Tuesday, April 29, 2008

Looping

Sorry for the lapse in time, but to be honest, that low number threw me for a loop. It’s been a really, really long time since I’ve gone that low, that quickly, with no provocation or inkling.

As such, I spent the next two days over-compensating, barely letting my sugar get below 120—just in case. (Me, starting the loop.)

Then I spent the next day trying to determine if every pang, twinge, thought, pause, skip and whatever other action my brain and body were doing meant something. Something bad. Something that was headed toward low. (Me, in the middle of the loop.)

And now, just within the past day and a half, I’ve overcome my hyper-awareness and am just settling back into my routine of normal eating, normal testing and normal activity. (Me, on the downside of the loop.)

I have to remind myself that there was no justifiable explanation for what happened, and chances are pretty good there’s nothing I could have done to produce a different outcome. I can only think positively that I reacted appropriately and no harm was done. And I have to get on with my life.

Of course, I did pack a really cute Kate Spade makeup bag (got it for free at work!) with juice boxes, Nutrigrain bars and an extra blood kit, and slid it under my bed. I’m going to pick up some Smarties, too and throw them in there. Just in case. (But I’m not going to obsess about the “just in case.”)

As always, more to come.

Friday, April 25, 2008

The Lowest Of The Lows

Last night, I hit a new low.

Let me start by saying that I was running a little low yesterday. To combat this, I did my favorite low-killing activity: I ate a piece of carrot cake. Then, for some reason, I was desperate for something salty to go with sweet, and I ate some potato chips.

Hence, when I got home from work, my sugar was 128--which I knew was going to happen from the pig-out junk-food love fest. Because I knew carbs were out of the question for dinner, I ate a big salad with tuna, olives, a little shredded cheese, etc. It couldn't have had more than 1/2 carb unit all together. I ate that around 7:00.

At 9:15, I checked my blood and my sugar was 115. I was headed to bed to read, and I figured since I was on the downswing, I should eat something to prevent going low in the middle of the night. So I ate a Fiber One bar, 28g carbs--almost two full carb units. I gave myself my Lantus insulin shot--the usual dosage--and went to bed.

So there I am, reading a book in bed. About 45 minutes later, I start to feel weird. I thought at first it was just my arm, which had fallen asleep (pins and needles), but then I realized it was more. I don't often feel low sugar symptoms--a little crankiness, a little confusion--but nothing more. And I rarely dip below 65, usually no lower than 70. But I knew something was wrong. I felt shaky, weak--like I was going to pass out. I paused a few seconds, to see if maybe my salad dressing had expired and I was experiencing pre-nausea. But I knew that wasn't it.

I've been keeping a blood kit on my nightstand, but for some reason, it got moved last week. So I stumbled down the stairs, clutching the wall, and grabbed my blood kit on the kitchen countertop and tested my finger. 50. 50. 50. Holy shit. I grabbed the package of juice boxes from the cabinet, grabbed one and sank to the floor, sucking through my little straw. I waited a couple minutes and still felt very close to passing out, so I sucked another one down. I waited five minutes and could feel myself getting a little steadier. I grabbed a NutriGrain bar and a granola bar from the pantry and headed upstairs, bringing my blood kit with me.

I ate the food and tested again. 72. I was rising, but I was still worried. I set my alarm for 45 minutes later so I could check my sugar again and lightly fell asleep. When the alarm went off, I was 152. I didn't even freak out over the high number. 1) It was only 45 minutes after I downed 5 carb units, and 2) I was just so glad I wasn't going to dive-bomb for the rest of the night I didn't care how high I was.

I skipped my workout this morning--that low number just completely drained me. When I woke up and tested at 7:00am, I was 111. I got ready and came to work, grabbing a muffin at the shop downstairs.

Now, sitting at my desk, I'm 93, having only drinken a glass of milk. It may be a low day today, which I why I bought the muffin--they usually keep me going.

One of the great mysteries of diabetes still to be explained:
115
ate 2 carb units
45 minutes later: 50

As always, more to come...

Wednesday, April 23, 2008

Necessary Evil

I don't like going to the dentist.

It smells funny. The sounds are horrific. They take my money and give me pain.

Enough said.

Tuesday, April 22, 2008

Vacation

I need a vacation—from work, from dogs, from my slowly-being-remodeled bathroom, from my why-aren’t-my-lilies-coming-up life. Luckily, I have a weekend planned in Philadelphia, where I will see beautiful artwork and the Liberty Bell (among other things).

The one thing I won’t be able to take a vacation from, that I really, truly desperately need, is the dreaded disease. I’ll spend at least 15 of my 30-minute packing on diabetic supplies and just-in-case back-ups and food.

There are days when I wake up and say to my husband. “How about you take the shot today, you count the carbs, you exercise.” Sometimes I even ask my dog. No one ever takes me up on my offer.

I’ve done partial vacation days. Checked my sugar just once in the morning and once at night and said to hell with it for the other 14 hours of the day, just going by how I felt. Feeling low? Eat. Feeling okay? Don’t eat. I did that on Sunday and I must’ve guessed well enough because at bedtime, my sugar was 114. I won’t guess what I was the rest of the day.

I’ve also had days where I’ve just been so hungry that I ate what I wanted to and just braced myself for the number 147 or 152.

I know that’s bad. I know I shouldn’t do that, but it’s as close as I can come to having a vacation from diabetes.

I know I’m lucky in that I haven’t had to live with it all my life, but maybe that makes it a little worse sometimes. I know what life was like before DKA. I know what’s it’s like to enjoy a really great meal in a restaurant without having to mentally count carbs in my head while reading the menu. I know what’s it’s like not to have blood smears on doorways, on sleeves and on my keyboard. I know what it’s like to say “I’m going on vacation” and only having to remember to pack my sunglasses.

My husband and I once had the conversation about “Is the glass half empty or half full?”. I said someone drank my glass. It’s not half empty by choice.

As always, more to come…

Thursday, April 17, 2008

Diabetes At Work

I work in an office, and usually, my diabetes doesn’t really interfere or cause me any grief. We’re not really allowed food or drink, but my boss lets me eat when I need to, and no one is bothered if they walk into my office and see me doing a blood test.

I say “usually,” because there is one area where I have yet to figure out how to combine my diabetic self with my career self: the business lunch.

Fortunately, it doesn’t happen all that often—maybe four or five times a year—but when it does, I find myself getting a bit flustered and always wind up with numbers too high or too low. Since I veer toward the low, when I fluster, I aim higher and figure the high number is better than a potential emergency.

Take yesterday and today for instance. Yesterday, I went to a mini-convention with my boss and a senior co-worker. We were only going to be gone for a couple hours, so I brought my lunch to work, as normal, and planned on eating when we got back. I made sure my sugar was okay before we left, and I took my blood kit with me. And, as every good diabetic does, I had food stashed in my bag as well.

After we had finished walking through the exhibits, my boss and co-worker decided they were hungry and we should go to lunch at the restaurant across the street. (If I had my say, I would have preferred to come back to work, eaten my lunch at my desk, then taken my lunch break outside where it was the first 70-degree day of the year. But I really didn’t have a say…)

So, we’re at the restaurant, and I really wanted to test. I’ve done the subtle, put-the-kit-in-my-lap trick, but I couldn’t configure it. I thought about getting up to go to the bathroom, but then I didn’t want to draw attention to myself. And I didn’t want to make it look like I wasn’t interested in the business conversation they were having.

So I didn’t test. I guessed. We had been walking, and I figured I needed some carbs, I just didn’t know how many. I looked at the salads, but none of them had any carbs in them—all lettuce and non-carb veggies. I looked at the sandwiches and I knew all of them would have a lot of carbs in them. Ideally, I would have liked to order a salad and an appetizer, but I always feel like I have to order in line with everyone else. If they don’t get an appetizer, I don’t. (I’m not paying.)

So (such a lovely transition word; that’s why I keep using it). So, I ordered a hamburger, knowing I would over-carb. I ate only part of my fries (probably should have ignored them all together) and ate the whole hamburger.

Back at the office, a bunch of stuff came up, then I had an irritating phone call and my stress shot up. When I checked my sugar at the end of the work day (about three hours after I ate), it was just over 150. Very, very high for me.

So (there it is again). So after work I went for a long walk, and I got my sugar down to 74 before I ate a light dinner.

And then today, I knew we were going to a business lunch. Two days in a row out for lunch with business people is rare, but it happened this week. I checked the menu of the place online before we left to get a handle on the menu (this helps sometimes) and configured a few things. The problem with this, though, is that everything goes out the door once you hear what everyone else is going to order. You don’t want to get the most expensive thing on the menu, but you don’t want to get the cheapest. If everyone else is getting a salad, you don’t want to be the one person getting an entrée. If everyone else is getting an entrée and no side, you don’t want to be the only one with an extra plate. So I waited to hear what everyone else would order and had a sandwich. Not too bad, I thought.

Then (see, I changed it up). Then we found out it was one of our lunchers birthday, so everyone ordered a dessert. That’s where I messed up. I ordered the same thing as everyone else, but I only ate part of it. If I hadn’t had the dessert, I probably would have been okay.

But here’s the other piece of the puzzle… When it rains, it pours. As it turns out, I also have an event to go to tonight right after work (office-related). It’s for “appetizers and drinks.” Now, that could mean full-on appetizers, or it could mean passed plates of tiny pieces of cucumber. And because it’s right after work, my usual dinner time will be delayed. I just checked my sugar (two hours after eating) and it’s 148. That’s high, and though my initial reaction is to freak out, I’m a little less freaky because I know I may not be able to eat anything real again for three more hours. In this situation, I think it may be better to be high, because I don’t want to fall hard and fast if I’m only 100.


I know it all sounds convoluted. Am I following some weird business rules of etiquette about ordering that don’t need to be followed? While I want to take care of my diabetes and keep an eye on that carb count, I don’t want to throw it anyone’s face or disrupt the business going on. I only have to deal with the situation randomly, and I can’t imagine what I would do if I had regular business lunches (I assume, hope, pray I would figure it out eventually).

Luckily, I know there’s no more lunches planned for a while, so I’ll be safe. And for now, for today and for yesterday, I’ll just have to live with those high numbers. Damn business lunches.

As always, more to come…

UPDATE: The next morning. I just wanted to point out that the "appetizers and drinks" thing turned out to be drinks only--not a crumb of food in sight. I went home, tested, and I was quickly descending from 102. Guess the high from lunch was warranted...

Tuesday, April 15, 2008

Just A Short One

I know I tend to be long-winded and it takes forever to read my entries, so today I’m doing something short and sweet. I’m crazy, crazy, crazy busy at work—leaving later than I should—and crazy at home (hole in bathroom ceiling), so this is just going to be some random thoughts swirling through my head….

1. Read a lot of great info yesterday with Raise Your Voice. One blog that hit home was the cost of diabetes. I had no health insurance when I was diagnosed and couldn’t get it afterward. Had to refinance my house to pay for the hospital bill. Thank God the husband has health insurance through work. Number one reason to get married instead of just “coupling up” like Goldie and Kurt: Health Insurance.

2. Went to a Diabetes Expo. Got a free new meter—an upgrade of my current one. Unfortunately, they only give you about six new strips, which I’d be lucky to have last me the day. Gotta investigate the cost of the new strips for the Freestyle Lite. It uses one less battery, though, and those can be pricey…

3. Also at the Diabetes Expo—the SoloStar pen for Lantus insulin. Have been watching its advance to the U.S. (the old OptiClick sucked, to be frank) and am glad it’s here. I got a demo and it looks good—getting a prescription at my next doctor’s appointment at the beginning of May.

4. Observed at Diabetes Expo: People will wait in really long lines to win a bottle of water. ???

5. (And I have to make it five because it’s a nice, round number.) I’m starting to learn the blog lingo and I love that I can be considered a part of the Diabetic O.C. It’s like I’m a cool, hip TV show and thereby cooler and hipper by association.

As always, more to come…

Thursday, April 10, 2008

My Day: Carb-by-Carb, BS-by-BS

I’m making notes and going through my day step-by-step. Of course, not every day is exactly the same, but I find if I stick to a routine, my body responds better not only with diabetes, but other things. So here it is…

*We’ll start with last night before I went to bed, since this is when I give myself my insulin shot. I went to bed early last night, so I gave myself my shot at 9:30. With Lantus, it’s important to give yourself the shot as close to the same time everyday as possible: I aim for between 9:30 and 10:00.

So, at 9:30 last night, I took 35 units of Lantus insulin in my stomach. It’s that 35 units that will sustain me through today. (I do have to say, though, that I did have some leakage after I pulled out the needle, so it may be more like 33 units. Don’t you love the smell of insulin, she asked sarcastically.)

TODAY.

5:00am: First alarm went off, and I took two of my many prescriptions. One is Synthroid (I also have Graves disease) and you have take it at the same time everyday, and you have to take it on an empty stomach and then wait for an hour before eating. Since I usually work out first thing in the morning, and often have to eat before I do, I have to make sure the hour is past. So I take my medication at 5am every morning (including weekends), then go back to sleep.

5:45am: Second alarm goes off and I hit snooze for about 1/2 hour before finally getting out of bed.

6:20am: BS: 89. If I’m below 100, I eat something before I start exercising. This morning I have 1/2 a Nutrigrain bar (Cherry is the best, 15g carb) and a small can of V8 Juice (7g carb; I can finally drink it without holding my nose). [1-1/2 carb units total.] (I also let the dogs out and filled their water bowl, just in case you’re tracking every minute.)

6:30-7:15: On the treadmill, in my spare bedroom/office/exercise room/throw-whatever-we-don’t-want-anyone-to-see-in-here space. I don’t run. In fact, I should probably state outright that I really, really dislike exercising, but it has such an undeniable impact on my sugar, that I can’t not do it. So I walk really fast while reading a book (I can read in any position, doing anything, anytime—a habit I learned at age 7 and have since mastered). I go at a speed of 4.0 and when I’m finished, I’ve gone 2.79 miles.

7:15-7:20: 50 crunches with the ab roller while simultaneously dodging the dogs who are trying to kiss my face and figure out why I’m on the floor.

7:25am: BS: 96.

7:25-7:35am: I make my lunch and eat breakfast. Breakfast is: one Fiber One Oats & Chocolate Chewy Bar (29g carb), glass of light white grape juice (18g carb), one Light & Fit raspberry yogurt (11g carb). [Four carb units total.] If I don’t work out, I skip the yogurt. While my sugars are at 96, they’ll continue to decline over the next few hours due to the exercise.

7:35-7:40am: Straighten my kitchen. If I don’t pick everything up, the dogs will have a field day with whatever they can find. I also have to put the kitchen stools in front of the drawers, as one of them has figured out how to open the drawers and empty their contents.

7:40-8:05am: Brush my teeth, do a flouride rinse (just went to the dentist; need to step up the dental hygiene routine), shower, blow-dry my hair, get dressed. Raining today, so I put on my thick socks over my regular ones and tuck my pants in my green boots. I’m out the door.

8:05-8:25am: Drive to work. Park in my parking space, which is several blocks from my building. I have to rent my space, and it’s cheaper if it’s further away.

8:25-8:35am: Walk the rest of the way to work. Again, at a fairly quick pace. It’s raining and I don’t want to get drenched.

8:35am: Sitting at my desk and ready for work. Well, not exactly working quite yet, since my boss isn’t in. I’m actually writing my day up until this point. When she arrives around 9:15, I’ll stop. I’ll check my sugar around 9:30, since it will be two hours since I’ve eaten and I’ll want to see how my breakfast is holding up.

9:40am: BS: 95. I should mention that my sugars, even without exercise, since the beginning of my diagnosis, have always run lower in the morning. With the exercise in the morning, they can get downright low and nasty. I tried to exercise at night, when they tend to run high, but by the time I get home from work, I’m not really up for exercising and wind up skipping it way too often. If I don’t do it first thing in the morning, I rarely do it all. I should be a fairly slow descent in my sugars from here, though. I usually eat something around 11, so I’ll check my sugars again closer to 10:30, 11:00.

Also, I should mention that at work, I’m sitting at a desk all day. The only exercise I get is to pick up my print-outs from the copier room (24 steps) and to get water from the drinking fountain outside our office door (52 steps—and no, I’m not that obsessive, I counted specifically today for this blog). Also, the women’s bathroom is on the other side of the building, but I haven’t been yet today, so I don’t know how many steps yet. And, technically, there’s no food allowed in our office, so there isn’t a kitchen and there aren’t usually snacks laying around—no temptation. I usually only eat what I bring, unless it’s Girl Scout cookie time. Then I skip some of what I bring and go with cookies. Not healthy, no, but I can’t refuse Peanut Butter Tagalongs and Samoas. And, I used to be a Girl Scout and had to sell hundreds of cookies, so I feel like I’m contributing to a good cause (any excuse that makes it okay, right?).

10:45am: BS: 85. Felt a little cloudy in the head, a little widgy. Could either be low BS, or my sinuses acting up (my head hates damp weather). I usually don’t feel low blood sugar until I’m below 80, then my first sign is generally extreme crankiness. 85 is a number where I could eat if I wanted to, but since I’m not really hungry right now, I’m going to wait a little longer. Yes, playing with fire, but I’m pretty sure I can hold out until 11:30 and probably still be above 75. Shall we see?

11:20am: 112 steps to the bathroom. I just counted.

12:00 noon: BS: 62. Ooops. Waited a little too long to test. Remember, as D-Life says: Test, don’t guess. I’ll fill my water bottle again, then eat lunch at my desk. Lunch today: mini-pretzels (15g carb), turkey & spinach roll-up (16g carb), Quaker Peanut Butter & Oats Morning Minis (24g carb—love these!). [3-1/2 carb units total.] I know the pretzels are 15g carb, because each week when I go to the grocery store, I buy a big bag, then use my trusty digital scale to weigh out the exact amount that makes up 15g carb, which I put into little baggies and keep in a bowl on my countertop, along with other little baggies of things I’ve measured out. The turkey & spinach roll-up I also made myself (made five of them on Sunday, so I could bring one to work each day), using a low-carb tortilla, some oven-roasted turkey, fresh spinach leaves and a smear of Neufchatel to keep it all together. I drink water with lunch.

Now, I do get an official lunch break (about 45 minutes) and I do take it somedays. If the weather is nice (over 45 degrees and not raining), I put on workout clothes and walk over to an outdoor track that’s about a 3-minute walk from my building. It’s a 1/4 mile track and I go round and round (I walk backwards for about three laps—don’t laugh, it works a whole new set of muscles) for the full 45 minutes, listening to my i-pod and occasionally dancing as I walk (I’m at that point in my life where I don’t care if I look weird, as long as I’m amusing myself.). I’ve tried to keep count of how many laps I do, but I always lose track after about 4. I’m guessing it’s about 8 or so laps, so probably around 2 miles (walking backward takes longer). I don’t walk incredibly fast, because I do have to go back to work, and I don’t have the opportunity to take a shower. (I just go with windswept hair for the afternoon and reapply my deodorant after a quick wipe-down.) With the weather being as unpredictable lately as it has been, I’ve only been able to go outside 2 or 3 times a week. But still, it’s exercise, and, as I said, it has a definite impact on my sugar.

Today, it’s raining, so I’ll probably just skip the break altogether. When I do go for a walk, it’s usually at about 2 or 3 o’clock, a couple hours after I’ve eaten. I check my sugar before I go, and once again, if it’s under 100, I eat a quick carb unit. I also check my sugar when I get back and eat if necessary.

Since I’m not walking I won’t check my sugar again until about three. The 3-1/2 carb units I had for lunch should carry me through plenty fine.

2:55pm: BS: 103. Pretty typical for this time of day, especially when I don’t walk at lunch.

4:45pm: BS: 91. Sometimes I crash around 4:30/5 for no good reason, so I usually check my sugar around this time and determine if I need a snack. I work until at least 6 about half the time, until 6:30 a 1/4 of the time, and until 7 the rest of the nights. If my sugar is high enough to drive home and back into my garage without hitting my husband’s car, and I know for sure I’m leaving at 6, I don’t eat anything, because I’ll have dinner right when I get home, and, as noted, my sugars run higher at night, so I hate to waste a carb unit on a snack when I could be saving it for dinner. If I’m too low, and I know I’m staying later, I’ll eat a carb unit—again, sugars run higher and that one carb unit will stay with me longer. I’m pretty sure I’m leaving close to 6 tonight, so I’m going to hold off on eating, which probably means I’ll be pretty low when I get home.

5:55pm: BS: 70. I tested once more before getting ready to leave. I was feeling a little cloudy and obviously, I was right. I ate a light applesauce (11g carb) to get me home.

6:00-6:10pm: Walked back to my parking spot.

6:10-6:40pm: Drove home. Was greeted at door by happy-to-see-me dogs. And husband.

6:40-6:45pm: Looked through mail. Put on many layers of clothing. I got my gas bill the other day and decided I would not have another high one. So no matter how cold it gets outside, or inside, my heat is off for the season. It’s cold in here. 52 degrees. (Another number.)

6:45-6:55pm: Updated here, while oven is preheating for dinner.

7:00pm: BS: 78.

7:00-7:20pm: Watching TV while dinner is cooking. For dinner tonight: flat-bread pizza. I make it using a low-carb whole wheat roll-up (17g carb). I put it in the oven to crisp up, then top with cheese and veggies. For dessert, I’ll have about three or four caramel Hershey kisses (somewhere around 10g carb). That’ll be it, and hopefully my sugars will be okay at bed. [2 carb units total].

7:25pm: Dinner!

Rest of the night: Watching TV, playing Mah Jong on the computer, petting the dogs.

10:00pm: BS: 109. Right where I should be—yay! I’m giving myself 34 units of Lantus, in the stomach again.

SUMMARY: Okay, even for me, some of these numbers are lower than I’d like them. I’m blaming them on the extra exercise I’ve been doing—the walking at lunch. Up until about two weeks ago, I wasn’t able to walk regularly due to the weather. Now that I am walking, it’s finally hitting my sugars. That’s the way exercise works with me. If it’s something I haven’t done before, or done in a while (a month or two), then it usually takes a good two weeks for the exercise to consistently affect my sugars. On the plus side, if I do it regularly for at least a month, I can skip about four days before I start seeing my sugars rise (good for when I’m sick). If my numbers stay consistently low for a couple more days, I’ll drop my insulin dosage a unit, then see where I land. An fyi, I often adjust my dosage, and I’ve been as high as 42, and as low as 30—so I’m in the low range now.

And that’s it. I’m going to bed so I can get up and start all over again. Time to make the donuts.

As always, more to come.

Wednesday, April 9, 2008

Labels, labels, labels

Insulin-dependent, non insulin-dependent. Type 1, Type 2, Type 1.5. Juvenile Diabetes. Gestational diabetes.

I can’t be a Type 1 diabetic because I wasn’t diagnosed until adulthood.

I can’t be a Type 2 diabetic, because my physical body has all the traits of a Type 1 diabetic.

I can’t be a Juvenile Diabetic, because, again, I was diagnosed after puberty.

I can’t be a Gestational Diabetic because I’ve never (no offense to moms everywhere, but thank god) been pregnant.

So the only thing that’s left is Type 1.5. Which someone asked me if I was, because they couldn’t believe I could only be on Lantus, and still be eating.

But according to everything I’ve read, I can’t be a Type 1.5 diabetic because of the way my diabetes was diagnosed and what my situation was when it was diagnosed.

From other bloggers and from some medical Web sites, I’ve read that Type 1.5 diabetics usually can control their sugars with oral medications for several months, and in cases, even a year or longer. Then the oral medications stop being effective and they move to insulin.

Part of me wishes I could be labeled as a Type 1.5, because then I would have had some sort of adjustment period, some amount of time to get used to the idea of being diabetic, time to learn the math of carb counting, time to gear up the courage to stick myself with a needle every day. Time to research, examine, talk to people, figure things out. But I didn’t have time.

One week, I felt a little tired. The next week, I couldn’t get enough to drink, I was peeing all the time and I felt completely worn down. The next week, I was in the ICU with ketoacidosis and an insulin drip. The next week I was home, shooting up insulin and throwing away every scrap of food that had sugar in it (Because isn’t that what all newly diagnosed diabetics do? Throw away sugar because they haven’t figured out yet that yes, you can still eat a cookie?)

After the non-stop retching and vomiting finally stopped two days after my admission to the hospital, after I was finally aware enough of my surroundings to complete a sentence as well as understand one, I was given a crash-course in how to be a diabetic. I was taught how to give myself a shot by a diabetes educator who stopped by my hospital room for an hour and showed me how to work a syringe by demonstrating on a sponge ball. I was taught how to carb count by a dietician who stopped by my room for an hour and walked me through it using plastic steaks and mashed potatoes to demonstrate serving size. They were both very nice and gave me a ton of brochures and pamphlets and charts to take home.

I’ve never felt so overwhelmed, so under-educated, so unprepared for anything in my life.

I went online to see what I could find out, and, unfortunately, “blogging” was still a funny word to most people and the only “real-people” information I could find were horror stories written in the comments sections of medical Web sites. I vowed not to do any online research anymore (luckily both I and the World Wide Web have changed) and resorted to putting an ad in the paper for a Diabetes Mentor. I just wanted to talk to someone who knew what I was going through, and who could give me advice about how they handled it. No one answered and I knew I was on my own. I figured out what I had to figure out, asked questions and did a lot of trial and error.

So the label thing. What type of diabetic am I? I’m the kind who requires insulin to stay alive, counts carbs and pokes my body for blood multiple times a day. I call myself a Type 1 diabetic because that’s what my body tells the doctors I am, and that’s how I’m treated.

I have big issues with people confusing Type 1 and Type 2 (as always, more later), but adding the 1.5 into the mix just seems to make things more confusing.

I know research is important in looking for a cure for diabetes, but maybe, just maybe, someone—a doctor, a scientist, a chemist, an inventor—can take a break from trying to produce 1.5, 1.6, 1.7 labels and focus on making them all go away.

Label me…
…hopeful
…optimistic
…pessimistic
…realistic
…fabulous
…egotistical
…humble
…funny
…loving
…anal
…controlling
…counting
…watching
…waiting

As always, more later.

Tuesday, April 8, 2008

Guilt

I feel like I should start off each entry like Bridget Jones’s Diary, only instead of saying how many cigarettes I’ve smoked, how much I weigh and how many embarrassing moments I’ve created for myself, I should reveal my sugar levels, how much exercise I’ve done and what I’ve eaten. But I’m trying to be less obsessed with numbers when I don’t need to be, so I guess I won’t be quite as clever as Bridget (and I won’t be ripping off Helen Fielding either).

I debated on which topic to start with, since there are several I want to cover, but when it came down to it, I’m going with the one I feel most strongly today—and that’s probably how I’ll go from here on out. Do what I feel.

And today, I’m feeling guilty.

Actually, there’s a lot of days I feel guilty. Guilty that I didn’t exercise. Guilty that I ate too much. Guilty that I ate the wrong thing. Guilty that someone else saw me eat something they think I shouldn’t be eating because I’m diabetic, even though it may be okay. That last one is the one that gets me the most.

I’m one of those people who says they don’t really care what other people think of them. I wear green rubber boots with striped socks if it’s wet outside. I wear high-waisted pants with shirts tucked in and those same green boots to garden in my backyard. I slick my hair back in a ponytail if I don’t feel like washing it and I generally say what’s on my mind, even if other people don’t agree with it. I’m mostly a free spirit, but with a little less hippy and a little more yuppy (although I really hate that word). So it surprises me when I feel guilty because of what other people think—especially if they don’t have the correct information to be thinking it. And especially, especially, if I don’t have any proof that that’s what they’re actually thinking.

I work in a small office and everyone knows I’m diabetic. And while they’ve seen me with smears of blood on my arm from testing my sugar, I’m not sure they know much else about diabetes. There’s a small bakery in a popular mall across the street and every now and then, when I can’t get my sugar levels to stay up or I’m just having a really serious craving, I’ll go over and order a piece of carrot cake and sit at the little green table and eat it. And when I do, I feel like I’m constantly looking around to see if anyone else from work is there and watching, and wondering why I’m eating cake when I have diabetes. It’s almost an instinct to have an excuse forming in my head as soon as I pull out the chair. “I’m only eating half.” “My sugars are really low today.” “I skipped part of my lunch so I could eat this.” I feel guilty. I even have to remind myself sometimes that there’s no way the strangers around me can possibly know I’m diabetic, and they don’t care that I’m eating carrot cake with cream cheese frosting. I feel guilty.

And if I’m with people who know a little more about me and my “dreaded disease,” I actually give them the full explanation of why I’m eating dessert (“I’m allowed to; it’s all about moderation and carb counting.”), or why I’m not (“I ate bread before dinner, so I have to skip dessert.”) I feel I owe them an explanation so I can relieve my guilt.

Maybe I’m like a spouse who’s cheated. In the movies, they always want to get it off their chests, to make themselves feel better by telling the one they love that they’ve done something wrong. Maybe I tell people so I won’t feel so guilty. But really, truthfully, honestly, no-holds-barred—it’s none of their business. And the people who actually do know me and do know my disease trust me implicitly to know when I can and cannot eat and what I choose to put on my fork. They know I’m in control.

They just don’t know how guilty I am.

As always, more to come…

Friday, April 4, 2008

The Numbers Game

Okay, so here’s the big explanation in case you need the info, the deets, the 411 (I’m down with it, just like my 15-year-old niece who would be mortified at my usage of this language). How about we make it easy for both of us and I do a mini-glossary to begin with? And please keep in mind I am in no way a medical professional or qualified to give medical information or advice. This is just what I know and how I know it.

Type 1 vs. Type 2: If you have Type 2 diabetes, that means your pancreas produces some insulin, but not enough, or your body doesn’t know how to process it properly. If you have Type 1 diabetes, that means your pancreas doesn’t produce any insulin at all. I have big, giant, humongous issues with people confusing the two (as always, more later). I am a Type 1 diabetic; everything from here on out, through eternity or the life of this blog, will always reference Type 1. If you’re Type 2, sorry—get your own blog.

Insulin: What I need to stay alive. Since my body doesn’t produce it naturally, I have to inject it myself. Please note that insulin is not a cure for diabetes, it’s a way to help control the disease so it doesn’t get out of whack. There is no cure for diabetes, although I keep reading that scientists are working on it. And while insulin keeps me alive, it can also kill me. (See Low Blood Sugar below).

Lantus: This is the type of insulin I use. I take an injection once a day, at night before I go to bed. While there are some people who use Lantus insulin in conjunction with other types of insulin, I only use Lantus. My doctors are amazed that I’m able to stick with just this, but it’s not a fluke—it’s me, doing a heck of a lot of mathematical wizardry. (You’ll see what I mean if you keep reading.)

Blood Sugar Measurements: The way I know how my diabetes is in check or not is by checking my blood sugar. I do this with a meter. First, I prick my arm with a lancet (a needle on a spring-loaded device) and get a drop of blood. Yes, I do my arm; I have a meter that can measure my blood sugar based on the blood in my arm (Freestyle—can’t live without it). The traditional way is to prick your fingers, but this hurts much worse and I can’t handle doing it. The blood goes onto a flat stick that’s already been put into my meter, and the meter whirs for a few seconds and gives me a number. That’s the number that dictates everything on a day-to-day basis. I check my blood sugar levels first thing in the morning, before I exercise, after I exercise, about four other times during the day, and right before I go to bed. I should point out, though, that the finger-prick, as opposed to the arm prick, gives you a more accurate, up-to-the-second reading; I do do the finger-prick when I'm low and need to know a real, true, undiluted number (although the difference is usually only a number or two for me, ie: 68 as opposed to 70). The number is either too high, too low or just right…

High Blood Sugar: If my blood sugar is too high, that means I’ve eaten too much, I’m stressed out, I’m sick or about to be or I’m about to get my period. If it stays too high for too many days, it means I’m not giving myself enough insulin. If my numbers are always high, and they never go low, and they’re high for years, it can cause complications—nerve damage that leads to amputations, blindness, death (yes, I truncated here, but isn’t the word “death” enough to get my point across?).

Low Blood Sugar: If my blood sugar is too low, that means I haven’t eaten enough, I’ve exercised or been excessively active without checking my sugar before I did it or I’ve given myself too much insulin. If I go a little too low, I get grumpy and irritable. if I go a little more too low, I get spacey and a little jittery and have to drink juice immediately to bring my blood sugar back up as quickly as possible. If I go lower than that, I can go into a coma and die. (Die, just a nasty a word as death.) That’s why my insulin can also kill me (see Insulin above).

Just Right Blood Sugar: Like I said, I like to take tight control and just right for me is between 110-120 two hours after a meal (I prefer closer to 110), and 70-85 before a meal (I try not to go too far below 75). All the other times of the day it’s either working toward the 110 or coming down from it.

Carbohydrates: My blood sugar levels are for the most part based on the carbohydrates I consume. Since I only take Lantus and it’s a once-a-day thing, I’m stuck with the numbers I get on my blood sugar meter—there is no opportunity for me to give myself a little more insulin if I want to eat more carbohydrates. To make sure that my carbohydrate intake and my insulin are matching up properly, and that my blood sugar levels remain in the “just right” category, I do what’s called “carb counting.” For every 15 grams of carbohydrates I consume, that’s considered one carb unit. After much trial and error, I know how many carb units I can eat for breakfast, lunch and dinner to make sure my blood sugar levels stay sane.

The Numbers Game…
Here’s where the balancing act comes in.
Insulin: Now, if I’ve been running consistently high for a few days, I up my insulin dosage by a fraction and wait a couple days. If my blood sugar lowers back to an acceptable number, I keep the insulin at that. If it’s still high, I up my insulin dosage by another fraction and wait a couple days. Same goes for if I’m consistently running too low—I keep lowering my dosage by a fraction until my numbers are back to normal.

Carbohydrates: If I check my blood and it’s supposed to be higher, I eat something with a carb unit value (ie: a container of yogurt, a glass of milk, half a Nutrigrain bar, a small banana, about 10 mini pretzels). If I’m hungry and I want to eat something when it’s not time for me to eat, I check my sugar. If it’s low enough, I eat. If it’s not, I either skip eating, or I eat something without carbohydrates (low-fat cheese, pickles, mushrooms, salad—the pickings are slim).


Sounds simple, right? But then, you have to take in effect that different foods affect different people different ways. For example, if my sugar is low and I eat grapes, they’ll give me a higher sugar level about an hour later. One hour after that, though, and my sugar will be right back where it started. I know other people who don’t have this same effect with grapes at all. The whole thing is trial and error. I eat something new, I take my blood sugar to see how it affected me; I do this a couple of times with the same food and come to some kind of conclusion about it.

I also have to take in account the time of day. My sugar tends to run lower in the morning, around 11am. It also tends to run higher at night, around 10pm. I also figured this out by trial and error, and lots of blood sugar testing.

I also have to take in account my physical activity. Riding my stationary bicycle barely registers a blip on my sugar level radar, but walking on the treadmill for 15 minutes can lower it instantly. I’ve also been gardening in the back yard when all of a sudden I felt pale and jittery and had to drink juice, then eat. The only way to work this one is to check my sugar right before I do the physical activity; if it’s under 100, I eat something before I go, go, go. I also check right after to see if I need to eat again because I’ve gone too low. And if I feel “funny” during the activity, I stop and check to see if it’s my sugar levels.

Then there’s all the other things: stress can make my sugar high; headaches can make my sugar high; if I’m about to get a cold, my sugar will go high before I even have my first sniffle. And there’s the unseen things: for no known reason, my sugar will spike high, or dive-bomb low, even though I’ve done everything right. And I don’t know what caused it and most likely never will. (And trust me, I spend hours analyzing what I've done that day, what I've eaten, how much, and every other possible factor with the exception of the tide and the moon, although now that I'm writing that, I wonder...)

And all of this, all of the above, I think about and calculate at least four to five times a day. It’s not that it consumes me, it’s just part of my life. It’s re-tying my shoe automatically when it comes undone. It’s picking dog hair off my sweater absent-mindedly while having a conversation. It’s testing my blood sugar at a stoplight while driving. It’s a conscious effort and it’s a non-aware measure. I’m always thinking about it and doing the math, but not often stopping to acknowledge that that’s what I’ve just done. It just is.

As always, more to come…

First off...

First off, why call it “the diabetes”? It’s a joke, if you will. I’ve heard people, mostly the older generation, or those who don’t really know about it, call what I have “the diabetes.” I suppose it’s no different from saying, “I’m going to the market,” as opposed to, “I’m going to market,” but for some reason, it strikes me funny. And if I can’t find humor in being diabetic where I can take it, then what good is sticking needles into my body every day? (No shock value intended.)

So why blog about it, when there are already people blogging in the diabetic world? Because they’re not me, and they don’t share my experiences. While I have the same worries and concerns as a lot of other people with diabetes, I’m also very in control of mine. I’m very (put that in capital letters, italicize it, bold it, surround it with a bevy of exclamation points) in control. I make myself be in control. Numbers are everything in my world (ironic, since I consistently failed math in elementary school) and I let them rule my actions quite frequently.

Not diabetic? Diabetic and don’t know all the details of my life? I’ll post another blog shortly that explains the ins-and-outs of what those numbers are and how they affect what I also refer to as “the dreaded disease,” (yet more strange humor). If you already know, then you can skip it and just read everything else. I hate to bore others with numbers when they don’t need it (I only wish my teachers had given me the same option. Seriously, I don’t use algebra in my daily life.)

As always, more to come…