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fever with diabetes

A Few Day Fever

A couple of weeks ago I was back up in Pennsylvania visiting family. After coming home from my brother’s house where my daughter and two nieces and one nephew were playing for a few hours, I felt extremely tired. I wasn’t sure if it was just the exhaustion of watching 4 kids play and runaround or the lack of sleep was just catching up to me.

I ended up falling asleep around 9-10 p.m. that night. I know that might sound late to some people, but to me, that is early.

The next day I was still a little sluggish but decided to go to the park to meet up with my friend’s kids and I just felt like crap. I was just sitting on the bench watching the kids have fun, but didn’t feel like getting up to do anything.

Ketones

My first thought was ketones. Definitely ketones.

Now, let me give a little history here. In my 14 years of living with diabetes, I have never, ever, checked for ketones at home.

Never.

My mentality has always been to just drink a lot of water when I had a high blood sugar or just felt sluggish with a “normal” blood sugar.

My brother was coming to the park too, so he was going to bring my some ketone sticks to check. Well, as soon as I got home, I checked and I had trace ketones.

I guessed right. That’s why I was sluggish and tired.

But then several hours later I felt warm.

So I checked my temperature.

101.4

Ut-oh.

That’s not normal.

Fever

I went for the Tylenol and hope that the fever broke and I would be ok.

Well, this went on for 2 days. Fever would go away, then come back, then go away and come back with the help of Tylenol.

I didn’t want to take Tylenol for more than 2-3 days so I knew that come Monday morning I was going to the doctor.

Now I know that with type 1 diabetes, you shouldn’t mess around with a fever, but here’s why I did.

No Out of State Insurance

My ACA insurance plan is only good in the state of Florida. I didn’t know that when I chose the plan, but if I went to the doctor or ER in PA, I would be set back a couple hundred dollars, if not more.

I was willing to go to the doctor or ER on the 3rd day if I had to, but I wanted to try and beat the fever.

Luckily, on the 3rd day I woke up and the fever was below 99.1. A few times it crept to about 99.3 that day, but nothing higher than that.

Now, I thought this was weird because I had an appetite, I wasn’t vomiting or feeling like I had to. Just a fever and tired.

I also had trace ketones the whole time this was occurring as well.

I am the type of person that coughs once and freaks out and thinks that something horribly wrong is happening. So I kept freaking myself out that something more serious was or still is going on.

Now that I am back in Florida I have set up a doctor’s appointment for next week to just get a check up and make sure everything is working inside of me.

I know that if you are reading this you are probably screaming through the computer screen or smart phone, that I should have went to the hospital or saw a doctor.

And you are 100% correct. I should have.

But I chose not to, so now I am hoping that it wasn’t anything serious that had long lasting effects on my body.

But we shall find out soon enough.

Thank You for Waiting 2 Hours: The Dark Side of ACA

Late last year, around October or so, my endo, primary care, my wife’s primary care, OBGYN, and endo all sent us letters stating that they were no longer accepting our MarketPlace insurance plan. This led us to searching for something new. Instead of just choosing a plan, we asked what MarketPlace plans they accepted. There was only one common plan, Ambetter from Sunshine Health. Don’t sound familiar to you? That’s because it’s a Florida based insurance plan, meaning, it can only be used in the state of Florida. That poses an obvious issue, but more on that in a later post.

My wife and I had to plan our yearly checkups and needed to find a new PCP. After calling about 10 who were either not accepting new patients, or didn’t have any openings for new patients for a few months we finally settled on one. We decided that we would schedule back to back appointments so that way one could be with the kid and then we could switch. These appointments were staggered between 2:45 for the first and 3:15 for the second.

My wife checked in for the appointment at 2:40 and she also checked me in while I walked the kid around in the stroller with the hopes that she would take a nap. After my wife filled out her paperwork, she thought it would be a good idea to hand me mine outside so I could get a head start. This was now around 3:00 p.m. (15 minutes after my wife’s scheduled time.)

At 3:15, which was my scheduled appointment time, my wife had still not been sent back to see the doctor. At this point, I am become a bit irritated, as I continue to walk around outside in 80 degree weather.

3:30 – nothing.

3:45 – nothing.

4:00 – nothing.

4:15 – my wife finally gets sent back to get her vitals taken.

At this time, it’s now an hour and a half past her original appointment time and then she was sent to another room to wait after her vitals were taken.

Finally, at 4:30, 1 hour and 45 minutes after her appointment time, she sees the doctor. This is the same time now that I get my vitals checked, 1 hour and 15 minutes after my scheduled appointment time.

After all was said and done, both of our check ups, in an-office EKG (which came out fine for me), and a few lab scripts later, my wife and I left the parking lot 2 hours and 45 minutes after our initial scheduled appointment time.

To say this was a nightmare and a disaster and an example of some of the negative effects that ACA has caused is an understatement.

There are not many doctors that take MarketPlace plans, this just so happens to be one of them. Which means, all of the people who are on a MarketPlace plan have very few doctors to choose from which creates these enourmous backups.

What’s the longest that you have ever waited for an appointment?

How I Became an Empowered Patient

Before I get into the how I became an empowered patient, I want to briefly talk about why I became one. First, what is an empowered patient? This question was brought up during the #ChatActChange #DSMA last Wednesday. To me, an empowered patient is someone who takes an active role in managing their illness, disease, disorder, etc. For me, that is taking an active role in managing my diabetes, not just from the “I test my blood sugar 6 times  a day” perspective, but from a more in depth one.

For example, I decided one day that just simply listening to what my endo and educator was telling me was not enough. I wanted to go and read more about these studies that they were talking about so we could have an actual conversation during our visits and it not just be a one way instructional visit. I wanted to not just do what I was being told to do, but I wanted to know why I was being told this and I also wanted to know if this really was the best thing for me to be doing.

Once I knew that I wanted to be a bit more involved, it was easy from there. I started to read more and consume more. I started to read about more of the science behind diabetes. I began to read as much from the ADA Scientific Sessions free posters that I could. I admit, 90% didn’t make sense, but I took notes and wrote things down and knew that I would go back later and start researching more of those words.

I began to learn more about different products and medications.

The very first time that I went into a visit with my CDE and I said, “hey, I read an ADA Scientific Sessions poster on the effects of wheat and gut bacteria….blah blah blah” I could see the look in her eyes like, wow this guy knows his shit. From that day forward, I had a lot more respect from my CDE as a patient and had a lot more involvement in my management.

Now, my visits start off with a conversation. My CDE asking me to evaluate myself and recommend my own changes and then she chimes in with her input and we come to a mutual decision on the next plan of action.

Having that feeling of knowing that I have the respect from my doctor has completely changed the way that I view my healthcare team. And I think it would for you also.

A Little Trip to the ER

You may have seen on Twitter yesterday that I was debating whether or not to go to the ER because I had a bit of pain in the lower right abdomen area. So, obviously my very first thought is appendix. I don’t know why, but since I was younger, I have had this fear of my appendix bursting. I think it is because anytime that I have ever heard someone talk about it, they describe the most excruciating pain in the world. So, whenever I feel pain in that area, it is my first thought.

Yesterday morning I woke up and had a slight pain in that area, but didn’t think anything of it at first. About 6 years ago, I had this same pain and went to the ER because of my fear. It ended up being a strained abdominal muscle and that’s it, I was sent right home. So, this is exactly what I was thinking was the issue again, except 6 years ago, I was working out a lot and it made sense. These days, not working out so much.

Between my mother, wife, other family members and friends all telling me to just go get it checked, I decided to be safe than sorry. Especially as someone with type 1 diabetes, I’ve had the mentality that if I feel like anything is wrong with me at all, I need to go let a professional determine if it’s an issue or if it is nothing at all.

I decided that I would go to an urgent care facility first because I read on their site that they had in-house imaging services, so I figured I could just pay a small co-pay and still get an CT scan there if needed. Well, unfortunately, they stop doing those at 4 p.m. and it was already 6 p.m. So, after wasting a $75 co-pay, the doctor basically told me the only way to know is by getting a CT scan and only the ER can do that for me at this time. So, after 45 seconds with the doctor and $75 later, I was on my way to the ER.

There was not much of a wait at the ER because I guess abdominal pain is one of those cases they bring you back pretty quickly. After the nurse initially checked me out, she kind of felt that it was not my appendix, but still wanted the blood work and the CT scan to see if there was anything else going on in there.

After about 2.5 hours altogether at the ER, blood work, CT scan, the nurse came in and told me that my white blood cell count was perfect, the CT scan came back with nothing wrong and that I was good to go. She said that it could be that I tweaked that area or their could be some sort of intestinal issue going on that the CT scan can’t determine. However, appendix, kidney stones and gull bladder issues were all ruled out.

So, that now makes two trips to the ER thinking my appendix is bursting and both times I was sent home with the nurses pretty much laughing at me. But, at the end of the day, I would rather pay to know for a fact that nothing is wrong.

One last thing about the ER trip. Apparently, there was Blue Light special at the ER last night because when the administration person came in, she mentioned that there was a 20% off co-pays for today. So, I guess I came to the ER on the right night!

Holding Myself Accountable

When things go wrong, excuses usually begin to fly. This is not only true with diabetes, but also with anything in life.  So, this morning when it was time to review my latest blood work, I was going to hold myself accountable for whatever the numbers told us.  I was not going to blame it on the diabetes, but my choices.

I knew going into reviewing the labs that my A1C was going to be higher and that there may be some issues with the lipid panel because of the horrible diet and forgetting what the inside of my gym looks like.

A1C was a little higher than last time, but lower than what I thought.  I honestly felt that my A1C was going to be between 8.0 – 8.5 because I’ve seen the numbers on my meter and they have been bad, probably my worst 3 months in the past 5-6 years.  Which is also why I knew it was time to go back onto the pump and get off of MDI.  The A1C was 7.5.  Not good, but better than I expected.  It was 7.1 six months ago, so I obviously wanted to improve on that, but didn’t.

Everything else in the lab results was good, except for one big issue.  Triglycerides.

I’ve never had an issue with my triglycerides being high because I always had some form of exercise, not intense, but would get at least an average of 15 minutes per day.  My triglycerides were 455.  If you know about triglycerides, then you know that’s pretty damn high.  The doc was concerned about this number obviously, but as I’ve written before, we have a great relationship and she does not scold me, but provides me with the information I need to make better decisions and make improvements.

There was a side of her that wanted to put me on medication, but she knows that by giving me a warning and doing labs again in 90 days, that it will motivate me to improve that number that she feels I won’t need medication.

So, here is to holding myself accountable. No more bolusing 40-50 units for one meal. Yes, you read that right, 40-50 units for just one meal!  No more just sitting on the couch watching horrible reality tv shows (my wife loves that shit!) and more of getting back to the gym, walking around the neighborhood, ANYTHING.

Here’s to lowering triglycerides

Day One of Diabetes Blog Week – Share and Don’t Share

If you haven’t heard of Diabetes Blog Week, then click the link and read all about it.  Today’s prompt is:

Often our health care team only sees us for about 15 minutes several times a year, and they might not have a sense of what our lives are really like. Today, let’s pretend our medical team is reading our blogs. What do you wish they could see about your and/or your loved one’s daily life with diabetes? On the other hand, what do you hope they don’t see?  (Thanks to Melissa Lee of Sweetly Voiced for this topic suggestion.)

I have blogged before that I am very lucky to have the medical team that I have. My previous endo was type 1 herself and wore a pump and knew the daily struggles that I was going through, so I never had to feel like I was making excuses for things.  She totally understood, but would push me to be better. (more…)

I Am Motivated by a Bravo TV Start

Amanda likes to watch this Bethenny Ever After, or whatever it is called on Bravo, so as the good boyfriend I am, I watch it with her.  I don’t like these shows at all, but I still watch them, mainly to make fun of these people.  Especially these Housewives shows because these women are living in a fantasy world and I would love to just smack them into reality.  Anyway, the reason that I am mentioning this is because this Bethenny lady motivates the hell out of me!  She has so much passion and enthusiasm for her product lines and her personal brand.  She was  talking about having someone write a blog for her about food.  I don’t know what it was, but she  really motivated me and that is why I am writing this blog post right now.

On to other things, I had my follow up visit for my knee today.  I had my MRI last week and the doctor took a look at the MRI results today and I do NOT need any surgery.  Thank goodness!  I do have a partial meniscus tear, but not serious enough to have surgery.  The doctor felt that I should just rehab it for about a week and do some light lifting with the legs.  I am allowed to start golfing right away and I can even play in the co-ed softball league again.  But, I’m not sure if I should play this week in the softball league or take another week off.

Last bit of news, I rescheduled my endo appointment for April because I have a few days off during that time period and it’s always best to have appointments on my days off.

So, have a great week everybody.

Forgot to Reschedule Endo Appointment, Oops

It’s been a while since my last A1C and my last endo visit.  I had an appointment scheduled in January, but it was cancelled because the doctor could not make the appointment.  My main doctor is on maternity leave, so the doctor taking her place has her own office and there was a scheduling conflict, so she had to cancel mine.  I just realized today that I never re-scheduled a new appointment, so I need to call tomorrow to make sure that I get a new appointment soon.

I was supposed to lose at least 5 pounds by next visit, and I guess you can say, luckily I got sick these last few days because I lost a few pounds, and now I am trying to keep them off.  Amanda and I are still settling into our new place and are cooking a little more often, but still not as frequently as we would like to.  Still wasting a lot of money and a lot of calories on take-out.

I am having some serious internet issues with Comcast right now, so I never know when I am going to actually have internet.  It works for a day, then doesn’t work for a few days, then works, etc.  Just one big viscous cycle, that I don’t like.  Anyway, my blog reader is up to close to 1,000 with a backlog of blogs, crazy huh?  I am determined to catch up on every single one of them, but it will definitely take some time, but I can get it done.

Well, time to get started on those blogs.

Stomach Pains Kept Me Worried

So the last few nights and days I have been feeling a little under the weather.  Starting Sunday night I had cramps in my stomach, but didn’t think anything of it.  Then Monday while I was at work, I started to get really sharp pains in my stomach.  Eventually it got to the point where I couldn’t sit at work any more and I had to go home and lay down because it hurt so bad.  All day yesterday my stomach would hurt anytime that I stood up for a long period of time or even just sat up.  So I just layed down all day long.  I was becoming worried that I was going to have to go to the ER because I had a fear that my appendix was bursting or something because my stomach hurt so bad.  All the pain was on the left side of my stomach though and I know that the appendix is on the right.

So today it didn’t hurt as bad and now tonight while I am typing this blog, it doesn’t really hurt at all.  I have an appetite and have been eating normally, so that also made me believe that it wasn’t my appendix.  My blood sugars were a little elevated during this time, which that always happens anytime that I am sick of any sort.

Well, I am still tired and body still feels week so I am going to lay down and watch Teen Mom with Amanda…. can’t believe that I watch this show.  Or is it more embarrassing that we watch Glee together also?  Well, we just decided this tonight because I loved the Katie Perry song from last week, ha.

Well, have a good week everyone.

Time To Re-Order Supplies ASAP

I contacted my endocrinologist today because I need a new prescription for my pump supplies before I see her later this morning.  I was hoping that I could just wait until I saw her on March 25 to get a prescription from her, but there is no way that I am going to have enough supplies until that time.  I only have four infusion sets left and about 7-8 reservoirs.  The reservoirs, I don’t really care too much about because I re-use them a couple times before I actually throw them away.  Infusion sets obviously can’t be re-used.  I have been keeping one set in for on average about 6 days, and that is not the best idea either.

I am also getting low on testing strips so I am going to get a prescription for that also.  I believe that I am going to stick with using my Freestyle Lite meter just because it is the one that I am the most comfortable with and have used for the longest time.  I don’t know if she will write the ‘script out until I actually see her, but I’m hoping that she will, she’s really nice, so I’m sure there is no reason why she won’t.

I have been out of sensors for a long time because the ones that I have expired in October or November, I’m not sure of the exact date, but I know that I shouldn’t be using them.  Thanks to a fellow d-blogger, not sure if you want to stay private or not, so I won’t mention your name unless you give the ok, was nice enough to lend me a few sensors until my insurance coverage gets a little better and I can start getting them on my own.  Now I just have to re-charge my transmitter because I haven’t used it in so long, not since October.  I am going to try and start using them on Wednesday, so I can get 2 full weeks worth of data for my doctor’s visit.

I hate being this low on supplies, but it is part of life.  I can get them, I just didn’t know the process of getting them and just became ignorant to that fact and haven’t taken initiative until recently to make a few phone calls to figure out what I was supposed to do.  Well, time to wait on the e-mail notification on whether or not I am going to get my scripts today or not.

Have a wonderful day everybody.