a leg amputated.

One very interesting thing about this place is that the patient is included in the team meetings along with the doctor, nurses, dietitian, therapists, etc. As progress is being discussed and goals set, I can include my input. And I’m listened to! I think it’s the way things should be. I “won” the “no concentrated sweets” argument last week. I ordered raisin bran for breakfast and got bran flakes instead. My nurse checked the nutrition information for me and I was able to point out that bran flakes had 20 grams of carbohydrate per serving, while raisin bran had 25 grams of carbohydrate per serving. I got my raisin bran the next morning.

I’m being discharged tomorrow (December 8) and my physical therapist is preparing an exercise list for me to do at home. She’s been working with me on bed exercises for the last couple of days to acclimate me to that rather than to doing them on a mat in the gym.

Next up? I don’t know. It’ll be interesting to find out. I can’t wait.

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