Advice needed

[Trex]

Hi Folks,
New Guy here.
I need some advice in regards to my feet if possible( feets don't fail me now).
I am a male, 50, type 2 for two years, metformin 1000mg/day, BG more or less under control with a few hiccups along the way.
So here is my problem: I am presently working at a extremely remote location in the far north on top of a mountain. Communications is limited(iffy sat phone and internet). Food provided is not good(starchy- high carb) but I am trying to pick and choose. As a result of fatague/diet my BG is spiking several times a day to over 12mmol/L. Been up here about 2 weeks and my feet are starting to kill me.They burn and itch 24/7 and it feels like a cross between bee stings and mosquito bites. Now I am starting to develop darker areas on my toes like a deep blood blister. I think the combination of cold ( 1 foot of snow here) and spiking BG is starting to effect circulation in my toes. For obvious reasons I do not have access to my regular caregiver. I really dont want to tell my employer that I need to go home but I am starting to worry a bit. I am keeping my feet as warm as possible and I think I will increase my Metformin to 1500mg/day and test more frequently to moniter spikes.
Sorry about the length of this post.
Any info or advice really would be appreciated.
Trex

[Peter Lee]

It looks as if you're between a rock and a hard place.

First, it sounds to me as if you are right to worry and I personally think that you have made sensible deductions as to what is going on.

You want to get your sugar down but can't alter your diet so the only other way is exercise to burn it off - pressups, situps, pushing weights around and test before and after so that you know what the effect has been.

The only thing I can suggest regarding the circulation in your feet is for you to regularly give them a good massage. The appearance of them that you describe is a bit worrying and you should be on your guard to spot any infection. If they do get infected then you do need medical help or you might lose them.

I am on 2550mg Metformin so your proposed increase to 1500mg sound reasonable - after all 12 mmol/l is not outrageously high, just highly undesirably high.

Well, that's my 10 pence worth. I'm sorry I can't be more helpful but I'm not a doctor. Are you able to e-mail or phone your normal medical carer?

The best of luck with this.

[byu barry]

Hey Trex, sorry to here about the fix you are in. I want to start this by letting you know I am not a DR. and my advice is based solely on my experiences. I too am 50 and and taking 1000 mg metformin a day. The high BG is probably what is causing your foot problems. Short quick spikes, although damaging, do not cause the type of long term damage prolonged high BG levels do. If you are running consistently high you need to get the levels down or get the **** out of there.

Also, 500 mg increments of metformin doesn't seem to be effective. Usually a good Dr. will prescribe a 1000 mg increase.

I hunt and fish a lot so I know how cold weather can be aggrivating to your feet. I usually accept the uncomfort as a just uncomforting. I would not accept it if my BG was out of control.

You stated the diet there wasn't very good. Could you please elaborate as to exactly what foods are available to you. If possible stick to meats, fats, leafy vegetables. Try not to eat bread, potatoes, beans, sugar, or fried foods that have been breaded. In other words a strict low carb diet will help if not fix your high BG.

As for your feet, you need to keep them dry and warm. Be sure your socks are loose fitting and you shoes/boots aren't tight (without being so loose they cause blisters). I know that I have to be very careful about my choose of shoes in cold weather. Some run me crazy while others are very comfortable.

[kctowers]

I have mild neuropathy in two toes of both feet and believe me the hospital have made it as plain as day that feet are a major concern for diabetics. My advice is get some medical help straight away and get the **** off that mountain. I wouldn't leave your condition to chance if I were you. The rest of your life may depend upon quick action now.

[Middle Aged Man]

Trex - Get out if you can, and save your feet. Sounds like neuropathy is setting in.

If you can't, then you might see if you can get your medication readjusted over that phone system.

Exercise would help. It also might help you to eat the small meal approach and even out the intake over the day.

I hope you find a solution. Neuropathy will be with you the rest of your life, along with the shoe inserts and high risk of future amputation.

PLEASE don't go there!

[lambchop]

No job is worth your feet!!!! - Get some medical advice ASAP.

This is not something you fool around with.

Having type 2 and coming from a family with lots of diabetes - believe it when it is said that this is not something you can just let go and hope it goes away. - Get help NOW.

[sydneya]

Hey, Trex!!
I'm sorry to hear of your situation. :banghead: It really does sound like you are between a rock and a hard spot. I can't give any advice that hasn't been offered to you--I can only say, I agree with it. Life is too short to take chances with your feet. If you can't get medical help, a way to get food that works for you, I'd run not walk off the mountain. Your employer might appreciate hearing of your predicament so he can make some adjustments and keep you. To put it bluntly, you won't be on the mountain if you don't have your feet.
Good luck making the best decision for you. :aetsch:

[Belinda]

go home to your doctor ASAP...it is not worth it and an employer should understand

[July2005]

First, I am sorry to hear your challenging situation. Second, I recommend you to take off work and visit your Dr. For the circulation problem I think walking is good, also fresh ginger root helps. You boil the ginger in water and then either you can drink tea (de-caffee) or anything you like with that.

Good luck,

[Trex]

First off let me thank you all for your input. This site is a great resource.

Thanks to the replies I recieved I believe I now have a handle on the situation. Upon giving my problem a little more thought here is what I think was happening:
I have been working for the last few years in temperate/tropical regions and my feet have not as yet been an issue.
I believe I have some neuropathy as a result of several years of undiagnosed type 2.
This is the first time in many years that I have returned to these conditions.
The weather here is -10 to -15C with 50 to 75 mph winds. The elevation is I believe just under 6000ft.
High wind chills will I believe provoke a condition somewhat like the "diving reflex" which reduces circulation to the extremeties. Combine that with moderately high altitude and mild neuropathy and the results were I guess to be expected.
I followed Peter Lee's advice and began massaging my tooties several times a day. I also began wearing much warmer clothing to insure I remained toasty warm at all times.
The results have been great. In the last 3 days the burning has been greatly reduced.
As to Byu Barrys questions about the diet here it is what your standard construction/logging camp would provde. Huge amounts of fresh bread, pasta, rice, potatoes and other starchy/high carb stuff.
I had a chat with the cook and she is making sure I have a supply of veggies every day and I am trying to pick and choose carefully from the high carb stuff.
I did not contact my caregiver because I believe I know what the gals at the Diabetes Resource Center will tell me: The same thing the rest of you already have said, in short "get out".
I just dont want to quite my job just yet and I think I am top of the situation now.
Ultimately I just wasnt taking my situation seriously enough and using common sense.
Thanks again all,
Trex

[kctowers]

Ultimately I just wasnt taking my situation seriously enough and using common sense.

Trex

You sound less distressed about the situation than you did in your first post and that's a good sign. Without frightening anybody, most diabetics know this anyway, diabetes is a degenerative disease that is an almost silent killer if not taken seriously. But you know this too, of course you do. It only takes a few minutes a day to prepare one's self for a comfortable and long life. I am type 2 and was diagnosed eighteen months ago -- around ten years late. I now have mild neuropathy because of that. I have never felt ill from having diabetes, just the odd hunger tremble and a bit drowsy at times, and if I hadn't been diagnosed I would still be unaware of having it.
I am sure you will now take that bit of extra time to make your self ready for the day and pay special attention to your feet. Massage is a great idea. I wish you well and I am glad I'm not stuck up a mountain with you -- I hate the cold. Have a happy Christmas.

PS. Sorry if I sound as though I am nagging you. I learnt it from the wife, bless her.

[Peter Lee]

Hi Trex. Nice to hear that you feel on top of the situation - but do take care - as the others have said, you only have one pair of feet. :shakehand

[sydneya]

:congrats: Glad things feel more in control now. :deal: Don't take any chances with yourself though. I know how important it is to do what you want to with your life. Being able to control the diabetes instead of it controlling you means a lot as long as the consequences aren't perilous. Talking with the cook was a good move. Let us know how you are doing. (And you have our permission to nag us, too. It's not just Keith's wife that does it well--I have my moments.) :hmpf:

[artistmiles]

I am new to the forum, but a long time Diabetic. I enourage your being proactive in foot care. Keep feet warm and dry and lotion or cream for dry skin. Lowered blood sugars will aid the burning and tingling. Neuropathy is a reality of Diabetes. As for diet the "good carbs" are those with high fiber.
Sounds like you have done good self care!