Saturday, January 27, 2007

Pancreas Sandwich

I have a history of Diabetes in my family. My dad has type two, his sister had type one (she was diagnosed when she was 11), and my husband's father also has type 2.

On December 25th, my dad, who is 70 was hospitalized for renal failure (kidney failure). We were told he had less than 24 hours to live. While my youngest sister flew out from Maine, my other sister and I juggled hospital visits, finding a place for our dad's dog, looking for missing keys and phones, and keeping our wits about us.

My dad has had type 2 diabetes for 25 years. He has a rare condition called Charcots foot which is a complication of diabetic neropathy, has heart disease (and has had several heart attacks), and he has an HMO.

He was treated sucessfully while he was hospitalized with a "slurry" which meant he didn't have to have dialasis. That was good news. The frustrating news, however was that his A1C was 14 and we couldn't get his blood sugars in the target.

It is now the end of January. We are still trying to manage this. He hit a 170 once, that was encouraging, but still has numbers in the high 2-300s. He has no stamina and therefor cannot exercise. He has told me that he gets winded just walking to his mail box.

I have been taking him to doctors appointments, running errands, and doing a bit of stuff around his house. I urged his physician's assistant (whom he sees regulary) to get him a case worker who could help me navigate what help was available for him and get more help in place as I plan to return to a contract job in 3 weeks. One of the hope I had was to get him on a meal plan that works with his insulin dose, as a nutritionist did with my daughter when she was diagnosed.

This seemed like a reasonable request, however, I recieved a call last night at 7:30 PM from the PA reprimanding me for asking for an appointment to see a nutritionist.

"Your father has seen the nutritionist many times over the years, what are your expecting to accomplish from this appointment?"

(Is this professional? Do doctor's assistants call their patients children after hours on Friday nights to yell at them?)

"Well, I was hoping to work out a carb count to get his meals working with his insulin doses and get his numbers in the target," I answered.

"Type two is not type one," she patronised, know ing I care for a type 1 child. "He knows all this stuff and can take care of himself."


This advice from a PA who didn't think to give my dad an insulin pen until I asked (his hands shake so much he couldn't hold a syringe) and who missed the fact that my dad's kidney's were failing several days before he was hospitalized and sent him home with a diagnosis of a fast heart rate...

Will someone please explain to me the best way to get my dad's blood sugars in the target without exercise and shed some light on this for me?

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