[[0010]] Diabetes Clinic (the first of many...)

I was going to post about the diabetes clinic sooner, but I ended up pulling a 11.5hr shift on Tuesday to help out alongside a mass shopping spree for the house yesterday and I honestly have crashed both nights (which was needed as my sleep has been appalling of late).

Anyway, I mentioned on Sunday that I was going to be attending my first Diabetes Clinic at my local hospital for the first time in Y E A R S. I know, I know, I should have continued to attend them, like most, if not all diabetics do, but... I had a rough time growing up, and I despised the consultant of the Diabetes Team for Paediatrics when I was a kid and young teen, so when I could, I just stopped going and eventually started doing all my check ups through my doctors surgery, of whom know my past, my history and why I have been like I have been. The reason I hated clinics at the hospital is because I was always made out to be a bad child by a family member, like I wasn't doing well looking after my diabetes myself and I was rebelling... and in a way, I was, because as a teen, I just wanted to be like everyone else. But this was when I was about 9 years old, when I wasn't fully looking after my own diabetes, and the consultant told me that if I carried on as I was, I would be dead by the time I was 18. What a great thing to say to a child! And it's always left its mark on me as well. Not only that, but when I lived with my Grandma, the doctor at the surgery there also tried to convince me to go to their Diabetes Clinic in that town and... I had strict orders from my Grandma that if it was under the same Consultant my Granddad was under, to just say no, because that guy nearly killed my Granddad by misdiagnosing bowel cancer as dementia. 

So you can see... I wasn't happy with these places.

But after being in hospital last October... and realising that the stress in my life was finally coming to an end, I knew I would have to attend a clinic eventually, to make sure that I can try to be healthier, in more control and all-in-all, live the best and longest life that I can. 

Honestly, I don't think I had enough time to explain everything to the Doctor. I would have loved double the amount of time to just explain everything but... they have other patients to see after all and I will attend again. The consultant seemed nice enough, but... I did get the talk of being in control to prevent problems and I already have retinopathy, kidney problems (not strictly diabetes related) and finally, neuropathy. It's the one talk I hate the most. Like, it sounds like I haven't tried over the years, and I really actually have tried... not as much as I am now, but that's because it is easier to try now because I don't have the majority of stress I used to have affecting my whole entire life. Like, I have diabetes, I know the problems, the issues, hell... a lot of my degree was about diabetes least of all my dissertation and masters project! I know all this... but... in all fairness, I think that was the only time I wanted to scream.

I did manage to cover the vast majority of changes and questions I needed to ask though. And thankfully my phone holding all my blood results was a God send, especially when the Diabetes Nurse took a look, and saw that day where I had way too many hypos as well as the fact in that week alone where I had about 9. The Doctor also noticed the massive amount of hypos I have been having, which thankfully led to a discussion about finally changing my night time, long acting basal insulin... which since hearing about Tresiba and Toujeo, I have wanted for ages. I haven't started on the new medication yet, but should hopefully be on it at the weekend at the earliest, or at least by the start of next week. This medication is much better than my Lantus insulin, which does not last the full 24 hours, but also has a high peak before dropping which can be the result of some of my night time hypo attacks. Toujeo lasts a bit longer so covers you for a whole day and means if needs be, can be injected a little later than whatever time I decide to pick to take it. I won't bore you with the Science of how it is better but I will do at a later date as I am always stupidly curious about these things. 

When I get this new medication, I am doing a straight swap between doses... it takes about three days to kick in so hypos may still occur in the beginning but if they continue, the dose can be reduced by ten percent. The insulin should also distribute around the body better so eventually, the peaks will become essentially a steady line once all settled. Once I get the insulin, I have to monitor everything for a week and send it to my nurse just in case the change doesn't work for me, however, this is the change that I really did need so we don't see how it won't work when I get it. 

The Doctor checked all my previous blood results, and stated my kidneys are not getting any better, which I partially knew... but I am unsure if he realises my kidney function has gone wrong ever since I had Gastroenteritis which led to the Polynephritis... this is what I mean when I say it was not ALL my diabetes. I was originally taken off my blood pressure tablets (I take these for my kidneys, not blood pressure) to help my kidneys get better, but I will be put back on them again to see if there is an improvement in about two weeks time. I hope so, I am still terrified I'll end up with a chronic kidney disease through no fault of my own other than kidneys are absolute wimps. 

I also bought a water filter finally yesterday (I have a big problem with the water here, its so harsh and has an odd after taste I tend to throw up if I drink too much of it). I've always preferred filtered water so getting this should hopefully mean I can drink more water without feeling sick and I hope that should help my kidneys too. But only time and a lot more blood tests will tell if that one works out as planned. Not like I don't have enough going on!!! I think I am being referred to a nephrology team at some point as well to keep an eye on my kidneys... so again, watch this space. 

I managed to mention, although only brief so I am not sure what will come of it, if I can have the medication I am on for my diabetic neuropathy changed. You may have seen me write about this before... and it's been bothering me for months now. Long story short, I was put on Duloxitine and had my anti-depressant sleeping tablet Mirtazapine, taken off me when I went into hospital, as Duloxitine is also an anti-depressant. Annoyingly, I started losing sleep straight away, and no longer was able to sleep for a solid six hours a night which has also badly influenced my mental health, as sleeping properly helps me function so much better in the world, even when things are tough. My mental health is everywhere nowadays, with some nights getting only 2-3 hours broken sleep, taking ages to get to sleep or just not sleeping properly at all. I mentioned to the Doctor that I wanted my old anti-depressant back and a different medication for neuropathy as not only is my sleep ruining, but I feel nausea worse than ever before, like travel sickness on the way home from work when I never had that before.

The Doctor said he was going to write to my Doctor about changing my prescription to have Candesartin back on script again, and he said he would mention about changing the Duloxitine, so fingers crossed in the next couple of days, I know what medication I will have instead. Worst comes to the worst, it's just going to be another trip to the doctors and some begging because I need my sleep back desperately. And I need my mental health back to a place I can manage and cope because I honestly cannot cope like this at the moment. 

(I also got a phone call this week in which I am going to have an appointment made for Counselling again with Occupational Health, so that be something too at least!)

The Diabetic Nurse mentioned that with the amount I blood test and as my bloods have been everywhere, that I may be eligible for a Libre in the future, which is something I do really really want for easier management of my blood sugar levels. This however, will involve carbohydrate counting... and this is where I honestly start to get a little panicked and overwhelmed (alas, I only realised this after the clinic...). Maybe I shouldn't keep reading all the diabetes blogs and groups but I do, I like reading and learning... but already the sheer thought of measuring carbs, equations, watching what I eat, medicating for every little thing I eat in some kind of ratio form, monitoring all physical activity (which yes, includes "night activities) ... I can feel one of my worst fears coming to life, which is simply, I don't want my life to be just about diabetes, I don't want it to control me and rule my life... but I have a feeling, to be the diabetic that I am meant to be, that is what is going to have to happen. Thank God I have counselling soon... even writing about it is setting me on edge. 

At least I was somewhat praised for lowering my HbA1c which is still my proudest achievement to date so I am so glad it was recognised. But they still want to lower it further, which is also understandable... so maybe all of these changes will help, but again, only time will tell. 

At least on a much happier note, the morning of the appointment on my way to work (I had literally no sleep because I was up all night panicking about the clinic), I caught a shiny Poochyena on Pokémon GO! I honestly felt I needed that kind of luck that morning, especially after the night I had and the anxiety floating through my veins. 

But alas... I'll have another clinic appointment in 4-6 months depending on my responses to Toujeo once I start taking it. And hopefully a nephrology one too. And add to the list I have a Diabetic Eye Screening appointment to rebook as well as a trip to see my Nurse and bloods in March and a potential Doctors trip to come up soon as well.

All in all, it's just what my new life is like now. 

And if I am honest, I am not in the right place to accept and enjoy it, but thankfully I don't have much choice so deal with it is just exactly what I will have to do, like I always do.

URGH.