Saturday, December 15, 2007

How to get past depression

Hubby has been quite depressed this past week. I couldn't figure out if it was meds, the fact that he decided not to go "home" for the holidays, the holidays themselves, or what. So, this morning, I said to him, "get dressed, we are going to go play today!"

I thought for sure he would say no, but he got dressed and grudgingly went along with me. I had to take something back to a department store and while waiting at the checkout counter, he found holiday outfits for our 2 little chihuahuas. And I knew from the look in his eyes....we were on the right path!

We managed to get all of his holiday shopping done today (just in time that I can wrap them and send them out UPS), went to lunch at one of his favorite places and were home by 2 pm. I ran out and picked up a full body massage/heat mat and brought it home for him to lay on. By 6 pm, he decided he wanted to go out to dinner and I agreed. It was a place I have refused to go to for a whole year, but I decided to give in tonight! While there, I asked if he was feeling better and he said that he felt great. He thanked me over and over for making him go out today. And although he hurt like heck, he said it was a great day! He just seems really happy tonight.

So I think he is past his depression, and he has his holiday shopping all done. Yeah! I think he is finally in the holiday spirit and I hope he keeps it for the next couple of weeks!

A little bit of education, fun and maybe money......

I have absolutely, positively no idea what I'm doing, but someone sent me a link to Pay Per Post....and I decided to learn a little bit about writing html and editing that in a post. But why shouldn't all/any of us make a few pennies as we post our journeys here?


Friday, December 14, 2007

Today's nephrology visit

I think I'm exhausted and it was his appointment. His HMO does not have a nephrologist, so this was a referral outside the system. Of course, there is not a whole lot that she can do other than make observations. Sigh.

His A1c is normal. You wouldn't believe the look I got from her when I said that he is having a lot of lows and must be having highs to balance out the A1c. I immediately knew she did not like me, did not want me there, did not want to hear any of this.

And it's such a game with him. She asked if his doctor had talked to him about diet and limiting salt. He said yes and that we use "no salt" or salt substitutes. She said, "good, good". And then I said that yes, they had talked to him about that, but he loves to eat out and that he doesn't really follow any of the recommended diet plans. Again, I got "that look".

They had taken him off allopurinol and colchicine because his creatine levels had gone up. She put him back on 100mg /day of allopurinol and is giving him a 9 day burst of prednisone. I was a bit surprised with this as it works to raise blood sugars. And not once did she mention to him or ask him about daily glucose monitoring. Sigh.

Further, she told him to go back on the colchicine as needed for pain, up to 1 every other day. So, does this mean that his creatine levels will go back up?

He is on Novulin N 66 twice a day and R 30 twice a day. She asked him to cut back his salt and cut back his lasix. His weight is up to 246 pounds. A gain of 25 pounds this year. She did tell him that he is stage 3 CKD, his function is now at 32% and that yes, it can go up after being down....that the creatine levels were probably up due to too many drugs (which she is putting him back on).

She wants to see him every 6 months.

I asked her about a non-invasive glucose monitor/pump like MiniMed Paradigm Real-Time of CGMS system Gold. She said we need to see his endocrinologist for that. He does not have one. He only has a rheumatologist and a primary care physician.

I explained the peeks/valleys that I see with Novolin R& N and asked about Lantus/Novolog or novorapid and again, she said see the primary care or endocrinologist.

I inquired about remedies for depression, foot pain, headaches (suggested a pain management clinic).....and with each one...she said we needed to see the primary care.

So on the way home, I suggest that he make an appointment to see his primary care as soon as he could and to have his labs redone in 2 weeks to see the impact of prednisone and the other drugs on all his levels.

He's gone back to his HMO now to get his RX filled, but I could tell he was a bit depressed. I think it's more because I was there asking questions rather than any answer she was giving us. But I can also see that he is obviously not giving these doctors the full, complete picture.

I did also mention that he cannot exercise due to the pain in his feet, knees, hips and back. Again, she said there wasn't much she could do about it.

I'm wonder if a nephrologist really only comes into play when a patient gets to stage 4? Or perhaps look at the combination of drugs they are currently on? But she really couldn't make a change in the type of insulin he is getting which I found interesting, but probably has more to do with the fact that this was a referral outside his HMO.

I will just continue to make my observations here, keep this as my notes to refer back to, and wait for the next doctor's visit. In the meantime, until he wants to make changes in his diet, I don't see much else that can be done.

Wednesday, December 12, 2007

A Miracle

Well, I am quite happy tonight, yet I cannot act as happy as I am! LOL!

For the past 10 years, every holiday, we have driven 15 hours (30 hours round trip) to visit the in-laws. My hubby has never missed a Christmas with his mother. But yesterday, he called me into his office and said that he did not want to make the drive this year.

I think I am still in shock. And I can't begin to describe the wave of relief that came over me. I have such problems with back pain and I was not looking forward to that drive at all.

We spent an hour discussing it. He rationalized all the reasons for not going. And I did nothing to talk him out of this decision! But it's true. His parents are early 70s and still work. We only see them for 2 hours a day. Except for the days that he goes to work with them and that is no fun for him. We are in the house with his 94 year old grandmother who yells at him all day long, so that's no fun either. His back hurt just from a 4 hour drive on Sunday and because of his incontinence problems...he is just concerned about the long drive.

But he is also depressed today about not going. He is putting off that phone call to his mom telling her that we won't be coming down. It will be quite strange...the first time we have been in our home for Christmas in 10 years. I'm hoping he can take the week and just rest. I'm hoping he will get over his depression quickly.

As a note, he goes to the doctor this Friday and I am going with him. I believe we will be seeing his neuropathy doc. I'm making a long list of questions to ask including

pain management
anti depression meds/treatment
long range plan for foot care

It will be interesting to see what the answers are.


Sunday, December 09, 2007

Understanding adrenaline

Obviously this is in response to a comment that I rejected.


The main cause of diabetes is the western diet--based on refined carbohydrates that rush sugar into the bloodstream, trans fatty acids that interfere with insulin receptors in the cells, and difficult-to-digest foods like pasteurized milk and modern soy foods that put a strain on the pancreas--but another cause of chronic high blood sugar levels, one that is often overlooked, is stress. Under stress, the adrenal glands produce adrenaline, an important stimulus for the production of glucagon, which raises blood sugar levels and allows the body to react with a "fight or flight" response. Chronic stress--the stress on the adult in the workplace, the stress on the student under pressure to perform, the stress on the child expected to conform to rigid guidelines or who has been sexually or emotionally abused, even the stress of a spiritual or religious outlook that assumes a clockwork universe or a vengeful god--results in constant outpourings of adrenaline resulting in overstimulation of glucagon to keep blood sugar levels high. The body then responds with increased production of insulin to bring blood sugar levels down.

So, when hubby is having a low, a good fight with me does the same thing as the stress mentioned above. Sugar is released into his body. There is an increased production of insulin to bring the sugars down. It is nothing but a vicious cycle....but it is his body's way of fighting to bring him from a low to a high to a normal.

A good fight increases sugar, and increases insulin production, gets him from his low to a high and back to a normal.

I think I'd rather he hit his thumb good and hard with a hammer, in time he starts an argument and I realize it's a low...I think I'll just hand him a hammer! LOL!

Life is peaceful for now

Just updating my thoughts here. The surgery was worth the 4 weeks of recovery. Hubby is walking quite nicely now. Pain is gone. He's getting more active and even riding the stationary bike once or twice a week.

He has quit eating bags of sugar....since I'm still on my no dessert kick. No dessert for me of any kind since Mother's diet soda...and almost no red meat. I cannot believe I have managed to stay away from sweets this long. I'm praying I can make it through the holiday season without breaking down!

We have had a few morning lows between the usual 8:30 and 10:30 am where he gets quite testy and we have a few arguments. I have decided to just "fight" back because it brings up his sugar level quicker and he gets back to normal quicker. And I write them all off as just being "normal" in that he is going to have these lows and I know he doesn't really remember what he has said. Our last one was last Monday when I was leaving to go visit my mom for a couple of days. wasn't long before he called an apologized. I just told myself that he didn't really mean the hateful things he said..he's having a low. I wish he understood that, but I'm sure he doesn't and I doubt that he ever will.

And because for the most part, life is quite calm at the moment, I can write those few outbursts off. But I want to blog them to record the progression of this disease.

We spent this weekend at my sister's house and she commented that she just couldn't believe how much he has improved from just a few weeks ago when she didn't think he would be alive by the end of this year.

In a couple of weeks, we are heading south to visit his parents over the holiday. I'm praying for a good trip. He has agreed to break up the drive into 2 days rather than 15 hours straight thru, and to only stay 5 nights rather than the usual 14 nights. So positive changes all the way around.