Covid and Work, Covid Advice and General Chat

JRT

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256
Apologies for placing this on here but I didn't think a new thread was needed. Absolutely gutted today, although not over surprised, that my first HBA1c result since last June has come back as 70 which is my highest since diagnosis in 2011. Previous highest was in 2015 when it was 64. Gutted because my readings in April 18, November 18 and June 19 were 49, 49, 48. It jumped to 58 in December 2019 but I got it down to 51 in June 20 so a 19 point jump in 8 months is worrying and depressing.

Haven't helped myself to be fair as I have sneaked back into the comfort foods with winter and dealing with the situation with mum in a care home but it's no excuse. I know chips and chocolate toffees aren't doing me any good! Plus that ball of the foot problem meant I couldn't walk for over a month which dented the exercise but I have been back pounding the pavements once every two days, or sometimes every day, as the foot is improving so was hoping the last three weeks back walking would have helped but not so obviously. Will try and walk for that 45 mins to an hour every day now if I can.

Spoke to the GP about something else today and she suddenly said my results from this morning came back quickly and she wanted me to book an appointment with the Diabetic Doctor although there aren't any appointments until the 22nd. She says the other GP will probably discuss diet and new medications to put me on as I already take four metformin a day so not sure what the new meds will be, on top of every other pill I take!! I didn't even bother asking about cholesterol etc!!

Really don't know how to improve the diet, bar cutting back again on the obvious carbs and sugars obviously. I live on my own and I'm no Gordon Ramsey and have suffered with IBS for years but keep it at bay by avoiding roughage and vegetables so a bit lost on what to do bar having egg, bacon and sausages every day!

Sorry for the off topic rant but it's really devastated me that has..
Hiya,no need for any apologies and sending big hugs! Lots of good advice off others here too.
Try not to be to hard on yourself. We all know what we should be doing but now more than ever it's so hard. Ironically the situation that's causing the stress is probably not helping with bloods.
It could be anyway that your body was on the edge of changing and stress has pushed it over edge.
When I was first diagnosed I found that after a few cautious months my bs stable pretty much whatever ate although a chinese meal always had a small impact.
Five years after that I had a very stressful few months and suddenly my blood sugars were through roof even if completely cut out as many carbs etc. They tried another medication which had no effect. Eventually I was put into a weekly injection which not insulin but similar. The results were pretty instant. I did question whether I still needed full dose of metformin even though things fine. For whatever reason they seem to think staying on full dose always needed. It could well be that reducing your metformin has had an impact.
I've been fine for 5 years. My last blood test was a year ago and levels slightly raised. I was very positive as had lost nearly a stone and smoking negligible. We were supposed to review last April but didnt happen. I have an appointment for next week. I'm expecting a similar result to yours. I did have healthier moments over last year but comfort food often won over common sense and put weight back on etc.
Take things step by step and be kind to yourself and see what GP says and take it from there.
I was also lucky enough to have my first vaccination today. I had the ffzer one. The sense of relief was unbelievable!
 
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Max68

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751
Well the GP sent me to the Head and Neck Clinic at the hospital, which I was nervous about due to Covid. Saw the the Consultant today and it is a cyst not a lymph node. She had a good feel all around head and neck area and assured me that there was absolutely nothing she was worried about. She couldn't even feel what I was worried about to start with. The "lump" I was conerned about which was lower than the "node" was just a normal part of my throat structure and she said no-one is 100% symetrical. I asked if an ultrasound was needed and she said she could offer me one if her opinion wasn't enough to put my mind at rest but she really didn't see the need. She had a deserved dig at me over a vice I have, I don't drink , but I have struggled over the years to completely give up smoking, but I will now try desperately to succeed with that, but she understands that with my mum on end of life care at a care home it's not the best time! She asked me if I had any symptoms in mouth or throat but she was however reassured that I'd had an endoscopy in 2017 for constant throat clearing that was clear. Relieved but also aware that many aren't so lucky.
 
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Hopeful34

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That's really good to hear Max, at least one thing less to worry about.
Sending hugs for your mum being on end of life care. It's such a hard time. Take care.
 

Max68

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751
That's really good to hear Max, at least one thing less to worry about.
Sending hugs for your mum being on end of life care. It's such a hard time. Take care.

Thank you. Isn't it strange how even when you see a consultant you still aren't 100% convinced!! Maybe it's just me! Mum wouldn't surprise me if she turned it around as she seems to keep the GP and care team guessing. So difficult though as you just want to see her but at the same time don't want to see her suffering, if you get my drift? Immensely proud of her though. Dementia, Covid, Body giving up and still fighting. One tough generation those born pre war days. Not really a religious person but I just wish she and dad one day will be together again playing golf again in the sky.
 
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Hopeful34

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No it's not just you, I would be the same, but try to just believe what they said and put it to the back of your mind if you can. Not easy I know!!!
Your mum sounds very much like mine, she fought for four years to stay, as we were very close, and she didn't want to leave me. It's very hard to see those you love suffering, we just want them to be how they were when they were well, so yes I understand where you're coming from.
 

Goonergal

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There are several Covid threads, but this is the one where I recall the criteria for being considered Clinically Extremely Vulnerable is discussed most often. There appears to have been some updated guidance issued yesterday, so I’m linking here to that, and also to a calculator for assessing risk - it’s one of those that uses assumptions around broad criteria like postcode and medical conditions (my risk goes up exponentially with my postcode, for example!), but interesting nonetheless.

https://digital.nhs.uk/coronavirus/risk-assessment/population
https://qcovid.org/Calculation
 

Max68

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751
There are several Covid threads, but this is the one where I recall the criteria for being considered Clinically Extremely Vulnerable is discussed most often. There appears to have been some updated guidance issued yesterday, so I’m linking here to that, and also to a calculator for assessing risk - it’s one of those that uses assumptions around broad criteria like postcode and medical conditions (my risk goes up exponentially with my postcode, for example!), but interesting nonetheless.

https://digital.nhs.uk/coronavirus/risk-assessment/population
https://qcovid.org/Calculation

Thanks Goonergal. I saw this mentioned on the news but it didn't really say whom they were adding to the list. Just using the tool mine came out at -

…………………………………...................................Absolute risk (a)………….Absolute risk with no risk factors (b)…...Relative risk (a/b)

COVID associated death….............................0.0197%...1 in 5076…….0.007%.....1 in 14286…………………….........2.8143

COVID associated hospital admission……...0.1096%...1 in 912……….0.0593%...1 in 1686……………………...........1.8482

In other words in a crowd of 10000 people with the same risk factors, 2 are likely to catch and die from COVID-19 and 11 to be admitted to hospital during a 90 day period similar to the recent peak.

COVID associated death
The absolute risk of a COVID-19 associated death is 1 in 5076.
This is in rank 73 out of 100, where 100 is most at risk.

I suspect as a long term smoker, albeit in the midst of cutting down that risk is even higher! :banghead:
 

HSSS

Expert
Messages
7,465
Type of diabetes
Type 2
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Diet only
Thanks Goonergal. I saw this mentioned on the news but it didn't really say whom they were adding to the list. Just using the tool mine came out at -

…………………………………...................................Absolute risk (a)………….Absolute risk with no risk factors (b)…...Relative risk (a/b)

COVID associated death….............................0.0197%...1 in 5076…….0.007%.....1 in 14286…………………….........2.8143

COVID associated hospital admission……...0.1096%...1 in 912……….0.0593%...1 in 1686……………………...........1.8482

In other words in a crowd of 10000 people with the same risk factors, 2 are likely to catch and die from COVID-19 and 11 to be admitted to hospital during a 90 day period similar to the recent peak.

COVID associated death
The absolute risk of a COVID-19 associated death is 1 in 5076.
This is in rank 73 out of 100, where 100 is most at risk.

I suspect as a long term smoker, albeit in the midst of cutting down that risk is even higher! :banghead:
My absolute risks are slightly lower than yours but my relative risk is noticeably higher than yours, using my postcode. They are all worse if I remove the postcode. If I lived 300m away they are worse again. Very arbitrary.

I take that to mean other people in my demographic but without my risk factors have a better chance than me! That’s if I understand it correctly.
 

HSSS

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I’ve today taken an unpaid leave of absence from work for 3 months from my part time job. I’ve been signed off with an injury caused by work since Christmas and have been on restricted duties for months due to a preexisting condition aggravated by work. I came to this decision as the alternative was hoping I continue to be granted fit notes each renewal from a random dr who could be anyone in the entire group of practices each time and/or returning working in an environment that was perhaps still unsuitable physically whilst in physio rehab and very stressful to me mentally covid wise. Whilst entitled to sick pay if/whilst I get the fit notes I cannot deal with the uncertainty and worry of that nor of being there due to covid. I’ve felt so much better the last 6 weeks I realise now the toll it was taking before Christmas (and pre the third wave and new variants at that!) I’m hoping this preserves the good working relationship with them and also long term job prospect for me which for many other reasons are pretty restricted at the best of times.

The downside is now neither of us are working but due to the structure of my other half’s now dormant business and pensions etc we get nothing in the way of help. We, and 3 older teen children, are surviving on retirement savings which should have been 8yrs away at least.

maybe a financially stupid move but at least I have some consistency for a while longer.
 
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Max68

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My absolute risks are slightly lower than yours but my relative risk is noticeably higher than yours, using my postcode. They are all worse if I remove the postcode. If I lived 300m away they are worse again. Very arbitrary.

I take that to mean other people in my demographic but without my risk factors have a better chance than me! That’s if I understand it correctly.

Interesting isn't it? What intrigues me is that they don't take into account certain other "risks". For instance I live alone so if I am going to pick it up it would be like the last couple of weeks a dentist, hospital and GP appointment. In the weeks I don't visit those, which is far more often, the only people I cross are out on a walk or delivery people at the door. Therefore I "assume" lowering my potential "viral load" risk. Whereas in a family situation people live with others so the potential viral load "would" possibly be higher. I haven't seen much science on viral load but if you take into account care homes and hospital wards I assume it has an impact.
 
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HSSS

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I’m reading on other forums and groups loads of previously gestational diabetic women have been added to the shielding list. That are not in the excessive bmi range either without other conditions. Have they failed to update codes and the systems think they are still diabetic and pregnant? Why else would they be shielded when the majority of us “currently” diabetic are not? Or perhaps they have a pregnant weight recorded last massively changing bmi.
 
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Bluetit1802

Legend
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25,216
Type of diabetes
Type 2 (in remission!)
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I’m reading on other forums and groups loads of previously gestational diabetic women have been added to the shielding list. That are not in the excessive bmi range either without other conditions. Have they failed to update codes and the systems think they are still diabetic and pregnant? Why else would they be shielded when the majority of us “currently” diabetic are not? Or perhaps they have a pregnant weight recorded last massively changing bmi.

Unfortunately, once a diagnosis is made and coded on medical records, if it was a correct diagnosis at the time, then it remains on the medical records and won't get deleted. It has happened to me. Not gestational diabetes, but kidney disease. 8 years ago I was on chemotherapy, and kidney function reduction is one of the side effects. My EGFR dropped to 64 for a period. My GP coded me with CKD stage 2 without proteinuria. Since chemo my EGFR has been perfect at above 90 but the coding still remains on my records. I did ask the GP to remove it but was told she couldn't as it was correct at the time.
 
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HSSS

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Unfortunately, once a diagnosis is made and coded on medical records, if it was a correct diagnosis at the time, then it remains on the medical records and won't get deleted. It has happened to me. Not gestational diabetes, but kidney disease. 8 years ago I was on chemotherapy, and kidney function reduction is one of the side effects. My EGFR dropped to 64 for a period. My GP coded me with CKD stage 2 without proteinuria. Since chemo my EGFR has been perfect at above 90 but the coding still remains on my records. I did ask the GP to remove it but was told she couldn't as it was correct at the time.
They can have resolved or in remission added though or be shown as no longer a current/active issue can’t they? Otherwise every broken leg remains broken and unhealed, every infection still raging
 

JRT

Well-Known Member
Messages
256
I’ve today taken an unpaid leave of absence from work for 3 months from my part time job. I’ve been signed off with an injury caused by work since Christmas and have been on restricted duties for months due to a preexisting condition aggravated by work. I came to this decision as the alternative was hoping I continue to be granted fit notes each renewal from a random dr who could be anyone in the entire group of practices each time and/or returning working in an environment that was perhaps still unsuitable physically whilst in physio rehab and very stressful to me mentally covid wise. Whilst entitled to sick pay if/whilst I get the fit notes I cannot deal with the uncertainty and worry of that nor of being there due to covid. I’ve felt so much better the last 6 weeks I realise now the toll it was taking before Christmas (and pre the third wave and new variants at that!) I’m hoping this preserves the good working relationship with them and also long term job prospect for me which for many other reasons are pretty restricted at the best of times.

The downside is now neither of us are working but due to the structure of my other half’s now dormant business and pensions etc we get nothing in the way of help. We, and 3 older teen children, are surviving on retirement savings which should have been 8yrs away at least.

maybe a financially stupid move but at least I have some consistency for a while longer.
I totally sympathise,last year even though my reasons for a sick note were totally genuine I always felt anxious when one was due! Often when a situation stops is when you realise how much pressure you were under! Hopefully in three months things will be much better.
 

JRT

Well-Known Member
Messages
256
I’m reading on other forums and groups loads of previously gestational diabetic women have been added to the shielding list. That are not in the excessive bmi range either without other conditions. Have they failed to update codes and the systems think they are still diabetic and pregnant? Why else would they be shielded when the majority of us “currently” diabetic are not? Or perhaps they have a pregnant weight recorded last massively changing bmi.
I think I've now given up on any sense being made of the official attitude to diabetes. It has been consistently up there with regard to risk but pretty much ignored. I think there are probably to many of us. I also think that most think those who are high risk can automatically WFH or keep themselves protected. Those who are high risk but working dont seem to be very newsworthy. I wonder how many have left jobs, are on unpaid leave or worse still have become seriously ill?
 

Max68

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Messages
751
I think I've now given up on any sense being made of the official attitude to diabetes. It has been consistently up there with regard to risk but pretty much ignored. I think there are probably to many of us. I also think that most think those who are high risk can automatically WFH or keep themselves protected. Those who are high risk but working dont seem to be very newsworthy. I wonder how many have left jobs, are on unpaid leave or worse still have become seriously ill?

Very much agreed. There are no statistics that help us at all to determine our risk. As you say there is a lot of us and even more probably undiagnosed. This is what intrigues me, how many who have become seriously unwell with Covid and have underlying conditions had "undiagnosed" underlying conditions compared to those who had diagnosed and medicated conditions? Diabetes and Heart Disease especially can easily go unnoticed certainly early doors if you don't go to the GP regularly and I suspect in many cases diagnosis has been stumbled upon.

Plus certain factors are unknown. I read recently that metformin has a benefit with Covid, although I don't know how. Same with Vitamin D. So is someone with a higher HBA1c but on metformin and Vitamin D have less or more risk than someone with a lower HBA1c but not on either? If you have a higher HBA1c but no current diabetic complications does that make you better off than someone with diabetic complications?
If the cytokine storm when the immune system attacks the body is the main problem then why are immune suppressed people at risk?

Still so many unknowns.
 

simo_M

Active Member
Messages
36
Type of diabetes
Type 2
Treatment type
Other
I've just been told that I've been added to the extremely vulnerable list and have no idea why! No risk factors other then well controlled type 2 (Metformin) and being male. Otherwise fit and healthy 45 year old with BMI of 24

Have discussed with my GP, who has said that she's not been told the criteria and can't see anything justifying it. She also mentioned that of the last shielding list about 40% of those the practice reviewed were incorrect.

According to calculator my absolute risk of death would be 1 in 7092. Of course, a critical piece of information missing from the calculator is that I've had covid and know from being a convelescent plasma donor that I still have plenty of antibodies. Can't help but think this dramatically changes risk.

I find it annoying that they do not provide any explanation of the factors that have resulted in the risk determination. Without this it's very difficult to know if it's just bad data, or something more concerning.
 
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JRT

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256
I've just been told that I've been added to the extremely vulnerable list and have no idea why! No risk factors other then well controlled type 2 (Metformin) and being male. Otherwise fit and healthy 45 year old with BMI of 24

Have discussed with my GP, who has said that she's not been told the criteria and can't see anything justifying it. She also mentioned that of the last shielding list about 40% of those the practice reviewed were incorrect.

According to calculator my absolute risk of death would be 1 in 7092. Of course, a critical piece of information missing from the calculator is that I've had covid and know from being a convelescent plasma donor that I still have plenty of antibodies. Can't help but think this dramatically changes risk.

I find it annoying that they do not provide any explanation of the factors that have resulted in the risk determination. Without this it's very difficult to know if it's just bad data, or something more concerning.
The only factor I can think of is maybe your postcode? I know it must be a complex process but I'm not sure which is most concerning-being put on shielding list with no real explanation or being left off when should be on it!
 

Max68

Well-Known Member
Messages
751
I've just been told that I've been added to the extremely vulnerable list and have no idea why! No risk factors other then well controlled type 2 (Metformin) and being male. Otherwise fit and healthy 45 year old with BMI of 24

Have discussed with my GP, who has said that she's not been told the criteria and can't see anything justifying it. She also mentioned that of the last shielding list about 40% of those the practice reviewed were incorrect.

According to calculator my absolute risk of death would be 1 in 7092. Of course, a critical piece of information missing from the calculator is that I've had covid and know from being a convelescent plasma donor that I still have plenty of antibodies. Can't help but think this dramatically changes risk.

I find it annoying that they do not provide any explanation of the factors that have resulted in the risk determination. Without this it's very difficult to know if it's just bad data, or something more concerning.

As JRT says it could be post code. I'm 52, a tad tubby, last HBA1c too high, on BP meds and statins, and have a penchant for the smokes and no letter as yet!
 

Bluetit1802

Legend
Messages
25,216
Type of diabetes
Type 2 (in remission!)
Treatment type
Diet only
They can have resolved or in remission added though or be shown as no longer a current/active issue can’t they? Otherwise every broken leg remains broken and unhealed, every infection still raging

Yes, I suppose they could. On my on-line records the "problems" are in 3 parts. Current, Past (significant) and Past (Minor). The coding for the kidney disease is in the Past (significant) section, so is my broken tibia and fibula, which happened in 1950 when I was 2 years old!!