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Sunday, February 24, 2013

Patience, grasshopper

Patience - I have none. Just ask my husband (I'm working on it).

I think the photo below kind of sums things up for the evening:

I know that if I had stopped at 4 glucose tabs like you're supposed to then first time I hit the line, this wouldn't be happening now. I find it hard to wait for the sugar to kick in for 15 minutes, and I find it hard to hold off an extra bolus when I'm at 300...

My husband suggested setting a time for 15 minutes, and not allowing a second treatment until it expires (provided the situation's not too critical of course). This seems impossible to me. If I see that I'm still dropping 5 minutes after, all bets are off. When am I going to become more brave again, I wonder?

I've been having a lot more lows trying to push things to an average of 120 (instead of 150-160), but it's really hard sometimes, and on nights like this I can't help but feel like I kind of suck at this Diabetes thing.

Oh well, try again tomorrow.

Friday, February 15, 2013

A little about me :)

Well - you already know I have Type 1 Diabetes (since 2006).

As my profile describes it, I am currently a Ph.D. student studying Cell Biology in Ohio. I am doing research in ovarian cancer for my project. Specifically, I study an immune system protein that promotes inflammation and may lead to angiogenesis (formation of blood vessels in the tumor). I can't wait to get started with Type 1 Diabetes research for my post-doc in a couple of years (provided they grant me my degree and all).

Here is some of the rest of me.


I was born in Russia. I grew up in Boston. I have lived in Spain. I do in fact consider myself to be a "citizen of the world".

On April 16th of 2013, I will be 25 years old. On April 18th of 2013, it will have been 5 years since I checked myself into MGH and had my first insulin shot.

I have smoked a lot of pot (still smoke, but much less than during undergrad).

I consider myself to be (somewhat of) a rebel.

When I was 22, I quit smoking (cigarettes) cold turkey (successfully).

I believe in love & freedom more than anything.

I (kind of/sometimes) hate talking about politics, but consider myself a Libertarian.

I have 2 wonderful puppies, who make my days better no matter what else happened. Also make me more busy, and provide more stuff to clean :)

I hope to have children  (my first child) in about 2.5 - 3 years. (yes, I know it's hard to plan, but I'm trying). Because I don't have time for and I can't afford any now, and also because my A1C isn't "where it should be" for getting pregnant.

I was in denial about my diabetes for 1.5 years after diagnosis and didn't treat. My first shot of insulin occurred when the DKA was very severe and my A1C was "over 18". I am lucky to be alive and healthy. And to have the supplies necessary to deal with T1D and lead a "normal?" life.

Today, I was in a meeting and a colleague was almost in tears and said she couldn't talk about it, because she would start crying. I didn't know what else to do (to make her feel better), but blurt out: "Hey, wanna know something personal and awful about my life? [she seemed eager to hear it]. I have Type 1 Diabetes, and sometimes I have to inject myself {with insulin} 7 or 8 times a day..." This spurted conversation about someone's niece who has type 1 and about insulin pumps (and distracted the almost crying lady completely, catching her off guard: go figure). Overall, it made me happy because (even a year ago) in the past, I was embarrassed about my diabetes and now I feel like I am starting to own it, starting to own myself.... [Mostly thanks to seeing T1s on TV (Nat Strand winning on the Amazing race), discovering (Kerri Morrone Sparling), and of course the #doc...

"life is like a sine graph" (something my mom always said). I believe it, live it, happy to be "down", because I know "up" is coming.

I have been considering getting a tattoo of a little black dragon on my right shoulder (never wanted a tattoo, then had a dream about a tattoo of a dragon on my right shoulder, after which the idea never left my head) - and soon after this blog was born... Maybe one day, after I get it all figured out, I might add a red leash around his neck ;)

Wednesday, February 13, 2013

Lows & Fears of WalkingTheDragon

So I may have mentioned once or twice on here that I’m “terrified of lows”. And I’m sure no one likes the: sweaty, confused, shaky, shaky, shaky, cold, hot, sweaty, crying…

I hadn’t cried in a long time until yesterday night. Not boasting – just saying – because once upon a time (8 or 9 years ago, when I was a teenage girl) I cried a lot (back then I also didn’t have diabetes, so I’m not sure what there was to cry about J) …

Some of you may know that last week (see: “frustrated”), I switched from Humulin R and N to Levemir and Humalog. Overall, it’s going fine. I’m trying to work out the basals, which is kind of working (i.e. I woke up at 6:40 this morning, and was at a BG level of 146 mg/dl with no corrections overnight, which would never happen on N J). On the other hand, fast-acting insulins scare me a little because of how fast BG can drop an hour or two after use, so I really have to get better at dosing with 100% accuracy and (more importantly?) waiting to eat after bolusing to improve post-prandial #s (which have sucked ass for the last few days)…

And then there is that one word: exercise. I suck at it, and can be only be defined as “inconsistent” when it comes to it (and some other things). I am 5’4” tall (1.63 m) and 115 lbs (52 kg) (on a good day), and also: I’m out of shape (read: can’t run 10 minutes without being out of breath). But, nevertheless – capable of running… SO – yesterday, when I got home and was feeling stressed about: comprehensive exams for my Ph.D. at the end of the month, never having enough time to clean the house anymore, diabetes, my beautiful puppies being more lonely during the semester.. I decided to (wait for it: exercise!). Not really. More like run around for 20-30 minutes with my dogs (read: lunges, sprints, laughter, throwing objects)… But it was fun, and (as I found out 2 hours later) totally counts as exercise (as do cleaning and sex).

I was around 140 before dinner (cgm #, because I am slightly lacking in test strips for a few days). Not giving much thought to the puppy play, I proceeded to dose 3 U of Humalog immediately before a dinner of: couscous (~44 g carb), chicken (negligible), and broccoli (tends to be negligible for me, as many vegetables are). Noticing about 30-45 minutes after, that I wasn’t peaking (at all, according to Dexcom), and considering the puppy play, I ate a small apple (a fibrous wonder of ~9 grabs of carbs). Also, I had some beer (about 2 lite beers, ~6.5 g carbs, and yes, I know OH lowers BG J).

Given my ratio of 1U:15 g carb, I thought I kind of nailed it. Nevertheless, 1.5 hrs after all this, I felt “OFF”. (I hate and love that feeling, because it’s a warning, but it’s terrifying). My brain felt “jello-like”? According to the CGM, I was @ 127 and steady. According to my Accu Chek I was 88. OK. I had a little juice, thinking “no big deal, just a bit of juice will do it.” (Don’t overtreat in the 80s, even post-prandially, don’t overtreat in the 80s…) BUT, about 10 minutes later, my Dexcom started yelling that I was 66 and falling, and all of the sudden I started feeling: sweaty, confused, shaky, shaky, shaky, cold, hot, sweaty. Oh, and also: my heart was beating out of my chest - HARD. At this point, I had more juice, and then (all of the sudden!) I found myself to be a crying mess, asking my husband to “bring me more juice in case I needed to drink more.” And I started crying more and more….

“Are you OK?”, he asked. “Yes, I’ll be fine, it’s just a low, it will pass”, I said. And then…

Then – I broke down and I told him about that time in Costa Rica 4 years ago, when I pre-dosed 3 U of R for dinner when I was 37 (I tested after I dosed, because I was rebellious and stupid, and determined not to let diabetes completely and totally rule my life). I told him how I chugged the sodapop that night at the hotel, bottle after bottle). And I told him how I was too proud to say anything, and how I had to be in control of myself, because I would never let anyone help me…

And then, saying all this through my tears, I remembered all of the sudden how BRAVE (young?) I used to be. It’s as if my stupidity back then inversely correlated with a sense of any fear. EVER. [Also I felt more in control of myself today, because I had plenty of juice as well as Glucagon. I have been carrying Glucagon with me only the last 1 year out of the last 6 years of being a Type 1 Diabetic]. I felt (slightly) better. Then I tested, and I was only 84 (after all that juice) and I drank more juice, still not feeling 100% (I’m also pretty sure that my meter of the last 4 years needs to be retired, because that felt like a 55-60 BG). Also I knew that I completely over-treated a low that was in the 60s at best.

I don’t know how you do it, #doc. When I read (once upon a time) Kerri Morrone Sparlings’s (@sixuntilme) post that she wrote at a BG=55, I wondered “wtf? If I was 55 right now, I would be destroying the contents of my fridge”. But, that is BRAVE: to trust your body and your math skills in time of crisis and not over-treat.  I know I can deal (even at a BG of 37), because it’s happened and I’ve lived. Nevertheless, I know it can end badly. And that’s the terrifying part…

Nevertheless, I love my diabetes. When I was diagnosed and finally accepted treatment, a teacher told me: “If you want to live a long and healthy life, find a disease – then nurse it.” Kind of stuck with me.  

I’m trying really hard to be grateful that my body pretty much  always alarms me right away if I’m under 80 (if I’m paying attention).  And I am hoping I can become a little bit more BRAVE like my younger self again. And with that: Don't live every day as if it were your last. Live every day as if it were your first. (Paolo Coelho).


Monday, February 4, 2013


These days I seem to be becoming more and more frustrated with myself. The Humulin R and N regimen I am on has been kicking my ass and leaving my BG high and leaving me pissed of. I am unable refuse to CONSISTENTLY pre-bolus by 30-40 minutes, and the NPH peak leaves me in a constant fear of nocturnal lows, resulting in keeping BG values higher than they should be, followed by a 50-80 point climb into the 200s by 5:30 AM, every day, like clock-work.

Why am I on R and N? I started on R and N in 2008 after diagnosis, and a couple of years ago was switched to Lantus and Humalog (for a period of 6 months). There was no significant change in my A1C going from R & N to Lantus & Humalog (7.8, 7.6), but I did see better AM numbers (I blame the lack of better control with analogs on not having a CGM at the time). After looking more into it, I found it highly concerning that Lantus has an extremely high affinity (like 18-fold higher than regular insulin) for the IGF-1 (insulin-like growth factor) receptor (mitogenic potential), and that at least two independent studies have shown an association between Lantus usage and cancer. So I went back to the old and trusty R and N (something about how old they are combined with the fact that they are structurally identical with human insulin, unlike analogs, makes me feel good as a cell [cancer] biologist). However, my experience with Humalog for those 6 month got me used to the convenience of a  later bolus, and I found it harder and harder to wait the amount of time required for the R to work properly. The N pisses me off even more. The morning injection kicks in and I am dropping like crazy by 1 PM. The nightly injection (regardless of whether I shoot up at 7 or 10 PM) always drops me at 2 AM and never covers my early morning dawn effect... So I find myself constantly shooting up, having snacks, and constantly frustrated.

Having gotten that off my chest, I have an appointment Endo in 2 weeks and I am requesting  (read: demanding) a change to Levimir and Humalog (or Novolog). Having looked into Levimir, I feel much better about it than Lantus and (psychologically) I can't stand the NPH anymore. The fast-acting analogs like Humalog are only structurally disrupted to prevent hexamerization (thus resulting in faster release than R), and these changes do not affect it's affinity for other (non-insulin) receptors, making me feel pretty good about them... At the end of the day, there might me some risk to analogs, which (if any) will become apparent as more time goes by, but the evidence of the complications of long-term high BG are clearly evident today. And I conclude that it would be stupid not to change up my regimen when I know it will likely: 1. Give me better BG control, thus preventing complication and 2) (dare I say more importantly) give me some freedom...

Question: any T1s out ther on Levimir? Do you use 1x or 2x daily??

Thanks #doc for listening <3