Refusing Conventional Treatment

[Guest jangrin]

During the C&P exam yesterday a question of conventinal treatment has come up. The exam doctor asked my husband about his DMII and his symptoms and testing levels.

My husband stated that his sugar levels were high a fluxuated greatly. He also told the C&P that his PCP wanted to start him on insulin this past year. My husband said no because we were going through financial difficulties and we didn't know where we would be living and he didn't want to start a new therapy and then have to stop it, especially something like insulin.

The doctor C&P doc stated that there is a lot of new thought about DMII and insulin and that there was also some new treatments for DMII that might be a possibility. And that he (my husband) should explore those.

If this is the case, and my husband should be rated a 40% to 60% according to his symptoms, but because he has elected to not take the insulin for the DMII, does this mean he only qualifies for the 20% rating in the CFR?

[Berta]

Possibly the doctor meant the atudies that have been done- with some success- on lizard saliva.

Lizards (the Gila Monster is the one they use) only eat a few times a year and somehow their saliva contains an insulin type alternative.

This is injectable now but there are studies to prepare it as an inhalant.

It is technically called exenatide.

Also inhaled exubera is another type of insulin therapy in lieu of injections of insulin.

I dont know how the VA would view a rating that is dependent on insulin injections as one that uses an alternative.

I would think the actual requirement for insulin as recommended by his doc- would put him into the higher rating- but then the VA could say he was refusing appropriate medical treatment and then keep his rating lower.

It would be good to see if you can get what this doc stated in writing-

and then pursue some alternatives.

I would imagine there are studies that are being done that would need DMII patients at low cost or no cost to the patient to participate in these studies.

The ADA web site might have more info and this article might have someone to contact:

http://www.webmd.com/content/Biography/7/1756_53655.htm

As the article shows this isnt voo doo:

"Both of these new therapies hold promise, but also uncertainty," American Diabetes Association president Robert Rizza, MD, tells WebMD. "They will increase the options for people with diabetes."

Worth looking into....

[Philip Rogers]

I'm sorry but I don't see why he wouldn't take the insulin. He'll die of kidney problems sooner if he doesn't take it. There is no cost to him and why would he have to stop the treatment?? As for refusing the treament, logic tells me they could keep him at 20%. Guess he's just trying suicide the lazy way. He can also start exercising and lose some weight to try and help the DM-II situation. Personally, I think you need to give him a kick in the butt cuz he'll be leaving you more sooner than later. Not fair to you and kids, if there are any. jmo

pr

[Berta]

PS -the VA knows all about exenatide- this is a very enlightening article-

http://www.mendosa.com/monster.htm

I have to agree with Philip here-

if the VA had diagnosed Rod properly he sure would have taken insulin or done anything to stave off his death-

Even lizard saliva-hell they ate them in the Nam anyhow-

Weight and lack of exercise are killers- for anyone -and this is compounded by diabetes.

I too wondered why he didnt want to take insulin-the VA would supply it-

I have read some scary stuff about DMII and when it is not properly medicated with insulin

or controlled by diet and exercise, it leads to heart disease and stroke and death- my husband had all of above due to untreated undiagnosed diabetes-

and the affect to vision, kidneys, all arteries- etc- is profound.

Rod went out to the barn and moved some hay around. He said he had been feeling better since the VA had changed his meds.

Within minutes he collapsed just like that. I gave CPR but he died as I did it-

It wasnt the med change-at all- he had a massive heart attack due to considerable progressive atherosclerosis-all caused by undiagnosed and untreated diabetes.

I had flashback to that awful day when I re-read your post-

I hope you have cell phones and also some electric wireless home phones and keep them with you whereever he goes.

I used our wireless to call EMS dispatcher as I gave Rod CPR-

there was no regular phone or cell phone in the barn.

It happened fast.

Brings up something- every spouse of a disabled veteran should know how to perform CPR.

The Red Cross gives an entire free course on CPR around here annually.

The words of my CPR instructer came to me immediatly- not only how to do it but what else he said-

he said that most likely we will have need to perform CPR at least once in our lifetime-

and it would most likely be on a close loved one.He was right.

[Pete53]

My diabetic Doc told me that the gila monster med is only really good for people in early stages of diabetes. It is basically a help for people who are using oral medication.

I don't know why people object to insulin as it is a natural medication with fewer side affects than the oral meds.

That is my opinion. If you don't get good control of diabetes than you are going to really suffer down the road and not all that far down either.

Its my opinion but any med therapy is only as good as the consistency and the diet used.

chuckles needs to take better care of himself.

[Josephine]

Jangrin,

Am I to understand that you husband has refused just the insulin treatment for his diabetes.

I am to assume that your husband is too intelligent to refuse all treatment, but he just doesn't want the needle type.

Is this correct?

What about his diet?

I know that the psychiatrist commented on my eating disorder in their C&P. Not true in my eyes. I just refuse to touch sweets, ice cream, pie, cookies or potatoes or any of the foods that I used to love.

Diabetes does not run in my family, but one day, my vision was so blurred, that I didn't know what was happening. I had placed a call to my doctor. ( 55 miles away) by the time he got back to me, a huge snow storm came up. Dr. P called and told my husband to buy a sugar monitor. I was coming in at almost 500 and started meds immediately. My a1c came in at 14. I ended up in the hospital 10 days later , have no recollection of going to the hospital, how I got there or anything else.

It has been 4 years and I took control, I was approaching 177 lbs when the diabetes was detected and have maintained a weight of 132 for 3 1/2 years since. I take 1/2 of a gluphage a day. ( 250).

I had my a1c checked just this week and it came in at 5.5.

If I were your husband, if the rating was to be higher, I would go for the insulin. I have several friends that take the insulin and prefer this.

I told you my story, for I do not know of many that can just drop all the foods that they onced loved. If the psychiatrist wants to call watching your carbs and sugar an eating disorder, more power to them.

He may be surprised just how much better he would feel, if her were to go on the insulin. My friends that take the insulin would not go back to the pills.

What works best for one does always work for another.

Always,

Josephine

Edited February 10, 2007 by Josephine

[Guest jangrin]

It has nothing to do with commiting suicide the lazy way. It has to do with the fact that we had been in the process of moving and unable to start a new treatment of injecting insulin and control the insulin levels, when we would be away from the doctor and unable to get medical help if we needed it.

This was a decision that was made with the primary care physician, not on our own. The VA doctor agreed it would be best to wait until we were resettled. The same way the doctors decided not to do an angiogram for his heart condition. They didn't want to do anything that would add problems while we were financially strapped and moving. The plan was to get the needed medical care when we arrived in our new area. We are here and the VA appts. are full of SC vets and we have to wait.

The other thing is once you start on insulin it is almost impossible to get off of it. There are alternatives, to insulin, and since my husband had only recently been diagnosed with DMII he has been trying to control with diet, weight loss and and alternative ways, under the supervision of his doctor.

We (husband and I with Doctor) planned on only postphoning the insulin decision for about 2-3 months. The problem is, it took 3 months to get resettled and over over five (5) months to get an appointment with the VA. Since the VA takes so long in granting/denying claims for benefits my husband is not SC yet from his initial claim and he has no priority in appt. scheduling.

He continues to wait and has an appt. for March 1st. It seems private doctors do not like promisary notes for payment. So we are in the waiting mode..... as most vets dealing with the VA are.

Treatment choice is exactly that. Just because someone tells you you need a back surgery, do you jump in and do it, or do you check out the options. Pesonally we check out the options, evidently my husband had undiagnosed DMII and heart conditions for many many years according to the doctors. They didn't feel at this point in the scheme of things a few months would make a whole lot of difference.

Thank you for your concern though, I know that is your intent. And I will kick him in the butt come March 1st when he finally gets under treatment again. He has many issues besides the DMII. His heart condition (atheriosclerosis, CAD, ischemia etc.) is the primary and he needs the angiogram as he failed the stress test and the nuclear perfusion test. Once thats done then he will address the DMII, NP, Hypertentsion, IBS, Foot Drop, Glacoma, PTSD, Depression, Tennitis, Hearing loss, ED just for starters.

DMII can be the cause of many hidden problems and then when it finally becomes apparent everything hits all at once and the stress is unbelievable. Luckily his Kidney function had not been affected by the DMII when last checked.

Jangrin

Edited February 10, 2007 by jangrin