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Posted 8/19/2010 2:49 AM (GMT 0)
Today my vision went blurry. Called gi and he referred me to my eye dr. After over an hour of testing, calling the lab for my cbc results, my sugar was up. The eye dr confirmed diabetes, said my eyes were cloudy and swollen. She and the GI think the combination of methotrexate and prednisone has caused the diabetes. She and my GI are conferring tomorrow to see what can be done, including taking me off current meds.

I am disgusted, frustrated...

Called the mayo today to ask about the blurry vision, they thought it was a good idea to see eye dr but they thought it was the prednisone, so they were probably right.

After all of this.. I think I am firing my GI and finding a new one..going to call the mayo and see if I can get in for an appointment because I don't know where to go from here.

I just don't know what to do ...
Posted 8/19/2010 2:56 AM (GMT 0)
Oh, June! You just don't get a break there, do you?

I'm so glad you decided to phone your doctors for advice.

I don't blame you for being frustrated: you don't need this.

:-(

Ivy.
Posted 8/19/2010 3:17 AM (GMT 0)
Junerainbow,

So sorry...another one bites the dust with Diabetes. I was also diagnosed with type two last Aug. Been trying to keep my sugars down with diet and exercise before using meds...(because alot of meds cause D!!! lovely!) Yea, when I asked my GI about my med's causing the Diabetes he kinda rolled his eyes and said...no no no...but I wonder!

I was on Pred for a whole year and well Imuran for like 6 years now...who knows????

I don't mean to make light of it...it's all pretty overwhelming when it happens. I cried the day I was prescribed my meter. My insurance didn't cover it because type 2 can usually be prevented from diet and exercise...no clause in there for STINKEN CROHNS>...... mad It takes awhile to get the hang of things but...in the long run your gonna feel better. The only difficult times is when my Crohns is really really bad and a person sorta rely's on Carbs. In those cases...I'm sorry, I just abandon ship!

Night sweats can sometimes be an issue for me when my sugar goes a little too high ...so I try to eat a good carb before bed.

There are other Crohnies on here who will have lots of good advice for you.

Again, give yourself sometime to get used to it all.

hugs

Heather June

 

Posted 8/19/2010 3:37 AM (GMT 0)
Steroids are well-known to 'trigger' diabetes. Lucky me got type 1. The doc said something like 'you must have had a tendency towards it and the steroids just pushed you over the edge'. It was funny (not) that at first, I was misdiagnosed type 2 and told to lose weight (I'm like 120 lbs) and spent the next few weeks with blood sugars in the 400's. I did lose weight - about 25 lbs that month. That was a sucky Christmas.
Posted 8/19/2010 4:33 AM (GMT 0)
Dont it just blow you away when you get something else to worry about because your taking meds for something else you worry about ??? I'm on insulin and I know its because of some of the meds I was put on long ago. Sometimes I feel like a white mouse in a test lab...
Posted 8/19/2010 11:57 AM (GMT 0)
White mouse in a test lab.... yes... yes I do.

this all sucks...Is there a tendency for some to react to all meds... I guess I wonder what happens if I can't take anything... I couldn't take the imuran because i got pancreatitis, taking me off prednisone because of diabetes, sounds like I may be off the methotrexate as well. Entocort makes me worse so that leaves what? If I keep reacting.. what happens..

I know most of you have had way worse things.. and I don't mean to complain.. This has just been a horrible eight months and I am not understanding why things can't get under control...it is getting to me...this year has been awful..between me being diagnosed with Crohn's, my son having a tumor in his jaw and needing surgery, my mom starting dementia, I lost my job, my husband lost his second job because of me being in the hospital...our house flooding, just enough... I am tired ..again.. I apologize for complaining..
Thank you all for being there for me...
Posted 8/19/2010 12:01 PM (GMT 0)
Geeeeeeez rainbow, you have good reason to complain and where better than here where we understand. You just complain away ,,all you need too...
Posted 8/19/2010 2:37 PM (GMT 0)
Well, I'd ditch that GI in a heartbeat. I'd guess it's the pred that is causing the diabetes, and since the dose you were on wasn't therapeutic for you anyway, no loss in stopping it. The diabetes diagnosis at least makes this decision clear, but I'd talk at length with Mayo before stopping the MTX.

You'll have to taper off the pred tho, so be careful! I think you'll get the hang of managing your sugar and hopefully that will be enough control for the moment so you can lose the steroid slowly. Talk to Mayo about it!

I'm sorry that you are in a place where there aren't a lot of choices in GI, and that you have to travel so far to see the Mayo team. Do you like your PCP? Can you coordinate your GI care through that DR with Mayo on the phone?
Posted 8/19/2010 2:59 PM (GMT 0)
my pcp thinks that he would be stepping on toes...so that is not an option sadly.

waiting on return call from mayo now.
thank you ....
Posted 8/19/2010 3:08 PM (GMT 0)
If I had the option of going to Mayo (and my insurance would pay for it).
Posted 8/19/2010 4:59 PM (GMT 0)
I've never heard of MTX causing diabetes, so you might be able to stay on that. But prednisone can definitely bring it on. Also, doesn't the diabetes sometimes go away when people go off of prednisone?
Posted 8/19/2010 6:23 PM (GMT 0)
They are telling me that the methotrexate amps up the side effects of the prednisone so the combination is what brought on the diabetes and to them explains why my one eye is so bad...

still waiting on the mayo..
Posted 8/19/2010 7:20 PM (GMT 0)
I think they need to get you off the Pred and things will settle down. I still think you should stay on the MTX and just wean off the Pred. JMHO
Posted 8/19/2010 7:27 PM (GMT 0)
I agree with all of the above. My endocrinologist watches my sugar levels pretty well because they tend to the high side because of the pred. Now that I'm low on pred its much better, so I think that lowering the pred is key and then see where you are at.

(((((HUGS)))))
Posted 8/19/2010 7:31 PM (GMT 0)
We started last week tapering... I am down to 30.. on saturday I switch to 25... so yes I am in agreement. I want off of Prednisone. The drs are in discussion right now over the mtx... they are worried about my eyes ...it will take time to taper and that would mean that I am still doing the combo of the pred and the mtx. I have never been more confused.

I don't want to give up on the mtx yet...all this stress doesn't help... does it?

hugs to you guys too.
Posted 8/19/2010 8:34 PM (GMT 0)

June,

I'd be concerned about this, "... eye dr ... said my eyes were cloudy and swollen." You said it effected only one eye? Did you see an ophthalmologist? (an MD, different from an optometrist.) Did he dilate your pupils and do a slit lamp test? Which part of your eye is swollen?

Sorry for all the questions, but I've had uveitis/iritis numerous times, and also papillitis, which is swelling of the optic nerve. Both situations are very serious, can lead to blindness, and need to be treated. Every time I had the iritis, I had no pain, only "cloudy" vision, like I was looking through a dirty windshield. I always called my ophthalmologist, who would use the slit lamp test, which is the only way to diagnose or confirm uveitis/iritis, and he always prescribed Pred Forte drops, (which need to be tapered like prednisone as you improve.) The one time I had the papillitis, they used a fluorescein angiogram to see it.

I've been on methotrexate and prednisone in the past (among lots of other meds) and I've never heard of MTX causing or contributing to diabetes, only pred. I know of lots of IBD patients who've had successs with MTX. I have Crohn's throughout my colon, and I'm now using Humira every 10 days with success.

You've been through some pretty frustrating situations with your disease. I live in Iowa, too. I guess I've been lucky to have access to decent (not the greatest, but above average) physicians in my community of 60,000. In the past I have made a choice to switch a couple of times, a rheumatologist and a GI doc, when I didn't feel they were giving me proper treatment (plus we didn't see eye-to-eye.)  I feel sad that you keep getting the "lemons," and I wish you had more docs to choose from. Hopefully Mayo will keep working with you to find the right combination of meds to get things under control.

I wish you the best of luck!

Jan

Posted 8/19/2010 10:12 PM (GMT 0)
June, just to add fuel to the fire, has anyone mentioned that this new development to could have
anything to do with the severe pancreatitis you had? Just a thought, as this the is gland that regulates
insulin. Since the damage I have to my pancreas, they constantly check for diabetes, and I've already
been told that it's likely that I will develop it.

I sure hope your luck starts to turn around ((((hugs))))
Posted 8/19/2010 10:25 PM (GMT 0)
Jan..she did dilate and she did run the slit lamp test... I am very confident with her.. actually more confident with her than with my gi.. kinda sad. The irritation and cloudy, the blurry vision is worse in my left eye but that is my bad eye.. I am actually having issues with both eyes. The mayo agrees with the eye dr.. they too said that methotrexate can increase the side effects of prednisone...a decision is still being made..hopefully tomorrow...all drs are weighing what they think is best..they are actually conferencing over this..

Vicky..I have loudly said this to all doctors...I would think that would be my problem because it was so severe. It seems everyone is focused on the mtx/prednisone combo and can't hear me.

I respect and appreciate everyone's thoughts....it helps me when I speak to the doctors..and it makes me feel not so alone...I agree with you guys..I am just tired...
Posted 8/19/2010 11:06 PM (GMT 0)
junerainbow which mayo clinic do you go to?

Yea, for sure prednisone can cause a huge increase in blood sugars. Things might go back to normal when you get off it. You can get blurry vision from high blood sugars.

Health insurance will look for any excuse not to pay for something, won't they? I've never heard of health insurance not paying for a meter or type 2 diabetes meds. That's ridiculous, especially if you are on prednisone. Also, some people get type 2 diabetes just because they are over the age of 40 and it runs in their family. I am sorry you have to go through this. It sounds like you've had a lot to deal with already.
Posted 8/19/2010 11:31 PM (GMT 0)
I go to the one in Rochester.

I thought I would have more answers today but I guess its too late now.. so tomorrow when I go for my shot.. I guess if the dr refuses to give it to me.. I will have my answer... I really think just continuing the taper would be a good idea..and leave the mtx alone.

thats my choice.
Posted 8/19/2010 11:46 PM (GMT 0)

June,

Your latest plan sounds good to me.

Regarding the eyes, I guess I was confused when you said cloudy and swollen. What was cloudy/swollen? I thought eye issues in diabetes happened in the retinal area. I guess if your eye doc did the slit lamp test and didn't say anything about uveitis or iritis, and didn't prescribe anything for your eyes,  then you're probably ok there. I've had blurry vision while on prednisone, but that was totally different from the cloudiness I had with iritis.

Ok, so I just looked at WebMD and I see "High blood sugar causes the lens of the eye to swell, which changes your ability to see." http://diabetes.webmd.com/diabetes-blurred-vision

But also, "Diabetes causes problems in the retina with what are collectively called microvascular abnormalities. The small blood vessels develop microaneurysms and leak blood. New blood vessel growth (neovascularization) occurs. Unfortunately, these blood vessels are weak and also leak. These leaks (hemorrhages) can cause irreversible damage to the retina, with subsequent vision loss." (Sorry, this sounds pretty scarey. I hope yours is reversible since they caught it soon!)   http://www.allaboutvision.com/askdoc/diabetes.htm

Anyway, I hope you get some answers and solutions soon. Good luck!

Jan

Post Edited (jan2003) : 8/19/2010 5:49:26 PM (GMT-6)

Posted 8/20/2010 2:18 AM (GMT 0)
wow Jan.. thank you for all of that....that was very helpful...and thanks for just being there..

the mayo called back tonight...they truly think I just need to continue taper of prednisone and continue with mtx..just watching the side effects for now of the mtx...now its just a question of the gi being on board for now.. until I can make a change.
Posted 8/20/2010 2:23 AM (GMT 0)
June, I know it is hard to argue with DRs sometimes, but if your GI is not "on board," then tell him what you want to do and insist on doing it that way. If he fires you as his patient, then you will clearly have to seek treatment elsewhere. But if he is just going to go along (grumpy or not), that would be ok. You are ultimately the one responsible for your decisions, not the GI.
Posted 8/20/2010 2:28 AM (GMT 0)
June, I just read all of what you've been through, and just reading it exhausted me! You have every right to "complain" though I don't consider it complaining when you're in a questionable situation, and just need to bounce ideas off and get ideas back from people.

I lost my job over a year ago, and have had a lot do deal with, and I have periods where if one little thing is added to my pile, I'm bound to break. It's understandable with all you've been through that you're tired.

I hope that things start turning a corner for you, and you start moving uphill instead of adding more and more to your plate. It sounds like you're quite a strong woman to deal with all the medical, financial and emotional things in your life (not to mention 3 kids!!!!)
Posted 8/23/2010 3:21 PM (GMT 0)
Thank you all so much for your support and information.

One hour before the injection, the dr called me to cancel it. I was livid and told him there was no way I was canceling and that I want the shot. I told him I had spoken with the Mayo drs and they agreed to keep me on the injection but to taper down the prednisone. My dr was none to happy.
Got the injection and I have to go for blood sugar tests this week to make sure that I don't have a more serious problem going on. I felt really awful after this injection... I was so tired and nauseous, I felt like I had the flu, maybe it was the stress of everything. I slept through Sunday. But to add to the fun, I have spots all over my legs and have no idea what they are. I have another call into the Mayo. My vision is clearing up so I am grateful for that.

Anyway...thank you all again.
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