My neurologist has just been to a conference on CIDP, and the presenter gave a talk on the treatment group that I fall into. The new treatment option is to continue IVIG as before but to add 1 gram of Solumedrol at the 2-week interval inbetween the IVIG treatment.
This is both good news and bad news.
The good news is that he also increased the dose of the IVIG back to 0.9 mg/kg. I had been losing ground on that. I could feel the nerves 'crinkling' up in my wrists and my feet were total blocks of nothing. I knew I was losing ground and was really feeling depressed about the whole thing.
The bad news is that Solumedrol is hell on blood sugar - especially when you are an insulin dependent LADA diabetic, which I am.
My IVIG treatment at the end of July was horrid. I was sick before I went - the day was bad all day, and the recovery was worse - took me three days to really start feeling better. If that wasn't bad enough, I caught that cold/flu/whatever bug that is going around so I never really did feel totally good afterwards. Top that off with a previously scheduled trip to my favorite auntie's house and all the stress that entails plus she has no a/c and I was not expecting to be doing well in the blood sugar department anyhow.
BUT...a bit of good news in another area. I had started taking krill oil since it is supposed to reduce inflammation. Since my primary condition is a chronic inflammatory one - I thought what the heck! Anyway - I had only been taking it for about 3 weeks and my blood glucose (BG) was actually about 10% lower. WHOOEEE! In spite of being sick, under a lot of extra stress, not eating like I normally do, and suffering in the heat - all of which normally push it higher. Thanks to the krill oil!
So, I get home from the trip and there is the bottle of Solumedrol tablets waiting for me. I've had Solumedrol before - but always in an IV. My dear doc told me he thought it would be quite a few pills - maybe 15-20 and wondered if I could handle that many. I take more than that daily (vitamins) so no sweat - right? Well the dose was 62!
Next day I took them (they taste absolutely horrid!) and started the every 2 hours BG monitoring and pushing huge doses of insulin to keep my BG somewhere in the sort of manageable range. Over the course of the next 36 hours I used a monstrous amount of both R and NPH insulin. But never let my BG get over 350 and that's saying something because with this stuff it can get up to 800-900 if you aren't careful.
Now for more good news. The "crinkles" in my wrist are gone! Yay! and my feet are acting up. Which actually is a good thing.
Now for some more bad news. Back for another IVIG treatment - the hospitalist who takes care of me on the infusion ward is really unhappy with me being on the Solumedrol because my triglycerides are out the roof again. over 1400. My total cholestrol isn't too bad, 230. She says the triglycerides mean my diabetes is "totally out of control" and that is the fault of the Solumedrol. Well, hardly. It's only one day. So she wants to go argue with my neurologist about it. She also suggested that it would be better if I went into the hospital to have the treatment so THEY could do my insulin. Ha!
Even my nurse laughed at that one. This is a VA hospital we're talking about. This particular nurse used to be a floor nurse in the surgical ward, where I have also spent considerable time. She knows what a knock-down drag-out fight it has always been about my insulin. They don't even want to give my my regular doses. This is because they generally always are dealing with Type II diabetics on pills. Or if they are on insulin - they are also taking pills. And their version of a sliding scale insulin prescription involves giving the patient 2 units of insulin when their BG gets over 200. In my case, 200 means I need 100 units to get back down to 100. They absolutely freak out of their minds. I get lectures, and they refuse to give it to me. They have a fit when I ask for 20. So you can see what would happen if I was in the hospital on Solumedrol. I generally am pushing 200-300 units of R insulin and 100 units of NPH insulin every 2 hours. There is no way this would work over there.
Now the good news. My primary care doc (PCP) had the pharmacist from the clinic call me about my insulin and my very high insulin resistance. She and I had a long talk - and about the Solumedrol day. And he has already written a new prescription for my insulin that includes the extra vials of R insulin I need to cover the Solumedrol day. And it's already here in the frig waiting for me for the next dose. Yay! So my PCP and my neuro (I have two more doses of Solumedrol here) are prepared for me to go ahead with this treatment. So am I.
Then I found out that krill oil also helps with insulin resistance. Triple Yay!
I also read a research article on Dr. Mercola's excellent site . that says using black cumin also reduces insulin resistance a lot. I have some coming - and will report as soon as I have some experience with it.
It's a choice between a rough day with the insulin and BG, or a choice between my limbs becoming progressivly more numb, and slowly choking to death. Not much of a choice in my estimation.
So, between the good news and the bad news, on the whole, things have kind of balanced a little more on the good news side. My health is slightly improving even though I haven't felt all that good this month. I can see an upside. And that is always hopeful.