Saturday, April 17, 2010

and a good day today

Finally! A good day! Hubby went to an electronics show and I went shopping. Then we went to a movie and out to dinner - had a salad.

At lunch, he packed everything he needed. At the movie, he took everything. What a change from Wednesday.

He dropped the humulin by 1cc in the am and pm. The lowest he has gone was 80. But he is staying high too much. Not sure what the resolution to that one is. I know being high is not good. But I truly hate the lows.

Today was great. If every day could just be like today......

DW

Thursday, April 15, 2010

help

Help me find my sanity! I'm going to post what happened - then tell me how I can ever find my sanity!!!

Yesterday. I knew it was going to be a busy day. I probably should have done a better job preparing for the day. But by gum...this is HIS disease!!! And he needs to own up to it - if I do everything for him, then he just blames me when it goes wrong.

I knew we had an education class at cardiac therapy at 1:30 pm. I was going to leave a little early and get over to the medical clinics to have a minor laser procedure done to my eyes. He had cardiac physical therapy from 2:45 - 3:45 pm. And his first grandson was supposed to be delivered at 10 am. So we thought we could drive and hour down to the hospital, see him, then be back by 1:30 pm. No problem.

So, we wake up and he is up, showered and ready to go at 8 am. He has his bag on his shoulder and says, "I'm ready when you are!" And I said, "aren't you going to call your son to see if his wif is in labor?" (of course used their names instead of the relationships I just wrote). So he sat down and called and of course, she hadn't even started. She was being induced and for some reason, hubby and his son think that meant she would deliver immediately. I said, "Sweetie, I want to tell you something and you can do with this whatever you want" He said, "what?" I said, "when my youngest son was due, they induced me. They told me he would come pretty fast. It took another 23 hours before I delivered him. Each woman is completely different. She might deliver quickly, but it could take a long time."

He said, "I'll call him and tell him we're not coming." I said, "why are you doing that?" He said, "it's obvious you don't want to go". I said, "That's not what I said at all. But what I don't want to do is to drive down there this morning, have nothing happen, and then have to drive back down there tomorrow!:"

And he went into the office and went to work.

So I should have known that was an indicator of the rest of the day. But a pretty good example of how he will take what I say and comletely twist it into something else.

We left shortly after 1 to head over to education. He had his bag. I didn't ask what was in it. Didn't remind him of this or that. I had my laser procedure done. More swelling than they thought. Doctor said I might wake up in the morning with my eyes swolle shut. They were about half open when I got done. Walked back over to where he was having therapy and he told me the baby had been born while we were in the education meeting. (found out later she gave 6 pushes - he came pretty fast once it started.)

So, of course, he wanted to drive down to see the baby after therapy. My gut told me not to go. But he insisted. And I knew if I drove home, he would take the car and drive himself....and he hasn't been released from surgery to drive yet. So we went. I had to lean my head back to see out of the slits in my eyes. I just drove slow. We got there fine. Cute baby. For a baby. His 6 pm alarm went off and I asked him if he brought his insulin No.

He took his glucose and he was at 52! (Did he not sense this at 70? 60?) He did not have any glucose tabs. He ran out (why did he not ask me to stop and get some on the way to education?) He did not even have smarties in his bag with him. We are an hour from home. He says, "Let's go to PFChangs!" I said, "no". But then I'm thinking - he's so low, he can't take the insulin, go ahead, get him wherever he wants to eat - get something in him...and PFC was next to the hospital. So we went.

Horrible choice for his current nutrition plan.

He should have packed glucose tabs, smarties, and apple, a peanut butter cup.
He should have taken his insulin with him.

But he didn't

And when he's down to 52, he's not about to make a healthy choice about where to eat.

And I knew if I didn't take him to PFChangs - he would simply make me misearable the rest of the evening with his pouting, or his depression, or his sullen quietness. We've been through this a million times.

Of course, I have huge bandages slanted over my upper eyes, am looking through slits to see where I'm going - and exactly what I wanted to do - or felt like doing - was eating out. I left my sunglasses on the whole time. Didn't need other people staring at me.

We made it home and I went straight to bed. Over exhausted at this point and totally not caring what his glucose is doing. But when he tested again he was low. We had stopped at the store on the way home and he got some more glucose tabs...but he had left them downstairs. So I got up and got them for him. Told him he HAS to lower his humulin both morning and evening tomorrow. Sigh. Why do I have to tell him? Because he's not going to do it on his own!!!

I lay down on my side to finally go to sleep. I took 2 benadryl as my eyelids were starting to itch. I feel a tear running across my nose. Get up and of course, it's blood, gushing out from where they did the laser. I take the dressings off, apply pressure for 20 minutes. Still bleeding. Apply pressure for another 20 minutes. No bleeding. By now, the benadryl has more than kicked in. I decide to adjust the bed to a reclining position and I manage to sleep most of the night - sitting up. I assume his glucose went back up - I wouldn't have been able to do anything for him and he wasn't able to be of any help to me.

So yes, I should not have had the laser procedure done while he is still recovering from surgery. But I had waited months to get an appointment. And it really doesn't matter when it was done - he could have still had a low.

We shouldn't have gone to see the baby after I had laser surgery - but he would have pouted and sulked....or worse yet, gotten in the car and driven himself.

We shouldn't have eaten out. I should have checked his bag. But why should I be the one to check his bag. Why can't he take everything he might need in the event plans change?

I should have checked his glucose tab supply. But why is that my job?

I should have checked his bag for insulin and everything else, but again, why is that my job?

And why is is that he can't figure out that he needs a mid-afternoon snack to keep his glucose up?

Why can't the endocrinologist see that he is still going low 1-2 times a day? And substantially lower his insulin? Why don't they put him back on the oher insulin? Why feed him carbs? Why not reduce the humulin or get him off it? Nasty stuff I think! Why aren't they monitoring him more closely?

Now I need to go chart what he ate at PFChangs and show him how he was 3x more sodium than he was supposed to have for the day! But I woke up with eyes swollen and even less of a slit to see out of and decided that today, I'm staying in bed. I can see find from a reclining position to just spend the day on my laptop. At 3 pm, I can take these dressings off and start my own post op care. I'm hoping if I remain quiet today, there won't be another bleeding episode tonight.

So, how do you care for a diabetic when you have to give 100% of your time caring for your own recovery?

How do you get a guy who is completely stupid when he goes low to retrain his thinking to tell himself during that low than rather than eating out, he needs to prepare and have healthy snacks in his bag with him at all times?

How do you get the diabetic to purchase their own glucose tabs BEFORE they run out?

How do you get a break from being a caregiver to someone who has diabetes???

And you know, I know there are no real answers....but I have to ask the questions anyway!

It's like the education session yesterday. 1 week after the session by the pharmiscists:

1. Hospital nutrition told him to use the entire line of Mrs. Dash
2. Pharmiscist said he cannot have any Mrs Dash that has potassium
3. Nutrition education said to use Mrs. Dash - did not even know some had potassium in them. Had 3 tubs of butter and asked us to determine which was the best. I pointed out that all 3 had potassium in them. I asked what he ws supposed to use for "butter". Her answer...."well, that is a problem, isn't it?"

No one has an answer.....


DW

Tuesday, April 13, 2010

Truly tired

I don't know how other spouses take care of their chronically ill husbands. I'm not doing so well. I can't keep up with the house, the yard, cooking, groceries.....and helping him out of his hypos.

I've been doing some research on humulin RU 500. From rxlist.com, they say:

deep secondary hypoglycemic reactions may develop 18 to 24 hours after the original injection of Humulin R (U-500)

patients should be carefully observed

prompt treatment of such reactions should be initiated with glucagon injections and/or with glucose by intravenous injection or gavage.

We don'thave a glucagon pen. He is not being closely monitored at all. He's still going low a couple of times a day. But at least it's not continuous from 2 - 6 pm like it was.

And then from wikipedia.org:

affect of hypoglycemia on the brain:

if the amount of glucose supplied by the blood falls, the brain is one of the first organs affected

subtle reduction of mental efficiency can be observed when the glucose falls below 65 mg/dl

Impairment of action and judgment usually becomes obvious below 40 mg/dl

Prolonged, severe hypoglycemia can produce lasting damage of a wide range

The likelihood of permanent brain damage from any given instance of severe hypoglycemia is difficult to estimate, and depends on a multitude of factors such as age, recent blood and brain glucose experience, concurrent problems such as hypoxia, and availability of alternative fuels.

manifestations

impaired judgment
moodiness
depression
negativism
irritability
belligerence
combativeness
rage
personality change
fatigue
weakness
apathy
lethargy
daydreaming
sleep
confusion
amnesia
dizziness
staring
"glassy" look
blurred vision
auomatic behavior
slurred speech
incoordination
abnormal breathing

Hubby has had all of those since heart surgery during his lows.

continuning on, the same website says:

There is no consistent order to the appearance of the symptoms, if symptoms even occur

Specific manifestations may also vary by age, by severity of the hypoglycemia and the speed of the decline.

It makes perfectly good sense that his physicians should be following him closely. So, define "close". Once a day? Once a week? Inpatient?

He has not heard from his primary care physician in over a week.

He has not heard from the endocrinologist in over 9 days.

The surgery team has only called him one time since surgery.

He is being seen 3 times a week by cardiac physical therapy, but they would have nothing to do with his blood sugar lows.

And tonight, I am way too tired to care. Too tired to talk to him about it (like that might do a bit of good?). Too tired to read anyting else.

Diabetes can cause depression in the diabetic. I've read all the reasons why. I believe that it can also cause depression in the spouse and family members. I'm tired of worrying about him. I'm tired of taking care of him. Tired of eating the way he has to eat. Tired of cooking healthy food. If I see another piece of lettuce today I would simply scream!!! Tired of toting all his stuff up and down the stairs every day. Tired of fastening the seat belt when he gets into the car. Tired of opening doors for him.....

The list is endless.

I keep telling myself we only have one more week to go til the surgeon should release him to do some of this stuff.

I wonder if I will make it one more week.

OK, just ignore me - I'm tired.

DW

Monday, April 12, 2010

Weekend notes

Sister and brother-in-law here. b-i-l got a new laptop and hubby helped him program it. Pretty good weekend all in all. Hubby started back to work today, part time, from home. He was exhausted and hoarse by noon. But sticking with schedules, menus and doing pretty good. One low today after PT, so probably from exercising. Will watch tomorrow. Might be time to reduce the Humulin even more. My sister went home this afternoon. She's been here a week. It has been wonderful. She motivated me to get back to my art which has been so much fun. Time for me to move ahead. Hubby is doing more and more. I still have to drive him everywhere for at least another week. Hope the surgeon will release him next week, but he may not be able to drive due to the narcotics he is on for back pain.

I'm starting to feel a bit more rested. This is an easy week. 3 days of PT, I have o/p surgery to remove tags from my eyelids on Wed - and the grandson is supposed to be delivered that morning. Should be a good week.

DW