Tuesday, September 30, 2008

Round-Up

Life:

* Turns out, I did take my insulin shot the other night. It was confirmed for sure when I hit a 70 mid-day.

* My sugars are holding steady at the higher insulin dosage of 43. Insulin ain't nothin' but a number.

* On a totally non-diabetes related note, I had my hair dyed purple. See? Even diabetics go wild and crazy.

* If you've lost five pounds, please let me know. I seem to have found it...

As always, more to come...

Friday, September 26, 2008

Subconscious Maintenance

It's 10:30 on Friday night and I'll admit that I'm definitely tipsy, bordering on downright drunk (please excuse all typos, grammatical errors and ramblings).

I am a victim of subconscious diabetes maintenance.

Before I go to bed, I take three pills and my nightly dose of Lantus insulin. One pill I take upstairs, two I take downstairs at the same time I take my insulin.

I follow the exact same routine every single night and don't really vary.

So tonight I went out to dinner with my husband and had two martinis and a glass of wine over the course of three hours. Somehow, for some god forsaken reason, I got into a discusssion/debate/argument with my husband over the Greek system. Please keep in mind that I have been out of college for over 18 years and my husband has been out for slightly less than that. There's absolutely, positively no reason either of us should feel that passionate about sororities and fraternities and the reasons people join them or don't, but somehow, we were. We kept arguing and debating back and forth about the individual merits; his university versus mine; his situation versus mine; his experience versus mine. (For the record, he was in a fraternity, I was not in a sorority.)

So, during this hour-long back-and-forth, I think I started preparing for bed. I remember taking my two pills from the insulin drawer, filling a crappy tupperware cup from the dish drainer with water and swallowing them, and measuring out insulin in my syringe.

When it came time for my husband and I to call a truce and go to bed (still slightly irked at each other and definitely still tipsy), I could not remember if I had actually given myself the injection. Did I take my insulin shot or not?

I'm on a one-dose a day regimen of Lantus. I get one shot at night and that carries me through the next day. If I don't take it, I run the risk of being really, really high the whole next day (especially when I've already been running high) and basically starving myself all day to keep from going any higher. If I accidentally double the dose, I'll be shoveling food in my mouth all day to keep the lows at bay.

And the thing is, I'm due to drive three hours by myself tomorrow to another state. Not exactly the best time to be monitoring a constant low or a constant high.

Ugh.

And ugh again.

I follow the same routine every single night, so individual memories no longer stick out in my brain. Was it tonight or last night that I opened the new bag of syringes? Was it last night or tonight that I remember flicking the bubble out of the syringe? Was it last night or tonight that I have the sensation of sticking my finger over my injection spot and massaging the insulin all the way in so nothing leaks out?

I can't remember.

I'm at the point where one shot no longer distinguishes itself from another and I can't for the life of me remember if I gave myself a shot or not.

I'm like a detective (a little drunk, tired, third rate detective), trying to search for clues in the mystery of "Was there Lantus or not?" I remember thinking earlier this week that I would need to change out my bottle of Lantus this weekend. In my insulin drawer, the bottle of Lantus is missing. Does this mean I gave myself a shot and threw the bottle away, knowing I would open a new bottle tomorrow? Or does this mean I set myself up to take the shot, left the bottle on a random countertop somewhere, and never took the shot? I went through the garbage can and there's a bottle in there, but is it from last month or this month? I usually keep the old bottle just in case. (I always figure old Lantus is better than no Lantus if I should somehow be forbidden to get my prescription filled.)

So now I'm left with the decision with what to do. Do I trust my memories from being from tonight? Or do I assume I've consumed a little too much alcohol to think rationally and I need to start from scratch on all the pills and the insulin?

And if I can't decisively make that decision, what's the worst of all evils? Too much insulin or not enough? I think I'm rational, sober, enough to think that less insulin is better. I can adjust my eating and live with some horribly high numbers for a day if I don't take the insulin, but it will be tougher to fight constant lows with a double-dose of insulin if I take it (again) and especially when I'm driving. I don't want to have to freak out every four minutes if I feel a twinge and instantly wolf down a Nutrigrain bar.

I feel absolutely stupid and young and irresponsible for getting myself into this situation. It's just such a rote thing that I do, giving myself this nightly shot, that I don't really have a conscious thought about it. I just do it, like I go to the bathroom before I go to bed without thinking about it.

So. I think with this entry I've convinced myself that I will not take an insulin shot. That I've already given myself one. That I've already taken my anti-anxiety med and my Avapro and that I'm set for the night.

And I guess time will tell. If tomorrow I wake up and my sugars are through the roof and they get higher and stay that way through the day, I'll know I was wrong and I didn't take my shot tonight. If I have a panic attack midway through the day because the car is passing over a bridge, I'll know I didn't take my anxiety meds.

If I make it through the day relatively normal, I'll know my memories are from tonight.

Either way, I know I need to make more of a conscious action of giving myself a shot and swallowing pills, no matter how many martinis I've had. My husband and I have this thing we do when we pull out of the garage. We live in the city and if you leave your garage door open, you're bound to get robbed (we lost two bicycles, a ream of toilet paper and a shovel at various times). We linger in the alley and one of us says, "door down" and the other one repeats "door down" so we're absolutely sure the garage door is closed. Maybe I need to do that with my nightly medicinal routine. "Shot done." "Pills swallowed."

It's times like this when I'm torn. Do I want my diabetes to become so much of a part of me that I don't always consciously acknowledge it, or do I want my diabetes to become so much a part of me that I'm 100 percent aware of what I'm doing every second of the day, even under the influence of 42 Below vodka?

As always, more to come...


Thursday, September 25, 2008

My Body Doesn't Know

So I’m still working through those highs. There’s no logical explanation for why all of a sudden I was waking up at 134 and shooting to 185 after eating one carb four hours prior. (I usually wake up around 95 and one carb unit does not make me break 180.)

I’m not sick. It’s not that time of month. I’ve got the usual amount of stress. I’ve been exercising. I changed my meter. I changed my strips. I changed my injection site. I started a new bottle of insulin. No difference.

So I started creeping up my insulin doses. I do one shot of Lantus nightly, then control my sugar during the day strictly by what I eat—no more insulin. I was at 36 units in a 1/2cc syringe. Now I’m up to 43.

It’s a tricky business with the Lantus. Since I only do the one nightly shot, there’s no chance for me to correct if I didn’t give myself enough insulin. And if I gave myself too much, I just have to eat constantly until I can drop my dosage later that night.

I inch up my doses unit by unit, waiting to see if it will get rid of my highs, without giving me the lows. It’s working so far; I haven’t seen a number over 140 in the last couple days. I also haven’t seen more than one or two numbers under 100. And I’m eating a really constricted carb diet (and lots of cheese and salmon and other non-carb things). I’ll probably inch up another unit or two over the next few days and see if I can’t get my range a little closer to where I like it, and where I can eat a normal meal again.

I get a little freaked out when I have to go over 40 units of insulin. I don’t know why. My syringe holds 50 units and I’ve pledged not to have to go to the next size syringe. The more I go over 40, the closer I get to having to buy that bigger syringe.

But I got a good piece of advice that I’m trying to keep in my head whenever I suck back the plunger: “Your body doesn’t know how many units of insulin it’s getting; it only knows it’s getting the insulin it needs.” Units ain’t nothin’ but a number.

I also feel a little sense of doom when my sugars go high and stay high and the only thing that drops them is more and more insulin. You’d think that after five years of being officially diagnosed, I’d be completely over that “Maybe it was a misdiagnosis thing and I’ll magically wake up one day and be done with it all.” But obviously, my body likes the whole “give me insulin” trajectory its on and has no intentions of giving it up. A not-so-subtle reminder to me that the whole diabetes diagnosis thing was obviously not a lab mix-up.

So. So. So. I’m making peace with everything…again. For those of you out there who’ve had diabetes a whole lot longer than I have: How many times do you have to reconcile with yourself and your diabetes before it’s a done deal? Or will I always, every now and again, be throwing up a white flag?

As always, more (insulin) to come…

Tuesday, September 16, 2008

Stubborn

My sugar isn't budging. My numbers are stubborn today, mostly because I'm being stubborn as well.

I had one sick day that raised my numbers, and now they won't go down. So I'm being stingy with my carbs to see if I can get them low. It seems that whenever I start out high, I just stay there unless I can jolt myself low.

This morning when I woke up, my number was 114 (I usually wake up around 90). I ate nothing. I got on the treadmill and did 37 minutes of brisk walking. I got off the treadmill and tested again: 104. I ate one container of yogurt, some turkey and some cheese. The yogurt was 11 carbs (that's less than one whole carb unit, for those of us who are counting) and that's all the carbohydrates I ingested. That was at 7:30 this morning.

I just tested again, now, at 11:17. My number: 112.

Stubborn, stubborn, stubborn. I realize 112 isn't a bad number, nor is 114 or 104. But seriously, am I doomed to eat just one carb at a time, with a half-hour of exercise between? This better be just some wonky phase I'm going through. I'm going to get awfully cranky surviving on just cheese, no matter how much I like it.

And here's the "let's throw in another diabetes weirdo for Lora to figure out": I feel like I'm low. I think my body is in a routine that automatically starts the low blood sugar symptoms at a certain time during the day and is continuing that routine, regardless of what the actual sugar level is. And trust me, I've tested finger after finger every time I feel this way, and always come up with a number well above a hundred. And I test 15 minutes or half an hour later to make sure, and 8 times out of 10, I'm even higher. I know it's not low blood sugar, but it feels like it.

So what's a girl to do? I normally treat the symptom if I feel low, and I'm usually right on target. But I know (from the past couple days experience) that if I treat the low feeling and not the number, I'll wind up 158 one carb unit later. I don't like 158. Again, not a high number for some, but high for me, bringing with it that rotten headache of a high number.

I'm upping my nightly insulin shot one unit at a time until I can get my numbers back on track and still eat. I'm even shooting in my thigh (which I haven't done in years) in the hopes that a "change of venue" will help.

I wish this sloggy low feeling would go away.

As always, more to come...


Friday, September 12, 2008

So Far, So Good

I got my new lancing device, the Accu-Chek Multiclix on Wednesday. It was delivered to work and I immediately opened the box. And immediately determined I was actually going to have to read the directions to figure out how to work it. I didn’t think I could get away with sitting at my desk experimenting for 15 minutes when I was on deadline, so I impatiently tucked it aside until I got home that night.

Once I figured out how everything worked, I decided that I like it. It’s a little more complicated than the crappy little lancing device that came with my FreeStyle meter, but then again, that’s why it probably works better—it was designed as its own mechanism, as opposed to an “aside accessory” to throw in with my meter so they can charge more for a complete “kit.” (Wow. That’s a lot of quote marks. Good thing we’re not having an actual conversation, or I’d look like that girl from Say Anything. I digress. Did I mention I have a fever and took a sick day yesterday?)

I am still figuring out the whole depth thing to get the right amount of blood, but I’m only about a drum of six lancets away from perfecting the process. I also, on a not-completely-safe note, will say that I think this will be much easier to use when I’m testing as I’m driving. It was kind of a pain to pull off the lancing device cap, insert a lancet, pull off the lancet cap and put it in my mouth so I could put it back on later, put the lancing device cap back on, pull the plunger back and press the button, all while holding on to the steering wheel and rudely gesturing to bike riders who keep cutting me off (Digress. Fever.).

One of my biggest surprises: how quiet it is. It doesn’t make nearly as loud a sound as the old lancing device did. It’s like getting a new high-tech dishwasher or washing machine with the “quieter action” option. (More quotes. It’s a “quote” “fever.”) I also really like that there’s six lancets already in there for me. In my fever-induced, ragingly high sugar situation, I’m testing quite a bit more often and it’s been a lot easier not to keep having to plug lancets into place. Also, on another digression but amusing/horrific note, my dog has been known to try and steal my used lancets from where they pile up on the countertop by the end of the day and that’s just wrong. I think the drum thing will help that—still a lot of test strips that wind up in weird places, but less actual lancets.

And now, in fear of another digression, I sign off.

As “always,” “more” to come “…”

Wednesday, September 10, 2008

Reckless

I have one test strip left.

I could have sworn I had another vial somewhere, but about a week ago, it became evident I didn’t.

I’ve been clinging to three test strips for the last three days, “saving” them for when I think I really need them. Turns out, I always really need them.

Without testing, I feel reckless—like driving without a seatbelt in rush-hour traffic or eating sushi from a 7-11. It’s like being a little tipsy all the time, and not knowing if you really are tipsy, or just a little off kilter.

I’m so used to testing five times a day that not testing at all seems abnormal. I’m not sure when in the last five years that subtle switch happened, but it did. Testing being the norm; not testing being the weird.

I figure in a situation like this, it’s probably best to err on the side of high, rather than low. I’ve been eating my regular meals without a lot of variation, but throwing in an extra carb unit here and there. If I feel even a hint wonky, I eat something.

My new supply of test strips are due to arrive today (I’ve been tracking them via UPS). As of this afternoon, I’ll be back in control—and I’ll know for sure just how in control I am. But just in case there’s a hold-up, I’m saving that last test strip in case of emergency.

As always, more to come (300 test strips, to be exact)…

Friday, September 5, 2008

Bruised And Boycotting

I’ve written before how much I hate my lancing device. It’s the mini one that comes with the Freestyle mini meters. I don’t like the mini one, but my big one had gone astray so I’ve been using the cheap little one. I got some great advice (thank you Diabetic OC!) about changing the type of lancets I was using to gentler ones, and that seemed to work for a little while.

But now I think my lancing device has a rebellious streak, or more accurately, a hostile attitude, and I’m convinced a spring has wound itself too tightly or the trigger is too trigger-happy and I’m back to hating the whole set-up.

I test on my arms for regular testing. I can normally test on my left arm (I’m right-handed) until the cows come home, with little fanfare other than some permanent red dots and a constant, slightly red, dry patch. Right now, however, each arm is covered in dime-size bruises and red welts. That’s right, both arms. I even tried switching back and forth but all it did was make both arms angry. And, as every diabetic knows, it’s hurts—a lot—to stick a needle (from a lancet or a syringe) into a bruise. Don’t even get me started on what happens if I test on a finger or my palm…

So today, I was ordering new test strips online and I said, “Enough!” and I ordered a new lancing device. I’ve previously done a little homework on the World Wide Web and at Target, checking out what’s there and what I think might work, and I went with an Accu-Chek Multiclix lancing device and that drum thingy that you use with the lancets inside. I’ve only seen one online and through the plastic packaging at the store, so I have no idea if I’ll like it or not, but seriously—can it be worse than what I’ve got now? If it’s even 5% better, I’ll be a happy camper. (But just to be on the safe side, I only ordered two boxes of lancet drums instead of my usual bulk six-month supply…).

Now I just have to wait until sometime next week when my box arrives via UPS Ground (it’s free that way). I can’t believe I’m excited about getting a new lancing device. (This is what my life has come to as a diabetic; I think I’m more excited about this than when I’m expecting new shoes from Zappos.)

As always, more to come (and I hope it comes quickly!)…

Thursday, September 4, 2008

Honeymoon’s Over—Again

My sugars were low. Were being the key word.

I’ve been on some sort of honeymoon with my numbers and I’ve been taking full advantage of it. So when I ate two slabs of fresh, crusty bread toasted and smeared with Neufchatel for breakfast, then showed up 77 barely three hours later, I figured I was still in the clear.

It’s very, very gloomy and rainy outside today; the temperature has barely cracked 65. So I did what any normal, red-blooded (and I definitely know it’s red) girl would do: I ate a toasted cheese sandwich. With french fries. And then I had a piece of cheesecake (How could I resist? They combined a cheesecake with a carrot cake. Two of my favorites in one delicious, rich, fattening, carb-loaded piece of sin.)

I just stabbed my arm and four hours later: 148.

I’d say my mini-honeymoon is definitely over. And I’d say that my dinner tonight is going to be cheese, cheese and more cheese.

As always, more to come (well, not so much more as less in the carb department)…

Tuesday, September 2, 2008

2 Good 2 B True

My numbers have been good lately. Really good. Scarily good. So good that I’m beginning to wonder if my meter is broken.

It was a holiday weekend and although I kept a rough sort of carb count, I by no means was the perfect eater. I barbecued. I drank wine. I ate homemade chocolate chip cookies. I even had pancakes for breakfast.

My numbers before bed are usually the rough ones; I usually go no-carb or one-carb for dinner and I’m still in the 135 range more often than I’d like. The last five or six days: 110, 115. And when I wake up: 83, 85. And the rest of the day fills in somewhere between that.

Maybe I’m experiencing another honeymoon period. Maybe vacuuming my whole house burns more carbs than I thought. Maybe reading burns carbs (I went to the library this weekend and tore through two books in two afternoons). Maybe my meter is broken.

That’s a lot of maybes, but I think I’m just going to add one more: Maybe I’ll take those really good numbers and go with it.

As always, more to come…