Transition Clinic

[Tina63]

My son had his first appointment with the Transition Clinic on Thursday. He went in alone, in fact the doctor didn't even acknowledge my presence 😱

He had half an hour with the consultant (one he has been seeing in his old clinic anyway) and half an hour with his new DSN and new Dietician.

HbA1c had crept up a bit higher still - 11.8 from 11.5 8 weeks ago, and his weight had dropped by 7kg. This, to me, tells the whole story, yet they seem to be pleased with his weight loss (it's NOT due to dieting in any way, shape or form) and said if it was due to him not having enough insulin his HbA1c would have been significantly higher.

Though I am not in agreement with the above, it does seem to have been a very positive appointment for him. He said he much prefers his new DSN, she is younger and more 'normal' than his previous one and her expectations are more realistic, and the dietician too. He said it was nice being spoken to as an adult rather than a child. The new DSN has taken his mobile number and given him hers and she is going to be in touch with him every couple of weeks. I see this as a really positive step forward.

He completely failed his AS levels, Us across the board, despite having an excellent set of GCSE results last year, though how much was down to diabetes, how much to his lack of revision, I really don't know. That has been a bit of a wake up call for him too I think. He has decided on a different course for his future though and is moving to college next term and has said that he really does feel it is time for a new start in every area of his life, including, it seems, his diabetes.

I have of course heard him saying before he is ready to start dealing with it, then does nothing, so I am going to just remain quietly optimistic at this stage. He tells me the day for this big change is Monday! He has tested a couple of times this week (first time in months) and of course got diabolical results - fasting of 15.0 and post breakfast and M3 of 18.3, so he really does have some serious work to do, but hopefully with this new DSN on his back he may start picking up a little. Fingers crossed everyone!

 

[Newtothis]

Hi Tina; so glad things are moving in the right direction, and I will keep everything crossed that this is a new beginning for your son. Now he has moved to the transition clinic he will be treated as the adult he is and therefore needs to start taking responsibility for his decisions and you know what maybe he does means it this time...you're doing a brilliant job...he's very lucky to have you as his mother.... 🙂

 

[Northerner]

HbA1c had crept up a bit higher still - 11.8 from 11.5 8 weeks ago, and his weight had dropped by 7kg. This, to me, tells the whole story, yet they seem to be pleased with his weight loss (it's NOT due to dieting in any way, shape or form) and said if it was due to him not having enough insulin his HbA1c would have been significantly higher.
...

,

Hi Tina, a mixed bag it seems - I really hope all this change will help him take a new outlook on life, and his diabetes, and he takes responsibility for his health.

I, like you, don't agree with the above either. You know his eating habits, and from what you have said in the past he eats when and whatever he likes - hardly Slimming World! Also, when I was diagnosed my HbA1c was 11.8% and my weight had dropped considerably. I would have thought it was obvious - if you eat indiscriminately and take lots of insulin for it then you will almost certainly put on weight, but if you lack insulin then your body will not be able to use energy properly, nor will it be able to store it as fat. Additionally, it will have to get energy from fat metabolism, so you lose weight. Maybe he's having some lantus so it is just about keeping ketones at bay (does he ever test for them?) and his weight loss is more gradual (when my pancreas was spluttering in the 2 years leading up to diagnosis I lost about 12kg very gradually). I think 7kg is quite a big drop for someone who isn't trying.

Anyway! I hope that things really do turn around finally and that he can get back on track with everything, including his studies. I also hope that he is able to build a good relationship with his new team to help him along the way. And I also hope that you can be finally relieved of the constant worry you have felt and things start to look much brighter for you all! 🙂

Let us know how things go!

 

[Pumper_Sue]

Hi Tina,
nice to hear your update. Some good and some not so good
Hopefully as you say this is the wake up call and he will begin to take notice of his own health.
Keep your chin up, I'm sure he will come right one day soon.

 

[DeusXM]

I'd have to agree with Northerner. I think the clinic is completely out of line telling someone with an A1C of 11.8% that they are getting enough insulin. He might be getting just enough to keep full blown DKA away but that's still concerning. I hope he's able to turn it around. Good luck!

 

[Tina63]

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Maybe he's having some lantus so it is just about keeping ketones at bay (does he ever test for them?) and his weight loss is more gradual (when my pancreas was spluttering in the 2 years leading up to diagnosis I lost about 12kg very gradually). I think 7kg is quite a big drop for someone who isn't trying.

He hasn't had any Lantus whatsoever for the past week (and more maybe). He is using his M3 in the mornings - most mornings - and has now reverted to using some Novorapid. Very sporadic use with that, sometimes having as much as 30u in one go it seems 😱 Some days none of that at all. He doesn't appear to be carb counting for it though, just having a random amount now and then. Given though that a month or so ago he was going the odd 48 hours with no insulin on board whatsoever, I do feel things are slowly creeping in the right direction.

Does he ever test for Ketones??? NOOO!!! As he barely tests his BG levels there is no way he will test for ketones, especially as I believe he realises this would mean very close to hospital admission. He only ever tested for ketones in his first week of diagnosis, has completely refused to ever since. I haven't noticed 'the smell' on him, so it's not obvious to an outsider if he is throwing out ketones, but I could see his weight was going down again. Not alarmingly yet, so hopefully now with his new DSN on his back things might level out. As I have said before, he could do with losing some weight, but not that way.

Anyway, onwards and upwards as they say!

 

[fencesitter]

Here's to new beginnings 😎