Level of care, education

I have diabetes (type 1). On most days, I average 7-10 blood glucose checks per day. These moments may be annoying in that they interrupt whatever I'm doing, but they are so important because each one helps me make a small decision that will add up to my total health. For example: Today I wasn't sure about exactly how much insulin I should take for my lunch because it's the start of my cycle and the haywire hormones resulted in me eating a whole extra granola bar while driving, just to not drop low after a typical breakfast bolus. So I took too little insulin for lunch. And two and a half hours later I was 266. I corrected. I moved on. I will check again after I finish writing this post. (sounds pretty typical, right?)

Yesterday, I was talking to a friend of mine. She is from India studying for her bio Ph.D. in the US and doing research in neuroscience. Her father had diabetes (type 2). He died of a heart attack when he was 57 a few years back. I knew this before. This is what I did not know (before yesterday):

She said (synopsis):

My father and aunt were both overweight and had a hard time managing their type 2 diabetes. My dad had eye problems, renal problems, underwent several surgeries. All the complications were either caused by or exacerbated by his diabetes. I know that every time my aunt checked her blood sugar it was 300 or 350... 

Besides the emotions I felt listening to a type zero talk about her diabetic family members and how it affected her, I was mostly shocked by hearing that her aunt's numbers were "always over 300" (sidenote: both were insulin-using type 2 diabetics). So I had to ask: How often did they check their blood sugar? And she said: "Maybe about once a month."

Needless to say, my jaw dropped. I couldn't imagine not checking for that long and taking insulin (although there was a time in my life when I didn't check very often at all). It's not that these people did not care about their health. It's that they didn't understand all the details about having diabetes and how to treat it. They did not have access to the tools and education they needed.

This made me so sad. And shocked. And grateful for what I have: latest tools, education, access to information through my endo, etc. Most importantly, I am grateful for the 300 test strips per month my old plan covered, and even more grateful for the unlimited test strips covered by my current plan. That is so huge. This man did not have to die at 57. Hearing how his death affected my friend tugged at my heartstrings more than she will ever know. Because I have diabetes too - as well as a family.

I don't have much time to write, but I had to share this. In other news, all is well. I am trying really hard to keep a tight grip on my own D management, and although the efforts are accompanied by lots of failure, I am optimistic. My endo left the state and I will be meeting my new one in two months. I am determined to make a good impression with respect to my A1C. I would fail that goal for sure if I went in today. But I cannot look behind me, I am only now responsible for what lays ahead.

Much love,

-MM

Daily Disasters with a Dusting of Diabetes

1. Bruises... From injections. Most probably from reusing the same pen needle (I know I know), caused by not having health insurance for five months and trying to conserve aforementioned pen needles. Now, I have health insurance (see #2), but it's hard to break the habit of not changing the needle each time. This is of course a very very minor disaster (it's not like it's bathing suit season anymore) and I am making every effort to get in the habit of treating my skin right again (or as right as it can be treated whilst receiving like 6-8 daily injections (counting Levemir twice a day).

2. Health insurance.. This is the first time I am a "policy holder" (Dear Maria, welcome to adulthood). After receiving my cards, I promptly called my old pharmacist and had him play around with the billing (having worked as a Pharmacy Tech for years as an undergrad I know a thing or two about instructing how to bill Rxs to third parties). And a (almost) disaster struck when I realized that this plan was far more expensive in terms of copays for drugs that do not have a generic alternative even if they are on the formulary (Levemir, Humalog, Test Strips). AND that I would thus apparently have to pay $100 per each script each month (OR $250/90 days/each script) until I meet my maximum (of like $2.5 k), which sounded ridiculous to me considering I used to pay $20/script with free pen needles (provided they are billed on the same day following any insulin script). Thankfully, I quickly figured out that the university I work for has a special program for people with chronic illnesses (Diabetes, COPD, and two others I can't remember). All I have to do is participate in four conversation sessions over the phone with the staff at the University hospital (basically it sounds like they want to make sure I'm compliant and collect statistical data) and I get each 90-day RX for $125!! (much better). In fact, next month I get to chat with one of their Diabetes nurses (who is Type 1 herself) and we will likely be chatting about insulin pumps (see #5). Yay!

3. Speaking of disasters... I'm really not happy with my diabetes management. That is not to say that I'm not trying. I'm extremely frustrated with just the fact that it is the way it is while at the same time slightly blaming myself for not being able to do better in my current circumstances (see #4, #5). Basically, it's kind of like this (I realize it's on it's side and that's just about how it feels, especially because I'm trying):

I know I need to pre-bolus more (among other things). I know I need to aim lower. (ALSO what this graph does not show is the 52 last week.)

4. Work!... My first real job (after college and grad school). I'm now almost two months in and am finally starting to feel more comfortable with everything. But holy shit the stress that was brought on. FIRST, I now have a commute (Scully if you're there I feel your woes, IT'S THE [MOTHERFUCKING] TRAFFIC)! As a result, I get up at 5:15 to get out by 6 to make it there by 7 (sometimes 7:30/8, see also #TRAFFIC). As a result, I'm extra stressed. Stressed about starting out in a new environment is fine, but I also feel extra stressed because of diabetes. My boss knows I have T1D but I'm not sure he knows exactly what it means (I totally brought it up in the context of science, all like "science is so cool man, 100 yrs. ago I wouldn't be alive" etc., etc.) And my coworker knows now, and he also knows (briefly) about the fact that there's Glucagon in my purse. (sidenote: most of the time, working with scientists makes life with D just a bit easier). Nevertheless I find myself still self-conscious to inject or test in front of them or my office mate (don't judge). I want to educate, and I'm doing the best I can. Any day now I will "come out" to my office mate (I know there's no shame in D but I always felt like I wanted people to get to know me a little before telling them; in fact, I feel it can make the educational process more effective, if you happen to break some stupid stereotypes they may have about it beforehand [insert slew of stereotypes here]).

5. I'm heavily (seriously, in the near future) considering getting an insulin pump. I think I want would (will) get the T-Slim. I crossed out "want" because I don't think anyone really wants an insulin pump. But I am thrilled with the options of recent technology. What I am not thrilled with (like at all) is a device attached to me at all times. Sure, I know it's useful (like with the Dexcom that I sometimes wear). But at the same time.. I just feel like it sucks to have a device attached at all times. I know I can always go back to treated my T1D in the way that works best for me, and I do feel like I (slightly maybe) want to really try pump therapy to see what kind of a difference it makes in my life (with [sometimes more than] a dusting of diabetes).

In other news... #Allsgood

Peace and Love
-MM

The last 10 weeks...

In the last 10 weeks I:

1. Defended my Ph.D. in cell and molecular biology :)
2. Published 1 review article and pushed my primary paper towards final submission :)
3. Celebrated my 5-yr wedding anniversary :)
4. Moved (which also included putting up fencing for our 3 dogs) :)

I'm sad I didn't have time to write but life has been happening! (And diabetes is definitely on the back burner...) Not to say I'm rolling around in the 200s and 300s all day long, but the frequency and length spent above where I want to be seems to have grown as dramatically in the last several weeks as my life has been progressing.

Tomorrow I start my new job. My first real, non-student job. Where I will be expected to know like Ph.D.-level things and stuff (what?) I can honestly say that the thought of not being a student (for the first time in my life) and being "an expert" in something is triggering a little "impostor syndrome" - yes it's a real thing and apparently more common in women: http://en.wikipedia.org/wiki/Impostor_syndrome

Soooo. Yeahh... Have I mentioned that I'm 26? That I'm thinking ahead about having babies in the next few years (not now!)? And as I fight through the silly thoughts of being an intellectual impostor I am also struggling with the discrepancies between my current diabetes management and my future (baby-producing) goals. But I know that I CAN DO IT IT CAN BE DONE. I think with slowly putting in more dedication and consistency over the next several years I can get to a point where I believe that I can do it. As I settle in (into "adult" life? wtf) over the next few months, I am hoping to make a genuine effort to improve my management (and by extension other aspects of my life). I know blogging (and more so reading all your blogs) has been extremely helpful to me over the last 1.5 years and I hope to find time for plenty of both in the upcoming future <3

Yours,

(Dr.) Maria M

T1D Hacktivism Brief (NOT medical advice):

1. Definitely, most-definitely pre-bolus for breakfast.

2. Definitely, most definitely, pre-bolus for white bread.

3. Try out the expired stuff, unless cloudy (insulin) or generally useless (e.g. Dexcom: Failed Sensor/???/etc.)

4. If you are a woman, you must immediately download the PeriodTracker App and figure out how to “compensate” for like idk the last 10 days of your cycle (case in point: days 21-30 I literally have to bolus like 20-30% more for breakfast and lunch).

5. Keep an old and trusty meter around (in case you ever don’t have insurance [ I don't have insurance ;( ], those test strips will cost waaay less). Mine is the Accuchek Active (and I can find strips on Amazon for like 15 bucks/50 strips [score])

6. Get a dog. Preferably a large one (or three). Like this:

They will DEMAND to be exercised as well as love you unconditionally, therefore improving your mood, along with your BGs :D)

#Dblog week: What brings me up

My family, my friends. My ability to share with them. My ability to share with you.

This wasn't true even two years ago for me. I was lonely in my diabetes life. I allowed myself to feel all those things all by myself and only by myself: the guilt, the fear, the carelessness, the depression, the anxiety, the feeling of wanting to be "normal" and knowing that diabetes won't let me... These are hard feelings to deal with.

I went to therapy - initially not because of diabetes.. In fact, as I progressed through the sessions, I came to realize - what a big role diabetes has played. In everything. In my attitude towards myself and others, in my risk-taking habits, in my sense of who I am. Diagnosed at 18.5 yrs. old, in the midst of what I will now only describe as a "very tough time in my [very young] life", it was a slap in the face and seemed nearly impossible to accept to say the least (I digress, that's a whole another story).

Today, my friend and I met over lunch (and may have smoked some pot ;). We talked about my upcoming dissertation and about my impending new job, we talked about research, and people we knew, we talked about our bosses, and summer plans. Somehow, diabetes came up. Here's where I'm lucky - being a scientist, most of my friends are familiar with diabetes - most basic things anyway. Side story: this particular friend of mine actually has a history of T2D in her family. Her father very sadly passed away in his 50s due to a heart attack, after many years of obesity and T2D.. (My friend herself has lost ~70 lbs. in the last 1.5 yrs due to this fact mainly). I proceeded to talk (ramble?) about the basal-bolus approach (imagine rambles herewith, including an in-depth discourse about the analog vs. human insulins, doses, lows, highs, etc.), concluding with the statement "so that's the current treatment approach ... sounds simple in theory..." I could tell that for someone who did not have diabetes, she understood very well. She sympathized in my struggle and opened up more about her dad..

I joined the DOC about 1.5 yrs. ago.  Feeling less alone, I felt like I could open up to others. I have not been disappointed. Whether it was my friends, my husband, or my family, I have been finding nothing but understanding and support when it comes to my diabetes life. The thing is I never would have known it was possible, that it was out there to that extent, if it wasn't for all your stories, for all your openness.

Today, I share. With you. Or IRL. And I am still amazed at how much it helps.

I love you all.

<3 -MM

#Dblog week: What brings me down

I haven't written in a month and a half, as life has been crazy, mostly in a good way. At the start of April I traveled to San Diego for a few days for a conference and caught up with my mom, which was fun. While there I received unexpected email for a job interview, a refreshing change of events after months of looking. This was for a 2-yr postdoctoral research position at a state university nearby, and I am both shocked and thrilled to report that I landed the job on the spot. This event set off a chain reaction of quickly finishing experiments and throwing together my dissertation. Currently, I am scheduled to defend my Ph.D. in less than two months, and start the new job at the end of July.

Of course, these are not the things that bring me down. These are all great (life-changing?) events, and I am both excited and terrified to tackle the heavy work-load for the next 1.5 months at the end of which will (hopefully, almost most-definitely) be my Ph.D., and a new job awaiting (one that will pay almost twice what I'm used to). What brings me down is the negativity that Diabetes sometimes casts over these exciting events. When I am at the Zoo and feel like total shit because the traveling and greasy food spiked my BG into the 300s. When I see an average on my BG meter that I don't want to admit is true. When I feel like summer-time BBQs and beer drinking should make me feel guilty. When I think about my future with my husband (which I would like to include children, many perhaps) I am excited, but at the same time Diabetes management ("poor" management in particular) casts a fearful shadow over what should only be happy thoughts. It makes me sad that I can't seem to have 100% enjoyment, because Diabetes is almost always (somewhere) on my mind when I think about my future.

At the same time, I have to remind myself that I am more that just a girl with Type 1 Diabetes. I am a daughter, a sister, a wife, a puppy momma, a researcher, a friend. I'm Maria. I am not just a disease, and I will not let this aspect of who I am take over. On the other hand, I cannot ignore it or it will take over. These days I find myself looking for this balance more than ever, and I am sure (especially after reading some other Dblogs from the DOC this week) that I am not alone in this. Thank you all for being there.

<3 MM

Update: the last Endo appointment, life.

After being tortured in my intravenous blood draw a few weeks back, I anxiously anticipated my lab results over the course of a few days (and was delighted to see an email from my practitioner a few days later). However, I was disappointed to see that although my thyroid, lipid panel, and cmp came back normal (and my glucose level was "high" at 103 mg/dL :), there was no mention anywhere of my A1C (although I read the order and there was supposed to be an A1C done.

In the end, they did one (finger-stick A1C) at the office last week. My Endo always does this thing where he comes in a starts chatting and lets you talk, and it's like you have to guess (or ask) what your A1C is. So I was chatting about how much insulin I was injecting and how I thought I had figured out a better I:C ratio for breakfast during and how that changed based on what week I was in my cycle. And about how I decided to stick with a consistent amount of Levemir daily (split) throughout the month. "Well, your efforts are paying off."  "Oh, really? what was my A1C?" (there, cracked and asked). "Ummm, six point.. six point... Ummm.." [searches through computer files].  But I had heard enough.

I am in the sixes, for the first time in years I'm in the sixes again. "What? I don't care even what it is" I blurted out. "I don't care if it's statistically insignificant from seven. I haven't been in the sixes in years."

I should have known when he asked to bring in the two medical students (he doesn't do it if it's not good news). They were 1st and 4th year D.O. students (worlds apart, basically), and we chatted about me finishing up my Ph.D. (this year!) and the long job search (in progress and still ahead). They tried to follow all my logic and chattering about my care, and stared at me as the Endo checked my feet, lungs, my injection sites. "D you have a cold? There is a little rumble. Not pneumonia or anything, nothing serious... Hmm, your Potassium is a little low, make sure you're getting lots of fruits and vegetables. Not worried/concerned by anything else... Your cholesterol levels are extremely good, just pristine..." [wow, thanks]

There, a clean bill of heath. And a sigh of relief.

My A1C was 6.8. When I first started treating, I had plenty of A1Cs in the sixes. But, I never tested, while taking good amount of insulin and just eating whatever I wanted, and I probably had a lot of lows. In fact, it's kind of surprising I didn't have any serious emergencies or hospitalizations occur during that time. However, after I realized that insulin could kill you (something I think my doctors avoided telling me at all costs in fear I wouldn't treat) my A1Cs jumped to the 8s and 7s for several years, despite obsessive/compulsive testing. In the end, I must (at least partially) credit to my ability to wear a CGM at least some of the time, today, largely due to generous donations from DOCcers (who switched to the G4 and had left-over 7+ sensors to spare).

It's spring time in Southern Ohio. In two days, I take off for San Diego, and I am super excited. I will be attending a cancer conference, as well as meeting up with my mom (whom I haven't seen in six months). I'm a little nervous about the earthquakes as I haven't been out west before (hopefully that's just paranoia). I am already planning how I will manage to shove all my diabetes shit into my carry-on. For this trip, I plan to wear really cute clothes and possibly a bathing suit, and although Dexcom old-faithful is on the back of my arm today, we shall part ways for my time in California.

I feel refreshed. I really needed to see a concrete improvement in my D-management, because I have been putting in a lot of effort, and sometimes lots of times, based on my averages and logs, I'm very disappointed. I really needed to see/hear from my doctor that something is getting done right. And now, although I won't lie to you all by saying I didn't give myself a few "sort of fuck-it" days after the appointment, the lowered result makes me want more improvements and makes me actually believe for a second that I might be able to will definitely actually try to do the pregnancy thing down the line. Things in my life are changing rapidly, and heath care is no different - next month I turn 26, and will no longer be on my parents' nice heath insurance. Will cross that bridge when I come to it.

For the time being, I want to live and enjoy the season. And I will keep walking the dragon, as I must.

Peace out.

Today: An (endo bloodwork) experience; may be "black-swan-classified"

"Hold on just a second", she said. "Marc, Marc!". More urgently now, "Marc, get in here NOW and get on a pair of gloves."

(NOT what one wants to hear when having blood drawn.) Shit.

***

So after escaping (read: lying about having a prior appointment to get out of) a particular TA meeting this afternoon, I felt guilted into making up for it (by making it a half-lie) and showing up to get my bloodwork done, as 1) it was requested by my endo and I have an appointment coming up; 2) my doctor's office is literally right next to my place of work; and 3) my insurance expires 5/1, so really I had no excuse.

I was especially happy to get in quickly and waited no longer than 3 minutes before a friendly plump nurse was penetrating my vein with an only-god-knows-what (20-something?) gauge syringe. Chatting about the weather and asking about IV blood drawings effect on BG levels, I knew something was up when she was not replying to my question.

"Is something wrong?", I finally inquired, as it seemed a very long time to fill up that first (of 3?) tubes of blood, still looking away from "the site". "No", she said, nervously, "just don't move your arm please". SHIT.

Fast forward what seemed like an eternity (probably 3 minutes), as Marc comes rushes in to help her wipe down [presumably the blood from] my arm (which's now numb from the turnicate with my palm sweating like crazy), hands her more tubes, bandaids my arm (finally).

"Am I done?" I asked, finally, feeling the turnicate release my arm, which no longer felt like it was attached to me... "Yes, go right ahead, I just have to make sure and clean this floor thoroghly..." Me: 'What now?" (as I get up) "OH JESUS" (not something I usually exclaim, anywhere really)...

As I stood up with my freshly cotton-balled and bandaided arm, I turned to see what was a splatter (no, more like a POOL) of my own blood. ON THE FLOOR.

Here's where it got really interesting. I had to lay down. I thought I was going to pass the fuck out right there like a deer in the (fluorescent) lights. "Please lay down" I was instructed. I obliged. As soon as I did, I felt the blood rush to my head. I sat up. OK, Maria. Check your BG and get the fuck out already. 

Marc handed me my BG case (I realize now that he took the liberty of taking it out of my purse). 125. dexcom: 99. OK. (I all but ignore Marc's inquiries about the CGM and murmur something about test strip samples, because "my insurance runs out on May 1st." Then I tell him that "it's been a rough 24 hrs BG-wise, but I won the last 3 hrs", as he invites himself to scroll through my Dexcom history.

Once I realize that my dizzy-spell occurred as a result of being tortured by (perhaps a less-than-proficient nurse?) the procedure, and not a result of a low BG, I  quickly collect my things and get out. I feel stupid for having to lay down, especially because I am a cancer biologist (researcher), and have seen and conducted so many dissections, as well as handled (still warm) blood samples of all sorts.I remember handling it rather well when on a lab rotation a few years back I witnessed a mouse being anesthesized, bled from the eye, and then dissected for each organ (with it's heart still beating to preserve the tissue) - all in the name of research of course. I felt nauseated the first time, but nothing like today. I guess something about the sight of your own pool of blood on the floor (especially under fluorescent lights) makes me feel panicked and helpless.

Perhaps it is more the "black-swanness" of it all. In (probably) over 20 times of having my blood drawn IV, I have never bled out all over myself, the nurses, the floor. It's just one of those unexpected things that makes you stop and say, "Wow, THAT JUST HAPPENED."

*Turns out the tube connected to the needle just "slipped off" and my blood collected on the floor for some time before the nurse pinched it off and got help.....

<3
-MM

What he thinks about my T1D...

I've often wondered, "what does my husband feel/think about my T1 diabetes?"

Here's the thing: When I was dx'd and started treating , I said to him (my husband/then boyfriend....and to myself), "Don't [you dare] treat me any different. I just need to inject insulin now to cover the food I eat..." Period...

And that's exactly what he did. Nothing different. More recently (~1 year ago), it all started to spill out of me: how hard diabetes and insulin management really is, how much of a mess I am when I'm low/high, etc. And the whole Glucagon conversation. And then there was Dexcom. All of the sudden (although it was "no big deal") I elected to stick myself with a needle/plastic device, one that would stay attached to my arm/stomach for a week (or longer).

And he reacted accordingly. Accordingly to how someone would act when they LOVE someone. He listened to me. He asked a few questions.

The other night Dexcom woke me up (mildly low according to Dex, low-normal according to meter), I had 3 sips of juice [~3-3:30 AM]. As I got back into bed, he (heavy-ass sleeper, of which I'm jealous) was awake. He spooned/squeezed me, and said "Are you OK?" "I'm OK" I replied.  And then I knew. Knew once again that the boy I married was "the one". Amazing man that he is. As amazing as when I'm low during daytime, and I'm crying and over-treating, and he says "Hey, wait. Wait for the juice to kick in. 15-15 rule, remember?"

Also, here's this: I always was afraid (being a bit insecure) that the Dexcom (or another medical device) would somehow ruin my (wonderful) sex appeal. Boy, was I wrong. The Dexcom experience has made me feel ever-so-confident to get an insulin pump.

I love you BM.

Truly Yours,

-MM

what might have been...what might (still) be...

Being human (and diabetic), I tend to often question "what might have been". Sometimes I question what I would have become if I didn't get type 1 diabetes at the age of 18. What would have been if I got it as a child? What would have been if I didn't start treating it when I did? Would my blood sugar have hit 300 and stayed there for hours this morning if I wasn't drinking beers last night, then overcompensating for a BG of 74 with juice and caramel-chocolate candies before bed?

These days, instead of asking those questions, I tend to ask myself  "what will become of me if I..." Of course, most of these questions/fears concern my future as a PWD. I am only 25. I have had this disease for about 7 (almost 8) years, of which the first year I refused to treat. Did I fuck up my life by doing that? Or is it more like: I have only had this disease for 7 years, and although my A1C isn't great, I am working hard, and I know that I can improve it. But what about NOW? Will I be saying this in 10 years "My A1C isn't great but I'm working on it." Is it/will it be enough? Enough to shelter me from complications, or at least from the fear of utterly hating myself if I get complications from diabetes.

These things are always in the back of my mind, but when I'm talking to others (like my mother, husband, or friends), I'm all positive, like: "The treatment options are so great today, my CGM is so helpful, I am lucky to be able to have the items I need to live (AND LIVE WELL) with this condition..." Inside, it's a constant psychological balance of "what if, what then?" and an even more presise physiological balance of "how much and when?". And more importantly, when will it "all work out", while you slowly come to realize that the answer to that is "NEVER", although there are those fleeting moments of beautiful numbers (and the feelings that accompany them) that seemingly were achieved with no hard work at all and with grace at that. And then, there are moments when I don't question anything, I take my insulin, I eat my lunch, and I don't wonder at all, because I don't really care. Because whether my BG is 250 or 85 I will have to go to work, write my dissertation, take care of my pets, my students, dinner, and my sanity. Sometimes, there are more important things that blood sugar values and IOB calculations. Sometimes, I'm going to hike/drink alcohol/dance/have sex/whatever no matter what my BG is because I WANT TO FEEL HUMAN... (unless it's under 60 and then I realize that I live with what appears to be an angry demon and not a friendly dragon at all).

This may seem to be a non-sequitor, but I have a little "PWD in the wild" side-story to tell. Sort of. A few months back at my endo's appointment, as I was sitting in the waiting room, a young woman walked in (probably my age, no older than 30). She smiled briefly, and I smiled back, as we politely and quietly aknowledged each other's presence. I could tell that I knew her from somewhere and just couldn't place her - living in a small ass town tends to have that effect - you constantly meet people you know or sort of know in random places. It finally came to me that she was a full-time employee at the grocery store I frequent. And then I noticed that she was about 5 months pregnant. Assuming she had T1D, my mind wandered to whether or not her employer was accomodating about her checking her blood sugar, etc. as I have seen her so many times, standing behind the register (presumably for hours at a time). Ironically, I saw her again several times in the last two months, and I noticed that she was no longer working the registers, but instead seemed to be doing other stuff in the back, and I wondered if that was a direct result of her pregnancy with T1D. I thought a few times about approaching her, saying something like: "I know this is going to sound strange, but I saw you at the endo's office, and I guess we have something in common, so I wanted to say hi." Probably that would be OK, but you never know how people will react to stuff like that so I didn't make the gesture. Not yet anyway. I saw her again at the store the other day, this time looking a lot huger and puffier, and I said somewhat of a silent prayer (which isn't something I normally do) on behalf of this stranger and her unborn child, who doesn't seem like a stranger at all to me for some reason. And then I said another one, for myself, for my future, for the possibility of children, for my family, and for the ability to not just find calmness in the serenity prayer, but to apply it to my life.

From high to low

I used to run high all the time in fear of lows passing out/dying. My BG averages used to hover in the 180-190 range, with some 200+s seen during travel/holiday/stress/sick times. About a month and a half ago, following another endo appointment - "uncontrolled, globally high" (albeit with a surprisingly lower A1C than I expected, 7.2) - I decided that if it took having some lows and getting used to them in order to do better overall, that's what I needed to do.

The good news is: My 7-day, 14-day, 30-day averages have all greately improved, and I feel a million times healthier (and dare I say happier). Hard to admit, but consistently high BGs can put a damper on my (or anyone's) mood.

The no-so-great news is:

58. I haven't been in the 50s in years and boy did I feel it. And may have cried a little. Thankfully, this is the only time in my tighter management days that I've been this low. I've seen so many more 70s, and am getting to the point where I'm rather functional in the high 70s range, and feel like total shit over 180.

Well, onwards then.

In other news:

We got a new cat! Our old one disappeared for 17! days... in the spirit of cats, out old cat showed up again within 3 hours of acquiring aforementioned new cat :) I should've known.. They are both staying though.

A #rhyming (#sortof) #WORDLESSWEDNESDAY

As I mentioned in my last post, I've been trying really hard to lower my overall BG values and largely I've been doing pretty well on that front. My 7-day BG clocked in at 140 :D about a week back:

At the same time, #Diabetes is unpredictable and this is today:

"Whether the weather be fine or whether the weather be not, we shall weather the weather, whatever the weather, whether we like it or not."

Determined...

I haven't posted in almost a month! Last time I was here I talked about my 1-yr blogaversary which corresponded nicely with an Endo appointment. That week I came down with a cold which kept my BGs even more out of sort that usual (read: High all the time), which was not very fun because presenting my Endo with a week of shitty numbers is not my idea of a good time. My A1C was "uncontrolled" (7.2) but in fact lower than I expected given the numbers I was seeing recently. My endo is awesome of course and was nothing but encouraging and helpful, although he made it clear that globally decreasing my BGs was the way to go. I think my I:C ratios are reasonable, but I did realize that my basals needed work, along with my psyche (specifically, I confessed to him that due to the fear of lows overnight, I go to bed higher than I should which in turn affects the next day)... Not sure how to fix that, except have a little faith confidence in my ability to maintain a relatively flat line of 80-120 mg/dL overnight. Easier said than done. However, armed with a donated Dexcom sensor (see last post), along with a refreshment read of particular sections of "How to Think Like a Pancreas", stringent monitoring of every bite I put in my mouth, logging, and no alcohol whatsoever (at least for now, while I figure things out with basals), I am incredibly determined to be the best I can possibly be at managing my condition and feeling better (physically and mentally) about my D. management. Last night, at a BG of 121 at 11 PM, I took a leap of faith confidence in Dexcom and went to bed without that sip or two of juice that I am for some reason so keen on having when my nighttime BG is below 150 (yes, you read that right, I feel compelled to go to bed higher, although during the day I'm incedibly comfortable with 90s these days :) Anyway, here is what happened:

And I think it is pretty awesome! And for the first time in I don't know how long waking up at 6:45 AM this morning (with a BG of 101) I managed to handle breakfast like a champ (you should see the typical 200+ peaks I ususally get...)

I can only hope that once this very last (in god knows how long) Dexcom sensor will hang on for dear life (day 12) and provide me with more and more pictures like this, so that I know when I rip off that sensor, I can do it again without it. And again. And again. 

Have I mentioned that I feel great?! I never realized how even consistent high 100s with some 200+s in between can make you feel like shit... My 7-day average on my meter is 154. I'm used to the 190s. 

I hope I can keep it up (down).

With love, -Maria