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Any doctors/diabetic expertish people around?

13 replies

TheJollyPirate · 08/09/2010 13:29

Just need a bit of advice about my Dad who is 65, type 1 diabetes, on insulin but a real "there's nowt wrong with me" person. As such my Dad eats chocolate (a real sweet tooth) and many other foods which should be restricted. As a result his diabetes is not under control and his blood sugars swing wildly.

Around three weeks ago he had some kind of virus (I think) and took hiself to bed for 2 days. He felt exhausted, aching and had diarrhoea. After 48 hours he began to feel better and seemed to be improving. However, he still has diarrhoes (up to 15 times a day) and today says he cannot wee. Now I am a nurse but tbh it's been nearly 20 years since I did any general stuff. I am thinking either dehydration ue to the amount of diarrhoes or kidney probs due to poor diabetes control or prostrate probs.

Dad has an appointment with his GP tomorrow - an appointment I have had to make as he will not. He says he doesn't like doctors Hmm but I think it's more anger about his diabetes and fear of what his GP might say (she is fab btw and will not be horrible in any way) but I think he is fearing what he might hear.

He refuses to go today even though he cannot pee at the moment. I've advised my Mum to call the surgery later if he still cannot pee and seems in pain but beyond that am at a loss. He says he feels okay and will wait till tomorrow - tbh the fact that he is agreeing to go tells me he does not feel well at all as if he DID feel okay he would not be going.

Any thoughts/opinions appreciated. Not sure of the insulin he's on but the pharmacists says it's one they don't keep much stock of as so few people are on it.

Am worried about the stubborn sod Sad

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TheJollyPirate · 08/09/2010 15:51

Bump

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QueenofWhatever · 08/09/2010 16:20

Sounds like urine retention and your Dad is a prime candidate for kidney disease I'm afraid. You can phone the GP and tell her your concerns. She cannot tell you anything about your Dad, including that he is seeing her tomoworrow.

You could start the conversation by saying 'I know you can't tell me anything about my Dad but I'm concerned because...'. She should do a proteineuria and/or eGfr test.

Good luck.

mattellie · 08/09/2010 16:57

Can?t help with the current problem I?m afraid.

With regard to his diabetes, would need to know: how long he?s had it, what type of insulin(s) he uses, how many injections he does a day and so on first. With the management tools available these days, there?s actually no need to ban any foods completely (even chocolate), but you do need to look after yourself in terms of regular exercise, lots of testing and carbohydrate counting as part of a balanced diet.

TheJollyPirate · 08/09/2010 17:42

Thanks folks - Sad not good really then. His GP has told him previously that he is showing early signs of kidney problems. I will ring his GP in the morning and just tell her my concerns - I know she can't tell me anything but hopefully my info might be helpful. My Mum is going with him but she is desperately worried and I don't think she is going to have a clear head.

He eats a sugary diet and definitely does not look at carb levels with his diet - or really check his blood sugars as he should either. It's like he's on a death wish tbh......Sad

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mattellie · 08/09/2010 18:06

Well, to give you some idea I check my blood sugars a minimum of 5 times a day, do at least 4 injections and check the carbs on everything I eat and adjust my insulin accordingly. Both my kids do similar.

Sorry, don?t mean to sound all goody-two-shoes, just giving you a basis of what is necessary to manage the condition properly. A lot of diabetic complications can be slowed down massively if you start to take care of yourself, but I think at your dad?s age he has to want to do it himself ? it?s different with young children you can nag endlessly Grin

What about suggesting your mum takes notes, it might help her and it also means she can relate it all to you later?

mybabywakesupsinging · 08/09/2010 23:27

How long is it since he passed urine?
If it is a substantial length of time then there are 2 possibilities:
either: there is no urine to pass, so no urge to go - this implies kidneys not producing any and this shouldn't wait until tomorrow to see GP. Could happen if he has some renal impairment and then has had bad diarrhoea and dehydration. Kidneys recover if treated properly but honestly, if he hasn't passed urine all day and still doesn't want to, this shouldn't wait - go to A&E and get kidney function checked (blood test).
Alternatively he could have a full bladder and start to feel desparate to go but not be able to - although this is uncomfortable and needs a catheter it is much less of a worry than the "no urine" situation as it is impossible to ignore and easy to fix.

Northernlurker · 08/09/2010 23:34

Kidney problems are very likely I think and that's not easy for patients to hear. If the GP has told him previously he was showing signs of it that sounds like they did an eGFR test then - that will give them something to compare against if they do one tomorrow, because he's been ill his eGFR will probably be lower than it was but it could still bounce back up when they get everything else sorted.

TheJollyPirate · 09/09/2010 07:50

Thank you all so much for your advice and thoughts as I really appreciate it. He DID pass urine in the end yesterday but it sounds as though his urine production is very reduced. I will ring his GP this morning from work and just let her know some of the issues before he goes in.
He flatly refused to go to A+E last night and my mother is ready to brain the stubborn old sod. I love him but honestly.........

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TheJollyPirate · 09/09/2010 16:08

Thanks for all the advice yesterday.

Dad saw his GP today - she has allowed him to go home as he has passed urine several times today but he has to tack urine and stool samples up for testing. He is also going to have some more blood tests.

So - the grumpy git is now sitting at home moaning because "there's nothing nice to eat in the house" GrinHmm

There is no hope for the man honestly

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TheJollyPirate · 09/09/2010 16:08

Thanks for all the advice yesterday.

Dad saw his GP today - she has allowed him to go home as he has passed urine several times today but he has to tack urine and stool samples up for testing. He is also going to have some more blood tests.

So - the grumpy git is now sitting at home moaning because "there's nothing nice to eat in the house" GrinHmm

There is no hope for the man honestly

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TheJollyPirate · 09/09/2010 16:09

Ooops - posted twice.

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mattellie · 09/09/2010 23:10

Hi JP, does your dad see a diabetes specialist doctor or nurse? Only reason I ask is that I've yet to meet a GP with more than a rudimentary understanding of T1 diabetes (apologies to any GPs out there, but that's been my experience). A good DSN is worth their weight in gold and might be able to make your dad listen in a way that his nearest and dearest cannot.

TheJollyPirate · 11/09/2010 09:28

Hi mattellie, yes - Dad has seen a couple of excellent diabetes nurse specialists who were brilliant with him and also a consultant who specialised in diabetes - he came home really positive from his visits with them which lasted precisely until he next hit Tescos and the chocolate aisle!

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