Pain

Pain. It’s been controlling my life for the last two months. I haven’t been able to do much of anything except work on finding comfortable positions and taking pain pills.

Let me start by saying that I will admit to having a very low pain tolerance. I’m a whimp when it comes to things that hurt. Blood draws cause anxiety, paper cuts can require neosporin and bandaids, and pump site changes require some serious mind over matter.

About two months ago I was exercising. I was lifting weights, and decided to “add in” some time on the elliptical trainer between sets. I didn’t have any shoes on, but didn’t stop and think that might lead to a problem. Which it did. I fell off the trainer and felt a muscle twinge in my right leg. I had pulled my hamstring. I took advil and babied it for about 10 days. Then it seemed to be feeling better. I didn’t think about it. Until 3 weeks ago. I started having serious pain in my hamstring, specifically in the places where it attaches to my pelvis and behind by knee. I was taking advil in mass doses, but it just seemed to get worse and worse.

I am not a fan of western medicine. I don’t have a “primary care doctor.” I see my endocrinologist twice a year, and she has agreed to do the things that a primary care doctor would manage. (cholesterol check, liver enzymes, etc.) I’m lucky that I don’t get sick very often. If I do have an infection I generally just go to urgent care, get some meds, and go on.

I have a large circle of friends who practice alternative medicine. When my leg was really hurting I had someone kinesio-tape my leg. I had several sessions of mayofacial release. I took epsom baths. I increased some vitamins. I had some relief from all of those strategies, but not enough. I was nervous about seeing an MD. I was convinced that my problem was just a pulled muscle and low pain tolerance. I hate going to urgent care because I usually get the “oh.... you have diabetes. Your problem is because of that.”

Two weeks ago I dragged myself to urgent care. The doctor pulls up my records and says, “Oh, you have diabetes and have had it for a long time. Do you take insulin?” Um, yeah.. I have type 1. She asks if I took insulin this week. Crap. This week?!?! My pump probably gave me some basal insulin 30 seconds ago, lady! Then she asks if I test my blood sugar. Again I say yes. She asks if I’ve checked this week. Argh. (see my frustration with western medicine?) Now let me also share that I am standing in the room, and she has my chart pulled up on her computer. The first paragraph at the top (which I eavesdropped and read while she was reading it) says, “excellent controlled type 1 diabetes.” Seems stupid that she asked those diabetes questions with that information kind of information about me.

This doctor decides that I need a Doppler study to rule out a blood clot and cyst behind my knee. Of course, they don’t do that at the clinic, so I need to drive over to the hospital to have it done. They do the study and the doctor calls me on the phone in the lobby. She says the tests were negative and she would prescribe narcotics and physical therapy. Later that afternoon the scheduler calls with two PT appointments.

For the record, my clinic is about 50 minutes away from my house. There is another branch that is about 40 minutes away. I choose to do the PT there.

I show up for my first appointment. The PT has no idea why I’m in so much pain. He works on my for 30 minutes and then tells me to come back tomorrow so that he can do more evaluation. I do. He is still perplexed.

On Monday I called the orthopedic department. They offered me an appointment on Tuesday. I went in. The doctor thought that I had tendonOsis. Apparently that is tendonitis that has stopped healing. He sent me for an MRI. I did that on Tuesday night. Wednesday, I saw him. He said that I had swelling in my bursa where the hamstring attaches, consistent with tendonitis. The treatment for tendonitis is large doses of prednisone. Not great for someone with diabetes. Even worse for someone who is allergic to insulin and will have to take lots of it to manage the increased blood sugars from the prednisone. He was concerned the tendonitis diagnosis didn’t explain all my pain. So he sent me to another MRI for my lumbar region.

I had that done yesterday afternoon. Turns out that I have a herniated disc. (or is it spelled “disk” ... ?) The tech brings me back to a room and says that the neurosurgeon is going to give me a spinal epidural shot to relieve the pain and hopefully help the disc/disk to heal on its own.

Have you ever had a shot in your spine?!?!? It hurts. A lot. It also is a steroid shot so it does crazy things to blood sugars.

I’m feeling less painful today. I guess it was worth it.

I’m supposed to being heading to Canada in less than three weeks for a canoe trip in the Quetico Provincial Park.

I’m hope that my body starts healing now.

I'm afraid of living with chronic pain.

Update and answers

(This is Dixie alerting. First, she pushes against me. If I don't respond she hits with her paw and stares at me until I test and treat.)




It’s been a fast-moving last month.

My insulin pump was part of a recall. Not for a big issue, just a little technical error when an extended bolus was given. I was sent two replacement pumps--one for my current pump and one for my old pump that is out of warranty. I have to transfer my settings by hand, because I use a Mac, and the software only works on PCs. I had the new pumps sitting around for a couple days waiting to be programmed. Finally, I decided it was time. I programmed both, and put one back in the closet as a back up. I hooked up to the new one, and sent the recalled ones back to Smith.

Two days later, I was eating a higher carb meal. I bolused, and started eating. I was watching an old ER rerun at the time, and kept wondering why there was a high pitched noise coming from the show. Finally I realized that the noise was coming from my pump. I took it out of my pocket and it was squealing and had the message “depleted battery.” I knew something was fishy because I had just put a new battery in when I started using it two days earlier. I replaced the battery and continued the bolus. I got another error message (occlusion alarm) and knew that this pump was on the fritz. I quickly got out the “backup” one that I had programmed and hooked up to that one. I called Smith and the technical support had me go through the history. She finally said, “yeah, it’s broken. We’ll send you another one.” I was thankful to have a backup ready to use. Having to go back to shots is really crippling.

I got a Wii Fit. It’s been fun playing with it. Although it’s a little humbling to have a Mii (the little character that you design to represent yourself) on the t.v. become plumpy after the Fit weighs. Your character starts out as stick thin, then plumps out after it calculates your weight/BMI.



Lately, I’ve been getting a slurry of emails, etc requesting information about Dixie and diabetes alert service dogs. I’m posting this as a review, in case new readers are reading this:

1. Dixie is my diabetes alert service dog. She alerts me when I’m low, high, or moving out of range. The longer we’ve been together, the smaller her “range” is. (she’s really happiest if my blood sugar is between 85-110. Heck, so am I!)

2. I got Dixie because I have had significant hypoglycemia unawareness since the day I was diagnosed. Even as a little, newly diagnosed child I was unable to tell when I was low. I have struggled with overnight hypoglycemia. I don't wake up on my own if I'm low. I was relying on friends and family to "alert" me when I was low. It was frustrating and embarrassing.

3. I don't test less because I have Dixie. Actually, I probably test more.

4. Dixie was trained at Great Plains Assistance Dog Foundation located in Jud, North Dakota. I spent three weeks at the facility training with Dixie. And no, she wasn’t trained using “scent training” techniques. (as some places use) She alerted me the first day that I worked with her, I praised her, and it was as if a light bulb immediately went off in her head. “AH, you want me to tell you that!” She didn’t alert 100% of the time for several months. It takes time (and experience) to master a job. That’s why it’s important for Dixie to be with me all (most) of the time. She is amazing at her job because she is around me all the time. I’m guessing that she wouldn’t be as skilled if I just “used” her overnight and didn’t take her with me to work, etc.

5. Dixie had to pass a “public access” exam before I could leave Great Plains. This test allows her to have access to public places. (she passed with flying colors, by the way) This means that Dixie can go everywhere with me...stores, school, haircuts, businesses, etc. She has flown with me on airplanes, and traveled in the Boundary Waters Canoe Area in a canoe with me.

6. Dixie cost $15,000 dollars. The school district that I work for did a large fundraiser for me, in addition to some money I got from my older sister. I was able to pay the amount in full. Scholarships, etc are available, but I didn’t need one because of the fund raising. Some service dog organizations (especially ones with major corporate sponsorship/funding) provide service dogs at no cost to the recipient. This seems to be a point of controversy in some of the comments/emails I get from people. Some believe that all service dogs should be free. Some think that $15,000 is excessive. Most wonder how I was able to pay that amount.

A service dog isn’t for everyone. But it was worth it for me and I would do it again in a heartbeat.

7. My life has changed because of Dixie. My A1c is the lowest it’s ever been, with minimal fluctuations and no severe lows. She’s a great dog.

I know that many people are interested in diabetes alert service dogs, and it's often hard to find information. Before I got Dixie, I googled, etc looking for information. There was little out there to read. I'm hoping that for people investigating now, there's more out there. I've answered some of the most common questions that I get. Feel free to ask away if you have others.

Who is that handsome couple?!

Well it's Scott and Dixie, of course.

We were at today's MN O.C. meet up this morning. A few of us locals got together at Caribou for hot beverages and chatting. The hot beverages were important, as we had spent the last 86 hours below zero degrees.

I find it interesting that I can meet new people who are living with diabetes, and feel like I've known them for a long time. Two of the people at the meet up today I met for the first time. A couple minutes into a conversation and I felt completely comfortable and as if we went "way back."

Scott and I have been at two O.C. meet ups in the last year together. I read his blog, and we occasionally exchange an email. I feel like I've known the guy since elementary school.

Is it because we speak the same language? (the d-chat, that is) Is it because we both wear pumps and are working to figure out how to just eat 15 carbs for a low and wait? Is it our love for diet pop? I'm guessing it's probably all of it.

Diabetes just brings us together.

If you haven't met up with other diabetes O.C. friends yet... I strongly encourage you to give it a try.

Individually, we all live separate lives. But together, we understand the big part (diabetes) that complicates it. We can learn from each other. We can support each other.

And... if you come to an O.C. get together that I'm at... you can get YOUR picture taken with Dixie. (but bring your tester, because Dixie will alert you if you aren't in the range she likes! :-)

Thanks, my new (and old) friends. It was fun.