Posts Tagged "diabetes"

Diabetes link to Alzheimer’s Risk – Didn’t we already know this? Regardless, whether or not this is a true study, controlling your sugars is a priority. Something I need to do better.

The other day, I was doing some searching for some water shoes, so I might be able to go swimming in a pool. If anyone knows me, swimming in the ocean is out of the question for me, as they freak me out and are probably not a good thing with my immunosuppressant drugs. This includes rivers and lakes. I won’t swim in them, they’re dirty, and no thanks. I know a pool is probably just as bad, but at least there’s usually chlorine in those. Anyways.

So I was looking for recommended water shoes for diabetics like me and I discovered something really intriguing to me. A lot of people don’t know about foot care for diabetics. I can understand this. There’s no reason for anyone to know about unless you have diabetes or know someone who is. However, it just seems like everyone is getting diabetes these days because of various reasons. Everyone thinks it’s just all about pricking your finger and testing your blood. Sorry, it’s a bit more than that folks.

For those of you who in danger of becoming diabetic, this post is for you. If you get diabetes, this is what you will have to live with, FOR THE REST OF YOUR LIFE. (sorry for the caps)

For me, it’s a routine. I know what I’m going to do, and it’s really automatic for me. I’ve been doing it for so long I guess it’s second nature. I’ll use the bullet method:

• Inspection of the feet – Any Thomas Covenant readers out there? Remember that routine he did where he’d visually inspect his entire body? What did they call it, VISE or something like that. Anyways, that’s what I do with my feet at the end of the night before I go to bed. However, I take it one step further and feel my feet just in case I missed anything.
• Never go barefoot – ever. Don’t do it. Why? Because you can cut your feet, you can accidentally step on anything that might just burrow into your foot. And the clincher here is, for some diabetics (like myself), you can’t feel anything with your feet. Yeah, it’s kinda weird walking. That’s why I walk with a cane. I lose balance really fast, and if I fall, that’s a bad thing too.
• Dry your feet after a shower – I know this may seem like a duh moment, but honestly, for many diabetics (like myself) we get neuropathic pain in our feet. That means you have the tingling sensation like your foot goes to sleep all the time. You know for everyone it just go away after you wake it up? Well, it never wakes up for some of us. And just the touch of a towel can be excruciatingly painful. Even sheets! You know, I don’t remember the last time I went to bed with the sheets over my feet. I always leave them out.
• Be very careful when clipping toenails – because the numbness is there, you won’t be able to tell when you clip off toenails or your own foot. I know some diabetics have someone cut their toenails for them, but I can’t bear anyone else touching my feet. It’s just too painful. Hell it’s painful just to take off my socks.
• Keep them moist but not too moist – Use some kind of lotion. Again, this may be a duh moment, but you don’t want them too moist because then you might get a fungus. (or something worse!) If your skin cracks, then you’re in trouble. Remember, diabetics take longer to heal, and because it’s on your feet, you might not know about it! Especially if you don’t do your visual checks!
• Watch for heat and cold – As a diabetic, you may as well forget about heat pads, icy hot patches, things like that. These are all bad things for you. Because of any numbness that might occur, you might not know if it’s too hot or too cold. Especially on your feet.
• Always wear socks – Did I mention this before? Yeah, it’s that important. If you don’t wear socks, then at least wear a non chafing slipper that will encase the whole foot. i.e. no open heel slippers.

What are the complications if you don’t do these things? Well, there are plenty of them. And I’ll tell you oh, they’re horrible. But you know what’s the worst? AMPUTATION. That’s all you need to know. If you don’t take care of your feet, they’re gonna eventually cut them off. It’s as simple as that. Have you heard of people losing their toes or feet to diabetes? Yeah, this is how it happens.

So hopefully, if you’re a newly diagnosed diabetic who happened to find this page and learned something, then my job is done. If you haven’t learned anything, then either you already knew about it, or you’re ignoring everything I say, in which case, you’ll find out sooner or later.

I just hope you don’t have to lose a foot to learn something.

As some of you may or may not know, on July 29th, 2009, I went into surgery to receive a kidney which my awesome sister was willing to donate. Well, it’s coming on the 2nd year anniversary, and I’m doing pretty good. I think a shout out goes to my sister. She’s pretty damn amazing to be willing to give me her kidney.

I’m not 100%, but I’ve still got so many other things that are wrong with me, not all of them have to do with my brain either! But I’m hanging in there.

I think a majority of my recovery has to be credited to my awesome wife, Meesh. I think without her, I’d still be in bed all day, feeling even more sorry for myself than now. I think she underestimates herself as my primary caregiver. She thinks she doesn’t do anything, but just being there has done quite a lot for me.

As for the rest of what’s going on, the pain comes and goes. I suppose you could probably call my case a mild case of Fibromyalgia, just to get a sense of what Neuropathy means. But I think anyone who has FM will tell you, there’s no such thing as a mild case. You either got it or you don’t. It just hurts that much. In my case I guess I’ve got it better in terms of pain. But it does hurt. I mean there are days when I feel like I want to die. Those are the bad days. The good days are the days where the pain is a 2 or 3 out of 10. There is never a time when I don’t feel pain. Never.

Along with the pain, when I eat, I sweat. I mean literally. I don’t sweat because it’s hot, or because I’m eating spicy food, but because my brain is too confused from all the damage it’s gotten and when I eat food, instead of feeling like “wow, this is the best food I’ve ever eaten”, I sweat. I have accepted it. Although I have to say with the warmer temperatures, it seems worse now.

So as not to sound like a total whiner, I won’t really talk about all the other stupid complications I’ve got going. If you’re online and feeling bored, you can always ask me about it, and I’m sure I’ll tell you all about it. Because it’s all about me, you know. :P

So here comes a bulleted post. If you don’t want to continue reading after that, don’t continue to read on. Otherwise, read on!

1. So I’ve started to increase my dosage of Gabapentin (aka Neurontin) as per the neurologist. My neuropathy is just getting worse every day it seems.
2. I’ve been considering to just go ahead and keep growing my hair to donate to Locks of Love.
3. I went to get a bunch of lab tests done, and my A1C was at an all time low I believe. (this is good)
4. Lately, I’ve been having issues with the right side of my body. I keep thinking it’s residual from my stroke, but it can’t be.

Well, I’ve decided I will try to do the Blogathon this year. I’m not sure what kind of theme or even which blog I will do it on. For that matter, I’m not entirely sure which charity I wish to donate too. Normally I do the Blogathon for Susan G. Komen for the Cure, but after my transplant and complications with diabetes, I have considered changing it. If I don’t do Susan G. Komen for the Cure, then I think I will feel just a little guilty. But then again, the diabetes and the transplant is happening right NOW and if there’s a hope for a cure for diabetes, I’m all for it. (I’ve read there’s supposed to be a cure within my lifetime.)

So we’ll see how it goes. Does anyone have any suggestions for the theme? In the past, I’ve done the movie quotes game, where you hear the quote and name the movie. But that’s a lot of work and well we shall see how things work out. Hopefully it won’t be like in the past. *crossing fingers*

So last month, I got my super flyer miles for staying in the hospital. I told Katie one day if I stay one more time, I get a free stay for a week. Like she said it’s kinda sad and funny at the same time. I swear I’ve been there enough times to recognize most of the nurses, doctors, IV team members, and mostly the lab people. The lab people stuck me enough times this last time.

Because my left arm has a fistula, they can’t do anything with it. They cannot put an IV in that arm or draw blood or anything. The left arm is untouchable. Therefore, they had to attack my right arm for labs and IV’s. You should have seen it, it was totally black and blue. I was in the hospital for four days, so that’s at least four sticks for lab tests, and one time, the IV team tried to insert a new IV and failed three times. I was severely dehydrated so it was very hard to get any needles in me. They also had to do an arterial blood gas, so that was pretty painful.

If you’re wondering, I had two things wrong with me to land in the hospital. I had Pancreatitis and Diabetic Ketoacidosis (DKA). Tons of fun! NOT.

At first, I was in moderate pain. I told Meesh to come home, I totally needed her and she came home. On her way home, the pain escalated to the point of agony. I was having a hard time even breathing. So I had Meesh call 911, and an ambulance was dispatched. I was going to have her take me to Urgent Care, but there was no way I could wait. The pain was on the verge of 10 out of 10. I mean this was the worst pain I’ve ever felt. I thought I was going to die, that’s how painful it was.

The EMT’s took good care of me and my blood sugar was 400+. I don’t remember what it was exactly, but it was 400 something. So for the first time in my life, I took a ride in an ambulance as a patient. (I’ve drove and ridden in ambulances many times as an EMT myself.)

I started to feel better. At first, we didn’t know what it was. Throughout the stay in the hospital it was determined (after an x-ray) I had pancreatitis. At first, they were baffled on the cause. They asked me repeatedly if I drank alcohol, since that’s the main factor of pancreatitis. But I haven’t drank a lick of alcohol for years. It’s not really a good thing as a kidney patient and diabetic to really drink. Especially in excess.

But after more labs, they determined the cause of my pancreas being so inflamed was DKA. I really needed to manage my insulin better.

The treatment for this was surprisingly simple. I was on PCA (Patient Controlled Analgesic – Heaven!) and npo or nothing by mouth. (Don’t ask me why po stands for by mouth…I forgot why) So I had ice chips for two days. After those two days, I was able to go on a clear liquid diet, which basically meant broth and jello. I must tell you, I never thought beef broth could taste so good. Sugar free jello was incredible.

I’m doing much better now and not planning on another stay in the hospital. Any more hospital stays from now on will definitely be planned. I hope.

So I got notified that there is no indications of any stenosis in my artery feeding my new kidney according to my CT scan. This is great news. That means no need to do an angiogram to open up the artery.

Good news for once is great to hear. On a different note…

We went to visit a nurse practitioner the other day to evaluate insulin pumps. Those are ungodly expensive but worth every penny I’d think. They can cost upwards to 5,000 bucks. That’s extreme though. I think with my insurance I would end up dishing out about 800 to a 1,000 bucks. Still pretty costly and it doesn’t include supplemental supplies like the tubing and the catheters.

I also learned I probably wouldn’t benefit too much from using it since I would have to replace the insulin every other day or so. It’s because I use anywhere from 150 to 200 units a day of insulin. Yes it’s quite a bit. Exercise and better eating will help this.

I’m going to see a nutritionist to see what she can recomend. I already know I need to eat more food that has a low glycemic index. I also know I need to become more active. With the neuropathy and back pains it’s really tough for me but I have to do it.

I think I might pass on the insulin pump only because my case is a bit different. I am very very insulin resistant. And I already spend a fortune on medicine and Medicare. I don’t think I need to add onto that. I should probably talk to my wife about it and come to a final decision. Crazy!

The other day I recall talking to one of my friends and my insulin regimen. It usually goes like this: long lasting insulin in the morning and bedtime. Short acting insulin before I eat my meals and snacks. All in all, that was about 6 shots a day. So every time I eat something, I have to take a shot. Unless of course I can manage to make a meal or snack that did not have carbs. Such as raw vegetables or pure protein. Of course, honestly, those aren’t too filling. But because of this, I told her it’s a great way to lose weight because I don’t necessarily want to eat because I don’t want to take a shot.

Yeah, that’s not really a great way to lose weight.

Honestly though, counting carbs in order to calculate how much insulin to take is a really great tool to losing weight. It makes you more conscious of what you are eating and aware of how much to eat. Portion size is really important to counting carbs. In many cases, where you think a package is only 1 serving, it’s actually 2 serving sizes. This is a tactic used by food companies to appear their food has lesser calories or fat. It’s not as if they’re lying. You’re just assuming it’s only 1 serving.

Another thing you’ll learn is that 0 does not necessarily mean 0. 0 could easily mean up to 0.5 mg or more! It’s one of those loopholes that seems to appear everywhere. I believe I’ve mentioned this before. Watch what you’re eating! This definitely goes for non-insulin dependent diabetics. Something to think about.

Dealing with post transplant has been surprisingly easy for me. This is not to say it’s been easy on Meesh. Unfortunately, she’s had to deal with more than she should mainly because I either cannot or should not do it. She lifts all the heavy things, she cleans the litter box, she does all the food shopping, and well you get the idea. She does it all. And I’m so thankful to have been blessed with such an awesome support group. My parents and my sister have been tremendous help too.

Working has definitely been different for me. Before, I was lucky if I could work a half of a day without getting exhausted. Now I’m actually able to work a 9 hour day without even thinking about it. Having this transplant has been the miracle of my life, and I have everyone to thank for it, especially my sister.

Dealing with my diabetes has been a chore however. The medicine I’m taking makes it tough. I suppose I might just throw caution to the wind and just take my medicine and leave it at that but how disrespectful is that? Not only to me but to my sister? So I am working as hard as possible to keep healthy and keep my sugars in check. If that means sticking myself about 10 times a day so be it. It’s a small sacrifice to stay alive.

A word of caution to those diabetics that aren’t taking care of themselves: it’s really not as bad as you think. If I could do it all over again I would have bit the bullet and did all my glucose checks and taken my insulin.

So now I am on hemodialysis. That’s the dialysis where there’s needles and such but I don’t have to have that yet, since my fistula isn’t in place yet. Don’t worry I’ll explain.

It all started out on a Friday. I woke up and felt horrible. I was shivering and I had a feeling I needed to do an exchange. So I got up and did an exchange. Lo behold I looked at the bag, and it was cloudy. It should be nice and clear but not this bag. It was pretty cloudy. So I started the flush process and called the dialysis clinic. I was told that I had to do the flush and then put antibiotics in the bag and let it dwell for 6 hours. Ok. No problem I said and I thought it ended.

First, when we went to use the antibiotics, I realized that we didn’t have syringes to do the transfer! So I called the unit and Meesh ended up picking up some at the clinic. Finally Meesh was able to do the antibiotics. At this point, I was feeling horrible and could hardly sit up.

A few hours later, after I took the antibiotics, I was not getting any better. Either I was not getting enough antibiotics or it wasn’t working. Then Meesh took my temp and realized it was 103.5 or something like that. The point being it was 103 or higher. That was the bell that told Meesh I need to go to the ER. So after some scheduling things around, we got my dad to take me there. Meesh ended up staying at home because she needed to stay there to get our new tv. (Yes, we got a new TV and it’s very big. 73″. You’ll find out more about it at hello! yoshi)

So me and my dad were at the ER. We were in the waiting room for about 3 hours. Now mind you the nurse when she finally saw me for triage told me she would put me on the urgent list, and it still took about 2.5 hours to get me inside the ER to be treated. Meanwhile while we were there, a gentleman who had his leg cut up by a skillsaw was bleeding out of his clothes. Obviously, this guy should have been taken care of before me, but he was still waiting in the waiting area when I went in! Sometimes, the triage at our hospital (I will not mention who) can be a bit crazy.

So I went in the ER and they took care of me nice, and I ended up getting the same doctor from when I was in the ER for my stroke. I also found out from some nurses that I was something of a legend at that hospital. Probably because I was the youngest stroke victim they’ve ever had. I wasn’t even 40 yet. I was 39. Crazy, I know.

So the doctor was on the fence. “Do I admit you in the hospital or not.” In the end, they decided to do so, because after some thought, the Nephrologist on duty had said that he wanted to pull my PD catbeter and patch me up and put a “perm catheter” in for hemodialysis.

I was then admitted to the hospital, this was about 8pm, about 8 hours after I went to the ER to get taken care of. They admitted me to the renal floor, and I finally got to be able to drain myself and they took that drain off to the lab to do some tests. I’m not quite sure what they are, but I’m sure they’re important.

At 10pm, I was finally taken down to the OR where they finally yanked my PD catheter. I have to express my sorries to the surgeon that put it in. I didn’t want to ruin her work! But I have to admit now that it’s a relief. No more feeling bloated or I can’t eat because my belly is so full of liquid. So they took it out and I was on some serious meds. I have no idea what really happened, but when I woke up I had a bandage where my catheter used to be. Sorry Danalyn you’ll never get to see that. But you can see the perm catheter if you’d like (to the right).

So after that I spent a few days in the hospital where I recovered. Believe me, I felt like crap. My stomach gave me some serious pain because it was infected and I had those holes in me where the tube was. I just needed to heal. So on monday when we got home I was in some serious pain. I was on vicodin at this point, since I couldn’t have anymore IV morphine. (which worked awesome btw, although I did throw up once when I got it. A whole other story there LOL.) I also had the perm catheter, which was located in my shoulder/neck area. My shoulder was sore as hell. Believe me I was popping vicodin like a drug addict.

Now, I am going to hemodialysis, 3 times a week, for 4 hours at a time. It’s about 12-15 hours a week, spent at the dialysis clinic. It’s almost kinda like having a part time job. (except I don’t get paid!) But it’s working for me and of course if it’s working then it must be worth it.

One thing you learn, being a diabetic, is how to read food labels. One thing you must remember is simple: just because it’s not on the label doesn’t mean it’s not in there. Not everything we need to know about food is on the label. However, for the simplest things, most of us won’t have to worry about that. Another thing to remember is this: just because it says there’s 0 mg of something doesn’t necessarily mean there is none. 0 could easily mean 0.1 or as much as 0.9. In most cases, who really cares, but this is important if you really need to know exactly how much there is in something.

First you want to look at the serving and serving size. As you can see from the label to the right, this contains 2 servings per container. While what you eat is a serving to you, the label might say a serving is less than what you eat. So, looking at the servings per container is important. In this case, if you are eating 2 servings, then you’ll have to double these values you see on this label.

As a diabetic, the most important label to read is the Total Carbohydrates. This is the basis of watching just how much we eat or how much insulin to take. In general, you should talk to your nutritionist on how much you can eat. In most cases, it takes some practice to find out just how much you can eat without throwing your sugar balance out of whack. You should also talk to your physician so you know what your goals are. It’s important to know where you are most comfortable.

Note, also the sugars. Most likely your glucose levels will probably go up really fast with food high with sugar. You’ll want to avoid these. However, know that everyone is different and experimentation is always a good thing. Know what foods send you high, and what foods don’t. Knowing this could make a big difference.

Just remember these points:

• Not all food labels will tell you everything. They only report the required nutrition facts. Just because it doesn’t say it on the label doesn’t mean it’s not in there. A good example of this is Potassium. It’s not always listed on the label.
• Note the serving size. What you eat may be 1 serving to you, but to the label it could be anything. I’ve seen a label say that there was 3 servings per container, but the container had 1 serving of what we would eat. This makes a big difference when counting carbs!
• Just because the label says there is 0 does not necessarily mean 0. It could mean as much as 0.9 in the serving. In some cases, if there are 3 servings per container, and there are say 0.9 carbs per serving, that would mean there’s really 2.7 carbs per container, when it could easily say 0. That’s a significant change for someone watching their carbs!

After a week of training, I’m now doing peritoneal dialysis (PD). It’s worthy to note PD is nothing like Hemo Dialysis, which is the one where you have needles and sticking. PD, however does require you to have a tube placed inside you, and this is a surgical procedure.

How it works: It’s basically pretty simple to understand. Basically, I put this liquid in me called the Dialysate, let it “dwell” inside me for a few hours and then drain it out. Yes, it looks just like urine. To quote a friend, it’s like I’m peeing out two holes in my body.

The process of filling and draining takes some time. Actually the filling/draining is not what takes the most time. The entire process of doing an exchange is what takes time. I have to take my vital signs (blood pressure, weight, temp, pulse, etc) before I even start, just to make sure I’m ok. My vitals determine what solution bag I use. There are typically 3 types of solutions, from low sugar content to highest sugar content. This is also geared towards each person as well. Not everyone is the same.

After my vitals, I now have to heat up the bag of dialysate. I don’t need to be putting something too cold inside me, that would cause cramps and well, I don’t need them. So believe it or not, microwaving the bag for about 5 minutes brings the bag up to about body temperature. As long as it’s a dry heat, it’s ok.

After I heat up the bag, it’s important to have all your stuff you need during the exchange. This is a clean procedure, so everything has to be clean, or I will get contaminated. When I get contaminated, it could lead to peritonitis, which is a bad, bad thing.

This entire process takes about 30 minutes for me. I have to do this 4 times a day. I’d like to say it’s very inconvenient, but as you know, the alternative to dialysis is “or death” and well, the or death option is not what I want.

Perhaps for reference purposes, I will bullet this process for those people looking for references. But for now, this is enough.

Well it’s been quiet around here, and for good reason. I’ve been busy with training for my peritoneal dialysis. Ooh, fun for sure. :D But as of now I’m starting my dialysis and so far, it just takes up a lot of time. If you want more details, you can always go on over to “Being Diabetic” where I talk about all that stuff.

I’ve also been busy with Japanese TV, since it’s the New Year, the new shows have started, and I’m just trying to keep up with everything. It would be a lot easier if I could just record every TV show that is aired in Japan, then sort them out later, but wow, that would be a large process! But it would be cool and fun for sure.

It’s the weekend, everything is quiet around here. I’m just gonna sit back and relax and finally catch up with some sleep.

Well, like I’ve said before, it seems that everything that can happen to a diabetic has happened to me except for amputation and I don’t plan on that one. Diabetic Retinopathy affects your vision and can cause blindness. How this manifests in me is pretty simple, I had blurred vision, or my vision was getting worse. I also had “floaties” in my vision where I would see black spots I could never really focus on, but they were always there. That was where the blood vessels had burst inside my eye, and left a residual trace.

I’m sure you’re wondering if I’m blind now. No, I’m lucky. With eternal vigilance (blood sugar checks and insulin), and laser surgery in my eye, I’ve managed to keep my sight. Although I have to admit I might have to get a new prescription, but only because I’m getting older.

There is a price to this situation however. I have a really hard time driving at night. I simply can’t see as well as say the average person can. The eye doctor told me it’s because when they laser the eye, what they’re doing is burning up parts of the eye. Yes, that’s right, they’re burning up parts of my eye, so I have less receptors to see. At least that’s how it was explained to me in simple, layman terms.

Unfortunately, the signs and symptons are sometimes never found. But if you are a diabetic, that annual or biannual eye exam is very important. Don’t pass it up. Which reminds me, I think I’m due for one in March…