Type 2 Diabetes with Complications -20 years

13 Jul

Next up in the series of guest posts is Fenella Lemonsky

I was diagnosed by accident. I had always struggled with my weight. I had a history of multi-impulsive bulimia which meant overeating mixed with typical bulimia since adolescence. Back then we didn’t have a diabetes online community like gbdoc or NHS leads like Dr Partha Kar, DSN leads who worked across the board and engaging people with diabetes themselves whether T1 or T2. Hospital & primary care senior  managers kept their doors shut.

I was about 27 years old and went to see a gynaecologist about very heavy bleeding. At the time the heavy bleeds didn’t worry me beyond understanding dysmenorrhea. I mean T2 diabetes never ever crossed my mind. The gynae ran bloods and 6 pm December 23rdI get a phone call to say my glucose was 28.

It was a very traumatic 24 hours although  my GP and practice nurse ( now Siobhan Harrington is CEO of Whittington Health NHS Trust) were good. However the struggle post diagnosis to get into a good Hospital consultant clinic was frustrating and upsetting. The GP believed he knew best however I had complications with mental health and found metformin very difficult. I was seen by one GP who was rude and ignored my MH difficulties with an eating disorder & emotional instability. Other GPs really got it’, the support was unconditional. However I was able to get into a good hospital consultant multidisciplinary team clinic. The consultant a tough academic was honest with a twinge of gentleness in his body language and voice. The DSN & dietician kind and never ever made me feel ashamed. I found  the podiatrists ( and still do) helpful but I had an issue  with stigma upsetting . Once arriving very early eating toast & peanut butter the podiatrist in the broom cupboard room said ‘ that won’t do your feet any good ‘ when I had my first ulcer. However it was a good move elsewhere and the best thing as  overall the diabetes podiatry service was friendly and clinically effective.

The hard inspiring work by the consultant clinical health psychologist I felt  so good but the feet problems  pushed me  over the edge. The move to a new clinic at a new hospital was a fresh brilliant start. . It was a time of huge NHS transformation in diabetes care.

I’m now in a good team at another Trust however the history is complex. A very  good MDT However podiatry whilst much better as completely different it’s very hard for me, I had really highly skilled podiatrists however they were turned into ‘operational managers’. It’s the transformation thing. The young new podiatrists will hopefully not leave for management now they have good diabetes skills.

Chronic foot ulcers & infections over the years and finding a balance with juggling multiple insulin injections. Then adherence and finger pricking. Sliding scales, Victoza in the mix.  Not easy however important I mention the pain consultants whose support has been outstanding. Negotiations over pain management not easy. Any higher opioids push me into delirium and dissociative states so the delicate balance of breakthrough pain relief in pain relief in chronic diabetic neuropathy important . I’ve had private health care and the luxury of consultant time without in/ out door going and the one to one privacy was a remarkable experience. However he was tough at times too ( ‘you ARE go8ng back on Lantus’….and that was painful to hear as I was told my foot ……) and it was never a walk in the park. Yet the clinical skill in NHS is outstanding however the overload of diabetes services is huge, the growing Type 2 Group only means more hospitals will have to think about how they support and empower earlier on. The employment of peer support like in mental health should not be discounted. In mental health this has been going on for years successfully.

I had a successful NHS career in both academic and NHS Trust / DoH work. I effected changes locally and worked with corporate teams who I had mutual respect for . It was a huge shift to give that up . Coming from progressive MH work with brilliant teams to now  just referred back into a specialist personality disorder service due to the complex trauma.

I was unfortunately diagnosed with osteomyelitis & sepsis last year and had my big right toe amputated. A huge shock as my blood glucose levels were very good. HBA1cs of 7-9. However I know it was the 15 odd years catching up . The add on of retinopathy and eye bleeds was the most frightening however an outstanding team support me and the nurse specialist there and her team smile as I arrive with a bag of chocolates. Can only be in diabetic retinopathy clinic. The consultant does international aid work in his own time training nurses & doctors abroad in war zones. He smiles as he walks up the corridor saying ‘ hi!’ with a cheeky grin. In the room he says ‘ can I see your app please .’ Blood glucose results. He’s bothered .

Finding myself on dark days eating the foods that spike my glucose and I shovel in extra novorapid & lantus however the support around me keeps me going .

A very last but not least mention to the community nurses who look after my feet in the week.  I’m about to start on the Freestyle Libre. Not cheap but I’m so anxious to prevent further deterioration. The online buzz around this important tech is inspiring. So yes I’m not on a pump but I still need tight control. It will help. Huge thanks to you all. Each and every one of you.

Thanks for reading this.

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