My mother in law is 64. Has been a diabetic, insuling dependent for several years. Last year at the same time my father in law went through cancer surgery and death, she was diagnosed with ESRD.
She was on HD for a while at first. She is now on Peritoneal Dialysis. She has had two recent episodes where we have had to call the paramedics because her blood sugar dropped-once it was 44 and in the same week it was 25. She went to the MD today and he switched her kind of insulin. Immediately following she went to see renal doctor who said dont do insulin at all and lets see what happens. She also has very low blood pressure-sometimes not readable by the home monitor. Any ideas? She is sick more than she is well, no energy, vomits, has severe back pain. We wish we could help her...she wants to do everything herself but we aren't sure this is working. Doctors don't seem to be a lot of help. Any advice even on where to look for answers.
Thanks for any response.

I am going to move your post and question to the PD experts, on the PD page. My knowledge of PD is basic, and I am afraid that I can not answer this question.

Please let me know how things turn out for you.

Carol

Having low blood pressure is a sign that she is dehydrated. She may need to be changed to a weaker solution for awhile.

But what about the drop in blood sugar? Who do you listen to when one doctor says change he kind of insulin and the other says stop taking insulin at all.

Should she be sick on a regular basis-vomitting, no energy, falling down? Is that just part of the life of a PD patient?

Bfarina,

IF your Mom is insulin dependent, that means that the body is no longer making enough insulin to regulate the bodies glucose right?
Additionally, insulin has many other vital functions to the body correct? So why in the world would the Nephrologist say not to take her insulin anymore? What I would do is 1) call your Insulin Dr and tell him what your Nephrologist said and ask what the implications would be if your mother stopped 2) Look for another Nephrologist and tell someone about your old Nephrologist. That is totally ridiculious

Bfarina,

I agree with TWoods. I would be very skeptical and leary about just stopping the Insulin.

As far as being having no energy and falling down, that could very well be due to low blood pressure. Low blood pressure can also cause you to feel sick. However, it sounds to me like there is much more to this thatn low blood pressure.

Don't give up on peritonial dialysis. I have been on it for awhile now, after three years on hemodialysis. I feel much better than I ever did on hemo. I think if you get the blood sugar issue straightened out, PD will work much better for you.


Please keep us posted and I will keep you in my prayers.

-- Mick

Thank you for the input. She has been on PD for about a year and goes through times where she does very well. But she goes for long stretches where she is really sick. This last thing baffled us. Appreciate your replies and will continue to check this page for help.
Thanks for your prayers.

I would also be curious if your mother is being compliant with her therapy. That I mean is she doing all of her exchanges and is she taking her EPO.

You said that your mother goes through spouts of this. Could be her insulin, could be that she is not taking her meds and doing all of her exchanges. Could be alot of things but definately get her to another Nephrolgoist and get her insulin regulated? Being a diabetic and all, is she gaining alot of weight? Does she have any residual renal function (is she urinating?) All important questions

Found out today that she has peritonitis. They gave her antibiotics in her bag. She is at home still sick. No one has suggested putting her in the hospital to make sure she recovers. She hates the hospital and fights going if she is able to do so.

We are 500 miles away. She has other children who live very close. My mother-in-law does not see any reason we should know what medications she is on or the amounts.
Is she compliant? I am sure that when her mind is functioning and she is functioning, she is pretty compliant. However, when she gets sick compliance drops off. We called the PD nurse to try to get the med info but she said she could not give us the information unless mom agreed because she is still competent.

You are also dealing with a person who lost their spouse of 40 years at the same time they were diagnosed with kidney failure--I am not kidding that her first hemo treatments were the week my father-in-law died. PD would not have been my choice for her but they gave her the option and she saw the chance to "be in control". But I wonder if it is too much for her to handle.

Thanks anyway for the input. I guess I was just wondering if being tired, nauseated, and having severe back pain is a normal part of PD. The sugar question had me baffled...I had wondered what could cause it.

Forgot to say that we have encouraged her to come stay with us for extended periods of time. This is when the meds and other things become vital for us to understand. Out of the three visits in the past six months. She was only really well during one visit. This last visit with the hypoglycemia incidents frightened us. We wonder what would happen if this occured at home and no one visited in a long span of time.

[This message has been edited by bfarina (edited 12-05-2001).]