@gedanjj

yup, amazing well done!

@kim_m_kk I dropped fenofibrate because I wasn't keen on getting gallstones as a side effect. What I did do was substitute the fenofibrate with fish oil pills. Right now, I'm taking the Kirkland Fish Oil pills from Costco. They contain about 300mg of Omega-3. I take one in the morning after I eat breakfast, and one after dinner. I read that Omega-3 can help lower cholesterol and/or triglyceride levels.

I started the switch from fenofibrate to Omega-3 about 3.5 weeks before my blood test showed that my triglyceride levels were lowered from that 327 number to 93. Now, I'd like to think that taking those pills are helping, but it sure beats potentially getting gallstones.

@kim_m_kk - It looks like Dr. Hays still has an office location in Irving, but is primarily in Houston...

Might be worth calling the Houston office just to ask.

https://www.vitals.com/doctors/Dr_Lowell_Hays.html

EDITED TO ADD: It might be worth calling and talking to Dr. Carpenter, and ask her if she works with anyone else to manage diabetes, etc. in your area. It won't hurt to ask (or maybe doing an initial consult, if it's affordable). Also, you'd be surprised what Chiros choose to learn these days. My stepmother's brother is one, and he's a few steps short of a full functional medicine degree just to his own passion at doing things the more natural way when possible, etc.

kim_m_kk wrote: »

I am not opposed to Chiropractic care but I need someone to help manage my mess at this point. Even reducing my meds I am getting lows. Two today had to eat carbs to correct. Anyone have a recommendation for a meter with cheap strips. I am going to be out of strips before I can renew my script.

@2t9nty
@ralflott

kpk54 wrote: »

kim_m_kk wrote: »

I am not opposed to Chiropractic care but I need someone to help manage my mess at this point. Even reducing my meds I am getting lows. Two today had to eat carbs to correct. Anyone have a recommendation for a meter with cheap strips. I am going to be out of strips before I can renew my script.

@2t9nty
@ralflott

@kim_m_kk -


1. Here are a couple recent round-ups of glucose meters:

• https://www.diabetestechnology.org/surveillance.shtml
• https://www.consumerreports.org/products/blood-glucose-meter/ratings-overview (subscription req.)

Of the inexpensive meters that were top-rated in both studies, I have tried only the FreeStyle Freedom Lite and Bayer Contour NEXT. I really like the Contour NEXT and bought 3 of them recently on Amazon for $25. You can get large quantities of soon-expiring strips for the Contour NEXT from Amazon or eBay at very good prices, if your insurance doesn't cover them. (Don't get the plain Contour - it's not the same animal.)


2. Your idea of getting an adequate supply of test strips is spot on!

If it were me......

I would test rigorously - upon waking, before each meal; 30, 60, 90, 120 minutes post meal; and before bed for maybe a week so that you can get a handle on how your meds, diet, and exercise affect your BG levels. This will also be great info for your (new) doctor. You would need 10-12 strips per day for the initial period until you've got these relationships established to your satisfaction.

Article on using glucose meters:
How to prevent diabetes and heart disease for $16
https://chriskresser.com/how-to-prevent-diabetes-and-heart-disease-for-16/
(Note - the meters recommendations in the above article are pretty dated.)






Off topic.....


3. If you haven't had full bloodwork and your insurance permits, it might be a good idea to fill in some blanks. Hopefully you can find a competent doctor (preferably a younger endo, IMHO), but if that will take time, perhaps you can get your current one to order whichever additional tests you might need. At a minimum, I would think you might want to get a complete blood count, HbA1c (or, better, fructosamine, which gives you a more recent average and more quickly shows changes in your BG from changes in diet and meds), a comprehensive metabolic panel, a hepatic panel, Vit. B12, Vit. D, CoQ10 (and possibly thyroid tests, depending on your history).


4. Lipids - my $.02

Keto experts and researchers Stephen Phinney and Jeff Volek emphasize that your LDLs and other lipid tests may initially appear to show worsening numbers - but this may be a transient thing that has nothing to do with your long-term health or lipid management! It's common to experience rising lipids as you begin your keto journey as a result of your body processing and disposing of the material stored in the fat cells you're burning as you lose weight. For that reason, it's best not to overemphasize lipid tests until your weight has stabilized and you've been at goal weight for a while.

The bigger lipid picture would be revealed in an advanced lipoprotein test. The advanced lipid test my endo orders is the "NMR Lipoprofile", which shows the breakdown of LDL and HDL subgroups. He also orders "Apolipoprotein A1" and "Apolipoprotein B." He also ordered Lp(a) one time in order to check for a genetic issue affecting my whacky lipids.

Triglycerides and ApoB tend to correlate pretty well with a real culprit - small, dense LDL particles. These nasty sdLDLs in turn tend to correlate with heart disease. The relationship between triglycerides, ApoB, and sdLDL varies between individuals, and the standard lipid panel just doesn't yield this sort of info. Before leaping to conclusions from triglycerides alone, if it were me, I'd want to get the more complete test. It can probably wait, but I really wish I'd gotten a snapshot of my full lipid picture when I started keto!


5. Another possible test....

If you've got a lot of cardiac risk factors, you can always consider asking for a coronary artery calcium (CAC) scan, which actually shows in a CT image whether you have any calcified plaque in your arteries. Judging from your youthful appearance, I would guess you'd have a comforting score of 0, which would reinforce the idea of not being too hasty with lipid management as your body goes through the healing process you're treating it to!

Good luck!!

Whew! Glad you're out of sick bay!

I'm totally perplexed by the DKA scenario, as all the diabetes docs seem to say that it only happens with very high BG (in "real" life, that is, not thinking about all the meds). But your A1c would suggest an average BG of maybe around 140. ?? So, I'm wondering.... was your recent BG extremely high?

kim_m_kk wrote: »

No I haven’t had a blood sugar reading over 200 in months. My blood sugar when I arrived at the ER was 99. I have been really working on keeping my blood sugar in range and being healthy since I saw 7.4 as my a1c in early December. The only explanation I was given was the Jardiance. I spent two days in icu and two days in a regular room. Was scary.

Jardiance has a side effect warning for DKA. Sorry you had to go through that.

That takes the, um, cake.

So the gurus at the ADA are worried about the relatively-remote possibility of hypos if they stop recommending carb-laden meals and snacks, yet their website and magazine are loaded with ads for profitable diabetes meds that carry the relatively-remote possibility of DKA.....