I am currently visiting family in Australia. Lovely as it is I have been feeling unwell, I suspected that I had a UTI. Eventually I decided to go the Emergency Department, thinking I needed anti biotics.
Blissful little hospital in a tropical setting. I was the only patient ( sorry Brits). While there,I was given a finger prick blood test following glucose levels of 19 from a urine sample. 20 and they would have taken me in. I have only ever had borderline diabetes 2 readings. I was prescribed Metformin which I stopped taking a few days ago because of really bad diarrhoea. I had no indication that this was serious from my UK doctors, no tests, no instructions nothing. Steroid induced diabetes that will normalise when I get off Pred - on 4.5 mgs. I thought Metformin was almost an after thought. This was a total shock. I am in good hands now with a new powerful drug Sitagllptin Phos Monohyd 100 mgs ( Xelevia) I hope I can get its’ equivalent in the UK. This wasn’t caused by a bad diet, sugar, or alcohol or lack of exercise even, it just happened insidiously with little warning. The doctor said I could have ended up in a coma. My blood glucose seems to be creeping down but it will take a while to normalise, it is a bit all over the place. I feel so much better. My lovely First Nation GP will get me right for the journey home I hope. The UTI symptoms were caused by the sugar in my system. Another thing to be on the alert for.
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SheffieldJane
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So sorry that your time with your family has been interrupted by this but what brilliant care you’ve had! A knowledgable, thorough doctor who takes the time to explain and reassure are qualities we all look for and hope for and it’s clear you hit the jackpot! Enjoy the rest of your visit while you continue to recover. 💐
Sorry to hear that - apparently sitaglyptin works in a different way and is listed as "less preferred" than metformin in the UK. As long as it sorts you out!!
Sorry to hear you have been poorly when spending time with your family - but what brilliant care you have had - I too have been unwell when in Australia and the care I received like yours was thorough and and effective and carried out full of care. I also have family there working in a hospital and their health system leaves us standing. Enjoy the rest of your time down under.
You are probably right - my cousin is a British immigrant, her daughter was born in Oz and is a nurse in A&E (nothing like our A&E !!!!) and is married to an Irish Doctor.
I've really enjoyed the series set in Australian hosptals - especially Melbourne ED. I think the regulation that ALL doctors MUST do 6 months in the ED is very good. Gives them another perspective.
Absolutely - my husband was in A&E here 3 times before Christmas - 6 hours, 5 hour and then 7 hours the same day without seeing a doctor, the third time 15 hours and then admitted but no beds on wards..... the staff were caring but just count cope with the numbers of people thinking A & E stands for All and Everything....
Always did according to staff! But definitely worse now. My daughter is an ACP in the ED - equivalent of an F1/F2 doctor but probably more use as she was on the road as a paramedic for 10 years so very broad experience. Sometimes people turn up with the daftest things - despite the long waits. Here they started charging when people turned up for things that should have been taken to the GP - and you get nothing free that you can get at the chemist, so plasters, bandages, painkillers you are sent to the pharmacy. Deterred quite a few.
We like to watch a programme here called 24 hours in A&E. Some of the cases are serious and the staff are excellent. However some of the cases I would never dream of bothering A&E staff with 🙄
I watch a lot of the TV programmes - an ambo was sent to 2 gentlemen (I use the word advisedly) sitting in their car outside a walk-in centre where they had decided the wait time of a couple of hours was unnacceptable. So they called 999. The paramedic examined him, established it was so minor it really WASN'T ambo transportation material, and told him so. I think it was a blister from his trainers! They really thought that arriving in a Big Yellow Taxi meant they jumped the queue at the ED. By the time the ambo had arrived and they had argued the point, they would probably have been seen in the MIU.
While an elderly patient having difficult breathing will wait all night because "I didn't want to bother you" as if they thought ambulance crews get to sleep on duty ...
And don't get me started on the leisure activities that contribute massively to the NHS burden but they don't have to have insurance to cover it. If you break something by falling off a horse or a mountain, you need the NHS, but I really think you should get the bill for the rescue and treatment!! Same with skiing - and I am guilty of benefitting from that (not the NHS though) - and now it is insisted here that skiers have insurance, there is a contribution in the price of your lift pass.
Maybe we should charge for ambulance call outs as they do in Australia? My great grandson went into anaphylactic shock when we were in a restaurant and despite using his EpiPen an ambulance had to be called, my granddaughter received the bill a couple of days later, I think it was for $750!!!
But that seriously impinges on the people who DO need one and haven't got the wherewithal to pay. A better point to charge is in the ED, which was introduced here for anyone deemed not to be in the correct place - i.e. should have gone to the GP or OOH service or the pharmacy. Our ambo service is free for emergencies but for outpatient things or transport home after a hospital stay the doctor must sign a prescription. You can be a member of the charity that provides the service and that gives you 6 transports where they aren't strictly necessary, plus holiday medical cover and repatriation - bargain! I use them for my cardiology appointments in the regional capital, over an hour down the toll motorway, over an hour and half on the free road and over 2 hours by train. It's getting there on time that worries me - sometimes I just take it one way and have lunch in the sun in town and get the train home (I have an annual pre-paid mobicard so effectively free) and treat it as a day out.
Yes - we have copays for everything medical except GP and in-patient treatment but there are exemptions for certain things though not blanket ones like in the UK where if you are diabetic or have thyroid problems all prescriptions are free which I think is unfair. I had to pay for all my rheumatology stuff for PMR until inflammatory arthritis was added! But you also get exemption for an annual household income under 40,000 euros but not necessarily age. OTOH, no cheap prescriptions for pain relief unless you need the heavy duty stuff that is prescription only - pay for paracetamol, ibuprofen and stuff like that. And no supermarket cheapies - only sold by the pharmacy at full price!! I stock up in Aldi/Lidl/Tesco in the UK!! I need eye drops but have to pay for them myself as well. If it comes on prescription - 2 euros, 1 euro if you have an exemption which is OK.
Yes quite unbelievable, and to add to that list drunks ,who call 999 should be made to pay ! My son and his crew have been in some nasty situations with belligerent people thinking it's their right ! Makes my blood boil !
I'm not saying we don't have drunks here but nothing like the UK. Drunks who need supervising until they sober up should be in an army tent in the carpark on mattresses on the floor so they can't fall further. And charged for the accommodation.
No I have to admit it you get a different type of drunk in the Uk, more aggressive! Having lived in Spain for over 12 years people do seem to take it slowly while enjoying a drink.Of course that's not to say like anywhere in the world they have their fair share of alcohol problems.
I never had to wait more than about 20 mins for an ambo when I needed one for my husband. I have had to wait a few hours in the ED though - 4 or 5 of us with minor injuries already diagnosed sat there one lunchtime as the staff took it in turns to have lunch comforting ourselves that that meant we weren't about to expire! But then. if you go to the ED here during the day but after about 10am in the ski season - the queue will be out the door with helicopters arriving on the roof. Certainly makes you think twice about skiing holidays!!
The orthopods got together and started a private clinic at the bottom of the main lift for tourists (mainly) but I used it too once to get a super leg brace rather than the simple one I got free for the totally torn collateral ligament - and it healed perfectly in a few months. Worked very well and the more minor stuff was kept out of the ED.
What the UK needs is education - there was a time we took responsibility for our actions, The primary problem in the ED is the result of drink and drugs - resulting in falls and violence. But if you work for the NHS you have a duty of care, whatever the underlying cause.
I think we need education on a lot of things, medical and non medical... people are just expected to know things and don't. Me too. A basic citizenship thing maybe, how to do stuff. I worry about saying ' thats not an appropriate reason for A &E' as non medical people vary wildly in what they think is serious/urgent and we'd be relying on them to decide correctly.
A lot of the problem at present is the lack of a decent GP service - my daughter sees a lot of patients who are proper poorly because they couldn't get to see their GP and arrived to her when push came to shove. And sometimes it is plain too late.
That’s really interesting. I’ve long thought that persistent failure to show up for appointments, for instance, should mean a fine, but no one seems to like this idea in my PPG committee…good luck Jane! Karen x
If you make an appointment and don't turn up here the first time, never mind persistently - it is a fine of over 50 euros unless you have a really good excuse - being ill and the GP confirms it for example. It's why I use my free rides to get to cardiology which is 50 miles away down a heavily used motorway - they will call and say, stuck on the motorway ... It is like anything - turn up or cancel and it costs nothing, And to claim you "forgot" when you made the appointment the same day should incur double the fine!
We get an automated text a week in advance where you have to confirm or cancel without penalty. GP appointments are a bit different - most of them it is old-fashioned "turn up and wait", take a book and select your day carefully! But you are guaranteed to see your GP on the same day. If you don't wait - you are obviously not sick enough!!
We also contribute a LOT more than most in the UK to our healthcare, pensions and health are separate. I think I worked out once that I was paying maybe 3x as much in contributions plus our tax is high as well. Medical bills are tax-deductible. But the fundamental of "free at the point of delivery" still applies - unlike the USA they worry about the cover once your life is saved. And if a doctor decides imaging is required - you will get it asap, not in 6 months.
I totally support the concept of copays for anyone who can afford it. Anyone with enough income to smoke or drink to oblivion cannot claim they can't afford to contribute for the illnesses/accidents that are directly linked. And if you indulge in expensive risky hobbies - skiing, riding, biking, then you can afford to pay for insurance to cover you.
Thank you Groggrim - I'm afraid it's an ongoing bladder/prostate problem and may not ever be resolved, but we are positive and have a supportive family and many friends. I'm 5 years into my PMR journey too and appreciate all the information and kindness there is from all the 'special' people here. x
Here we have an out of hours GP clinic in the hospital and if they think what people have is not really appropriate for A&E they send them there, just down the corridor.
There should be a unit like that in every ED - staffed by advanced care practitioners, nurses and paramedics. But they are all on the road or in the ED. Different EDs have different set-ups though and in some even triage is overwhelmed.
What a shock for you Jane but such excellent medical care. Sorry it’s interrupted time with your family but hope you’re on the road to recovery and can travel home feeling better.
Oddly enough I'd been thinking about you a lot lately, as I hadn't noticed recent communications. Sorry that your health news wasn't better but so glad you got sorted very quickly once the problem was discovered. I hope you feel well enough to enjoy the rest of your time with your family. Take care. 🌺
I think about you too and some other regular contributors over the years. I find that I have less to contribute now after 8 years, I think my PMR/ GCA is in remission but I am left with the damage, T2 Diabetes, High BP, difficulty getting off the last few Preds, symptoms from my Adrenal system trying to work. Infections that I seem prone to and strict instructions to follow sick day protocols from my Endocrinologist . Thank you for thinking of me, I hope you and your loved ones are well. I am renting on the edge of a shallow lagoon that teems with birdlife including Pelicans, black Swans, cranes etc absolutely fascinating and very good for the stress levels.
"I find that I have less to contribute now after 8 years"
Don't think that necessarily follows - you have the experience you have gathered over that 8 years relevant to recognising problems and coping with them. Especially your experiences with an obviously good endocrinologist.
PMRpro is right. Your experience is invaluable and as long as you feel like sharing with others I know your comments will be welcome. I confess to assuming that about myself as I drop in nearly daily and sometimes randomly see a question I feel some qualifications to help shed light on.✨
I find that I have less to contribute now after 8 years
You don’t have less to contribute- in fact probably have more - but you may not have the enthusiasm to engage as often.
That’s absolutely fine, you have a lot to contend with [and have had for a long time], so just be a bit more selective about being on the forum. There’s no pressure on anyone to on 24/7, nor to respond to all or any posts.
Hope you get to grips with your latest health issue.. and enjoy your current location.🌸
Oh I am here alright, daily. Whenever I think of something to contribute to a post, I see that you and PMRPro have dealt with it already 😃. Your efficiency has made me lazy. I kind of meant that the issues I am experiencing are no longer strictly PMR and GCA, just the aftermath I guess, and complicated to manage.
Yes understand -but I doubt you are the only one to have other health issues as an aftermath of PMR/GCA. Plus of course you did have those, so experience is still there, but if you need to move on to deal with new challenges then that’s understandable.
Was just reiterating you have something to offer that’s all.
Sorry to hear how you have been, but glad you have the comfort of your family, and excellent healthcare....enjoy your lovely peaceful surroundings, I don't post too often after being told they "think" I now have Fibromyalgia.....Like HeroNS I often wonder how you are and MrsNails, and others.....we can all relate to how each other are feeling, and hope to be able to help.
So sorry to hear of your Fibromyalgia diagnosis. It is a diagnosis I dread, I don’t think it gets the interest and respect it warrants. I fear that some doctors use it to dismiss you. It is why I left my first Rheumatologist and ended up with Sarah Mackie. Wishing you the recovery we all dream of. X
Thank you, I am not convinced I have Fibro, when I look it up, not the symptoms I have, my legs are collapsing under me, so weak, falling into the walls at home, so dizzy! I am waiting after 10 months to see a Neurologist!....now thinking of trying to see an Endocrinologist. I am so stuck in housebound, but it's a sunny week forecast, so hoping to be able to walk round garden with my stick!....Sorry to moan on!.Hope you continue to improve........enjoy where you are...
I have had phases of hardly daring to go down the steps from my front door and down my garden path. You have just reminded me that this has improved considerably in this climate. So come and join me and we can watch the birdlife from my veranda while we heal.
I have my case packed ready!!…..silly me, don’t have a passport any longer☹️
Yes, warmth helps us……who do you think helped you most in dealing with your health struggles?Dr Sarah Mackie? After having a PET and told I don’t now have inflammation, it must be Fibro! …..such a battle, worked all my life, so very happy to pay private if I have to. Now sitting back imagining I’m on your veranda…. Blissful x
Last November, I was diagnosed with 'steroid-induced diabetes' as well. (Last fall was a windfall of new challenges). I'd just recently come off three months of 60mg a day after a flare, and my GP ordered an A1C blood test. Although I'd always shown the usual spikes, it was 7.6. Some doctors in the States like to see it at 6. She put me on Ozempic because it has also been shown to benefit some with cardiac issues. I feel good and don't believe I've suffered any side effects. Some constipation, but who knows what 'dog in the kennel' is causing that~!😳🤪 She assured me it is strictly steroid-induced, as did your doctor. I'll be staying on 5 mg per day for the duration, on 9mg at the moment.
I'm so happy you are with your family and hope you have a great time making memories.💞
Sorry to hear you're not well especially on a vacation with family.Hopefully it will stabilize with the drugs.If not tired take a little walk.It brings my sugar down💕
Well done SheffieldJane, so glad you got sorted and are progressing. We're so happy our English and Irish doctors and dentists come out to Australia for a bit of sunshine and a short working holiday. We love them. But please don't be alarmed they certainly don't stay long.
Glad you got sorted, our system works pretty well most of the time ..👍
My eldest is a child and family therapist, she came out as a psychiatric nurse 20 years ago. She has more work than she can handle. My middle daughter is married to a doctor and they have been in Australia for about 8 years now. She works as a women’s health coordinator. They have a lot of British friends who have made Oz their home.
It’s the health funding in the UK, everything is free and it has become unsustainable, it breaks good people especially since the pandemic.
Sitagliptin is available in the UK, but so is alternate Metformin -if you have side effects.
Uk has their own recommend guidelines for treatment of diabetes. They would have prescribed an alternative Metformin in your case- did you get a chance to speak to your GP/Nurse /GP practice Pharmacist before stopping Metformin?
Yeah- steroid induced diabetes is very real side effect and needs to be managed appropriately with medication and see what happens when your steroids stop.
It's the ongoing raised blood sugars that cause damage associated with diabetes, so very important not to stop meds before discussing with a GP or Nurse or GP Pharmacist- they will check your bloods and urine then adjust doses or stop them in some cases.
Thanks! I learned the hard way. I have read on the internet that stopping the Metformin suddenly could have had a boomerang effect. I hadn’t been on my low dose for very long.
Best wishes from Somerset Sheffield Jane, soak up those rays! 🌞 I’m borderline diabetes but will get my urine checked on the next round of blood tests following your experience. All the best.
If sugar is spilling out in your urine, the blood level will already be VERY high. Much better to get Hba1c and BS checked regularly - and any self-respecting doctor should be doing that for a pred patient. And there is a very good reason why one of the first things paramedics do when they get to a very unwell patient is check their BS level with a fingerprick test. High or low - BS can tell you a lot.
Thank you Pro for your excellent advice. I have a F2F with my GP soon and will raise this with her. Her outlook on diabetes checks is, from memory, that they should be annual. How regularly would you recommend ?
When you are on pred at least 6 monthly Hba1c and preferably 3-monthly. Just doing that will catch your average BS rising - it can be a bit up, that is likely with pred, but if it continues to rise it needs closer monitoring. Yes, annual diabetes for Joe Bloggs is OK - but not for a patient on pred who is at an increased risk of developing steroid-induced diabetes and other things. Same applies for BP and weight. If they start to rise, there are things you can do to mitigate it but you have to know - doesn't come written on your forehead! Just getting the patient off pred is not always the answer - you can manage a balance when you know what is going wrong.
That’s very helpful, thank you indeed and great to go armed with this knowledge. I’m very pleased to have your input. Best wishes to you in beautiful Italy!
Thank you SheffieldJane for taking the time to alert us all to your recent experiences of being unwell as the result of yet another side effect of our lovely medication! I'm sorry that you have been taken poorly whilst on visiting family over in Australia and I hope that you continue to recover well. Take care x
P.S. I've never been in a hospital before with no other patients! That is an experience in itself! I was once on a 4 hour plane trip back to the Canary Islands with just 10 other people during the covid pandemic and that was an experience in itself 😆!
I have been labeled a Diabetic since 2003. Long before PMR. I have been in remission since 2017. So I have to go way back to answer your question. I was on 4 Glicazide pills for a long time. I went to Ozempic about 6 or 7 years ago along with the Gliclazide at first and came off it gradually after losing 45 lbs. I am only on Ozempic now.
I live in a regional city in Australia and there is a major public hospital here and two very good private hospitals. I have had Vasculitis for five years now and the medical care here is great However people still complain about waiting times in ER.
I hope you enjoyed most of your visit to our lovely country and good luck for the future.
PS the ambulance service is free in the state I live in.
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Diabetes? really? 
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CGM blood sugar monitors now available witout having to do the ZOE pogramme
Bruising, Ozempic, Nausea, Depression, Steroids, Facial Hair. You Name It. 
