Type 2 BG and Painful Medical Appointments

[SockFiddler]

I'm just back from my MRI for my back and it went really, really badly.

Knowing I'd have to lie on my back in the machine, I took a double-Tramadol / Naproxin (NSAID) well ahead of the appointment in an attempt to get myself through it (pain killers and general opiate haze inducers), but to no avail. I couldn't get the MRI done because the pain of trying to be flat enough to get into the machine was too great and we had to stop when, after about 3 minutes of trying to get my legs straight, they went completely numb.

I generally don't feel pain too much (which is how my back got this bad anyway), so to feel it all so sharply was shocking enough as it is - apparently my (wonderful) friend who had come along to support me heard me in the waiting room and knew it wasn't going well. Also, though, it means that my back is in far worse shape than anyone had thought and the implications of that aren't amazing and I'm trying not to think about them too much at the moment. And, of course, not being able to cope with the scan means treatment options are severely limited because we still don't know either the extent or cause of the damage.

None of this is fabulous. Immediately after the scan, my friend said I'd gone quite pale and noticed I was shaking. My BG had shot up to 8.5 and stubbornly stayed there for a couple of hours. She's an amazing trooper, my friend - when we got to the cafe afterwards (to wait for another close friend who'd had Euan for a couple of days to come and met us), she talked me out of cake, fruit and panini and ordered me a low-carb coffee. Good girl. She also fixed my mascara

Now., three hours later, my BG is still super-high (for me). Generally it bounces happily along in the 5's, peaking at the 6.5 either immediately after food or when I get my liver dump at 5am. Right now it's 7.8. I'm also still very thirsty, shaky and tearful, I have a low-grade headache and I'm quite clammy and sweaty.

I have no idea how to get my BG down, which is the first part of my question. But, more importantly, I know an MRI is critical to getting the right care for my back. So my main question is... how can I get that test done without messing up my BG? I know there are several members who cope with bouts of pain regularly - how do you maintain good BG levels and do you have any suggestions on how to cope better with painful tests in the future?

Many thanks, gang,

Sock x

 

[SockFiddler]

Double-post: Apologies.

Have just found this, could be a life-saver (or mobility saver?). Does anyone else have experience on this?

http://www.uprightmri.co.uk/

 

[Pipp]

Being in the scanner can be quite stressful without the added discomfort and pain of having to lie flat and keep still. I have managed by meditating throughout. It was suggested to me beforehand that I could opt for sedation for the procedure. Would this be a possibility for you?

 

[Guzzler]

While I can't advise you on your high bg I can sympathise with the mri process. I ask for the knee cushion when I have mine which helps but still the pain can be horrendous and there's nothing to be done about the twitching. As my legs were completely numb by the end of my last scan they had to hunt for the aluminium wheelchair which had gone missing. The radiographer was nasty and I ended up 'having a word' with him. All in all it was an unpleasant experience and you have my utmost sympathy. Hope you feel better soon, lass.

 

[SockFiddler]

I'd taken what I could to chill out and had been able to have some quiet time (Euan wasn't home, so I could take a few minutes to straighten my head out and have a talk with myself) before leaving the house. Once in there, I was doing my HPDB (Happy Place Deep Breathing). I'm not scared of the machine - or, indeed, of pain - but I was shocked at how hard that whole experience was.

I'm going to book a phone appointment with my GP to see if she's got any suggestions before we try again (and whether that Upright MRI thing is a possibility - there's one in Birmingham where Said Amazing Friend's family lives). I had lots of padding under my head and knees, but it just wasn't enough - my spine just doesn't go that way anymore. It was also the first time I'd lost my legs when not being upright; every time before this, they've only gone numb when I've walked too far.

The radiographer was utterly sympathetic and compassionate, giving lots of support and letting me take my time trying to move around. She did say that the Children's Hospital (across the way) had a scanner that was 10cm bigger, which could possibly allow my legs to be a bit more bent as it had more clearance and, because it was newer, the imaging would be a much faster process. She said it's hard to justify the need for adults to use it, but it wasn't unheard of and that she'll see what she can do before letting my GP know if there's any point in re-referring, but to use the Childrens' one.

I take it the BG will just come down as my cortisol and adrenaline drop? Keep it low-carb and let nature do the rest? Maybe I'll put a movie on and nap on the couch for a bit - I also slept super-badly last night, which isn't helping anything at all.

 

[Struma]

Double-post: Apologies.

Have just found this, could be a life-saver (or mobility saver?). Does anyone else have experience on this?

http://www.uprightmri.co.uk/

I was getting ready to surprise you with this whilst I read post#1!!

Have only seen it used on TV - it looked like an excellent remedy, you just sit in a space, and the scanner is either side, instead of being like a 'toilet roll' you go into. I would ask your HP's, maybe there's one close?

 

[Pipp]

I would think that BG would be raised with the trauma of the experience. I would grab the opportunity to relax, rest up if still in pain, drink plenty of water, and watch what I was eating.

 

[JohnEGreen]

You can get upright scan done in one of the private centres if it is approved by your NHS trust this though is after written information on your case and a request for Upright scan from a consultant radiologist to the Trust and for a guarantee of payment for the service by the NHS trust is given.

But there is provision for it within the NHS rules, So there is the possibility but would be difficult to get I think.

 

[ickihun]

I'm optimistic they will find a solution for you. Til then keep smiling whenever possible. Your such a great lady.
Keep us posted.

Ps. Only thing I can do is have a run of double tramadol hours before proceedure too. Paracetamol at the ready too, if I start to burn up.

 

[SockFiddler]

I've filled out Exceptional Costs forms for families I've worked with - they're quite complicated but they're not difficult. But they do need the GP's support (which, I know, Dr Jenny won't oppose but I don't know the Practice Policy on this), I've got contacts in the Children's Commissioning Team, who might be able to give me some advice ahead of submitting my application, so who knows?

Once again, I'm so grateful to have this forum and you wonderful folks to turn to. Thank you, both those who have posted and those who might post later on. Your words mean the world to me.

It's funny. I just had a mental health assessment because I'm not processing my increasing immobility at all - I've completely squashed all anger, anxiety and upset and just gotten on with it (a strong aversion to personal drama combined with a natural determination to just keep on going make me a strong candidate for denial). I think, however, today's events have broken through that denial shield - I feel dazed, like I've been hit by a train.

Actually, I feel much like I did the day Euan was diagnosed with ASD.

 

[Guzzler]

Yup, cortisol will do that. I have no problem with the 'toilet roll' scanner but afterwards I must admit it is straight to bed for me. I would advise not to lay on the couch for too long, it is better to move about gently, no lifting bags of coal etc.

 

[Bluetit1802]

What a dreadful experience for you.

Your levels will return to your normal once everything is out of your system (cortisol, adrenaline and possibly those painkillers) so don't worry on that score. Let nature takes its course, drink plenty, and rest.

 

[donnellysdogs]

Your levels were not that high to really, really be concerned about though...
you need to be able to accept as much as we do everything we can.. sometines some circumstances are out of our control.

Ie if you were to be admittted as T1's are for operations most surgeons do not worry as my friend an orthapaedic surgeon said to me... we dont expect to have levels under 11.0 on days of ops... hba1cs lower than 7.0 are rare!

So acceptance of a stress impact on bloods is needed.

However so is a different way to get you to have scan done.

This depends on what they are looking for. There may be alternatives like the stand up. Basing exceptional cost funding is unlikely to be given on blood levels at 8.5... only on pain and this could be hard to prove...

 

[JohnEGreen]

"
Commissioned
as an exception
where all the
following
criteria are met,
note prior
approval is
always
required:
Clinically urgent cases (required within 14 days)
In most cases where clinically urgent a normal MRI scanner would be
preferable and could be arranged with sedation etc as necessary. If an
upright MRI scan is requested as an urgent case this will need to have
been discussed with a consultant radiologist to exclude other means of
accessing imaging.
Non clinically urgent cases (not required within 14 days)
Referral for open MRI scanning of at least 0.5T as an alternative to
conventional MRI may be commissioned in the following circumstances as
an exception where all the criteria are met in full:
 patients who suffer from claustrophobia where an oral
prescription sedative has been tried and documented in clinical
notes that this not been effective (flexibility in the route of
sedative administration may be required in paediatric patients
as oral prescription may not be appropriate)
OR
 patients who are obese and cannot fit comfortably in
conventional MRI scanners as determined by a Consultant
Radiologist/Radiology department policy (LTH largest bore is
70 cm and the weight limit 250 kg; The issue re size is how the
weight is distributed).
OR
 patients who cannot lie properly in in conventional MRI
scanners because of severe pain
AND
The purpose of the scan is a last resort to exclude larger lesions if this is
4
clinically relevant in the brain and spine. Peripheral body parts will not
normally be considered for upright MRI unless at the specific request of an
acute consultant who believes this is essential to clinical management due to
failed trial of single body part MRI.
AND
A consultant led clinical team (be it MSK service ,orthopaedics or
neurosciences) has reviewed the case or directly initiated the request, and
make a recommendation following discussion with a consultant radiologist
that upright MRI is clinically essential to the management of the case.
IN ADDITION The CCGs will only fund uMRI of the specific anatomy
requested."

The above is from a PDF and is for the NHS trust Leeds.

But would be generally relevant I think.

https://www.leedssouthandeastccg.nh...e_of_upright_MRI_scanner_-2015-2018-FINAL.pdf

 

[Pinkorchid]

I know an MRI is critical to getting the right care for my back. So my main question is... how can I get that test done

My neighbour had been suffering with a severe bad back problem for a long time she had xrays scans and other tests at various hospitals but nothing was conclusive. The consultant wanted an MRI scan but she is claustrophobic so knew she could not go in the normal MRI scanner so she was sent for a upright MRI scan at a clinic in Harley Street might be worth asking your doctor about that

 

[DCUKMod]

@SockFiddler - To be honest, in terms of your bloods on the day of such and event, my attitude tends to be to go with the flow. If you need to have such investigations done, then sometimes the elevated bloods are just a byproduct. Stressing about them won't help them go down any faster.

For now, it probably makes sense to try to get comfortable and drink plenty to flush the meds out of your system.

I'm sure there'll be a way to have the diagnostics done; just not today.

Look after yourself.

 

[ickihun]

I've filled out Exceptional Costs forms for families I've worked with - they're quite complicated but they're not difficult. But they do need the GP's support (which, I know, Dr Jenny won't oppose but I don't know the Practice Policy on this), I've got contacts in the Children's Commissioning Team, who might be able to give me some advice ahead of submitting my application, so who knows?

Once again, I'm so grateful to have this forum and you wonderful folks to turn to. Thank you, both those who have posted and those who might post later on. Your words mean the world to me.

It's funny. I just had a mental health assessment because I'm not processing my increasing immobility at all - I've completely squashed all anger, anxiety and upset and just gotten on with it (a strong aversion to personal drama combined with a natural determination to just keep on going make me a strong candidate for denial). I think, however, today's events have broken through that denial shield - I feel dazed, like I've been hit by a train.

Actually, I feel much like I did the day Euan was diagnosed with ASD.

Oh @SockFiddler . I'm with you on the denial part, believe me.
It's a shock when you've always been active. Your body just won't do what you need it to do. Things will improve, I'm sure of that.
Once diagnosed properly treatment can help, right?

Tuck yourself in bed and try and think happy thoughts. Your day has been traumatic. Tomorrow will be far far better.

 

[donnellysdogs]

Denial shields break.. and we re shape ourselves...

It sounds as if you may have had some possible ACT therapy for pain? If you havent it is pretty good.. however it does not take the pain away if there is a physical operation needed or something serious going on. It does get people to accept and change management of pain though. Eg with so many of our cancer therapy group pain management cannot conquer it from medicines.. so we do art therapy and for the short time we do it we are taking those thoughts away from painnand cancer. Our drop in therapeutic art cafes on Fridays are filled talk and laughter you wouldnt believe. We eat, drink and do different thinks with different arts. Some do a lot, some little but laughter is fantastic. Its sessions like this that can help pain.

We all also realised that we need to ask for help when we need it. But needed to be able to say "whoa, I can manage that" when people started to take over for us without realising.

I have a good pain psychologist. At night I still apparently scream and swear when asleep and turn over and still wake in pain. Its still there but I cant take pain relief but do manage during the day by accepting rather than getting wound up.

Important to follow up with your medic to see if you can get alternative scan quickly. .... but do relax on bloods tipping towards higher for a few hours...

Hope you have settled back lower bloods today.

 

[SockFiddler]

You guys are amazing. Thank you so much for yesterday. Your kind words and compassion really carried me through, and I could write an essay on what it means to me to have such brilliant support.

Thank you, particularly, to @JohnEGreen for that wonderful research - I'll let you know how it goes when I chat with my doc about it tomorrow.

Bloods are still a bit skewy, but I've decided not to care much. I've also decided not to fuss, worry or plan too much. On the cards are a couple of movies, some with Euan and playing some Mass Effect 2.

For anyone who's interested (there's no test!), I wrote about this more fully just now. It's quite long and a bit sweary and there's no obligation:

http://www.diabetes.co.uk/forum/blog-entry/the-mri.1706/

@donnellysdogs I don't know what ACT is, but I'm going to look it up now. And, yes, distraction will be the fulcrum of my day today. I'm laying off the pain meds to get a feel for how bad it actually is at the moment and probably going to get a bit more sleep very soon.

Thank you all, again. I hope that I can be of as much comfort to you guys as you were / are to me.

Sock xx


EDIT: ACT: https://en.wikipedia.org/wiki/Acceptance_and_commitment_therapy

Oh, I did smile. That's always struck me as just the sensible way to live! That someone made money out of turning it into a form of therapy? Part of me thinks "Good for them!" the other part thinks, "You really missed a trick, Kiddo."

Have always been a big fan of people like Skinner, Asch and Zimbardo. Interesting to see how they've rubbed off on me. Thanks, Boys!

 

[donnellysdogs]

ACT - ACCEPT, COMMIT Therapy I believe its full name.

Now being used by Counsellors and Pain clinics especially. I have good pain physio and psychoanalyst.
Physio recognised one shoulder dropped an inch after mast and my standing posture due to pain was not right and could be improved . Psychoanalyst helped a lot as thru some bad NHS **** I could come over as angry when I wasnt... and this made me wound up and that impacted upon the way my brain related to muscles and tension etc.

It isnt natural to relax, to do things ACT way. I feally found it odd but having 6 sessions with psycho n hubby together made me realise about asking for help (nicely!!-hubby not a mind reader... ) and for him to realise that if I say I can do something, let me do it!
It also doesnt tell you todo 5 leg lifts or 5 arm lifts etc... as we all are different.. it tells to stop before a certain level of pain.. as otherwise we are on a burnout roller coaster...

Ie if we manage to go for days out with our cancer group on bus we do ensure that wheelchairs go, support help goes, regular breaks, no one imales comments if someone cant eat food or drinks etc.. we value peoples personalities rather than highligting difficulties..but if someone ones to stay on bus for a while or in cafe etc its not a problem.. we find rekatives and friends can push us beyond our comfort limits and we all recognise that we need to accept what we are....and this enables us all more...