Hi, my name is Andrea and I have a 30 year old son who broke his leg (tibia and fibula) last week. He had surgery on Saturday and he came home on Sunday. He’s on blood thinners for 6 weeks but is really struggling to eat, feeling/ being sick and has diarrhoea. Consequently his blood control is difficult, it’s usually good. Does anybody have any advice of blood control after a break and on thinners? I’d be really grateful
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Advice please after broken leg
- Thread starter Andieb
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Leadinglights
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I assume it is clexane that he needs to inject once a day, it does mention nausea as a potential side effect but I had no issue when I had to take when I had knee surgery.
If he is on any pain medication then that could be the cause of the other symptoms but stress and injury can cause blood glucose to increase.
Can he speak to his DSN for advise about his blood glucose management in these new circumstances. Was his condition well managed before the incident.
Yes, it was really well controlled beforehand. It’s Fragmin that he injects at night. We were warned that his levels would increase but didn’t realise quite how much! He’s tripled his insulin. I will certainly give his DSN a call tomorrow and ask for more advice.
rebrascora
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Which insulins does he use and does he have a copy of sick day rules for managing his levels when he is ill/injured? Testing for ketones will be important if his levels are high and particularly if he is struggling to eat and vomiting. Does he have a means of testing for ketones? Either blood ketone strips for his BG meter or Ketostix to dip his urine?
Morning Andrea.
Can’t comment about the break apart from the obvious impediment to exercise to lower BG but don’t think blood thinners themselves have any direct effect but it that may vary depending on what drug they are using.
If it is something like Apixaban that I have been in for 18 months with no effect whatsoever.
Are the blood thinners a precaution against developing a DVT or a result of any damage to vascular system.
Flower
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Hello @Andieb
I’m in a cast at present for a long term leg problem but after surgery I found it a challenge to get my glucose stable due to such a change in my normal daily routine & activity levels. I didn’t notice any obvious impact on my glucose levels from 6 weeks of Fragmin injections.
Hopefully as his body recovers from the trauma of anaesthetic, surgery & being so out of routine things will start to settle for him and the nausea will stop. Keeping on top of the pain with medication will help reduce glucose levels. I did rely on glucose drinks a lot for the first few weeks post surgery as I couldn’t stomach food,
If he’s able to I’d ask for advice from his DSN and do his normal stuff to manage high glucose.
I’m in a cast at present for a long term leg problem but after surgery I found it a challenge to get my glucose stable due to such a change in my normal daily routine & activity levels. I didn’t notice any obvious impact on my glucose levels from 6 weeks of Fragmin injections.
Hopefully as his body recovers from the trauma of anaesthetic, surgery & being so out of routine things will start to settle for him and the nausea will stop. Keeping on top of the pain with medication will help reduce glucose levels. I did rely on glucose drinks a lot for the first few weeks post surgery as I couldn’t stomach food,
If he’s able to I’d ask for advice from his DSN and do his normal stuff to manage high glucose.
Thankyou so much for your reply. Yes, I have contacted his DSN this morning and am waiting for a return call. I think his sickness is now starting to settle down a bit, but he’s still finding it hard to eat anything without the nausea, although scrambled egg seems ok! He is struggling with the pain, he can’t tolerate codeine too well so only on a very low dose, along with paracetamol and amitriptyline.
Leadinglights
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It could be the pain meds that are causing the nausea, I can not tolerate codeine and amitriptyline made me feel totally spaced out and dizzy.
What about yoghurt or soup until his stomach settles.
Thankyou for your reply. He’s on the blood thinners for six weeks as a precaution against DVT, he has an injection each night of Fragmin. I have contacted his DSN this morning so hopefully they can give a bit more advice on getting his levels under control although I expect it will just be a waiting game as he recovers.
trophywench
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@Andieb - I use a pump and needed 3x the amount of insulin after I smashed my patella on which thay had to operate to pin and wire it back together - took 4 weeks to reduce that at all, then gradually reduced but roughly 2 months before it got anywhere near normal. Once I started the physio, it stayed higher for longer because that was painful at times - and pain always increases my BG. Thing was although I was well over 60 when I did it - was the very first time in my life I'd ever broken a bone!
You just need what you need, full stop.
You just need what you need, full stop.
Thankyou for your reply. It’s certainly making me feel less anxious about the whole situation. Yes, Josh has pretty much tripled his insulin and is starting to feel a bit better this morning. I think maybe the shock of the whole situation (and coming to terms with the increase of insulin that goes with it) is starting to subside slightly.
Glad things are improving.
I do find it harder to manage diabetes when unwell. For me, a higher BG can make the symptoms (coughs, sore throat, pain, etc.) feel much worse which will push my BG up further which will make it even worse which will push my BG higher which ...
And, on top of that , a higher BG will mean I become insulin resistant which makes it harder to lower my BG which makes the symptoms of my illness which started the BG rise seem worse which ...
It's like being in an ever rising spiral of high BG and worse symptoms.
Until, I finally find the sweet spot which starts to reduce my BG which reduces the symptoms which makes me feel human again.
Then the trick is to pull back on the insulin dose rise before I reach hypo.
It is definitely a delicate balance which is much easier with an insulin pump because I can make adjustments to my basal much quicker.
I do find it harder to manage diabetes when unwell. For me, a higher BG can make the symptoms (coughs, sore throat, pain, etc.) feel much worse which will push my BG up further which will make it even worse which will push my BG higher which ...
And, on top of that , a higher BG will mean I become insulin resistant which makes it harder to lower my BG which makes the symptoms of my illness which started the BG rise seem worse which ...
It's like being in an ever rising spiral of high BG and worse symptoms.
Until, I finally find the sweet spot which starts to reduce my BG which reduces the symptoms which makes me feel human again.
Then the trick is to pull back on the insulin dose rise before I reach hypo.
It is definitely a delicate balance which is much easier with an insulin pump because I can make adjustments to my basal much quicker.
JonathanGi
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I have broken many bones, including my femur....
But more recently, after cancer surgery, I had to have clexane which I thoroughly disliked. I know any type of illness can make managing diabetes much more difficult....it took me several weeks to stabilise again. It was definitely a case of more insulin and less food.
But more recently, after cancer surgery, I had to have clexane which I thoroughly disliked. I know any type of illness can make managing diabetes much more difficult....it took me several weeks to stabilise again. It was definitely a case of more insulin and less food.
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