- Wow, I have really lost track of time since Oct 9th. 18:41:49
- New blog post: My Daughter Megan Has Diabetes http://bit.ly/1pisc7 18:37:04
Archives for October 2009
My Daughter Megan Has Diabetes
If you have followed what few Tweets and Facebook comments I have posted since October 9th, you will know that my daughter Megan has been diagnosed with diabetes. For those of you that haven’t kept up, let me bring you up to speed.
Megan went to see her doctor on Wednesday October 8th because the doctor would not refill a prescription for her unless she was seen. In hindsight, this was a blessing in disguise. The doctor was concerned that she had lost a lot of weight in a very short time. She had gone from a size 16 to an 8 in less than two months. Blood tests were done to find out what was going on. We didn’t really think a too much of it at the time and Megan drove down here to Alabama on October 9th. While she was driving down, her doctor’s office called her with the test results. Hearing the word “diabetes” sent her into panic mode. She called me in tears, she called her boyfriend in tears, she called her uncle in tears all while trying to drive down here. What she failed to mention to me is that they needed to see her back as soon as possible (that would only make sense). When I asked her about it later, she was just wanting to be able to come visit and thought this would have prevented her from coming down. Since she wanted to visit and her doctor was going on vacation the following week, she got an appointment for October 19th.
While she was driving down, I started revisiting all the symptoms of Prozac. My heart stopped when I saw that one of the “rare” side effects was diabetes. Megan had also been dealing with a laundry list of symptoms related to her being on Prozac.
When she got here, she looked awful. She had lost a lot of weight, she was short of breathe and tired. Shortly after she got here, her doctor’s office called again. They wanted to start her on insulin right away. As soon as Megan heard that she went into a panic attack, so I took the phone. They were wanting to call in a prescription for insulin for her. At that point I went whoa, wait a minute. Call in a prescription? She doesn’t even know how to administer it and top it off with her being terrified of needles so I asked do I need to bring her back to Tennessee? I told the nurse, you get us an appointment and I will have her there.
So we are out the door heading to Tennessee and an 11:30AM appointment with her doctor. We got there at 10:30 and they took us right back. it wasn’t long before we were talking with her doctor and going over her blood test results – her A1C was 13.1% I had to bring myself up to speed to understand what that represented and still have heard different ranges that the test represents, 2-3 months, 3 months, 3-4 months. But it still coincided with her being on Prozac.
Okay, before you jump on me and tell me I’m in denial about all this, I’m not. It is still very possible that Megan was pre-diabetic even before she was put on Prozac. But most of her Prozac symptoms have disappeared since she has now stopped taking it.
So we discuss Megan’s treatment plan, the doctor has requested that Megan come stay with me for up to two weeks. One of the things she gives Megan is a doctor’s excuse to be absent from work (under the Family Medical Leave Act) for two weeks, but she could return earlier if Megan felt she was up to it. In hindsight, I wonder if I too should have taken off under the FMLA. More blood work is done to determine if Megan is type 1 or type 2 diabetes. The doctor seems a bit concerned that it might be type 1 because Megan doesn’t fit the profile for type 2. We had a good discussion about Prozac and it’s symptoms too.
After the blood work, the nurse was going to show us how to use a blood glucose meter along with giving us all the prescriptions. At this point it seemed clear that there were no plans to give Megan an injection of insulin so I asked if she would be receiving one before we left. The nurse had to go ask the doctor. She came back and that she would have to test Megan’s sugar. Okay, that made sense. Megan was 430. She definitely needed her sugar to come down. So now she gets instructions on how to give herself an injection with an insulin “pen” and we go over the sliding scale chart again. Something catches my eye that the nurse can’t answer so we have to wait for the doctor to finish with a patient. We are also told that Megan would need to attend a 1 day diabetes class.
We gather everything up and head to get some lunch with Megan’s boyfriend so we can bring him up to speed on what is going on. Next we head to get the prescriptions filled. The pen needles and the Metformin we very reasonable. I almost fell over when the saw the price of the test strips. How do people afford $1 a test strip?
It’s now 3PM and Megan needs to do her first test. I’m worried because she does not like needles. We get everything figured out, she tests but we’re not quite sure if she’s supposed to do more insulin. So it’s a call to the doctor’s office – yes keep repeating the insulin per the sliding scale. Now Megan gets to give herself her first injection. I had already decided she was going to need to take control of this herself. Fortunately, the insulin pen she is using made it a bit easier for her and she did it.
We still have two more stops before we can head back to Alabama. Megan needs pick up a few things for her extended stay with us, she needs to give the doctor’s note to her work and pick up her paycheck. Finally, we hit the road. We made it back around 8PM.
While I’m driving back I started running things through my head – first the original phone just wanting to call in a prescription of insulin, then if I hadn’t asked about if Megan needed a dose of insulin before leaving, we probably would never have had the hands on demonstration of the meter or how to give the injection. These were truly things that couldn’t wait.
Over the first weekend Megan’s glucose reading bounced all over the place to the high side. She even went over 400 again, twice. The second time she went over 400 (469), I decided it was time to get a bit more aggressive. The doctor’s notes said every 1-2 hours, but I had been letting her go to every 2 hours (trying to give her a break). So we starting testing every hour and adjusting her dosage according to her sliding scale. She also started walking on the treadmill. Her next reading was much better. We also decided to move up the twice a day dosage for the Metformin a bit eariler since she seemed to be tolerating it well.
Then we began taking a much closer look at her diet. We had been winging it, trying to follow what we had found online at diabetes.org. Fortunately, the Diabetes Center from the hospital near her doctor’s office called and I was able to explain how we felt like we had been thrown to the wolves. The dietitian emailed me a meal planner outlining Megan’s total carbs and took time to step me through how to balance everything. It was then I decided we needed to attend the next diabetes class, the sooner we learned what Megan needed to be doing, the better.
The next class was on Thursday October 15 8AM – 3:30PM. Since there was no way we could make it up in time leaving Thursday, we drove up Wednesday afternoon. I’ll share with you all the details of the class in my next post. One of the positive things that came out of it was the nurse teaching the class realized Megan’s insulin dosages were not quite right. She got back with the doctor’s office and Megan was put on a second insulin – a long acting one to be taken at bed time. The dosages for the first insulin were adjusted for meal times and she was also taken off the oral medication Actos (I was really afraid to see how much that would have been).