Medical Issues

Diabetes: My Three Month Follow Up With The Endocrinologist

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Yes, it’s that time again, where I got to go and get stuck in poor veins that roll, and give up my blood for the lab tests that dictate my life. I was afraid the doctor was going to yell at me, which he has a reputation for doing if you aren’t following his instructions. Before you say I shouldn’t have to put up with that sort of behaviour, let me just say that he has never yelled at ME. And if he did, I would probably deserve it.

I was afraid of the doctor’s wrath because I know I have been eating not quite right for a while for someone with diabetes. I don’t eat enough vegetables, and I eat too many sweets for someone who is diabetic. I just can’t give them up, though. I love sweets, and I get grumpy if I can’t have them. I just need to learn to be moderate with them. Because, you know, when I eat too many carbs, I pay for it with pain in my feet. That thing right there makes me try to do better. I don’t always achieve the level of moderation I am striving for, but I do try.

We quit buying ice cream, and most cookies. No donuts, and no chocolate cake. My nemesis lately has been cream horns. Who can walk away from those things?

So, my lab results:

A1C: 7.3 up. Not up by much, but still UP.Three months ago it was 6.1. I have to work on that.

Cholesterol: 63 down. In January it was over 160, so it is down a lot. I started taking Atorvastatin 10 mg. I will continue to take it. My doctor was very pleased with this. So was I.

Weight: UP by 3 pounds. Not telling you how much total. Ladies don’t. HA! Gotta get that down for sure.

Exercise: None to speak of. I need to get back to doing something, even if it is only walking for five minutes.

We discussed the pain in my feet, and decided that it is not bad enough to add another medication yet. We’ll just monitor it, and hope that I can get my sugar levels consistently low enough that I don’t have the pain.

And last, the doctor increased my insulin dosage. Now, instead of 10 units before each meal, I am to take 10 units before breakfast; 14 units before lunch; and 18 units before dinner. We will see how my lab results reflect that increased dosage three months from now.

Do you have diabetes? If so, how are your numbers? Do you have any complications, like neuropathy? Do you take insulin? What are you doing to get your numbers down?

I added this post to the Blogger Babes March Lifestyle Link Party.

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What is Vertigo?

Karen · 2 Comments

You may have heard the phrase “vertigo” but if you are like many of us, the term has an elusive meaning, at best. To give it some greater clarity, let’s consider some medical background on it.

What is Vertigo? Image Courtesy of pixabay.com

Put simply, vertigo is a health difficulty that expresses itself as dizziness. Consider it a chronic form of being dizzy. Rather than just an occasional spell of dizziness when standing up after a long time of sitting — vertigo is a chronic and recurring condition.

Causes of Vertigo:

The vertigo syndrome is often found to be a result of some health abnormality taking place in the inner ear. Some forms of the condition are age-related and can set on at some random point in your aging, whereas other forms of vertigo are related to infections occurring in the ear. When it is a matter of an infection, often times, the complication is viral in nature and should be able to be naturally handled by your body with proper health, nutrition and medicines (if needed).

Symptoms of Vertigo:

What is Vertigo? Image Courtesy of medicinenet.com

You’ll know vertigo is affecting you if you notice yourself feeling like the world is spinning, swaying or perhaps even tilting. You could also experience a lack of balance or the tendency to walk more towards one side over another; almost rather crooked in nature. In some cases, there have been reports of rapid eye movements as well as intense sweating. Others will report massive, splitting headaches or even on rare occasions, hearing loss.

Treatment of Vertigo:

While your specific treatment choice will ultimately be largely dependent on the particular reason why you have vertigo, it remains true that (at least in many cases) you can actually beat vertigo with your body’s own natural immuno-defense capabilities. A good part of this natural adaptation and ability to ward off vertigo is thought to be an evolutionary trait expressing itself as the brain’s power to essentially “rewire” itself when there is a specific need to do so. Before just deciding to wait it out, a simple check up to an ENT might also be wise.

Final Thoughts on Vertigo:

While it is absolutely true that sometimes a vertigo diagnosis can be more serious, it is usually just a temporary phase in an individual’s body chemistry and biological growth. Nonetheless, it can be very disorienting and uncomfortable, so knowing what to look for, how to take steps to slow down or entirely stop vertigo from even happening are wise topics to study. Despite the most common causes of vertigo, there are some, including the possibility of a tumor, that would be far more serious. It is because of the existence of some more serious health conditions which have vertigo as just a component that you should make sure to get checked out by a doctor immediately if you find yourself having repeated bouts of dizziness.

Waiting too long will not only make the symptoms get worse, but can also make a diagnosis more difficult and costly to complete. Those who specialize in diagnosis of vertigo, such as the professionals at Becker ENT, will be able to run a few simple, affordable tests to determine whether you should have any reason to continue looking into causes or if your vertigo is perhaps caused by some other primary health concern such as stress or malnutrition or poor blood flow.

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5 of the Biggest Disadvantages to Being Obese

Karen · 2 Comments

Millions of people all over the world are obese, and these numbers are growing. It is a true pandemic, therefore, and efforts have to be made to contain it. There are many disadvantages to being obese, which range from minor inconveniences to truly frightening ones. Let’s take a look at just five of the biggest disadvantages.

1. It Is Harder to Accomplish Your Goals

When you are obese, it is generally much harder to get what you want, whatever it is that you want. You will be less physically active, which means you can’t excel at sports. You will have frequent doctor’s appointments, which means you will have too much time off work to get that promotion. You will have lower self-esteem, which means it becomes harder to motivate yourself, to find love and more.

2. You Will Experience Social Problems

As much as we know that obesity is a global health problem, it is not socially acceptable to be obese. And perhaps it shouldn’t be, because this would make it even harder for people to motivate themselves to lose weight, even if it is through bariatric procedures. Unfortunately, obese people have fewer friends and are less likely to end up in a lasting, loving relationship.

3. You May Have Sexual Problems

There have been a number of studies that have demonstrated there is a clear link between sexual ineptitude and obesity. The obese often get less enjoyment from sex, have insufficient energy to engage in sex, have more difficulties in finding a partner and more.

4. You Are at Higher Risk of Depression

People who are obese are at much greater chance of being depressed. Some show it, some admit somewhat to it, some hide it. Either way, depression is a very serious mental illness that can lead to suicidal thoughts, self-harm and more. The fact that the obese have to deal with the other disadvantages of being obese means that they often end up in a vicious cycle, in which their depression gets worse and worse. And, since they are often socially isolated, it is all too easy for them to never get the help they need. Unfortunately, successful and attempted suicide rates alike are much higher in the obese.

5. Your Health Will Deteriorate

Everybody knows by now that being obese has some very serious health consequences. Just some of the illnesses you can develop as a result of obesity include:
• Hypertension, which has its own health dangers.
• Type 2 diabetes, which, again, can lead to various other problems.
• Fertility issues.
• Difficulty breathing, including asthma and sleep apneas.
• Heart problems, including heart attacks.
• An increased risk of strokes.
• High levels of cholesterol, which can lead to heart attacks and strokes.
• Cancer.
It is very important to understand just how serious these issues actually are. The reality is that obesity kills, albeit not directly. Nobody wants to die or, if you do, you are dealing with depression probably caused by obesity. Help is out there, make sure you get it.

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My Diabetes Update With Information About Less Expensive Insulin Options

Karen · 3 Comments

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The last time I updated about my diabetes was in August. A lot has happened since then, so I decided to update y’all. I started taking Novolog using a prefilled pen type of injector after my August visit with the endocrinologist. It was easy enough to get used to, and it worked well in keeping my blood sugar under control. Then, in November, I entered into the “Medicare Gap”. For those of you who do not know what that is, I’ll try to explain.

This is from Senior65.com:

In 2015, if your Medicare Part D drug plan has a coverage gap once you and your insurance provider have paid $2,960 toward your covered drugs and you exit it at $4,700. Here is what you’ll owe for generics and your plan’s covered brand name drugs during the donut-hole:

Generic costs: 65%
Brand name costs: 45%

My insulin was going to cost me over $300 for each prescription for the month of December. I was panicking because I really didn’t know where almost $700 was going to come from to pay for my medications. I went to the Haralson County Department of Family and Children’s Services, which is the agency I needed to apply for the “Extra Help” that is available to some people who are having problems paying for their medications through Medicare. I did not qualify for that extra help. The next step was to apply for “financial assistance” from the manufacturers of the two forms of insulin I take. I did not qualify for that either, because I have insurance. Catch 22, eh?

Next, I asked my primary care doctor if she had any samples she could offer me so that I could make it to January, when I would be out of the gap purely because it was new year. She told me that she was no longer able to dispense medication samples due (I think, see note) to a provision of the Affordable Healthcare Act (Obamacare). This provision mandates that in order for rural healthcare providers to dispense samples of medications to their patients, they must keep a record of what medications they gave out, and they must call each patient who is using sample medications every day for five consecutive days to ask the patient if they are having any problems with those medications. In order to do the required patient contact and associated reporting, my doctor would have had to hire someone specifically to take care of making the calls, entering the data into the computer, and fill out out reports to comply with the mandate. Because hiring another person for her practice would be financially draining she opted to not give out medication samples. (note: I googled my brains out trying to find information to back this up but was unable to find anything. Next time I talk to my doctor, I will ask where to find information about this.)

My endocrinologist is in another county and city that is not considered to be rural, so I went to his office next and requested samples that would be enough to get through December. Because so many of his patients are on medicare, and are all in “the donut hole”, they were completely out of samples. I understand that. I am not the only person who was floating in this boat. So, at this point, I had exhausted all of my options for getting any financial help or free samples of my medication. I ended up doing without one of my insulin prescriptions for three weeks simply because I could not afford it.

I had a regular appointment with my endocrinologist the first week of January. Amazingly, my hbA1C was 6.1. The doctor remarked that I was the first patient he had seen that day with a normal A1C. I then had a discussion with him about the unaffordability of the medications he had prescribed for me, and I asked if there was a cheaper option I could take. That is when he told me that Wal-Mart has their own brand of insulin, both the long acting and the fast acting types, and that I could get them without a prescription at the Wal-Mart pharmacy for about $25 each. He told me which one of their brands was equivalent to the meds I take, and how to take each one. That was a real relief to me, because I would be going into the medicare gap this year in April, making my insulin just plain unaffordable for more than 7 months.

The price of the two vials I need every month of insulin, one of each type, plus the syringes I need to be able to give myself the injections, is $62.64. If I were to go through my insurance company and get to get the pre-filled pens that my doctor prescribed for me to begin with, the cost would be $90–two $45 co-pays. And, it would throw me into the “gap” starting in April, making all of my medications more expensive until November, when I would have paid enough out of pocket to come out of the gap. What I don’t understand is why I had to go through all of the steps I went through, and do without my medication for almost a month, before I got the information I needed. Why would my doctor not tell me about a less expensive brand of medication that works just as well? I already know the answer, but I still had to ask it here, just to provoke people to think about what they are doing.

Now, my advice to any of you who have gotten this far reading about my medical hassles, is to 1) Tell your doctor you can’t afford the medication he has prescribed, and 2) ask your doctor if there is a more inexpensive medication that will work just as well for you. You are your own best advocate–open your mouth and speak up for yourself.

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VSL#3 Brings You Delicious IBS Friendly Recipes #VSL3KnowtheDifference

Karen ·

This is a product-provided, sponsored conversation that contains affiliate links. All opinions, text and experiences are my own. VSL#3 is a high-potency probiotic medical food for the dietary management of IBS, UC and ileal pouch and must be used under medical supervision. These statements have not been evaluated by the FDA. The product is not intended to diagnose, treat, cure or prevent any disease.

VSL#3 logo

Chances are, you know someone who has IBS. IBS is a serious GI issue that affects the large intestine (colon) and commonly causes cramping, abdominal pain, bloating, gas, diarrhea and constipation. There is no known cure or cause for IBS. It is so common that it affects up to 1 in 5 Americans, including 15% of children*. IBS can be managed by making healthy diet choices, by using IBS Friendly recipes, but that is not always an easy thing to do, especially this time of year when so many celebrations center around food. Using the right probiotic can help, along with knowing and avoiding ingredients that trigger IBS symptoms.

While many people are familiar with the general term “probiotics”, most do not understand the importance of knowing which specific strain of organism should be used for which specific disease or condition. #VSL3KnowtheDifference Probiotics work on three areas of the gut: the microbial barrier; the chemical barrier; and the physical barrier. It is suggested that adults should take at least one billion cells (also called colony-forming units or CFU’s) daily. VSL#3 has at least 112.5 billion CFU’s. VSL#3 is a high potency probiotic medical food that must be used under a doctor’s supervision. Their products are gluten free, Kosher, and Halal certified, and must be refrigerated. VSL#3 can colonize the gastrointestinal tract with beneficial bacteria, reduce gas and bloating from IBS,and maintain remission in UC (Ulcerative Colitis) an ileal pouch.

Flavor without FODMAPs: Love the Food that Loves You Back by Patsy Catsos

In addition to using VSL#3 Probiotics, you can also learn to make food choices that are Low FODMAP. Patsy Catsos, a medical nutrition therapist and registered dietician, has a new book called Flavor without FODMAPs Cookbook: Love the Food that Loves You Back. The book explains what FODMAPs are, and provides over a hundred recipes and meal plans to help you choose the right foods if you have IBS, UC, or an Ileal pouch.
I tried the Cream of Tomato Soup recipe from the recipe cards I received, and I have to say, it was surprisingly easy to make, and tasted very good. I garnished mine with crumbled gluten free pretzels.

Cream of Tomato Soup

1 ¾ lbs fresh tomatoes or 28 oz can of fire roasted diced tomatoes, not drained
1 tablespoon garlic-infused oil
1 teaspoon sugar
¼ teaspoon salt
¼ teaspoon pepper
½ cup water
¼ teaspoon thyme, crushed
¼ teaspoon crushed red pepper flakes (optional)
6 tablespoons heavy cream
2 tablespoons marsala wine or sherry (optional)
Combine tomatoes, water, sugar, and spices in the bowl of a blender or food processor and blend until smooth. Stir in heavy cream and optional sherry or marsala wine. To serve warm, transfer the soup to a medium saucepan and heat gently over medium heat, stirring occasionally, until very warm but not boiling. Makes 4 servings.

For more information on VSL#3 please visit www.vsl3.com and use the code “DOCTOR” at checkout for $5 off your next purchase. You can enter the IBS-Friendly Feast Giveaway today for a chance to be the Grand Prize winner to receive a cooking class for two at your local William Sonoma or Sur La Table stores and custom IBS-friendly recipes from VSL#3. Five Runners-up will also receive a one month supply of VSL3# product. Enter before 11/25 at 12 p.m. ET.

Join VSL#3 on Facebook for giveaways and exclusive offers.
Check out their series of videos packed with helpful info about IBS & UC.
You can find more delicious IBS-Friendly recipes at VSL#3 Recipes.

Do you live with IBS, UC, or an ileal pouch? If you do, I hope you find some recipes and other information that can help you feel better.

*Harris Poll conducted the GI Issues Survey on behalf of VSL#3. The survey was administered online within the United States between April 1 – 7, 2015 among 607 adult’s ages 18+ who have been diagnosed with a digestive or gastrointestinal condition, irritable bowel syndrome, or ulcerative colitis, ileal pouch (“sufferers”). VSL#3® is a high-potency probiotic medical food that’s clinically proven in the dietary management of IBS, ulcerative colitis, and ileal pouch. To learn more visit www.vsl3.com and LIKE the brand on Facebook.

VSL#3® is a high-potency probiotic medical food that’s clinically proven in the dietary management of IBS, ulcerative colitis, and ileal pouch. To learn more visit www.vsl3.com and LIKE the brand on Facebook.

This is a product-provided, sponsored conversation that contains affiliate links. All opinions, text and experiences are my own. VSL#3® is a high-potency probiotic medical food for the dietary management of IBS, UC and ileal pouch and must be used under medical supervision. These statements have not been evaluated by the FDA. The product is not intended to diagnose, treat, cure or prevent any disease.

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We Joined A Gym: Silver Sneakers Makes It Free Through Medicare

Karen · Leave a Comment

Last year when we got our insurance cards in the mail from Humana, they also send us each a Silver Sneakers card. This was an unexpected perk for using Humana to provide our medicare advantage plan D coverage. The Silver Sneakers card allows the cardholder to join any gym for free that participates in the program. Fabgrandpa and I have been talking about joining a gym for several months now.

When I went to the endocrinologist last month, I discussed it with him. I told him I wanted to go so I could use the treadmill and the stationery bicycle, at least. He said it was a very good idea, and that it was better for me than trying to walk in the heat of the summer. Then, Fabgrandpa’s doctor at the VA said it was a good thing, too.

Using our Silver Sneakers cards to go to the gym!

We actually went to the gym in town and talked with them last month, and had a short tour of the facility. They have all kinds of machines, weights, and classes for exercise. But, we are mainly interested in getting moving. So, today, we went over there and actually did something for the first time.

I was able to make for 2 minutes on the treadmill, and then for 3 minutes on the bicycle. I also did about 5 repetitions with a weight thing that worked my upper arms. That was enough for the first day. I was moving, and that was what it is all about.

So, I have decided to put a little box in my sidebar, and update it every time we go to the gym. I’ll be so brave as to put my weight, and how long I made it walking, bicycling, and whatever else I do. Y’all can help me by leaving encouraging comments here, and I’ll put a permanent link to this post in the box, too. What do you do to get moving? If you are a senior, and on medicare, do you have Silver Sneakers? If you do, do you use it? Will you start?

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My Diabetes And I Visited An Endocrinologist. And A Poll For You!

Karen · 5 Comments

Last week I had an appointment with an endocrinologist. My primary care doctor and I decided it was time for this because I have not been able to get my blood sugar down below 200 in the morning in quite a while. I had started taking a slow acting insulin before bed last summer. That worked for a couple of months, but then the morning finger prick numbers started going up again. The primary care doctor had me increase the amount of insulin injected over a period of about two months, from 10 units to 25 units, and it still wasn’t enough. That is when we talked about seeing the endocrinologist.

Dr. Vavrik was a pretty nice guy, to the point, and I liked him. I think that liking your doctor is important, because when you have a good relationship with him or her, you feel like you can ask questions of them easier.

I asked him why, after nearly 15 years of being a diagnosed diabetic, and keeping my blood sugar under control since diagnosis until last summer, I was having such a hard time now. He explained that most type 2 diabetic have a good ten years after their initial diagnosis, if they eat right and take their medications, before their pancreas gives out completely, and complicates things. Since I experienced good control for more than 14 years, he said, I was lucky that my control lasted that long. He also told me it was nothing that I did right or wrong, that caused my blood sugar to suddenly go whacky. That is just the nature of the disease. After answering my questions about why and how this happened, we got down to talking about what to do now.

So, here is my new plan. I am still to take metformin 500 mg two times a day. Even though my pancreas has stopped working to produce insulin, taking insulin injections can cause weight gain. The metformin helps prevent that weight gain, so Dr. V wants me to keep taking it. Next, I had gotten up to 32 units of Lantus, the slow acting insulin that I take at night. He wants me to continue to take that as well, to keep my blood sugar lowered while I sleep. He said the trick is to keep your blood sugar lowered all the time, so taking the Lantus is good.

Then, he prescribed for me to take Novalog, a fast acting insulin, before each meal, three times a day. I now have to check my blood sugar before each meal as well. Since this is a fast acting insulin, it has to be taken 0 to 10 minutes before a meal. So, if we go out to eat, I should not ever inject my insulin until my food is served. That is because, if I were to inject the insulin, then there was a problem with my order and my meal was delayed arriving at the table, my blood sugar could drop to a dangerous low. So, the process is like this: order my food. Check my blood sugar. If it is below 160, I take 10 units of Novalog. If my blood sugar is OVER 160, I take extra Novalog determined by a chart I was given. I keep that chart in my kit along with my other diabetes supplies. Once my food is on the table, prepare the injection, give myself the shot, then eat. Simple.

Now, I have a question for you, my dear readers. Whether or not you are diabetic, I hope that you would take this simple poll. I want to find out how you feel about diabetics giving themselves a shot in the restaurant, in a public place. If you have any objections or anything else to say, please do leave a comment. It is very important to me, as a diabetic, to understand how others feel about this topic.

[socialpoll id=”2283622″]

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My Diabetes Is Out Of Control

Karen · 16 Comments

I was diagnosed with Type 2 diabetes in January 2001. For many years after that diagnosis, I kept my blood sugar under great control, with HBa1C test results coming back at or around 6.1 every time. For those who don’t know, that number should be under 6, so my blood sugar control was considered good.

Sometime last summer, things changed. I lost 48 pounds without dieting, without trying. I felt fatigued and drank water at an alarming rate. For some reason, that did not compute in my head as a problem with diabetes. A visit to my primary care physician was all it took to find that my blood sugar had gone whacky.

Month/Year	HBa1C Test Result
Dec/2011	6.1
Dec/2012	6.2
Aug/2014	11.8
Jun/2015	9.7

Dr. Howell advised me to increase my metformin to two tablets a day, and prescribed Lantus, an insulin injectable medication. I started out with 10 units of insulin per night, right before bedtime. The next time I went to see her, six months later, my blood sugar was still out of control. She told me to increase my insulin by 5 units every four or five days until it was at 25 units a night.

On Monday, I went for a follow up visit, and had blood drawn again. This time, my HBa1C was 9.7, a little better but still not good. That is unacceptable. The doctor told me this time to start increasing my insulin injection by 1 unit per night until my morning blood test is at 110 or below. This morning, it was at 128. I have a ways to go yet, and need to get it down by at least 18 points, or more.

So, I am asking you, my readers, who may have Type 2 Diabetes or have a family member who does, to give me some tips on how to get my numbers down. If you have links to recipes you enjoy that are good for a diabetic diet, or links to websites that you use, please do add them to your comments. If you have ideas about exercises someone can do sitting in a chair, I need that info as well. I need help as I am running out of ideas.

I am thinking about adding a little box in my sidebar to update with my morning blood glucose finger prick results. Maybe that will help me get things going in the right direction. Any other ideas you might have? Let me know.

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