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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Comments
  1. Wow.. my thoughts and prayers are with you, as you begin this new chapter. I so wish I understood Diabetes, and how food, exercise, and even stress affect it. Being newly diagnosed with Pre-Type II, (mostly due to steroid usage for 7 years, for treatment of RA) I am very scared. Some things do not affect me at all, (some sugars) while other times it seems to sky rocket my glucose level. (potatoes or pasta) I have brought my A1C from 7.4 to 6.1 with no meds, just cutting white bread and most sugar and salt and fats, but I am scared, and confused, with no idea what is good or bad, what the max is for sugars or carbs.. as I have tingly toes and a tingly left foot! Reading your story is scary.

    I wish you all the best, and a fast healing, and a GREAT time at Disney!! :)

    Posted by Kim |
  2. You are an inspiration on this. Keep up the good work.

    Posted by Nora Nevers |
  3. Jan, I applaud your courage, and I will pray for you as you develop the skills to live the fullest possible life. My Mom has had to do in patient rehab a few times, and I know it’s a struggle, for both patient and family.

    You will refine your skills at home.

    Posted by Margaret Michaels |
  4. Jan, I am glad to hear that the board is no longer invading your underwear ;-) It’s comments like that that make us WANT to pull for you. You’ve been through a lot but you still have your sense of humor. I’ve been lucky that my type 2 is well controlled, but it’s nice to know that if/when things go downhill it is possible to get through it and to even get through it with a chuckle. Keep on keepin’ on and we’ll keep pulling for you.
    Later……

    Posted by Jeff Dailey |
  5. Dear Jan, I am sorry to hear you are in rehab! I hope you will be better soon! Please know that I am thinking of you! Sharon

    Posted by Sharon Brousseau |
  6. You did so well in rehab. I knew you would. You have such a positive attitude. Watch out for those lows. You can’t always know how much your blood sugars will drop with exercise or for you just getting around is alot more exercise while you recover. Keep glucouse tabs nearby. They work well and you can easily quantify your sugar. Take care.

    Posted by Fran |
  7. I have just discovered your blog. I am the spouse of a Type 2 diabetic, who has been in denial for the last 15 years. All your comments are so revelant to me. :Your bravery is humbling.
    I hope you don,t mind me reading our blog. I live in sydney australia.

    Posted by anna |
  8. Jan, your courage is that of a lady warrior. And that’s what you are—fighting diabetes complications. I’m telling you right now–if I had my choice of a person to stand up(no pun intended) for me, it would be YOU! Your common sense, medical knowledge and boldness are strong enough to overcome the most daunting situations. Your wit always makes me laugh out loud(and when I’m at work). I’m so glad the rehab place has been a positive for you. You just give the rest of us out here so much hope for our future if we have to undergo such an operation. I am praying you’ll be able to go on the Disney trip & cruise. Something good and fun to look forward to doing. You deserve that so much.

    Posted by Linda M. |

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Foot Care
Getting a Foot Up On Diabetes Care (02/25/14)
Simple Steps Can Reduce Amputation Rate by Half (02/01/13)
Limb Loss Awareness Month (04/05/12)
Peripheral Arterial Disease Underrecognized in Women (03/09/12)

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New Approach for Neuropathy Pain? (08/18/14)
Study Evaluating Treatment for Neuropathy Pain (07/08/14)
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