A question for the doctors/nurses in Catheland

[kgalas]

Hi everyone!

My mom just called me in tears despondent about her health situation. A little backround: she is 53, 220# and 5'6". She was just diagnosed with Type 2 diabetes (unfasted blood glucose was 166, fasted was 116). Her doctor immediately put her on medication. She has hypertension. She was also diagnosed with gout and widespread arthritis. She needs knee surgery for a tear in the cartilage. She has extensive back pain stemming from spinal stenosis, degenerative disc disease, bone spurs, herniated discs requiring surgery-probably lumbar fusion. She currently takes Celebrex, Percoset, Oxicontin, Lyrica, Singulair, Wellbutrin, Zyloprim, Uloric, Restoral, and Fortamet, Ativan!

She is at a loss as to how to go about getting herself well. I thought I'd try here first because I know how smart and informed the ladies and men of this forum are. If anyone can point me in the right direction, I'd greatly appreciate it.

She has been helping everyone but herself her entire life. She was my grandpa's caretaker when he was dying from cancer and now takes care of my grandma. I told her she needs to make herself her number one priority-it's a matter of life and death now.

Thanks in advance!

 

[ImFiddY]

omg... I'm not a nurse but she is on a lot of med's. Hopefully she can start a weight loss/life change in her eating patterns. And then find some type of exercise she can do. With the back pain it's going to be hard.

I hope she finds the time to take care of herself. Hugs to you and best of health to her.

I just remembered ..... Wellbutrin raises blood pressure. If she has high blood pressure the Wellbutrin will make it worse.

 

[meredith]

Hi Klaudia, I am an RN and will offer an opinion based on my experience but feel free to take it or leave it. All medications have side effects and she is on some high powered pain killers and anti-anxiety drugs that most people can't tolerate well for very long. But she is probably in a lot of pain from her back and needs them. She needs to get her back fixed, but surgery may or may not be the answer. The results on back surgery are fairly poor. Find a really good doctor, I would recommend an orthopedist. Weight loss should be her #1 job right now - it will help her back, her diabetes, her arthritis, virtually all of her problems, including anxiety. I bet you can help her with that. Good luck.

 

[kgalas]

Just bumping!

 

[cakebaker]

Weight Watchers

Just bumping!

There are plenty of people at any given Weight Watchers meeting who are walking in her shoes - overweight, over medicated, type 2 diabetes, etc., etc. I would go to a meeting with her & she could meet people who are losing weight and getting themselves healthy like she needs to be doing. She could be doing Leslie Sansone walk-aerobics DVD's to get her started with exercise. Just a thought.

 

[dianas]

If your mother was recently diagnosed with diabetes she should ask for diabetes education if her doctor hasn't already ordered it. She will get advice regarding an individualized meal plan and also suggestions on activity, learn how to test her blood sugar, all the meds, how to reduce her risk of complications, etc. Most programs have individual and group classes. (By the way I am a nurse.)

Also regarding the physical limitations/pain. Sometimes a revisit to a physical therapist for chronic injuries can do wonders. They can help her find the activities that she can tolerate that won't aggravate her existing injuries. Also for general activity sometimes a stationary bike or pool activities are better tolerated by those with back and joint problems or other limitations. Everybody's different. I would start with a dr's clearance for activity and a physical therapist though.

Diana

 

[Miss Lee]

If your mother was recently diagnosed with diabetes she should ask for diabetes education if her doctor hasn't already ordered it. She will get advice regarding an individualized meal plan and also suggestions on activity, learn how to test her blood sugar, all the meds, how to reduce her risk of complications, etc. Most programs have individual and group classes. (By the way I am a nurse.)

Also regarding the physical limitations/pain. Sometimes a revisit to a physical therapist for chronic injuries can do wonders. They can help her find the activities that she can tolerate that won't aggravate her existing injuries. Also for general activity sometimes a stationary bike or pool activities are better tolerated by those with back and joint problems or other limitations. Everybody's different. I would start with a dr's clearance for activity and a physical therapist though.

Diana

I would like to add my RN's seal of approval to this post!! I agree with it 100%!! Your mom is YOUNG (I know because I'm 54 ), and there is no reason why she can't recover her health and vitality if she's willing to put forth the effort. I know the pain impedes her progress, but I STRONGLY urge you to get her to see a physical therapist. She should start by requesting a consult from her MD. Swimming is an excellent choice for her, but if she doesn't like the water, then I highly recommend a stationery bike or an elliptical. A consult with a dietitian would be great, too, or WW. I like WW for the moral support. My best to your mom on her journey to good health!

 

[RapidBreath]

Its going to be incredibly difficult to lose weight because of the Wellbutrin. My brother is on that and its known to cause weight gain and lethargy.

As for the other body issues, the combination of "gout' and type II diabetes is tricky because the diet for the diabetes is the opposite of the diet for the gout. My dad has gout. I have the insulin resistance (some people call it pre-diabetes.) I am not a doctor, but what helps my Dad with his pain is a little bit (1/4 tsp.) of baking soda in a glass (8 oz.) of water. The uric acid which causes his gout is buffered by the baking soda. Also, she needs to not drink any sodas or eat spinach. Soda will irritate her body because of the phosphates. She should also avoid red meat, that will make the gout worse. Normally, for a person with diabetes I would suggest a lower carb (not No carb ok low carb!) diet. For your Mom, I would be worried about her getting too much protein which is known to irritate the gout. My dad eats vegetables, some carbs (mostly whole grains.) and a small amount of protein (chicken or fish.) He eats a lot of good fats and that seems to help as well. You may already know to avoid "purines" for her.

As for the diabetes: the cool part is that its mostly effected by diet. Exercise has helped but it was my eating that changed my fasting glucose. Incidentally, a fasting glucose of 116 is not the end of the world. If she can switch to only whole grains and no white foods it will help with her blood sugar. Adding plenty of healthy fats helped with my triglycerides.

Regards physical activity: I have a friend with a bad sciatic nerve which normally renders her bed ridden but she is able to have pool therapy, I highly recommend it. That may help her feel better. She probably will have a hard time with any physical activity because of the wellbutrin. From what I understand, that drug causes you to retain body heat and people who are on it are not able to perform exercise because it can raise the body temperature to a dangerous level. My brother has this side effect. Its very debilitating, he sweats all the time and is easily winded/tired.

We have had some success with giving my mother ginger for her arthritis. I don't know if that would help your mother.

I was doing a little reading about the drugs she is taking, these are the thoughts that I had:

Since she is taking acetomenphin watch her liver, it is known to hit the liver hard.
One of the possible side effects of Ativan is depression and suicidal thoughts, so her mood may not be improved by this drug if she has an adverse reaction. That said, it really helped my cousin when she was going through chemo for bone cancer ten years ago (she is still with us )

The metformin (Fortamet) can cause nausea in the beginning and a lot of people have to adjust the dosage until they find the amount that they can tolerate. Its supposed to be a very effective drug and may help with the diabetes right away.

There is an herb that I use to help with my blood sugar, but be aware it is very potent and some people fall asleep. Its called Gymnema and its supposed to support pancreatic function and insulin production. It will alter the amount of sugars that are absorbed out of the intestine. Its not very expensive and can be bought online or in many health food stores.

I hope she feels better soon, let her know we are thinking of her. Hugs!

 

[farmgirl]

I agree with most of the above...however Wellbutrin would not be to blame for weight gain...it is weight neutral and can actually help with weight loss. A few of her other meds however COULD and likely are contributing to weight gain (Lyrica, Restoril, and most pain meds). My mother has similar medical concerns and has made steady progress towards improvement, she was also on multiple meds, however she has metabolic syndrome, not diabetes...but she's at great risk for DM and CAD.
Reviewing her medications with either her primary care provider or an internal medicine specialist could help decrease side effects while improving her conditions. If surgery is imminent, she definitely should consider meeting with a dietician to help promote post op healing as this is often compromised with DM. Also, physical therapy is a must to help set up an exercise program for prior to and after surgery. So many patients wait until they are totally debilitated and don't understand when they don't bounce back after what should have "made it all better". Patient education is key to helping patients help themselves. Many times we don't have adequate time with patients to teach everything they should know about their medical conditions but it should be a priority.
Your mom is fortunate to have a daughter who cares...providing loving support and guidance can make all the difference. If you have time and your mom is OK with it, I would recommend going along to important consultations to be a second set of ears and also be sure that all of your mom's questions are answered. My mom is 54 and a RN, but it was still so helpful to her when I was able to go to her specialist appointments.
Take care!
julie

 

[kgalas]

Thank you all so very much! I'm going to print all your responses and take them to my mom today so we can get her on the road to wellbeing. I appreciate all your help and kind words.

 

[Miss Lee]

Klaudia, please keep us posted. I'd like to know how she does.