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Am I expecting too much?

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happydog

happydog

Well-Known Member
Relationship to Diabetes
Type 2
Had an operation for breast cancer on 21 June and have a second one next Monday. DN is chasing me because my HbA1c in the hospital was 51. (I had just had the operation.) I know I put on 2 kg during lockdown and have had no success in shifting it. I am trying two small low carb meals per day and have done that since the op. Nothing has happened to either my weight or my BG. Am I expecting too much? I would have thought that a month would have had some effect. Should I just forget it until after my op and then try something like the Newcastle for 8 weeks? DN wants another HbA1c mid September and says that if it is not more "normal" I will have to take medication. I realise I don't have to do what she recommends but I would like to get back in control. Any suggestions?🙂
 
@happydog (and a very cute dog it is), I wanted to offer my sympathy and say that is sounds as if you have a lot going on with your breast cancer.
As I have Type 1, the advice I can offer is limited. However, I have noticed in the past some type 2s have very kindly offered to review what others eat and offer suggestions for adjusting their menus.
Some times, unexpected carbs can find their ways into our low carb diets and a second pair of eyes can spot something we don't.
This may not be the case for you but a suggestion.

I also thought @Docb 's response in this thread was a lovely way of explaining the options.
 
Sorr yo hear you are going through such a tough time and now your DN is chasing you because your Hb1ac in hospital was 51 , 51 I ask you, what is it with her, she should be congratulating you on having a good Hb1ac what with all the trauma you are going through, if I were you I would be telling her off .

So you’ve put on a bit of weight , don’t worry you will get it off but not right now .
Maybe your body is trying hard to hang on to it because your meals are too small for its needs right now. I am sure you know all about low carb foods but are you having enough protein and a little fat everyday also I would try to increase the size of your meals. This may fool your body into thinking ahh she’s not starving.
,
 
Hello @happydog, good luck with your surgery and recovery.
I have to ask ........... Does your DSN not know that stress/illness will affect blood sugars?

Personally I think you are doing very well, having a DSN basically giving you more stress is not helpful imho.
 
51 is a perfectly fine HBA1C given what your body is going through. Your body is under extreme stress and putting energy into healing. Once you’re recovered from your surgeries and any treatment then you can address any concerns you have about your weight and look at how your HBA1C is. I hope all goes well with the op.
 
Thank you all for your reassuring messages. I live alone now so I do not have anyone to ask about things, so it is extra good to be able to get support from the forum. I think I will put the diabetes on the back burner for now and concentrate on the breast cancer. Hopefully Monday will see the last of it gone. Of course I have not been able to do as much exercise as I usually do although I have got back to at least 10,000 steps a day 😉. I will try very hard when the op is over. Hope you all have a good day and don't get too hot 🙂
 
@happydog - In your shoes, right now, my aim would be to ensure I was eating good nutritional food. In my world, when I was having breast issues, including some slightly complex slice and dice (turned out to be destructive, but thankfully benign), I studiously did not test my blood sugars. I know, for me, stress does impact my sugars on a day to day basis, and given a few weeks of tests, stress and surgical trauma, I personally allowed myself a bit of slack on my results.

It could be that running up to your op and likely these last few hotter days you could have been a bit less active, but please don't forget you will also have swelling around your operation site.

In my view, if your nurse is grumpy about it, let her waste her energy, and you invest your energy in giving your body the nutrition it needs to heal well, and move forward to other parts of your treatment if there are any in the master plan.

Now is not the time to sweat a kilo or two, or for that matter an only just diabetic range A1c. It's more important you get well. Once well, with more energy you can tackle to scales and nudging the meter down a notch.
 
I really don't understand how my consultant can be extremely happy with me getting an HbA1c of 52 despite me being a little disappointed with a slight increase over last year, but your nurse gives you grief over a reading of 51 and threatens medication.... and that is not taking into consideration your extremely mitigating circumstances.... which she most certainly should have. You would think they were on some sort of incentive scheme or bonus to get HbA1c results reduced and completely forget that they are dealing with people who need support and kindness and encouragement.

I appreciate that I am Type1 and you are Type2 but surely an HbA1c of 51 or 52 is the same and will have the same impact on our bodies and yes we would like it to be lower but I really feel that Type 2s get a rough ride with this, particularly when they are doing their utmost with quite restrictive dietary measures and exercise, whereas Type 1s or even Type 2s on insulin can eat whatever they want within reason and inject insulin to cover it. I don't understand why we Type 1s often get sympathy and support and Type 2s, particularly those who are really trying hard, get harassed and scolded and threatened and pressurized. It reinforces the guilt and fault culture surrounding Type 2. No wonder people become demotivated!

Personally I would give yourself plenty of time to heal after your second surgery before you consider something like the Newcastle. Your body needs plenty of good nutrition to heal, so please don't rush into that sort of extreme diet when you are recovering from such significant trauma.
 
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Is this a real, properly medically trained (ie a separate university degree on top of their normal Uni Nursing degree they already did, before deciding to specialise!) Clinical Specialist Nurse working full time in a Hospital Diabetes Clinic setting, or just a nurse at your GP surgery who has to deal with all the diabetics registered to the surgery? I sincerely hope it is the latter - otherwise she obviously didn't learn much!, and explain why

It is NOT our job to educate them - and some want to learn so yes you can teach em stuff - so the one at our GP is usually great - but I still sometimes need to say, Sorry J (cos we're on first name terms) - that doesn't work well for a T1, usually - and then explain why - eg the 'Stress/Trauma' effect - and because she now knows I know more about at the very least my own T1 than she ever can (not being me!) we can usually have a really lovely chat for 10-15 mins instead of her needing to spend the whole appt educating me/checking I'm still doing this that or the other - so last Thursday - annual GP diabetes check - I got several things moving for both myself and my husband! as well as toes tickled, height, weight and BP. The bonus for patients is, she would absolutely not now criticise anyone with such a low HBA1c anyway, even if she may have done years ago. And honestly she'd be more likely to greet you with Hello Ms Bloggs - has your cancer now been completely sorted out, or have you got to have further treatment? - because she's INTERESTED in YOU. If your result had shot up higher - again she'd ask first what on earth had been going on in your life that may have caused it, and whether you were 100% certain you really were perfectly OK other healthwise?
 
Thank you for all your encouragement. I will get through Monday, then give myself a couple of weeks to heal, after which I will have another go at the diabetes and see what happens. The DN at the surgery does not know much about diabetes. She says I should have fruit every day such as bananas and grapes. That told me everything. I have also decided that if I don't want another HbA1c in September I will just say no. Everyone on this forum is so kind and knowledgeable and always willing to help. Thank you.🙂
 
I do wish I could be there with you, I would soon get her sorted out, in the nicest possible way of course .

When’s she’s giving such advise , atm just nod and smile, nod and smile.
You can deal with that much later but only if you wish too.

Giving you grief over a brill Hb1ac beggars belief.
 
Hope it all goes well on Monday @happydog . Recovering from that is the priority. Take care.
 
Good luck for Monday, @happydog. Be kind to yourself.
 
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rebrascora said:
You would think they were on some sort of incentive scheme or bonus to get HbA1c results reduced and completely forget that they are dealing with people who need support and kindness and encouragement.
Click to expand...
You have hit the nail on the head. Doctor’s surgeries are paid financial incentives to get a certain percentage of patients with lower Hba1cs. I first came across this due to being on the patients panel of our surgery. See this blog http://www.drbriffa.com/2009/03/13/...regarding-diabetes-doing-more-harm-than-good/ which explains why they want to get people with higher Hba1cs on medication and why it’s not necessarily a good idea.

@happydog hope all goes well on Monday and please go easy on yourself, just concentrate on healing and take no notice of that ignorant nurse who has no empathy for her patients.
 
@Pattidevans
Thanks for that link. I am guessing then that this nurse may be stressed and under pressure to hit her target and that is causing her to lose sight of the humanity of the situation and she is perhaps therefore to be sympathized with to a certain extent too.
Education and encouragement is the way forward with diabetes and self help groups like this forum seem to have a high success rate, but maybe that is because the people who come to them are self motivated and want to change things and improve their health and lifestyle.
 
Deal with one thing at a time and putting diabetes on the back burner is a good idea, just eat as well as you can and look after yourself that Nurse is daft and unrealistic IMO.
 
I don't get to actually see her. It is nearly two years since I saw anyone other than a person extracting blood in the car park LOL. Must praise NHS for their cancer care which has been superb so far. On one of the occasions when I did see her she opened the review with "Can we be quick about this? My washing machine has broken down and I need to arrange to get it fixed". That is why I cannot take her seriously. 🙂
 
happydog said:
I don't get to actually see her. It is nearly two years since I saw anyone other than a person extracting blood in the car park LOL. Must praise NHS for their cancer care which has been superb so far. On one of the occasions when I did see her she opened the review with "Can we be quick about this? My washing machine has broken down and I need to arrange to get it fixed". That is why I cannot take her seriously. 🙂
Click to expand...
OMG that is really unbeliveable thank God you have seen that most NHS staff are good but that takes the biscuit. Next time you see her say "Sorry but can we make this quick as I need to speak to a professional" :D
 
Sending positive vibes your way for Monday @happydog

Be kind to yourself, and let us know how things go whenever you feel able to. ((((hugs))))
 
Thank you to everyone for their kind wishes for Monday. I will let you know how it goes. My guess is it will be a two week wait to find out if it has been successful and what treatment plan is proposed. You have all been brilliant and I appreciate it so much. Focussing on the Mindfulness book recommended by everydayupsanddowns to keep me sane. 🙂
 
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