
Wednesday, July 23, 2008
Tuesday, July 22, 2008
Cortisone's A Bitch.....And So Am I
Especially when injected into a joint of a diabetic.
OUCH! ON EVERY LEVEL.
Yesterday morning, I sat on gurney in a darkened room, with an audience consisting of a Radiologist, a nurse, and three attending physicians, (including one from China,) all crowded around an ultrasound watching as the image of my foot went from a grayish hue to reddish orange.
The Radiologist showed me (and my audience,) exactly where my foot was inflamed on the ultrasound, and I knew what was coming next. The one thing that I’d tried so hard to avoid these past 8 months was about to become a reality. Damn Metasalgia! He turned on the lights and started to speak.
Radiologist:“You have severe inflammation of the foot, second metatarsal & ligament. First, I'm going to numb you with lydacane, and then inject you with cortisone in the exact area that’s inflamed. Oh GOODY, I think to myself. I'm going to mark your foot exactly where the injection goes, because we need to be precise as possible, especially when it comes to the metatarsal area.
Now Kelly, are you aware that cortisone can cause elevated blood sugars for the next 7 to 21 days? I also need to make you aware of infections that can occur. Your a diabetic and this is your foot.”
Me: “Yes, I know all about the elevated blood sugars caused by cortisone and I’m totally aware of infection and foot issues for diabetics.”
Radiologist: Before I give you the shot, I need to know how you’ll handle your blood sugars.”
Me: “I’ll test often and keep in contact with my CDE.”
Radiologist: Great. Any sign of infection, I need you to go to a Dr. ASAP.
Me: “No problem. So will this fix me? If it doesn’t work, what’s next? When can I start aerobic activity and resume my longs walks? When can I wear pretty shoes again? When will everything be back to the way it was?”
Radiologist: You need to stay off your foot for a few days, ice it, elevate it, and take Tylenol for the pain. No aspirin for 24 hours. You can’t walk or run a marathon just yet Kelly. You’ll need to ease back into that type of activity, but not for at least 3 weeks, and then, start slow. It takes the cortisone a good 4 to 7 days to actually reduce the inflammation and your foot is really going to hurt for the next week or so.”
Me: “OK, I just want to get better. I take it that strappy peep toed wedges are still off limits until then?”
He didn’t answer me.
He dimmed the lights again and showed my inflamed area on the ultrasound to the audience of attendings. The shot and the pressure of the lydacane and then the cortisone being injected into my joint brought tears to my eyes. I tensed up and tried to be brave.
I continued to breathe deep and waited for it to be over.
When I looked up, one of the attendings, a woman near my age, who had asked me about the insulin pump and my experience with diabetes, looked right into my eyes and told me it would be OK. “Your going to do your 10 mile walks again Kelly.” At that moment, I really needed to hear that.
“Thanks," I said and smiled.
I took my blood sugar (139) and increased my basal rate before I left the office.
By the time I drove home, my Blood Sugar was 63. I treated and watched it creep up every hour and adjusted the basal accordingly.
When the lydacane wore off, I could barely apply pressure to my foot, it hurt me more than words can describe. Basically, it felt like I’d stepped on a butter knife, continued walking on said knife, while traipsing over hot coals. I could tell I was in for a long evening of testing, icing, and elevating,
Which I did - religiously. I live on my own, no one to help or watch me. I need to be able to handle this if I want to continue to live an independent life.
By the end of the day, my Basal rate was up to 4.25 units an hour. Normally, my basal rate is between 1 and 1.15 units an hour. My blood sugar was around 199 at 9 p.m, and I raised my basal again to 4.5 units. I woke up with a low of 66 at 6 a.m.
Yesterdays total insulin intake 58 units.
Today’s insulin tally so far: 60.
Normally, my daily insulin total in a 24 hour period is somewhere between 30 and 39 units.
My highest cortisone blood sugar was 245 and my median cortisone blood sugar was 186.Not great, but not terrible, as far as cortisone and it’s diabetes issues are concerned.
When I had trigger finger two and a half years ago and received cortisone, no one at the Dr’s office bothered to tell me that steroids cause severe spikes in blood sugar.
I had to learn the hard way, by blowing close to a 500 BS when I got back home. Which resulted in several infusion set replacements, almost throwing out a new bottle of insulin, and an emergency call to my CDE, who set things straight. I also called the hand surgeons office and threatened to sue, if they didn’t immediately create a document that warned all diabetic patients of cortisones effect on blood sugars, which of course, they did….But I digress...That’s another story for another post.
Back to the whole inflamed foot thing. When I tested at breakfast this morning I was 115.
And At lunch I was 68. I treated and have started to decrease my basal rate, ever so slowly.
The foot feels a bit better, certainly not as tender to pressure as it was last night.
It no longer feels like I’m walking on a knife plunged into my foot while walking over hot coals. THANK GOD.
I’m still monitoring like a hawk stalking prey and I’ve gone through almost two containers of test strips so far.
Tomorrow evening I go to my acupuncturist for the pain. I’ve been going for a month and have seen a huge difference in the pain caused from Metatarsalgia, I wish I had started seeing her sooner.
Diabetes complicates things, but it doesn’t mean that it will win. My Metatarsalgia was not caused by diabetes, (it was actually caused by my love of walking long distances and a nasty toe brake two years ago) but the diabetes certainly didn’t help matters.
Still, the whole thing is teaching me patience on every level, and is reinforcing me to be an active patient in my recovery.
Today, I sit at home working, with my foot elevated and my ice pack near by.
I’m visualizing my first 3 mile walk on Kelly drive, and my first 5 mile walk on the Ventnor /Atlantic City boardwalk. The sun is shining on my face, the wind is blowing my hair, and I’m walking to the beat of my own drum. I can smell the ocean and I smile just thinking about it. I’m also dreaming about strappy wedge heeled, peep toed shoes with my toenails painted red.
I'm looking good and feel great! "FEET DON"T FAIL ME NOW!"
I plan on making the above paragraph a reality in the very near future.
Cortisone may be a bitch, so is Diabetes & Metatarsalgia for that matter. BUT, I got news for you Cortisone; Diabetes, and blasted Metatarsalgia, SO AM I !
Friday, July 18, 2008
Blood Sugars, Insulin Pumps, & Needles - OH MY!
Diabetes accouterments that keep us alive.
I deal, and you deal,
We all deal every day.
Still it doesn't mean that we want Diabetes to stay!
We prod and poke our fingers
Like getting blood from a calloused stone.
Wishing and hoping all the while that the Damn Diabetes would just leave us alone.
Just imagine a life without testing, injecting, and such.
Could such a life really become our reality?
Is it asking too much?
Never having to calculating carbs, before contemplating Ben and Jerry’s.
Or measuring out foods, right down to the cherry.
No celiac issues, or gluten free zones.
Never wishing diabetes would just leave us alone.
No CGM denials on a daily bases.
No dodging doorknobs and buying juice boxes by the cases,
And no never ending trails of used test strips, found in the oddest of places.
Never having to explain daily, our Achilles heel.
Answering peoples stupid diabetes questions,
And just...trying to deal.
“Are you allowed to eat that?”
“Have some orange juice instead.”
“Go do a to test Kel,”
Or
“AND YOU SURE YOU PACKED YOUR MEDS?”
Not having to explain to a “Potential” all the facts.
That this Chicks bionic and wears her pancreas on a clip,
That’s more often than not, attached to her hip.
Sometimes it’s my waist,
Other times much more sexy....and strapped to my thigh.
Regardless of the lo-cal,
Those who can’t handle the D facts, really need not apply.
Never having to see to see the look in parents eyes,
Knowing that our disease is what makes them cry.
Walking Season starts soon,
Teams are bucking up for the cure.
Posting all about their efforts and knocking on doors.
Teams for Charlie, Riley, Brendon, Daniel, Crystal,
And more.
Teams turning miles into dollars,
And dollars into a cure.
Talk the Walk up BIG TIME, and help spread the word.
The JDRF's Walk to Cure Diabetes is coming,
And ALL efforts MUST be heard!!
Wednesday, July 16, 2008
Idiots Who Spread Diabetes Stupidity , LOOK OUT
Again, this was work related class. (I was recently hired by an ortho and DME company and my job is to work with diabetic senior citizens with orthotic needs- Diabetes Comedy and Advocacy alone does not pay the bills.) but I had to correct his obvious idiocy. Not just because of my ego, but because there were 50 other students in the class and who needed to be armed with education regarding diabetes awareness and facts, not discrimination and fallacy.
I sat on the incident a while before I wrote this post. I needed some space and some time to think about it.
Tell me, do you think I handled it right?
So I'm in said training class that my company sent me to and paid for, and the instructor starts talking about his diabetic patients.
Idiot: "I treat my diabetic Orthotic patients like Crack addicts," he said in a condescending tone.
Idiot:"Instead of crack, they are addicted to sugar, and act like children regarding their health. They are brittle and non compliant."
Work related or not, my hand shot up and I'm sure that steam was coming out of my ears."
Kelly K: " I really don't think that's an appropriate way to treat your diabetic patients, we aren't crack addicts. Maybe your patients are depressed about their diagnoses and at the way the public perceives their disease. You know, putting the BLAME ON THEM."
(ASSHOLE,) I thought to myself.
Idiot: "Well, obviously you respect your self and your disease. Many diabetics don't"
Kelly K "It's obvious many non-diabetics don't respect diabetics and their disease."
Kelly K:"Look, the diabetes community doesn't even use the word brittle anymore. And we don't measure the sugar content of our food, we count carbohydrates, test our blood sugars and measure our insulin appropriately. Nothing is off limits. There's a lot of discrimination regarding diabetes, TALK ABOUT STRESS."
Idiot Instructor: "My own son-in-law, who also wears the pump, didn't respect the disease until he passed out."
Kelly K "Was it from a high or low blood sugar?"
Idiot Instructor: "I'm not really sure."
Kelly K: " There's a big difference between the two. There are many reasons he could have passed out. He could over bolused his insulin, miss calculated his carb intake, his BS could have dropped for no apparent reason, he might be highly insulin sensitive, or he might absorption issues at his infusion site. "
Idiot: "Well, he learned his lesson."
Kelly K: "I think the lesson we all need to learn is that Diabetics need empathy and education, so does anyone dealing with diabetics. Referring to them as "crack addicts" might not be the best approach. "
Idiot: "Thank-you for your input. Now, back to....."
Many students came up to me during the lunch break and started asking me how they should handle their patients with diabetes.
Respect them, listen to what they have to say, and suggest instead of preaching.
You really can catch more flies with honey.
Nobody was asking him anything, and he left to catch up on his emails.
After bitching about my experience all weekend to my friends, (who told me not to mention it at work,) I met with my employer and he asked how I liked the class, the facility, and the different instructors.
I took a deep breath & told him the truth. I said that while I learned a lot, one of the instructors really offended me as a diabetic. He may be an expert in the field of orthotics and Durable Medical Equipment, but he knew absolutely nothing about handling his diabetic patients. And then I mentioned the "crack' comment.
My boss was shocked, but appreciated my honesty.
He recently told me that 4 other employees that he'd sent to training found his "humor" regarding diabetes offensive.
On the positive side, that idiot gave me loads of material for my comedy routine.
I'm speaking at Virtua Hospital and you know I'm going to work that idiot's stupidity into my routine BIG TIME.
The fact that I countered what he said said in a somewhat calm and educated manner taught the other students a lesson that they really needed to learn.
Still, the fact that this guy was teaching really really pissed me off to say the least.
Diabetes Stupidity exists in and out of the work place, and on every level. I may have to hear it, but you know for damn sure I'm going to correct it, no matter where it might occur, or who says it.
I not only owe it to myself, but I also owe it to my clients, and my community.
Monday, July 14, 2008
Life, Lemons, Letting Go, And Becoming

As of late, I've been suffering from life throwing me a few lemons. While some of these lemons are easily turned into delicious lemonade, others leave bruises that make them not so easy to forget.
The stress of my job; my moms heath, the fact that I still beat myself up over stupid mistakes instead of learning from them and letting them go.
So today.....I'm letting go....OF ALL OF IT.
.
I'm letting go of all the things that weigh me down.
I'm letting go of not measuring up to my own set of impossible standards, and anyone else's for that matter.
I'm letting go of all the anger towards anyone who ever hurt me in anyway.
I'm letting go of the person I thought I'd be and am embracing the person I am becoming.
I am becoming smarter and more enlightened.
I am becoming an expert at finding the humor in both life and diabetes.
I am becoming a person who embraces her successes and learns from her failures.
I am becoming a person who cries not only when she's sad, but also when she's happy.
I an a person who not only laughs from her gut, but is starting to listen to it as well.
I am a person who is still somewhat sloppy in the whole organizational department, but I'm so MUCH BETTER than I used to be.
I am a person who's becoming quite technically savvy.....who'd a thunk it?
I am a person who now can take her anger and use it as a motivator for positive change.
In no particular order: I am a Blogger; a Taurus, a lover of the ocean and any and all bodies of water.
I am loyal, I am funny, I am sweet and temperamental. I am both shy and an extrovert.
I am a woman, a daughter, a sister, a friend, a Diabetic, a Comedienne, an Actor, a chameleon, and a Wise Ass who happens to have a great ass and nice legs.
I am a finder of the funny, with a heart that's empathetic, a humor that is sardonic, and a pancreas that's far from perfect!
I'm far from perfect, nor am I perfect from afar.
And that's OK.
Life - Lemons or not, goes on....And is a mixture of both the sweet and tart.
Tuesday, July 8, 2008
A Little High Fructose Corn Syrup For Thought - Take 2
Can You Say "KING CORN?"
I decided to copy & paste the article, (along with a few links to some really cool websites) for your review.
I wanted to make sure my peeps in dBlogville knew the deal.
Anywho, Here's the article:
"The Corn Refiners Association is launching a major advertising and public relations campaign designed to rehabilitate the reputation of high fructose corn syrup (HFCS). HFCS has been linked by many scientists to the nation's obesity epidemic.
The group is running full-page ads in more than a dozen major newspapers, claiming that the product is no worse for you than sugar. The ad, which features a stalk of corn, carries the headline: 'And Now a Little Food for Thought.'
The Corn Refiners Association "has been trying to counter the bad publicity around HFCS since 2004," but concluded it "could no longer afford to rely on simple grass-roots marketing tactics such as talking with nutritionists and doctors."
So next time your reading a magazine or newspaper, be on the look out for a Stalk of Corn with the Tag line: " And now a little food for thought."
Here's a thought for the TCRA: How can HFCS be "no worse for us than sugar on Honey? " Sugar and honey are actually edible in their raw form, neither are genetically engineered, and both are all natural.
HFCS is none of those things. So....How can it actually be the same?
Also, why are major food manufacturers spending big bucks to advertise their products as HFCS free? Hmmmm, kinda makes you think.
both go into more detail and have some great info on the subject - take a look!
Wednesday, July 2, 2008
And The Beat Goes On.....It Just Skips Every Now And Then
Work and life issues.
Challenges, both good and not so.
Actually, she had four.
They didn’t take, but she’s doing OK. Her heart’s not beating fast, it’s actually beating at a textbook rate....It just skips a beat every now and then.
Her defibulator and pacemaker can’t seem to keep up with Marjory's unique tempo.
So for now, mom's marching to her own beat.
Me, I’m trying to figure IT ALL OUT.
Tonight, when I finally got around to checking my email, someone had sent me
“The Dali Lama’s Instructions for Life.”
Karmatically speaking, it was just what I needed.
So I'm passing it on to all of dBlogville.
Because...
I love ya!
* When you lose, don't lose the lesson.
* Follow the three R's:
- Respect for self.
- Respect for others.
- Responsibility for all of your actions.
* Remember that not getting what you want is sometimes a wonderful stroke of luck.
* Learn the rules so you know how to break them properly.
* Don't let a little dispute injure a great friendship.
* When you realize you've made a mistake, take immediate steps to correct it.
* Spend some time alone every day.
* Open your arms to change, but don't let go of your values.
* Remember that silence is sometimes the best answer.
* Live a good, honorable life. Then when you get older and think back, you'll be able to enjoy it a second time.
* A loving atmosphere in your home is the foundation for your life.
* In disagreements with loved ones, deal only with the current situation. Don't bring up the past.
* Share your knowledge. It's a way to achieve immortality.
* Be gentle with the earth.
* Once a year, go someplace you've never been before.
* Remember that the best relationship is one in which your love for each other exceeds your need for each other.
* Judge your success by what you had to give up in order to get it.
* Approach love and cooking with reckless abandon.