Appointment with diabetic nurse / pain management clinic / hip & knee consultant

@Scouser58 @donnellysdogs @Anie

Just a quick update following my doctor’s appointment this morning….think it went well and doctor was sympathetic to my situation….told him stress / worries about foot ulcer / forthcoming holiday / travel insurance etc; concerns over medication / not testing / driving etc following recent diabetic nurse appointment (including not testing of feet properly); fact that he spends most time in bed / not motivated / inactive and effect of not taking medications on regular basis (morning meds not taken till lunchtime) etc…..basically threw everything at him for the record so that he could see why I was not coping / getting stressed…..also told him effect it was having on me not being able to relax / feeling hyperactive etc etc

The result of my rant was that he totally sympathises with my situation….but if my partner will not follow the medical advice he has been given then there is little he can do for him.

As far as I am concerned / what the doctor can do for me .....the proposed course of action is fasting blood test (full blood count / fasting glucose / fasting lipids / thyroid function test - already booked for 4th Sept) just to check nothing is physically wrong with me.....he doubts there is...

Antidepressants were mentioned as an option but I said I did not want to go down that route…why should I when it is not really me with the problem, other than he is the problem!…..have agreed to go down counselling route as gives an opportunity for me to talk it through (phoned for referral and have initial telephone consultation booked for next Tuesday afternoon)

The GP has also suggested that I contact the local community diabetic team to see what potential help or advice they can give…..have got the number and address but as I was working this afternoon have not had an opportunity to call them….will do so tomorrow or early next week. Didn’t totally see how this would help but think that it may give me an opportunity to discuss issues with someone and express my worries / concerns for my partner…..how they can then help I am not sure but perhaps there are things they can suggest that the GP / diabetic nurse in the practice cannot.

Has anyone any experience of Community Diabetic Care teams (if that is the right term)…..how do they differ from GP practice and what they can offer that the GP practice cannot?

Whether any of the above helps to solve the problem only time will tell but at least I am looking after my own health and wellbeing …finally the GP suggested seeing me again in 4 weeks time ...an appointment I will make and keep...

Anyway the end result is that the doctor listened….I offloaded my worries / concerns …the GP now has more information on the situation…..I can do something positive for myself …..and I feel a little less stressed for the time being. ......until the next issue....

Scouser58 said:

Hello Molly, so glad you have been and seen the gp, and got lots off your chest, back, any everywhere else.
Glad to hear he is running the full service tests as donnellydogs has said, so now you have time to think, what are you going to do for yourself?. After all these busy appointments, have been too and arranged including return to gp, are you going to have time for time out with your friend, to lower the stress you still have. Is there anywhere you could go for an aromatherapy massage, they can mix the blend to suit your needs, and help balance you and give you calming less stressfull times. Molly glad you are looking out for yourself, and maybe stepping back and seeing what your man does next. Post to you again , ttfn

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@Scouser58 thank you for your message....am feeling a little less stressed since my visit to the GP ....just sharing my concerns with him has helped plus I have some plan of action to help myself....

On a positive note it appears that his foot ulcer is actually getting better so perhaps some of my worries about this and our forthcoming holiday will not be such a problem.....some may say that I was worrying unnecessarily but then again it could just as easily have got worse so I don't think my worries were totally unfounded given the timescale.

As far as other matters are concerned I do still have worries but am learning to set them to one side and concentrate on myself for a while....had a very productive day in the garden today clearing brambles and bindweed from the back fence....very therapeutic....spent most of the day on my own as he was in bed for much of the day (what a waste!)....but enjoyed my task so not too bothered by his absence. Have filled four sacks of rubbish for him to take to the tip later in the week so that will give him something to do!!!!!.....will probably take a couple of trips!

Have got some plans for tomorrow and the rest of the week so keeping myself occupied......includes doctors appointment for him on Wednesday with same GP so will be interesting to see how that goes given my recent visit....will go along with him to see what is suggested as he never remembers what they say.......at least the GP has a better understanding of the situation now so can hopefully suggest some appropriate course of action.

An aromatherapy massage sounds like a good idea....will look into that ..............it's my birthday next month so perhaps I can suggest it as a present

Molly56 said:

…..have agreed to go down counselling route as gives an opportunity for me to talk it through (phoned for referral and have initial telephone consultation booked for next Tuesday afternoon)

The GP has also suggested that I contact the local community diabetic team to see what potential help or advice they can give…..have got the number and address but as I was working this afternoon have not had an opportunity to call them….will do so tomorrow or early next week.

Anyway the end result is that the doctor listened….I offloaded my worries / concerns …the GP now has more information on the situation…..I can do something positive for myself …..and I feel a little less stressed for the time being. ......until the next issue....

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As a quick update .....have spoken with the therapy team on initial telephone consultation and they have accepted that I can have one to one counselling sessions....hopefully this will give me an opportunity to voice my worries and concerns and to develop better strategies for me to deal with them. Am a little sceptical about how this will work but am prepared to give it a go.

Have not yet contacted the community diabetic team due to other work commitments and attending GP appointment with my partner today but it is definitely on my "to do" list for either later this week or maybe next week

Looks like the "next issue" is a potential knee replacement operation......not for me I hasten to add......just another challenge to be faced....

Scouser58 said:

Hi Molly, talking can sometimes get the person to open up and reveal the reasons for the actions that have been taken/or not as the case maybe. Take your time in organising things, so that you can plan things out and get the best date for the appointments, and don't let your "to do" list get too long, they just get tatty and then get thrown away uncompleted.
Knee replacement operation, now that is another serious matter and must be looked at in a more calm manner, I am facing this surgery on both my knees, right one first I think is the plan, that is when I am thinner, so a while to go then!!??. Who ever is looking at knee operations, must be planning their recovery and having stuff done, before they go in, as it will be limp/hop along for a while during recovery, wish them luck and a speedy recovery. So Molly have the decisions been taken about your holiday?, still going?, well keep in touch ttfn

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@Scouser58 ...just to clarify, the talking therapy is just for me ...for me to work out how best to deal with the situation that I am in and does not involve my partner. He was offered similar help about two years ago...he went along to the first appointment..decided it was a waste of time and promptly cancelled the rest.

However I am prepared to give it a go and as you say I will go along prepared to get the most out of each session...am thinking perhaps it would be a good idea for me to prepare something in writing before the first appointment that will explain in a nutshell the challenges that I face rather than have to remember it all and explain it verbally.....am thinking it could be a rather large nutshell, perhaps coconut sized

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

As far as holiday is concerned now that the foot ulcer is on its way to healing I think it is safe to go away...it could easily have gone the other way though so I feel that my worries and concerns from a few weeks ago are not totally unfounded.....think it is safe to start packing my case now

phoenix said:

One thing about the knee replacement, it can be done under local anaesthetic rather than a general which I assume makes it considerably safer.
My father is about to have his 3rd, ie a replacement replacement knee. He is 86 has had a heart valve replacement and still has atrial fibrillation, he is on warfarin and a host of other cardiac related pills. He has just had an' aggressive ' melanoma removed but they are still about to do the operation.
They ask what music you would like during the operation, he has asked for ' the anvil chorus'.

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@phoenix Not sure I would want to have an operation such as a knee replacement done under local anaesthetic....I think you would have to knock me out first.......don't think I would be a very good patient.
Hope your father gets on OK with his operation

Scouser58 said:

Hi Molly, well you really are getting yourself into the sorting out mode, nice one.
There could be the 'pain transference' i.e the pain he is most registaring is the hip/groin pain, which he feels is worse than the knee pain, and when the knee replacement happens, he may find that the pain is back to the knee, but will have a knock on effect, maybe the hip/groin should be given consideration pre-operation. The doctor I am with wants me to loose weight, before he operates, I have a revisit before anything is decided and as my weight has not gone down far enough, then maybe back to the diet before the op, waiting for another appointment in november for a review, which is not far away, the co-op in alsager has already got the christmas sweet tins in stock??what! much too soon, we have to get past, all the other day things before chrimble!!,Both my knees are not as painful as they were previously, and this is a head scratching situation, but at times I do seeze up and legs go stiff? when I walk, knees are complecated things in the middle of the legs, glad to hear that you are going on holiday, and the foot ulcer is clearing up, so rest the mind for that one problem. Did him indoors have any problems during the hot weather, extra thirsty, etc? as the heat can have effects on blood sugar levels, and the temption to have a few extra drinks, is a consideration. Has he made any efforts in the testing department?, what about this, he needs to get going testing, so that when away, he can be incontrol in the hotter weather, so getting the levels noted down,so he can understand and be aware of bs levels going up/down in the heat.
Post again soon Molly, ttfn

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@Scouser58 I see what you are saying about pain transference as I know it is possible to feel pain in a different area to the origin of the problem as in sciatica.....was wondering though if the lack of pain in the knee is due to nerve damage / neuropathy / loss of sensation caused by his diabetes ....

The GP has referred him for a hip xray which he has booked for the 11th September to check that out so hopefully we will get the verdict on that before the appointment comes through for the consultant for the knee.....at least there will then be up-to-date xrays for both hip and knee on the system for the consultant to refer to in making any recommendations.

Unfortunately he still doesn't see the point or the need in testing...to be honest I haven't been bothered to remind him lately and he has not had the initiative to do it himself.

Was considering taking the test kit in my suitcase but will probably not be worth it....after all if he is not prepared to do it at home he is going to be even more reluctant to do it when he is on holiday.......may pack it anyway, just in case...

Am accepting that I am perhaps losing the battle and just need to let him get on with it and suffer the consequences.......perhaps one day he will hopefully get the wake up call to make him do something about his diabetes....am hoping the orthopaedic consultant may be it.....but not convinced

In the meantime am just getting on with my own life.....have found a new sewing project / potential business venture to throw myself into so will be busy with that

connie104 said:

I have just come out of hospital after having a hip replacement operation. I am 2 weeks in now and the results are good. The operation was done by epidural and a mild sedative to make you drowsy and I indeed did wake up in the middle of it and although I could feel no pain. I was aware of them drilling and banging !!! I am not overweight BMI of 21 and they still would not operate on me unless my BG was in range ( under 7 I believe) I live in Spain so the rules may be different here but they seem to have strict guidelines about operating on diabetics .

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@connie104 thank you for sharing your experience...am pleased to hear that it went well.
As you say different rules may apply in different countries but it is useful to know what different people have been told in terms of criteria for this kind of operation - I am assuming it was your diabetes rather than your weight that led to the operation being done under local rather than general anaesthetic.
Wishing you a speedy recovery

Have just had a conversation with my partner and he tells me that he felt dizzy / wobbly on his feet when he got up this morning......I had gone out to work so wasn't here .....

Was wondering if this is starting to indicate that his blood sugar levels are coming down to a level where he may suffer from a hypo...I asked if he had tested and he said no.....just suggested that he test it now but he refused.

Am not sure what, if anything, he did to deal with the symptoms but assumed that he just took his morning medication and then went out as per normal (skipping breakfast) to have his lunch (evidently he had eggs on toast) and to get the newspapers and some shopping......

Which leads me to the fact that he did not test before driving........so now I will need to start worrying about that again.......I know this was a previous concern but based on the fact his levels were in the high teens I had concluded this was not the most important issue I was having to deal with at the time.....

If now his levels are falling .....last reading was 9.9 in the morning about a week or so ago....perhaps the potential for hypos is now more relevant.

It could of course be that I am reading something into this that is not there ...............but who knows.....

CarbsRok said:

If his blood sugar was lower than he is used to then it could have been a false hypo. But as DD says no testing so not going to find out.
It's a shame really as it's such a waste of a life and all he has to do is make some dietary adjustments and he could lead a perfectly normal life.

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@CarbsRok .....as I mentioned in my answer to your other question (on other thread) ....I also think lack of activity is a key issue