Moving on….Starting on insulin....positive signs of improvement ...glimmers of hope...

donnellysdogs said:

I have gained a great friend (she is a pharmacy manager) in the last year, purely from being a local chemist and when reviewing my meds (as they should do if they manage your prescriptions).
She was actually more interested about my pump...
Anyhow, just saying that it is possible to strike up good relationships with Pharmacists on a personal basis and telling them what is happening with penalty charges and prosecutions...
She has really listened to me and now cards are asked for from everybody.
Let your Pharmacy Managers know whats happening and the majority of them will take it on board. Most of them have private discussion rooms so the conversation doesn't have to take place in public.
Having a good relationship with your pharmacist is so important anyway and mine certainly is exceptional not just because we have a good friendship but because she listened to me in the very 1st place when reviewing my meds...

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Totally agree with this…..our local pharmacy is my first port of call for any queries about his medication…they are just so helpful and knowledgeable….being a small independent pharmacy I also feel that they have that personal touch not found in some of the larger branches…

Have already used them on a couple of occasions….firstly when he changed one of his medications and I was concerned about potential reaction with an existing one…

..secondly when his blood sugar levels were running in the mid twenties and he was clearly not well – being at the end of a week (late Friday) and not having access to the GP service until the Monday at the earliest my first thought was to go to the pharmacist…..so much better than phoning 111 or sitting in A&E (he would have resisted this option anyway)….

….not being the patient myself it is sometimes a bit tricky but they do have his medication details on the screen and I can talk with authority as to what he is taking and what for….this somehow gets round the patient confidentiality issue and I get the advice that I need…..in fact on the second occasion I came away with a plan of action for the next few days and felt reassured that I could cope and deal with the situation…

On this basis the pharmacy will be my first port of call should I have any queries when he moves on to the insulin….at least I can just walk in off the street and ask a question….getting in touch with the nurse or the diabetic care team involves phone calls and rather annoying phone systems…(push 1 for x, push 2 for y….get through to an answerphone and we will call you back…or if you get through a receptionist who will insist that you 'make an appointment' for three weeks time, if one is even available.)….so the pharmacist is a great option..

If only more people would use their pharmacists perhaps the NHS wouldn’t be experiencing their current problems with GP and emergency service departments…

Molly56 said:

…..this is a matter that concerns me in that I doubt very much if my partner even mentioned his diabetes to the consultant when he saw him…..let alone mention the fact that he is shortly to start on insulin…referral appointment booked in about a months time….

I am hoping that these facts will be picked up at any pre-assessment rather than on the day of the operation as it would be a waste of the surgeon’s time and a hospital bed if the operation were to be cancelled at that point…

Ordinarily I would attend appointments with my partner to provide support and remember what is said but on this occasion he wanted to see the consultant on his own which I had to respect….I do worry though that not all information was disclosed and that it seemed too easily agreed to go ahead with the procedure without discussing all of the potential risks….having effectively poorly controlled blood sugar levels may I know affect healing and the possibility of infection, neither of which would be desirable given the nature of the procedure involved..

I hope that common sense prevails and that the relevant questions are asked at the pre-assessment stage by the relevant parties….I cannot see that I will be attending this so hope that the medical professionals carrying it out ask (and receive) the correct information…this one is effectively out of my hands…....

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Looks like his diabetes was mentioned by the consultant when he was recently seen about proposed operation….received copy of letter written from consultant to GP yesterday in which he does make mention of my partner’s diabetes…
..firstly with reference to the initial letter of referral from the GP to the consultant (so GP had made consultant aware)…..and secondly in the final couple of sentences where it is stated that the consultant had “stressed the importance of good diabetic control” and the final sentence….”he will no doubt consult you with regards to this in due course”…indicating that he was perhaps told to see GP about blood sugar levels to get them under control / to an acceptable level for surgery…
…this tells me that even though he has been placed on the waiting list any operation is not guaranteed until certain conditions are met….
…..am slightly reassured that the diabetes issue has at least been picked up and is on the record….

Is funny though how my partner seems to have not made any mention of this and in fact does not recollect the consultant saying anything about his diabetes….the letter clearly proves it was discussed….think he just heard what he wanted to hear …….and don’t think he has grasped the significance of the last couple of sentences in the consultant ‘s letter…..I think he thinks he is just waiting for a date….

Will have to see what happens……has an appointment with the practice nurse this week for a “review” of his diabetes….with the appointment about going on to insulin booked with community diabetic team for a month’s time……clearly there is still much to sort out before any potential operation takes place.....

CarbsRok said:

When I had pre op assessment for cataract surgery I did ask what the upper limit was for surgery and was told point blank that anyone over 8 was sent away again. This was for all ops at the hospital, unless a life saving emergency.
Must admit I was shocked it was set so high anyway.

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Last HbA1c result taken in October last year was 74 or 8.9% as far as I can remember so clearly over the threshold mentioned here.....is due to have another HbA1c blood test at the end of this coming week in preparation for the appointment to go on to insulin.....am assuming it will probably be about the same level but don't suppose he will get the result of the test until we go along for that appointment in the second week of February.....but the GP and hospital will at least have the result on file before that date if they need to make any decisions.

Scouser58 said:

Hi Molly 56, from what I remember about insulin, it has a more strict set of rules about its use.
There are time lines that have to be stuck too, and when to eat is also a strict requirement.
The T1's who I worked with, had to get up, have injection, then at a set time later have something to eat, within 30 minutes they said. The keep in touch with how they were feeling and watch what they ate. Then in the time for 2nd injection (if that was the case) repeat the above system of injection, then meal. Having insulin is not to be seen as the get away with what I am doing 'my way' excuse.
Then there is the having to keep an eye on time, food intake and the hated bs levels.
So Molly as others have said it's Molly time, will you pass on the Facebook address for your @bags of sanity'project. So for now Molly, and post again soon, Karen

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Scouser58 said:

Molly, you are so caring and when and where are you going to have your next 'time out' for sanity sake, well for now ttfn from Karen.

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Scouser58 said:

Hi Molly, I think there is typical 'male deafness' and head in the sand syndrome.
He will be very disappointed when no appointment arrives. When the diabetic nurse fills in the missing/ignored bit about his diabetes, then he might get a wake up call, or may well just decide to go without the operation.
Would you feel happier if he was put in the hospital diabetic ward, in order to get the bs balanced, and get ready for the op?, well for now Molly ttfn Karen

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@Scouser58 …..just replying to your recent posts…

To be honest with everything going on at the moment, the best thing for me to do is to concentrate on my own work and leisure routine….this is my way of taking ‘time out’ from the situation rather than thinking of going away for a holiday or short break…..whilst this is some peoples idea of taking time out it really doesn’t suit me….better that I keep busy with a normal day to day routine whatever that is…..

The whole prospect of moving on to insulin does concern me as I can see it will not be an easy transition given the circumstances and how his daily routine is far from the conventional…..how an insulin regime will fit in with that I have no idea but this will be up to the diabetic team to work out…..I can only tell them how it is and they will have to sort out how to adapt to suit……I think there will need to be compromise on both sides but how this will work in practice I really don’t know…..will find out in a month’s time….

As far as being disappointed when no appointment arrives will have to wait and see what happens…..the first priority must be to get his blood sugar levels sorted so I am kind of relieved that the letter said what it did ……I can only deal with so much at any one time and if it had suggested that it went ahead straight away then it would have just been more to deal with……is probably for the best and is not that urgent anyway….can wait a while…one thing at a time as they say….

Was trying to think of a name for my bag project but not sure if ‘bags of sanity’ quite does it….it does have a certain ring to it so perhaps privately I will think of it as that……will let you know the link to the Facebook page sometime by private message….have plenty to be getting on with so a good excuse for some ‘me time’ and ‘time out’ as and when required…..

Scouser58 said:

Hi Molly, you sound calm and patiently waiting for the next step in the process, this is good for you and so glad the 'Bags of Sanity' project is on the tracks and rolling along.
Keep up with the calmness approach it sounds much better, ttfn from Karen.

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@Scouser58 ....strange as it may seem I do feel a bit more calm and relaxed at the moment......or perhaps it is just a realisation that much of this is out of my hands and dependent on someone else taking control of their condition.....
This was partly reinforced when he went to see the nurse today for an interim review whilst waiting for his insulin appointment in February.....hopefully he will have taken notice of some of the suggestions that she made but will have to wait and see.

Blood sugar levels are still running high in the mid to high teens but as she explained this is because his pancreas is no longer working as it should...

Will have to see what the next few weeks bring, what his HbA1c test shows and what insulin regime they put him on in February....have just booked a holiday for October so hope this is plenty of time for him to take control and for the healthcare professionals to make the necessary changes to medication
....the proviso for the holiday is that he gets to grips with this before we go away or I / we won't be going.....hope this is enough incentive for him to make the necessary changes.....perhaps this is the reason he needs, who knows....is worth a try I thought...

Also gives me plenty of time before now and then to find some time for me.....may arrange a short break away to visit my son in Bath and/or my friend in Chester....and I always have my bag project to be getting on with...x

@Scouser58.....to be honest this picture probably sums it up better.......appearances can be deceptive.....

Think this picture better sums up how things are at the moment.......has been a very challenging week and prospects not looking great for the next few weeks with numerous appointments coming up etc......some diabetes related (moving on to insulin) and others to do with operations / proposed operation date received........can see I will have to be paddling extra hard to maintain a calm exterior........is very hard to have a positive outlook at the moment....