Advice needed....insulin quantity when ill or not eating....

[Molly56]

Earlier this week my partner had a fall and damaged his knee ligaments....he is currently confined to bed and the house trying to recover from this injury before our holiday in less than three weeks time...this weekend I have to go away for a couple of days (to support my son through a medical procedure) and will be in London from Sunday through to Tuesday....

.....my concern is that over the last couple of days his bs levels have been unusually low with readings of 5.5 this morning (when normally around 9 or 10 for him) and 7.3 last night (when normally around 10-12 at that time of day)....these new readings I know are good and what he should be aiming for but he just tells me that he will just not eat whilst I am away......I had asked him what food he wanted whilst I am away and he is unable to get out and have been shopping tonight and left some items in the fridge but whether he chooses to eat it or not is clearly out of my hands....is relatively low carb anyway (salads, cheese slices, yoghurts) and he has already eaten some of it already so can only hope he will have enough to last for next four days...

..this I guess would be ok if he were not on the medication he is on which includes insulin (Novomix 30....fixed dose of 30 units in the morning and 30 units before evening meal)...regardless of what he eats (or not) or regardless of bs levels if he actually tests (have noticed he rarely tests before injecting anyway) he continues to use the same 30 units without thinking or considering implications ....

....so I guess my question is..... should he still be taking the same amount of insulin if he is not well and choosing not to eat.. ....he has not received (or so he says) any instruction about what to do if bs levels are low ....to date he has not fallen to levels where he has experienced an actual hypo and I fear he is not prepared to deal with this if he did.......more than likely he would just take to or stay in his bed and will certainly not think of testing / treating as a hypo......am slightly fearful as to what I may return to....

 

[ButtterflyLady]

Earlier this week my partner had a fall and damaged his knee ligaments....he is currently confined to bed and the house trying to recover from this injury before our holiday in less than three weeks time...this weekend I have to go away for a couple of days (to support my son through a medical procedure) and will be in London from Sunday through to Tuesday....

.....my concern is that over the last couple of days his bs levels have been unusually low with readings of 5.5 this morning (when normally around 9 or 10 for him) and 7.3 last night (when normally around 10-12 at that time of day)....these new readings I know are good and what he should be aiming for but he just tells me that he will just not eat whilst I am away......I had asked him what food he wanted whilst I am away and he is unable to get out and have been shopping tonight and left some items in the fridge but whether he chooses to eat it or not is clearly out of my hands....is relatively low carb anyway (salads, cheese slices, yoghurts) and he has already eaten some of it already so can only hope he will have enough to last for next four days...

..this I guess would be ok if he were not on the medication he is on which includes insulin (Novomix 30....fixed dose of 30 units in the morning and 30 units before evening meal)...regardless of what he eats (or not) or regardless of bs levels if he actually tests (have noticed he rarely tests before injecting anyway) he continues to use the same 30 units without thinking or considering implications ....

....so I guess my question is..... should he still be taking the same amount of insulin if he is not well and choosing not to eat.. ....he has not received (or so he says) any instruction about what to do if bs levels are low ....to date he has not fallen to levels where he has experienced an actual hypo and I fear he is not prepared to deal with this if he did.......more than likely he would just take to or stay in his bed and will certainly not think of testing / treating as a hypo......am slightly fearful as to what I may return to....

You could find some info about how to prevent and treat hypos, print it out and give it to him. At the end of the day he is responsible for his health and you have done your best to help him. The rest is up to him.

 

[Molly56]

You could find some info about how to prevent and treat hypos, print it out and give it to him. At the end of the day he is responsible for his health and you have done your best to help him. The rest is up to him.

@CatLadyNZ ....good advice other than the fact that he firmly believes that he will never have a hypo.....he has it set in his head that "I am hyper, not hypo".....no amount of me trying to explain will ever change this....he becomes very defensive and just accuses me of "you don't understand" if I challenge his "I'm hyper" ....
....the only thing that will change it is the day that he experiences his first real hypo....hopefully this will not be while I am away over the weekend but if it is he will just have to deal with it (or not as the case may be)....how I don't know as he has no hypo remedies to hand....I did buy and explain the use of glucose tablets some time ago just in case but these were just dismissed as "I don't need them"....

 

[ButtterflyLady]

@CatLadyNZ ....good advice other than the fact that he firmly believes that he will never have a hypo.....he has it set in his head that "I am hyper, not hypo".....no amount of me trying to explain will ever change this....he becomes very defensive and just accuses me of "you don't understand" if I challenge his "I'm hyper" ....
....the only thing that will change it is the day that he experiences his first real hypo....hopefully this will not be while I am away over the weekend but if it is he will just have to deal with it (or not as the case may be)....how I don't know as he has no hypo remedies to hand....I did buy and explain the use of glucose tablets some time ago just in case but these were just dismissed as "I don't need them"....

Yeah, he is not very open minded is he? It's not rocket science that insulin lowers BGs and can cause hypos, especially if not eating. Giving him something in writing is better than telling him, because he can't talk back to you at the time. You could leave glucose tabs or sugar cubes on the bench with the info when you leave.

There is probably a package insert with his insulin that explains about hypos.

Later on you could contact his nurse and let her know that he seems to believe he can't hypo. Hopefully she will talk to him about it.

 

[phoenix]

There is a difference between being unwell and not choosing to eat. Very often the need for insulin increases when someone has an infection . In that case there are lots of sick day rules pamphlets like this one http://www.nhslanarkshire.org.uk/Se...es - Sick Day Rules - Type 2 - on insulin.pdf
The mixed insulin he takes is based upon eating a regular amount of carbs, if he lowers the amount he does, as you know risk hypoglycaemia.
Without testing he isn't going to know what's happening in any case.

 

[AndBreathe]

You may just find he has a miraculous improvement whilst you are away.

Whilst his leg may not permit him to meander to the shops or whatever, I'm sure it wouldn't inhibit him using the phone. Domino's and the local takeaway joints do delivery, don't they?

He's an adult. Let him get on with it.

He has made his own bed, and now he's literally lying in it. For once, he will be accountable for his actions over the weekend.

 

[Molly56]

@CatLadyNZ @phoenix @AndBreathe ...thanks for the advice....
Have packed my bags and left him .......at least until Tuesday......
..my priority for the next few days is supporting my son who is donating stem cells....he was found to be a match for someone who needs a transplant so that is taking place over the next couple of days. ....sounds like I have just swapped one medical issue for another but at least hopefully this one will have a positive outcome....for both my son and the recipient ....am very proud of him for what he is doing

 

[AndBreathe]

@CatLadyNZ @phoenix @AndBreathe ...thanks for the advice....
Have packed my bags and left him .......at least until Tuesday......
..my priority for the next few days is supporting my son who is donating stem cells....he was found to be a match for someone who needs a transplant so that is taking place over the next couple of days. ....sounds like I have just swapped one medical issue for another but at least hopefully this one will have a positive outcome....for both my son and the recipient ....am very proud of him for what he is doing

As someone who has gone to the wire as a bone marrow donor (it was cancelled very late on, which one can only conclude wasn't for a great reason), your son will have had all sorts of medical tests and checks to ensure he will not be compromised for more than a few days as a result of his procedure.

I'll never forget my old GP (now retired) saying to me when I had gone with my carrier bag full of blood vials and paraphernalia for more bloods and "counselling", in the run up/medicals process,..... "Now don't you even think about pulling out of this madame". I thought it was a novel approach to counselling, but I had no intention of backing out. I was very proud, and deeply saddened when the procedure was cancelled, but I can't imagine my emotion was anything close to that of the potential recipient and their loved ones.

I'm sure you are proud of him Molly. What a fabulous thing to be able to do; to give someone the possibility of a future. Not many of us have such an opportunity. I hope it goes well for all concerned.

 

[zand]

I know someone who has received donated stem cells. This is a truly fantastic gift and the young lady in question has already had 5 more years of life because of it. Good on your son @Molly56 what a great young man!

 

[donnellysdogs]

Truly wonderful that such a young man could do this...Anyhony Nolan used to get a lot of press coverage etc years ago but nowadays you hear more pleads for blood donating.
It is a regret I have that they will not take diabetic blood. But I do give my blood annually to research for diabetes instead.

So important to give. Hope that all goes well as I inderstand it can be quite a painful procedure. Let him know we are all thinking of him.

As for partner.. Sink or swim molly.. You'll prob find he can get "extras" whilst you are away. I doubt very much if a hypo will happen.

 

[Molly56]

@CatLadyNZ @phoenix @AndBreathe ...thanks for the advice....
Have packed my bags and left him .......at least until Tuesday......
..my priority for the next few days is supporting my son who is donating stem cells....he was found to be a match for someone who needs a transplant so that is taking place over the next couple of days. ....sounds like I have just swapped one medical issue for another but at least hopefully this one will have a positive outcome....for both my son and the recipient ....am very proud of him for what he is doing

@CatLadyNZ @phoenix @AndBreathe @zand @donnellysdogs Just returned from my trip to London to support my son through his stem cell donation with Anthony Nolan trust....a very positive experience and couldn't fault the hospital or the staff....so helpful throughout the whole process...the only slight downside is that he had to repeat the procedure two days running to get the required number of stem cells but is a small price to pay to help someone else......my thoughts are with the recipient and hope that they have an equally positive experience wherever they are...

Sadly the same can't be said about what has happened here at home....all seem ok but small things just highlight that he is not managing his diabetes as he should....he tells me that he took his tablets and insulin but that he didn't bother to test at all whilst I was away....
.....this worries me as he is blindly injecting insulin without any consideration as to what his bs levels are and what the consequences could be....I know it is a fixed dose and mixed insulin but surely some consideration needs to be given to what this is doing to his body.....and the dangers of ignoring important checks....

.to be honest at the moment I am too tired by the events of the last few days to even think about this ....will return my thoughts to the positive experiences of the last few days and concentrate on those....

 

[ButtterflyLady]

@CatLadyNZ @phoenix @AndBreathe @zand @donnellysdogs Just returned from my trip to London to support my son through his stem cell donation with Anthony Nolan trust....a very positive experience and couldn't fault the hospital or the staff....so helpful throughout the whole process...the only slight downside is that he had to repeat the procedure two days running to get the required number of stem cells but is a small price to pay to help someone else......my thoughts are with the recipient and hope that they have an equally positive experience wherever they are...

Sadly the same can't be said about what has happened here at home....all seem ok but small things just highlight that he is not managing his diabetes as he should....he tells me that he took his tablets and insulin but that he didn't bother to test at all whilst I was away....
.....this worries me as he is blindly injecting insulin without any consideration as to what his bs levels are and what the consequences could be....I know it is a fixed dose and mixed insulin but surely some consideration needs to be given to what this is doing to his body.....and the dangers of ignoring important checks....

.to be honest at the moment I am too tired by the events of the last few days to even think about this ....will return my thoughts to the positive experiences of the last few days and concentrate on those....

When I went through burnout from having a partner like your hubby I didn't take action to look after myself until I was forced to by the burnout. I still have some symptoms of burnout years later, which I bitterly resent and regret. Please don't do what I did. Look after your health now, by ignoring his self destructive behaviour and focusing on yourself and those who respect themselves and you. If you find you can't ignore him then to be perfectly honest the healthy thing to do is end the marriage.

Look at your son and his maturity and selflessness. You did good there. You are not responsible for your husband's poor choices or the consequences of them. So often women will stay too long, and only end it when they are forced to. A friend of mine only left when she could see the effect on her kids - I wish she had done it years earlier, for herself.

The brain is like any other organ. Mild psychological damage is reversible but severe damage often is not. There is only so much worry your brain can take before negative patterns become entrenched. It also affects your physical health. Often women develop heart disease after menopause because of prolonged stress.

 

[Molly56]

When I went through burnout from having a partner like your hubby I didn't take action to look after myself until I was forced to by the burnout. I still have some symptoms of burnout years later, which I bitterly resent and regret. Please don't do what I did. Look after your health now, by ignoring his self destructive behaviour and focusing on yourself and those who respect themselves and you. If you find you can't ignore him then to be perfectly honest the healthy thing to do is end the marriage.

Look at your son and his maturity and selflessness. You did good there. You are not responsible for your husband's poor choices or the consequences of them. So often women will stay too long, and only end it when they are forced to. A friend of mine only left when she could see the effect on her kids - I wish she had done it years earlier, for herself.

The brain is like any other organ. Mild psychological damage is reversible but severe damage often is not. There is only so much worry your brain can take before negative patterns become entrenched. It also affects your physical health. Often women develop heart disease after menopause because of prolonged stress.

@CatLadyNZ ....thanks for the warning and advice.....just to clarify though that we are not married and if anyone is walking out on this relationship then it will have to be him doing the walking not me in terms of I own the property if that makes any difference...

In terms of stress it just seems that I have many stresses in my life just now, him and his diabetes being just one of them at the moment.....if I can just get past the next couple of weeks a number of those other stress factors will be gone or reduced....just feel like I am running on nervous energy at the moment....am taking two big steps back from his diabetes for now and just leaving him to get on with it as there are far more important things I need to be dealing with for now. Can feel some of the effects on my physical health at the moment so need to reverse these if possible before any permanent damage is caused.

As you rightly say I should be proud of the way my son has turned out and I am.....is good to focus on the positives for once. ...so will return to those positive thoughts in times of potential stress and remind myself that life is so precious...

Time now for some much needed sleep after some very hectic and busy days...

 

[ButtterflyLady]

@CatLadyNZ ....thanks for the warning and advice.....just to clarify though that we are not married and if anyone is walking out on this relationship then it will have to be him doing the walking not me in terms of I own the property if that makes any difference...

In terms of stress it just seems that I have many stresses in my life just now, him and his diabetes being just one of them at the moment.....if I can just get past the next couple of weeks a number of those other stress factors will be gone or reduced....just feel like I am running on nervous energy at the moment....am taking two big steps back from his diabetes for now and just leaving him to get on with it as there are far more important things I need to be dealing with for now. Can feel some of the effects on my physical health at the moment so need to reverse these if possible before any permanent damage is caused.

As you rightly say I should be proud of the way my son has turned out and I am.....is good to focus on the positives for once. ...so will return to those positive thoughts in times of potential stress and remind myself that life is so precious...

Time now for some much needed sleep after some very hectic and busy days...

Good to hear, you are doing the right thing by stepping back. xx