Diabetes Self-Management Blog

As I write this (on Monday), men are tearing my bathroom apart. WooHOO! The contractor says it should be finished in one-and-a-half to two weeks. Then I will have a whole new bathroom with grab bars, a built-in shower seat, a detachable showerhead I can reach, and everything.

In the meantime, it’s forcing me to wear my prosthetic leg because the bathroom that’s being torn apart is the only one I can get into on my scooter. I do have my permanent leg now — got it last Tuesday — and it’s awesome. My temporary leg was painful, and it took a while to adjust the leg the prosthetist used as a pattern to make my permanent one so that it was comfortable. It usually doesn’t take as long as it did, but I was busy having surgeries to get rid of a gi-normous kidney stone.

So I’m beginning to walk now, albeit by clinging for dear life to a walker, but I’ll get there. Again…wooHOO! In the meantime, I should get enough practice walking this week to enable me to reach row 26 on the airplane to Las Vegas next week for the annual meeting of the American Association of Diabetes Educators (AADE).

My health-insurance company has this program where a nurse calls you every three months or so to see where you may be having problems and to get you to set goals. Like, you forget to take your pills, so what can you do to remember (I put mine in a weekly whatzit on my desk). So a nurse called me last week. And got onto me for not getting a lot of aerobic exercise.

“But I only have one leg,” I told her.

“Don’t you have a prosthesis?”

“Yes, but I just got one that doesn’t hurt a couple of days ago.”

“Well, you need to exercise.”

“Could I learn to walk first?” I asked.

I’m not a total slacker. I work on my upper-body strength (since I use my arms a lot — I have to in order to get around). I do stretching. Sometimes I dance in my chair. I just haven’t been walking. I tend not to do things that hurt when I do them. So now it doesn’t hurt (much — that residual limb needs to toughen up a bit, but it’s tolerable, and I’m not getting swelling and bruises).

Then she asked me what my fasting glucose level was that morning.

“Fifty-four.”

So she got onto me about that.

I’d had a larger-than-usual lunch the day before, plus I fell asleep before eating dinner and didn’t wake up until morning. In addition, my continuous glucose monitor was in warm-up mode so it wasn’t putting out data and, therefore, didn’t alarm when I began to go low.

To me, the 54 mg/dl blood glucose level was a good thing: It told me I needed to lower my overnight basal rate a bit. I guess she didn’t understand that a good way to check basal rates is to skip a meal and see if your glucose deviates more than 30 points either way. And may not have been listening when I told her I’m rarely hypoglycemic when I wake up. And, furthermore, didn’t understand that you don’t apply some special formula and have your glucose automagically straighten out. Besides, my body doesn’t immediately react to changes in insulin dosage, so it takes me a while to make a change, wait to see how it goes, tweak the dosage again, wait again…

Diabetes control is an art, not a science. Too many factors enter into the equation. Am I sick (or getting sick)? Do I have an infection? Did I exercise too much? Too little? What’s happening with my hormones at this time of month? Did I forget to remember to hold my tongue just right? Is Venus crossing Mars? Whaddaya mean I should have listened to jazz instead of bluegrass?

It can be frustrating having a condition where you can do the same things and eat the same foods at the same time every day and still have your glucose whack around. Can be. Unless, of course, you like solving mysteries. Sometimes I do. Usually, I feel more like uttering a few colorful metaphors.

Wouldn’t it be great if people who counseled you about your diabetes control had at least half a clue? I’ve often had this fantasy that everybody, at some time, had the worst case of diabetes possible. Just for one month. Wildly fluctuating blood glucose. A complication or two, even if minor. Having to count carbohydrates. Having person after person ask, “Should you be eating that?”

As I said, just for one month. Maybe they’d “get it.” Maybe they’d understand that the care and feeding of diabetes takes time, experimentation, and knowledge. Maybe they’d chill out a bit when we don’t perform as expected: As “they” expect.

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Comments
  1. wow….so true! I was diagnosed approx 2 years ago with type II. As you said, I can eat the same foods at the same time every day, and have had my blood sugar go from 59 (that was a rush) to over 400. ??? I’ve been working thru my primary care, and finally insisted on a an endocrinoligist which I finally see next week. Don’t want to be on insulin, but don’t want to have sores that takes months to heal either! Congrats on your new bath!

    Lorian

    Posted by Lorian Rivers |
  2. nice to see Jan is at her best again. Loading the blunderbus with grapshot and scrap iron and firing dead on point blank range.

    jim snell

    Posted by jim snell |
  3. Love this post. I completely agree with the frustration of “doing the same thing with different BG results.”

    Sometimes I think the health care workers are so over-exposed to people who aren’t doing the wrong thing that they tend to paint all of their patients with the same brush. Bad numbers? You did the wrong thing. Bah. I try to have sympathy for their point of view, but still it is frustrating.

    Good luck with the new leg!

    Posted by Cathy R |
  4. YES!!!
    Actually it would be nice to have a Endo. who’s went thru a hypo attack themselves & didn’t tell you to “just stop” w/the sugary stuff before it is too much!

    Posted by Redneck Angel |
  5. Way to go, Jan! You said what a lot of us are thinking. Best of luck, oh bionic one.

    Posted by Cathy A. |
  6. Wow, Jan, I am on board your train. Our health insurance has a similar program. I liken it to a blind person driving the car with a deaf and mute passenger. They do not like to think outside the box, but rather stay withing those oh-so-safe borders.

    Posted by Elizabeth Ferguson |
  7. As a diabetes educator, I pray no one I counsel EVER says those things about ME! It’s about truly LISTENING, isn’t it? Thank you so much for the reminder of how it “really is”.
    FYI…I regularly refer to your columns.

    Posted by Jackie Kelley RN MS CDE |

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