This week I had a follow-up appointment with my diabetes educator nurse. It had been about a month or so since my first appointment, where she got all my medical history and we discussed some basics about type 1 diabetes management.
At this second visit, we mainly talked about diabetes sick days. I haven’t gotten sick since I was diagnosed so this is a topic I was completely clueless about. During our discussion, I learned that it is extremely important to keep tabs on my diabetes when ill as the body puts out more glucose than usual to fight the illness. This means that I may need to make adjustments to my insulin dosages and even if I don’t eat a meal because I’m not hungry, I may still need to take some insulin. This was quite fascinating to me. I had read about illness affecting blood glucose levels, but I didn’t know that it could become quite serious if I just ignored my numbers thinking that maybe I was just a “tad” high and didn’t do anything about it.
Now that I am diabetic, it seems I have to make sure I really take care of myself when sick and not put off going to the doctor as I usually do. When I get a cold, it always seems to be the same kind so I don’t tend to go to the doctor unless it’s been a while and I don’t feel it’s getting better. Besides the usual cold symptoms of runny nose, eyes, headache (and occasionally a fever and/or sore throat) I get an awful whooping cough that almost always ends up evolving into bronchitis. Even when all the other symptoms are gone, it usually takes a whole month for the cough to completely go away. When I was a kid, I would be home sick for an entire week as the cough really becomes a nuisance and takes the life out of me. Once a cough attack begins, I just cannot stop. The cough is so severe that my abdominal muscles gets extremely painful and my lungs feel like they are going to burst at any time from all the stress of coughing. Not a pleasant experience.
In addition to having to go to the doctor now when ill to help my body recover faster, it seems this also means that I really have to just STAY HOME and rest. I usually battle through the initial stages of a cold and don’t take sick days until it gets to the point where it has gotten extremely bad. Or after I do take a few sick days I decide that “I am fine” and go to work anyway, even though I am not completely recovered and am still coughing up a lung. At some point in the past I have been told: “Have you gone to the doctor? You sound like you are approaching the gates of death.”…..Yes, my colds are that bad. I feel my body would probably recover much faster from illness if I just stopped and stayed home resting as soon as the initial symptoms show up. But no, I try to be the warrior and pretend I’m fine, which makes my body take even longer to recover. Now with diabetes though, I don’t want to spend a whole month sick with high blood glucose on top of it as high blood glucose drains my energy completely and makes me feel awful. Therefore, I will make my best effort to get well as soon as possible whenever I get sick (easier said than done though).
The diabetes education sessions have been extremely beneficial for me so far. There is still a lot I don’t know about diabetes and I look forward to my continued education with the diabetes educator nurse. I feel I am now becoming more knowledgeable and better prepared to manage my diabetes with an insulin pump (if I get approved for one). I also have to say, I am now glad that I actually did start insulin treatment as there’s no way I could manage high blood glucose while being sick the way I used to (with excessive exercise). Excessive exercise while sick would probably just make things worse and I am sure I would end up in the hospital in no time. So far, I think I started insulin at the right time.
In addition to discussing sick days, we also discussed potentially changing my endocrinologist. The problem right now is that my health insurance did not approve for me to see the diabetes educator/nutritionist at the clinic my endocrinologist works in. They only approved for diabetes education at one of the bigger clinics I am going to right now to see my diabetes educator and nutritionist. This makes my diabetes care team scattered between two different clinics and it makes it a bit difficult for my care team of endocrinologist and diabetes educator/nutritionist to work together and help me. It would be much easier if I just had an endocrinologist in the same clinic as my diabetes educator/nutritionist are in. It just makes more sense, especially if I end up going on an insulin pump as I know that will probably require more collaboration between my diabetes care team members for education on use of the insulin pump and dosage adjusting. I got the referral from my PCP for a new endo and have an appointment in a couple of weeks. We’ll see how it goes. I hope I get a new endo that I click with and am confident in as it’s always pretty difficult for me to find a doctor that I trust. Stay tuned!