Life in LADA land

Living Philippians 1:6 with type 1.5 diabetes

Rehab

I had a knee replaced 12 days ago.  I now have more artificial parts of my body than I ever expected – a little metal pump that functions like my pancreas, and now a plastic/metal joint that eventually will work with less pain than my old flesh and bone knee.  Medical technology is truly amazing, isn’t it?

However, the transition to the little metal pancreas was a piece of cake (well, sugar-free cake) compared to adjustment to a new knee. This past two weeks has been the hardest that I can ever remember, physically and emotionally.  I have experienced more pain than ever before.  A friend asked me how this compares to childbirth and I think I just laughed. Childbirth was so much easier, even without drugs the second time around.  The hardest part is that the pain is mostly self-inflicted, as I push myself through PT and the  exercises I have for homework.  It is the only way this surgery will be successful in the end.  The one piece of advice I got from everyone who has had this surgery was “DO THE EXERCISES!”.  Before surgery, I wondered why they emphasized this so much, since I don’t consider myself a slacker and could not imagine why I would not so something so simple as that.  HA!  Doing the exercises is an exercise in self-torture 3 times a day, pushing a joint to bend when that is the last thing it seems to want to do.

All of this has me wondering how I am going to come out on the other end of this process.  Compared to knee replacement, the challenges of diabetes now seem to have shrunk in my estimation.  Coping with blood sugars throughout this recovery period has definitely been a challenge, don’t get me wrong. I have been running my pump at double the usual basal dose most days, and have had to dose more for food than usual as well.  But BG management has taken a backseat to pain management and rehab.  Part of me hopes that this ability to put diabetes in the shadows will continue.  It had taken such a front-and-center role in my life the weeks prior to surgery, and that was so discouraging.  I would like to think that the struggles of knee replacement will pay off with some kind of new perspective that will allow me to manage my diabetes well, without its becoming the beast that distracts me from the rest of my life.

I’m still chewing on the lessons I have learned in the past 12 days.  A big lesson is on expectations, and I will write about that soon.  I am also learning that the limits we think we have might not be the limits we actually have.   I am not through this yet, but I can see the light at the end of this tunnel.  That is encouraging, because even two days ago, I felt like I would never actually return to normal life.  God is good, and is strengthening me each day to meet the challenges He has set for me.

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Surgery

This coming Tuesday, I will be having a knee replacement.  Full on, hospital-stay-requiring surgery.  It has been quite an education in managing diabetes, and has really made me appreciate the support I have personally, spiritually and diabetically.

My blood glucose (BG from here on out) has been wacky for months.  Swimming has been particularly problematic, since my BG has been going way up after a half hour in the pool, rather than down.  I assume this is due to the stress that it is on my knee, despite my trying not to use that knee as I push off for each new lap.  I actually just stopped swimming a week or so ago because the emotional toll of dealing with that was just more than I could handle right now.

I have had to stop all the various meds that could contribute to blood thinning a week prior to surgery.  That means no Aleve, which I did not realize had been keeping a lot of pain at bay for the past few months. Each day is more painful than the last, and I am so ready for this to be done with.  I have 3 days to go and am finding myself being very efficient in all that I do in order to use the fewest steps possible.  Ouch.  Because of this, I have been running my basal insulin rates (the insulin that is delivered continuously via my pump 24/7) 30% higher than normal this week just to deal with the increased BG associated with pain.  I wonder what that will look like next week post-op and during and after PT………

And then there are all the hospital details.  I have been well  prepared for this procedure, I must say. My surgeon provides a JET class (joint education and testing) and a shared medical appointment the week before surgery to give us all the information we need to be ready to make a completely successful recovery.  I am so impressed. However, it has also shown me how many people are involved in my care, and how complicated that seems to make managing my diabetes.  I still don’t really know how I am going to deal with refilling my pump in hospital, or how much scrutiny I will get in how I dose or test, or whether my CGM will freak anyone out.  I have to admit that this is causing me some anxiety, which on top of the anxiety of what they are going to do to my knee, is starting to add up.

It’s a brutal surgery.  I won’t elaborate beyond that. I am not at all squeamish – just ask me what I used to do to mice and rats when I was doing research.  But this procedure has me pretty rattled.  I am trying hard to focus on the outcome – being able to walk long distances without pain, hiking again with my husband and kids, bicycling, using the exercise equipment at my fitness center without worrying about whether or not I will be able to walk the next day- all these are things I look forward to.  Heck, just being able to do a shopping trip through Sam’s without having to cling on to the cart by the end will be great!

So many people are praying for me.  And offering their support after surgery.  And bringing meals (I peeked at the website where this is handled and already there are people thinking about what they will cook for us.).  I am so humbled by this, and do not take it for granted.  Several of the people in the surgery prep classes I attended this week had no one to care for them after surgery.  I feel very blessed.

I guess this is just another adventure in life with T1D. I am trying to look at it that way, rather than as a trauma.  I’ll let you know how well that works.

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