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Dr too slow? Go to the hospital?
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PoolQ Offline

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Post: #21
RE: Dr too slow? Go to the hospital?
(03-18-2016 08:12 AM)49er Wrote:  
(03-17-2016 03:14 PM)dd777 Wrote:  
(03-17-2016 01:41 PM)49er Wrote:  dd777,

Your husband might want to purchase a glucometer and start measuring his blood sugar in response to the foods he eats. That is how I knew I had a problem in spite of doctors not being concerned even though I recently joined the pre diabetic club.

By doing this, he'll learn what foods cause big time spikes vs. the ones that don't. For example, oatmeal, which is thought of as a diabetic friendly food by some in the medical profession caused me to have a 78 point spike which is not good. Fats and a moderate amount of protein do not.

I would also google the diabetes daily forum as I have found those folks very friendly and helpful.

Best of luck.

49er

Thank you for your suggestion! His dr finally prescribed one today and he is supposed to pick it up tomorrow. drs have seen blood sugar issues for at least 5 or 6 years so i don't understand why it took so long. I've been pushing him to get one for soo long but he doesnt always listen to me! i even got him one from my mom and then he said the strips were too expensive. i am insisting now that he picks it up and i WILL be the nagging wife if i have to!!! (booooo)

Good to hear.

If you google Misdiagnosis By Design, "The Story Behind the ADA Diagnostic Criteria", that will provide an excellent explanation. One thing the article did mention is many of the signs that people show that point to diabetes can easily be blamed on something else. By the time, someone gets a diabetes diagnosis, alot more damage has occurred.

PoolQ, on the phlaunt website, there is research showing that any blood sugars above 140 after 1 hour can eventually be damaging. On lowcarb RN's website and according to other folks, blood sugars for diabetics shouldn't go above 110/120 after a meal. Obviously, each person has to decide for themselves what makes sense in their own situation.

49er

49er, yep that is why I said after the largest meal it should not go above 160 absolutely worse case. Not that I let it go that high, as it takes me way too long to get it back down with diet alone. As for low carb, I can't even follow their guidelines and keep my glucose under control.
03-18-2016 11:28 AM
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holden4th Online

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Post: #22
RE: Dr too slow? Go to the hospital?
The problem with EKGs is that they don't pick up all the problems. I had a serious heart issue for years. Once I even went to the emergency clinic who took an EKG which said that there were no issues, despite a history of chest pain, etc. What masked any symptoms was my general level of fitness. Other things will also mask issues

A change of GP got me quickly into a radiologist who did a myocardial perfusion. This specialised x-ray showed that I had three badly blocked arteries, 99% in one and 95% in another. The triple bypass took place less than 48 hours later and if I hadn't had that procedure then I would have been dead within a maximum of three months. The minimum is too frightening to think about.

I suspect that you need to speed up the process and here's how I would go about it.

Report to the emergency department of your hospital complaining of chest pain, sweating, nausea and fatigue. (Your partner may have this already). This will jump him to the head of the queue and he will be quickly hooked up to a variey of monitors, including oxygen saturation, EKG, etc. This should now give doctors a chance to look at data from differing monitors allowing them to build a picture of what might be happening. If it's serious enough then procedures such as a myocardial perfusion, echocardiogram, angiogram will be put into motion.

Good luck.
(This post was last modified: 03-18-2016 06:28 PM by holden4th.)
03-18-2016 06:26 PM
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OMyMyOHellYes Offline

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Post: #23
RE: Dr too slow? Go to the hospital?
(03-18-2016 06:26 PM)holden4th Wrote:  I suspect that you need to speed up the process and here's how I would go about it.

Report to the emergency department of your hospital complaining of chest pain, sweating, nausea and fatigue. (Your partner may have this already). This will jump him to the head of the queue and he will be quickly hooked up to a variey of monitors, including oxygen saturation, EKG, etc. This should now give doctors a chance to look at data from differing monitors allowing them to build a picture of what might be happening. If it's serious enough then procedures such as a myocardial perfusion, echocardiogram, angiogram will be put into motion.

Good luck.

Did I read that to say go in to the ER complaining of symptoms he doesn't really have just to get bumped to the front of the line and force a bunch of monitoring and testing?

OMMOHY
03-19-2016 05:30 AM
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Homerec130 Offline

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Post: #24
RE: Dr too slow? Go to the hospital?
In the hospitals around me, all that would get him is early triage and then back to the waiting room.

Homer
03-19-2016 12:06 PM
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dd777 Offline

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Post: #25
RE: Dr too slow? Go to the hospital?
I think holden4th was (correctly) assuming that my husband is already experiencing these symptoms.


-------


I think all it took was for me to start talking openly (even just on this forum) for things to finally really start going into motion - which they suddenly have. Dr put him on Oxygen treatment starting last night. They have found several heart-related issues:

- Bradycardia (heartbeat is too slow) during the day
- As soon as he falls asleep his oxygen saturation level drops to extreme lows -- and his heart rate skyrockets / Tachycardia (beats too fast)
- In addition to beating too slow (during the day) or too fast (at night), there are some irregularities / arrhythmias that showed on the Electrocardiogram that are named "Long QT" and "Torsades". I believe these are from having improperly treated Rheumatic Fever when he was a child (but we will find out soon hopefully if that is true or not). When he was getting his EKG they told him that Rheumatic Fever at the specific age range he had it, can lead to these specific heart problems and often seem to suddenly get worse right around the age he is at now (mid to late 40s) and causes a rapid deterioration.
- Glucose monitor shows blood sugar is going back and forth between too high and too low. Dr wants to monitor this for a bit and then decide how to follow-up.

He got an Echocardiogram, waiting for results.
In-clinic sleep study consultation is scheduled.

So, we know there are heart problems and they have names. For many, that would be considered "bad news" - but for us, that is a HUGE step forward as it's taken 20 years to get much more than "it's in your head" or "hmmmm that's odd". Hopefully the oxygen will help. Otherwise we are currently back to waiting. Hopefully we won't be waiting for more than a week to hear the results of the Echocardiogram and speak to a Cardiologist.
03-19-2016 06:31 PM
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holden4th Online

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Post: #26
RE: Dr too slow? Go to the hospital?
(03-19-2016 05:30 AM)OMyMyOHellYes Wrote:  
(03-18-2016 06:26 PM)holden4th Wrote:  I suspect that you need to speed up the process and here's how I would go about it.

Report to the emergency department of your hospital complaining of chest pain, sweating, nausea and fatigue. (Your partner may have this already). This will jump him to the head of the queue and he will be quickly hooked up to a variey of monitors, including oxygen saturation, EKG, etc. This should now give doctors a chance to look at data from differing monitors allowing them to build a picture of what might be happening. If it's serious enough then procedures such as a myocardial perfusion, echocardiogram, angiogram will be put into motion.

Good luck.


Did I read that to say go in to the ER complaining of symptoms he doesn't really have just to get bumped to the front of the line and force a bunch of monitoring and testing?

OMMOHY

These are symptoms that he does have! Any one of those with his history needs to looked at very quickly. How many people that we know have taken the slow route and died before being treated. It's not like he's a hypochondriac, he has a condition that needs to be looked at. The next time he has any of those he should present himself to emergency care. This is nothing to do with jumping the queue. From what I've read he should be close to the front of it!
03-20-2016 03:28 AM
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49er Online

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Post: #27
RE: Dr too slow? Go to the hospital?
(03-19-2016 06:31 PM)dd777 Wrote:  - Glucose monitor shows blood sugar is going back and forth between too high and too low. Dr wants to monitor this for a bit and then decide how to follow-up.

Can you please clarify? Has he been taking his fasting blood sugar in the morning when he gets up and then an hour, two hours after meals? Can you provide examples of numbers you are getting?

It is good the doctor wants to monitor what is going on but your husband can take control now by noticing what foods are causing spikes and eliminating those. And by the way, so called health foods can do this as I found out when plain oatmeal spiked my blood sugar 78 points.

You also might want to google ketogenic (high fat, low carb) diet as many diabetics have found by going on this diet, it greatly improved their situation. Some (not all) were able to completely go off of medication.

However, please check with his doctor to make sure their wouldn't be any contraindications to trying this.

Best of luck.

49er
03-20-2016 04:01 AM
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dd777 Offline

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Post: #28
RE: Dr too slow? Go to the hospital?
(03-20-2016 04:01 AM)49er Wrote:  
(03-19-2016 06:31 PM)dd777 Wrote:  - Glucose monitor shows blood sugar is going back and forth between too high and too low. Dr wants to monitor this for a bit and then decide how to follow-up.

Can you please clarify? Has he been taking his fasting blood sugar in the morning when he gets up and then an hour, two hours after meals? Can you provide examples of numbers you are getting?

It is good the doctor wants to monitor what is going on but your husband can take control now by noticing what foods are causing spikes and eliminating those. And by the way, so called health foods can do this as I found out when plain oatmeal spiked my blood sugar 78 points.

You also might want to google ketogenic (high fat, low carb) diet as many diabetics have found by going on this diet, it greatly improved their situation. Some (not all) were able to completely go off of medication.

However, please check with his doctor to make sure their wouldn't be any contraindications to trying this.

Best of luck.

49er

BLOOD SUGAR
So the dr recently finally officially diagnosed him as diabetic, with both Hyperglycemia and Hypoglycemia which he says "is more rare, but does happen" ... i say finally because various drs have been mentioning blood sugar issues for years (about 5 years now?) without diagnosing him and seem confused about his data. His last dr was positive he was Type 1.5 LADA - but ran further tests that were required for the paperwork and got confused and said she was stumped. I think it had to do with not having some antibody markers or something like that he would need to have to confirm the diagnosis.

Based on the 4hr Glucose Tolerance Test he took recently, his new Dr says his blood sugar in the morning when he wakes up and before eating is too high (120) - then later on it drops too low (73).

After eating anything larger than a tiny snack, he tends to "crash" - basically he feels ill and falls asleep against his will. we try to keep him awake and cannot. as he is falling asleep i try to talk to him to see how responsive he is and i will lift his arm and it falls without any resistance. his speech is slurred and he seems drunk. sometimes he starts jerking around in his "sleep" and that wakes him up. then oddly enough he suddenly seems normal again.

However, the last 2 days (since we got the glucose monitor) the numbers i am seeing don't seem super alarming to me - but i am NEW to all of this.

Glucose numbers from yesterday:

- 109 / 5:38a upon waking

- 100 / 9:42a 1.5hrs after toast & small cup of coffee (cream & sugar)

- 71 / 3:22p 1hr after a short bike ride to go get lunch (shared a hamburger, fries, side salad, coffee w/cream & sugar - normally he limits himself to 1 cup of coffee so this was unusual) - upon getting home started to CRASH.

- 88 / 4:32p 2hrs after lunch - CRASH (not too bad though in comparison to other days - i think the extra dose of coffee/sugar and the exercise actually might have helped keep him from crashing harder than he would have???)

- 118 / 8:37p 1hr after dinner (shrimp & mixed wild, brown rice & water) - another CRASH



Glucose numbers from Friday:

- 128 / 10p getting into bed (our first reading)


DIET & EXERCISE
Because we know he crashes and has been told he has blood sugar issues and also has a lot of digestive issues, he is fairly careful about what he eats. Mainly, he tries to eat many small bits throughout the day. The hamburger lunch w/extra cup of coffee yesterday was unusual for him. Normally he would make himself something like a shrimp spring roll or just nibble on a variety of stuff at home (salami, cheese, crackers, olives, apples, homemade juice or smoothie with wheatgrass, celery, carrots, oranges, etc). I wonder what the readings would be if he ate a "normal" sized meals or something with more sugar (like a donut).

He has problems with his gallbladder which makes it hard for him to digest fats (especially red meat), and he is highly sensitive to nickel (found in many foods he likes & tends to eat such as seafood, poultry, eggs, carrots, apples and peanut butter) - as well foods he normally should eat more of (like green leafy vegtables), so that complicates things a bit when it comes to how food makes him feel and what he should/shouldnt eat. He meets with a dr mandated nutritionist once a week who recently put him through a pretty intense elimination diet.

I remember one day he came home and told me he had a donut (oops!) and how good it was -- then he made a shrimp and avocado ceviche type salad and afterwards had the worst crash i had seen. ..... it took a lot of effort for me to wake him up and he started convulsing? in his sleep (he started jerking, and then it seemed to catch a type of momentum and then he woke up) -- but then he was totally fine and normal. my mom said if it was any type of seizure he would have been dazed afterwards and would not have been able to remember it? so we don't know what to think about that.

Basically, he is scared of eating and scared of sleeping.

He is in better fitness than I am when it comes to going on walks, leisurly bike rides, etc. But he will suddenly get shortness of breath, dizzy and see "black" for no apparent reason unrelated to exercise - especially getting out of bed at night or in the morning and when he takes his morning shower. he doesnt exercise a TON because he doesnt feel well and is often either trying to make himself eat something "safe", is crashed out after eating, or trying to nap to get some extra sleep -- but he does get up and around every day. he is a stay at home dad and takes care of a 3 yr old so that keeps you movin!! I work at home so much of my "work" hours are not actually spent working! they are spent worrying or trying to get the kiddo out of the house so he can get some rest and some quiet time.


SYPTOMS (a few of them)
At night he has horrible sweating. Like BUCKETS of water were dumped on the bed. It is not uncommon for us to have to change his clothes and the bedding in the middle of the night.

He has to get up and pee A LOT throughout the night. Sometimes as many as 8 times in one night.

He often complains of pressure and pain in his chest.

Shortness of breath, dizziness, nausea.



BLOOD PRESSURE & HEART RATE
I have been monitoring his blood pressure and heart rate for a few days now and those numbers look much more concerning to me than his blood sugar does.

His systolic number generally looks like it is in ok ranges, but diastolic jumps around from too high (92) to too low (56).

His heart rate numbers during the last couple days have been between 57 and 73. We know from the Oximetry results that upon going to bed his bpm have started out as low as 40. As soon as he falls asleep his heart rate instantly jumps up to a sustained average of 160, with highs of 197.

------------

I'm anxious to get some type of a monitor that he can wear that will track his blood pressure, heart rate and oxygen levels all day and all night. I'm hoping to get a chance to research options for that today.

I keep trying to get him to go to the hospital for his chest discomfort, night sweats, dizziness and shortness of breath -- but he won't go. just says he's getting closer to maybe going soon. so frustrating.
03-20-2016 02:48 PM
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justMongo Offline

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Post: #29
RE: Dr too slow? Go to the hospital?
Torsades de pointes requires close monitoring of electrolytes such as Magnesium, Calcium, and Potassium.
It also is often found in combination with prolonged QT interval.

In my strictly amateur opinion, no one with a cardiac arrhythmia should ingest caffeine (such as coffee.)

Remember, I offer no medical opinion.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
03-20-2016 03:56 PM
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