Six-Month Diabetic Follow-up Class

Yesterday Dad and I attended a one-hour class as a six-month followup led by the diabetic nurse educator that has assisted Dad since his diabetic coma in March 2007. MJ has helped tremendously in keeping Dad's blood sugar as stable as possible by following his numbers and adjusting dosage as necessary.

Soon after our initial visit with MJ last year, I created a log on Excel. Dad keeps the log sheets in a spiral notebook on the kitchen table, along with his syringe and monitor kit, because he tests four times a day. He is now on two kinds of insulin, one he takes prior to each meal and the other two hours after his last meal.

After the meeting MJ sat with us and reviewed Dad's needs. He ended up with a new monitor and easier way to obtain blood for his tests.

Along the way, I learned some interesting information about following a diabetic diet that I will share in the next post. We were also given a monthly schedule of one hour meetings we can attend if we want to, to receive further information and encouragement. The monthly sessions are heavy on question and answers.

The Diabetic Center at the hospital where MJ works is actively involved in teaching diabetics how to manage their disease. MJ has called us numerous times to track Dad's numbers, including evenings and weekends. At times she has needed to call several times a week for a while, then was able to back off to once a month or every couple of months. She has always been friendly and caring, even taking time to chat with Dad about his life.

People like MJ are a God-send to those who have to live with diabetes. My kudos to MJ and others on staff for their willingness to go beyond the call to help Dad and others like him.

It takes "a village" when it comes to senior care. Be sure to give a special thank you to those who are helping you and your loved one in their latter years.

New Reason for Seniors to Avoid Fruit Juices

A recent article on SeniorJournal.com highlights a new reason why seniors need to avoid not only grapefruit juice, but other kinds of juice as well.

Certain drug prescription bottles have contained a warning about grapefruit and grapefruit juice for quite some time. Apparently grapefruit can substantially increase the absorption of certain drugs possibly turning normal doses into toxic overdoses.

Now, researchers are reporting new evidence indicates grapefruit juice and other fruit juices substantially decrease the oral absorption of certain drugs. According to the article, "the concern is loss of benefit of medications essential for treatment of serious medical conditions."

Be sure to check with your pharmacist and read the information included with your prescriptions to make sure you are not under or overdosing yourself.

Researchers have already found over 50 drugs that are affected and more are likely to be added to the list as further studies are performed.

Have you checked your prescriptions for potential problems with what you eat or drink? Please do so today? And, feel free to leave a comment with your opinion of these findings.

Insulin Emergency 101

Emergencies are called emergencies for a reason. The Merriam-Webster's Collegiate definition is "an unforeseen combination of circumstances or the resulting state that calls for immediate action."

About 9:00 p.m. last night I discovered Dad's insulin injection pen lying on the kitchen table. Two things struck me as odd: first of all, he always keeps the pen in the refrigerator, and the color of the pen didn't jive with the time of night.

A little background...

Dad takes four insulin injections a day. The first three are just prior to each meal and are a fast-acting insulin (in the dark blue pen). The fourth is a slow-acting 24-hour insulin and the pen is light grey. Because Dad is color blind, the two different colors help him know which one to use.

He has been on the pen system since earlier this year and has not had any problem with picking up the wrong one. When I discovered the wrong pen lying on the table, I asked Dad about the insulin he was supposed to take around 7:30 p.m. As it turns out he took the wrong one.

The problem? He took four doses of the fast acting insulin, instead of three, and now needed to take the slow-acting so that he didn't run into problems during the night or the next day.

What to do? I ended up calling his diabetes education nurse at home, she walked us through what he should do which included taking a half dose of the slow acting, and eating a meal. He got to eat his favorite PB&J sandwich and drink a glass of milk. We were instructed to call her this morning with his blood sugar number and we would go from there.

As it turns out, his number this morning was good. We are to watch his test scores during the day for any high spikes, and just continue his normal routine.

I know with age all of us are distracted at times. Dad and I discussed what happened and he just doesn't know why he took the wrong insulin. We all have those "senior" moments, so it was understandable.

It also is a bit scary, because we don't know if this will happen again, or if it is just a negative blip on our radar.

What I do know, by definition, it was an emergency.

Have you had an emergency lately? How did you handle it? Did you have help?

The Elderly and Their Medications

As symptoms of aging or disease increase, it is likely the number of doctors and prescriptions will increase. Therefore, incidents of over or under medicating can become a serious problem in an elderly persons life. A main concern is the interaction of medications to the detriment of your loved one.

When my father visits his primary physician every three months, he places all medications in a plastic bag to take with him. The nurse always makes note of the medications and the dosage he is currently taking. That way if another physician has made any changes, Dad's primary physician is aware and can make any necessary adjustments.

Caregivers should play a vital role in monitoring their loved ones medications. Note what they are taking along with the amount and frequency. Work with their pharmacist or doctor regarding side effects and know what symptoms to watch for.

Pharmacists are highly trained in the interaction and effects of drugs. An especially good resource if you have any questions regarding possible side effects are those pharmacists specifically trained in geriatrics.

These key tips may help you in caring for your loved one.

1. Make sure all physicians are aware of current medications, including prescriptions, over the counter medications such as cold medications and aspirin, daily multivitamins, and herbal remedies.

The cumulative effect of medicine can cause side effects to show up a month or so after starting a new drug. Talk to your physician about what to watch for so that you understand when you see a new symptom.

2. With newly prescribed drugs, find out:

+ Can another drug be removed?
+ Should the drug be listed on an ID bracelet?
+ What side effects should you watch for?
+ Which side effects should you immediately report?

3. Watch dosage amounts, how often to take the medication, and whether to take prior to or after a meal. Also helpful:

+ Plastic dosage containers with the day of the week or time of day
+ Request large type on prescription labels
+ Double check the label to insure correct medication is taken
+ Keep medication in a dedicated storage area to prevent over or under usage

Physicians cannot always eliminate side effects when they are trying to address a patient’s symptoms. They will try to maintain the correct balance if they are aware of all current medications.

Use drugs with extreme caution and only for specific symptoms. Watch for symptoms such as dizziness, blurred vision, drowsiness, increased confusion, increased agitation, falling, or the appearance of a rash. Immediately notify your elder’s physician of any disturbing reactions.

When you keep informed as to what your loved one is taking, seek further information from their physician or pharmacy when necessary, and oversee their daily dosage requirements and regimen, you play a huge role in helping your loved one live a better quality of life.