Back to blogging (again)!

I have been thinking about getting back to this blog for the last few days, but just now I saw this entry from Kerri at SixUntilMe and it touched a chord. I still have my fear of hypos and one of the parts of my fear is to do with people thinking I'm weird or a nutter if they see me having a hypo. But watching Kerri's video has made me realise that non-diabetics probably wouldn't even notice. Thanks Kerri, I don't need to be so self-conscious.

As a quick update, it turned out the raised prolactin level was caused by the domperidone. I came off it and everything returned back to normal, in fact i am more regular now than I have ever been! I now take erythromycin for the gastroparesis, and (touch wood) have not had any vomitting episodes for 18 months.

Hubby is doing well, all his check-ups are clear which is such a relief.

And we have a new family member, Susie, a 4 year old Golden Labrador that we got from Labrador Rescue 4 weeks ago tomorrow


I will go and check in with the blogs I used to follow and see what you have all been up to, and talk to you again soon.

Prolactin

After not menstruating for 7 months (and not being pregnant) my GP took some blood tests and apparently my prolactin level is through the roof. This explains my lack of periods and there is a chance it is caused by a growth on the pituitary gland. She reassured me that this would be benign, but I am going for an MRI scan on 25th April to see if that is what is causing it.

It can also be caused by domperidone which I take for my gastroparesis.

Anyone else had this experience or symptoms?

I am seeing an endo on 2nd April to see if they can shed any light on things.

Where does the panic come from?

At 1.20pm my bgs were 13.8. (248) I took 4 units extended over an hour and had about 50g of carbs.

At 2.10pm my bgs were 14.6. (263) I drove to work.

At 2.40pm - 13.2. (237) Brain kicks in, "you are dropping - start getting anxious!!!" So I did!

At 3.00pm - 12.2. (219) Brain says "YOU ARE DROPPING FAST, PANIC AND DRINK LUCOZADE!!!!!!!!!!! So I did!!!!!

At 3.20pm - 13.2. (237) Phew, going back up, think "Stupid woman, now you are full of Lucozade and you'll have to correct later!!!!!!!!!!!

What happened was my immediate panic response kicked in. I believed that my stomach wasn't absorbing the food (gastroparesis kicking in) and that I would drop right down and pass out at work and have to have an ambulance, etc etc, big hoo hah!!!!

The fact was that had not happened, my brain just convinced me that it had. I was already too high to start with and had a LONG way to go to end up hypo.

HOW CAN I STOP THIS HAPPENING?????????????? I am seeing my GP on Monday about some dizziness I've been having so I may ask if I can be referred to the psychologist for some help or I'm never going to get these bgs down.

Rumblings - an explanation

Dr. W. gave me this explanation yesterday of why gastroparesis is made worse by high bgs........

Imagine you are a non-diabetic for a bit (I know, I WISH!!). Anyway, if you are hungry your stomach rumbles right? This is because your brain knows your blood sugar is low and prepares your stomach to receive food, by making it more active to digest the food when it gets there, hence the rumbling. When you have eaten, the brain notices a blood sugar rise and knows the food has been digested, so the stomach slows down again.

In a diabetic, we get that hunger and rumbling when our bgs are low. But if the blood sugar is high, the brain tells the stomach to slow down because it doesn't need food. Therefore, if we then eat, the food isn't digested as fast, and the combination of this and the nerve damage which has occurred as a result of consistent high bgs makes the gastroparesis worse.

Now I know this, it makes so much more sense to keep my blood sugars down. I'm still doing okay, at 12 noon I was 8.5 (153) and 2.30pm I was 11.1 (199). I am happy with these results at the moment, but know I will have to tighten them up. Let's hope it continues to improve.

My clinic visit results

A good and a bad day really.

My hair turned out a nice colour, no pic as yet though.

As for my appointment with Dr. W., well..............My kidneys are fine, the high urea result is due to dehydration, because my bgs are so high at the moment. As for the A1c (11.3), he wasn't impressed. He said there was no way a pump patient should have an A1c in double figures! As my pump is funded by my local Primary Care Trust, he said they (the PCT) would probably look at the result as a good reason to withdraw funding. Ok, I could afford to fund the consumables myself if it came to it, but I don''t want to have to. So there is reason 1 to get the result down.

I am also in a vicious circle with regard to the gastroparesis. Keeping high bgs so I don't go low if the gastro kicks in, is making it more likely to happen. Reason 2 to get the result down. I now have to take domperidone and erythromycin to help my stomach work better. I also got a prescription for an injection of metclopramide in case I really need it, but it is not to be used willy-nilly. My husband is not too chuffed at the prospect that there might come a time when he has to inject me with it, or the Glucagon that I also got today. He has never given me even an insulin injection before and really doesn't like the idea. But he would do it if it came to it.

I also got myself a blood pressure monitor to use at home. I always get "white coat syndrome" so they don't bother to check it for me at the clinic, so I have to take my own results in. I only had a wrist one before and they aren't very accurate.

It was also suggested again that I go onto the ward for a week so they could monitor me and keep an eye on stuff and sort me out. I am not keen on this idea and want to avoid it, Reason 3 to get the result down.

So, as of now, I am going to do things right. No more messing about, if I get anxious i will think things through logically and try not to just focus on all the negative thoughts. I bolused correctly for my dinner this evening and that's how i have to carry on.

Oh, and my thigh pouch came, not very flattering but no-one will see it. Well I might just flash it once for my friend Bex to have a giggle at!!!

What was I THINKING?????

I realise that all my posts up to now are kind of on the negative side. So I apologise in advance that this one is going to be along the same lines. However, after this one I will pull myself together and DO SOMETHING ABOUT IT!!!

Anyway I just wanted to talk about how stupid I am..........

I have high blood sugars. Fact.
I need to get them down. Fact.

What did I do this morning? Wait for it.........

I woke up at 9am with a bg of 12.8 (230). What would you do? Correct the high, right? Not me. I have a worry that my gastroparesis will kick in and not absorb my breakfast, so I eat first. I then wait 45 minutes until my bg is now 15.5 (279). Now I take a 2 units bolus plus 2 extended over 45 minutes!!!! This has no correction bolus built in, and is probably not enough to cover the carb in the porridge anyway. I then go out to the Post Office and back a walk of twenty minutes tops. When I get back I test again, still around 15. I fancy a biscuit so I take 2 units and eat 20g carbs.
Half an hour later bg is 13.5 (243). Instead of thinking "oh good its coming down", I think, "Oh god its coming down, I'll keep an eye on it."
Another 20 minutes, bg 12.9 (232)
Another half hour, bg 11.3 (203)

Inside my head, "Oh no, the biscuit didn't absorb, my gastro is playing up, the insulin is in and going to keep working until I drop to zero, panic, panic, panic, drink Lucozade, NOW!!!"

So I did!!!!!!!!!

Guess what? 20 minutes have passed and I'm up to 13.1 (235). What a surprise!!!! My stomach is fine, I wasn't going to die, I'm not panicking.

This is how my mind works all the time at the moment. What am I doing to myself acting this way? More importantly, how do I get over it?

Complications - gastroparesis.

Thanks to Caro for her comment on my first post. This has given me a subject for today's post - gastroparesis.

What is gastroparesis?
Gastroparesis, also called delayed gastric emptying, is a disorder in which the stomach takes too long to empty its contents. It often occurs in people with type 1 diabetes or type 2 diabetes. Gastroparesis happens when nerves to the stomach are damaged or stop working. The vagus nerve controls the movement of food through the digestive tract. If the vagus nerve is damaged, the muscles of the stomach and intestines do not work normally, and the movement of food is slowed or stopped. Diabetes can damage the vagus nerve if blood glucose levels remain high over a long period of time. High blood glucose causes chemical changes in nerves and damages the blood vessels that carry oxygen and nutrients to the nerves. (Follow the link above for more information).

The first symptoms I had were unexplained bouts of vomiting. As it was only about once a year I didn't really think too much about it. I did mention it at a diabetes clinic visit but I was told it could be anything and not to assume that any illnesses I had were necessarily caused by having diabetes. When I had had 2 bouts a few months apart, I mentioned it again, and it was suggested that I go for a gastric emptying test. This couldn't be done at my local hospital so I had to get up early and get a train 20 miles to Liverpool for an 8.30am appointment. I had to fast from the evening before.

On arrival I was seated in front of a large machine which was going to track the food I was about to eat for the next 2 hours. I had to take my insulin and then because the machine was in front of me and I couldn't feed myself, I was spoonfed some porridge, then a sandwich and had to drink a cup of tea through a straw. Most undignified!! All of this was laced with a radioactive substance which would be tracked. I then had to sit still for 2 hours or so. A nurse was with me and basically we just chatted.

The results were that my stomach was emptying slower than it should do. As it was very infrequent, no treatment was suggested apart from tightening up my blood sugars. I think I had that test about 5 or 6 years ago. I continued to have bouts of vomitting lasting a couple of days each, about twice a year, and was given Domperidone which speeds up the activity of the stomach.

The episodes of gastroparesis can occur quite spontaneously. Usually I wake in the early hours of the morning feeling very hot and with what I call "eggy burps" - an awful sulphurous taste. This is caused by undigested food starting to go off in my stomach. A few minutes later I throw up. Now, these episodes are easy to handle as there is no "active" insulin in my system at that time of day, just the basal amounts from the pump. I just don't eat for the rest of the day, check bgs often, keep up fluids - just water usually and sometimes that doesn't stay in! - and wait until it all calms down. I may throw up a few times during the day but eventually it stops. It then takes a couple of days to stop feeling like I've been kicked in the stomach, and then I'm back to normal.

I went onto the pump in August 2004 and it seemed that I was only getting an episide once a year. In March this year I had a different episode. I'd woken up with a bg of 9 (not unusual for me - I am usually running high) and had my insulin and breakfast as usual. About an hour later I felt something wasn't right, and checked my bgs - 8. As they usually shoot up after breakfast I kept an eye on them, and watched as they dropped to 6 in the next half an hour. I guessed something odd was going on and took some Lucozade. The bgs dropped again. More Lucozade and Glucostop, but they kept dropping. At 4.2 we decided to pop over to A&E. By the time I got there, I was shaking and very weak, and was taken straight through and given some toast and jam. It was about another 20 minutes before my bgs were checked, and of course they had started to rise. I started to feel a bit daft, but I am prone to panic when my bgs drop.

I had various bloodtests done and a chest Xray to try to find out what had caused it, and the conclusion was that I had recently had an undetected chest infection. (But I thought infection raised the blood sugar?) I was given antibiotics and sent home after 4 hours. By now my Bgs were 18. The gastroparesis then kicked in and I had my usual vomiting for the rest of the day.

In May I had another early morning episode, but I am now shaken up and expecting it to happen any day at any time. I keep thinking that if my bgs had started off at 4 and had dropped and the glucose hadn't worked I would have gone unconcious. I have never gone unconcious before and this is a really scary thing for me. I am therefore checking bgs, then eating and waiting to check the bgs are rising before I take my bolus. By the time it kicks in, the bgs are far too high into the mid-teens but at least I am nowhere near a hypo.

I now take a Domperidone every morning, and I have been given a prescription for Erythromycin which also encourages stomach activity but I haven't taken them yet. The thing is that between episodes my stomach works absolutely fine and it is only now and again that it doesn't. So I don't want to be taking a long term antibiotic if I don't have to.

I am currently running blood sugars of 10-14 all the time, which I KNOW isn't a good idea. Ggggrrrrrrrrrrrrrrrrrrrrrrr!!!!