dr's driving me bonkers

webmd.com give some really good information on fibromyalgia and it's treatments and give regular newsletters on managing it. I have personally found it invaluable. I can't look at other website forums regarding fibro, as they are soooooo depressing. I think you may find it useful as well as this site to look up the website mentioned, as it may help you.

donnellysdogs said:

IGiving figures of 9-ish for feeling depression is a buit misleading, as depression is a big part of fibromyalgia and the way our brains operate. I have had hba1c of 6.7 and still feeling depressed- I could have a level of 5 and be far more depressed if I wasn't on my fibro medicines.

Click to expand...

Hi Donnellysdogs, I think you misread what I said - that was my hba1c not my general readings, which were far higher than 9 to get that hba1c, and I was talking about me personally... but I also read a medical report 3yrs ago which charted the risks of clinical depression against hba1c and whilst I can't remember them all (obviously) I do remember that my risk at diagnosis was 44% due to my hba1c.

Not all diabetics are depressed at diagnosis though - I know that, definitely, and it's obvious - but I've also spoken to someone on this forum privately who was the same as me and when I say demented, I mean, truly demented..... so some of us are sensitive to a high hba1c, and some aren't. I'm not talking about one high reading either - it's the hba1c that counts, ie long-term high readings. Since Megan has been speaking about depression and generally linking it to her long term control and higher readings (that's how I read her posts, anyway), I thought it was well worth pointing out that for some people at least, there is a true connection, and she might well not be imagining things. Maybe I misread, in a hurry - you can see from the time I first posted that it was very, very late.

I've read academic articles which show a significant association between diabetics' depression and HbA1c, but they found that the tighter the control (lower HbA1c) the more depression they found. It doesn't surprise me at all that there are links with depression and higher hbA1c though, because after all 'depression' is a term which covers a lot of different things; and everyone is different.
I've also read academic articles which show that once a 'diabetic' (didn't say which type) gets depressed they are more likely to relapse than a non-diabetic. No explanation though as to whether that's a chemical thing or just a feature of living with a complicated annoying chronic condition. Or, indeed, as with Megan, the stress of having to cope with ignorant health professionals who give confusing advice.

Anyway... you all inspire me, which personally I find makes life easier than if you weren't here on the forum....have a nice smiley face. :mrgreen: (actually I still don't know what this green icon is supposed to mean...)

It :mrgreen: looks like an evil laugh to me............

. . . or jealousy :mrgreen:

Viv

I know there is a lot out there about diabetes and depression....well known that diabetics get depression, however in your posting you mentioned about coming off antidepressant tablets asap...I just wanted to state that with fibromyalgia you are unlikely to ever come off tablets for depression or pain.Also, just from my experience and how my body works only-I found that citilopram and dufloxitine and gabapentin and lyrica and all the other antidepresants I have been subjected to have all actually lowered my BG levels, and have caused me to have to play around with all my basals and bolus's on my insulin pump on every single changeover from all the different cocktail of drugs i have been prescribed.

If indeed Megan has fibromyalgia, then it can take a long while to get medication that works to alleviate the pain and depression, and then of course the diabetes as well is always there. My diabetes control is actually better when I have my depression sorted out, so coming off antidepressants as soon as possible etc may not be the best way to get better BG's.

Fibro and diabetes is not easy to balance. Diabetes is unseen unless getting out injections etc. Fibromyalgia is even more hidden....people can tell you that you look fantastic-but you feel so ****. Other times people can tell you that you look like **** and looking so tired.

In all honesty I sued to get thoughts in my head all the time that I was just so fed up of living (not that I would do anything about it), I have just not wanted to live and be here and thought so much that my husband would have an easier life without me. I had these thoughts as a constant in my head, all day, everyday-even on various cocktails of antidepressants. Now I have the right antidepressant which also gives me some pain relief, those thoughts aren't in my head all day, everyday,24/7/365. Coping with going on to a pump as well was not easy because my brain is constantly under working and feels like fog, and with difficulties remembering, so that also has been hard.

Fibro people are not easily understood by doctors, and it is very hard to get lifted from the depression. So please don't think that I was deliberating at what levels people with diabetes get depression. All I was actually trying to state was that depression is a major part of fibromyalgia, and it is very, very unlikely that fibro's ever come off antidperessants and painkillers......I have found, and it is only me that dealing with the fibro and accepting my limitations has helped my diabetes.

Megan

Glad to hear that increasing may have helped the depression lift a little.

One thing about fibro, is that it takes a lot to limit ourselves from over doing things. it is horrible because we are not able to do all the things we used to so easily. I used to spped walk, nowadays I can barely walk without my walking stick and it can take me 21/2 hours to walk 3 miles!!! But, I do it, but just at my own pace. I have an 80 year old man that over takes me every day on the way and on the way back, but at least I am doing the walk. A 80 year old with a false leg also used to overtake me (he's unfortunately died now), but it hasn't actually stopped me doing my walk with my dogs, just that I have to allow such a long time to do it. I no longer mow my garden, have handed that job over to my husband, and I hate it because I used to be a gardener with my own business, but I help our neighbours and friends now with advice on plants and greenhouses etc instead.

The ampitryptalene and duloxitine for me have been the best combination, although I feel hungover every morning until about 11.30am, so not without all side effects, but therefore I have felt so bad each morning, not wanting to get up because of still feeling tired that feeling hungover isn't much of a side effect if my brain is actually a little bit happier.

Afraid, if it is fibromyalgia then you will have to learn to slow down and not to over do things......

Megan

If you have an Accu chek meter you can ask them to send you a bg monitoring book that allows you to enter carb, bolus, correction bolus, basal rate and bg levels for every hour of the day. It is meant for insulin pump users but anyone using MDI bolus/basal can use it too. It doesn't cost anything and will make bg monitoring so much easier for everyone.

One of the reasons why bolus/basal fails so many people is that they don't have adequate bg monitoring books. The companies that produce bg meters issue monitoring books that are just about ok for biphasic insulin users who eat the same amount of carb day in day out.

If you haven't got an Accu chek meter, phone them and get a free one sent out to you and get a pump bg monitoring book. You'll find altering your insulin for the carb you eat much easier. It's not hard, really it isn't.

Megan

I have the log books that iHs is talking about. They are good.

I went to fill in my log book last night for 3 days (ooopss!!!)-like you I think I will make time to do it and that time occurring is a rarity unless my husband really pushes me. So last night hubby pushed me to complete it, and I couldn't even remember what I cooked the night before or even all the stuff that we had ate last night......and we eat a lot of similar food each day, just mainly the meat or fish that changes..thank goodness hubbys memory is switched on...it is a **** good thing that I am on the pump now, as it also records all the grams of food and bolus's and basals in it's memory, so that make things a lot easier.
You will get there Megan, as indeed I will. It just takes time to find the right medication to help us along.
Personally, when I feel happier in myself then I am more able to see things like my handling of my diabetes.
I know what you mean about bits of paper, and writing things down. Hubby helps me to try and remember and writes things down for me, and I try and write things down as well, but I still don't get round to doing even some of the most simple things, so then I end up with the lists re-written and re-written. I absolutely hate the way that I can barely manage myself these days, when I consider that I used to manage 160+ men at work.
But on the positive side, some of the most stupid things I have done raise a smile, getting lost, accidentally poisoning our dinner, accidentally giving John my medication, the list of things should be for a person with Alzheimers or dementia really , not a now 47 year old.
You'll get there, how is your blood control now?

Megan

Hypnotherapy might help you mood wise to be able to tackle your pain levels so you can look into that yourself. There are many books and cds available which tackle the power of positive thinking and they are worth investigating.....

As for your bg levels..........

Who's gone and told you that you are using too much insulin?

If your bg levels are continually high then it's fairly clear that you are not using enough :?

Everyones need for insulin changes from person to person. You may be using more insulin than persons A and B but persons F and G might well be using a lot more than you. C is yourself and D and E are people you've not bothered to ask

1.5u for 10g is pretty average for most people as we tend to need more insulin in the morning than we do at lunch time. But, everyone is different and it doesn't matter at all if you use 1u for 5g if it gets your bg levels to come down. I used to use 1u to 3g at one time. Whether testing bg levels causes anxiety or not, anxiety and ill health is going to come because your bg levels are too high and by not testing, you don't know how much insulin you need to use.

When you get a better bg diary and can write everything down, work for the time being on a correction dose of 1u to allow your bg levels to fall by 2mmol. So if your bg level is on 12 before a main meal, use a target bg level of 8 to correct to: 12-8=4. You will therfore need to use a correction dose of 2u (4 divided by 2) plus the insulin to carb ratio that you use. Everyone's ratio adjusts as they work towards going in the right direction with their bg levels. The reason why I have suggested a target of 8 is that it sort of safeguards people from over correcting while they work towards finding their ideal TDD. Once you've got your ideal TDD figured out regardless of whatever insulin you use, you can then divide that into 100 and that will then give you a more accurate correction figure that 1u will lower you by.

Keep testing and adjusting your insulin up or down or if you find it easier, use your ratio to adjust the carb. If for example you have a bg level of 7mmol before you eat a main meal and you eat 30g carb and then 2hrs later you have a bg of 8-10mmol then you look at the amount of bolus you injected which might be for example 6u, divide the 30g by 6u and your ratio will be 1u for 5g. If your bg levels are higher or lower, then you need to adjust the ratios. Most ratios are can be worked out by dividing the carb by the insulin.

Oh Megan....

The only person that knows your levels and your requirements is you. It is only you (and your immediate family!!LOL) that live with the diabetes 24/7/365.

iHs is so right, if you need more insulin etc to keep your levels lower, then you need to do whatever it takes to be quite honest. If it takes more or less insulin, then that is what you have to do.

I don't really know what to say that iHs hasn't said, but everything that she has written to me is spot on.

From going on my pump I have realised just how much my diabetes control is down to me, and if I need more insulin I give more and if I need less then it is less, no quibbles, no wondering, just doing it. It is a real shame that you do appear to be so confident on wanting to manage your diabetes that you have ended up questioning yourself and what you are doing.

You are sounding a lot more positive, and I know that none of us are HCP's BUT we lare the ones that live with the diabetes, we just don't see a glimpse of a persons life through an hba1c and an appointment. on this forum we all have good and bad experiences, that can be taken or left, but generally I have found that people that live with it have a **** good insight as to how they manage.

It's a bit like the log books for recording details-really you can use whatever book best suits you, and gives you the best chance of monitoring what is going on. It isn't really down to an HCP to tell you what type of record book you should be using. As long as you are managing to get your levels better, then what device or book or meter etc you use should be down to the individual. you shouldn't have to copy records over from one book to another to just suit your HCP. Sounds harsh against HCP's, but it isn't meant that way. We have to find a way to live and get the best control we can to suit our bodies and our lifestyles, we do enough by testing, writing, bloodtests, food etc to really be picked on for what type of recording books etc we have. Same with the insulin, it is you that lives the diabetic life, not your HCP. If you need more on a daily basis, (or less) then you should not be compared to others-it has to be what gives you good control...

You sound much more positive, and that is good. I know I can't see you to know how you really are feeling (probably hiding the fact that you feel like cr*p-LOL!!!) but at the end of the day......someone yesterday put this expression in my head-what is the worst thing that could happen-' from you increasing your insulin?

The person that gave me this expression yesterday to manage my stress and anxiety used the expression-'what is the worst thing that could happen?'- Today, when I have thought that, it has made me think really of the worst-and the worst thing isn't really that bad and it is manageable.....

Thank goodness I'm not a bungee jumper!!!!!!