Living with a partner with uncontrolled type 2 diabetes

[Molly56]

@graj0 .....have just posted another message about the knee replacement on another thread.....

With regards to the knee replacement as you say this will need some planning...have already given it some thought...

The issues will be his diabetes (last Hb1Ac result was about 10 as far as I remember).....his weight, approx 124kg which gives a BMI of about 39 (will probably be advised to lose weight) ....and whether they consider him fit for the operation and recovery.......... Have already mentioned to him that strengthening the muscles in his leg before the operation would be a good idea as it would help with recovery but doubt he has taken any notice of that.

One thing that does confuse me slightly is that he says that he doesn't really suffer any pain in his knee anymore (despite the x-ray showing significant deterioration of the knee joint).........the pain in his hip / groin area seems to be the dominant pain at the moment.......... Could the lack of pain indicate some other problem such as nerve damage / neuropathy in his knee area and, if so, how will this affect his chance of getting the knee replacement. Not sure if this is a question I should raise as don't want to jeopardise his chances of being accepted for knee surgery but don't know how relevant it is in terms of the operation itself / recovery etc.

You say that you are waiting for knee surgery....if you don't mind me asking what is the criteria that you have been given for the operation to go ahead....it may give me some idea of where we need to aim for :)

My partner is about five years older than yourself and like you has arthritis in his knee and i am guessing has similar symptoms of reduced cartilage ...the xray also showed some additional boney growth within the knee according to the GP which I believe is a symptom of the problem and the reason for the proposed knee replacement.

Just wondered, if you didn't mind me asking, what criteria you have been given for your knee operation to go ahead and what advice you have been given in terms of your diabetes and how this will affect the operation and recovery.

Good luck with your appointment on Monday.....hope it goes well

 

[Indy51]

If your partner's BG is as high as you believe, he may be refused surgery - it happens quite frequently because it causes healing issues. Maybe that will be enough to make him wake up to himself?

 

[Molly56]

If your partner's BG is as high as you believe, he may be refused surgery - it happens quite frequently because it causes healing issues. Maybe that will be enough to make him wake up to himself?

Was thinking that myself especially with a major surgical procedure such as a knee replacement.....will have to see what the consultant has to say....

 

[graj0]

Hi Molly,

as far as the NHS is concerned there is no possibility of knee replacement yet, the GP and the NHS consultant have both told me that I'm too young.
I had a private consultation with a knee specialist 2 years ago who said I should lose some weight first, easier said than done when you eat well below the Basic Metabolic Rate as calculated using the Harris Benedict formula (similar if not identical to what Weight Watchers etc use). Even more frustrating when I was swimming 1km 5 times a week and playing golf, personal trainer, swimming lesson.

Fortunately low carbing allowed me to lose 3 stone although that has plateaued and I'm now eating about 1,000 cals a day against my BMR of 1900. I use a piece of computer software called "weight by date" to track everything I consume so I know what I'm eating, also only eating 80gms of carb instead of the more usual 250 gms. The low carb has been an absolute godsend because I was able to drop three different meds, all of which had side effects.

I haven't been given any criteria unless you consider "lose a bit of weight" (I should have said "how much?", but forgot). I'll have a list of questions for the consultant on Monday, he's already got the list of 20+ things I wanted to do again with new knees that he received from my GP. No advice on diabetes but then as I'm now only taking Metformin there shouldn't be any issues. I've unfortunately had two emergency admissions in the last year and there haven't been any issues on those occasions.

I'm guessing that there might be some issues with healing that goes with having diabetes, but nothing that I can't cope with (one of my emergencies was a massive internal bleed that required 4 units of the red stuff, that's 2.4 litres, and 4 litres of saline, so not insignificant), no idea where it all went.

Thanks for the good wishes, I'm still at the hands of the consultant, but I'm better prepared with my list of questions unlike last time. I just feel that I'm wasting time waiting, I've still got the Atlantic to sail across and some skis to get back onto. Got to have an aim or I might as well give up now.

 

[Deleted member 83869]

Was thinking that myself especially with a major surgical procedure such as a knee replacement.....will have to see what the consultant has to say....

Hello Molly

I have spent nearly 3 hours reading this thread lol..and honestly I don't see how you have managed...you have done so well to keep things together etc as I know that if I was in this situation I would be going mental!!

Maybe telling him (repeatedly) that if his Hba1c doesn't come down then he will be refused surgery....I know how important that is as I need surgery on my back and my Hba1c is coming down but is still high...it is about a 9 I think but previously has been a 14!!

Like others have said, focus on your health and well-being more than his, if he is not interested....unless he has a change of heart then let him know that you will be there to help every step of the way!

Also, maybe he does care but doesn't want to actually admit it to you...hence the depression?? Just a thought??

Anyway, I hope things start to improve for you soon and keep up the good work, you are doing well!! xx

 

[Molly56]

Hi Molly,

as far as the NHS is concerned there is no possibility of knee replacement yet, the GP and the NHS consultant have both told me that I'm too young.
I had a private consultation with a knee specialist 2 years ago who said I should lose some weight first, easier said than done when you eat well below the Basic Metabolic Rate as calculated using the Harris Benedict formula (similar if not identical to what Weight Watchers etc use). Even more frustrating when I was swimming 1km 5 times a week and playing golf, personal trainer, swimming lesson.

Fortunately low carbing allowed me to lose 3 stone although that has plateaued and I'm now eating about 1,000 cals a day against my BMR of 1900. I use a piece of computer software called "weight by date" to track everything I consume so I know what I'm eating, also only eating 80gms of carb instead of the more usual 250 gms. The low carb has been an absolute godsend because I was able to drop three different meds, all of which had side effects.

I haven't been given any criteria unless you consider "lose a bit of weight" (I should have said "how much?", but forgot). I'll have a list of questions for the consultant on Monday, he's already got the list of 20+ things I wanted to do again with new knees that he received from my GP. No advice on diabetes but then as I'm now only taking Metformin there shouldn't be any issues. I've unfortunately had two emergency admissions in the last year and there haven't been any issues on those occasions.

I'm guessing that there might be some issues with healing that goes with having diabetes, but nothing that I can't cope with (one of my emergencies was a massive internal bleed that required 4 units of the red stuff, that's 2.4 litres, and 4 litres of saline, so not insignificant), no idea where it all went.

Thanks for the good wishes, I'm still at the hands of the consultant, but I'm better prepared with my list of questions unlike last time. I just feel that I'm wasting time waiting, I've still got the Atlantic to sail across and some skis to get back onto. Got to have an aim or I might as well give up now.

@graj0 ...so good to hear that you have taken control of the situation and you have managed to lose the weight and reduce diabetic medication....just wish I could get my partner to see that there is another way of dealing with this....

It's good too that you have plans for what you want to do and achieve......hope you get the chance to sail the Atlantic

.......I sometimes ask my partner what he plans to do tomorrow and his answer is "wake up".....I just think - what a waste of a life...

Perhaps you can bottle some of your positive mental attitude and let me have it

......good idea to go prepared with your list of questions - hope you get the answers you need.

 

[Molly56]

This may just be your breakthrough. And he may be bringing it about himself.

Whether or not we realise it, when we need to change, part, if not all, of the motivation we find is the"what's in it for me?" factor. This may what galvanises some change in him. Did your husband want to go and have this issue addressed? Does he want the pain to stop? Would he like to find stairs, walking or generally moving around more comfortable?

How far would he go to achieve that?

I'm not sure if you have noticed, or indeed if it has occurred since you've been coming on here, but quite regularly people end up here when they have been rejected for surgery, on the basis of their bloods. Poorer diabetic control can result in poorer healing, and the the danger that any minor infection could run riot.

Not all of those new people arriving here are new diabetics, discovered in the pre-op period, some have been living with diabetes for some time leading up to their pre-ops, but either couldn't or didn't make the desired level of changes required for surgery to take place safely. Being rejected for their surgery is often the catalyst for change.

See what I mean about the "What's in it for me?" factor?

For them, there is a stated requirement to achieve an HbA1c score of X before surgery can occur. The message delivered is, "No surgery for you, for now. Come back when your HbA1c is X and we'll get you scheduled."

The "what's in it for me?" is an HbA1c equals surgery, which equals being pain free, which equals better quality of life. Suddenly better diabetic control isn't the end objective, but a stepping stone to something else.

Whilst I don't want your husband to be rejected for surgery he may well need, but if he wants a change of knee, he may just get motivated to take notice of his diabetes.

What do you think?

And finally, if there is anyone reading this who arrived here in the manner I describe, please don't think I'm judging you. Sometimes change is just too overwhelmingly difficult, and we can't make the change for whatever reason. We've all been there at some stage, for some reason, including me.

@AndBreathe ....I agree with what you say and hope that this is actually the breakthrough moment where he gets to realise that he needs to do something about his diabetes.

Whilst I hope in some ways that he gets the result he wants I also hope that the consultant will lay down strict guidelines about what he needs to do in order to be accepted for surgery....I anticipate that both his HbA1c results and his weight may be issues that need addressing first

Let's hope the "what's in it for me" factor is realised.....

Just as a footnote to this message I was just going to say what a great user name you have chosen.....in moments of stress I just remember "And Breathe"....thank you

 

[donnellysdogs]

Molly

Since gp visit has partner been testing himself voluntarily?

 

[Molly56]

Molly

Since gp visit has partner been testing himself voluntarily?

@donnellysdogs ....no, he only tests when I suggest it or prompt him to do it.....I still don't think he sees the point of it (no pun intended)...

 

[donnellysdogs]

What a shame, I was hoping that he may have thought I better check!
Does he realise he needs to have improved bloods for an op? Did gp mention that?

 

[Molly56]

What a shame, I was hoping that he may have thought I better check!
Does he realise he needs to have improved bloods for an op? Did gp mention that?

@donnellysdogs ....GP did mention that he needed to pay attention to what he had been told by the diabetic nurse and to follow her instructions to the letter..he probably did mention that bloods had to be improved for op but in my view did not stress it enough...as usual my partner did not really remember any of what he was told but that is just par for the course and hence why I always go along too.

I am assuming that the need for better diabetic control will be covered in depth at any consultation with the orthopaedic consultant at the hospital.......GP has just referred on for next stage of the process...

Get the feeling that my partner thinks it will be a straightforward process and that if he needs a new knee he will get a new knee.....am thinking he could potentially be very disappointed.

Seems this is just the latest episode I am having to deal with....I wonder what is next?

 

[Molly56]

@donnellysdogs ....no, he only tests when I suggest it or prompt him to do it.....I still don't think he sees the point of it (no pun intended)...

@donnellysdogs .....got him to test before dinner tonight....reading of 11.6....is lower than some of the original readings but still a way to go to get down to recommended levels. Will continue to prompt him when I can in the hope that he will see some improvement...

 

[donnellysdogs]

@Molly56

I worry for you to be honest. I wonder what his reaction will be when the consultant refuses to operate? That will effectively be another knock down for him when he already appears to not give a ****. Then that leads me to worry about the effect on you.

11.6 is lower but when is he next being reviewed for his diabetes? Will it be before seeing consultant?

 

[Molly56]

@Molly56

I worry for you to be honest. I wonder what his reaction will be when the consultant refuses to operate? That will effectively be another knock down for him when he already appears to not give a ****. Then that leads me to worry about the effect on you.

11.6 is lower but when is he next being reviewed for his diabetes? Will it be before seeing consultant?

@donnellysdogs ...from what I remember the diabetic nurse wanted to see him again in three months which makes it sometime towards the end of September.....was going to make this before we go away in October.
As the referral letter has just gone to the consultant I doubt that we will get an appointment for that before we get back from holiday...or if before I will suggest moving it to after so that I can go along to the appointment too (am quite busy myself before we go away so would be better after...)

I am fully expecting the consultant to tell him that he will need to lose weight and get control of his diabetes before the operation can take place and hope this is the case for his own good.....hope that doesn't sound too nasty...my fear would be that the consultant says that the operation can go ahead without addressing these issues.

Apologies here to anyone that thinks I am being cruel to suggest this but am hoping this is perhaps the wake up call he needs to take control of the situation and finally do something about it..

As for myself .....I feel a lot more relaxed about all of this at the moment and feel that I am in dealing well with things....am finding plenty of time to do the things that I want to do and start new projects

 

[Molly56]

Thought today was going to be different.....he had actually got up by 9 o'clock!......how wrong was I?.....
After breakfast he promptly went back to bed ......and is still there .....
Looks like another day to myself......time for some me time .....housework done, now for some gardening

 

[Molly56]

Was reading through a post this morning and it mentioned about the fact that fizzy drinks are bad even if they are those that are described as diet…..

Diet plays a major factor and soda is bad for you. Although the diet version doesn't contain any sugar it still has sweetner and tricks your body into releasing insulin.

Thought it would be worthwhile checking this out as my partner does tend to drink quite a lot of these….in the region of 4 – 6 per day…..his other drink of choice is cans of cider, something which I questioned in an earlier posting…

Anyway looking at the diet fizzy drinks I knew that the sweeteners were not necessarily good…aspartame is the main one mentioned …..but was unaware of the fact that these could potentially trick your body into releasing insulin….a bit of internet searching came up with the following link....

http://articles.mercola.com/sites/a...9/artificial-sweeteners-worse-than-sugar.aspx

which begins by saying…“Diet foods and drinks are promoted to help you lose weight but compelling evidence shows that artificial sweeteners like aspartame cause weightgain rather than weight loss. That’s right, aspartame―which was once hailed as a wonder chemical because it tastes like sugar without the calories―actually makes you fatter, and adversely affects your blood glucose levels and insulin sensitivity.”

If indeed any of this is true then my question is…..am I just on a losing battle in terms of my partner needing to lose weight in order to.......a) better control his diabetes and......b) prepare for a potential knee replacement operation

Calculating his current weight this gives him a BMI in the region of 37.8…....plus.......being on the maximum dosage of gliclazide (this will not help as one of the known side effects of gliclazide is weight gain)….......add to this his consumption of fizzy drinks ……and his inactivity…

………should I just give up now???????

 

[connie104]

I,m sorry to say Molly but I think I would have given up long ago ! How can you help him if he won't help himself . After just going through a hip replacement I know the strict criteria expected to be able to have the op and I really cannot see your partner reaching it x

 

[Molly56]

I,m sorry to say Molly but I think I would have given up long ago ! How can you help him if he won't help himself . After just going through a hip replacement I know the strict criteria expected to be able to have the op and I really cannot see your partner reaching it x

@connie104 ....I agree with you on that....I can't see him meeting the criteria either....

 

[donnellysdogs]

Oh Molly56... I so feel for you.

Like Connie.. I must admit I would have given up long ago.....

Paesonally, if this was just about fizzy drinks I would have said not to worry too much if he could get readings within normal realms. However, there has been a lot of info rearing its head on sweeteners in general making ys humans want to basically conaume more sweeter products whether they then be sweetened or carb laden.

Drinks are hard to think of huge recipes for... Itsnot easy. I hate cold drinks including water but haveone exception milk.. But again not a particularly good choice.. Its really difficult with drinks.

I rather feel that you are feeling quite down trodden today, I wish there was a fairy with just her wand to give you one wish... But I rather fear you would pick for your partner to have better health, than for that fairy to grant you something better for you....

I think it is always going to be a struggle for you until something comes along to change your partners attitude, but that is going to have to be one helluva major event...I don't think he values his life at all.

Have you had your blood results back from tests done? Are you keeping well? Sorry, sometimes the Carer's get forgotten....x

 

[Scandichic]

Was reading through a post this morning and it mentioned about the fact that fizzy drinks are bad even if they are those that are described as diet…..



Thought it would be worthwhile checking this out as my partner does tend to drink quite a lot of these….in the region of 4 – 6 per day…..his other drink of choice is cans of cider, something which I questioned in an earlier posting…

Anyway looking at the diet fizzy drinks I knew that the sweeteners were not necessarily good…aspartame is the main one mentioned …..but was unaware of the fact that these could potentially trick your body into releasing insulin….a bit of internet searching came up with the following link....

http://articles.mercola.com/sites/a...9/artificial-sweeteners-worse-than-sugar.aspx

which begins by saying…“Diet foods and drinks are promoted to help you lose weight but compelling evidence shows that artificial sweeteners like aspartame cause weightgain rather than weight loss. That’s right, aspartame―which was once hailed as a wonder chemical because it tastes like sugar without the calories―actually makes you fatter, and adversely affects your blood glucose levels and insulin sensitivity.”

If indeed any of this is true then my question is…..am I just on a losing battle in terms of my partner needing to lose weight in order to.......a) better control his diabetes and......b) prepare for a potential knee replacement operation

Calculating his current weight this gives him a BMI in the region of 37.8…....plus.......being on the maximum dosage of gliclazide (this will not help as one of the known side effects of gliclazide is weight gain)….......add to this his consumption of fizzy drinks ……and his inactivity…

………should I just give up now???????

Big hugs. I know you're very worried but you can lead a horse to water but you can't make it drink! He needs to accept responsibility for his own health! He is an adult and needs to start behaving like one. Like @donnellysdogs I wish I could wave a magic wand! Take care! X