Monday, December 15, 2008

To reschecule or not to reschedule....

....that is the question.

I had to cancel my endoc appt. 2 wks ago due to a stomach bug, and have yet to reschedule it. I guess there are two components to my reluctance. First, I have the feeling my A1C will not be stellar. I'm always thinking that though, and am usually pleasantly surprised with the results. So the bigger factor is that I still feel like I don't get much help from my endoc other than ensuring a signature on those prescriptions.

When I mentioned to a friend at church who is a nurse that I had to cancel my endoc appt and mammogram last week, she got this worried look on her face and said something like "Oh, wow, that's not good, will you be OK until you can get in to see your endoc?". A nice well-meaning question, but pretty far off target. I replied, "I've been at this a long time, and really the endoc doesn't tell me much I don't already know." Probably sounded arrogant, but it's true.

Last time, I asked him for help in avoiding lows while running. He said I could fax him some numbers and handed me a worksheet with blanks for only before and after meals, no space for a pump basal rate, etc. I asked if I could send him a spreadsheet instead that included room for more testing, carb intake, etc. surrounding exercise, and he said they preferred all patients to use their (totally inadequate) form. This really should not upset me that much since I have a history of not doing a very good job of logging anyway. But it was just a sign of being alone in managing my diabetes, and has rattled around in my brain since then. Were it not for this wonderful online community, I would feel very alone with it indeed.

On the plus side, he did suggest I look into CGM's, and would likely be willing to help me get one. He was also very helpful when I had a pump malfunction that required me going back to shots for a little while. I'm probably looking for too much in a doctor, and this one isn't bad. So I guess I just need to book that appointment. Maybe I'll call...tomorrow.

I'm also curious...how many of you feel that you genuinely get help with your specific issues from your endoc/diabetes team? Am I expecting too much?

Thursday, September 11, 2008

Am I Borg?

Had a weird dream last night. I was on an elevator with a bunch of strangers when I realized that my infusion set was in my cheek. No, not THAT cheek, the one on my face! It was the same feeling as the "realizing you are naked at school" dream. So what does this mean? Do I secretly want to be a member of the borg collective? Or could it be that I still feel self conscious about my pump? Or is it that I think it might be better if others had to truly come face to face with at least one reality of diabetes? It really is a hidden disease in so many ways, even for those of us who are pretty open about having it. How about you? What weird D related dreams have you had?

Monday, August 11, 2008

Multitasking

Multitasking is a way of life. I ususally blame that on e-mail, voicemail, blogging, cell phone, blackberry, and other technological "advances". But I realized this morning that it has invaded my site change routine. While changing my set and cartridge, I also brushed my teeth, applied base makeup, and worked some conditioning cream through my hair. You know, there are those pauses while the pump realizes you've pulled out the old cartridge, and while the new cartridge is loading. Perfect time to trim your nails.

So is this odd? Do you multitask as you are changing out your set/cartridge? What things do you accomplish amongst the whirring and beeping of a cartridge loading?

Tuesday, July 1, 2008

REQUEST FOR CGMS: DENIED BY INSURANCE



I didn't ask to have to worry about whether I will go low when I go for a run or even a walk, go to sleep, or God forbid, while I drive. I keep my blood sugars higher than recommended sometimes because there are so many unknown variables and the lows are debilitating. In case you are wondering, it's not a simple case of counting carbs and taking the right insulin doses. There are hormones, activity levels, and stress to try to "quantify", which is of course impossible. That is where a CGM could really help. Since we cannot account for everything, the best we can do sometimes is react to it. A CGM will help us to react faster, and to avoid the short term disaster of a severe low behind the wheel, as well as some of the long term damage that our bodies are racking up due to BG's that are too high as we try to avoid those lows based on as many test strips as we can afford. It would also help me to not lose heart in my battle to remain as healthy as I can.
My doctor suggested I look into getting a CGM, but so far I have found that I cannot afford it. Aside from the initial outlay for the device, the ongoing costs are roughly $400 per month. Trust me, I have no desire to wired up like a cyborg with my insulin pump and yet another device. But it is difficult to know that I cannot afford to come one step closer to a normal life. I don't know whether to address this to the insurance companies, the CGM manufacturers or our government, but I sincerely hope that all of them will hear our plea.

Wednesday, June 25, 2008

I Just Might Make It

It seems like a long time ago that I signed up for the Diabetic Runner Challenge (see emblem on the lower right side of my BLOG). The challenge was to run 500 miles this year. I know the emblem says 1000 miles, but I picked the wrong emblem :(.

The last 6 months has not been a stellar time for me in terms of logging a lot of miles, but I did enjoy a few 5K's in the spring with progressive personal records, and have been doing a few shorter runs per week. Now it's mid-year, so figured I'd check my mileage total. Total miles logged on my Garmin....284. Woooohoooo, I just might make it!

Wednesday, June 11, 2008

Keep on Keepin' On

Is it just me, or have others of you searched the news from the ADA conference looking for something to get excited about and come up lacking anything of substance?

Don't get me wrong, I'm so grateful for the tools that I have to manage my diabetes and realize how far things have come. I'm also grateful for the researchers who take a long term view and are patient enough to conduct their studies. But taking a shorter term view, say of the last 5 years, I just don't see anything that changes the way I LIVE with this disease. None of the studies and none of the devices. There still is not a closed loop pump/monitor. Continuous glucose monitors are not finding favor with insurance companies. There is continuing debate about the costs/benefits of tight vs. supertight control of blood glucose. I'm still not sure if the variability of my BG or the average is more important in preventing long term complications, and I don't know if it's more important to avoid the lows (other than to make myself not feel horrible in the moment and avoid passing out). I exercise because I like the way it makes me feel, but still don't know if the surrounding BG excursions do more harm than good. I haven't even seen meter sizes shrinking to smaller than my current Flash, or a pump that makes it worth ditching my Cozmo.

I guess I'll just keep on keepin' on! I'll admit I haven't read everything that has come out of the conference, so maybe I'm missing something big. How about you, anything coming out of the conference going to change the way you LIVE? Maybe I'll ask my endoc the same thing tomorrow.

p.s. I almost forgot, I did like the study that suggested it might be a good thing that I have gained a little weight since diagnosis. Still don't find it to be particularly useful though.

Monday, May 19, 2008

Walking Barefoot on the Beach

Hubby and I just returned from a beach vacation in Destin, Florida. It was absolutely beautiful, and we had a wonderful time just relaxing, enjoying each other and doing "beachy" things. We were also celebrating our 20th anniversary. I cannot believe I've been married to the most wonderful guy in the world for 20 years!

The sand in Desitin is a beautiful white and almost looks like snow, and the water ranges from turquiose to emerald to blue depending on the depth and the weather. So splish spashing our way along the beach together was a favorite passtime. I felt like such a rebel because I walked (shhh...don't tell the diabetes police) BAREFOOT every day in the sugar white sand. Yes, I realize that I was literally risking life and limb to do this, but sometimes you just have to throw caution to the wind. Hubby even got a little cut on his foot, but I continued in my daredevil ways. Some people parasail, some surf, and some swim with sharks, but I rubbed my toes in the sand, dagnabit!

It is amazing though, how much I thought about it. How lame is it that it was this big daily conscious choice? I'm also a "food tourist", so ate all sorts of hard-to-bolus-for things. Again, I enjoyed every moment of it, but thought about it a lot, puzzling over the carb counts and fat delays.

What would we do with all that mental energy if we didn't have diabetes?

Tuesday, February 19, 2008

Diet Matters

The ole BG logging truck is definitely broken down and on the side of the road. That's the bad news. The good news is that I'm logging Weight Watchers points instead. Hubby is doing the online version, and I'm doing my own Excel worksheet version. I've been inspired by many of you in the OC who are losing weight with Weight Watchers. I lost 10 lbs with them a few years ago, and....ahem...need to re-lose at least those 10 again. After one week, hubby lost 5 lbs and I lost 3. I'm pretty sure that's the most weight I have ever lost in a week!

It is definitely making a difference in my BG's. I pulled the numbers out of my meter for the last week and here they are:

Average BG 108
Standard deviation 46%
41% in range, 39% low, 20% high

The number of lows is not acceptable, and I'm tweaking my ratios to try and get a handle on that. It's a little concerning since my BG upon waking in the morning has been in the 40's for 5 of the last 7 days. Not a good way to start the day!

On the job front, I'm starting a part-time, work from home accounting job tomorrow, and really looking forward to getting started. Pet sitting has picked up a bit as well, and I met with a really nice new client last night. Actually, all my clients are great. People who love their animals just tend to be my kinda people. Best of all, I found out last week that a new satellite church is opening soon in our area. The pastor and his wife were both used by God in my introduction to Christ, and my husband really respects them as well. We are both interested in helping with the new church.

Monday, February 4, 2008

Logging for Superbowl Week

Superbowl Sunday was pretty fun this year, even without the Cowboys. Our family came over to watch, and we had some bad-for-you football food. I made Sloppy Joe's w/ lean ground turkey and Rotel Dip w/ a little sausage thrown in. Can you guess which one we ate more of? We didn't even make the attempt at putting out a salad or veggies. And why is Rotel Dip so addictive anyway? Had a post meal high of 227, but brought that down to 117 by bed time. I did spend much of the day raking, mulching, and pulling weeds in the back yard, so maybe that counted for something.

As for logging, I'm sorry to report another not stellar week of keeping up with it. I did log my blood sugars, but mostly a day or two after the fact. At that point, it seems too difficult to remember what I ate or when I exercised, or to pull the bolus amounts out of my pump history. The only way I'm going to keep up with it is to do it at least daily. Here are the results. They highlight why my A1C comes back better than I think it should. I'm all over the place, but the average is decent. That "normal range" sure is slippery to hang onto! Guess that greasy Rotel Dip (and the chips) didn't help! Is anyone else willing to share their standard deviation with me? I know we're all different, but I just wonder how out of line mine is in comparison w/ other "living real life" Type 1's out there?

Avg BG -- 171 (wk1), 161 (wk2), 140 (wk3), 156 (wk4), 141 (wk5)
Normal Range -- 25%, 43%, 40%, 34%, 34%
High -- 64%, 49%, 40%, 56%, 48%
Low -- 11%, 8%, 20%, 10%, 18%
Average Daily Standard Deviation -- 64, 65, 62, 55, 62


I did get my resume updated, contacted my references and other contacts, and even got a little action on a couple of jobs I sent in for last week. Took a while to get myself psyched up, but I'm starting to get a better feeling about being able to balance some part time accounting work with pet sitting jobs, and still maintain some lifestyle flexibility. I have a phone interview this week w/ a local firm who wants someone part time with a home office set-up (check), one of my former employees may want me to do some work for his family's business, and I have lunch set up with my old boss who may need me to do a little contract work for the old job AND have a pet sitting job for me. May also help a friend with a team photo shoot and the related processing, which would be fun. All of this is rather preliminary, so not counting my chickens before they hatch, but it's at least encouraging. This free-flowing work life thing is still new to me, and part of me loves it. The other part still obsesses about making the right choices, how much to charge, how much work to take on, etc.

Monday, January 28, 2008

Wheels Off the Logging Truck

Confession time. My logging for last week stopped on Wednesday. It wasn't really a conscious choice, and at first, I wasn't sure why. But it just occurred to me that I had a couple of fairly stressful events around that time. They are not valid excuses, but do give me some insight into why I might have fallen off the logging wagon.

First, on Tuesday, I was out jogging with my dog Katy, a medium sized mutt. We had barely started running when a loose Boxer approached us. I thought things were going to be OK and they were going to be friends, but then another Boxer came tearing towards us and immediately jumped on Katy. He was twice her size and the fight was no match. A man out in the yard thankfully ran over and pulled him off of Katy fairly quickly. I checked her over quickly, and thought she had emerged unscathed. Then, the next day (Wednesday), I found a nasty looking gash on her neck/chest area.

It was somewhat obsured by her fur at the time, but I still can't believe I missed it. So off to the vet for antibiotics. It was already slightly infected so they didn't want to sew it up. Think she'll be OK, and the boxers' owner has agreed to pay the vet bills. But it was obviously upsetting, and also emotionally difficult to summon up the courage to confront the owners about the vet bills since I didn't discover the wound immediately.

Second stressful event was that hubby and I had agreed that I would look for some part-time accounting work since pet sitting is really slow this time of year. This is hard because it sort of feels like I'm giving up on pet sitting, even though I know that doesn't have to be true. At bible study on Wednesday, I mentioned that as I was chatting with my discussion leader after class. She then suggested I meet the Finance Director at the church as they had a need for someone on a part-time basis to analyze stats, giving trends, etc. We discussed the opportunity and I told her I'd consider it. It was totally out of the blue, and I had to do some serious praying and soul searching to see if that was something I should pursue. Although I have seen lots of confidential financial info in my career and learned not to let it impact my attitude, I have not done so for a church. I'm not a member of this church, just go to a ladies' bible study there. Although it did not shake my faith in Christ, my previous church had a serious financial scandal that rocked my confidence in churches being good stewards. Giving is an area of challenge for me right now, and I've always hated the constant touting of membership numbers etc. that is prevalent in many churches. So I opted not to pursue that job.

Meanwhile, back to the point of this post. It would seem that spiritual and emotional struggles impact my staying on track with logging. I had plenty of time to enter everything in my log, but apparently I am still really struggling deep down with not spending too much emotional energy in facing those numbers on a daily basis. I thought I was cool and analytical about it, but there is more to it than that.

At any rate, what I DID learn is that NOT logging also has an impact, and it's not so good. Even though I didn't log, I did go back and catch up on entering my BG's to see the overall trends. See the week 4 numbers below.

Avg BG -- 171 (wk1), 161 (wk2), 140 (wk3), 156 (wk4)
Normal Range -- 25%, 43%, 40%, 34%
High -- 64%, 49%, 40%, 56%
Low -- 11%, 8%, 20%, 10%
Average Daily Standard Deviation -- 64, 65, 62, 55

Monday, January 21, 2008

Log Blog Update

I'm proud to say that I have completed my third week of logging after a lengthy vacation from recording any D related numbers. Acutally, it was more like a sabatical since the time span was measured in years, not days. So remind me, how long does it take for a habit to become ingrained? Am I getting close?

It would seem that just by virtue of putting it all down in the spreadsheet, my control has gotten a wee bit better. But as with other aspects of D, even that picture is not clear. The first couple of weeks I was battling the cold virus that kept on giving, and my exercise level was below my norm. The third week was closer to a normal week in that regard, but came with its own hormonal challenges. Nightime went from being my worst time period, to my best time period. I do see some consistency in a spike after breakfast, so will try a little bigger boluses to see if that helps there.

Avg BG -- 171 (wk1), 161 (wk2), 140 (wk3)
% Normal Range -- 25%, 43%, 40%
% High -- 64%, 49%, 40%
% Low -- 11%, 8%, 20%
Average Daily Standard Deviation -- 64, 65, 62

Weight watchers has got it goin' on in terms of group support and accountability. When you're struggling, you can show your food log to your leader, and he/she will give you some pointers re: drinking more water, eating all your points, low point snacks, etc. Wouldn't it be cool if we could have group meetings like that....maybe something called "Glucose Watchers"? Fortunately, we have each other here in cyberspace, and for that I am very grateful.

Monday, January 14, 2008

Gentle Flow Logging

I've been at it again...logging my blood sugars, carbs and insulin doses for a second week in a row. This could be habit forming, at least I hope so. Had a major relapse of my cold, so my activity level was way off, but since I promised myself no judgements about the numbers, I continued to enter every number. This week showed a slight downward trend. Avg BG was 161, 43% in range, 49% high, and 8% low, with a standard deviation of 65. Still not ready to make any adjustments until I resume my normal exercise this week.

Speaking of exercise, I went to Gentle Flow Yoga class for the second time ever today. I'm still trying to figure out how twisting my legs up like a maimed pidgeon, posing as an insecure, trembling warrior, and sticking my butt up in the air to impersonate a dog can be considered gentle. I'm officially convinced that I must be the least flexible woman on the planet. The only other folks in the class who seem to struggle as much as me are the guys. I know it's not good to compare myself to others. Surely that is interrupting the gently flowing-zenlike-warrior-pidgeon-depressed-dog energy that I'm supposed to be generating. But sheesh, a girl needs something to do while taking breaks to avoid a full body cramp.

Monday, January 7, 2008

I Did It! I Logged for a Week!

Wow, I actually did it! I logged for a week. And I did it without any judgements about me based on my numbers. I was sick for much of the week (cold), and even though I knew that would probably make for a pretty lousy week blood sugar wise, I logged anyway! I'm going to gather another week of data (sans the cold) and then see about making some adjustments to my pump settings. Results for this week were: Overall average 171, 25% in range, 11% low, and 64% high. Weekend average, after I was mostly over my cold and back to a more normal activity level, was 135. Overnights seem to be the largest problem area for highs thus far. More next week.

Wednesday, January 2, 2008

2008, Year of the Log

No, not hog, log! Not a Yule log, or another log on the fire, or a logarithm. You know the kind of log I'm talking about. Yes, I know it's kind of lame to do the new year's resolution thing, but I've got to start somewhere. So start yesterday I did.

Goal is to calmly log my bg, carbs, and insulin without judgement or stress. Just log them and that's it. No good or bad numbers, just numbers. Log now, analyze later. Just do it! And use whatever prayers and motivational slogans I can to get those numbers in that log. It's been a LONG time since I did this. I test regularly and bolus accordingly, but logging has eluded me like a greased pig! OK, so maybe this does have something to do with a hog afterall.

I have been dancing with denial. I have focused on exercise, but ignored the fact that my blood sugar swings have gotten worse, not better. I have focused on training for a half marathon, but gotten really sloppy with carb counts. Treating lows has gone from glucose tabs only to whatever I can chow down on and then some. I can see now that I have been trying to distract myself from focusing on the one thing that is probably most important health wise....proactive diabetes management. So here's to 2008, the year of the log!