Someone Please Advise me

Verenda

Hello, this is my first post. My friend had a mastectomy almost 2 months ago and started chemo last week on Tuesday. She is also diabetic. Since Friday she has not eaten anything but 1 apple, a banana and a piece of bread with jelly. She keeps saying she cannot eat because it makes her diarrhea worse, or she is too tired or too something else. I am at my wits end trying to encourage her to eat. Since she is diabetic not eating can have serious consequences and it can also be causing the diarrhea. I have tried talking to her about how her body needs nutrients to function etc but she is not eating. Today she has not eaten anything. I told her to eat the bananas since she did eat 1 last night. She told me she can only have 1 banana every couple of days because she has to watch her potassium. I told her but you are not eating anything else so you can eat 5 bananas and it would cover the 2000 mg a day you are allowed. She is on a renal diet which limits her potassium intake. I said to her that she has not been eating anything so she could eat all the bananas. I am so frustrated by her thinking and I am sorry to say I became angry this morning when she said she could not eat the bananas. Also, she has pretty much been in bed since she got back Friday because she says she is tired and aches all over. I told her if she would get up out of the bed and move around she would hurt less from staying in one position for so long.

Tuesday I told her I was taking her to the ER due to the diarrhea and her refusal to eat. She refused to go. She called her cancer dr and go more meds for the diarrhea. She is also incontinent and I had to tell her to clean her room yesterday because she had not thrown out the depends and the room smelled strongly of urine. I was upset about this because I felt she should have more respect for herself and my home. I feel like she is feeling sorry for herself, complaining of feeling miserable but I do not see her doing anything to help herself or take care of herself. I do not know what else to do or say .

I care for her very much. I took the past 2 months off from work to help her but I am tired and it seems like she is doing nothing to help herself. She always says, I can't, or shes too tired, or she is sick, etc when asked to do basic care such as eating. My ability to stay positive with all of the negativity is becoming very hard to maintain.

Any advice or thought would be greatly appreciated.

edwards750

What a good friend you are taking time off from work to be her caregiver.

I have a friend who is diabetic so I understand a bit about the do’s and donts regarding food.

I didn’t have a MX or chemo so I can’t offer any sage advice about the side effects of either but I did have BC 6 years ago. So far, so good.

Does your friend have a family? It sounds like she is resistant to feeling better. She seems very depressed. Lots of women facing a BC DX take anti-anxiety meds. It’s a frightening and sometimes debilitating disease.

I would find someone who can help you convince her she has to keep up her strength. If not a family member maybe a counselor from the hospital or doctors office. I had a patient advocate.

The problem with trying to seek help from her doctor are the privacy laws.

She is blessed to have you as a friend.

Diane

Spookiesmom

I am type 2 diabetic on an insulin pump. During the worst of my chemo, I had severe diarrhea and quit eating. I did try to drink water, even that was hard to get down.

Yes, she should try to eat, something, anything. Boost or Glucerna might work.

You can lead a horse to water, but you can’t make them drink. If she gets really bad, call 911 and let them take over.

Verenda

Thank you both for your responses. She had one chemo treatment last week. Her son went with her to Philly to have the treatment. I have considered speaking with him. I am not sure I would be able to speak with her Dr. I have decided that if she does not eat something by Friday and if she refuses to go to the ER I will call 911. I do not see how she can go a week without food without serious effects to her body. What can this do in regards to the diabetes? As far as I know she is still taking insulin everyday.

ShetlandPony

Verenda, I think that your taking care of your friend in your home gives you some moral right to talk to her family and caregivers. You are functioning as her family. I would try talking to the son; maybe he has permission to discuss with her caregivers. Alternatively, would your friend be willing to sign the paper giving the doctors permission to talk to you about her care? If she does not give permission, the caregivers cannot tell you anything, but you could call the social worker or doctor or insurance case manager and say, "I know you are not allowed to discuss my friend's care with me, but you can listen to me and there is something important you need to know. She is staying in my home and ..." It seems like this situation could become serious.

Libber

You are a sweetheart for taking care of your friend. I have Type 1 Diabetes and went through chemo.

First if she is getting steroids with chemo that will increase blood sugar levels. I actually was able to avoid those to keep from getting high BS.

Diabetes or not she should be taking meds to deal with diarrhea. Medications work. Also drinking lots of water throughout the day.

Try protein drinks like Glucerna. Protein helps to keep BS more stable. Protein and more protein to keep it stable.

And if no change definately reach out for help on her behalf. Tell the medics and clinicians what you observe. They may not be able to respond to you due to HIPPA but you can tell then about your observations. They will listen

Lula73

ditto what everyone above has said about trying to talk to son, talk to her medical care team and/or ask her to sign off on the HIPAA authorization for you to be able to discuss her care with the medical team.

I have a lot of experience with type 1 and type 2 diabetes. Yes not eating can negatively affect her blood sugar. However, the physical and mental stress she's already gone through and is currently going through makes blood sugar rise (it's one of the body's compensation mechanisms to help your body in times of flight or fight). Odds are her sugars are running high even without the food intake. She may be worried about making those blood sugars worse by eating. Hopefully she is doing her blood sugar readings and recording them or has a downloadable glucose meter that records them. A visit to the dr that prescribed the insulin would be a good idea. You didn't say what kind of insulin she is taking. There are more than 10 different types on the market (they all work differently too) as well as some other injectable meds for diabetes that are often confused with insulin. Some are more prone to causing hypoglycemia than others especially if she is not eating. With that being said, the risk of low blood sugar is always there. As her temporary caregiver you need to know what to do in case of low sugar including if she is non-responsive (she should have a glucagon kit for this). If you can check what the label on the insulin says I can help you understand how it will affect her blood sugar and allow you to know what to expect.

It does sound like she's likely depressed too - VERY common. Another reason to see either the doc that prescribed the insulin or her MO. Either can help with that.

I know you're not feeling very appreciated right now. But one day soon your friend will realize just what a wonderful treasure you have been. She is very lucky to have you in her life. we should truly all be so lucky and fortunate to have a friend like you

Pei128

So sorry I saw this post late. You're such a sweet friend. I wanted to post as my mom is diabetic as well.

I was thinking if your friend has difficulty eating, please consider getting diabetic milk powder for her. She can drink that and get the nutrition that she needs. My mom takes 5 scoops of it, dilute it with water for breakfast every morning. The exact measurements will all be printed on the bottle. The brand my mom takes is called Nutren Diabetes Powder. But I'm sure there are also other brands for diabetics, so just find out what is available. I do hope this helps. Take care!