Thursday, 29 August 2013

Having Diabetic GP vs Being An Athlete

I have been an athlete my entire life! I started ice skating just before I was 2, I started tee ball at 4, hockey at 5 and softball at 6. I continued playing both competitively until 22, playing both sports sometimes year round. Sports have always been a big part of my life and have helped shaped who I am today. Sports are definitely in my family, my 75 year old grandma still drives a Zamboni and has my entire life and my 80 year old grandpa still works at a golf course! My mom and dad are also athletes so it runs in my blood! Most of my best friends growing up I met on teams I played on. Basically, I live and breathe all sports! I enjoy an active lifestyle and have always LOVED pushing myself physically! I love to compete, and at anything it doesn't matter what it is, I am a competitor through and through!

I have been a diabetic since I was 4, so growing up being an athlete definitely helped my diabetes and helped keep it controlled and keep me healthy. I definitely had high and low blood sugars throughout my years playing hockey and softball, before, after and during games but I was always able to correct it and continue on playing. Never having any serious reactions for close to 10 years and I contribute that to being an athlete.

Since having Diabetic GP, that began in 2007, I have not been able to play on any sports teams, I am unable to commit to any teams because of my symptoms and frequent hospital stays. However I do other activities like golfing, swimming at the lake, yoga, going for daily walks, and/or pilates when I can. I sometimes go to the gym to work out if I'm up for it. One thing I cannot do is over exert myself as that can bring on an episode of the GP which is extremely frustrating because I love pushing myself physically. Here's my frustrations with having Diabetic GP vs. Being An Athlete:

1.If the GP symptoms are happening that means I'm not doing anything physical, I'll be laying down not wanting to do any type of movement let alone workout...very frustrating!

2. If the GP symptoms are calm or not present, then it's my diabetes that starts acting up and quite often, more often then it ever did growing up. I never leave the house without sugar or glucose tabs. If I end up on the low side, any activity is out of the question no matter where I am or what I am doing, it stops me in my tracks.. I have to make sure my sugars are anywhere from 9.0 mmol/L or 165 mg/dL to around 15 mmol/L or 270mg/dL because if don't I'll definitely have a low while exercising, even if I'm just walking to the store that's 10-15 min away. I've had to stop many times from  low sugars and it's only been this bad since having GP. it was never this bad growing up and I was way more active. I know how to handle my diabetes and exercise, I grew up with it and I was always active and training and I definitely did not have the issues with the severity of the low and high sugars compared to now. My sugars are always moving, never stable which makes it very difficult to maintain a healthy active lifestyle...this is very frustrating!

3. I CANNOT over exert myself. I have known this for quite some time but I definitely learned this one again in a hard way. Last November Brian and I were moving to a new town and it was a quick move which was a little stressful in itself but what did me in and what helped put me in the hospital last winter for 4 1/2 months was over doing it, over exerting myself. We moved onto the 3rd floor so going up and down those stairs with heavy boxes and furniture was tiring and I didn't even move very much myself because everyone else could tell I wasn't doing to good as the nausea started showing up. Thanks to Brian's mom and stepdad for helping us move because we would not have been able to do it ourselves. That move was painful, I have to admit. I am a physically strong woman and I always have been so now having Diabetic GP I get extremely frustrating because I can't even move without getting sick....This is extremely frustration!

4. I will most likely never play softball ever again because of the Diabetic Retinopathy in my eyes. The GP made it worse for awhile but  it's now stable. I've had 16 procedures on my eyes, whether it be surgery on my eyes where I was put under, laser surgery, or other treatments that were given by needles in the eyes. None of it has changed my vision but it has changed the way my eyes focus. It takes me longer to focus in on things. Catching a ball coming towards me wouldn't be good because I'd lose sight of it...This is real frustrating because I was a pretty good ball player and I'd do anything to be able to play again. I miss it!

5. I've always been strong physically. So now, when I've gone weeks or months without being able to eat and am extremely weak and have absolutely no muscle, I still think in a strong, physically fit mindset. So when I go to do something light like say climb a flight of stairs, I get so frustrated because I am not as strong as I used to be and something as small as that, is very difficult...that's if I can even climb the stairs. I used to run stairs all the time training for hockey and now sometimes I am unable to climb one flight. This is so very frustrating!

I try and take advantage of everyday that I am feeling well. I'll do stretching, yoga, pilates, and/or go for walks whenever I can. It's important to get as much exercise as you can with Diabetic GP, plus being active just a little bit will help move things around in the stomach. A good time to go for walks or do a little moving around is after meals. This can really make a difference and help with bloating which can help lessen the pain and discomfort.

I would give anything to be able to play ball or hockey again! Every year there's a co-ed hockey tournament in my hometown and every year my goal is to play in it. Unfortunately I have yet to play in it but I will not give up! I will play in that tournament someday!!

Hope today is a good tummy day! :)

Monday, 12 August 2013

GI Specialist Appointment

Two weeks ago I travelled almost 700 kilometers for an appointment to see my GI specialist who specializes in gastroparesis. Dr. Andrews is an Amazing doctor and I highly recommend him! He is easy to talk to and very caring, he is sincere and genuinely concerned, he answers every question and gives his honest opinion on what's best for me. I trust my health in his hands!

I had sent Dr. Andrews a medical report to fill out a few weeks before the appointment so he had it ready when I saw him. The medical report was for a federal disability program here in Canada. He gave a lot of information on my case and on how Gastroparesis effects my everyday life. He included all the paperwork from my last few hospital stays, which was a ton of paperwork due to my 4 1/2 month long hospital stay. He also included blood work results. With the medical report and my part of the application, it turned out to be a lot of information on gastroparesis, so hopefully I am approved and that it doesn't take too long to find out...I'll keep you all posted :)

I got Dr. Andrews to write up a new and updated Care Plan for me for when I go into the ER and/or hospital. It's a guideline for the doctors to follow on how to treat my Diabetic GP,  what medications to give, how much and how often. It helps A LOT because so many doctors have no clue about GP and how to treat it. More often then not I am having to teach the doctors and nurses about GP. I have two care plans, one from Dr. Andrews  now and one from my Endocrinologist. The one from my endo has info on what to do if my sugars are low and I am unable to keep anything down to bring it back up. She states that I am not to have any juice because the acidity can make the nausea worse, which it does. I am to have glucose tabs (they dissolve in my mouth) or if those don't work I am to get an injection with dextrose to bring the sugars up. She also has on my care plan to give pain medication subcutaneously because getting an IV is extremely difficult, it can take hours, and if they do get one it doesn't last long. Getting it subcutaneously I can get the medication immediately. Plus subcutaneous injections last longer then getting the pain medication through an IV. My endocrinologist has a lot of pull at the hospital I usually go to, so having a care plan from her usually gets things done properly and efficiently. But also having one from Dr. Andrews, the GP specialist will also help especially at other hospitals. Having two is definitely not a bad thing and it can only help! It really helps ease the stress of going into the ER and not knowing what doctor I am going to get and if they will give me the proper medication and doses or not.

Dr. Andrews was overall happy with my current medications. Both him and my family doctor agreed that I should not take Busopan (an anti-spasmatic medication that relaxes the muscles in the stomach and it is used for nausea and vomiting) along with Domparidone because Domparidone is a motility medication that gets the muscles in the stomach moving so basically both medications cancel each other out. I obviously want the stomach to move so discontinuing the Busopan I am on board with. I was only on the Buscopan daily for 3-4 months so we'll see if things start moving a bit faster being off of it. I am also lowering my dosages of Cesamet (Nabilone) and Zofran (Ondansetron) as my nausea decreases.

I asked when is the best time to get a feeding tube?  I was unable to eat for over 5 months this past winter and was on TPN (total parental nutrition) for about 5 weeks total. There were talks about getting a feeding tube placed but I didn't want to get it done without Dr. Andrews opinion. Unfortunately he was out of the country at the time and was unavailable. I didn't want to get it done without his opinion and the GI doctor I had at the time looking after my case, was reluctant to proceed with the feeding tube when Dr. Andrews was gone. Now that he is back I got his opinion and he suggests that if I go through an episode like I did this winter then I should get a j-tube placed instead of getting TPN through a picc line. TPN has a lot of risk of infection compared to a j-tube and getting nutrients through a j-tube, which goes directly into the small intestine, is a more natural way of receiving nutrition versus getting it through a picc line that goes through your veins. The small intestine absorbs the nutrients more effectively rather than through the blood stream. I am and always have been afraid of getting a feeding tube but if it's safer than TPN and I am going through an episode like that again, then I am on board with that decision, as scary as it may be! :)

I asked about getting another Gastric Emptying Study done to maybe see any improvements in my digestion times even though I am doing good now compared to my last one 5 years ago while I was sick so I imagine going through an episode versus not will make a difference in the results.  Dr.Andrews said that we already know I have Gastroparesis so there's really no new information we can learn from doing another one. When I was at the Mayo Clinic in 2008, they recommended I get a nerve test done annually to check for more nerve damage throughout my body. I have never had one done and it's 5 years later, so I asked about getting one done and I got the same answer, we already know I have nerve damage and we probably won't learn anything new. Plus it's a pretty costly test.

All in all it was a very good appointment! The next one will be a conference call so I won't have to drive 7 hours to see happy about that as travelling can be very difficult depending on how I am feeling :)

Hope everyone's having a good tummy day! :)