Lowest insulin dose, and my DSN visit

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Northerner

Northerner

Admin (Retired)
Relationship to Diabetes
Type 1
Yesterday I had my lowest insulin dose since I was diagnosed - a total of 30 units, down from 60 at the beginning of April. Despite that, I still had two mild hypos - a 3.7 and a 3.8, so maybe further reductions are needed?

I was talking to my DSN about it the other day - how could such a dramatic reduction come about? The conclusion we reached was that maybe, because I was so ill and underweight for many months from diagnosis, it was only by April that my body had recovered fully enough. Makes some logical sense to me. When you're ill, your body is throwing out all sorts of 'distress' and 'recovery' hormones - natural steroids etc. - that it's not using the insulin as efficiently as it is now I'm back to full strength and everying is in balance. There was a fair degree of inactivity in the first few months too, because of my suspected heart attack, and many, many more high-powered drugs as well as being severely underweight. I have put on two stone since Christmas, and my weight has now stabilised.

Whilst I was at the DSN's, I also gave her a poster of the forum and she agreed to put it up. She was enthusiastic about forums, and said she often browsed them, but seemed a little surprised when I said she should join ours. Maybe that is why we have so few (that we know of) healthcare professionals here - may be they thing they're 'not allowed' or something? She did think it interesting the way that people will much rather seek help on a forum than to ask their healthcare team first! I think there is quite a bit of truth in that. Maybe it's because the responses here are quick, and we can 'test the water' before we go to the trouble of making appointments and phone calls etc.?

We also had a chat about 'the Nurse', as I happened to have a copy of Balance with me, and she was suitably appalled! She was very impressed with my HbA1c - and wished that all her patients were like me! So it was a good visit and nice to chat face-to-face with someone. I also discussed whether there was a cat in hell's chance of me getting a pump, because my control was so good, but she didn't dismiss the idea, because it would give me more freedom with my lifestyle which she also regarded as very important. So, I will have a good long think about it and raise the question when I next see the consultant, although that won't be for a couple of months yet.
 
Northerner said:
Whilst I was at the DSN's, I also gave her a poster of the forum and she agreed to put it up. She was enthusiastic about forums, and said she often browsed them, but seemed a little surprised when I said she should join ours. Maybe that is why we have so few (that we know of) healthcare professionals here - may be they thing they're 'not allowed' or something?
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that does seem rather strange , maybe she/they would feel if they joined a forum they would be inundated with questions etc etc and would'nt be able to manage lo, i'm pleased it was a good visit thought northener sounds like she is really easy to talk to as welll
 
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Hi Northerner,
Yes that actually makes some sort of sense about your body returning to its pre-diagnosis state.
I think the difference between you and Alex's requirements is that perhaps where his body has also returned to this state - he is a growing boy - so it has been masked by his growth hormones - whereas yours hasnt because obviously youve stopped growing!

It would be great if your consultant agreed to a pump for you! I realise your control is brilliant - but - i have now met lots of adults who pump - and they all say without doubt that they have 'got their lives back' - and in fact they have all said they almost forget they are diabetic because its all so much more relaxed etc..Also they have all said that they completely forget they are wearing a pump within a few weeks of having one!

Selfishly, it would be great for us all as you would be able to give us all advice and your experiences of a pump! He he.:DBev
 
Blimey Northie, judging by your pic (in the other thread) you must have been very underweight if you've put on 2 stone! Glad you're OK and doing so well now. Her explanation sounds like a good one. She sounds like a really nice person. Maybe professionals are reluctant to take part because of time constraints and because we do (quite rightly) occasionally complain about the service or lack of, from some 'professionals'?

I had a look on the noticeboard of our surgery for the poster I took in the week before - couldn't see it. Will raise the issue again and take in another next time I go.

Would like to know how you get on with application and pump, if you get one. Not sure I'd want to go down that route, but wil remain open-minded.
 
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I was 8st 10lb at Christmas!

There are two DSNs at the clinic that I have met, and they are both really lovely people. I think that the main thing is that they are really good listeners, and I tend to babble on which they let me do. I did get quite emotional by the end, because my care has been so good and I think about all the appalling stories of poor or indifferent care that people have reported - I just wish everyone had DSNs like me!🙂

Even if they don't join, I think it is good that (some) professionals do browse the forums and no doubt get a better picture of what it's actually like living with diabetes.
 
Good to hear you are getting better. People don't believe me when I tell them it is just as bad being underwieght as it is overweight.

It would certainly be nice if more professionals joined the boards, although nothing can compare to personal experience.

I'd certainly rather come here if I need advice quickly as it is sometimes a couple of weeks before I can get a doctors appointment.
 
Northerner said:
I was 8st 10lb at Christmas!

There are two DSNs at the clinic that I have met, and they are both really lovely people. I think that the main thing is that they are really good listeners, and I tend to babble on which they let me do. I did get quite emotional by the end, because my care has been so good and I think about all the appalling stories of poor or indifferent care that people have reported - I just wish everyone had DSNs like me!🙂

Even if they don't join, I think it is good that (some) professionals do browse the forums and no doubt get a better picture of what it's actually like living with diabetes.
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Yes, it would be great if they would join. Not surprised you got a bit emotional - it's been one hlluva journey in a short space of time! Blimey again - I haven't weighed that since about the age of 9, can't imagine how ill you felt.
 
That sounds like a good appointment and your DSN sounds lovely. Mine also lets me talk and I have been quite emotional with her on one occasion. What I like is that you get to know your DSN and consultant over time.

I think one of the problems with professionals joining forums is if they are giving advice from a professional point of view, then they could run into problems if they give advice and something negative happens. As we always say on here medical advice can't be given because we don't knwo people whole circumstances and medical history etc.

No harm asking your consultant about a pump. I often think the people who could really use a pump well rule themselves out by having too good control.
 
Well done Alan!

A good appointment is so refreshing isnt it?! Feels like all the effort we make, every single day is somehow a little rewarded?!

I read that you showed her your Balance magazine, but what about your poems? I can tell you my DSN would go nuts (....she is a little already I suspect :D) for something like that- she has such a sense of humour!

Great news that she didnt dismiss your pump request. Never under-estimate a DSN when you have one on your side! Fantastic! But dont forget John Davis at INPUT either if you do start to progress towards a pump. He knows the NICE guidelines inside out and may be able to assist you in the process, especially given you have shown a very good response to MDI. Have you done DAFNE as yet? If you are seriously in your pursuit of a pump, get your name down quick as sometimes it takes a while and is requirement before pumping. I also had to do a psychological support group once a month for 6 months pre-requisit! I needed it though at the time- so Im not complaining, but the time frame is here can be HUGE I guess depending on your clinic. They probably vary from clinic to clinic too (sorry, I just read that back and it sounds really depressing Northerner, please dont be put off by my experience! Its worth it, honest!).

Im so pleased you have a good HbA1c Northener, but also how much healthier you must be, you must be pleased with yourself...🙂

Lou
 
I think the reason that some people get more out of their DSN appointment than others in the majority of cases is all about personality.

Some people will happily chat away about all there issues and the if the DSN is a happy, helpful person they will spend time helping you out. Some people are more shy and just go in to appointment hoping the DSN will do all the talking. I personally am quite shy, so when I go to an appointment I usually forget to ask half the things I wanted to ask and the DSN asks all the questions, I just reply.

I met a guy from my university course at a diebetes meet-up thing recently and when the nurses and consultants saw him they all knew his name and said hi. I just said Hi to my consultant and I doubt he remembered my name :D This is because he is a chatty confident guy. So I think you atre at a major advantage with most things if you aren't shy.

Anyway... Just thought I'd say that I don't think it's always down to poor DSNs etc, you get out of it what you put into it.
 
I'm sure some professionals mean well but probably don't have time to visit such forums that much, as they may only work 9-5 or similar, but we should try and spread the word.

Northener, 2 stone on! Jes you must have been poorly, glad you're doing better. I think my weight has only ever varied by 1/2 a stone my whole adult life!!

Very good point Katie, I always intend asking/telling lots, not that I've seen her for months, but end of forgetting, and just nodding etc.
Hmm maybe I need to book an appointment and chat to her.
She is good though, don't get me wrong.
 
Well done on the Insulin reduction !! Its always good when you can reduce meds and still get good results 🙂🙂 Keep up the good work. :D
 
Hi Northener

Good to hear you had a good visit and a chance to chat things over. Also glad to hear that she has not ruled out the possibility of a pump for you. Do keep us posted with any further news!
Take care 🙂🙂
 
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