What is it this time?

[Kats]

I've just joined today and posted in 'intro's'.

Basically, my husband is an insulin controlled diabetic aged 36. His life came crashing down after a payday drinking session left him with severe pancreatitis and made him diabetic. After fighting against advice and attempting to drink just one glass of beer left him hospitalised again he had to give up the alchohol completely.

We met 2 years ago and a few months after he was in intensive care. Pancreatitis again. I put up with the wry looks the docs gave when he said he hadn't been drinking (which I knew). It turned out that his triglyceride(sp?) fats were very very high and this had been the trigger this time. A fry up, a fish and chip takeaway and some bousin all within 24 hours were blamed. He was put on more meds and was fine for quite some time.

His last bout of stomach pain was 9 months ago and was deemed not to be pancreatitis. We were told we would get a referral to gastro out patients. We are still waiting. No reason was given.

He is currently upstairs in quite a bit of stomach pain again. We got married on Friday. He's eaten a grilled rump steak, some Brie and a beer that is alchohol free. That's the only things out of the ordinary all weekend.
I've phoned the emergency doctor and am awaiting a call back, he doesn't want to go to hospital. He's not eaten all day (2 slices toast 8.30am), has drunk a lot less water then normal and his sugar is 13.6.

I'm at a loss as to what he should and should not be eating, fed up of him being either told he's doing it all wrong, or told he needn't worry about it. If he says he hasn't eaten something they just say he 'must have done'. If he has anymore pancreatitis issues they are gong to consider surgery. But surely this can be managed better at home? I just don't know what to do.

He's on a cocktail of the following:-

Sanatogen
Pioglitazone
Ramipril
Bezafibrate XL
Simvastatin
Metaformin

Insulin is Humalog Mix 25.

Any advice at all much appreciated. I need to get him to care more about his condition, and to get some advice that's actually useful and relevant.

Kat.

 

[Mark T]

Congratulations on your wedding and welcome to the forum 🙂

Obviously your husband needs to care a bit more because he doesn't want to spend the rest of his life being in pain. Depending on how out of control his sugars are, he risks doing long term damage as well.

He probably needs to treat food similar to how my wife (an IBS sufferer) does things. She tends to only change one thing on her menu at a time and stick to a fairly constant diet.

I'm not a doctor, but going from what you have written I'll guess that alcohol and triglycerides (fats) are probably important things to watch out for. Both that steak and the brie would have been loaded with saturated fats. Coincidentally, my wife's IBS is also triggered by fats!

13.8 is fairly high too. Although the best way to get that down would probably to go for a walk and he's probably in no condition to do that.

 

[Kats]

Congratulations on your wedding and welcome to the forum 🙂

Obviously your husband needs to care a bit more because he doesn't want to spend the rest of his life being in pain. Depending on how out of control his sugars are, he risks doing long term damage as well.

He probably needs to treat food similar to how my wife (an IBS sufferer) does things. She tends to only change one thing on her menu at a time and stick to a fairly constant diet.

I'm not a doctor, but going from what you have written I'll guess that alcohol and triglycerides (fats) are probably important things to watch out for. Both that steak and the brie would have been loaded with saturated fats. Coincidentally, my wife's IBS is also triggered by fats!

13.8 is fairly high too. Although the best way to get that down would probably to go for a walk and he's probably in no condition to do that.

No def not up for a walk :/ This started this morning with him feeling slightly off, then mild pain and now I'm just shy off phoning for an ambulance. He's not had any alchohol for just over 2 years, so its got to be the fats. I've never needed to know about saturated fats and sugars etc, and since we've been together I've been trying to learn. His diabetic nurse will say something is awful one minute and then tell me I'm fretting too much the next. Its not helpful!

I think he does need a more consistent diet, but I need some sort of angle to sell that to him. Obviously the pain is not enough and I end up feeling like hitler nagging at him.

 

[Kats]

Waiting for the paramedics. Docs confirmed hospital admittance again. This has got to stop.

 

[Mark T]

I guess it's a bit of balancing act diet wise.

If he has to avoid fats (although is it just saturated fats or all fats?) then he has to get his food energy from the other two food groups - carbohydrates and protein.

High protein diets have been rumored to cause kidney problems in the long term (the truth of that, I don't know) and carbohydrates will put up his blood sugars.

The one thing to remember is that all carbohydrates in food will put up his blood glucose, not just the sugars. It's just a case of how quickly it happens (the glycemic index).

How you motivate him to take things serious I don't know. I've always been a fan of the blunt technique, but that doesn't work in all cases.

 

[Copepod]

Welcome Kats. Has your husband ever been offered any input from a dietician? With his complex needs, it would be worth asking for a referrral to help him find a diet that suits him.

 

[Kats]

He's just left with the paramedics.

Nope, we've never seen a dietician, that would be very helpful. The double edged sword is that he feels like he's lost so much...no alcohol, no desserts, giving up smoking, and thus even being told he can't drink diet coke any more makes him tune out. Not that he drinks lots of that.

I'm just not equipped to guess what his diet should be, if eating carbs is upping his sugars as well as avoiding fats. Its a right minefield.

We'll see in the morning what's to be done. The paramedics asked me if he's ever had an endoscopy...whatever that is...or seen a gastric specialist. Nope and nope

 

[Otenba]

I'm just not equipped to guess what his diet should be, if eating carbs is upping his sugars as well as avoiding fats. Its a right minefield.

Carbohydrates, both fast (like sugar) and slow (like potatos, chocolate, stuff like that) are all capable of making anyone's sugar level rise, especially if diabetic. I wonder if it will help for you to not only learn what he can eat but also how to carb count... it may help in the long run.

I really hope the hospital can help you... not just your husband, but you yourself as well. Might even be worth contacting the NHS's wellbeing service for counselling. You seem to have so much on your plate, it must be extremely stressful.

For other's information from the intro thread - Kat's husband is Type 3, a complication of his condition: http://www.nhs.uk/Conditions/Pancreatitis-chronic/Pages/Complications.aspx

 

[Kim23]

Congratulations on your wedding 🙂

Has your husband had his gallbladder checked?? This can be one the things wrong when they think pancreatitis. Lots of probs for everyone going around with the gallbladders lately. Esp if he has eaten fats this will cause intense pain if it ain't working right.

Kim x

 

[Kats]

They do check each time he goes in, so far he's been clear but that's not to say its not that this time.

Thanks for the suggestion 🙂

 

[Kim23]

Whatever it is hopefully they will find out soon enough and make him better soon 🙂

Us diabetics are never easy to deal with I'm afraid! lol as things are usually crossed linked and the diabetes messes with healing and all sorts but if in doubt just ask anything even if you think it's a silly question there is never such a thing with health issues

 

[Kats]

Thank you 😱

 

[Steff]

Hi and welcome

 

[DeusXM]

It turned out that his triglyceride(sp?) fats were very very high and this had been the trigger this time. A fry up, a fish and chip takeaway and some bousin all within 24 hours were blamed.

I am not a doctor, but here's the dirty truth about triglycerides.

They're probably nothing to do with dietary fat.

http://en.wikipedia.org/wiki/Triglycerides#Reducing_triglyceride_levels

Reducing triglyceride levels

Diets high in carbohydrates, with carbohydrates accounting for more than 60% of the total energy intake, can increase triglyceride levels.[3] Of note is how the correlation is stronger for those with higher BMI (28+) and insulin resistance (more common among overweight and obese) is a primary suspect cause of this phenomenon of carbohydrate-induced hypertriglyceridemia.[4]

There is evidence that carbohydrate consumption causing a high glycemic index can cause insulin overproduction and increase triglyceride levels in women.[5]

Adverse changes associated with carbohydrate intake, including triglyceride levels, are stronger risk factors for heart disease in women than in men.[6]

Triglyceride levels are also reduced by exercise and by consuming omega-3 fatty acids from fish, flax seed oil, and other sources. See health effects of Omega-3.

Carnitine has the ability to lower blood triglyceride levels.[7] In some cases, fibrates have been used to bring down triglycerides substantially.[8]

Heavy use of alcohol can elevate triglycerides levels.[9]

I'm not 100% convinced your husband should be avoiding fats - on this information, it looks more like he should be avoiding carbs and alcohol. He needs to see a dietician and the dietician needs to have this stuff explained to them, as dieticians only ever get one training class where they're taught to say 'fat is bad' and then stop thinking.

 

[Kats]

Oh wow, we've always been told 'no fats' but not a lot else. So it could actually be the carbs that are the issue. He does eat a lot of these over fruit and veg but does like his proteins too.

Good grief, its a minefield of dodgy info

 

[Kats]

He's coming home today. The docs have said its a viral gastro enteritis and given him morphine. This has helped I'm told and he has to rest for the next few days. I'm concerned that this 'virus' is a 'I dunno' type diagnosis and what he really needs is a gastric specialist and a dietician.

I think a stern visit to the GP is in order.

 

[DeusXM]

Oh wow, we've always been told 'no fats' but not a lot else. So it could actually be the carbs that are the issue.

Possibly. As I said, I'm not a doctor and this is also Wikipedia info (sourced, yes, but still from Wiki) so I would not base any treatment approach on just this information. But I do think it needs to be raised with a dietician, along with the sources of information. It's worth noting that a fry-up is high in both carbs and fat (from the beans, sausages, toast/fried bread, hash browns, tomato), despite what the Daily Mail would have everyone believe, and fish 'n' chips is also high in both from the batter and the chips. There is a debate over high or low carb, high or low fat, but there is no debate that high-fat, high carb is extremely bad for the body.

You are absolutely right that there is a minefield of conflicting information and this is an area of conflict between patients and doctors. A lot of people with diabetes find the supposed good advice simply doesn't stand up to real world scrutiny, yet doctors persist in recommending basing meals around starches with few fats.

 

[martindt1606]

Kats,

Following a business trip to the US I was diagnosed with Pancreatitis following one bad stomach pain following an American size Surf & Turf - I thought it was a bad prawn.

As a result I have been on the following drugs for almost 10 years:
Domperidone
Omeprazole
Creon

As far as I am aware only the Creon is essential as my pancreas had stopped producing the enzimes that digest food - especially fats.

The main sign for this is the quality of your husbands stools. If they are greasy and like cow pats he should raise this with the doctor. As long as I match the creon to my food intake I can eat anything (that I'm allowed to eat as a diabetic).

The endoscope mentioned in an earlier reply is a camera that passes down through the mouth and throat. If your husband needs one then tell him to be sensible and take the option to be but to sleep. I've had 3 now - the first experience was awful, the second 2 I do not remember....

 

[KateF]

Kats,

I am also married to someone with Diabetes and we have had quite a few challenged with it so my heart goes out to you. We went to the DUK national event a few weeks ago and I met several other stressed spouses (I definitely am one sometimes) which made me realise how many of us are affected by our partner's diagnosis.

Have you perhaps looked at something like Carbs and Cals? http://www.carbsandcals.com/ is their website where you can buy their book and see what it is about. They are also on facebook. They do a version of the book (or the phone apps - I'd go app if you have a smartphone) which can help you work out the carbs, cals, protein and fat of foods, so you would be able to perhaps work out what he is eating and what is affecting him? We have the apps and the book for the kitchen and use it daily. You can keep a food diary in the app to look back and see what might have affected you (good and bad).

If you can see a dietician then you can also perhaps ask them what they recommend as a diet in terms of how much carb, protein etc each day, then use the C&C&Protein&Fat book/app to help you work out what to eat and cook to stick with the appropriate proportions?

Someone more knowledgeable than me may come along with better advice relevant to his T3 but I thought this might be something worth looking at.

All the best wishes.