Re: I just got back from the dr, questions and info needed

December 28, 2001

, don't give up the good fight...you've been an inspiration to many

here and you've come such a long way. We're all bound to have setbacks now

and then but that doesn't mean you should give up and indulge permanently. A

binge now and then...a short one...okay. If you can stop after a one-day

binge I'd say go for it...except for some, it's hard to get back on the

wagon.

There are no guarantees. We all try to keep our BGs down in the hopes that

this will keep the bad stuff at bay. We can only keep trying. Remember,

there is no data on well-controlled diabetics, we're in the avant garde here.

We want to prove that it can be done.

Oh, and BTW, I also take Prinivil. I think it's recommended for all diabetics

since we're at increased risk for heart disease and the " i-l " drugs are well

known to help decrease that risk. So it's well worth the expense. Take

care. Vicki

December 28, 2001

wrote:

> She gave me a hard time when i said i wanted them to do a 24

> hr urine to test for the same thing, and also to do a repeat urine

> test, even though i have a urinary tract infection, which can cause

> elevation in this.

You are right to ask for a 24 hour test as this is a confirmation test

which needs to be done when random samples are elevated.

> She's a good dr, and said that if i went to the endo at Albany Med,

> i'd automatically be put on an ACE inhibitor, and that i should just

> go ahead and take this.

My doc told me basically the same thing, " All diabetics need to be on an

ACE inhibitor as a prophylaxis. She put me on Prinivil 10 mg daily, even

though my BP was only mildly elevated 140's over 80-85

> I need info on the medication,

Did you mean Enalapril or Enalaprilat? If so, here is a link from

rxlist.com where you can get a little more info about them - scroll down

the list to find the medication:

http://www.rxlist.com/cgi/rxlist.cgi?drug=*pril & imageField223.x=13 & imageField223\

..y=8

> info on the urine test,

Here is a site for the Creatinine issue:

http://www.labtestsonline.org/understanding/analytes/creatinine/glance.html

I also just uploaded a file to our groups " file: list called

" Renal_Disease_In_Diabetics.doc " This is a chart showing protien/urine

tests are their correlation to various stages of kidney problems.

> and if i should fight it, or take it, info on why i'm having

> complications if i'm in good control.... and if i'm having

> complications anyway why should i bother to eat right?

I think it would be advisable to take an ACE inhibitor. Barb responded

to you while I was putting this together. She is also taking Prinivil.

Others are taking other ACE Inhibitors. If you can swing it, it would

probably be helpful to you.

> And yeah i know i need to not get upset and stressed out about all fo

> this....

You said it! )

Rick

December 28, 2001

wrote:

> She gave me a hard time when i said i wanted them to do a 24

> hr urine to test for the same thing, and also to do a repeat urine

> test, even though i have a urinary tract infection, which can cause

> elevation in this.

You are right to ask for a 24 hour test as this is a confirmation test

which needs to be done when random samples are elevated.

> She's a good dr, and said that if i went to the endo at Albany Med,

> i'd automatically be put on an ACE inhibitor, and that i should just

> go ahead and take this.

My doc told me basically the same thing, " All diabetics need to be on an

ACE inhibitor as a prophylaxis. She put me on Prinivil 10 mg daily, even

though my BP was only mildly elevated 140's over 80-85

> I need info on the medication,

Did you mean Enalapril or Enalaprilat? If so, here is a link from

rxlist.com where you can get a little more info about them - scroll down

the list to find the medication:

http://www.rxlist.com/cgi/rxlist.cgi?drug=*pril & imageField223.x=13 & imageField223\

..y=8

> info on the urine test,

Here is a site for the Creatinine issue:

http://www.labtestsonline.org/understanding/analytes/creatinine/glance.html

I also just uploaded a file to our groups " file: list called

" Renal_Disease_In_Diabetics.doc " This is a chart showing protien/urine

tests are their correlation to various stages of kidney problems.

> and if i should fight it, or take it, info on why i'm having

> complications if i'm in good control.... and if i'm having

> complications anyway why should i bother to eat right?

I think it would be advisable to take an ACE inhibitor. Barb responded

to you while I was putting this together. She is also taking Prinivil.

Others are taking other ACE Inhibitors. If you can swing it, it would

probably be helpful to you.

> And yeah i know i need to not get upset and stressed out about all fo

> this....

You said it! )

Rick

December 28, 2001

wrote:

> She gave me a hard time when i said i wanted them to do a 24

> hr urine to test for the same thing, and also to do a repeat urine

> test, even though i have a urinary tract infection, which can cause

> elevation in this.

You are right to ask for a 24 hour test as this is a confirmation test

which needs to be done when random samples are elevated.

> She's a good dr, and said that if i went to the endo at Albany Med,

> i'd automatically be put on an ACE inhibitor, and that i should just

> go ahead and take this.

My doc told me basically the same thing, " All diabetics need to be on an

ACE inhibitor as a prophylaxis. She put me on Prinivil 10 mg daily, even

though my BP was only mildly elevated 140's over 80-85

> I need info on the medication,

Did you mean Enalapril or Enalaprilat? If so, here is a link from

rxlist.com where you can get a little more info about them - scroll down

the list to find the medication:

http://www.rxlist.com/cgi/rxlist.cgi?drug=*pril & imageField223.x=13 & imageField223\

..y=8

> info on the urine test,

Here is a site for the Creatinine issue:

http://www.labtestsonline.org/understanding/analytes/creatinine/glance.html

I also just uploaded a file to our groups " file: list called

" Renal_Disease_In_Diabetics.doc " This is a chart showing protien/urine

tests are their correlation to various stages of kidney problems.

> and if i should fight it, or take it, info on why i'm having

> complications if i'm in good control.... and if i'm having

> complications anyway why should i bother to eat right?

I think it would be advisable to take an ACE inhibitor. Barb responded

to you while I was putting this together. She is also taking Prinivil.

Others are taking other ACE Inhibitors. If you can swing it, it would

probably be helpful to you.

> And yeah i know i need to not get upset and stressed out about all fo

> this....

You said it! )

Rick

December 28, 2001

Thanks everyone, i've calmed down a bit

For whomever asked, it is Enalapril 5mg 1 a day.

I'm going to check and see if i can get on the indigent program, and get it

donated from the pharmaceutical co. Its only about 32 a month, but i can't

currently pay my taxes and gas and electric bills, so even 32 more per month

is to much.

I sure wish i could find a job i can do, but with my back restrictions, and

the fact that i've not worked in about 7 yrs, noone seems to want to hire me,

even as a nurse with the nursing shortage.

I am still eating pretty much correctly, i've been splurging since christmas

and eating about a cup full of carbs a day (a bit of potatoe, stuffing, and

scalloped oysters) to - 1 cup of stuff.

Its almost all gone, I won't be making that again for ages, but i just

couldn't picture christmas without it.

I send the excess potatoes, stuffing, rolls, pies, home with someone who'd

come for dinner, but i did keep a small amount so that Kate and i could eat a

bit more of it.

I'm going to check more into this urine test, and try doing it in the am,

after my urinary track infection is cleared up.

December 28, 2001

Thanks everyone, i've calmed down a bit

For whomever asked, it is Enalapril 5mg 1 a day.

I'm going to check and see if i can get on the indigent program, and get it

donated from the pharmaceutical co. Its only about 32 a month, but i can't

currently pay my taxes and gas and electric bills, so even 32 more per month

is to much.

I sure wish i could find a job i can do, but with my back restrictions, and

the fact that i've not worked in about 7 yrs, noone seems to want to hire me,

even as a nurse with the nursing shortage.

I am still eating pretty much correctly, i've been splurging since christmas

and eating about a cup full of carbs a day (a bit of potatoe, stuffing, and

scalloped oysters) to - 1 cup of stuff.

Its almost all gone, I won't be making that again for ages, but i just

couldn't picture christmas without it.

I send the excess potatoes, stuffing, rolls, pies, home with someone who'd

come for dinner, but i did keep a small amount so that Kate and i could eat a

bit more of it.

I'm going to check more into this urine test, and try doing it in the am,

after my urinary track infection is cleared up.

December 28, 2001

> my protein creatine ratio has been

> fine, but now in oct, and a repeat last

> week is elevated 56 in oct, 44 now.

> dr wants it under 30 i believe it was 10

> in Nov 2000. They want to put me on enapapril

> (sp) an ace inhibitor....

If that is microalbuminuria then 20mg/l is the limit for a negative

result, I believe. Getting it under 30 sounds like a good idea. I was

put on Atacand Plus which is 16mg candesartancilexetil plus 12.5mg

hydrochlorothiazid when mine went up to 46mg/l so that sounds about

right. Don't forget that microalbuminuria is still reversible with

medication while it is below 300mg/l so you have quite some way to go

yet, cheer up!

> My b/p runs 106/60

So the ACE inhibitor is for the kidneys, not the blood pressure.

> So i don't agree with the scale. I'm upset ...

Yeah, , I know THAT feeling!

> ... she's telling me that the elevated

> protein-creatine ratio in my urine, is

> due to my kidneys being damaged by the

> diabetes....

Yes, that's what happens. Microalbuminuria is the earliest possible

indication of a diabetic nephropathy. I understand that the state of

the kidneys is an indicator of long-term average blood glucose, just

like the retina (like the HbA1c but over years instead of months).

Have you had an eye examination recently? Twice a year is usually

recommended here.

> I thought if i was doing good with my

> bs readings, and HBA1C's, that i'd not

> get problems with my kidneys, and or

> other complications...

My opthalmologist tells me that it takes at least 5 years of elevated

blood glucose for the first eye damage to appear. The kidneys are

much the same so your recent BG readings are probably not so relevant

as your BG level a few years ago.

> I can't stop crying, .... all i want

> to do is eat foods that are not ok,

Try thinking positive, . Just consider how many people there

are around who are in a much worse state than you and don't even know

it. Many diabetics don't even get diagnosed until they are being

considered for dialysis.

> i can't afford to purchase the

> medication on a regular basis,

It is a good investment.

> ... she gave me a hard time when

> i said i wanted them to do a 24 hr

> urine to test for the same thing,

> and also to do a repeat urine test,

> even though i have a urinary tract

> infection, which can cause elevation

> in this.

I have had that problem, too, , but it seems that 24-hr urine

tests have gone out of fashion, except maybe in hospitals. When my

physician got high microprotein readings at the first try last year I

had climbed six floors by the stairs to get to his office before I

gave the sample and that (or any other exertion) can give a false

positive result, I found out later.

I, too, wanted him to do a 24-hour test but he said that they are not

done these days (they don't trust outpatients to make a 100%

collection). But he did make a microalbuminuria re-test later when I

came up in the elevator and he got a much better result. The best

results are obtained with the first morning urine so you should take

the sample at home after you wake up and not some time later during

the day.

By the way, you can buy urine test strips for microalbuminuria and

test yourself semi-quantitively if you want to.

I found that my results matched his when the sample was taken without

previous exertion. You should also eat very little protein in the

week before the test. If you had been eating high protein, high fat,

low carbohydrate meals before the test then that might have

contributed to a false positive result. Menstruation can also be a

factor and so can a high intake of fluids.

These precautions are described in the package insert that comes with

the test strips. Even then you should make three tests on different

days over a period of a few weeks and take the best two out of the

three.

> She's a good dr, and said that if

> i went to the endo at Albany Med,

> i'd automatically be put on an ACE

> inhibitor, and that i should just

> go ahead and take this.

It appears to be usual in Germany to put diabetics on an ACE

inhibitor to protect their kidneys. It seems to be a standard

precaution.

> ... info on why i'm having complications

> if i'm in good control.... and if i'm

> having complications anyway why should i

> bother to eat right?

In my opinion, as I said above, any complications you might be seeing

now could be the result of your BG levels a few years ago. You will

get the benefit of your present good control in a few year's time.

Anyway the aim is to postpone the onset and limit the effect of

complications, isn't it? I believe that the only way not to have any

complications at all is to die young.

I have seen reports over here of diabetics over 90 years old, 40

years on insulin, who have had every diabetes complication known to

medical science and who are still looking forward to next Christmas!

> And yeah i know i need to not get

> upset and stressed out about all of

> this....

Let it all come out, . If you choke it back it might show up

somewhere else, like an inflammation of the bowels (that's what

happens to me)! The positive approach is to make a list of all the

things that you should or could be doing and see where you could take

some action.

Cheer up!

December 29, 2001

Carol wrote....

<<now that you took a nutritional vacation for a day, ask yourself how

you feel? Probably not any better, so why not start fresh today with

something healthy that you really like. Take a walk, unless ice is all over

the place. Do something nice for yourself...visit a friend, etc, get a great

library book. >>

I didn't do too bad as a " nutritional vacation " , and do feel better today,

but its not due to what i ate

I've got 2 things on the agenda today, one that's not so fun, my oldest dog,

Holly has a tumor on her right hip area, which has been growing for over 5

yrs, it was tested and was benign, so we decided not to do surgery, as we did

it once about 7 yrs ago, and it grew back, however she's now been licking,

and chewing at it, and has it raw, so she needs some intervention, and i'm

not sure what they can do for her, she's 13, and is great health otherwise,

but this is a very large mass, like a grapefruit in size now.

The other thing on the agenda is that i'm going to be talking on the phone to

a great friend of mine, the woman who convinced me to try the low carb eating

(along with some of you) and she's been helping me along with it all the way,

we have a phone date at 3pm ET

So I'm going to be doign something fun, as well as something not fun today.

I'm also going to be eating the way i've been eating for the last year, and

moving fwd with this stuff....

I'm considering making an appt with the Endo clinic, since i'm going to have

to find a new dr anyway.

I think i'm also going to have them repeat the test after i finish the

bactrim (for the UTI) And not start on the med till after that.

Thanks for all your support,

December 29, 2001