Poor Diabetes Management: What I Had To Learn the Hard Way
_This is the second part of the series, Misdiagnosed Gallbladder Leads To Better Diabetes Management _
Six years ago, my husband and I were invited over to another couple’s house for 4th of July. We had great food, great wine, thoroughly enjoying the night. Nothing was over indulgent. We traveled home about 10:30, and by 11PM, I wasn’t feeling well. I wondered if it was the red meat and red wine. Neither is regular in my diet, and I’ve been known to have trouble with tannins in red wine. I decided to just try to sleep, but was restless. By 3 am I was feeling significantly worse. All I wanted to do was get sick to see if I could get whatever was in my system out. By 5:30 am, I was lying on the bathroom floor thinking this is not red meat and red wine overkill, what was happening?
More than a year before my 4th of July incident, I started having signs of the trouble that lay ahead. For example, on several occasions, I had gone for a run between 6 and 10 miles only to return home with 300 to 500 blood sugars. One day, I ran 10 miles and when I had returned home, I had 538 blood sugar. What? In 15 years of running, my body would respond by lowering the blood sugar while running and my diabetes management was easier when I exercised. A shift was definitely happening, but why?
I had been going to a general practitioner for my care. Because my A1C was pretty good - rarely above 7 - and my overall health was good, she never referred me to an endocrinologist. When I appeared in my general practitioner’s office for a check up, I told her my blood sugar and running story. She felt this really wasn’t her specialty, but she would recommend me to Dr. H., a great endocrinologist, that she referred lots of her patients to see.
I called and made an appointment for 2 months, and in the meantime, I worked like hell to follow my blood sugars more regularly and get on top of my eating. In 2 months, I went into see Dr. H and my A1C was 7.8. I told her about my blood sugar highs and without even looking up at me, she announced that I did not take care of myself. I was stunned! She accused me of missing injections, not eating proper foods and not knowing how to manage my diabetes. While her words stung, I took it to heart that maybe my management of diabetes was not so hot. It had been years since I was involved in diabetes education, so I thought “Ok, I’m game, fill me in!” She proceeded to tell me that I needed to see a nutritionist and diabetes educator, but only gave me the card of the nutritionist at my GP’s office.
I met with the nutritionist and she gave me the food pyramid, which I found to be as helpful as a screen door on a submarine! She asked me if I knew how to carb count and I said sort of, but could use a refresher. My appointment was a half hour long and she explained how to measure food, follow the food pyramid and what a healthy meal should consist of. No carb counting or Calorie King recommendation.
In 4 months, I went back to see Dr. H. and she told me that my A1C was down to 6.8. Success! Why change anything? I had a 6.8, my change was I switched to Lantus from Humulin and from the food pyramid, I knew how many servings of the 5 food groups I needed to have. Cool!
I continued to run, and continued life in pretty much the same pattern. In January 2004, I had my first ER visit in probably 12-15 years. I woke up around 5 am and felt sick, soon followed by getting really sick. I asked my husband to take me to the ER for an IV and I stayed there for several hours. After palpating my abs, they assured me it was probably just the flu or food poisoning. I traveled home and laid low for a couple of days to recover in case it was the flu. A couple of weeks later, I met a friend for dinner and while sipping on a beer, I noticed that it didn’t sit well with me. I felt slightly nauseous and something like mild heartburn, so I stopped drinking it.
What I would have done differently:
If the doctor isn’t examining me before making a claim that I’m not doing something correctly, then I should have asked her to give me concrete evidence besides my blood glucose to explain her claim. I would hold her feet to the fire for a good explanation because that feeds the ability for both of you to decide on a course of action.
If the doctor makes a recommendation, make sure you get everyone’s information. For example, my doctor recommended the nutritionist AND diabetes educator, but only gave me the card for the nutritionist.
Ask for reading recommendations and local group support and see what they offer. If they don’t have information to local ADA, JDRF, or the hospital does not have support to offer, then do your homework. The doctors are not the end all, be all to our health… David Mendosa is! My point is network! Someone from your community may have experience or an idea for you!
Next: Health Unraveling and Emergency Care
Ann wrote for HealthCentral as a patient expert for Diabetes.