Tale of the “Overly Sweet” Mother-in-Law
This evening, Doug and I picked up his Mom, and we went out to grab a bite to eat. I’m off from school for the rest of this week, and Doug is off from work for the next week and a half. I hadn’t seen Althea in nearly two weeks, and I missed her. So - off we all went together, something we rarely get a chance to do.
Althea and I often compare our medical issues, since we have a few things in common, and sometimes even accompany each other on doc’s appointments so that we can go out and eat together after they’re done. She has all of the medical problems I have, plus CHF and diabetes. She’s scared us more than once in the last year by having some of her lab values go off the charts … and subsequently ending up in the hospital.
Tonight, on our way to the restaurant, I wondered if she was still being given Procrit injections for her anemia, which is secondary to her kidney failure. Medicare only covers it when she’s actually anemic, so when her numbers come up to normal, they take the Procrit away until the numbers slide back down again. The problem with that is you can take Procrit for up to six weeks before you begin to actually feel its benefits, so she sometimes goes for months on end when she’s just dragging herself through life.
She was obviously tired, and not feeling well … and it showed. I asked how she was doing with her shots. She misunderstood me, and told me that she was taking them every night, but they weren’t helping.
Every night? You don’t take Procrit every night …
Slowly, the story unfolded. Her type II diabetes was worse … lots worse. She had recently begun taking injections every night, but they weren’t helping. Her numbers in the last several days had been between 400 and up above 500.
My chin dropped!
“Did you tell the doctor?”
“Yes … I called a couple times. Didn’t help, though.”
“Did he tell you what you’re allowed to eat?”
“He hasn’t talked to me about food.”
“Did he tell you that you could have someone help you with your diet, so that you can learn what you can and can’t eat?”
“No.”
“When do you see him again?”
“Beginning of August, I think.”
“What about Dr. R?” (nephrologist)
“That one’s in August, too.”
The primary care she’s seeing is one that I’ve heard horror stories about before. He’s always had a reputation for not listening to his patients. She’s been with him for years and years and years … and just stays there because it’s easier than finding someone new. I won’t go into the stories, but I’ve known about this guy for nearly the entire 30 years I’ve been in the area, and none of what I’ve ever been told was ever positive.
Now, I’m no doctor, but I think that blood sugar levels of 400 to up over 500 for a prolonged length of time being ignored by a physician is criminal. This lady has CRF, CHF, HTN, and diabetes to boot. This is killing her! Is he just not bothering because she’s elderly? She’s independent, lives alone, travels, is extremely sharp witted … but is receiving egregiously poor care from her primary physician.
Should I be carting her off to the ER? Should I see if she can be transferred to another doc somehow?
No one’s even bothered to talk to her about her diet, for heaven’s sake! I’m honestly afraid that this fellow is going to just continue to ignore this!
What I need to know is if I’m overreacting … and just what I should do to help her right now? Also, what could I do to move her into the care of someone who’s not just going to stand back and let her die?
Is there some sort of specialist I could make her an appointment with who could at least be in charge of her diabetes? Is that something her nephrologist might be able to deal with?
Sorry for tweaking out … but this is important. Althea and I are quite close, I don’t want anything bad happen to her, and I don’t want to see her sicker than she needs to be! I need some ammo … !!!
Advice appreciated … I will print it out and take it to her. Thanks in advance.
Sweet Mom-In-Law:
- Tale of the “Overly Sweet” Mother-in-Law
- The Upshot
- Upshot #2
July 3rd, 2007 at 9:53 pm
Honey, I’m not a doctor, but blood glucose that high is WAY TOO HIGH to be ignored, period. An Endocrinologist can treat diabetes, but so can someone in Internal Medicine — those are the first to come to mind. Can you take her level yourelf, to verify those readings? Do you know a nurse or doctor locally that you could call? Sounds to me, the absolute non-medical-professional, that this situation requires pretty immediate attention.
Good luck, and let us know how things go. Bless all y’all’s hearts!
Suzanne
July 3rd, 2007 at 9:54 pm
Get her to an endocrinologist stat. An insulin-dependent diabetic should probably be seeing one periodically.
July 3rd, 2007 at 9:57 pm
July 3rd, 2007 at 9:59 pm
http://diabetes.webmd.com/tc/Type-2-Diabetes-Living-With-the-Disease-When-to-Call-a-Doctor
That has good info — says to notify a healthcare professional for consistent readings above 300.
July 3rd, 2007 at 10:14 pm
OK Moof, here’s your chance to be patient advocate for your MIL. She is obviously not getting good care from her primary care physician but if she doesn’t want to change perhaps you should go with her and ask all these questions. Here is so different that I don’t want to suggest anything. We need a referral to a specialist which the primary care physician initiates. Are you sure she is giving him all the information? She probably needs her insulin titrated and may need it more than once a day. We often had diabetics in the hospital to get their insulin titrated and they could be getting shots four times a day of the regular insulin, rather than the long acting. She definitely need a dietitian’s advice because controlling the diet could help a lot. The ideas about food for diabetics has changed and the important thing is to try to keep the level of carbohydrates even during the day. This information seems to be available in books now, so maybe you could help her there, but I think expert advice would help to get you started.
I think you need to go with her wherever you decide to go. Even if she is still very sharp you often need two minds to grasp it all, especially if it’s something new to her.
Good luck to her, I hope it gets sorted sooner rather than later.
regards
jmb
July 3rd, 2007 at 10:28 pm
With numbers like that I would take her to an urgent care and tell them that her PCP is blowing her off. Ask for a referral to an endocrinologist, if possible.
My mom, who had end stage renal disease, DIED because her primary care doctor blew her off in the same way. Don’t let it happen to your lovely MIL.
July 4th, 2007 at 2:09 am
I agree with the above said. My PCP sent me to a dietician before I reached diabetes when I was preggers cause she didn’t want me to get there because the risk was higher for having it later in life. To this day she still has me check my blood sugar every so often. Go with her help her find a good diet and try and talk to her about what regular PCP’s do. This is not normal. the doctor treating her this way I mean. This is not accectable. The number are to dangerously high. My husbands grandfather died from diebieties. Being this uncontrolled is very very bad. Push the issue Moof. Find her a new doctor.
July 4th, 2007 at 8:22 am
Moof, those numbers would scare me to death. I would call that Doc. and ask about her seeing a diabetes conselor. My mom had one, and this woman was great. She set her insulin and talked and talked to her about nutrition. She kept a close eye on her and we could call any time her numbers wern’t right.
I hope this all works out and I feel bad for her knowing how bad she must feel.
July 4th, 2007 at 12:57 pm
if this was MY diabetic mom (and my mom is diabetic … I’d take her to an urgent care or an ER … seriously.
July 4th, 2007 at 3:54 pm
Moof…as a nurse and CNM I am APPALLED at your MIL’s doctor ignoring blood sugar levels that high! Please, take her to an urgent care center or ER NOW! Sugars that high can cause several problems all alone, and your lovely MIL has enough problems. After the sugars get under control, please have her see a diatician. Medicare (which I assume she is on) covers diabetic counseling. Let us know what happens, please.
July 4th, 2007 at 7:51 pm
This is an unfortunate story. Yes, I agree the doctor is coming close to being negligent,but your mother-in-law’s health is in her hands. Another physician may or may not be beneficial but more vigilance on her part will most assuredly help. Good luck.
July 4th, 2007 at 9:19 pm
You should definitely encourage(talk her into) changing primary docs. tell her the horror stories, point out he is not giving her even adequate care. I went thru this with my Dad before I moved him here from Fla. His doctor was horrid, told me he had failure to thrive and there are alot of stories i could share about him also. He was like a new man once he got some decent care up North here, where we found a careing doc. he was like a new man. ok done with my mini rant here.
Good luck!
July 4th, 2007 at 9:28 pm
Moofie:
You’re a smart lady.
You know perfectly well that your MIL is getting substandard care and that it’s posing an immediate threat to her health.
If you need the reassurance of a bunch of strangers (technically) on the internet reiterating the obvious, then by all means add my voice to the crowd.
If what you really want is to say, “OMG, can you believe what this incompetent doc is doing to my poor MIL” (a perfectly valid sentiment that certainly deserves a rant) then I agree wholeheartedly: What a jerk!
Since I know you know exactly what you need to do, instead of offering “advice” I’ll offer reassurance: Yes, it is appropriate for you to intervene. My prayers (and love) are with you, helping you find the strength to do what has to be done.
July 4th, 2007 at 10:17 pm
Moof,
Sounds to me like your MIL’s doc has his head up his butt, IMHO. Why else would he ignore all of these chronic conditions? My advice would be to get her to an ER or an urgent care to get her blood sugar down NOW, and then see about finding her a doc who actually pays proper attention to her various problems, many of which are likely to be interrelated. If you can’t convince her to do it, perhaps you should get her nephrologist involved. (Perhaps they know someone and can get her a proper referral.) What is it lately about these doctor horror stories we keep hearing from you? There ARE decent, non-specialist docs out there…you just need to find yourself a couple! Wish I could be of more help…
July 5th, 2007 at 9:32 am
Moof, my wife’s father, sister, and cousin all have diabetes. Her father died of it some time ago; she is very afraid of developing it, and has read extensively on the subject. She has no medical training, but she has worked to help her cousin find information on diet, since his doctors have been less than helpful in that regard.
Her own opinion is this: if she talked to her cousin on the phone, and he had one reading of 200 or more, we’d be making the two plus hour drive up to see that he got help, even if it was midnight. I suspect she may be leaving a tiny margin for caution there, but not that large a margin. She suggests you call the local emergency room, give them the readings, and ask if your mother-in-law needs to be seen.
Also, if your mother-in-law is interested in learning the latest on diet, Google “glycemic index” and give her the results. As far as the doctor, I’d say with the number of stories you’ve heard, “where there’s smoke, there’s fire”. I hope things work out well for both of you.