Well, yesterday was very interesting. I had my two year complete physical at Cornell. I go to the ACCORD program there. ACCORD stands for Action to control cardiovascular disease in diabetic woman.

When I first went there I was at least 30 lbs heavier, my a1c was 9 and my blood pressure was controlled by monopril. Been on that for over 25 years.

My diabetes meds at the time were glucophage, then glucovance, then avandia. Nothing worked.

Why did I ultimately join the ACCORD program? Because it was sometime in February and I went out to shovel snow, (I love to shovel snow by the way), I felt great, so I thought to myself. "well I just did a big workout, I bet my sugar reading will be good". I take my sugar and it was 400. I nearly passed out. I had rarely gone over 265 and usually was around 150. So where did this 400 come from.

I immediately went to my doctor who said "what on earth did you eat? and I said "I didn't eat any thing, I shoveled snow". He said "Oh, of course, that did it, you shoveled snow". I looked at him like he lost his mind. He immediately said "I want you off of all these oral crap and I want you on Lantus. Of course I demured saying "i don't want to give myself a shot every day". but he was adamant. Saved my life by the way.

Two days later, I signed up with the Accord program at Cornell and they gave me a complete physical and explained why shoveling snow made my sugar go so high (I have had this explained to me 100 times, but it doesn't penetrate my brain).

So I go once a month, or once every two months, I get weighed backward (don't ask, it's a mental thing, I don't want to know what I weigh).
They have reduced my lantus from 46 units (one shot every morning) down to 34. Because my a1c is now 6, they believe they will reduce it even further by next week. I have to wait until all the test results come back. (they took a lot of bloodwork).

Now let's get to my blood pressure before we get to my neuropathy.
They hook me up to the machine and it takes your pressure 3 times and averages it out. Well, it averaged out to 87/52. They said "Oh dear". and I said "no wonder when I get up too fast or change position (or blow my nose hard) I get dizzy. They immediately reduced my zestoretic from 20/25 to 20/12 and a half. Next time I go in March they will decide if the 20 has to go down to 10.

My sugar reading in the a.m. is 95 so that's all positive. I lost two more pounds in the last month. They think this is the cat's meow, I think they've lost their marbles but they did explain that losing slowly is the way to do it so I go, Okay, whatever you say!!.

Now sometime last year when they tested my feet, they did the tuning fork thing on the toes and stuck little pin things on the tops of my feet and toes and it was determined that I had neuropathy.

So yesterday they redid the whole test. She bangs the tuning fork, puts it on my foot (where a person would have a bunion (but I don't have any bunions). and she goes "tell me when it stops vibrating". I told her "it never started". She bangs the tuning fork again, goes down my foot a little bit and I said "oh, I feel that and she goes, tell me when it stops, and I did.

Then she does this think with a pointy end and says to me "tell me when you feel what I am doing, it won't hurt, but I need to know if you feel it.
So I close my eyes and told her when I felt anything.

She then told me "well, you know you do have neuropathy, right?". I said "yes, but I don't have anything like my husband has, with the stabbing and pins and needles, etc. he's gone crazy with pain for 18 years until he found Dr. Theirl". She explained that in my case it's more loss of sensation then anything else. She explained that the best thing I can do is keep my blood sugar under control and watch my a1c number.

There were two people in the room and I said "well, I looked at a blood test I took in 1999, the other day, and I happened to notice that my a1c was 11"

They both looked at each other and said "Aha, now we know why you have neuropathy. But I don't have it in my eyes (according to my eye specialist).

So I'm doing good weight wise, blood pressure wise, and while my neuropathy is obviously going up my foot in dribs and drabs (I'm not entirely sure what's going to happen). I am determined to keep tight control of my blood sugar.

Does this neuropathy thing have to get worse. I mean, if I keep a tight control, do I eventually have to have it like Alan has it or will I just continue to get the numbness?

I asked them but it wasn't too clear to me.

Just wanted to update all of you.

First of all congrats on weight loss thats not an easy thing to do.
I don't know for sure if it makes a lot of differance or not to high blood pressure, but for many years i haven't used regular salt, i have been using a product over here called " Lite salt ", even when i first got PN i was overweight but still my blood pressure only went up a tiny bit, no were near enough to take any meds for it, as soon as i lost the weight it went back to perfect, well thats what my doc keeps on saying anyway.

I was classified as pre diabetic when the PN thing started up, my neuro said it was the cause of it, he said keep right away from any high sugary carbs and you will eventually reverse the damage, i done what he said and he was spot on, i have read that its the the same deal with diabetic people with PN it can be reversed if you do all the right things, so you would think that by keeping a tight control on your blood sugars, it should make a big POSITIVE differance to the outcome of your PN, i hope so anyway
Brian

--diabetic neuropathy can be reversible if it's caught early, as his was; even later, it can be arrested with tight blood sugar control, exercise, good diet--and I recommend good vitamin/antioxidant supplements too, in order to try and get optimal healing conditions.

The mechanism in diabetic neuropathy is thougth to be primarily ischemic--that is, due to the circulatory breakdown caused by impaire glucose tolerance. The nerves are less supported by the breakdown in blood vessel integrity--they get less nourishment and oxygen, and wastes build up, harming nerves. This is why diabetic neuropathy is generally length dependent, happening in the toes/fingers first--longer distance to transport things through the blood stream--and why it generally is a disease of smaller fibers, as these are supported by smaller blood vessels that are easier to compromise. Of course, there are variations--some people get painful symptoms, many get numbness, others get electrical shoots, still others combinations or different things at different times; damaged nerves can produce all kinds of wacky signals.

I think, Mel, you're doing much of what you can to prevent your neuropathy from spreading. It is tougher to do as one ages--one simply has less cardiovascular resiliency--but it still can be done. Other things that you might consider, though I don't know how much insurance coverage you have to help you with these--or if the Cornell people would finance it as part of your program--are the Rebuilder or other TENS type system, or perhaps even Anodyne or other infrared therapy.

I also wonder if your doctors there would recommend things like Alpha-Lipoic/R-lipoic acid, a potent antioxidant with glucose regulating properties comnonly used for diabetic neuropathy in Europe--or even adding cinnamon to everything (cinnamon also has insulin/glucose regulating effects). Obviously, since you are on diabetic meds, this should only be done with physician input/monitoring.

I agree with Glen regarding nerve stimulation. I have been using a shiatsu massage machine for 2 months,and have never felt less pain than I do now. I take no pain meds for PN. I am only taking my BP meds. Now I only take pain meds for headaches or when my back starts hurting.

Also I listened to everyone regarding my magnesium and purchased a good quality one. This thankfully has stopped the twitching.

I thought you were going to discuss and drop the diuretic portion of your
lisinopril. You know thiazide diuretics increase blood sugar as well, and
have a warning for diabetics. Since you had that elevated blood work,
for uric acid etc, now would have been the time for a trial without.

Mrs. D. I showed Dr. Gantz the blood test where it said the uric acid information and she immediately said what Dr. Fred said when I showed it to him. She said "oh, you were dehydrated". I replied "yeah, I never drank any water when I fasted".

Then she lowered the water pill part of my zestoretic,taking me from 20/25 to 20/12 l/2. She said, when I come back for my next visit, they'll check my blood pressure again and might either take me off the water pill part or put me to 10/12 1/2. I have absolutely no idea what the heck this means. Dr. Gantz did say that as I am losing weight this might be the reason my blood pressure is going down.

I'm on a specific protocol (in the blood pressure part, I'm in the intensive group and in the diabetic part I'm in the conservative group), so I guess I have to trust they know what the heck they're doing right?

Should I mention anything to them the next time I go?

I will tell you something. I noticed a difference right away in my energy level when they lowered the zestoretic to 20/12 1/2. If I move in different directions, or blow my nose, I'm not getting dizzy anymore.


Maybe they didn't drop the thiazide portion completely because my blood sugar reading was 95 and my a1c was 6.

That's a good thing right??

melody

I just cleaned my whole hose with my swiffer and don't need to take a nap today.