Archive for February, 2012

Take Responsibility For Your Own Good Health

I know it is difficult to talk to some doctors. They really want the best for you. However, they have a tendency to dictate. Some have only a prescribed amount of time per appointment, others seem to be more relaxed and manage the time as if you are the only patient they have.

Keeping your blood sugar in a normal or near normal range for the A1c, allows you to function more normally. You can be more active, walking, swimming, having a daily routine enjoying it with family and friends, meeting strangers, learning about new things and on and on. We have so much available at our finger tips today. Doing nothing rewards you with a shorter unproductive existence.

It seems when some people reach retirement age, they give up, or quit everything. It is as if they weren’t ready for this new phase of life, or have no goals. My mom was one who felt she had worked very hard all her life and deserved to “just do nothing”. This really bothered me as she was so productive and now not at all. In no time, she had Alzheimer’s and breast cancer. When dad wanted to travel and do other things she was no longer able to. She died in her early 70’s. Dad really missed her and lived another 13 lonely years without her.

Think about those you may leave behind and what you can still contribute to them verbally or in written form. With all the new technology we really have no excuse. Write your life story. I am sure many would love to hear your story. This may be crazy, but I enjoy reading my childhood neighbors and classmates parents obituary stories and wished I had known them better as a kid.
so much is missing in these short write ups.

Anyway now that I have gotten off the track, you really need to be responsible for you own good health and as a diabetic understanding that your diabetes is unique to you and what it does to your body. So, keep records.

One thing, as a diabetic, I really needed was the A1c and blood number charts. I found not all of them were the same. One doctor gave me two that I keep with my testing chart. Yes, I keep a running chart of all my testing. I test 2 and sometimes 3 or more times a day. It gives me a picture of what I have been doing. I write notes on it to let me know what and where I ate and what I did that may have caused my blood sugar to spike or drop.

I will share the following charts I use. Don’t hesitate to ask you doctor for the charts he uses or refers to. My husband created a Blood Glucose chart on the computer for me to use and printed it out for me. It covers 4 weeks at a glance. You can use the computer to keep track. My records go back over 15 years.

Hope these help.


Your goals?
Test _______. times a day.
Best times to test_______ __________ .
Keep my blood sugar range between ________mg/dL to _______ mg/
Waking up (fasting)
Before meals 2 hours after meals

Note that even these professional charts vary quite a bit. I use the first one the most. It works for me.

Brought to you by Charcot Awareness Education Foundation

Don’t Get Stuck With A High A1c

Recently, I had my yearly appointment with my eye doctor. Because of my diabetes, I went blind in my left eye in 2003. I mean completely blind. The eye completely filled with blood. It was like pulling a black blind over a window cutting out all sources of light. Anyway, a few days later, he performed a Victrectomy on that eye restoring my sight. Now 2012 the sight in that eye is stable and nearly 20/20. He asked me what my A1c was at my last testing and I told him it was 7.2 a little higher than what the doctor wanted. He paused and then said, “I wish all my patients had a 7.2”

He then went on to tell me most of his diabetic patients had A1c’s of 10, 11, and even 13. I was shocked and puzzled. As I looked back over the years of being as diabetic, now nearly 20. The first three years I was very conscientious, I really watched everything I ate and yet I don’t think I ever made it to a 7 A1c. Usually, I was in the 8’s, but never any 9’s. The national expectations changed and numbers were lowered wanting the diabetic to get closer to a “normal” reading which on some charts is a 6.5. The doctor changed my meds which caused me to have severe lows at night to the place where I stumbled down the hall with cold sweats, sat in a chair eating a hand full of cashews, sitting for 20 minutes, or so until I felt “normal” and could go back to bed. I changed doctors and learned that some of the medication I was taking at the wrong time of day. This was corrected and haven’t had to change for many years. Things were much better.

Shortly after having a Victrectomy in each eye, saving my sight, I was diagnosed with Charcot Foot made worse because of my diabetes. I began listening to other diabetics to find out how they approached their disease. Some were extremely conscientious about testing three or more times a day. They were aware of the food that raised or lower their testing numbers. Others didn’t do any testing at all. Some try to fool the doctor. In fact, one person loved to drink and was on insulin playing a very dangerous game. He would shoot insulin when he would get an extremely high reading because of the booze. He would immediately shoot more insulin to the place his reading would drop so low he would go into a coma. For a long time he was found and rushed to a hospital where he was stabilized. However, the one time it didn’t work, I was told, his home looked like a war zone with blood every where and they couldn’t save him.

My husband told of an incident with an uncle of his. He could “eat what he wanted” because he was taking insulin. He said he could eat two or three pieces of pie and ice cream and it wouldn’t matter because he would just take more insulin. He is no longer with us either.

I am really frustrated because I have days when I don’t want to deal with my diabetes either. I really don’t want to face some of the trials and tribulations of life, but I don’t want to die. A positive attitude really does help. I loved my career in teaching and the children who crossed my path. It is exciting to hear from many of them over the year now in my retirement. I love the retirement too because there are so many things to do. My husband and I are involved with many things. We wouldn’t have it any other way.

Another frustration that may exist is the fact the A!c and the daily testing numbers don’t seem to correlate. In fact it varies from testing machine to testing machine. I often take my machine with me to the doctors office so I can test the blood at the same time they do. There is usually a small difference in the readings. Since the A!c is a test over the past three month or 120 days of readings it will be off slightly. If you understand this and it’s relation to your records you will understand where you are.

Keep your brain active. Use it, problem solve. Don’t be like the little doggie in the car window and merely shake you head every time the car stops. If you don’t agree with someone, when you think they want you to agree with them and you really don’t, or you think it is easier this way.

Brought to you by Charcot Awareness Education Foundation

Who Might Have Charcot

There are some 24 diseases that cause Charcot foot to become worse. The following list of diseases by Ali Nawaz Khan MBBS Riyadh, Saudi Arabia appeared in an article in emedicine on Feb.21, 2007.

  • Diabetes
  • Use of steroids
  • Alcoholism
  • Trauma
  • Infection
  • Amyloidosis
  • Prenicious anemia
  • Syphilis
  • Syringomyelia
  • Spina bifida
  • Myelomeningocele
  • Leprosy
  • Multiple scierosis
  • Congenital vascular disease
  • Charcot-Marie-Tooth disease
  • Cord compression
  • Asymbolia
  • Connective disorders, such as rehumatoid arthritis and sclerodema
  • Ehlers-Danlos syndrome
  • Raynaud disease
  • Adrenal hypercorticism
  • Thalidomide embryopathy (congenital arthropathy in offspring of exposed mothers)
  • Paraneoplastic sensory neuropathy
  • Cauda equina lipoma

Since diabetes heads the list, diabetics need to be aware that this article says15% of the diabetic population has Charcot foot and a 2004 University of Washington study states that 1/600-700 diabetics with diabetes mellitus neuropathy has Charcot Foot.

Charcot is, apparently, difficult to diagnose and is often miss diagnosed as arthritis. One needs to find a Charcot knowledgeable professional. A podiatrist DPM, or a foot and ankle specialist (surgeon) DPM, FACFAS who is able to diagnose correctly.

Since nueropathy is a loss of sensation in the foot, one is unable to detect painful sensations. A doctor once told me a patient came into her office unable to remove his shoe and couldn’t understand why. When she looked at the bottom of the shoe she found a nail. It had gone through the shoe and well into his foot. It was removed and the shoe taken off to reveal a traumatic situation. Because of Neuropathy much goes undetected that could save the foot and individual from pain.

If you don’t have someone to help you check your feet, place a mirror on the floor that can be used to check your feet daily. Also, avoid going bare foot.

Brought to you by Charcot Awareness Education Foundation

Depression

Bonnie commented on the dark days of Alaska in the fall and winter while she was trying to heal her Charcot Foot. Later she talks of not remembering some things and how depressed she was. She really enjoyed the sun. Both of us having grown up in Nebraska, I could understand her feelings. In looking back on my recovery from Charcot Foot surgery, we chose to have the surgery during the summer as I felt that was better for me. Bonnie, as well as, many others have no choice. Many of our friends felt we would be better off having the surgery during the fall. With recovery during fall and winter because you can’t do a lot because of the weather. I wasn’t thinking about depression, but the fact that the weather would be warmer. We could leave doors to my studio open if I wanted. I didn’t have to think about Max driving to doctors appointments on icy roads, or my being pushed in a wheel chair either. I just knew I would be happier being able to look outside and be able to go out doors if I wanted.

Mid February, I discovered an article on depression in the Star-Herald from Scottsbluff, NE written by Nicole Vidlak, a licensed clinical psychologist and contributing writer. Her focus was primarily on heart disease. She referenced Johns Hopkins University in Baltimore, MD. She listed nine physical effects which I have blocked out here for you to read.
Depression notes

It was mentioned that individuals who are depressed may have difficulty taking some medications they need for their treatment. It seems Chronically-elevated levels of stress hormones common in depression can have negative effects. One who seeks mental health treatment for depression can make a positive impact on their over all health.

Upon further research we discovered a power point presentation by Terrence Sheehan, MD Chief Medical officer and Director of Amputee Rehabilitation Program at Adventist Rehabilitation Hospital in Rockville, Maryland. Though his topic was Physical Issues Following Limb Loss: Adapting in the Context of a Natural Disaster. It had some statistics and information very relevant to anyone and especially someone with diabetes.

These are really eye opening. Depressing? Statistics

At my last podiatrist appointment, he commented he hadn’t had any new Charcot
patients and was kinda surprised. His nurse, however, may have hit on the answer. She said most go to emergency or urgent care and end up having to have the limb amputated because they went for help too late. If they had gone to a podiatrist when they first had foot problems and had been diagnosed correctly. They could have avoided amputation.

Brought to you by Charcot Awareness Education Foundation