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A1c continues to improve and endo appointments only twice a year :)

Posted by @retiredteacher, Sun, Aug 26 4:15pm

I have been AWOL from the discussions but some time back–a few months ago or longer, I wrote that I could not be concerned with my diabetes because my husband had an eye stroke and high blood pressure and then skin cancer on his shin. I was so overwhelmed with doctor appointments with him that I didn't have time for diabetes. He had radiation on his shin twice a week (the biopsy was cancerous) and eye injections every four weeks and cardiologist in between all of that for echocardiogram and other basic tests for his heart. He has had quad by pass after a heart attack and after stents four times and then with by pass the aorta had to be replaced and started leaking. Just one thing after another. My last endocrinologist appointment before the dam broke with my husband's problems was really good. No problems. A1C was 5.9 and all profile numbers were in range except my weight. I do not exercise–a problem for me, but at my age (74), I do the cooking and washing and regular household chores, and count that as exercise. We have a two story house and going up and down stairs is exercise enough. Wrong way to look at it, but that's it for me.
I have grabbed a few times to read Mayo posts along and read some about morning numbers. I have had higher morning numbers since I was told by letter from my PCP that I had Diabetes 2. I cannot get a handle on it. If I eat the same thing for two days in a row, the numbers still vary. I've asked the endo about it, but he says as long as they go down, he's not concerned. So I take morning blood which is not terribly high (usually from 120's to 140's). Then after lunch my numbers are usually under or right around 100. Because of all the dr. appointments for my husband and being in places where eating wrong food was better than not eating at all, some of my numbers have been higher with my husband's health problems. But my A1c at my six month check a couple of weeks ago was 6.0, so endo said I'm still what he calls a controlled diabetic. I take NO meds and control with diet. I have had this disease 2 years and 4 months, so I think I was on the edge when I got the letter from my PCP. If he had been paying attention to my numbers, he could have stopped it, but he only looks at how much he can charge. I have no faith in him at all, but changing doctors is not an option. So I research and continue to dr. myself.
For those who have really big and multiple problems, I sympathize with you and admire your courage. I don't think I could go through all the meds and tests and situations that many have. I pray that I can continue to control myself. My next appointment is another six months, so I figure the endo isn't very concerned since I'm not a big money-maker for him. After all these rounds with my husband, I am very skeptical about the medical community and their interest in anything but money. Worse than them are the pharmaceutical companies. Big Pharma is definitely running the entire medical show.
Good health or better health to all.
retiredteacher

REPLY

@retiredteacher I have an endo appointment on Friday and I am afraid of what my numbers will be. I go for the lab work tomorrow morning. I really have not been very good at all. I survived my liver problems and transplant, my knee replacement, so diabetes took a back seat. I really have to get back to paying more attention to it.
I hope your numbers continue to be within range, and I hope mine will be too.
I do exercise a lot so maybe that will save me. If you have a decent health club close to you, you might be surprised at how many people your age are there. There are a number of women in my water exercise classes who are in their 80s. I think the range of ages is from 50+ to about 85. It's good exercise and low-impact since it's in the water. I do other exercises also, like my recumbent bike, and the gym occasionally. Frankly, I hate going but I feel like it's a necessity. I do enjoy the water because there's a great group of people there — mostly women and a couple of spouses.
JK

retired teacher…WOW. Your numbers are fab especially with all the stress you have been under. Exercise can be walking, climbing stairs and with all your running around you can create your own at home. I touch toes, lift legs, have one of those exercise balls and whatever else catches my fancy during the day. All of it is good, I am concentrating a bit on balance and keeping back straight. I noticed when I was involved in groups and walking miles a day, and staying away from carbs, my numbers still climbed…slowly but climbed. My theory is if it is a gene issue, you can help control how fast but meditation helps as much and giving yourself a lot of love, for all you do.

@contentandwell

@retiredteacher I have an endo appointment on Friday and I am afraid of what my numbers will be. I go for the lab work tomorrow morning. I really have not been very good at all. I survived my liver problems and transplant, my knee replacement, so diabetes took a back seat. I really have to get back to paying more attention to it.
I hope your numbers continue to be within range, and I hope mine will be too.
I do exercise a lot so maybe that will save me. If you have a decent health club close to you, you might be surprised at how many people your age are there. There are a number of women in my water exercise classes who are in their 80s. I think the range of ages is from 50+ to about 85. It's good exercise and low-impact since it's in the water. I do other exercises also, like my recumbent bike, and the gym occasionally. Frankly, I hate going but I feel like it's a necessity. I do enjoy the water because there's a great group of people there — mostly women and a couple of spouses.
JK

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@contentandwell. I know having to go to endo for all the checks is unnerving, or it is for me. I considered canceling because my routine had been so crazy and I had eaten off the grid. I just knew my A1c would be high, but luckily, it only went from 5.9 to 6.0. All of my test profiles were within range and so I felt blessed. I got back on my food routine and daily blood numbers are back to my usual.
I hope you have good results and numbers for you haven't changed that much.
I am not a gym or health club person. When I was younger I was an exercise freak, but did aerobic classes and then exercise tapes at home. I lost too much weight and my PCP told me I was too frail looking so I gained some weight back and then when heath problems started for my husband almost ten years ago, exercise was not in the picture. I was teaching and that was exercise every day! I loved it and thought I would still be teaching, but when health problems rear their ugly heads, the body takes over and working isn't possible. So I have to do what I can and I am a control freak, so I can pretty well have control except for things that happen in getting older.
Good luck with your appointment.
@retiredteacher

@contentandwell

@retiredteacher I have an endo appointment on Friday and I am afraid of what my numbers will be. I go for the lab work tomorrow morning. I really have not been very good at all. I survived my liver problems and transplant, my knee replacement, so diabetes took a back seat. I really have to get back to paying more attention to it.
I hope your numbers continue to be within range, and I hope mine will be too.
I do exercise a lot so maybe that will save me. If you have a decent health club close to you, you might be surprised at how many people your age are there. There are a number of women in my water exercise classes who are in their 80s. I think the range of ages is from 50+ to about 85. It's good exercise and low-impact since it's in the water. I do other exercises also, like my recumbent bike, and the gym occasionally. Frankly, I hate going but I feel like it's a necessity. I do enjoy the water because there's a great group of people there — mostly women and a couple of spouses.
JK

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@retiredteacher I am the opposite of you. Way back, when I was single (I've been married for 43 years) I used to do a lot of biking, skiing, tennis, and other activities, but then I got lazy and did nothing for years. I knew when I needed to have a liver transplant that I would fare better if I lost weight and got into better shape so I really went at it. I already was going to a health club but mainly for the water exercise. Now I feel sort of guilty if I don't get some exercise in every day! My son and kids, especially my son, a real exercise and health addict, are amazed at how much I do. As I said, I do not enjoy it but feel it is a necessity for me. We all have to do what is right for us.

Thanks for the encouragement about the appointment. I too thought about postponing it and trying to be better but who am I kidding? I said that a few months ago! They say if you lose a lot of weight you can almost turn diabetes around and I have lost a lot of weight, about 45 pounds after finding out that I needed a transplant, and about 90 pounds overall (actually right now it's more like 83 pounds).
I WILL BE GOOD. I have to, I have a whole new wardrobe that's too snug on me! Plus my kids and husband were so proud of me that I don't want to go back to anywhere near where I was. My son is my biggest supporter.
JK

@retiredteacher – so great to hear from you. I remember your saying a bit back that you felt your diabetes had to be put on the back burner for a time due to your husband's health issues. Sounds like you and he have been through a lot with those.

That is really commendable that despite the somewhat altered lifestyle with your husband's health problems, the endocrinologist said you are still what he calls a controlled diabetic, controlled with diet and no medications.

Sounds like you have been through some challenging experiences, especially with your husband's care, that have prompted some skepticism about the medical community. What I wondered about is your mention that you have no faith in your doctor at all, but changing is not an option. Would you share more about why you don't think changing is a possibility for you?

We live in a rural area; with the county seat/town about thirty minutes drive. It is one of those situations we would like not to be in but really had the wool pulled over our eyes when we moved from our hometown. It didn't matter when we were working and able to travel and go when we wanted to. We've always been healthy and had wonderful doctors in our hometown. I say changing doctors is not possible because other doctors will not take patients from their comrades. We have been to the same PCP almost the entire 20 years we have lived here. The doctor is nice to us, but when we were faced with the first crisis (my husband's heart attack) the PCP didn't even know about it until he was back home from an out-of-state hospital.There is really no care or concern for patients. My endo is elderly and practices one day a week, so I am now seeing him two times a year. He is kind and considerate, but I don't think he is up-to-date on diabetes options. As long as I can be my own dr. that's okay. I expect him to retire soon. He is the only endo in town so I would have to travel to see a new one. The main problem is the PCP. If a patient questions a decision, that patient is told not to return to the practice to see any of the doctors in the group. I just find this very unprofessional. There are examples I could give that would shock you, but that's the way it is. At our ages, we really have no need to try to change, so it is what it is.
Thanks for asking.
@retiredteacher

@contentandwell

@retiredteacher I have an endo appointment on Friday and I am afraid of what my numbers will be. I go for the lab work tomorrow morning. I really have not been very good at all. I survived my liver problems and transplant, my knee replacement, so diabetes took a back seat. I really have to get back to paying more attention to it.
I hope your numbers continue to be within range, and I hope mine will be too.
I do exercise a lot so maybe that will save me. If you have a decent health club close to you, you might be surprised at how many people your age are there. There are a number of women in my water exercise classes who are in their 80s. I think the range of ages is from 50+ to about 85. It's good exercise and low-impact since it's in the water. I do other exercises also, like my recumbent bike, and the gym occasionally. Frankly, I hate going but I feel like it's a necessity. I do enjoy the water because there's a great group of people there — mostly women and a couple of spouses.
JK

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I had my endo appointment yesterday and it was a very pleasant surprise. My A1c is only 6.1, and that's with not avoiding carbs at all! I was so surprised, and so relieved. My endo also monitors my hypothyroid condition and that too is going well. I was avoiding taking my levothyroxine close to my immunosuppressants because a pharmacist told me to, but the doctor looked it up and said he did not feel it should be a problem so now I can take everything at once. He is having me go for tests in a month to make sure it has not affected my TSH.
This doctor moved away from my area and I had to drive an hour and ten minutes to go to him, but he's literally a 5-star doctor and worth the drive. He is very thorough, and patient. Having a doctor who you like and are confident of, makes it worth it.
JK

@contentandwell

I had my endo appointment yesterday and it was a very pleasant surprise. My A1c is only 6.1, and that's with not avoiding carbs at all! I was so surprised, and so relieved. My endo also monitors my hypothyroid condition and that too is going well. I was avoiding taking my levothyroxine close to my immunosuppressants because a pharmacist told me to, but the doctor looked it up and said he did not feel it should be a problem so now I can take everything at once. He is having me go for tests in a month to make sure it has not affected my TSH.
This doctor moved away from my area and I had to drive an hour and ten minutes to go to him, but he's literally a 5-star doctor and worth the drive. He is very thorough, and patient. Having a doctor who you like and are confident of, makes it worth it.
JK

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Congratulations, @contentandwell ! Lots of good news. There are a couple of doctors, that I drive a ways to see as well. When you have confidence, the drive is worth it!

I have endocrinology follow up too in October. I also have an eye check scheduled for diabetes. I think the idea is that they can see more veins in eye than anyplace else. So if you're eyes are ok than your body is ok. That is how they explained to me. So it really is important to do the yearly eye check where they put drops in your eyes and look inside for retinopathy. Then for me its twice per year a1c. I thought I was doing well but I did develop skin lesions so I put antibiotic cream on them so they can heal. I think diabetes means excess sugar and that can cause skin infections. I found this can happen if when a1c numbers are good. My a1c was 6.7. So it is still diabetes but without meds. Having diabetes is a tough job.

@ihatediabetes

I have endocrinology follow up too in October. I also have an eye check scheduled for diabetes. I think the idea is that they can see more veins in eye than anyplace else. So if you're eyes are ok than your body is ok. That is how they explained to me. So it really is important to do the yearly eye check where they put drops in your eyes and look inside for retinopathy. Then for me its twice per year a1c. I thought I was doing well but I did develop skin lesions so I put antibiotic cream on them so they can heal. I think diabetes means excess sugar and that can cause skin infections. I found this can happen if when a1c numbers are good. My a1c was 6.7. So it is still diabetes but without meds. Having diabetes is a tough job.

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Hello @ihatediabetes
You provided some useful information regarding the veins in the eye and the importance of eye exams. I hope your check-ups go well in October and that your skin lesions heal nicely. Have you had the skin lesions before?

@hopeful33250

Hello @ihatediabetes
You provided some useful information regarding the veins in the eye and the importance of eye exams. I hope your check-ups go well in October and that your skin lesions heal nicely. Have you had the skin lesions before?

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Yes its important for people to know that retinopathy and neuropathy are related conditions caused by diabetes. But retinopathy is easier to detect because blood vessels in eyes are easy to see compared to blood vessels in one's feet. So pay attention to retinopathy because if you don't have that then to don't have neuropathy either. And if one has retinopathy then neuropathy isn't far behind. So I don't go by a1c alone. If I was developing retinopathy then my A1c is too high for me. Diabetes and medication isn't one size fits all. Last time I saw ophthalmologist he said no retinopathy. Then I have been seeing another specialist for strabismus and he wrote that a "wool spot" has been detected. I don't know what a wool spot means but I am assuming that its beginning retinopathy. The techs said that I might have gotten that before I was diagnosed with diabetes and did not know I had it. You can get lots of information from techs that doctors don't say because they are doctors and only tell you what you need to know. I never had skin lesions before. But I was in perimenopause when I was diagnosed with diabetes. So my hormones were going up and down. Lots of women have skin problems in this phase of life. Well they told me recently that I hit menopause based on my estrogen levels. So it's official. Of course they don't tell you details but I think they are waiting to see if my skin lesions clear because of change of life. Doctors watch and wait a lot, especially mayo doctors. That's because they are good doctors. They know that the human body heals itself and medical care often is watching what happens. It's the younger doctors that want to operate right away or medicate right away. Older doctors are more experienced and patient. They will just tell you to wait and see. Maybe that's why they only tell you what you need to know. They don't want you to worry and they are waiting to see what happens. I have 24 years at Mayo Clinic. First as mother of son with genetic condition. Now I am patient too. So I have experienced both caregiver and patient roles. They are not the same at all.

@ihatediabetes

Yes its important for people to know that retinopathy and neuropathy are related conditions caused by diabetes. But retinopathy is easier to detect because blood vessels in eyes are easy to see compared to blood vessels in one's feet. So pay attention to retinopathy because if you don't have that then to don't have neuropathy either. And if one has retinopathy then neuropathy isn't far behind. So I don't go by a1c alone. If I was developing retinopathy then my A1c is too high for me. Diabetes and medication isn't one size fits all. Last time I saw ophthalmologist he said no retinopathy. Then I have been seeing another specialist for strabismus and he wrote that a "wool spot" has been detected. I don't know what a wool spot means but I am assuming that its beginning retinopathy. The techs said that I might have gotten that before I was diagnosed with diabetes and did not know I had it. You can get lots of information from techs that doctors don't say because they are doctors and only tell you what you need to know. I never had skin lesions before. But I was in perimenopause when I was diagnosed with diabetes. So my hormones were going up and down. Lots of women have skin problems in this phase of life. Well they told me recently that I hit menopause based on my estrogen levels. So it's official. Of course they don't tell you details but I think they are waiting to see if my skin lesions clear because of change of life. Doctors watch and wait a lot, especially mayo doctors. That's because they are good doctors. They know that the human body heals itself and medical care often is watching what happens. It's the younger doctors that want to operate right away or medicate right away. Older doctors are more experienced and patient. They will just tell you to wait and see. Maybe that's why they only tell you what you need to know. They don't want you to worry and they are waiting to see what happens. I have 24 years at Mayo Clinic. First as mother of son with genetic condition. Now I am patient too. So I have experienced both caregiver and patient roles. They are not the same at all.

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Hello @ihatediabetes

I had not heard of "wool spots, either but I did a google search and there is what I found, https://nei.nih.gov/faqs/retina-cotton-wool-spots"

"Cotton wool spots are small yellowish-white deposits (resembling cotton fluffs) in the retina. They represent swelling of the retinal nerve fibers. This swelling usually occurs because the blood supply to that area has been impaired and the decreased blood flow has injured the nerve fibers in that location.

The most common causes of cotton wool spots are chronic diseases, such as diabetes and high blood pressure. However, infections, trauma, toxins, and other unknown factors can also initiate the chain of events that creates the deposits.

Often cotton wool spots will disappear on their own, but some localized vision loss may be permanent."

For more information from other health sites, please visit the following webpages:
Digital Reference of Ophthalmology, Retinal Vascular Diseases
http://dro.hs.columbia.edu/ctwool.htm (link is external)
University of Michigan Kellogg Eye Center, Cotton Wool Spots
http://www.kellogg.umich.edu/theeyeshaveit/optic-fundus/cotton-wool.html (link is external)
You may wish to contact our Information Specialist:
Telephone: (301) 496-5248
Email: 2020@nei.nih.gov

From this article, it certainly can be caused by diabetes and/or other chronic diseases like high BP. Has your vision been affected by these "spots" ?

Also, here is an article from the American Diabetes Association about skin problems resulting from diabetes, http://www.diabetes.org/living-with-diabetes/complications/skin-complications.html

@hopeful33250

Hello @ihatediabetes

I had not heard of "wool spots, either but I did a google search and there is what I found, https://nei.nih.gov/faqs/retina-cotton-wool-spots"

"Cotton wool spots are small yellowish-white deposits (resembling cotton fluffs) in the retina. They represent swelling of the retinal nerve fibers. This swelling usually occurs because the blood supply to that area has been impaired and the decreased blood flow has injured the nerve fibers in that location.

The most common causes of cotton wool spots are chronic diseases, such as diabetes and high blood pressure. However, infections, trauma, toxins, and other unknown factors can also initiate the chain of events that creates the deposits.

Often cotton wool spots will disappear on their own, but some localized vision loss may be permanent."

For more information from other health sites, please visit the following webpages:
Digital Reference of Ophthalmology, Retinal Vascular Diseases
http://dro.hs.columbia.edu/ctwool.htm (link is external)
University of Michigan Kellogg Eye Center, Cotton Wool Spots
http://www.kellogg.umich.edu/theeyeshaveit/optic-fundus/cotton-wool.html (link is external)
You may wish to contact our Information Specialist:
Telephone: (301) 496-5248
Email: 2020@nei.nih.gov

From this article, it certainly can be caused by diabetes and/or other chronic diseases like high BP. Has your vision been affected by these "spots" ?

Also, here is an article from the American Diabetes Association about skin problems resulting from diabetes, http://www.diabetes.org/living-with-diabetes/complications/skin-complications.html

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Thanks for looking that up. I didn't know what wool spot meant. I just read in my notes from eye examination. My vision is actually getting better because I am being treated for strabismus. I am wearing prism film on my glasses to help my eyes converge. I was the kid with amblyopia that never resolved. So that's another thing that happened from going to diabetes eye checks. I saw a resident for diabetes and he said that I have strabismus. That's how I got to adult strabismus ophthalmologist. Mayo Clinic has specialists and a sub specialists for things you never heard of. But I am happy my eyes are getting better. Now we are watching and waiting to see if I develop 3d or binocular vision. I never had that before because of amblyopia. But now my brain is relearning how to process images and doctors just wait to see. They can't really fix how one's brain combines images from left and right eyes. That's the human body and God at work. Doctors just watch these things.

@ihatediabetes

Thanks for looking that up. I didn't know what wool spot meant. I just read in my notes from eye examination. My vision is actually getting better because I am being treated for strabismus. I am wearing prism film on my glasses to help my eyes converge. I was the kid with amblyopia that never resolved. So that's another thing that happened from going to diabetes eye checks. I saw a resident for diabetes and he said that I have strabismus. That's how I got to adult strabismus ophthalmologist. Mayo Clinic has specialists and a sub specialists for things you never heard of. But I am happy my eyes are getting better. Now we are watching and waiting to see if I develop 3d or binocular vision. I never had that before because of amblyopia. But now my brain is relearning how to process images and doctors just wait to see. They can't really fix how one's brain combines images from left and right eyes. That's the human body and God at work. Doctors just watch these things.

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I have heard of prisms in lenses, but never heard of prism film before. Could you describe it?

@hopeful33250

I have heard of prisms in lenses, but never heard of prism film before. Could you describe it?

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Its like a plastic film with the prism correction built it. The doctor had a woman cut the film and put on my left eyeglass. So light is bent to correct strabismus. I never had binocular vision. I can trip and fall because depth perception off because of strabismus. So now we are waiting to see what my brain does with the prism. Will I develop 3d vision? This is actually a big question if someone my age can still develop 3d or binocular vision. Its something that develops in childhood. But I never had it. I couldn't play softball because I couldn't track ball in 3d space. But I could bowl and play kickball because the ball is rolling on the ground so I could track it.

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