Melody,

Seems to me that at least a private taxi would be better, or better yet, an ambulette considering the procedure. How much is an ambulette? How far of a ride is it? Would you be willing to take donations? You've helped so many on this board.....we could all donate via paypal? If you think it's a good idea, count me in.

Ann

--at various times and under various circumstances. While the home blood sugar devices are not as accurate as tests done through labs, at leat you can get rough estimates, and notice any big discrepancies.

It's always possible, you know, that the 38 reading was a lab error. These do happen, and sometimes a future repetition of a test shows a more "normal" reading.

As far as Alan's spinal tap, I'm sure the doctors will want to err ont eh side of caution, meaning he will probably be monitored and allowed to lie there as long as they and both of you feel is necessary. When I had mine done, I lay still for about four hours on my back (watching TV--fortunately, I had lots of cartoons ) until I hd to get up and go to the bathroom, but I did not get a headache. (This was when I was an inpatient in SI University Hosptial in 2003, a month into my saga, getting oodles of tests performed.)

Generally, what docs look for are signs of autoimmune disease, so such as protein banding that might represent a breakdown of myelin. They will also look for excess blood cells in the fluid, or any signs of infection. Normal spinal fluid is crystal clear, cloudy fluid is suspicious. (They found absolutely nothing amiss in mine, so even a normal results doesn't necessarily rule out problems.)

You have to have made the most generous offer I have ever heard. You see, when you've had stuff happen to you and you lose trust in people and you just go along your merry way, living your life and just being glad to get up in the morning, and then some stranger comes along and offers a helping hand, well all I can say is (and you should have seen Alan's face when I told him). I can only say a resounding Thank You.

I could never accept donations. Maybe it's the italian blood or stupid pride or whatever and actually, I never thought we'd be in this position but we were talking last night about getting an ambulette. I think they run about $80 one way. So we go to the bank, take out the money and he's safe.

We have learned to live frugally and have gotten used to it. It would be nice if instead of giving aid to Africa and Iraq, our government put a little more money in a disability check every month, but hey, we're alive and Alan is doing yoga.

So believe me, when I say thank you, I mean thank you.

You are an


Mel

Here's Alan's results from last night till this morning.

After eating dinner, I took his sugar at 10 p.m., it was 95.

He had one of those 100 calorie snack bags at 11:30 pm. Ate nothing from 11:30 pm till I took his sugar this morning.

Just took his sugar at 8:30 a.m. this morning and it was 79.

Now we will eat breakfast and I'll take it again two hours later.

How's he doing so far??
mel

As long as you feed Alan that diet, which is heart healthy and
similar to that which is used to control diabetes, you are not going to
see the same blood sugar fluctuations you had reported on the test.

That test administered glucose--- to see how it was absorbed and
metabolized.

When your diet has low glycemic carbs, and protein, these are metabolized slowly, to glucose in the body and wide fluctuations are less common.

If you want to see if you can duplicate the very low reading (assuming that low reading was not an error), you need to give Alan a sugar challenge, and test for 5 hours on a fast. The next best test is after the workout, before he eats
anything.

You can use glucose tablets for the challenge (glucose is best because it requires no metabolic change--other sugars have to be changed in the body to glucose and that takes TIME). Here is a website that gives estimated elevations for certain doses. You can call the lab and find out if Alan had a 50gm solution or 100 gram solution for his test.
http://www.diabetesnet.com/diabetes_..._treatment.php

This quote is to raise extremely low blood sugars for diabetics. But the information can pertain to helping you test at home.
Since Alan does not show the typical low blood sugar responses your
job is more difficult.
reasons for this:
1) autonomic neuropathy which blocks the symptoms
2) poor adrenal function (blunts symptom response to lows)
3) poor nutrient absorption (sugar poorly absorbed from GI tract)
4) adequate protein which blunts the sugar response
5) since lots of time has passed, he may be ignoring or not sensing
symptoms
6) he is not able to communicate body impressions well
7) poor glycogen stores
8) he has felt this way for so long he has no other memory of feeling differently!

Since he has had the neuropathy for YEARS as you state, it is not inconceivable that he has some autonomic issues.

I used to have fasting sugars of 70 commonly, when my thyroid was hypo.
I used to feel awful too, when I had to fast for tests. When this was finally
found on a radio-uptake test (technicium scan) (my serum values were not that illustrative),
and I was put on thyroid hormone, my fasting sugars went to 90 and I could do the fasting tests without discomfort. It was a small thing, and the doctor overlooked the low values as "good" instead of wondering why it was so low and looking for a reason. I was like that for 15 yrs! And angry when it was finally fixed...all that time..I felt horrible.

Your other option is to have another test..to check to see if the first one was
done in error (testing failure), and also have it done for a 5hr test..longer, to see if the low readings persist. And of course at the same time you can have the fasting insulin taken, with the first fasting glucose sample.

Mrs. D. You said you felt terrible after your fasting test. Alan never felt terrible anytime at all after any test. He never felt dizzy after not eating for a long period of time.

Tonight I will take his sugar reading, then give him the glucose tablets at about 9 p.m..(I've got the bottle right in front of me, it's called DEX 4 raspberry glucose tablets, and each tablet is 4 grams of carbs) I'll give him 4 or 5 tablets, right??) then I'll take his sugar 30 minutes later. Then nothing for the rest of the night, he'll go to sleep. Then he'll sleep all night and I'll take his sugar tomorrow morning. So we'll have a sugar reading 2 hours after dinner (9 p.m.), then the tablets, then another sugar reading at 9 30 p.m. then tomorrow morning the fasting reading.

Maybe that will tell us something. Dr. Fred is going to run a whole batch of blood tests again when we go back.

Right now, I'm calling up ambulette services.

You know I wonder about something. What on earth would this man do if he wasn't married??

lol Melody

your welcome...

good luck and i'm sure alan will do well

ann

Guess what just happened??

I call up the hospital where he's going to have the spinal tap (don't forget, I was told, he can't move his head, etc.). So I tell them, I will need an ambulette and she connects me to transportation. I tell them the story and she goes. "what insurance do you have'. I said, "No, I checked, insurance won't pay, this is on me, so how do I get an ambulette from your department?" She goes. "oh, I can give you some ambulette service numbers".

So I call one called Alert, I explain that he's having a spinal tap and they go, OH, he has to lie flat, then we don't do that, you need to call an ambulance"
I go "what????"

I then call back the spinal tap department and explain what the ambulette people said and the girl says "well, I don't know what to tell you, I just make the appointments, you have to speak to someone in the recovery department". I said (and thank God I know how to talk).
I respectfully ask to be switched to the recovery department and she goes "well, we have several, we don't know which one Alan will be in". and I go: "Switch me to ANY ONE BECAUSE THE RULES WILL BE THE SAME NO MATTER WHERE HE WILL BE RECOVERING, SOMEONE WILL KNOW WHAT THEY DO WITH PEOPLE AFTER THEY HAVE SPINAL TAPS!!!!"

So I get switched and some lovely woman answered and I said "my husband is having a spinal tap on the 5th, and she goes "yes, I know, what do you need to know" and as I'm talking she is going, "he just has to rest when he gets home, he has to relax, he can't move around a lot".

I say very politely "maam, I know all that. I need to know exactly what happens when he is released and he gets off the bed he is recovering from. How does he get to the ambulance, the taxicab WHATEVER???' is he lying down or can he get in a wheelchair? She laughs and goes "oh, THAT'S WHAT YOU WANT TO KNOW???" She said "we don't release anyone until he can go into a wheelchair and by 2 p.m, your husband will be fine enough to just sit up quietly, we'll put him in the wheelchair and you can take him down till the acess a ride comes'" Then when he gets home, you must take care of him". I told her "I've been taking care of him for 25 years, don't worry". She burst out laughing.

So now we know.
He goes in at 10 a.m., he recovers till 2 p.m. he gets in a wheelchair and goes down and hopefully the access-a-ride will be there waiting, if not, he'll sit in the wheelchair and relax until they come. We might even call a taxi service.

I actually thought that he had to be taken home in a lying down position. She explained, "NO, that's only immediately after the spinal tap and for about two hours, that's the main time he has to keep his head down".

So at least I have some answers.

My hair is now all grey and I'll have a nervous breakdown.

thank you all for your comfort, answers and patience with my inexperience.

Love, Melody

If you want to duplicate the hospital test, you need to do so
so that the time intervals are the same.

For example...fast all night, give the glucose tablets (50grams at least) and
monitor the blood for the next 4 hours at least, first thing in the morning with no other food present.

If you do this at night, then the whole night his liver will kick in, and form
new glucose from the amino acids in the protein he ate at dinner.

If his reading of 38 is real and not a lab error, then you need to tag it
in that same time frame. In severe reactive hypoglycemia, the low lows
occur only in a certain time frame. With normal liver action, the blood sugar
then starts to go up again, stabilize. This is called gluconeogenesis. This typically happens when glycogen stores are exhausted.

If you are going to have more tests, for Alan, then just wait until then and
have a new longer GTT done.

I think it is important because very low blood sugars can cause fainting/falling and if not understood, the fall would be unexpected and perhaps dangerously injurious. (for example a neighbor girl had her wisdom teeth taken out one summer in the morning, and fasted, came home, slept, and in the afternoon passed out in shower from low blood sugar--I was outside and heard her sister call for help, so I called 911 for her)

If Alan is undergoing some medical changes in his body, that you have just "caught" early, they could continue to worsen, if you ignore the low reading of 38. So I think you should repeat the tests, with a longer time frame to see if the low low is still there, or was an artifact. If you do not repeat the tests, then trying to see if the low low happens at home is the next best way to check him out. Taking readings while he is eating normal food, may not show anything unless you catch it after a high carb meal.
If he truly has hypoglycemia, he would show some low readings after working out. He would use up his glucose faster than the liver can make new from protein, so it might show up then.

Driving a car, doing a fast paced mental job on your feet with that low blood sugar, is not easy. People do vary in how they respond to low blood sugar.
With Alan's heavy work outs, he may have some stored muscle glycogen that is helping him there. People with less muscle storage would feel weaker faster.

All I am saying is that you need more information. You know many times it is the "common" simple things that sneak up on you to bite you when you least
expect them.

Mrs. D. God, I wish I had your brains!!!

I will ask Alan if he will let me do the fasting all night and giving him the 50 grms of glucose pills and monitoring him over the 4 hours.
Exactly what does "monitoring him mean". I give him a lot of glucose pills, then take his sugar every hour and after 4 hours I will have 4 readings.

Is this what you mean? So if he gets up at 8:30 a.m., I take his sugar, give him all the glucose tablets, and take his reading at 9 30, 10 30 and then 11 30a.m.

Then post the readings on the board. Is that okay? (that is if he willing to do this).

Oh, instead of the glucose pills, we have this Tropicana drink that has 30 grams of sugar. Can I give him an 8 oz glass and two glucose pills. Would that be the same thing?

thanks,
Melody