Monday, January 31, 2011

Idiotic Sunday Evening . . .

idiotLast night, I was a total idiot.  Over and over again.  It was like I threw everything I knew about diabetes management right out the window.  I have no excuses.  I was just plain stupid.

It started late afternoon when I did my site change.  An hour later, my CGM high alarm went off and a finger-stick showed me at 225.  I decided the spike was due to the chips I ate with my tuna sandwich at lunch.  The pump said I didn’t need a correction, so all was well.

An hour later, I was at 237.  I took a correction and figured things would start heading down.  After another hour, I was at 235 and by this time we were at my parent’s house for dinner.  I started to wonder if perhaps my new site was bad.  But (Idiotic Move #1) I bolused a bunch more insulin and ate dinner anyway.

After dinner, my CGM showed me soaring towards 300.  Of course, there was no way I was going to be easting dessert.  And then my mom said “I have a special treat tonight.  I made a pound cake and I have strawberries and whipped cream.  We can pretend it’s summer and eat strawberry shortcakes.”  I blame Idiotic Move #2 on the fact that the snow is driving me slightly insane.

ParkingLot
This is a snow pile in a parking lot near my house. I'm so not kidding. You'd be insane too.

That’s right.  You guessed it.  I SWAGGED a bunch more insulin and ate strawberry shortcake.  Even though my CGM said I was nearing 300.  And no, I hadn’t tested since before dinner because I didn’t really want to see that I was actually well over 300.

By now it was clear to me that the new site was crap and I needed to change it out immediately.  So what did I do?  Did Pete and I go straight home?  Nnnoooooooo, we took a quick trip to the grocery store instead.  (Idiotic Move #3, for those keeping track.)  Clearly my pressing need for an onion and two peppers was much more important than insulin, right?

So, we grabbed our bag of groceries and headed home.  The minute we walked in the door, I ran upstairs and did a site change.  Which seems like the smart thing to do, right?  Nope.  Because (Idiotic Move #4) I didn’t test my blood sugar before doing the site change.  In fact, I hadn’t tested my blood sugar since before dinner.  And wouldn’t you know it, the exact minute I filled the cannula on the new site, my CGM alarmed.  I looked down to see “Fall Rate” flashing at me, and the CGM reading 230 with two rapid down arrows.  The old site has been working fine.  A finger-stick showed my blood sugar was actually 147 - which would seem like a good thing.  Until you take into account all of the insulin I had been (idiotically) swagging all evening.  I had almost 6 units on board.  And the juice I drank did not keep me from hitting a blood sugar of 38 by 9:30 pm.

Why did I do such a crappy job last night?  Why didn’t I test more?  Why did I eat dinner and dessert instead of waiting to get a handle on my blood sugar first?  I don’t know.  I’m embarrassed to say I have no good reason for any of it.  I had a very Idiotic Night with diabetes.

Friday, January 28, 2011

D-Feast Friday: Noodley Soup

Mmmmm soup!  I love soup and I eat it all year round.  Although I do keep a few cans of soup around for Soup Emergencies, I usually like to make my own.  This one is not really a recipe, it’s more like a quick list of things to throw in the pot.  It’s yummy and soothing but easy enough to make even when you are feeling like road kill.

Soup

First, grab a package of fresh pasta - these are going to be your noodles.  I usually use Fettuccini but all they had at the store last time was Linguine.  It doesn’t really matter; you can use whatever you want.  Just cut them up into bite-size noodley pieces.  I do this with my kitchen shears.  Put about 1/3 of the noodles in your pot.  You can package up the other 2/3s into two zip-top freezer bags and pop them in the freezer for your next two pots of soup.

Noodles

Now chop up some garlic and add it to the pot.  Then grab half of a lemon and cut off a few slices.  Toss those in the pot too, and squeeze in the juice from what is left of your lemon half.  (Just the juice, not the seeds, silly!!)  Pour four cups of chicken broth into the pot and bring it to a boil for a few minutes to cook the noodles.

Once your noodles are cooked and yummy, ladle the soup into your bowl and sprinkle on some grated cheese.  And that’s it - you are done!  A bowl of lemony, garlicky noodley chicken goodness - perfect for warming you up and soothing a sore throat!  Trust me, this stuff beats any noodle soup from a can!

soup3

If you are feeling energetic and want to bulk up the soup a bit more, you can add some chicken meat and perhaps some vegetables.  Fresh spinach is wonderful wilted into this soup right before serving.  Or you could probably add a bag of frozen vegetables at the beginning and let them cook in the soup.

For carb counts, you should probably consult your packages of noodles and broth.  For the brands I used, 1/3 of the package of noodles was 46 grams, and the box of broth was 4 grams - bringing my pot of soup to a 50 gram total.  I’d say it serves four - but honestly, I usually eat half the pot at a time.

Thursday, January 27, 2011

My Health in One Word . . .

OneEarlier this month, Amanda from WEGO Health challenged us to Finish This Tweet:
“My health in one word is . . . “
Summing my health up in one word seemed like an impossible task at first.  But I found it didn’t take me too long to find a word that I felt fit.
“My health in one word is COMPLICATED.”
First of all, I feel that overall, I am a healthy person.  I am a healthy person with a chronic illness.  That statement alone feels like a contradiction in terms - and that in itself is complicated.

Beyond that, being a human pancreas? It's very complicated, you know?  Eating involves testing my blood sugar, weighing and measuring portions, tallying carbohydrates, checking fiber content to see if it requires subtracting some carbs, and thinking about how fat and protein will influence how quickly my  body will process my meal or snack.  Using all of that information and my Insulin to Carb ratio, I must then compute how much insulin I should take.  I also need to figure out how long to wait between dosing that insulin and beginning to eat, so that hopefully the insulin is working by the time my food is hitting my blood stream.  I also need to decide if I should take the entire dose at once, or if I should let my pump infuse it over a period of time, again hoping to match the insulin’s action to the spike I’ll see from the food.

As if that isn’t complicated enough, let’s think about reasons my blood sugar could be too high or too low.
  • I didn’t exercise enough
  • I exercised too much
  • I didn’t sleep well
  • I’m stressed
  • I’m coming down with a cold / flu / miscellaneous illness
  • my period is coming in a few days
  • my period started yesterday
  • I’m feeling depressed
  • my insulin has gone bad
  • my infusion site feels fine, but the cannula beneath my skin is actually kinked
  • I had a glass of wine
The list goes on and on.  And now let’s talk about the randomness of diabetes.  I can have two days where I get the same amount of sleep, do the same amount of exercise, eat the exact same foods, have the same level of stress and hormones, and guess what?  Things can still be completely different.  Why?  Because, DIABETES IS COMPLICATED!!

How would you sum up your health in one word?  You can see what some other people said here.

Wednesday, January 26, 2011

Mission Accomplished . . . .

I was in the beverage isle of the grocery store last week looking to replenish my supply of Mott’s for Tots Juice Boxes.  Because if you have to be low, it helps to have some smiley cute fruit friends to get you through.  Anyway, as I scanned the shelves for my Strawberry-Banana buddies I overheard a girl nearby utter a magical (also made-up) word to her Mom  . . .


I marched over, butted in (I’m so rude) and exclaimed “Did you say Trop-A-Rocka?  I’ve been looking for that forever!!”  They politely pointed it out on the shelf and promptly ran away from the Crazy Tea Lady.

I was a bit disappointed to see it was only being sold in six-packs.  I was hoping I could buy just one bottle and sample it - because frankly, the combo of flavors sounded kind of weird and I wasn’t sure I’d like it.  Green and black tea, mango, pear, peach, vanilla, cinnamon - I think those are the flavors in it and I thought it sounded like an odd mixture.  But a six-pack was my only choice and I went for it.

troparocka

You know what?  I like it.  No, wait, I might even say I love it!!  Picky, fussy me.  The girl who doesn’t like mangos and isn’t all the crazy about peaches.  I was shocked, but something about this odd mix of flavors really worked for me.  And if it tastes good now, jut think how refreshing it will be on a hot summer day?

At long last, my mission to sample Trop-A-Rocka has been accomplished.  Hey Snapple, just promise me you’ll keep making it, okay??

Tuesday, January 25, 2011

Road kill . . .

truck
Hey, did you happen to get the license plate of the truck that ran over me??

But seriously, my high blood sugar mystery has been solved.  Friday night I slept like a log.  And I saw better post exercise numbers on Saturday.  But on Sunday, I actually did feel like a splattered mass of road kill!  I had a sore throat, a queasy stomach, aches, chills and general ickies.

And my numbers?  I’ve seen more readings in the 200s and 300s in the past five days than I’ve seen in the past five months! I tried to be proactive and cranked my basal up to 150% but even that wasn’t working.  No matter what I eat, my CGM immediately starts yelping and giving me double up arrows.  It’s enough to drive a girl insane!!  I went through an entire box of tissues yesterday and I have the bright red nose to prove it.  What? Did you say something?  I can’t hear you because my ears are so plugged up.

Luckily, I’m feeling quite a bit better today.  And although I’m still hitting the 200s more often than I’d like, I haven’t seen a 300 since Sunday. 

Diabetes is hard enough on it’s own.  When you add Real People Sick to the mix, it just turns you into road kill!!

Monday, January 24, 2011

The same but different . . . .

After Thursday’s post-exercise blood sugar disaster I was very nervous about doing another work-out.  Since I had spent many hours with moderate ketones I knew I should skip a work-out on Friday, and frankly I was relieved about that.  But after breakfast on Saturday morning, I decided it was time to squash my fears and give the same routine another go.

workout

So I did the exact same workout I devised with my Wii.  One song on Just Dance 2 as a warm-up.  A ten minute Island Run on Wii Fit Plus.  And a session with my personal trainer on EA Sports Active.  I’ll admit I started to panic when I heard my CGM Rise Rate alarm go off during the Island Run.  I debated stopping, testing and perhaps bolusing, but decided to just finish the routine and see what happened.  Sure enough, when I was three exercises away from the end of the work-out, my CGM Fall Rate alarm sounded.  I again decided to finish up and then test my blood sugar and see where I was.

My post-exercise finger-stick showed a 132, and my CGM was reading 124 and falling.  Now THOSE are closer to the results I’m used to seeing after exercise!!  Actually, even those are a little bit on the high side for post-exercise numbers, but I wasn’t worried about it.  I was just glad that I didn’t see the same huge spike as Thursday.  I was overjoyed that, although my routine was the same, the results I saw were very very different!!

Friday, January 21, 2011

Stuck . . . .

Yesterday I decided it was high time to stop making excuses and start getting some exercise again.  After all, shorts-weather is right around the corner.  (Yes, I know it really isn’t right around the corner, but let me lie to myself, okay?  It’s the only way I can deal with all the snow and frigid temps!!)

The workout felt great, but when I finished my CGM showed me above 200 with double up arrows.  I know that exercise can sometimes cause blood sugar to rise, but it never has for me.  I’m always dropping by the end of a workout.  I debated if I should take a correction or not.  Surely the exercise would have me dropping soon.  (Spoiler: The exercise did not drop me.  And don’t call me Shirley.)  My gut told me to go ahead and correct - and it’s a good thing I did.

Stuck
This was just the beginning!!
For the next seven hours I was stuck between 240 and 310.  I tested every hour and took corrections.  I changed my site out.  But nothing would get me moving downward again.  When I checked for ketones, the stick lit up really fast and turned that “Moderate” shade that I hate to see.  And that’s when I really started to get scared.

I don’t know what the worst thing is about a blood sugar that is stuck up high.  Sometimes I think it’s the fear I feel when nothing I’m doing will bring it down.  The terror when the ketones start showing.  The feeling of helplessness and failure.  The physical effects of achiness and thirst and headache and nausea.  Or the frustration of trying to figure out what caused this marathon of highs.

Yes, maybe that last one is the worst.  I don’t know what exactly caused the hellish afternoon I had yesterday.  It could be some weird response to the exercise, even though this has never happened before.  It could have been that my site went bad, even though the site change didn’t seem to help.  It could have been some rouge germs that my body is trying to fend off, because I do feel like I’m coming down with something.  Or it could just be that diabetes is messing with me and my friends.  Because Kelly had a weird high streak too.  And George was flat-lined.

Nope, I guess I’ll never actually know what happened to my blood sugar yesterday.  And that is very discouraging - because how can I work to prevent it in the future if I don’t know what caused it in the first place?

Thursday, January 20, 2011

Hard Core

For the almost three years I’ve been a pumper, I’ve always used the same style of insertion set.  The Minimed Quick-set.  I’ve never had any real problems with it and I like that it has three options of tubing length.  In addition, I always use my Quick-Serter to insert my site and usually that all goes well too.

SiteOnce in a while, though, the Quick-Serter gives me a bit of a problem.  Like last week, when the sticky stuff somehow got stuck to the walls of the Quick-Serter.  Instead of hearing a happy SHWOOP when I pressed the Quick-Serter button, I heard an odd FWOP as the needle went partially into me and the tape adhered to both me and the Serter.  I peeled everything off as best I could, reloaded it back into the Serter and tried again.  Of course, it seems that particular site had a mad crush on the Serter, because once again to clung to it for dear life.

So now I had a decision to make.  I could waste the site and start over with a new one.  Or I could try, for the first time ever, to insert in manually.  I decided to be very cheap brave and give manual insertion a go.  I took a deep breath and SMACK I popped the site right in.  It wasn’t all that bad.  It did cross my mind that three insertion attempts might have done some damage to the cannula, but that wasn’t the case and the site worked just fine.

When it came time for my next site change, I thought about the manual insertion I had done last time.  And I thought about how it might be nice to know I don’t have to depend on the Quick-Serter.  So once again, I did a manual insertion.  It went well, but it definitely hurt more than when I use my Serter.  But you know what?  I think I’m going to keep inserting my sites manually from now on.  Because in some lame way, it makes me feel kind of Bad-Ass.  And who wouldn’t want to feel a little more Bad-Ass?

Thursday, January 13, 2011

Perpetuating the Myths

Yes, we look exactly like this!!
Yes, we look exactly like this!!
On Tuesday we were all anticipating the huge snowstorm that was expected to (and for once did) hit New England.  Pete and I have our weekly ballroom dance lesson on Tuesdays and I noticed my instructor had jokingly put the following in her Facebook status:
“Getting ready for snow- ugh. Remember, cancelations will not be accepted, just walk to the studio! I'll be there with hot cocoa and dancing!”
Because I can never pass up a chance to be a wise-ass, I left the following reply:
“If you make me drink hot cocoa, we're going to have to do Swing for the entire 45 minutes or my blood sugar will skyrocket!! ;)”
She joked back, we had a few laughs and decided she’d make me some coffee instead, and then some other students started leaving smart-aleck comments for her as well.  And that’s when I began to have second thoughts about my comment.

It’s fine to joke about the hot chocolate with Juliet, because after years of lessons with me she understands a lot about diabetes.  She’s one of those great people who is sincerely interested, asks intelligent questions and listens to my answers and explanations.  She never judges, and heck, she even has her friends bring me things from Germany to treat lows!

But what about the other people who read her Facebook page.  Looking at my comment they will probably think that I can’t have hot chocolate because I’m a Type 1 Diabetic.  And while it’s true I usually pass it up because I don’t find hot cocoa as bolus-worthy as a block of actual chocolate, the fact is if I wanted the hot chocolate I could certainly count the carbs and dose for it.  You know that . . . . I know that . . . . BUT most of the people reading her Facebook page don’t.

Was it wrong of me to make a joke like that?  We grumble a lot about the Diabetes Police, but did I just give them more ammunition?  Have you ever made comments in jest that you later regretted because they perpetuate the myths we are fighting so hard to banish?

Tuesday, January 11, 2011

Shocking Confession . . . .

I feel that I need to admit something.  Something that I know will come as a great shock to most of you.  But I can’t hide it anymore.  So here goes . . . . .

I change my lancet every morning!  *gasp*

lancet

That’s right.  It’s true.  Okay, I may miss a morning here and there every few months - but for the most part, my lancet gets changed each and every morning before I take my fasting reading.  No #BluntLancet for me!!

I sure hope that doesn’t get me voted out of the Diabetes Club!!

Thursday, January 6, 2011

3 Fortune Cookies: January WEGO Blog Carnival

This month for the January Health Activist Blog Carnival Amanda is challenging us to come up with three fortunes for ourselves and our health community.  Or three messages from a Dove Promise or three quotes or three Snapple lid facts.  I chose to do a mix of these and came up with phrases that I hope will inspire both me and other health activists to do great things in 2011.


FortuneCookieFortune Cookie:  Confucius say even longest journey begins with one small step.
I think it's easy to think about what we want to do as health activists and get overwhelmed.  Or to feel like we have goals but aren’t quite sure how to make them happen.  The important thing to remember here is to just keep moving forward.  Each step, no matter how small, will bring you closer to where you want to be.


DovePromiseDove Promise:  Don’t wait for opportunities, make opportunities.
Amy K’s post Speaking Out as a Health Activist inspired this one.  Amy urges us to look for events that might be great opportunities for us as speakers, and then inquire about the possibility of being added to the schedule.  This is wonderful advice than can be carried into other areas of Health Activism as well.


QuoteFavorite Quote: A bird doesn't sing because it has an answer, it sings because it has a song. ~Maya Angelou
I don’t have all the answers.  I’m guessing you don’t either.  But that’s okay.  The important thing is that we use our voice and share our experiences with our community.  Just knowing others are going through the same struggles you are is a huge help, even if there is no solution for the struggle.  Just knowing you aren’t going it alone is a comfort in itself.

This post is my January entry in the Health Activist Blog Carnival.  If you’re interested in participating too, you can read all about here: http://blog.wegohealth.com/2011/01/04/january-habc-3-fortune-cookies/.”

Tuesday, January 4, 2011

Daring . . .

Yesterday I did something pretty daring.

I put my infusion site and my CGM sensor in my abdomen.  *gasp*

tummy
I know, I know, you are all thinking “Big deal, everyone uses their tummy.  It’s prime real estate!”  Well, not for me.  When I was on MDIs I used my stomach almost exclusively.  As a result, I built up a large amount of dreaded scar tissue.  Sites and sensors go on strike upon insertion there, bouncing off the scar tissue as if it were rubber and leaving me with a bleeding hole.  If by chance I do get a site or sensor inserted they don’t work well at all and get very irritated very quickly.  So I’ve avoided using my abs for the past two years, plunking all of my sensors and sites into my lower back and butt cheeks.

The thing is I can feel scar tissue starting to form back there too.  I’m running out of real estate fast.  So I thought I’d give the old tummy a try again.  After its two year break, maybe it will be willing to perform a little better?  The site and sensor went in just fine yesterday.  They felt very irritated all day but are doing better so far today.  My CGM readings have been pretty accurate.  And I think my site is doing okay.

Or maybe it “was” doing okay.  I woke up with a fasting of 67.  Awesome!!  But the Greek yogurt I ate for breakfast an hour ago has just set off my CGM high alarm.  I show a 170 with two up arrows.  My finger stick confirms a 190 with a .35u correction needed.  This is not a normal post-Greek yogurt reaction.  Paranoia tells me the site has gone bad already.  The (small) rational part of me says it could be a million other things, including the sore throat I woke up with this morning.  So I’ll try not to be paranoid, I’ll keep an eye on my CGM graph, and I’ll just wait and see . . .

Monday, January 3, 2011

Goals, not resolutions . . .

NewYearI’m great at making resolutions.  I’m a champion list maker for anything and everything.  I’m also really great at picking areas of my life that I feel I’ve done an utterly crappy job.  So resolution lists get made every New Year’s, and often at multiple times during the year as well.

As great as I am at making resolutions, I’m not so good at keeping resolutions.  Yes, I do make sure my resolutions are measurable and attainable and all those other tips we read about resolution making.  The problem, I think, is that I try to change too much at once.  I have my long list of what I’m doing wrong and what I need to fix.  And after a few days, I get totally overwhelmed and discouraged and just give up - one resolution at a time.

This year, I’ve decided to do something different.  Instead of making a list of resolutions, I’m going to work throughout the year on improving myself and my life, one small step at a time.  Each week, I will take a baby step toward doing something in my life better.  The next week, I’ll pick something new to focus on - hopefully while keeping up on the “resolution” from the week before.  If I start to slip on one of the goals, there will be no reason to abandon the whole process, because I can just restart that goal again when another week starts.  The idea is to be constantly moving forward throughout the year, one tiny goal at a time.

My goal for this week is an easy one, yet one that is pretty important.  You see, I’ve been getting sloppy with my diabetes management over the past month.  The first thing that slips when burn-out hits is my oral medications.  Throughout the month of December, I’ve been really (really really) lax about taking my cholesterol and blood pressure medication, as well as my iron, Vitamin D and Vitamin C pills.  There really is no reason not to take five seconds to swallow down these capsules, other than pure laziness with a bit of forgetfulness mixed in.  So, since January 1st, I take my morning pills while waiting for my coffee to brew.  And I take my evening pills before hopping into bed.  Easy as pie.  (Mmmm, pie.)  A goal that I know I can continue through the year.  Which leaves me feeling good and ready to choose a new goal to work on next week . . .