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Naylorfan

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I am approaching 75 years of age. I have been a type 2 diabetic since 2006, discovered at work by the occupational nurse. Treated with diet and metformin for a few years. Since having both knees and both hips replaced I have become a daily Walker, 10,000 steps is my daily goal and I usually exceed that. I have lost weight over the past five years, I feel very fit, but blood sugar is becoming increasingly tricky. I now have a single slow acting insulin jab in the morning and small fast acting insulin three times a day to coincide with eating. I have never drunk alcohol. I have never smoked cigarettes.
I suffer with carpal tunnel in my right hand. Two referrals have been cancelled due to high blood sugar. Diabetic nurse is trying hard to tweak my meds and I work hard each day to exercise and being careful what I eat. Carpal tunnel causes me real distress and discomfort each day and I am puzzled why such a minor op under local anaesthetic is treated as though I’m having a heart transplant.
I’m hoping to learn more about diabetes and especially effective control from joining this group.
 
Hi and welcome, I'm sure someone with more experience than me will be along soon. I hope you get some good advice. Cheers
 
i had carpal tunnel in both wrists had an op in one and my bgs were not stable at time so i would ask what levels they want you to be at and why
take care and keep us posted
gail
 
Hi @Naylorfan and welcome to the forum - sorry to hear about your recent struggles with your BG and Carpal Tunnel - If your HbA1c is too high, many procedures will not be considered as this increases the risk of infection and complications following surgery - this is probably why you've had the procedures denied in the past - I hope your DSN can get your medication sorted soon so you can have the operation which will obviously be a big help
 
Hi and welcome.

Great to hear that your replacement hips and knees are enabling you to keep fit and active.
What sort of blood glucose readings are you typically seeing on a daily basis now that you are on insulin? Do you carb count and adjust your doses yourself depending upon what you eat?
Which insulins are you using?
As mentioned by Matt above, if your levels are too high, it puts your recovery from surgery at risk because you are more likely to get an infection and it will be harder to heal and the surgery itself and recovery will cause your levels to go higher, so having them as low as possible before the surgery is really important. I think different types of surgery will have different cut off levels for HbA1c and they refuse to do surgery if you are above that level because there is less chance of a successful outcome.
Hopefully your nurse will be able to adjust your doses to get your levels down to a better place for the surgery to go ahead, but it may be that you can help yourself a bit by adjusting your diet, depending on the sort of readings you are getting before and after meals.
 
Thanks for all your replies. My first referral for carpal tunnel resulted in a definite operation date which was cancelled with 20 hours to go. The consultant surgeon had found my blood sugar reading was 70 (two months before) and his cut off was 69.
My second referral was to a private hospital working for the NHS and just before my pre op assessment they just decided they didn’t want to operate on a diabetic even though my reading was then 65.
I am now working with my diabetic nurse and using a device attached to my arm that enables a continual and detailed blood assessment. I can, within reason, adjust my fast acting insulin accordingly.
 
Hello & welcome @Naylorfan

Sorry to hear about the cancellations for carpal tunnel. It is an extremely painful condition.
I’ve had surgery on both wrists & had to meet an HbA1c level before it was done. As said above it is to give you the best chance of a good recovery and limit chances of infection and complications that higher blood glucose could cause.

It is a quick operation under local anaesthetic, the injection of anaesthetic into the hand pre surgery along with the tourniquet during surgery were the most painful parts for me. Afterwards there was instant relief from the pain down the nerves down my arms. The wound is a bit sore for a few days.

What HbA1c level have you been told is acceptable for surgery? I hope the tweaks to your medication and use of a cgm will enable you to achieve an acceptable HbA1c to get surgery & relief from the pain as soon as is possible.
 
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Hi @Naylorfan and welcome to the forum from me too!

I'm happy to hear you're keeping active and I'm sorry about the cancelled operations, that can be really disheartening. I agree with what the others have said in terms of needing to reach that appropriate HbA1c level for the operation. You mentioned you're careful about what you eat - as a few have said, you should likely be able to help you levels by looking into the food you're having. The info on 'what's best to eat' changes with the seasons (mind you, it's different for each person as well), but you might find it useful to look around the forum, especially the 'food' section, where people share what works for them in making their levels 'behave'. Hopefully that and your discussions with your DSN could get you on the right track to get rescheduled for that operation as soon as possible. <3
 
Naylorfan said:
I am approaching 75 years of age. I have been a type 2 diabetic since 2006, discovered at work by the occupational nurse. Treated with diet and metformin for a few years. Since having both knees and both hips replaced I have become a daily Walker, 10,000 steps is my daily goal and I usually exceed that. I have lost weight over the past five years, I feel very fit, but blood sugar is becoming increasingly tricky. I now have a single slow acting insulin jab in the morning and small fast acting insulin three times a day to coincide with eating. I have never drunk alcohol. I have never smoked cigarettes.
I suffer with carpal tunnel in my right hand. Two referrals have been cancelled due to high blood sugar. Diabetic nurse is trying hard to tweak my meds and I work hard each day to exercise and being careful what I eat. Carpal tunnel causes me real distress and discomfort each day and I am puzzled why such a minor op under local anaesthetic is treated as though I’m having a heart transplant.
I’m hoping to learn more about diabetes and especially effective control from joining this group.
Click to expand...
I'm sorry to hear about your cancellation.
I used to have carol tunnel in both my wrist/hand when I worked with horses. Who new plaiting manes could cause it? I went to see a McTimothy/Bowen Technique practitioner. Whilst I had to go and number of times over 3 months, it sorted the problem out for me. It might be worth you trying to find a practitioner local to you.
 
Sorry to hear about your cancelled operations @Naylorfan

Must be very frustrating for you, especially as the goalposts seem to be shifting about :(

Great to hear that you have a CGM (continuous glucose monitor) to help you keep track of your levels and adjust your doses.

HVe you been shown how to calculate and adjust doses for each meal with an insulin:carbohydrate ratio and insulin sensitivity factor, or have you been given fixed doses and carb counts for meals?
 
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