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Diabetes and 'Acute on Chronic Pancreatitis'

L

leather_ferret

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Doctors who think they know more than they do and are too arrogant to refer you on when they reach the limits of their ability.
Celebratory status, insane wages high fashion and womens make-up
(I'll get shot syaing things like that! :o))
Hi Folks,

I had severe Acute Pancreatitis in Dec 2004, grew a 5 litre pseudocyst on the pancreas and 4 months later, was released following major surgery.

Unfortunately, permanent damage had been done and my pancreas is now slowly but surely digesting itself and disappearing up it's own orifice.

Over the last 2 weeks, I have had the excessive thirst/peeing, a mouth like a well seasoned timber case and totally sapped of energy. This has got worse as time has gone on.

On Thursday, after the usual scrap with the receptionist (nothing new there :lol: ) I got to see the practice nurse and started the ball rolling with a test strip result of 18.5 mmol/l

Got seen by the Diabetes Consultant and the Specialist Nurse at 8:30 am Friday morning at the Diabetic Clinic and my reading was 21.5 and ketones normal.

Consultant's feeling was that, as I am obviously still producing some insulin from the tattered remains of my pancreas, she wanted to try and stabilise things with Metformin first and save the insulin for later.
I was started on Metformin 1 x 500mg/day the first week, 2 x 500 for the second and 3 x 500 thereafter.

As usual, these things always happen at the weekend. I have only taken two tabs and even on my usual restricted and very low sugar diet, my results have risen to 24.9 before breakfast (a banana) this morning and, of course, the clinic is shut.

Basically I guess I need to know at what sort of level I should be ringing the alarm bells and heading for help ....and/or ....what further measures I can take try and lower my blood sugars.
My feeling at the moment is to risk ignoring the 'staggered start' and 'up the dose' of Metformin.

I have a follow-up with the Nurse next wednesday. The Nurse reckons I should probably be on insulin and has planned this appointment for a time when the Consultant will be in.

Hope someone will be able to nudge me in the right direction please.

be good and be lucky :wink:

Dave

I would be very keen to 'meet up ' with other pancreatitis sufferers in this forum.
 
Hi Dave,
Welcome to the forum.
Sorry to hear of your troubles. Have you got any ketostix where you test your urine for keytones? if not pop to your chemist and purchase some, high keytone readings along with high bs is a trip to the hospital. If you haven't any ketostix and are feeling unwell at all and can't reach Dr on call, i'd seriously think of heading to hospital any way, always better to be safe than sorry.
As to your question of anything else you can do, as well as lowering your sugar intake, try lowering your carbohydrate intake as well to see how you go.
I'm sure someone with more knowledge will be along, i'm a person who always airs on the side of caution, and your situation isn't straight forward diabetes.
Let us know how you get on throughout the day,
Suzi x
 
Hi Sue,

thanks for that.

Unfortunately my good lady is away with the car and we are in the middle of nowhere. I'll try and beg some ketostix from a mate later, and get a boxfull on monday.

I took 500mg Metformin before breakfast and first test of 24.9, and my pre lunch test has dropped to 14.5.

I'll have my porridge (about the only food the pancreas will tolerate at the moment :? ) and test again in a couple of hours.

Thanks again

Dave
 
Hi Dave,
Gosh 24.9 before breakfast is pretty high, i'd bet that if you'd had ketostix this morning you'd definately of had keytones of some amount. Hope you get hold of some soon and make an appointment to see your Dr 2moro (if you can !!) if its like our surgery, its a joke. Hope your Dr gets you sorted, let us know how you get on,
Take care and best of luck,
Suzi x
 
Hi Dave

Pancreatitis sufferer hear. Type 1 diabetic. Just going thru codeine withdrawal at the moment and recovering from first major hypo. Found thrashing in the street ..

Speak soon
 
suzi said:
Hi Dave,
Gosh 24.9 before breakfast is pretty high, i'd bet that if you'd had ketostix this morning you'd definately of had keytones of some amount.
Take care and best of luck,
Suzi x
Click to expand...

Hi Suzi, thanks for your support and encouragement

I have been back to the Hossie today (26.1 this morning :? ) and they have whacked up the Metformin to 3/day. Hopefully that will make a dent in it, if not I want to try glicazide on top before contemplating Insulin. I'll keep you posted

Surprised again that ketones were absolutely normal. Apparently I am still producing enough of my own insulin to allow some glucose to 'get through' without starting to deplete fat reserves. I have ketostix at the ready :D ... and despite having lost 55kg (one normal nurse's weight :D ) I still have some fat reserves standing by :lol:

be good and be lucky

Dave
 
Jenny's Dad said:
Hi Dave

Pancreatitis sufferer hear. Type 1 diabetic. Just going thru codeine withdrawal at the moment and recovering from first major hypo. Found thrashing in the street ..

Speak soon
Click to expand...

Hi Jenny's Dad,
from another Jenny's Dad (to save confusion I will keep my nickname and btw.mine is the one who is a vet in Northampton)

Life is one long laugh with pancreatitis eh ??

Sorry to hear about the hypo. Pretty frightening episode, but I hope you resolve to get better control and don't let it dent your confidence.

I am on Fentanyl, MST Oramorph, amitriptyline, pregabalin, zopliclone and until not long ago codeine too .... all potentially addictive :?
I am undoubtably physically dependant on most of these drugs, but that is very different to being addicted to them. This is a concept that very few of the medical profession outside Pain Clinics seem able to grasp. :evil: I wish you well in coming off codeine my friend.

Even with my armoury of weapons against pain, I still live with 24/7 chronic 5-6/10 pain, after normal meds dose.
I chose to accept this level of pain after balancing against all the nasty side effects of the drugs. Keeping the lower dosage does allow meds for frequent and really mindblowing breathrough pain to work faster and better. At times it is hard not to 'up' the background dose but so far I have managed to remain reasonably stable.

If you have never visited, there is an excellent non-judgemental and very informative Pancreatitis forum (I would say that ..I am a moderator there - same nick- :lol: ) and if you'd care to call in, you would be made most welcome.

http://www.pancreatitis-forum.org.uk/index.php

I do hope they quickly manage to help you get a bit better control with the diabetes.

be good and be lucky ... and stay in touch

Dave
 
Hi Folks,

Update

After three abortive weeks trying to control BGLs with Metformin and Gliclazide, finally been started on Lantus and Novorapid. This seems to be doing the trick and hopefully will only need a few weeks to titrate the dose and get used to using it.

My levels swing wildly for little apparent reason which is causing the Doc to scratch her head a bit and make ' Hmmm ??? ' noises. I wonder if this is going to turn out as 'Brittle Diabetes' .. a common end result for folks with chronic pancreatitis. .... any thoughts ??

Cheers

Dave
 
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