Friday, May 31, 2013

Not going so well...

I can't lie... I'm not loving MDI. I know it's early, but I cannot get my bg under control. It starts off fine in the morning, until I eat something. And the rest of the day it goes to hell. It's currently sitting at 260, where it's been for a few hours, creeping up. But it hasn't been long enough since my last bolus, because I guess I'm supposed to wait 4 hours between boluses to correct a high (is that really true???). So my bg is in the toilet. And it being that high has prevented me from eating supper tonight, for fear of it going even higher before bedtime. This shit sucks. I give a lot more credit to MDI users... this is harder than it looks!

It's making me feel depressed and anxious. And I've had a nasty bad headache all afternoon/evening from the sustained high bg. Not a good way to start off on MDI. It doesn't make me feel very hopeful. And it's making me feel stupid that I am not able to get control of things.

Thursday, May 30, 2013

Bad diabetes decisions.

Ever had one of those what were you thinking moments?


photo credit: inanutshell.ca


I had one of those today, and I made a bad diabetes decision.

I mentioned in my previous post that I was using one more final pod (infusion set) in order to finish off my current vial of Novolog, before switching to MDI for the first time ever, for which I will use a Novolog Jr. pen. So last night, I put on my last pod, placing it on my upper left butt. I went to work this morning, and as I was getting out of my car, my pod errored out. BEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEP.... that noise. I had not planned for this. It never crossed my mind to bring an extra source of insulin in case of pump failure. I turned off the alarm and sat back in the car seat, thinking, Oh boy, now what am I going to do?

I went inside work, put my stuff down on my desk, and went over to my manager to explain I needed to run back home to get my insulin pen. She gave me the go-ahead, but advised me it would be an attendance "occurance," since it was unplanned time taken off work to run home. I hate getting an occurance for a 40 minute round trip drive. Sucks. But anyway, I ran home, grabbed my pen, grabbed an insulin cartridge from the fridge (I have a refillable pen), and ran back to work.

I grabbed some coffee, sat at my desk, and prepared to give myself insulin so I could eat my breakfast. I start taking my supplies out of my bag. Novo Jr. pen? Check. Insulin cartridge? Check. Pen needle tips? .... Pen needle tips? ... Oh crap... I forgot to grab pen needle tips.I couldn't believe I forgot these! I have no way of administering the insulin. I forgave myself for forgetting these, as I've never done shots before and am not used to gathering all the necessary supplies. But the problem remained- what am I going to do for the rest of the day? I wasn't going to run right back home and get another attendance occurance. My option was to run home at lunch, which is a little risky because just a smidgeon of traffic will make me late coming back from our alotted 45-minute lunch break (which would be another attendance occurance). I looked at my food for the day, pretty low carb, and make the BAD decision to go without any insulin the entire day.

At first, this didn't seem like a bad idea. I ate my egg breakfast w/ veggies with no raise in bg (98). I skipped my 2 little nectarines.




I ate lunch- a 1/4 chicken breast with a 1/2 c of plain butternut squash and a caff free diet coke. And I watched my bg get up to 160 2 hours after eating. But it didn't go higher than that, so I didn't worry about it too much because 160 isn't a horrible blood sugar.

But as the afternoon wore on, I started to feel iffy. Sweaty, (despite finally having A/C turned on at work), blurry vision that I kept blinking away, and later, difficulty moving my arms, fingers, legs and jaw. At 3pm when I got off work, I was so light headed that I feared driving home. I felt panicked and almost cried. But I talked myself down and got myself home, where I ate M&Ms to get my bg high enough to administer insulin. I finally figured out how to assemble my Novo jr. pen. I couldn't figure out how to get the screw-thingy in so I could put the cartridge in. So I broke out the instruction manual and figured it out. I clearly didn't pay attention when the CDE showed me in the office last week. And doing all this for the first time makes me feel like I'm in Diabetes 101 all over again.




But I'll get it all figured out and be a pro by the end of the week.

And I'll make sure to pack everything I need for diabetes tmrw in my handbag so I don't have to try to remember everything at 5am when I'm basically sleep walking around the house getting ready for work.

Wednesday, May 29, 2013

Ghost low bg symptoms and Shame on you, Hoda Kotb.

It was back to work on Tuesday, after a 3-day holiday weekend. Low blood sugar readings caused me to start my weekend plans (a 2-hr drive away) on Saturday instead of Friday, as I had originally planned. Stubborn blood sugar stayed in the 50s for 1/2 a day, into the evening, on Friday. After eating every carb in the house, I was able to bring my blood sugar near 100, but never over, and it wouldn't stay put, either.

I didn't get too upset about this, as this is part of having type 1 diabetes. You always have to expect the unexpected, and go with the flow. I could have certainly gotten mad about it, but it wouldn't have changed anything, so why put yourself through the added stress?

Returning to work is always tough after a long weekend. You'd think you'd feel more refreshed after having an extra day off, but in my experience, I find I try to cram as much into a long weekend as possible and end up more exhausted than after any regular 2-day weekend. Tuesday and today were also a little tough at work because the office hasn't quite figured out what to do with the thermometer. This Minnesota weather has been a little bipolar, with one day in the 50s and the next in the 90s, so the office doesn't know whether to turn on the heat or the air conditioning. And since it's a 3 story building, there is always a good 1 day lag time in changing the temp in the building. Well, since it was colder recently, the heat was still on, even though it was humid and hot today. So I was sitting in my cube sweating to death all day, drinking water like crazy. And if you have t1, you know what heat does to blood sugar. Luckily, I haven't taken my pump off yet (haven't yet made the switch to MDI), so I was able to suspend my basal insulin on and off throughout the day to help manage the lows. I will use up one more pod (infusion set), just to finish off my current bottle of Novolog, then I start my Levemir and Novolog Jr. injections. The closer it gets to making the switch, the less I am looking forward to it. Mind you, it is a choice, so I know in the back of my head I can change my mind. But I know I need to learn MDI as a backup. I've never actually given myself an insulin shot.

I think what I'm most worried about is losing the control that I have right now over my t1. It's not perfect, but it's been manageable and I have this fear that with MDI I won't be able to manage it as well. This is solely based on fear and not experience, since I've never tried MDI. And I have a little fear of not being able to snack as much between meals, since I can only dose insulin in 0.5 increments, instead of the 0.05 increments I can do with the pump. So this isn't just a change in insulin management, but a change in behavior and lifestyle (eating) habits. At my CDE's recommendation, I put my CGM back on after a long hiatus. I'm using up my last Dexcom Seven sensor (even though it is expired now, it's been accurate). Then I'll put my G4 back on. I wonder how long the sensors are good for after the expiration? The Dexcom Seven sensor I'm wearing had an expiration of Sept 2012 (!!!) and still works. Hmm.

Today was a day of feeling fake lows- you know, those ones where you have low bg symptoms, but not actual low bg? I'm still having them right now, and I'm sitting at 100 with a stable arrow on the CGM. In fact, it's been stable all day; hovering in the 90s and low 100s since last night. So I don't get the low bg symptoms. I keep feeling the urge to treat it.

On a GF note, I have become obsessed with GoPicnic's gluten free ready-to-eat meals. I cannot express my love for these enough. What a PERFECT idea for road trips, vacations, and grab-n-go food for us celia-folks. They do not contain GMOs or high fructose corn syrups. And of the 3 I've tried- they are all so delicious. You can order them online at www.goppicnic.com or go to your SuperTarget ($3.99 at Target so a little cheaper than online). Just ask a sales associate what aisle they keep them in. I've seen them in different places in different Target stores. This is one of my favorites:



Shelf stable with long expiration dates, you can bet I'll be carrying one of these in my carry-all bag for those just in case food emergency situations.

If you follow me on Twitter, you probably saw my tweets on Monday and Tuesday about Hoda Kotb's despicable comments on the Today Show on Monday. A long-time fan of their show, I just can't stomach watching it anymore. Even though I don't fault Kathie Lee, who did not agree with Hoda's comments. If you missed the episode, Hoda said she would never date a man if on a date, he asked the waiter "does this have gluten in it?" and repeatedly implied that a man is not a real man if he doesn't eat gluten. Despite Kathie Lee's comment that some people MUST eat gluten free for medical reasons, Hoda implied that any man that has any food restrictions, ("gluten, dairy" were her words) is NOT a real man. I had to rewind the DVR and rewatch the segment, because I couldn't believe I heard her right. Talk about offensive and rude. Thanks for throwing it out on NATIONAL TELEVISION that you think eating gluten free is a load of sh*t, Hoda. Wonder how many restaurant managers were watching and now think the same. I can feel my blood pressure go up writing about it right now, reliving it. I better stop now before I write bad things.




Monday, May 20, 2013

Reasons I'm getting off the pump-and trying MDI for the first time - Ever.

Ahhh. Just got home from work. Walked in the door, said hi to the dog and bee lined for the closet to change out of my work clothes and get into my jammies. Its customary for me to do this routine as soon as I get home if I don’t have to go anywhere else for the evening. So comfortable.

Well, I meet with the CDE this week to discuss getting off the insulin pump and going to MDI. There are a couple of reasons for this-

1. The cost. Always high at the beginning of each calendar year until I meet my out of pocket maximum.
2. The adhesive is irritating to my skin.
3. I don’t always like having the visual “announcement” that I am diabetic. It is ALWAYS a conversation piece, whether I like it or not.
4. I don’t want the weird oval/egg shaped tan lines all over my arms/stomach/upper butt from wearing it all summer. The tan lines it creates are stuuuuuupid. Nothing like having white egg shapes all over. Or better- having to put a fresh pod with extra strong adhesive on sunburned skin.
5. I don’t like carrying all the pump junk around all the time.

Now here’s the thing. I’ve never done injections because I am afraid of needles. So two things might happen-

1. I might not be able to do the shots on my own out of fear of the needles.
2. I might not be able to manage my diabetes on MDI, because I use so little insulin at a time and the needles (even the kid ones) only administer insulin in either 1 unit or .5 unit increments. My endo previously advised me I would end up having to let my bg go higher and in turn, have a higher A1c. Because unlike a pump, where I can bolus in .05 increments, I wouldn’t be able to fix “small” highs, since I have a high sensitivity to insulin.
3. I like having the option of suspending the basal insulin when I am low.

So, it’s something I’m considering trying out for the summer and see how it goes. I can always go back to the pump if I change my mind. I’m a little nervous about the venture, because I am used to having really good control of my diabetes since its inception in 2010 and I give most of that credit to having the pump early on, which does most of the work for me.

I also need to briefly rant about my glucose meter. I am currently using a Bayer meter. I have both the Bayer Contour and the Bayer Contour USB. I am only using it until I finish up my remaining Bayer test strip stash (6 more vials). I started using the Bayer meter in October 2011 when I was forced to switch due to my new insurance only covering Bayer products (at that time). I had been using a couple different Freestyle meters for 2 years and LOVED them – everything about them. Extremely accurate, uses very little blood, doesn’t error out if you don’t put enough blood on the strip, and has a light at the test strip entrance so you can test in the dark-no problem. Well, I switched to Bayer by force and have disliked it. Everything about it is opposite of the Freestyle- the strips always error out, they are not accurate in comparison to my other meters (even the ReliOn brand I used for a while was more accurate), there is no test strip light, and requires more blood. Today was another example of why I can’t stand the Bayer meter. With clean hands (as always, I wash before testing), I tested my BG prior to eating a snack, which came in as 80. I bolused for 15g of carb. Literally 3 minutes later I felt LOW. I tested, and the meter read 65. I tested again, it read 60. I tested a 3rd time, it said 60. And my bolus insulin had not even hit my system yet. So I knew I was going to be in trouble. I treated the low with a juice box, then followed up with the snack I was planning to have.

This inaccurate blood sugar reading has been an issue with Bayer since I switched to it. I have been sent 2 different meters by Bayer because the two I had were so inaccurate that I thought they were broken. Too many times I would test- get one reading- then test again right after because it doesn’t match how I felt- and get a completely different reading. This didn’t happen with my Freestyle, at least not enough for me to ever remember or ever complain about it. I loved my Freestyle the 2 years I had it.

Luckily, when my insurance changed last October, it began to cover both Bayer and Accu-chek products. So I immediately switched to the Accu-chek Nano. I’ve had no issues with it. Unfortunately, I still have Bayer strips I need to use up, so I’ve had to go back to the Bayer for a while. I cannot WAIT to finish these off.

I sure wish my insurance would cover Freestyle… Oh well, Accu-chek is ok.

Forgive my rant but I think when you are making important decisions (with your insulin) based on your bg readings, those meters need to be accurate. And I’m sorry to the Bayer meter lovers out there. Your experience may be different than mine.

I haven't been using the Dexcom for while, either. I was wearing the Dexcom Seven, then I upgraded to the new one, the G4 last fall. But the cost is high and I really don't want to wear yet another device. And carry around another device. How many things can I wear on my belt clip before I'm considered a nerd? Anyway, for some reason, the CGM doesn't work great on me at night time. During the day, it works like a champ. But every night, even though I calibrate it according to Dexcom's guidelines, it goes haywire at night with crazy high (wrong) readings. All night, every night. I was turning it off at night and re-starting it in the morning, but it just got to be too much so I stopped wearing it. And again, I don't want the tan lines for summer. I have 12 sensors still so if I have the desire to put it back on, I will. And I have to be mindful that those sensors expire in kinda short period of time so I will need to use them up at some point.

I'm lucky to have these complaints- poor me, my diabetes is so well controlled right now that I don't need the pump or the CGM- wahhh wahhh. I hear ya. It goes in phases, just like yours, where it behaves for awhile. It's been pretty good for a while now, since I switched to the Paleo Diet last November. It made a HUGE difference in my bg trends.

Ok well, I'm off. I have some work to do and I need to watch Mad Men from last night.

Monday, May 13, 2013

Feeling MacGuyver-ish with diabetes.

I know Mondays have the bad reputation of being, well, Monday, but this one really lived up to it. As with every Monday, I hit the snooze button one too many times and was racing to get ready for work (read: no makeup, finger combing hair, brush teeth, out the door). My alarm goes off at 4:30am, but I snoozed until 5:15. This does not leave me much time to get ready and drive to work. Lucky for me, I make my breakfast and lunch the night before!

In my harriedness, I failed to realize that my insulin pump pod had expired at 5:31am, and that I needed to put a new one on. This discovery was not made until I was down the road from my workplace- too far from home to turn around and get it without being late (I work in a workplace where if you are literally one minute late, it is counted as a 'tardy'). I pulled in the parking lot, hoping that an idea would come to me. I didn't have anyone that could run to my place and grab me a new pod (my friends unfortunately have jobs, too). Well, I know my pump will continue to administer the background insulin for 2 hours post expiration. That will take me until 7:30am. I work until 3pm. Hmm.

Luckily, my breakfast was pretty much carb-free. Two egg whites scrambled with almond milk, spinach and tomatoes. No bg spikes should happen there.

Around 8:30ish, bg was still holding steady in the 90s and feeling really pooped from getting to bed late (I am SUCH a night owl!!), I grabbed a cup of coffee from work. I can't drink black coffee; it needs some sort of milk/cream and fake sugar. Against my better judgement, I added milk to it. I can't possibly describe what a huge mistake this was. Let's list the reasons why this was a bad idea:

1. I have a mild milk allergy and an overall intolerance of all things dairy.

2. Milk makes my blood sugar go up.

I fixed the bg problem by issuing a bolus. The good thing with my pump is I can at least continue to issue boluses even after the pump has expired. I decided to turn my boluses into background insulin by by using the extended/slow release funtion on my pump. I did this until the end of the day. I just had to deal with the hourly alarms that alerted me to my pump expiration, which then turned into every 20 minutes (sorry, co-workers, for being exceptionally beepy today). Oh well, gotta do what you gotta do. I felt kind of MacGuyer-ish, coming up with that solution.

Problem #2 turned out to be a bigger issue. TMI AHEAD. TMI. TMI. Okay, you've been warned.

Well, let me just say it like it is. Milk makes me extremely gassy. Not the quiet, stinky, maybe-they'll-think-it's-someone-else kind. More the extremely loud, non-stinky, can't predict when they are coming or stop kind. I sounded like a fake fart toy. Ever seen the movie Van Wilder, the noises that come out of the dude that drank Colon Blow? Yeah, THOSE kinds of noises. The loud growls coming from my stomach were not mistakeable for hunger growls. They were angry growls. My co-workers were kind enough not to come over and ask me what was going on over in my cube. Probably for the best.

I get home, take a probiotic and some Nexium. Go out to my deck where I was drying some clothes on my flat clothes dryer gadget, only to find that my clothes were gone. Not as in stolen, but as in blew in to my neighbors yards. So I walk out behind the houses in my jammy pants, picking up my jeans and bras strewn across the yards. Awesome.

So what did I learn.

1. Keep a pod backup in your desk. When you use it up (which I had), replace it with another back up.

2. NO MORE MILK IN PUBLIC! NO EXCEPTIONS!

Happy Monday!!!

Sunday, May 12, 2013

I get tempted.

Maybe it's the change of the season, with warm weather here and everybody running around in good moods, feeling free and happy. But I find that since the sunshine has arrived I've grown inpatient with all the attention I must give to my diseases; I want to run around and be carefree, too. The coming of the warm weather brought with it a sense of freedom that many of us living with diseases don't always get to fully experience.

I've noticed since the warm weather has arrived, I have been a little less type A about my BGs and have not been checking it as often (normally every 2 hours). Even with my celiac, I was SOOOOO tempted on Friday to go to Burger King and get a Whopper- something I haven't been able to have in 3 years- and eat it, regardless of how sick it would make me or the intestinal damage that would take months to heal. There was just this feeling, this URGE, to do "normal" people things for a while, like spontaneously eating out on a whim without having to plan everything out in advance and do the research needed. I miss the spontaneity in life that having disease steals from you.

But alas, I am much too careful and responsible to ever knowingly eat gluten, even if I do occasionally day dream about it. I have never cheated in the 3 years I've had it. And as for my 'betes, I still manage it closely and my pump is reporting a 7-day bg average of 103, so I must not be doing too horrible of a job, even though I've slacked a bit lately.

Last week I sold my dresser on Craig's List. It's all part of a larger overhaul of my life I'm in the process of. Little by little, I'm getting rid of a lot of my stuff; stuff that I don't love and doesn't really fit in my life anymore. My new life motto is Simple And Transparent. Simple meaning not having a ton of crap that soaks up all the energy in my house, collects dust and clutters up my closets, and only keeping that which has use and/or meaning to me. Transparent meaning what you see with me is what you get- no shame or embarassment in who I am or how I live, no more hiding things. Yes, my life has many limitations and anyone who choses to be a part of my life (friendship or otherwise) will have to accept that. I have lived with a lot of guilt the last three years; guilt in feeling bad for putting others through my diseases. I felt guilty that people didn't know how to cook gluten free for me, guilty that I couldn't go out to eat at just any restaurant, guilty that I would have a severe low blood sugar which would make me feel like I "ruined" someone's evening. I felt guilty that I had to subject others to my diseases; that inevitably they affected other people whether I wanted them to or not. Trying to downplay these diseases and act like they aren't a big part of my life when they absolutely are. But then I had a Good Will Hunting moment in my life, you know that scene in the movie where Robin Williams corners Matt Damon against the wall and repeatedly says "It's not your fault. It's not your fault. It's not your fault." Yeah, I had that moment with myself. It was time to quit blaming myself for getting sick, it was time to quit feeling guilty for what I felt was "inconveniencing" others with my diseases. Because it isn't my fault that I have them. I need to STOP feeling like less of a person, less worthy. I'm not entirely sure how to accomplish this, but I'm working on it.

Overall though, life's been good. I know my blog has been quiet; it was just me taking the time needed to plan the overhaul in my life, meditate, and calmly think of what I want the next steps in my life to be. Sometimes you gotta get real quiet with yourself in order to hear what your conscious mind is whispering to you. It's been a great journey. I feel very positive about life, about my future. It also involved evaluating relationships with people and beginning the process of slowly weeding toxic people out of my life for good. Energy suckers is what I call them. I want to surround myself with positive-minded, caring people. Have you read the book The Magic by Rhonda Byrne? If you haven't, pull up a session of Amazon RIGHT NOW and go buy this book today. It's amazing! I have already read it and am starting over because I read it after my spinal cord surgery when I wasn't really ready for its message.

I have been thinking A LOT about all of you who read my blog, and have felt a pure sense of thankfulness in my heart that there are people out there that care enough to read my blog, and also people that care enough to comment and say something to me. It means so much to me. I try to read everyone else's blogs, too, because there is so much to learn from others going through the same things as you. It just fills my heart with so much love.

I'll be on the blog this week, and *hoping* to be on #DSMA on Wednesday night. Speaking of, does anyone know of any Twitter chats going on for celiacs?

God Bless, have a good week, y'all. I'll be back soon.