Dear Dr. Roach: I am a 53-year-old female, and I weigh 190 pounds. A year and a half ago, I had gastric sleeve surgery. I have lost 24 pounds. I have been diabetic since about 2013. At my last blood analysis, in August 2018, my A1C was 6.5, which I understand is still high. In January 2018, my A1C was 6.6. When I had my surgery, these numbers were higher.
I do an average of 109 blood tests per week by finger prick. In your opinion, should I continue to do the daily blood pricks to my finger, or can I do them less often?
A: With an A1C of 6.6 percent, your diabetes is under very good control. How often to do fingersticks depends a bit on how you are treated. If you are taking insulin, more frequently is necessary, since the insulin can cause dramatic shifts in blood sugar. If you are on oral medication or if your diabetes is controlled by diet and exercise, less frequent is probably OK.
Providers taking care of people with diabetes want lots of information. If it doesn't bother you too much to get them daily, your provider will be happy with the information -- the more we have, the better we can make adjustments in your regimen.
However, you may not need adjustments often, so as long as you aren't seeing numbers that are over, say, 200, I would think a few times a week would be OK. If your weight and A1C continue to decrease, you may need fingersticks even less frequently.
No matter how often you get the blood readings, I would recommend you get some readings fasting and some 1-2 hours after eating. Some people with diabetes have excellent fasting glucose that goes sky-high after eating.
Dear Dr. Roach: My husband had a stroke March 23, 2018. It was on the base of the left side of his brain. It affected his balance on the left side. The doctor said it could take up to a year to get over it.
He has had weeks of therapy, and they finally discharged him. He continues to walk on the treadmill twice a day for 30 to 40 minutes, and he lifts weights for 10 minutes. He doesn't seem to have improved much. His balance is still off. He is using a walker but still struggles. He is a farmer and does what he can to feed the cows. He has fallen down a few times. He wanted me to send you this email and ask if you think he could ever get over this and get back to normal.
A: I am sorry to hear about your husband. Strokes are losses of brain cells and function in discrete areas. They run from almost unnoticeable to devastating, and it sounds like your husband's is in between. Preventing strokes is critical, because brain cells do not regenerate well. However, other parts of the brain sometimes can take over, allowing for better function.
If the stroke was in the base of the brain and on the same side as the symptoms, the stroke may have been in the cerebellum, which is responsible for coordinating movement on the same side of the body (as opposed to most of the brain, which controls the opposite side). Many people with a stroke in the cerebellum have clumsy movements and can fall.
Since it has been nearly a year, further spontaneous improvement is less likely. I know he has had therapy, but balance exercises and occupational therapy may still be of benefit if he hasn't had these.