Tag Archives: Diabetes

Random Thursday Night Thoughts

For seven eight months now, I have been battling this infection in my foot.  It has gone from a part of my foot into my ankle, my skin (cellulitis) , and now my bone marrow.  They have been pumping me full of antibiotics and then to keep from developing colitis, they give me probiotics.  If you have ever had probiotics to go with your antibiotics, your quality of life goes way down.  They are just there to minimize the worst of the what the antibiotics are going to do to you.  Even my pharmacist would get freaked out at what I was being prescribed.  The antibiotics make some progress but at the end of the day, the infection comes back worse when they are done.

It came back yesterday and I was stuck with the worst fever and chills cycle that I have ever experienced.  Then today I topped that fever and chills cycle.  My whole body aches from it.  That was my last two days.  I spend hours trying to get warm and then the fever goes the other ways and I have a hissy fit trying to get the covers off of me and so I can cool down. (no one throws a hissy fit like me when I am burning up and I have seven blankets on me)

As a diabetic, this is not a lot of fun because it plays havoc with my blood sugar levels.  Twice in 2015 my blood sugar has gone so high that I have acne on my hands as the body is trying to figure out what to do (yeah, that was gross).  As one doctor said when he looked at my blood sugar numbers, “oh fuck”.   It’s so far down on the list of things they need to fix that they haven’t really made any progress in dealing with it.  Of course it means that a combination of fighting this infection and the high blood sugar levels means that I am exhausted all of the time.

Of course part of the treatment is with CPAS.  If one department needed to reorganized and changed as part of lean, it is them.  Wendy goes to every appointment with me because she helps me with this wound on my foot. This should be straight forward but it never is.  Several times I have been given appointments for things that don’t happen on that day or even that facility.  Other times they call me and say, “You had an appointment”. Wendy and I are saying, “umm, no one said anything to us about this.”  Then we get lectured because we show up for appointments written on an appointment card (and confirmed) but don’t show up for appointments no one tells us about.

Then when I am there, I get lectured by nurses because I haven’t had this test done or an appointment yet with a specialist.  You know I tried to walk in and ask for a MRI myself and that didn’t go so well… I don’t even know what to say (which as we all know, is rare for me).  I’m the one caught in the cracks of a slow system, you don’t think I want this resolved?

I wish I could say it wasn’t painful but it is.  The dog licked my leg this morning (creepy, I know) and I thought I would going to pass out.  The one saving grace from all of this is that it is summer and I can wear short pants (also trying to get a job at the PMO).  I have had jeans on lately and the pain was horrible.  It’s not like I don’t have a high tolerance for pain.  I have had neuropathy for years and cope with it without pain killers but this is something else.

I wish I could say that I have faith in our Medicare system but I don’t.  8 months.  Of course my mother lost her leg in a very similar way.  It just took a couple of years.   The weird thing is that this just seems normal here and from my personal experience and family history it is.

So this was unexpected

If you remember, last winter I got really sick with a chest infection and flu.  I couldn’t sleep, I couldn’t eat, I couldn’t do anything.  Even writing my weekly column or appearing on The Saskatoon Afternoon Show was exhausting.    Shortly before this, my doctor just quit his practice and disappeared without anyone from his practice telling me. I was left without a family doctor (he wasn’t that great) so I went into a walk in clinic and saw someone who prescribed me some serious medication (that would come back and haunt me later).  On the same day I went into the doctor, I noticed my foot was badly infected.  The doctor assured me that the anti-biotic that she was giving me for my chest would kill that as well and as far as I realized, it had.

I eventually got better in early January but in late January I was out and slipped on some ice and really hurt the ankle.  It swelled up and has bothered me for months.  I have badly sprained things before and never thought that much about it.  A doctor looked at it and thought it was tendonitis which seemed to make sense to me. 

The swelling continued and got worse for weeks.  It would go down at night and return in the morning.  During that time I was having some of the worst fevers and chills that I have ever had.  I would get some cold that I would violently shake for hours at night and then get so hot as I would be burning up.  My night table still has gloves and toque in it when I would be trying to get warm.  Wendy thought it was something more serious but I just shrugged it off as a flu.

It wasn’t.  I woke up one morning to large ulcer on the bottom of my foot one morning. It was almost an inch deep.  I had no idea how long it was there but there was a trail of blood that followed me from the bed to the tub.  Long time readers of the blog know that I suffer from neuropathy quite badly.  When your feet always hurt, you tend to ignore the pain to cope.  Excruciating pain in my feet is the norm, not the exception but I knew right away I was in deep trouble.

My mother lost her right left to an ulcer just like this.  It took years but the ulcer won.  Here I was without a family doctor, type II diabetic, and freaking inch deep bleeding ulcer on my foot. 

So I went back to the walk in clinic.  I got lectured by the doctor over not having a family doctor.  I snapped back for him to recommend me one because the web thinks that many of them are quacks.  He looked at the list and said, “I wouldn’t recommend any of these to you.”  I know, I had been phoning and searching for months.  It’s hard to find a good doctor.  I have horror stories of being the only one in a waiting room but still being left for an hour.   Another one couldn’t remember basic things about me despite reading my chart in front of me.

The walk in clinic doctor referred me to the wound clinic at City Hospital.  I would start to go down there regularly were they would dress my would and tell me to come back in a couple of days.  I would be back with a different dressing.  Since I shower every day of my life and the dressing needs to be dry, I kind of would dress it again myself.  For all of the areas in my life where I am incompetent, this is the one thing I do quite well. 

Since then, they have done some circulation tests and a lot of treatments on the wound.  It is slowly healing but the foot was still infected.

During this I finally found a good family doctor.  The web likes him.  The nurses that I see almost all of the time all approve of him and he has updated magazines in his examination rooms.  He has put me one some extremely powerful antibiotics.  They were so powerful the pharmacist that we go and see was uncomfortable with them.  The good news is that they seem to be working.  I can see my ankle and foot tonight.  This is a big deal.

The bad news is that they make me really sick.  I am taking pro-biotics to counter the negative effects of the anti-biotics but the reality is that the rest of my body is hating these things as much as the infection in my foot is.  Another 12 days of this round of anti-biotics and then the hope is the diminished swelling the lack of infection in my foot will lead to some healing.

And some sleeping in.  I am back at City Hospital early tomorrow morning.  Hopefully things keep healing.  It has almost been six months of this and I am getting tired of it.

Neuragen and Neuropathy

Every time I write about neuropathy and Neuragen here, I get a lot of emails about the substance and if it works.  Here is my attempt to explain it.

  • It costs around $45 from Shopper’s Drug Mart.  It isn’t covered by any drug plan but I find it to be worth it.  I keep several bottles around (cabin, two in the house, and one in my car) and they last around a year.
  • You don’t drink it, you just put a drop or two on the nerve that is in pain, rub it around and it works in about 5 seconds.  You seriously go from I’M IN EXCRUCIATING PAIN AND I WANT TO DIE to, I feel like getting a cookie in about 5 seconds.
  • It smells medicinal.  My great aunt lived in a senior’s home in Regina and the entire place smelled like ointment.  I’d fit right in.  It’s not a gross smell but distinctive.
  • You can get it in a spray bottle but I don’t find it works as a spray.  Several others have told me the same thing as well.  The concentrated drops work way better.
  • It isn’t addictive.
  • You can clean it off once you have applied it.  It works as soon as it has been absorbed.
  • Neuragen don’t work with all people.  Lot’s of people have gotten angry at me when it doesn’t work but often they want it to do something for a pain that it isn’t designed for. 

I also use Alpha Lipolic Acid.

I take the pills every morning and night.  They too can be bought at a grocery store (although not the Safeway closest to my house) and are pretty cheap.  They are an anti-toxicant and work to control neuropathic pain.  Outside of the fact that they are kind of gross when caught in the throat, they work well.  

While getting my eyes checked this summer, my eye doctor and I started talking diabetes and he got me on to cinnamon pills which regulate blood glucose levels.  Sadly cinnamon buns don’t work the same way.  The secret to taking these pills is to tell yourself that it is a cinnamon bun and you are living the high life.

I get asked where I hear about these things but most pharmacies have free magazines on diabetes which is a good way to keep up to date on things to ask your doctor about.  He or she has hundreds of patients while I am responsible for my health.  I don’t want to have to rely on him or her to take care of me.  Some ideas they have encouraged, other ideas they have questioned but I am surprised at how many diabetics I know who just suffer from the diabetes without trying anything else.

It’s raining in my office

For the last several months, it’s been raining everywhere I went.  I have looked for leaks in my house, my office, at the mall, at friends places, and on sunny clear days.  No matter where I go, it feels like it is raining on my face, hands, and arms.

The most obvious explanation is that I am one of the Gruesome’s, Fred and Wilma’s neighbours from the Flintstones who had that cloud that went everywhere they went.   Sadly it isn’t that easy but it’s a side effect of my diabetes.  I have a rare nerve disease which means that thousands of my nerves are constantly misfiring.  As explained to me, the rain drops falling on my body is how my brain processes what is happening to me and it happens in hundreds of places all at the same time.

While that is the good news, the bad news is that there are 20 to 30 places that are in excruciating pain at the same time.  They are misfiring really badly and have for years.  Looking back at life, my mom suffered from sciatic nerve pain but I really wonder if she was struggling with this.  They have tried to treat it with Gabapentin which coats your brain receptors and therefore softens the blow of the pain.  That is a great idea in theory but in reality it gave me really bad phantom feelings and therefore pain that didn’t really exist.  That and I couldn’t walk that well with my phantom feet and I had trouble picking up my car keys with my phantom fingers.   The only way to describe walking was that my feet felt like they grew several sizes and the rocker of my skate was off.  I could walk but it wasn’t natural.

Another solution was Oxycontin which is a rather addictive opiate based pain killer.  Of course they never told me that when they gave it to me.   I tried that and I wish I could say I enjoyed it but it left my constipated and emotional and for that know me, know that I hate emotions, especially my own.  A non-stop upset stomach didn’t help me.  If there was pain relief or a high, I didn’t get it.  That being said I have a freakish non-response to some muscle relaxants so maybe I was just resistant to everything but the side effects.

I was on Gabapentin and Oxycontin at the same time and I remember laying on my couch in terrible pain trying to decide if I was going to kill myself or not when I just decided to toss the pills and face the pain.  My doctor was shocked I had no problem quitting the drug.  Maybe I did but without emotions or constipation to bug me, it was like I was on drugs.  To be honest it made very little difference in the amount of pain I was in but I wasn’t as foggy which I took as a win.

Also the process of accepting that it was never going to get better was a big step for me.  It let me accept and process the pain rather than try to escape it.  I am told that I have a high pain tolerance but you can start to learn to live with it.

Since I have been diagnosed with neuropathy, I have been shot full of electrodes to see how my nerves are doing and the truth is; not that good.   I remember the first time after I was diagnosed that they tried my reflexes in my knees.  Nothing happened.  I felt it but my leg didn’t respond.  As they tried it again and again, I realized that this was not a good thing.  My legs are particularly unresponsive while my hands are deteriorating as well.  The result has been that I drop more things but I am starting to fall more often.

My balance started to go while I was at The Salvation Army.  I fell off my front porch one summer morning and broke my ankle.  I fell once while walking in the hall and several times stumbled into a wall.  This winter I fell twice on ice while downtown; both times in front of prominent developers locations who should have shovelled but in the end, I gave myself two serious concussions.  Well maybe the concrete had a roll in all of that but still…

Some on council have bugged me for my strong stance on snow removal after they voted it down.  I’d like them to try to walk through Mayfair or Nutana with my balance.  Even 20th Street, downtown, or Broadway can all be bad.  Walkable streets and neighbourhoods need to be that way for all of us.  

I fall at home now.  Generally getting up but often while walking around the house.  Walking has become a very deliberate and intentional act for me.  It’s weird to lose something like that and to be honest really scary.  I am not going to pretend it hasn’t been related to a bad bout of depression that I have struggled with this winter.  Well either that or the concussions but who knows?  Ether way I am taking the steps of handles in the showers.  My face hit my toilet bowl at a high velocity this winter.  Neither were impressed with that.

According to tests, it’s getting worse which means two things.  I have a closing window on a life of mobility and at least I am not going crazy.

I am not giving up.  There isn’t really anything I can do to stop or reverse what is happening but I can work out more and take some steps to make things better. I started to wear those geeky Vibram FiveFinger Shoes to slow the muscle atrophy in my feet and am working my core more at the gym and at home to help with balance issues.  The falling hasn’t helped my shoulder heal at all but it is coming along as long as I can stay upright.  Physiotherapy is helping a bit as well.

Of course another thing that Wendy and I struggle with is should I quit my job and go take a high paying job while I can or keep working with the homeless.  Working with the homeless doesn’t pay well and I don’t have any benefits at work which complicates the decision.  If I go, I feel like I am giving up but if I stay, it’s a gamble that can hurt the family in the long run.  

I get asked what the pain is like.  It either feels like I am being burned badly (which actually generated blisters), an extended shot of electricity, or a slow drill moving through your body.  It can be treated quite effectively by a naturopathic medicine called Neuragen.  A drop or two can stop the pain completely at that point but in times like right now, there isn’t enough Neuragen to stop all of the pain.  Being woken up 25 times a night by nerve pain take a lot out of you as well.

Before I discovered Neuragen and when they were giving me Gabepentin and Oxycontin all of the time, the pain was incredible.  The doctors would tell me that by next week the medicine would work and I would be fine.  At the time the only thing that would work is that I could grab my iPod and go for long walks in the neighbourhood.  I remember a couple of the local cops would stop me from time to time to see why I was always walking.  Later on they would see how I was going but I always hated to stop because if I could keep walking, the pain would go away and I could actually walk home and maybe fall asleep before the pain came back.  It was the worst time of my life and many nights I remember going out for the walk and thinking, “I should just end this tonight”.  I was never serious and while I will always disagree with those that choose death to end suffering, I understand it.

Now the pain is as bad or worse but I cope with it.  I know it’s never going away and never going to get better.  It is always going to be there, the question is how bad it today going to be?  The good news is that once I gave up all hope of getting better, it just became another thing and it could be dealt with like all other things.

What has changed for me is that the neuropathy has kicked it up a notch and now I need to deal with the lack of balance by figuring this out.

The good news is that this isn’t a terminal condition (although I am about 30 minutes closer to dying than I was at the start of this post) but a chronic condition.  It is just a chronic condition that is progressing at a rate I am rather unhappy with. Now if I could only find out where that water is coming from…

Vibram Five Fingers

I have written about my type 2 diabetes before here and one of the more troubling aspects of it is what it has done to my feet.  Both my feet have suffered a lot of nerve damage and while the pain is under control by walking, taking alpha lipolic acid and using Neurogen.  Despite using both of those, I can’t walk barefoot on asphalt (the pain is overwhelming) or on sand.  At the lake I have on a pair of water shoes that makes it possible to go into the water and they work fine.

I had been thinking of getting a pair of Vibram FiveFingers shoes for a couple of years but they look dorkish and I didn’t think I would wear them.  Over the last couple of weeks I have been talking to a bunch of diabetic doctors who all swear by them, especially because they prevent some of the atrophy of the feet that come from the nerve damage that we experience.  

I finally decided to try some.  Sport Chek has both the Vibram Five Fingers and the Adidas Adipure.  I decided on a pair of black Vibram Fivefingers KSO (KSO stands for Keeping Stuff Out)

Vibram FiveFingers KSO

So far I don’t know if I like them which from what I have been told is kind of normal at first moving from a regular running or hiking shoe but we will see how it goes.  Michael Hyatt posted this review of his in 2009.  As he says,

Twenty-five percent of all your bones are in your feet. Your feet are a marvel of biological engineering. They are designed to adjust your stride, distribute your weight, and minimize the impact on your joints—on the fly. Unfortunately, when you encase them in modern running shoes, your feet lose contact with the ground. They don’t adjust. They aren’t free to do what they were made to do.

While I have read that your feet take some time to adjust to the shoes and initially feel quite tired, my feet have loved the shoes and have felt quite comfortable in them.  We will see how this goes throughout the summer and see if I get back any of the balance I have lost over the next several months.

4 minutes

Yesterday I went to see my doctor.  As most of you know, I am a Type II diabetic and I haven’t been feeling great lately despite taking alpha lipolic acid (for the pain) on the side.  I asked if it I should double my intake of glyburide and the response was, “sure” and he wrote me a prescription.

While I was there, I decided to ask him about a swollen gland I had that was probably connected to my ear ache and sore throat.  He looked at me for a second and said, “everything’s fine” and was done.

Well my gland was still swollen, my throat is extremely sore, I still had a fever, and I think he just doubled my medication without even ordering any blood work.  I was in and out in four minutes and for that, the Saskatchewan Government is going to get a really big bill.

I was off work today (oddly enough, sore throat, swollen gland, ear ache and high fever are still all there) but I did take some time to call around and set up an interview with a prospective doctor.  Let’s hope this time I can find one that does more than write out prescriptions for anything I want.

Update: I was just reading up on gyburide.  Apparently when taken with metformin (which myself and every Type II diabetic I know takes together), our mortality rates go way up.

Type 1

My mother was a Type 1 diabetic.  She injected insulin into her leg every day that I knew her.  When I found out that I was diabetic, I was concerned but relieved that I was Type 2.  I gave up Coke and Pepsi, I gave up sweets (Nutra Sweet is terrible tasking), and even gave up a lot of carbs.  If it tasted good, I stopped eating it.  For the longest time, four metphormin, two glyboride, and some alpha lipolic acid tablets kept the blood sugar down, the neuropathy in check and life rolling along.

Yogi BearAfter the H1N1, I found it impossible to wake up in the morning, would come home from work and take a nap.  Last week my hands started to tingle, my neuropathy came back, and my blood sugar started to climb and climb and climb.  I may not be smarter than the average bear but I am smart enough to know that something was wrong.  That wrong was the transition from Type 2 diabetes to Type 1 diabetes. 

The doctor doesn’t know how long this will last or if it is a permanent thing.  Shooting my leg with insulin every day isn’t my idea of fun but it probably wasn’t Bobby Clarke’s idea of fun either.  Along with the insulin come a new work out routine and a battery of other tests.  I don’t mind the tests but many a lab tech has failed in getting my blood so it is never simple or quick getting blood work done.  The phrase, “I hope that is enough” gets used almost every time.

It’s frustrating although it will be nice for the feeling to return to my hands.