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Sunday, January 22, 2006

The Boy and His Pills

The Boy gets a pair of trips to his endocrinologist each quarter — one to draw blood, one to get the results. As we expected, his sloppy maintenance resulted in an A1C score of roughly 10... if you don’t know what that means, it’s not good; it should be around 7. After a stern lecture from the doc, who went into graphic detail of the slow painful death (piece by piece) that awaits him if he doesn’t get his act together, he confirmed that The Boy is indeed a Type II rather than Type I. “He would have probably hit 500 and ended up in the hospital over the summer if he was Type I.”

This is very good news for The Boy: it means he’s down to typically one injection (the Lantus he takes at bedtime) per day, with the Novolog as a backup if he needs it. Of course, he still has to poke himself and meter his glucose, but that’s no big deal by comparison.

I took an empty pill bottle and had him put a few of his pills in it to keep here. His regular supply is at his apartment, but if he comes home for a weekend or whatever he’ll have them even if he forgets his normal supply. (We also have a backup glucose meter.)


  1. FARfetched, I don't know how old your boy is, but it sounds like he is at that age where he knows with a certainty he will never know again that nothing bad can ever happen to him.

    If there is a youth diabtetes support group in your area, if there is any way you could wheedle/scold/bribe him to go, it might do him some good to hear it from other people his age.

    Complications of diabetes are no joke, and if he does not get it together, he WILL get them, it is just a question of when, and once you get them, you've got them, and you have to work even harder just to get back to where he is now!

    You are both in my prayers.

  2. FARfetched, I got my wakeup call when my HA1C hit 9.1. It isn't easy to think about my blood sugars all the time, so I understand what you son is going through.

    Does he seem aware of how serious a 10 is?

  3. The Boy just turned 18 last weekend. I looked around for a youth-oriented support group when he got it, but didn't find one (we're in a pretty rural area). I think he understands how serious the situation is, and I'm hoping he'll take it seriously. I've asked him on a couple of occasions how he'll play guitar when his fingers start coming off....

  4. "I've asked him on a couple of occasions how he'll play guitar when his fingers start coming off...."

    This is actually an effective way to warn a youth about habitual dangers. You should continue to point those things out. Ask him what model of wheel chair he wants after he loses his feet -- that you're interested because he will probably be needing one in 10 years or so at his rate.

    Just casually force him to look ahead at the consequences of his actions.

    I snapped to when I realized that my uncle was only 11 years older than I am now when he died of complications from diabetes. It doesn't take too long with numbers like I had for things to go really bad.

    Your son might still be counting on a future. But you can help him put a timeline to it.

  5. FARfetched, if you think a detailed descriptionn of just what is meant by "painful peripheral neuropathy" would help, let me know and I will be most happy to post it.

    Although it may not seem so, I do try to avoid complaining, or graphic chronicles of the minutiae out of regard for more sensitive viewers, but I would make an exception if it might be of assistance.

  6. When diabetes is not controlled, sugar enters places where it should not be, including the nerves. This damages, and eventually destroys them.

    When nerves are damaged, this causes the victim to feel sensations of things that are not really happening.

    A large percentage of diabetics will develop some degree of neuropathy. For most, those who keep their blood sugar under control, symptoms may be minimal, or even not present. But uncontolled or poorly controlled diabetes will almost certainly guarantee that you will develop a painful neuropathy.

    The first time I felt it, I thought that a crumb of fire from my cigarette had fallen and was burning my foot. I leapt up and began shaking out my clothes, the pillows, frantically looking for what I was certain was a smoldering fire.

    Neuropathy, like diabetes itself, is progressive. This means it gets worse. If blood sugar remains uncontrolled, the feet lose sensation, that is, they lose the ability to feel external sensation. The cigarettes, etc. are still there, though the feet are actually numb. This is how people with diabetes lose their feet, and even their legs. When you cannot feel when you step on a piece of glass, or even when you have a blister, it gets infected. The nerve damage also impairs circulation, and the infection gets worse, and will not heal. You might not feel the cut on your foot, or the sore that develops when it gets infected, but you still feel the pain of the neuropathy.

    Today, that occasional isolated crumb of fire on my foot has progressed to actual cigarettes, or cigars, held to my feet. Several of them at once. First here, now there, but always somewhere, always several.

    At the same time, I have the sensation of long, thick needles being thrust with great force under my toenails, even as other toes are being smashed with hammers. If you have ever dropped something on your toe, or even hit one against something, or accidentally hit one with a hammer, you will have an idea of how that feels. With an injury, however, the pain eventually lessens and subsides. With neuropathy, it does not.

    Every hour of ever day, my feet feel exactly as if all these things, cigarettes, needles, hammers, were actually occurring.

    That is because the nerves are sending the exact same signals to my brain that they would if those things were really happening.

    The pain cannot be eliminated. The doctors are working to "control" it. They call this "taking the edge off."

    At the present time, to try to take that edge off, every day I must take 900 mgs of epilepsy medicine every 4 hours. That is 18 pills. I also must take narcotics, oxycodone 10. It might sound cool to get to take narcotics, but if you have to take them all the time, in addition to the epilepsy medicine, it means that you live your life in a constant state of heavy sedation. It is not fun, and when pain is severe, you don't even get a "buzz." And the pain is just dulled a bit, it is still QUITE there.

    Eventually, almost all people with chronic pain are given anti-depressants. If you read about treatment for neuropathy, for instance, it may talk about anti-depressants as helpful. They are. Almost all people with chronic pain are eventually given anti-depressants so they will not become suicidal.

  7. Whoo. I didn't realize it could get that bad. I think his endocrinologist went over a lot of the bad stuff... and when I tell The Boy about this, he'll probably tell me he's already heard about it and he's doing a better job of controlling it.

    Thanks for sharing, Ductape. As I was reading, I was thinking it might be more merciful to cut the feet off just to not have that pain.

  8. Don't tell him, FARfetched, just print it out and let him read it.

    And yes, the thought you mention has occurred to me, I am ashamed to say, however, the thought of not having feet is hardly more appealing :)


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