Day 19: Ups and Downs, Ends On a Good Note But Overwhelmed: Physiotherapist not Supportive & Made Me Feel Hopeless in Front of Other Patients and Staff

September 6, 2013

7:49am

FBG 144 Got off to a bad start by being off schedule. Usually take my morning insulin at 8am but didn't get to it until 9:30. Had a rough night pain from my leg injury kept me awake. Bailey woke me up at 7:49 with bad doggy breath kisses and I reached over and checked my Fasting since it was high but not dangerously so  and I was exhausted I intended to go back to sleep for another 20 minutes.

Best laid plans - it was 9:30 by the time I dragged myself out of bed and this was because my leg was screaming in pain.

9:36am

FBG 145 50U insulin – as I said my leg was screaming in pain, checked my BG again, took my insulin and ate a late breakfast of some plain cottage cheese and drank 2 mugs of coffee tried to get easy, it decreased some but was bothersome for the next few hours.

This morning everything came out ok and appears back to normal. Pretty sure what contributed to the harder than normal stools is that this week I have had to take a full (rather than half) pain pill at night to sleep after physiotherapy. Normally I manage with ibuprofen and take a small dose of the prescription meds two or three times a week if I have stressed the injury more than usual. If it is not one thing it is another.

12noon

PP BG 166   I had no recourse but to take a pain pill; within an hour the pain was finally beginning to subside. Looking back, there is an element of correlation between the level of pain and the elevated blood sugar.

3:00pm

PP BG 94  Pain is nearly gone when I am not up and about, manageable when I am; ate a late lunch of only 5 gm carbs.

6:00pm

PP BG 129

Made a batch of Ayurvedic analgesic oil tonight, a formula that was passed down to me containing buffered acetylsalicylic acid, a little wintergreen and a little Emu oil in a mustard oil base. The original formula contains arnica and camphor as well but I am out of these. I did not have massage grade mustard oil so it might be a little strong - but I am not using it as perfumeJ

 It is suppose to age for several days but I need it ASAP. I usually have some on hand but ran out a few months ago and never did make a new batch. It has always worked well in the past as it is absorbed right into the sore muscles and joints acting directly thereby reducing my need for pain medication.

9:00pm

BG 147 47U insulin. A little high, had a cheese stick, 1gm carb, about 7:30 or so, it is not whole milk but I wonder if it is impacting my BG in some way.  Took my evening insulin and ate a late dinner of 9gm carbs. I am enjoying my new Escali Scale and with a quick input of a three digit number it gives accurate nutritional info, taking the guesswork and calculations out of the mix for greater accuracy in my meal plan. Just took a few seconds. Very pleased I recommend it highly.

Pain is making itself known again. Took a pain pill along with ibuprofen but also massaged in some of my new batch of  Ayurvedic analgesic oil.

11:00am

PP BG 106 Good number. Tomorrow I am back on schedule.

The analgesic oil has worked; for the first time in many days I do not feel pain in my hip. I have been so overwhelmned with so many things I should have put together a batch of the Ayurvedic analgesic oil a couple of months ago.

Now I must resist the urge to carb.

Tomorrow is another day.

1:30am

BG 79, a little low for me, smell ammonia, will eat some ricotta and berries. Just realized I only ate 35 carbs total today – may be not enough with the amount of insulin I take. I’ll reassess in the morning.

Regarding LCHF: I aim for 60 to 75 carbs per day and don't stress too much if I go over as long as  my numbers are ok. Right now I can feasibly eat 75% fat and count calories. I tried .5 gm protein per kilo the formula for those who are essentially sedentary due to the musculoskeletal pain limiting my activity but one piece of Salmon blows that out of the water so I am staying under 1gm protein per Kilo. Although referred to as Low Carb High Fat, my plan is Low Carb Healthy Fat. It is still higher in fat than normal diets and I am eating good fats in foods and healthy oils as they are meant to be, no altered, non, low or 2% fats but I do use half and half in my coffee as opposed to full cream because I like the way it tastes. From the literature I have read I am still getting the good benefits (better blood glucose numbers, exceptionally so) and it seems some of the high fat tenets are so people feel full and satisfied. Not my problem because I had been decreasing my food intake for eight months prior to embarking on Low Carb "Healthy" Fat diet so I get full on smaller portions and remain satisfied. I did not embark on the LCHF diet to lose weight alone, I am already doing that, but to lower insulin doses and improve my blood glucose and this it is doing :)

Addendum:

I have been a bit over-whelmed of late. Not so much by the diabetes management but my physiotherapist really made me feel helpless and hopeless yesterday. It has been a rough week this week, having to heat, massage and medicate to relieve the pains of the day before I fall asleep and having to arise early for morning appointments so I am definitely off my game physically.  I was not prepared or even imagined that I would have such a conversation with an insensitive Physiotherapist who I felt was more interested in how my lack of progress reflected on her skill as a physiotherapist rather than Medicare, after only five visits. She discussed my financial and insurance info in front of an entire room of patients and staff. Besides all heads turned towards us, one of the staff looked at her incredulously as she told me she just could not understand what was going on with me since I am not making progress and nothing she is doing helps and essentially what she said was that since she wasn’t able to solve my problem I was not a success for her even though she blamed it on Medicare after 5 visits. I wrote for Medicare for decades and even took cases before an administrative law judge and mine is not near one of those cases that need such justification. Perhaps if she took a step back and let me work with another therapist who is focusing on rehab of the actual trouble areas I point out and working with my actual abilities rather than where she thinks they are coming from and focusing on how a normal person without my multiple problems would progress I just might make progress. She also would also be able write a valid Medicare note that would get approved. The day the PTA worked with me and taught me stretches and assessed my gait and pointed out the problems and how my use of the cane was contributing did more than she had in her four visits. I was astonished, and I so much pain, that I just could barely reply. Maybe it is because she is has been ready to deliver her baby “any day now” for the past two weeks as she was visibly distressed and short with all her patients, her face a tense grimace even before she realized I was there, in fact it was the first thing I noticed when I walked in.

We’ll see what transpires at my appointment this coming Monday.