Progress Trumps Perfection

Emergency Brake

2011-03-21T19:15:00.000-07:00

Have you ever pulled out of the driveway, and realized you had the emergency brake on? The car goes alright, and maybe even quite a distance before you notice it, but it's slow and sluggish.

Well, that's how I think I've been approaching my athletic endeavors. Yes, I've been pulling out of the driveway, and even getting onto the road pretty often, but not doing everything I can to achieve. So I decided this is the year that I take the brake off. I finished my 3rd 1/2 marathon in late February, and am moving on to a goal of one triathlon a month for the next 6 months. Instead of ignoring the orthotics with a hole, and the IT band pain that has been with me off and on for the last couple of years, I have sought out professional help for each issue (no, not that kind...at least not yet :) ). I replaced my mountain bike with a road bike that is more appropriate for triathlons. I've joined an online mentor group, and ask lots of questions. Oh, and yes, I am training consistently, and hopefully getting a little smarter about it along the way. I've dropped 8 lbs since mid December, and it's gotten easier instead of harder to eat well.

I don't know why I have not done these things before, but there is just been this underlying fear of really going all in, or that I somehow don't deserve the resources to help me along the way. I'm sure there will be bumps along this road, but it's just a different attitude of tackling them instead of hoping they will go away. So no more burning up the emergency brake!

The Value of Acknowledgement

2011-01-26T08:43:00.000-08:00

I went to a new podiatrist this week for an opinion as to whether my orthotics and shoes were right for me. Long runs have been causing me some pain, and I'm trying to be proactive about it instead of waiting for a total breakdown that makes me scrub my goal of my 3rd half marathon. So I found one who is about my age, and training for her first ironman. Based on my experience with other non-endoc medical professionals, I wasn't expecting a whole lot with regards to diabetes understanding.

We got to that inevitable question..."So, how is your diabetes?". I proceeded to tell her "decent...A1C usually around 6.5, slipped up to 7.0 last time but working on it". The next thing she said was music to my ears. "Well, it can always be better, but that's actually pretty good for a T1. I know it's a really difficult thing to manage." It was those last words that got me. I just don't hear that much except for the DOC. It means so much for someone else to simply acknowledge that it is difficult. No advice, no second guessing, no dwelling on the issue, just acknowledgement of what is a fact.

I hope I can apply that to being a better friend to others.

Speechless

2010-11-10T12:27:00.000-08:00

I've read lots of great posts lately about educating and advocating. I just can't figure out how to do that when I'm speechless. Today at a work luncheon, small pieces of toffee were passed around for us to sample as a potential client gift. I had one that measured maybe 1/2 an inch, and the lady across the table from me looks at me and says very loudly...."You can't eat that!". She then proceeds to tell everyone at the table "She is diabetic!" Then she turns to me again with a scowl on her face and says "You're cheating!!!" No, she wasn't joking. All I could manage to get out was "I take insulin so I can eat. Here's my pump (pointing)". I knew that anything I could say would be useless in convincing this lady of anything. One of my co-workers nodded and shot me a look of understanding and encouragement, and I frankly think the rest of them were as dumbstruck as I was. So perhaps staying silent was the best thing I could have done so that her rudeness could just echo in the conference room without interference. I have the urge to send her some educational material about diabetes, or perhaps an excerpt from a few of the wonderful "6 things" posts that you guys have written, but I doubt it would be worth the effort.

It's Not Always the D

2010-07-27T06:47:00.000-07:00

I just returned from a run that dropped my blood sugar. Only down to 72, but in the middle of a run, that's not the best place for it to be. So I choked down 4 glucose tabs, swigged some water, and continued on. Not the best run, but it's summer in TX, and the heat and humidity really saps me. When I got home, I took off all my gear (fuel belt, Ipod, etc.) as usual. Then I noticed that I could not hear well out of my right ear. Sort of felt like it was under water.

So I start thinking, wow, this must be a new symptom of a low. As I got my meter out, I was expecting a 46 or something similar. But my blood sugar tested at 116, so all was well there. Then I start wondering if maybe I have some water in my ear from swimming on Sunday, or maybe I turned my Ipod up too loud, or maybe this is a residual symptom of an earlier drop in blood sugar, or.....???? Finally, I reached up to feel my ear and realized that the spongy earbud cover from my ipod had come off and stayed stuck in there. Had to just laugh at that point. Talk about overlooking the obvious! I hate it when other people or doctors jump to the conclusion that everything going on with us is somehow D related, and there I went and did it myself!

Late to the Party

2010-05-14T05:44:00.000-07:00

I really wanted to participate in D blog week. You know, be a better citizien of the online diabetes community. But my "want to" got swallowed up in other aspects of life, and I didn't ever get around to it. Actually, that's not true. I wrote a post the first day, then promptly lost it. Anyway, I have really enjoyed reading everyone's posts, so I thought I'd try to catch up with an abbreviated version of the week's topics.

What is a Typical Day? - Although my A1C is decent (usually around 6.5), there is no typical day, and my standard deviation is not very standard. Diabetes tends to be randomly unpredictable, and also morphs over time. The trouble is, it's hard to separate what is day to day unpredictability and what are truly trends. That is especially true since I also have trouble making myself sit down to analyze the data. But either way, diabetes is always playing a tune, either in the background, or blaring into the foreground.

How to deal with lows? - Sometimes I'm very measured and disciplined with eating glucose tabs or a cliff shot block and waiting. Other times, I wind up raiding the pantry for things like cake frosting or molasses, and chase it with orange juice. If that doesn't make me feel better, but I know I've already overtreated, peanut butter is the ticket. I can't remember what my lowest low has been (upper 20's I think), but I have never passed out in 17 years with D, so perhaps I inherited the "no pass out" gene along with the T1 gene. My glucagon is long expired, so hope I don't need it.

Best Supporter? - That's easy. My husband is the absolute best at balancing loving concern with letting me handle it. I cannot tell you how grateful I am for him. I really struggle with letting non-D folks in on what it is really like living with D, and tend to put on a brave face with most. I also do that with family members who have overreacted in the past. But my husband sees my not-so-brave face, and still manages to stay balanced. Amazing!

Carbs? - Absolutely, in moderation. Nothing is off limits, but some things are not for the best. Keeping it to 45 grams per meal or less is what works for me, and I do that for most of the day. But I'm afraid my pump has given me a little too much license in the snacking department. My after dinner snack-bolus-snack-bolus fests are the bane of my control, but I have yet to chase that monster back into the closet. So total carbs have been averaging 165 per day of late. Still fairly moderate I suppose.

Exercise? - This is weird, I know, but I love it! Running, walking, and more recently swimming and biking. It's all good. It is an escape, a chance for my mind to wander, for me to pray, and to just feel alive. I love experiencing changes in the weather, and have been known to purposely run in the rain. I often take my most active dog along, and love to watch her senses come alive as we stalk squirrels, or she drops to the ground to roll in the cool grass. I've done lots of 5K's, a couple of 10K's, a couple of (very slow) 1/2 marathons and 1 triathlon so far. It's not easy trying to balance the insulin/carbs/exercise/all other X factors equation. Sometimes I fail miserably and wind up in tears as I cut a run short to treat a low. But part of the appeal of exercise is that feeling of transcending diabetes in order to do it.

Thanks for indulging my tardiness, and I look forward to reading more of everyone's posts.

Why this but not that?

2010-03-25T07:21:00.001-07:00

I work as a CPA, but do not prepare federal income tax returns as part of my work. Never have; I just don't want to specialize in that. Around this time of year, as April 15th approaches, lots of well meaning friends express concern about "how busy you must be this time of year". This is in spite of me having told many of them previously that I don't do taxes. I do not find this to be upsetting at all, and have plenty of patience and grace to extend to those friends, as I'm sure they extend to me on other things.

Contrast that with how I feel when those same well meaning friends make comments about my diabetes. You know what I'm talking about....things like "oh, I forgot, you can't eat that, can you?", or "you need to eat your lunch right on time, don't you?" That in spite of me having told them previously that Type 1 diabetes is not so much about what I cannot eat or when I eat (thanks to my pump), but about matching insulin with what I do eat and my activity level. Why do those questions still cause a flood of emotions, and leave me often reliving the comment long after it is made? I do my best to extend grace to those friends, and in my head realize it's unrealistic to expect them to remember much about my diabetes. But it's a battle to fight through those initial emotions to get there sometimes.

Both are sterotypes of sorts, but one leaves me feeling judged, and the other does not. How about you, have you found a dichotomy in how you respond to D related comments vs. comments about other aspects of your life?

Not a Flat Line

2009-12-18T17:30:00.000-08:00

This week I had my annual eye exam with the retina specialist. I thankfully don't need a retina specialist at this point, but figured it would be good to get to know a good one before I do. And it fulfills my annual oath as a person with diabetes to have the all important dilated eye exam. OK, so there is no oath, and I apparently turned it into a biennial kind of thing since they don't send out reminder cards and neither did my brain. But I digress....

The real reason for this post is the conundrum posed by the ineveitable questions posed by most health professionals to those of us who are pancreatically challenged. The first of those is "so, what do your blood sugars usually run?". This time I dodged that bullet by giving them my A1C of 6.5, which drew a "not too bad" response (is that like a 7 from the russian judge?). Then, the tech or assistant or whatever her title moved in for the kill..."so, are they pretty steady?", she queried. At this point, I couldn't help it, and just laughed. After I got that out of my system, I told her that "Type 1 diabetes simply isn't like that. Different days bring different challenges, and blood glucose is not always a flat line, so that is a very difficult question to answer. Today happens to be a good one, but a couple of days before that...not so much." Then a really good and unexpected thing happened, and she told me she has a friend with type 1 who says the same thing. Well, yippee, at least we are singing the same song.

Anyway, I'm not sure why those questions are so annoying to me, but they are. The tech was very nice, and our exchange was amicable, but I always feel icky after answering, like I'm taking a test with no correct answer. Basically, anyone who asks me things like that, other than my endoc or another person living with T1, just draws an automatic assumption on my part that they won't possibly understand a real answer. I have this desire to whip out a few weeks worth of CGM data and ask them to tell me "Can you define steady? Is this steady enough?". Maybe I'll do that next time :). Life is not a flat line, and neither is my CGM graph.

First Triathlon

2009-10-25T16:16:00.000-07:00

Monster Triathlon Race Report (300 meter swim, 12 mile bike, 3.1 mile run)

A good friend and I finished our first triathlon this morning, and had a great time doing it. I still don't know our time, but I'm sure it wasn't particularly fast. Had lots of time to get nervous before the swim, with 750 of us lining up (sort of). Nice big pool with 50 meter X 8 foot lanes, and after waiting about 45 minutes for our turn, my friend and I were able to start one right after the other. We actually passed a few people! Considering that both of us were freaked out about just putting our faces in the water only a few months ago, we did pretty well. We did get held up behind a couple that missed the memo about staying right unless you are passing. They insisted on staying side by side, taking up the whole lane. While she attempted to breast stroke and side stroke, he swam along shouting encouragement whilst not letting anyone pass. Tried the left, no good, tried the middle, and they closed ranks, but finally got by! Other than that, our swimming fears have been laid to rest, and the swim was my favorite part of the whole thing, even though it was the part I dreaded. Go figure!

T1 was fine, and thanks to the volunteers, I didn't miss the timing mat on the way in like I tried to. I didn't test, and my CGM had not "found iteslf" by the time I started. The bike leg was good, but pretty hilly and quite windy today, so a bit tougher than we anticipated. Two loops, so we knew what we were in for the 2nd time around. We were both riding our mountain bikes, but managed to actually pass a few folks on spiffier bikes. Heard a high blood sugar alert from from my continuous monitor early in the bike ride, so knew I didn't need any carbs.

Before the swim, my BG was 181 and supposedly dropping. But by the time T2 came, it was at 340. Adrenaline + going anaerobic on the hills + being disconnceted from my insulin pump waiting to swim + plus the beginning of a cold = not a good combo for that. So I need a new plan for next time to at least replace the basal insulin I missed during the swim line up and swim.

Between that and the harder bike ride, the run pretty much sucked for me. Back tightened up like never before, and I had to stop to stretch it and walk a fair amount. My friend stuck with me, but I kind of wish she had gone on so I wouldn't feel bad for sucking AND holding her back. I think it was something like 34 minutes for the run/walk we wound up doing. It was her turn to come in ahead (long story), so I encouraged her to go ahead for the last 1/10th. I managed to run in the last 1/2 mile or so looking reasonably strong, and raised my arms in victory crossing the finish line.

Cool finishers medal, and nice long sleeve orange and black tech shirt to complete the halloween theme. Awesome support from our husbands, who carted our extra "stuff" around, took pictures, and put up with our pre-race nerves. My mom even came to cheer us on . Would I do it again?....yep....but not right now!

The Hay is in the Barn

2009-10-20T08:16:00.000-07:00

This Sunday I'll be attempting my first triathlon. It's a relatively short one, with a 300 meter swim, a 12 mile bike ride, and a 3.1 mile run. This will be a fairly light workout week leading up to it, since the training I have already done is what matters physically. It's been a bumpy ride during the 12 week training program, with a 2 week cold/flu thing in weeks 4 and 5, being a few lbs heavier than I'd like to be, and now a tear in my right arch. As of today, I think I'm reasonably ready to complete it, though perhaps not as well as I would have hoped initially.

The training has consisted mainly of doing either a swim, bike, or run 5 or 6 days a week. On some days, I've put together biking and swimming, and on a few others, biking and running. But Sunday will be my first time putting all 3 together. Although that's fairly normal in preparing for a first triathlon, it leaves me with some lingering questions as far as BG management. I'm hoping my CGM will be in synch come Sunday so I don't have to test in the middle of the bike ride, but it may come down to that. I've had a couple of episodes lately where the CGM trend totally misled me. The swim is so short that testing after that in T1 won't do much good, and after the bike ride in T2 will be too late for any carbs I take in to do much good. I'll just have to play the CGM game by ear and hope for the best.

So I'm reminding myself this week that: "Many are the plans in a man's heart, but it is the Lord's purpose that prevails." (Prov 19:21). I've trained with a good friend who will be racing that day too, and our friendship is stronger and deeper as a result. My awesome husband will be getting up a 0-dark-thirty with me so he can support me and hand my pump back to me after the swim. God willing, all will go the way I would like it to, but if not, it will still be alright, and there is purpose in that too.

CGM Jury Still Out

2009-07-30T10:21:00.000-07:00

Thanks so much for the comments on my last post. In spite of a power outage that caused some bad hair this morning, I went to my Endoc appt today. I received the results of my first A1C after starting on a CGM two months ago. He does the quickie in office A1C test, and has even moved the machine that hums and whirs to produce that magic number into the exam room, which leaves me with sort of a Magic 8 ball type of feeling about the whole thing.

A1C six mos ago was 6.5, and today it was 6.6. I've bounced between 6.3 and 6.7 for the last few years. So is the CGM helping? I think the jury is still out. I know I like being able to see what's going on, and that I'm less hesitant to make changes, but I think a little less talk and a little more action (thanks Elvis) are in order. Got a couple of suggestions from my endoc that will hopefully help get my overnight #'s in better shape, and he offered to help me troubleshoot between appts if not.

I also have to realize that over time, my body changes, and sometimes just staying the same is a victory. I'm in my 40's, have put on a few unwanted pounds in the last few months, and have seen, but not wanted to acknowledge, that I'm not quite as insulin sensitive as a result. Denial is a many splendored thing. So I'm crankin' up the juice a little more and we'll see what happens.

The A1C after the CGM

2009-07-29T10:46:00.000-07:00

Tomorrow is my first post CGMing appointment with my endoc. I almost cancelled it, but somehow managed to "select 1 to confirm the appointment" when I got the reminder call yesterday.

So what's the problem?? I'm afraid I haven't done the CGM justice by reducing my A1C.

I have made some positive changes that may actually lower it, like increasing overnight basals, not purposely running so high prior to exercise, bolusing more aggressively when appropriate, and correcting more often. It's also been less than 2 months that I've been hooked up and seeing those nice graphs, so why can't I cut myself a little "learning curve" slack?

But I have this feeling in the pit of my stomach like if the A1C is not better, I might have to give my CGM back. Ridiculous thought (I mean...who would I give it back to?), and intellectually I know it's not true, but it is how it FEELS. But I'm going tomorrow, though I may look odd clutching my CGM site and hissing at anyone who approaches me.

Breaking the Rules

2009-06-12T06:02:00.000-07:00

Disclaimer: I'm not a medical professional, just another diabetic, so don't take what I do as correct...it's just what I do.

We had a series of thunderstorms this week, and my 90 year old father-in-law lost his power. So he came to spend the night with us. We got up early the next morning, and he was stressed out about getting home...insisting he needed to take one of his medications right at 6:45 am. We took him home right away. This may have been right for that medication, and perhaps a few minutes on either side would really matter.

Since then I've been feeling resentment about the many "rules" that I was told early on applied to my diabetes care. I know the folks who taught me these rules were erring on the side of caution, and telling me what they were legally bound to say. But diabetes puts enough demands on life that I don't need any "extra" ones. Early in my diagnosis, I didn't know how to sort out what was really critical, so tried to follow everything to the letter. Here are the ones I can think of that I have kicked to the curb over the years:

Change your lancet after every use -- umm once in a blue moon
Swab your finger with alcohol before you do a finger stick -- never
Swab your injection site, pump site, CGM site with alcohol prior to injecting (or inserting) -- never, just make sure area is clean
Always refrigerate your insulin -- I used to stress over whether there would be a fridge at hotels, now current bottle stays at room temp and additional supply is in fridge at home
Change your pump site every 2 days -- umm 4 or 5 days usually
Change your CGM site every 3 days -- I lie to my pump -- telling it I have a new sensor when I really don't -- so I can use for each sensor for 6 days. The poor thing has yet to wise up!
Take Lantus at same time every day -- early on I was dogmatic about this, but soon found out that for me the darned stuff didn't last 24 hours anyway
Swab top of insulin bottle with alcohol -- never

How about you? Are you a diabetes renegade?

CGM Truth or Dare??

2009-06-04T05:58:00.000-07:00

Last week the curtains were pulled back to reveal a 24X7 movie of my BG control. There was no red carpet rollout for the premier, but it was a big event for me nonetheless. I started on a new Minimed pump and CGM last Thursday.

First, I was giddy with being able to see so much more about what is happening, and just kept looking at the trends in a distant sort of way, as if they were not really connected to me. This week, reality is starting to sink in, and I'm faced with some things that I need to change if I want to improve my control. Like cutting out the late night snacking, and upping my basal rate after I workout. Both of those things are scary to me in their own ways. Even though I may have suspected them before, now the data is smacking me in the face and hard to ignore. No more namby pamby..."I'm not really sure what's happening so I'll just keep doing what I want to." I know this is a good thing, but as with facing any challenge, there is emotion and resistance to overcome.

So I guess it's really more of a game of truth AND dare now, isn't it?

To reschecule or not to reschedule....

2008-12-15T06:02:00.001-08:00

....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?

Am I Borg?

2008-09-11T11:31:00.000-07:00

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?

Multitasking

2008-08-11T11:38:00.000-07:00

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?

REQUEST FOR CGMS: DENIED BY INSURANCE

2008-07-01T10:10:00.001-07:00

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.

I Just Might Make It

2008-06-25T07:13:00.000-07:00

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!

Keep on Keepin' On

2008-06-11T11:23:00.000-07:00

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.

Walking Barefoot on the Beach

2008-05-19T10:30:00.000-07:00

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?

Diet Matters

2008-02-19T12:02:00.000-08:00

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.

Logging for Superbowl Week

2008-02-04T07:38:00.000-08:00

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.

Wheels Off the Logging Truck

2008-01-28T08:58:00.001-08:00

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

Log Blog Update

2008-01-21T05:42:00.001-08:00

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.

Gentle Flow Logging

2008-01-14T11:56:00.000-08:00

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.

I Did It! I Logged for a Week!

2008-01-07T06:03:00.000-08:00

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.

2008, Year of the Log

2008-01-02T07:57:00.000-08:00

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!

Out of the Box

2007-12-28T16:44:00.000-08:00

"Out of the Box"

I really hate that phrase. It smacks of something corporate and trite. But this week it perfectly describes my diabetes.

Monday, I had a full slate of pet sitting visits to make. Dogs inside, dogs in crates, all waiting for me to let them out and cater to their diverse doggy needs. Grabbed some coffee, got in the car, and decided to test before I headed out even though I felt fine. 54. Damn!!! Back inside, not saying nice things. My diabetes was out of it's box, and impacting my life, and my plans.

Tuesday (Christmas morning), finished walking a rambunctious, 9 month old golden retriever. Felt a bit light headed, tested, 49. OK, this is not what I wanted from Santa. Diabetes is out of it's box again, impacting my ability to do my job, and causing yet another delay.

Friday, I haven't run since my 5 miler with mom on Christmas day. Basal cut in 1/2 an hour before my run, just a routine test before I change to head out. 363. No run for me today. Diabetes is out of it's damn box again!

This week has felt like some sort of sick version of "pop goes the weasel", with diabetes rearing its ugly head at just the wrong moments and impacting my plans as well as my confidence. I'm now a pet sitter and doing what I love, but is it realistic to think the varied schedule and activity level that goes with that will work long term with my diabetes? I've been trying to work my way back up in mileage after a running injury with the goal of completing a half marathon in February. But is it really best to push myself that much, doing different workouts on different days, and always trying to play catchup with the blood sugar levels? I just wish this disease would get in it's box and stay there so I can live my life without having to spend hours trying to stuff it back in!

Diabetic Runner Challenge

2007-12-19T07:24:00.001-08:00

So I just signed up for the Diabetic Runner Challenge. Cool idea, thanks for creating it Jamie! If you want to join the fun, go to http://yes.diabeticrunner.com/ .

The goal I set is to run 500 miles in 2008 or roughly 10 miles/week. I actually plan on averaging closer to the 20 miles throughout the year, but I learned in 2007 that it pays to rest when your body needs it.

A "too much, too soon" type of injury (hip flexor strain) kept me out of running for 6 weeks, so I didn't want to tempt myself to keep going when I shouldn't. The injury came at exactly the wrong time running wise, and I missed my first ever half marathon (Dallas White Rock) despite having trained over the long hot Texas summer and ramping my long run up to 11 miles.

I still want to run a half, so have set my sights on the Cowtown Half in late February. Im using a more conservative training schedule....Hal Higdon Novice Half Marathon plan. It has more cross training, strength training and rest than the plan I used previously, and so far feels more right for my body and experience level.

I'm hoping that accepting this challenge will also motivate me to be more diligent about logging my miles AND my blood sugar.

Reactive Diabetes

2007-12-13T13:44:00.000-08:00

First of all, hi there to all of you in blogland. I haven't posted in a while, just been lazily commenting here and there. But what better to spark a post than a visit to the Endoc, right?

So my A1c was 6.3 today, exactly the same as what it was back in June. Weight down a little, cholesterol good. The doc rated it an "A". But I know it could be better, and that my standard deviation is...well...highly deviant and not very standard. For a very long time (a few years) I have been pretty happy to not log (in spite of Kevin sending me his awesome spreadsheet), not change pump settings, and just correct with each new meter reading. I've got the whole exercise and BG thing working well enough to make it through most workouts, and I eat pretty much what I want (within portion controlled reason of course). I test frequently, so I think that is why the A1C looks decent. I actually found myself hoping that my A1C might come back higher to spur me into proactive mode.

So how about you OCers? Are you currently proactive or reactive with your basal rates and bolus/correction ratios and why?

Putting Yourself First

2007-07-25T05:36:00.000-07:00

I had a conversation with my husband this morning about putting yourself first. He goes to work earlier than most of his co-workers, and usually stays as late or later than they do. Not terribly late, but sometimes I see it interfering with him taking care of himself. As in yesterday when he stayed late and skipped his workout. He sees it as having a good work ethic and being a team player.

That made me think about how many of our workplaces subtly (and not so subtly) encourage us to sacrifice our health for the sake of work, and how having diabetes has changed my thinking on in regards to that topic.

Before diabetes, I was pretty hard core, going above and beyond, skipping lunch at times, working weekends, giving them more than they asked for at work, not working out much, etc. My bosses loved me. Slowly but surely, I have come to the point of putting myself first in terms of things I do for my health, and I really wonder if that is somehow actually easier for me than most because of diabetes.

When I was on a less flexible insulin regimen, I HAD to eat at certain times, so I did, regardless of what was going on at work. I ate at my desk, I ate in meetings, whatever it took, but I put eating the carbs I was committed to via my last insulin shot first. When I had a low, I HAD to take care of it. So work stopped, everything stopped so I could eat some glucose tabs and regain a clear mind. Some of that has spilled over into other ways of taking care of my health that aren't as urgent. I became a morning exerciser (at least most days), and shifted my schedule at work back a little to accommodate that. I would always eat breakfast, even if it meant being a little late on occasion (I also stayed late on occasion). I jealously guarded getting a good night's sleep. I didn't skip meals, even though I could once I went on a more flexible insulin regimen and now the pump.

Another reason for this shift is seeing that working harder than the next guy or gal, and being loyal to your company does not often yield loyalty in return. I've seen it over and over again, and I know most of you have too...folks who gave up their health, time with their kids, sleep, etc., only to get laid off. Seeing a friend work many nights pumping out proposals, not seeing her husband and son, and then being passed over for promotion. Seeing a company wait to terminate the employment of a programmer until he finished the project that requires hours of overtime and late nights (without extra pay since he was salaried). Those things have never happened to me personally, and I've been treated better than most throughout my career, but just seeing it changes you.

So I still believe in having a strong work ethic. If I am getting paid to do a job, I do my best to do it well. But I no longer see it as heroic to sacrifice my health or family in order to get a gold star in the workplace. Gold stars are overrated!

It's all good, right?

2007-06-19T17:52:00.001-07:00

The last few days have been mostly good.

1. Met with the running group on Saturday morning. The run was cancelled due to lightening. But as I chatted with a woman about how fast gels hit your system, I mentioned that I wore an insulin pump. She said one of the marathon coaches is also a pumper! He wasn't there, but I just can't get over how cool that is. What are the odds, since I've only met a couple of other people (other than here in blogland). I will plan on meeting him and picking his brain later.

2. Appointment with the endoc went well today. A1C was 6.3, and HDL (the good kind) was still over 100. Everything else OK. Also, he went skiing the same place I did last year, so it was fun to compare notes on that.

3. I haven't been doing much praying or bible study lately, but yesterday I picked up a bible study on the parables, completed the first chapter, and prayed. I wrote the prayers down, and asked God to show me how to use my talents to serve Him. I don't have a church to call home right now, so that's out. But today, I went to the internet to check out volunteer opps with a local charity I think does good work. All of them left me feeling unmoved, but I clicked on the link anyway, just to see where it would take me. It took me to a listing of local volunteer opps. One of them is with an organization that uses horses as therapy for children. Very cool, as I love animals and have had a lifelong fascination with horses. This charity appears to need help in several areas. I'm going to check it out.

I went with hubby to the local rec center this evening so he could run around the indoor track. I already ran outside this morning and lifted weights, so sat on a bench reading a book. My old Jazzercise instructor approached me, we caught up a bit, and she asked me if I'd like to be a class manager as she has a couple of openings. At first I said "no" since I'm training for a half marathon and go to another gym. But then I realized this might be an answer to that prayer and it might not be all about me! So I told her I'd think about it and wrote down her cell number.

4. On the not so good side, my run this morning sucked. I woke up with BG of 295, and gave myself about 2/3 the normal correction bolus. Headed out to run and felt like crap most of the way. Yes, I know it is not recommended to exercise with BG over 225, but I'm trying to stick to a schedule here! Felt nauseous as I arrived back home and figured I was still too high. But BG was 65. Not too bad really, but it felt yucky.

Geez, my posts are so long they bore me. I either need to learn brevity or post more often :)

Co-Pay Roulette

2007-06-13T07:46:00.001-07:00

Step right up folks, spin the wheel and win a new co-pay!

Disclaimer: This is purely a game of chance, no logic involved, and the house usually wins.

I am now on hubby's insurance, which is with United Healthcare (Medco for pharmacy). United (Medco) was also my previous insurance carrier, but this is a different plan/employer.

This all started when I went to the local pharmacy yesterday to pick up refills on my test strips and birth control pills. The test strips rang up with ZERO co-pay, which is a new but welcome phenomenon. The BC pills (same ones I have been taking for years), could not be filled because they needed "pre-authorization" from the doctor. Huh???? I wonder if the ins co would rather pay for a complex pregnancy for a Type 1 over 40 than BC pills.

So I decided to take the bull by the horns and call Medco. I'm convinced the first person I talked to was not really a person, but a trained parrot. When I asked why the BC pills required pre-authorization since the purpose was obvious, she just kept giving me the number for the doctor to call. Apparently they can answer who, what, when and where, but not why.

I then went through their automated system to get co-pays on Novolog, Cozmo Cartridges and Quick-Sets. The co-pay on Novolog was about $25 for 30 day supply locally -- OK, not too bad. And the co-pay on Cozmo Cartridges was ZERO for mail order from Medco -- GREAT, but really?? since I had been paying $125 before to for the same thing to Medco?

I couldn't get the automated system to recognize the Quick-Sets, so called back in for a live person. She confirmed that the Cartridges really are free, but that Medco no longer carries Quick-Sets and I will need to get those from my local pharmacy. Co-pay will be 30% of cost with a minimum of $20 and a max of $75. I didn't think local pharmacies carried infusion sets, and told the insurance rep that. She said that Wal-Mart, Walgreens, CVS, etc. do carry them. I thought "maybe something has changed since I tried that years ago", and called 3 local pharmacies. They don't carry them.

So I have left a message with the mail order diabetes supply house that I used previously (that is before Medco told me I had to order from Medco several years ago).

It's hard for me to trust a parrot, so a question for the OC....any of you getting Minimed Quicksets from Medco? I find it hard to believe they don't carry them anymore.

I wonder what the next spin of the wheel is going to yield. Oh well, so far I'm doing better than I did with the slot machines in Las Vegas.

Have I Lost My Ever Lovin' Mind?

2007-06-05T19:28:00.000-07:00

Well, I did it. Or I should say "we" did it. Hubby and I signed up for a half marathon training program tonight. I'm a 5K veteran, that is if a handfull of not-so-speedy 5K's makes one a veteran. But a half marathon is a whole 'nother animal. As in four times as long as a 5K. But it is a six month training program that starts from about where I am now, so that makes me feel that it is possible.

Tonight was orientation, and I had a chance to talk to the coaches. I talked to them about testing and my hope that I would not hold the group back when I stoped to test. I'm OK with NOT testing for the 3 and 4 milers that I do now, but with the mileage ramp-up, I'm not sure how the old bod will react. Should be interesting.

I'm VERY happy that hubby also signed up. At orientation he ran into (well not literally...there was no running, just talk) a friend he used to work with. They will be in the same training group. He was on the fence about signing up, so this was really nice. The CEO/Owner of the company I resigned from a month ago is also planning to participate, so I look forward to catching up with him without the pressures of work intervening. We ran together once, and seemed pretty well matched. But I have the feeling he may be faster than me. I guess we'll see.

As far as a name for my new pump, I'm still undecided. My first pump was named Wilbur...partly for Charlotte's web, and partly for a wonderful cat that graced our lives for many years. I'm seriously considering Chrissy, in honor of one my favorite dogs who is no longer with us. She was so sweet and affectionate, but also moody, so I'm a little hesitant to name a pump after a moody dog. But Chrissy just has a nice ring to it, and despite her moods, she loved us in her doggy way.

I've really been enjoying my sabbatical, and catching up on yard work. I am really enjoying using my body as opposed to my brain. Know that sounds silly, but after 20 years in accounting/finance/mgmt, maybe it's understandable. After doing yard work, I can see a difference. After many meetings I often could not.

That's about it. I thought I would blog more after my "retirement", but I've pretty much avoided anything requiring thought lately. Maybe after I get the yard in shape..... I still enjoy reading yours though, so if you're so inclined, keep up the good work fellow bloggers :)

Pumpie is Dead

2007-05-15T08:09:00.000-07:00

OK, I'll admit it, I never named the new pump that I started on last week. Maybe that is the problem. Or maybe it's that I put it in my sweaty jog bra for my run this morning. Or that I loaded it up myself without waiting for my official training since it is the same brand as the pump I have worn for the last 4 years. This poor pump has been disrespected from the get-go. So I am posthumously calling it "Pumpie". It's sort of like how you call a new dog "Puppy" until you figure out it's real name.

I have cancelled my plans to go to Dallas today and am waiting for a call from my doctor's office. I have an old "Plan B" for occasions like this involving NPH (which I don't have on hand), but until now have never had to use it, so thought I'd check in. New pump will arrive tomorrow.

So I have two questions for the learned OC. (1) What is your "Plan B" insulin regimen for short-term pump failures? and (2) Got any suggestions on what to name the new pump that arrives tomorrow? I want to get it off to a good start by showing it the proper respect.

Educational Opportunity

2007-03-28T17:43:00.000-07:00

Outside my office (which I will soon be vacating), sits some of the company's IT staff. Among them is a young fellow, Daniel. He's very sharp, graduated from MIT and deep down, is a nice kid. But he is also an impetuous hothead who talks and cusses incessantly. Let's just say he has provided hours of entertainment. So I heard him spouting off yesterday about how the coke and candy he was eating had so much sugar he would probably get diabetes. He continues to run on about how sugar is what causes diabetes, and how he is probably doomed to get it.

Finally, I step into the fray, and asked him if he was sure about sugar consumption causing diabetes. "Absolutely" he replies, "everybody knows that". So I bait the hook a little more with "Daniel, are you 100% sure?". His reply, "oh yes". I give him one more chance "No doubt in your mind?". He says: "Nope, none."

By this time about five of his co-workers are looking on, several of whom know that I wear a pump and have diabetes. They are smiling and looking on, knowing what is coming. So I tell Daniel that I happen to know that what he is saying is not true, point to my pump and ask him if he knows what it is? He says confidently "It's a cell phone". I say "wrong again, it's an insulin pump, and I have diabetes". His expression was priceless, and he started trying to backpedal, but dug a deeper hole. Finally, he says..."I'm an asshole". I reply with, "yes, I know, but we love you anyway" and proceded with my elevator speech about diabetes.

The Great Unknown

2007-03-25T08:17:00.000-07:00

Tomorrow is the day. I'm tendering my resignation, giving a month's notice. I've been struggling with this decision for over a year. I have prayed and asked for God's wisdom, talked it through with hubby, and asked for input from friends and other wise counselors. It is unanimous.

From the outside it may look crazy. In many people's eyes, I have the perfect job. Nice salary, good benefits, short commute, flexible hours, spot on the executive team, the trust of the CEO/owner, almost eight years of tenure and the vacation that goes with that. It is very convenient, safe, and familiar. But what the job itself has evolved into, I dread most days. Money, convenience and my need for security are the only things still keeping me there. I am truly blessed to have the option to give this up, and I know that for many, there is not an option like that. It hasn't always been for me either.

I have had a mounting sense that I no longer was supposed to be there that gets so strong it literally leaves me speechless. I know that God has something better than money and convenience ahead. I'm a planner at heart, but I don't know the details of the plan this time. That's hard, but I'm going to open myself up to letting it not be my plan this time.

The Differences

2007-03-25T07:38:00.000-07:00

I went to a ladies retreat with a friend and her mother-in-law (I'll call her MIL) on Friday/Saturday. We roomed together, and had a wonderful time. MIL is a delightful lady who has Type 2. I have Type 1. Spending some time with her really brought it home how these are such different diseases. Each has it's own unique challenges, but it's hard to fathom how they can be discussed in the same breath. Sort of like if I mentioned that I went to a game at the American Airlines center (our local indoor professional sports venue). I'd have to tell you what kind of game it was -- hockey or basketball -- Stars or Mavericks -- in order for us to have a meaningful conversation about it. That is, if any conversation about either sport is meaningful. OK, so that's a whole 'nother suject (hope my hubby doesn't read this)!

MIL recently started on Byetta, but decided not to bring it to the retreat with her since it has to be refrigerated. I wore my insulin pump and brought an extra vial of insulin and 2 set changes with all the accessories, an extra vial of test strips, and extra batteries for the pump just in case (for a one night stay). MIL gets her Byetta from a mail order pharmacy, I get my insulin from a local pharmacy because I don't want to take the chance on a screw up via mail order, or on not being able to get a quick refill if I drop a bottle. I asked MIL how often she tests. She said she hasn't been lately, but needs to get back to checking it in the mornings. I tested six times on Saturday to make sure I stayed in range to feel as good as possible so I could enjoy the retreat. We talked about food, and she works to spread her carbs out over the day. I do to a certain extent, but feel more free in varying the carb count since I know I can compensate w/ insulin. She seems to feel some guilt about her diagnosis. I don't.

Of course, we are two individuals, and there would likely be differences between us even if our conditions were switched. We each have our own unique struggles, but these are two drastically different diseases that should never be discussed as one. That, among other things, was very clear this weekend.

Giving In

2007-02-27T19:34:00.000-08:00

Today, was our quarterly planning session for work. The weather was springlike, and I had been staring out the conference room winow from 38 floors up much of the afternoon thinking of what it would be like to be outside, rather than discussing new products and team dysfunctions.

When we finished up at about 4 pm, I felt truly blessed by the opportunity to dash home and head out for a run in the park. Sort of like I was getting away with something naughty but fun even though none of us were heading back to the office. BG had been running high all day, and before I left for home it registered 228. Not great, but a good run should bring it down. So I cut my basal in half and drove home.

Changed clothes, leashed dog #4 (Katie, my running buddy), and headed out. Walked a little to warm up and then we started to run. Felt absolutely devoid of energy from the get-go, but figured I just needed to get the kinks worked out, get into the groove, or maybe find just the right song on my ipod. A half mile later, felt even less energetic. Thought "no way could I be low coming off that 228 and a reduced basal". Then I noticed that I was getting dizzy and felt detached from my body. The meter was at home, so I ate four glucose tabs and made a turn that would take me home. Katie was acting awful and trying to veer into the yards along the way...definitely NOT helping.

I got home in some state that felt like floating and lumbering all at the same time, and registered at 56 on the Flash meter. Not that bad, but that was after 16 grams of glucose about 10 minutes before. Made half a peanut butter and banana sandwich and sat down, just in time for hubby to arrive home. He asked if I was low, and I said yes. I don't know why, but peanut butter is a favorite low chaser for me, and he knows this.

Instead of treating the low and then getting on with life, I gave in to it this time. Told hubby that I wanted to skip the gym tonight, to which he was totally agreeable. I felt terrible, still devoid of any energy or drive to accomplish anything. It is such a desparate and out of control feeling. When my BG is coming back up, I have a tendency to get cold, so I covered up and invited Katie to lay down with me. We napped for about 20 minutes, and then got up to make a dinner of frozen thin crust pizza and watch American Idol.

Giving in to a low like that, skipping a workout night, and not marching on feels like a defeat in some ways. But on some level it also feels like a victory in allowing myself to be vulnerable and human. This disease is a teacher in forgiving myself and others, and for that I am grateful. But it is also a b-i-t-c-h!

New Endoc Visit

2007-02-17T06:27:00.000-08:00

After going to the same endoc for over 10 years, I went to a new one this week. I got my A1C results in 7 minutes, as opposed to waiting over a month to get them from the previous endoc. Also got my cholesterol results right there. A1C was 6.5. down a smidge from 6.6 last time. At least I'm consistent. Total cholesterol 170, and HDL (the good kind) over 100. I guess the exercise is working since my HDL was in the 70's last time. Newbie doc seemed knowledgable, but not pushy or arrogant.

Noone wanted to download my meter. I offered it to the nurse, but she declined. The doc asked about my sick day mgmt plan, which is a good thing to review every so often. Since I knew about basal testing, insulin to carb ratios and correction factors, he commented that I had already been well trained, and didn't really offer any suggestions. We did talk a little about how I handle exercise, but no new suggestions. We talked about options for replacing my pump and I got current #'s for the local pump reps. We talked about the pros and cons of CGM. He is close to home and work, affiliated with my local hospital of choice, and knows my other doctors. He checks cholesterol at every visit. And he will not insist on seeing me every quarter, and said every 6 mos is OK. Ran some other lab work with results to come later.

Overall, I think it went well and am comfy making this change, but I still left feeling just a little let down. This is such a self-managed disease, and most of me is really glad for that since I'm pretty independent by nature. But there is another small part that would like to feel that someone knows some tricks that I don't. Or that someone wants to look with me at the downloads from my meter and help me to differentiate the forrest from the trees. The only person who has ever done that with me was my dietitian/cde, who is now working for Abbott. I think I miss that a little bit.

Wellness Program or Intrusion?

2007-02-03T07:05:00.000-08:00

On Friday, I and a couple of others from my company met with a sales rep from a national chain of health clubs that is venturing into the wellness and health insurance brokerage arena. They can bring folks in to do blood draws and adminster health risk assessment questionaires to our employees, and then provide each employee with a nice color booklet with their results, explanations, and graphs. They will also provide the company with a composite snapshot of the same, just with no names associated, so we might know what wellness activities to target. For folks who have severly out of range test result(s), they will have a nurse call the employee to recommend a course of action (likely...get thee to a doctor). So far I'm OK with all of that.

From there we started to talk dollars and measurements. We asked...if the company invests in these things, how do we know its doing any good and can it help with our health insurance rates? Mr. Sales Rep suggests offering incentives...those who participate pay a lower percentage of their insurance premiums than those who don't. One of the offerings is a "life coach" who will help employees who are identified through the testing as at risk or with health conditions. The employee will talk to their life coach and get pointers on managing their condition or risk factors.

At this point, my business hat is pushed aside as the hair stands up on the back of my neck. I maintain my cool, but inside am thinking...no way, no how, do I want someone from a call center who probably doesn't know anything about me or the difference between T1 and T2 "coaching" me. I can hear it all now...

Me: Hi Coach, I cannot figure out why my overnight basal rates are working some nights and not others. Some morings I wake up at 120, and others at 225. What gives?

Coach: Carol, we would suggest that you take your insulin as presribed and get exercise at least 3 times a week. Oh, and 120 is above the clinical guidelines for fasting glucose, you may want to see your doctor.

Me: I know that, I pump Novolog, run 20 miles a week and lift weights 2 to 3 times. Now could we get back to my basal rates?

Coach: What is a basal rate, and what does inflating your tires have to do with anything?

Me: Slams the phone down, knowing I will be labeled as noncompliant and that I'll pay more for my health insurance because I don't want to participate in the wellnes program.

I guess this is a selfish view, because I know that there are folks who would be helped, primarily those who have not sought out information about their conditions or risks on their own. But the thought of spending more time on diabetes, especially if it does not help, is enough to make me want to scream.

To Ski or Not to Ski

2007-01-26T18:44:00.000-08:00

Here I am heading towards a nice bonus at work after a very tumultous career year, and hubby's job now includes flight benefits (which we thought were gone forever....whole 'nother story). So I'm thinking, cool, good year for a ski trip with the girls. Except the "girls" are my friend, her sister, and her sister's friend. And my friend is going on a cruise and then having shoulder surgery that has a long recovery. Screech....there goes the ski trip.

Or does it? I found a "Ski Camp" just for women in Utah. Looks like a good growth experience seeing as how I'm a low intermediate chicken of a skier with delusions of grandeur AND a strong introvert. I rarely fall because I take very few risks. I only ski about once every 3 years, but dream of it often. This camp is for intermediate to advanced skiers and I will likely be outclassed. It says you will be encouraged to go to the next level. Four days of on-mountain instruction and challenge, demos, opportunities to learn to telemark or snowshoe, yoga in the mornings, tips from pros, welcome cocktails, closing banquet. Sounds overwhelming in a way, but somehow I'm drawn to it (is this like a mosquito heading for the bug zapper?).

So why am I hesitating? It's expensive and I've tried to play the "thrifty spouse" card. But my incredible hubby says go for it. I thought work might be a problem, but I got the days off approved today. Everyone I have asked is encouraging me to go.

So is part of it diabetes? What if....I get up there all by myself and have a severe low? How will my BG's react to 4 days of very different activity? What basal rate will I use? What if I crash and burn and ruin my pump? What if I have a series of lows, have to stop to eat and recover and slow the group down? What if....I get hurt, and noone knows how to take care of me and my diabetes?

All of these are thoughts I would not have had before diabetes. So I have to wonder.... how many of my life choices are being shaped by it? Will I let this be one of them?

New Endoc and Other DB Thoughts

2007-01-10T13:36:00.000-08:00

Realized that a few diabetes related thoughts have been rolling around in my head lately, and it might do some good to write them out in view of the OC, because I know you understand.

New Endoc

First, I have an appointment scheduled with an new endoc in Feb that is starting to wig me out a bit. I put a lot of thought into considering a change. My current endoc (of 11 + years) is not giving me much input, the dietitian/educator I really liked has moved to an industry position, it takes forever to get my A1C results, current doc is affiliated with a hospital that I will likely never go to (too far), the office is not keeping up with technology...I have to show them how to download my meter readings at times, and the office staff is consistently rude. The new doctor is only 10 minutes away, affiliated with my hospital of choice, and comes well recommended. What I'm wigged out about, deep down, is that he might actually want me to....gasp....change something! Hmmm, that's part of the reason I'm going is that I SAID I wanted more input than I'm getting from my current team. Now the thought of more input, or specificially more expectations for me, is somehow offputting. He might want me to keep logs like Scott does (great job by the way....your records and consistency in keeping them over time are superb).

The Common Cold vs. Diabetes

I've been fighting a cold, and started thinking about the smiliarities between colds and diabetes. They both strike otherwise "healthy" people without warning, affect young and old, and we cannot prevent them even when we take precautions. So why is it that people jump to such conclusions about how we got diabetes but now about how we contracted the common cold? You know what I mean...."Oh, so you ate to much sugar", or "I guess you didn't exercise enough", etc. I guess it's the fact that most everyone has personally experienced a cold, but not personally experienced diabetes.

Perhaps these thoughs are the result of the cold and accompanying fight to keep my BG's in line. Just tested, 339, yuck! Correction boluses are my specialty of late.

MEME

2006-12-23T06:40:00.000-08:00

Wow, my first MEME! Thans for posting Kerri. Hope these answers don't get me drummed out of the OC.

2006 Year End Top Five

1. Top Five Resolutions for 2007

Get closer to figuring out what I am meant to do when I grow up.
Spend more time and energy on friends and family, and less on the job.
Run a 1/2 marathon in Dec. 2007. Gonna need all year to get ready.
Travel more. Hubby recently took a job with flight benefits :-).
Change Endoc's. Trial appt. set with new one in Feb.

2. Top Five Albums/Songs You're Embarrassed to Admit Loving

Everybody Loves to Cha, Cha, Cha (James Taylor)
Kokomo (Beach Boys)
Leader of the Band (Dan Fogelberg)
This Old Guitar (John Denver)
Isn't that enough?

3. Top Five Fictional People You'd Like to Ride in a Hot Air Balloon With

George Jetson
Garfield
One of "The Others" from Lost
Captain Kirk
Ricky Bobby

And the bonus question: Who's your favorite reindeer of the bunch?

Vixen -- becaues I have a feeling she causes trouble with the other reindeer

San Francisco

2006-12-17T08:20:00.000-08:00

Just returned home from a short trip to San Francisco. Hubby had training there for a week, so I joined him starting Wednesday night to do some sight seeing. We were staying downtown and didn't have a car, so I decided to explore the city on foot. For two days I literally walked for 5 or 6 hours a day. It was interesting the effect this had on my bg, as in "WOW...how can I find a job where I walk all the time?"

Fantasy Blood Sugars for a Day

Friday was one of those walking days and also included a 4o minute run along the Embarcadero, a little weight lifting in the hotel gym, and a delicious italian dinner (ravioli in cheese sauce:-) in South Beach. The BG's...drumroll please...55,69,87,117,69,93,103,99. Scott, please do not report me to the "excessive testing police". By golly, those numbers look downright non-diabetic! But as if to keep me from entertaining THAT fantasy, reality sets in hat I'm back home. So far this morning 139 (1am, 3 hours after last meal...not bad) then whammo this morning 266 (6 am), 274(8 am).

Chinatown

Did you know that Chinatown is a good place to fix your insulin pump? A small piece of plastic on the cap that holds the reservoir in place chipped off, and while the cap would screw on, it was tilted and would not sit squarely as it should. I became concerned that it might impact delivery. So off I went on my excursion for the day and I saw a general store in Chinatown, figuring I could maybe tape the cap down with tape or a bandaid or something until I could get a new one. The shop was part hardware store, so after considering duct tape and masking tape, I settled on a three roll pack of yellow, blue and red PVC pipe tape (hey, the pump IS plastic, right). The proprietor even let me use his scissors and helped me tape it up.

I also did not realize that taking pictures of food at an asian grocery is NOT looked upon favorably. I was happily doing the tourist thing, snapping digital pics of everything in sight, when the shopkeeper started yelling at me. I really thought she was going to hit me. She screamed something about me going back to school to learn some respect. I got the picture (literally and figuratively).

But all in all a great time and some interesting experiences.

Chips and Honey

2006-12-10T06:30:00.000-08:00

Thanks to the members of the OC for the warm welcome! You are an amazing and encouraging bunch, and you even gave me permission to whine. Anyone who wants to add my link to their page is welcome to. I'd like to do same, but haven't figured out how yet.

The Tex-Mex Treatment
It's Thursday night. I'm tired, Kerry (DH) is tired and we are both hungry. This is not a good combination for maintaining willpower, so we decide to blow off our usual trip to the gym, and head instead to Posado's, a tex-mex restaurant. I order a glass of wine, he orders a beer and we start talking. I notice that I cannot really follow what he is saying...something about IP addresses, servers and a lack of communication, but it's all really fuzzy (no, the wine had not arrived). Tech talk gets fuzzy for me anyway, but the conversation just seems kind of far off. So I test and see a 53 on the meter. I don't really want the glucose tabs in my purse since my mouth is set for mexican food. So I get serious about munching the chips and hot sauce. Still feeling fuzzy headed. But I salvage the mexican theme when I see a bottle of honey on the table and start to use it as my new chip dip. The glucose tabs never come out.

One More thing We Cannot Do
On a different note, was having a conversation with a co-worker. She is a smoker. I lead our wellness program at work (yes, I know...quite a contradiction to the behavior above:-), and I was asking her how the company could help those who might be at the point of wanting to quit. She said..."You don't smoke, right? Diabetics can't smoke." I kind of chuckled and said, "Yes, actually we can, but fortunately I never took it up". Where do people come up with this stuff? And why don't I think of better responses on the fly?

First Post

2006-12-03T16:56:00.000-08:00

My first entry into blogsphere. I am a frequent lurker on the OC, and sort of happened into setting this blog thing up trying to reply to http://screwabetic.blogspot.com/. Lost that reply, but here I am. My husband is the "techie" in the family, so I must admit to wondering if I'll be able to figure all this out without his help. If not, well, he's used to it!

Anyway, I'm 40, happily married, 4 dogs, 1 cat. Have worked at a local company for the last 7 years, and am currently the Controller there. Still trying to decide exactly what I want to be when I grow up, but it's a nice place to be in the interim. Type 1 diabetic for 14 years, and still figuring out how to balance living and this disease. Started running this year, and have done five 5K's (hmmm...that sounds nice and round, doesn't it?). Been pumping (Cozmo) for almost 4 years, and looking forward (sort of) to figuring out which pump to get next. Have often said that someone will have to pry my cold dead hands off my pump because of the freedom that it has provided compared to MDI.

Guess I'll keep this fairly short in case I don't have success posting it. Already lost that reply I was trying to send to screwabetic. Oh well, I've been thinking about doing this anyway thanks to reading the blogs of the fine members of the OC. Hmmm, now I have to figure out how to join that group if they will have me.