Updates

After clinical one day last semester I was deeply touched, rather scared out of my mind by a patient of mine. She had renal failure and was on dialysis. Also she is diabetic, like me. But she was only in her 40's. I talked to her about her diabetes leading up to the kidney failure. Her a1c's were pretty similar, if not lower than mine.

Quick lesson on a1c's for those who don't know. You have red blood cells and you have sugar in your blood. That sugar also sticks to your RBCs. A normal person has a low a1c, usually less than 6. This is because there isn't as much free floating sugar in the blood to stick to the cells because insulin is pushing the sugar into the body's cells to be used for energy (and lower blood sugar). In a diabetic there isn't enough insulin so the sugar floats in the blood and sticks to the RBC's and also shows up as high blood sugar. Diabetics have a1c's over 7, as much as 12 or 13! Diabetics have their a1c's checked every 3 months or so to see how much free sugar is floating around in their blood over the last 3 months. This tells how well the diabetes is controlled.

Ok with that being said I set myself up for an appointment with an endocrinologist. He's pretty well known and has been one of Atlanta's Top Doctors several years. I figured if anyone would crack down on my diabetes it would be him.

So I meet with him and he runs tons of tests. He doesn't see any signs of nerve or eye damage (that diabetics are notorious for). Thank God. Everything else looks pretty good. He has some blood drawn and wants to see me again in a few weeks.

The few weeks go by and I go back to my appointment. Last time he was talking about strict insulin therapy that would leave me feeling so much better, so I was excited. I can't tell you how many times my blood sugar is sky high and I feel like crap. Every once in awhile I barely have enough energy to get up and do things. I test my blood sugar 3 times a day and it's always in the 200-300's. Normal is less than 120. Around 140 or so your kidneys can't handle all the sugar and it spills over into the urine. Your body wants to flush out all the sugar so you start peeing alot and that makes you thirsty and dehydrated. So you drink and drink, you just pee more and more and your sugar just goes higher and higher. Just an ugly situation.

I give him my daily numbers and he's surprised. He reviews my blood test results and says "I'm not making any medication changes because your a1c is good. It's 6.3." WTF? No medication changes?! Dude! Do you see my 200-300's?!

So it didn't make sense. My daily numbers should have produced at least a 7-8 a1c which isn't good. Why do I barely have a 6? He gives me a replacement monitor to start testing with. Maybe my monitor was bad. I should start getting lower numbers with the new monitor.

Well I don't. Same 200-300's. I still feel sick as a dog.

Sometimes if someone is anemic their a1c can be falsely low because there isn't as many RBC's for the sugar to stick to. But I'm not anemic. Ugh. I can't explain it!

So I go in last week to have my blood drawn again. I went to my appointment on Monday. I was anxious to hear my blood test results. He tells me he's concerned because my a1c jumped AN ENTIRE POINT to 7.3. I've NEVER done a jump that dramatic.

Ok, a 1 point jump in 1 month is really bad. It means something happened and my diabetes is starting to get out of control. My BP has already been high and I'm double dosed on a beta blocker called Atenolol. But it's even higher now. So he prescribes another BP med. An ACE inhibitor called Lisinopril. The good thing about this drug is it will bring my BP down but it will also protect my kidneys against the diabetes. But for the diabetes he adds yet ANOTHER drug to my routine. This drug is a sulfonylurea. Try saying that 3 times fast LOL

I now have numerous medication bottles and I actually have to take a Sharpie and write on it which meds are taken in the AM and which are taken in the PM. I have to check my BP every day and my blood sugar at least 3 times a day. And I've got it good. Some people have it way worse.

From what was explained to me, being on the sulfonylurea will also tell us something else. How much is my pancreas working? This drug works before I eat by telling my pancreas I'm about to eat and to start pumping out insulin. If my pancreas isn't working much at all there isn't much this drug can do and I'll be back on the stupid insulin shots. I don't want to go there again.

Another thing that sucks is 4 of my meds cause drowsiness and I take 2 in the AM and 2 in the PM. So if the diabetes doesn't have me tired, the meds are.

So I just wanted to update those who care on the unwelcomed drama in my life LOL!

Take care everyone!!!!

Almost done!

Let's see here... hmmm...

Oh yeah. I'm almost done with nursing this semester! Yay! Today I passed my IV checkoff. The only thing I messed up on was forgetting to close the clamp before I spiked the bag. But I realized I did it before it was too late and verbalized it. So she didn't count that against me. My infusion to give was 1000 ml of D5 1/2NS to be given at 140 ml/hr. My drop factor was 15 so that came out to be an even 35 gtt/min (I like NEVER end up with an even number). When she came over to count it she came out with 36 gtt/min, which is awesome because we had a +/- 4 gtts/min. YAY!

The only checkoff left is Foley Catheters! That'll be a toughie I'm sure. Maybe not. I just can't find any volunteers to let me practice with. Hmm... any volunteers? It's real simple, really. I'll just shove a tube into your bladder and then take it out.

I've passed all my exams and I only have 2 more left (I think) plus the final. I feel pretty good about it, but I don't want to get overconfident. I tend to overstress about things but that keeps me from getting lazy. Sometimes the overstressing is bad though, when I'm overstressing about too much at once it proves detrimental to my health LOL

Oh yeah, speaking of which, I got to talk to my dr about my stinkin blood pressure. I'm on Atenolol and my bp has been spiking alot lately. I'm so terrified of having a stroke or heart attack. My grandmother died of a stroke within a month of finding out she was a diabetic. I was so traumatized. So now here I am a diabetic for what? 6 years? My A1C's are decent (around 7) but my dailies are not. Plus the HBP doesn't help. And I could definitely stand to lose a few. And my dad had like a quadruple bypass earlier this year. Anything he gets physically, I tend to as well. He's diabetic with HPB with the same liver crap that I have. WAAAH! Ok Amy... chill tha hell out. Yer fine!

Ok everyone! I'm off to the land of sedation heaven! Muchos lovos and stuff.