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Wednesday, December 23, 2015

Update :)

It has been forever since I blogged, so look at me - two in one day! ;)

I just wanted to acknowledge that my 3-year blogaversary was 12/12/15, and I missed it again this year! I have been busy in the best possible ways, visiting family, which included our nephew's first birthday party (which was the cutest), and (of course) working! I cannot express in words (although I will try) how much peace writing about life with diabetes has brought me over the last 3 years. It has brought me acceptance, and put me into a position to take the best care of myself possible, diligently, and with peace of mind. A lot of the changes in my attitude and concrete habits of D management over the last three years came about as a result of writing (you can probably tell this is kind of my journal). Also, however, my mind and heart have been changed by reading everyone else's blogs - be it dx stories, pregnancy adventures, travel blogs, or diabetes burnout - we all share this unique bond that noone else can understand - I love you all!

I want to wish everyone a very happy and healthy holiday season and the best of wishes in 2016!

<3


Check, check, check

Every time I have issues with blood sugar than span more than one day, I pretty much know I have to start logging to help me tease out all the variables.


-Did my fast-acting go bad? No.

-How about my long-acting? No.

-Am I eating too much fat and causing IR? Maybe.

-Am I waiting enough between meals, or am I snacking too much (Totally guilty of snacking too much) [Note to self: stop eating so many almonds without bolusing]

- Have I gained weight? (Yes - 5 lbs).

-So my long-acting isn't holding me steady anymore since I gained 5 lbs? (Bingo!) [Note to self - lose 5 lbs. stat]

-Am I drinking too much coffee? (Always)

-Am I stressed? (Most of the time, but I am working on it!)


So. Many. Variables.


It has come to my attention that a lot is expected of us diabetics on a daily basis:


Wake up - test your blood sugar. Check.
Correct or bolus for DP, or pre-bolus for breakfast. Check.
Test again before driving. Check.
Get to work. Test. Correct/ bolus for more coffee. Check.
Do work. Don't forget to check! Check.
Drink water. Check.
Check BG. Check.
Lunch-time check. Bolus, wait, eat. Check.
Check in a couple of hours, correct if needed. Check.
Test before driving home, correct if needed. Check.
Check BG, pack snacks. water, take dogs for a walk. Check, check, check.
Make dinner. Check.
Check BG, bolus, wait, eat. Check.
2 hr. pp reading? Check. Correct for extra fat/protein? Check.
Clean kitchen, make lunch for next day. Check.
Bedtime BG? Check.
Wake up in the middle of the night? Check BG. Check.

That was at least 13 checks and adjustments in a "regular" day.

Next morning - do it all over again. Every day.

That's what my days looks like - and that's just a regular day - one that is not hindered by stubborn highs or nasty lows or any additional stresses. The good news is that if my control is good, so is my mood, and the rest of the things in the day tend to be done with ease, maybe even motivated passion (at least the walking of the dogs ;)



Friday, November 6, 2015

(time to face the strange) ch-ch-changes....

Change – we all experience it. Whether it’s by choice or whether it’s forced on us by this thing called life we are all a part of.

In my life the last year or so has been difficult as far as diabetes management. My (roundtrip) commute clocks in at just over 2 hours (which is not only sedentary but can be stressful too). The stress of living life “in the real world” outside of grad school, the stress of grant-writing and publishing pressures, coupled with the stress of not knowing what lays ahead for me and my husband (next year) has (to say the least) made for an unsettling trend in my blood sugar and A1C this year.
Knowing full-well that stress is unlikely to just dissipate, and not wanting to continue on the roller-coaster high-low in my struggle to chase sugars in either direction, I tried to focus on specific concrete changes I could make to improve the state of things. I settled on changing my food intake, slowly shifting towards (what I now estimate to be) 90% grain-free low-carb home-prepared choices. II set out in this simply experimenting, but over time I must say that I am happy with my success. What is success? How do you measure success? I measure success by how I feel (not necessarily by the numbers). The stress that Diabetes used to impose (daily and nightly) has faded, and (in addition to improved glycemic control) this is the biggest measure of accomplishment for me. I don’t worry about low blood sugar anymore, because I never take more than 2U of short-acting insulin at a time. I don’t eat after 6 PM, most days, and thus am able to achieve great stability overnight. In addition, the focus of high-quality proteins and fats in my diet has seemingly smoothened exercise-induced dips (e.g. these days I can hike on a handful of nuts and maybe 1 lifesaver if needed, as opposed to pre-gaming with granola bars or even juice in anticipation of a crash…) These are changes that I have chosen to make in order to improve my health and quality of life. In a way, sometimes I feel like I HAD TO make these changes (or some changes) that would make a difference, because I was really starting to get depressed and angry that I had to work so hard just to be chasing bgs in every direction on an almost daily basis (not to mention the averages on my meter, which had the potential to make me cry some weeks). I have mentioned that I don’t really miss high carb foods, and if I do I (wait for it) I EAT THEM! Usually, I regret it, but I am not one of those people who has to be extreme or perfect about my diet in order to gain what I need from it. This way of eating and dosing insulin in much smaller quantities has greatly improved my stress and anxiety levels. It has made a permanent dent in my bg trends (as an example, I used to have spikes into the 200s almost daily, but now anything like that gets a weird raised eyebrow, because that just doesn’t happen most days anymore.. AND I have had exactly ZERO LOWS. Sure, I was always vigilant about not having serious lows, but with this way of eating I am much more comfortable running in the GASP! Normal range!) Anyway, this isn’t to brag about my sudden morph into some diabetes dominatrix. I still have work to do – there is ALWAYS more work to do with Diabetes! J

This change in eating habits has been coupled with another lifestyle change – my ethanol consumption has gone down dramatically. When I found myself using alcohol to help deal with stress, I recognized right away that it wasn’t a very healthy outlet for stress, simply because it’s bad for your health and (for me) provides an excuse to run higher BGs in anticipation of the over-night crash after drinking. I am happy to say that I am much more comfortable right now with my alcohol consumption, and that I have been actively using other means of stress relief more times than not (such as putting my work away and training my dogs or sewing.) Sewing has been something that I didn’t expect to fall in love with but did, much to my (sewing) grandmother’s delight. There is something about sewing that earnestly teaches me the patience I lack and Diabetes has failed to teach me. When the thread catches or (worse) when the needle breaks (Arghh!!) all you can do is stop and fix it. Kind of like with blood sugar. Or life.

My mom always said – life is like a sine graph. We do the best we can, and we ride the waves. There are things we can control. There are things that are out of our control. Important to remember (for me anyway).

As life doesn’t slow down, and with even more changes on the near horizon in my professional and personal life, today I am stopping for a moment to acknowledge how far I have come. Also, to acknowledge how excited I am for my future.


<3 You DOC J Peace out.

Friday, October 9, 2015

The shit my doctors say

I love me a good doctor – a doctor who is knowledgeable, respectful, and listens (but emphasis is on the knowledgeable part for me). Unfortunately, *some doctors are just total ass-hats, who either 1. Don’t care; 2. Are too terrified of getting sued to REALLY try to help the patient; 3. Are really not knowledgeable at all (read: they get any if at all CE from rx reps).

In no particular order, here’s some shit my doctors have said:

1.       “Oh, you have diabetes. Just don’t eat any white foods. Cheese, butter – those are all bad for diabetics…” (UMMMM…. I didn’t have a reply for this one. I was simply stunned.)

2.       “Oh well, I don’t want to write you a prescription for lorazepam because that can be addictive. Let me give you an SSRI instead – it works in the same way for anxiety.” (Cue my rant about SSRI mechanisms of action vs. benzodiazepines, concluding with the fact that SSRI “discontinuation” typically has pretty significant withdrawal symptoms. As I proceed with my rant about not wanting to take a pill every day [with a number of side-effects], when I may use the lorazepam on a prn basis once or twice a month maybe [if even that frequently], she concurs that the two drugs are in fact very different and that there are withdrawal symptoms from anti-depressants, although she prefers to call them “discontinuation”. In the end, I went a floor down at the University health clinic to get the rx I needed from a much more knowledgeable NP). I haven’t had a lorazepam in about two years – the three remaining pills sit in my cabinet still.

3.       (from staff at dentist’s office in a sarcastic/derogatory tone) “Oh wow – a risk of “zero” – you must never eat anything or drink anything at all, which may be good for your teeth but not so good for the rest of your body.” (Did this woman just skinny-shame me? She definitely did! I roll my eyes…)

4.       “Oh, well if you continue on this way, you will be on dialysis by the time you are 30!” (He was probably right. These words were spoken when I was in DKA and refusing to treat my T1D due to severe denial that I in fact had diabetes. BUT – trust me when I say saying that kind of thing to a patient is not motivational – just devastating.)

5.       (eye doctor after hearing my A1C) “Oh- so you are an UNCONTROLLED diabetic!!! *Scoffs and turns to me and says in an accusatory tone – “Did you know that Diabetes is the #1 leading cause of blindness? Here is a pamphlet of what you vision will look like soon if you remain UNCONTROLLED.” (This eye doctor did get confronted, and ended up apologizing. No need to treat patients like shit – no really. This especially ticked me off because my A1C was in the 7s at the time, and honestly – I know that’s not ideal, but also I can only imagine how she would treat someone with an even higher A1C.)

6.       Her: Do you have any eye disease? Me: Not yet J Her: Oh, don’t be so pessimistic - glass half-full right? (After a while I realize that she has not a clue that I have diabetes…) Me: You know I have type 1 diabetes, right? It’s right there in my chart – along with my most recent A1C – I was assuming you’d want it… Her; Oh, WOW! I had NO IDEA……

Well, doc, since I went on this rant about medical professionals, let me let you in also on a few heart-warming moments with them:

1.       Nurse Erin at MGH. OMG. I love her still – to this day. She took care of me when I started treating and she was so upbeat and helpful! She brought me literature about diabetes management, magazines, and told me all about her T1D auntie who lives a great awesome life, and diabetes is just part of it. THAT. THAT IS what I needed to hear (she also stood by my side as I performed/ butchered my first injection, together with my mom, and was reassuring and when I did it she said – great job, see – nothing to it!)

2.       My old endo. I loved him so and was slightly devastated when he moved his practice back to Cali last year. He was THE MOST knowledgeable endo I could imagine. He did research. He actually read studies. He actually took the time and listened to patients. He was reassuring. He was helpful. He was in no way ever an ass-hat.

Unfortunately, it seems that I can think of more ass-hat than heart-warming moments. SO – if you are a medical professional, please (pretty please):

1.       Do your own research (at least read the studies yourself before giving advice about meds)
2.       Don’t expect your patient to not know more than you about some things – you never know who you are getting (and I’m pretty sure some of these doctors thought I was a difficult ass-hat – but hey – it’s MY health, MY life, and I deserve the best care I can get – and so do you!)
3.       Don’t be rude. Don’t be fear-mongering. It’s one thing to make sure your patient understands the possible consequences of their condition, but shaming or accusing in NOT ACCEPTABLE.

Cheers J



Thursday, September 24, 2015

Food

Food is my focus as I continue to strive towards a "good" a1c. Mainly my focus is on extremely accurate carb counting, limiting total # of carbs (per meal), as well as finding new awesome recipes with a good balance of (good) fat & protein. Also - prebolusing more and bolusing for coffee spikes (but that's another story). Last week I bought my first bag of almond flour and made low-carb pancakes (yum!) Recipe: https://recipes.sparkpeople.com/recipe-detail.asp?recipe=489838 but I used milk instead of water! I have enjoyed these for brunch and breakfast alike. The other day I had my first a avocado (on it's own, not guac) - surprisingly tasty and satisfying. I am learning to bolus for protein (when needed). I am learning a lot of new stuff :) Pics below..

On another note, I found out this week that I was selected to give a talk at an international conference on neural tube defects at the end of next month (super excited/ slightly terrified - my first talk at a "real" meeting with PhD in hand) As a result I had to reschedule my Endo... Again. But - I have a feeling my next a1c will not be disappointing like the last one (and now I have even longer to improve it). Great BGs with no lows make me feel like a rockstar in the best way possible and it doesn't take endo guilt to make me want to work my butt off for my future <3 love y'all













Friday, September 11, 2015

Confession

I sort of have a confession to make. My biological Russian grandpa on my dad's side had diabetes. I don't know what type. All I know is that the family would talk about it sometimes. I also remember him - he was always incredibly skinny (passed away in his 80s, Heart disease if I'm not mistaken). The thing is when I ask my mom (what type) she doesn't really sound like she knows for sure (assumes type 2). I don't feel comfortable even asking my dad. We don't have a great relationship. So I don't know if there is a genetic cause to my D. I have never had any testing done.  I wonder sometimes if I might be more likely to pass it on to my future kids if it did "run in the family" but I know I can't really know because it's a probability that is based on too many variables at this point (in time/scientific progress). That is all (I think). Oh wait - my husband's grandpa (mom's side) died skiing because of low BG ; Him - I never knew, and B doesn't know what type (but I am assuming type 2).. No idea in reality though what type (and thus no idea re: genetic probabilities IF both our grandpas were type 1s.) THAT is all. I am not sad about it - just weirded out a little by the not knowing. Then again - if I knew - would it matter (statistically or realistically)? And moreover - if a child of mine did get type 1 - what then? In any case - as I like to say - it is what it is. And I am pretty sure that life in the future for a diabetic kid is going to be much better than today. And mine is pretty awesome :) Happy Friday

Monday, August 31, 2015

Obsessing...

Sometimes I really don’t want to think about Diabetes anymore. I would really like to just enjoy my life like a “normal person”. My management has been OK – certainly not great but certainly not horrendous. I’ll have blood drawn in about 6 weeks and I am hoping to make further improvements by then. I am not logging. But I am being diligent. But not obsessive. I’m just so over thinking about Diabetes ALL THE TIME. Honestly – I feel like I deserve better quality of life than that. My eating is good – meaning that I am eating things that I pretty much know what they will do to my BG, which makes it relatively easy (at least a lot easier than say Chinese food takeout or beer and pizza). I am thinking about having kids still – in fact I spent the weekend reading a baby book – not necessary because pregnancy is imminent but just because I would rather know about all the fun and gory details ahead of time (Aside: when I read about postpartum lactation during sex/orgasms, white wine shot out of my nose – it was that unexpected and really really funny). I will not spend my pregnancy (whenever it happens) obsessing. I repeat – I will NOT spend it obsessing. I am a hypochondriac. You’ve heard about the skin rash of the summer (I obsessed and it was nothing!) – now you will hear about my foot (hint: I obsessed and it was nothing). In a stupid effort to prevent my muddy dog from running into the house, I raised my bare foot to stop her from entering, but she just plowed right into it – with her teeth (poor thing) – leaving two nasty teeth imprints/blood blisters on the bottom of my foot :/ Of course I spent a good amount of time obsessing (e.g. reading up on dry gangrene and diabetes due to the blackish color of the blisters, which is of course normal). Of course my foot healed completely in the textbook time of 3 weeks it takes for a blood blister to dry up and peel off (gross). But yeah – I checked it – every day, multiple times (driving my husband up the wall I think). As a PWD I am primed to suspect bad stuff (teeth, feet, skin, you-name-it). Being a scientist in the biomedical field, exaggerates that further I think. But I am definitely over the threshold of “healthy obsession” (I think it’s normal to be concerned if you have a foot injury and diabetes, and make sure that it does not get infected and is healing properly, etc.) and into the “full on crazy obsession" (e.g. I have a blister on my foot so of course it’s going to get infected and not heal properly and of course I will face the horrible complications). NOT healthy. Speaking of complications from diabetes, I hate thinking about it, but I also somewhat feel like it’s inevitable. Which is a stupid thing to think because I don’t know that. I don’t know and no one does – YDMV. Then again, perhaps the unhealthy obsessions are just a result of guilt for not being “perfect” or working as hard as possible all the time to manage this disease the way I *should. I have a feeling others may have felt this way too at times.

Anyway – I am still trying to find a balance that encompasses diligent self-care and living the life I want to live without sweating the small stuff (but being honest and responsible) about my health. 

Tuesday, August 11, 2015

A Low Tale

A few months back, after a full Saturday of hiking and then drinking in the evening, I went to bed at a safely higher number and woke up early on Sunday morning to a BG of 180-something. I decided to take about ¼ U Humalog along with my morning Levemir and went back to bed. An hour and a half later I woke up (sort of). Drenched in sweat and feeling like I am starting to trip. Low low low. I knew I was probably low, but for some reason in my still sleepy haze I was quite calm about it. ¼ U of Humalog – I must be in the 80s or 70s but dropping still because of the exercise and ethanol from yesterday I thought. I got up (sort of). More like forced my arms to lift my ever-so-heavy body up and onto the carpet (I don’t keep snacks or a glucometer near the bed, but perhaps I should). My legs did not feel like they really wanted to move at all (at all!) but I used all remaining brain-power to rescue myself as I balanced ever-so-slowly towards the kitchen. The 30 feet or so of walking seemed loaded with every ounce of effort I could muster. I got to the kitchen – cold cold cold floor. I reached into my purse on the kitchen counter, pulled out my meter case, unzipped it, got out a strip, put it in, pricked my finger, and waited. 46.

I grabbed 2 Capri Suns and my testing supplies in my hands and “walked” back to the bedroom, where I promptly fell into bed and tried to keep myself propped up against the wall as I struggled to keep my balance and punch the straw into the juice box. “B, B, I’m 46. I am trying to get this juice open.” And then (as if I really was tripping) I began to sort of laugh uncontrollably. It seemed so incredibly ridiculous to me at that moment that I could not get that straw into the juice box. I finally did and then proceeded to suck it down. Juice number 2 – B had to help me get the straw in that one, much to my amusement. As I sat there, waiting for the carbs to kick in, fighting the urge to pass out/sleep (which one I am not sure), I felt a ridiculous amount of calm and control. “I’ll be fine” I said. “Go to sleep, I will sit here and wait it out”. B’s hand reached out to me and squeezed my hand, as I used the other to wipe/smear the sweat all over my face and chest. “I could barely walk to the kitchen” I said. “It was sooo difficult.” And then I kind of laughed some more, like a crazy person.

A BG check 15-20 minutes later showed a 65, and in half hour a 99. I went back to bed. I woke up an hour later, started breakfast, felt “lowish”, tested and was 79. I ate without blousing, contemplating my next move. Eventually, the increased insulin sensitivity as a result of the previous day’s activities subsided and I was able to resume some “Normalcy”. I am still amazed at my calm demeanor throughout the event, as I haven’t been in the 40s in many years. It took me about three months to finally write it down -


The weirdest low I have ever had. 

Thursday, July 16, 2015

Invisible in the wild

It was a hot cruising day and the pool-loungers were out in full swing. The smell of tanning oils, sunblock, chlorine, and sea water was thick in the humid air. We navigated the deck, passing by the slew of semi-naked people, most of them sunbathing, eyes closed with headphones on, or perhaps reading, or chatting enthusiastically. And then I saw it. A woman, probably in her 30s, with what can only be described as the elusive “perfect” body – tan but not too tan, six-pack intact, classy bikini, great haircut, laying on her back, eyes closed, enjoying. The cannula on her stomach, with a tiny hot pink thing (sorry, I don’t pump, so I don’t know if different cannulas from different companies have different colors and what exactly the hot pink thing on the site was, but it stood out to me) connected to the tubing which was tethered out of sight on the side of her. I am pretty sure no-one else noticed. Perhaps (probably) some of them did, but I doubt they thought much of it. What went through my mind was – shit – it’s hot – I hope her insulin is OK. I wonder if her pump is in a special case or has an icepack nearby. I wonder how this vacation is going for her diabetes. And also – I am not alone! On this cruise-ship – here’s another from my tribe.


I wish I could’ve talked to her. Well, I know I could have but I didn’t even know if she spoke English. And also I didn’t want to make her feel uncomfortable in any way. I saw her again in the restaurant a couple of days later. Husband and two energetic kiddos. Eating a bowl of yogurt. “How the hell did she carb count that one?” I thought to myself (the pink, I assume strawberry, yogurt was just served in a giant bowl so go figure how much sugar is in that one). And then the realization that now that she was fully clothed I would never had known about her diabetes. And no one around does either. It is (mostly) invisible. 

Wednesday, July 15, 2015

Update!

Random list J

1.       I am back from Europe and it was pretty eventful. And full of freshly baked bread and hidden carbs and stubbornly high blood sugars. And alcohol. And hiking. And family time. And some stress nonetheless. On the way home our flight was delayed by 8 hours, causing us to miss a connection, and as a result spending 36 hours in various airports without even sleeping or brushing our teeth. The good news is we are getting financial compensation (happy dance!)

2.       The day before we left I noticed I had two very itchy bites – one on each of my legs – at least I assumed they were bites. Anyway, they itched very badly and I scratched them, and then within a day or two I had a secondary infection on my skin - a horrible itchy rash spreading with a vengeance - which is nothing that has happened to me ever before. At first I thought it might be poison ivy or something, but then quickly realized it was something else. So there I was – in Europe, high blood sugar, and a (really f’ing itchy) skin infection… In Greece I consulted with a pharmacist and we both agreed it was bacterial – so got a steroid/antibiotic cream. Which helped a bit (but I didn’t consider the double-whammy of rubbing that shit on my legs and then going out into the sun.) Can you say sunburn/ peeling/ super-irritated skin! And then the 36 hour airport adventure and all the Googling on skin conditions I did had me convinced that I might have anything from dermatitis to psoriasis to scabies. Yep, I am a hypochondriac.

3.       After coming home with my skin not looking any better, my BG in the 300s, and no sleep for almost two days, I may have had a slight mental breakdown. In fact, I cried about diabetes (something I have NEVER done before, but I guess needed to happen). I admitted (in a sobbing mess) to my husband that I was doing a shitty job controlling my diabetes, that my skin was probably still infected because I couldn’t get my BG down low enough for my immune system to help out, and that pretty much everything sucked and that I was a horrible person because of my shitty blood sugars. Yep. He responded so well. Hugs, and a “what can I do to help?” (side-note: I love him). Once I calmed down a bit, I asked for him to help hold me accountable. To help with carb counts. To ask me what my blood sugar is sometimes (not to like keep checks on me but just allowing him to be more involved, but not in a pedantic way if that makes any sense at all).

4.       After getting about 11 hours of sleep, re-hydrating, and getting the BG to come down a bit, I felt pretty silly about being a crying mess the day before. But something changed that day. I think when you come out and say to someone (besides yourself or the internet): “I am struggling and I need help”, you give yourself permission not to be perfect, and permission to love yourself when you are far from it. And even motivation to try harder. Anyway.

5.       The skin- about three days after getting back I went to one of those Minute Clinics and had my skin checked out. Of course by then, it was almost back to normal (the NP must’ve thought I was crazy). She said it wasn’t infected anymore and that I could switch from the Ab/Strd cream to OTC HCT 1%/. The rash is completely gone by now – apparently it was just some random infection that can happen whenever there is any break in the skin – cellulitis – and it was not serious and it happens to lots of people all the time. Of course, me being me, I spent a lot of time blaming my poor BG control for it. But maybe it was just a random rash and I shouldn’t have been so concerned.

6.       I went to the dentist last week! There is an exclamation point because: 1. I haven’t been in about 6 or 7 years :O and 2. This was the first appointment I scheduled for myself (my mom would schedule all of mine, even in my early 20s..)  And I was so happy that there were really no issues and that I got complimented on my oral hygiene. Also, I lied about my A1C, giving them the 6.8 (which it was about a year ago), instead of the last 8.6. I just didn’t want the f’ing lecture (dum dum dum complications gum disease uncontrolled blah blah blah) – can you blame me?

7.       I rescheduled my endo appointment to the end of October because I can’t face him right now nor can I face my A1C.

8.       I may have said this before but I feel very determined to get my A1C under 7 (like now). I know I can do it. It’s so weird – how time flies. B and I have started looking for jobs. There have been HR departments we are keeping in contact with and it seems like there are lots of exciting opportunities. Shit’s going down this year (or next), depending on when B finishes his Ph.D. and when/where we move. And then... Well – I mean – we are pushing 30 and probably going to want to start a family (what?) Re-reading some posts of Kerri and other ladies who have had pregnancies with T1D has been very motivational. Re-reading some of my old posts has brought laughter and a little bittersweet sadness. I’m not 17 anymore. Much closer to 30 now (how DID that happen!?)


Not much of a point to this post besides the update – we are working hard on careers as well as continuing with the training our dogs received while we were away. Celebrated 6 years of marriage last Sunday. And lots to do, lots to do, and hopefully a little fun to be had before the summer ends <3

Wednesday, June 17, 2015

On training future ophthalmologists

I am fortunate to have to opportunity to help train our ophthalmology graduate students at one of the top-two ophthalmology programs in the country! Very exciting!
In fact, training graduate students of all sorts is a typical job for postdocs like myself. In case you are not familiar, a postdoc is someone who just/recently received a Ph.D. and takes on a training opportunity (usually ~1-5 yrs. in a typically academic research environment) prior to pursuing a "real" job (such as a professorship or other). Also: postdoc = underpaid slave = TRUE

Anyway, as a diabetic I am especially interested in eye physiology/disease and especially on fostering connections/mutual understanding between doctors and patients as much as possible in order to improve the quality of care and help improve human health in general. Thus, last year, when I was offered a postdoctoral position in the college of optometry at a major state university, I did not hesitate to accept. But until recently, I never considered how working in an optometry clinic fundamentally connected me to diabetes/PWDs/people who know about diabetes. And specifically optometry students, who are already and will continue to be seeing PWD's for the better part of the 21st century. And I have a chance to make a difference in their training. On both a professional and a personal level.

Case in point: I shared my type 1 diabetes with my graduate student. Here's the biggest thing I realized as we discussed - the absolute lack of knowledge of how grueling the management can be. Here is a brief snapshot:

Him: Yeah, people who don't manage their diabetes - it's crazy - we've had people pass out from low BG - so we always have juice boxes on stock - and soooo many people don't even know what their HbA1C is! I am just happy to hear when my patient KNOWS what their A1C is because it shows they are managing their condition. The A1C gives so much more information than just the last number, you know?! Some of my patients tell me their last number and I sometimes wonder if they're lying. But if they know what an A1C even is, that means they really care so...  [he sounded so excited and knowledgeable... Yes, I know..]

Me:Yes, it's important to know your A1C. I also need to point out that the last number is not at all reflective of a person's care. Blood sugar swings are very common, especially in people who use insulin. Additionally, people can and do lie about their A1C. The thing is, sometimes when we see a doctor, we can feel very judged about our numbers, especially if we don't feel like the physician understands how much we care, and how difficult the management is.

(For instance, I once had a physician rattle off all the possible effects of having a slightly higher than "acceptable" last bg value/A1C. She did this in a very pedantic and accusatory way: "Oh, so you're an UNCONTROLLED DIABETIC??!!... Did you know that Diabetes is the leading cause of blindness??" Those were actually her exact words. I still remember her tone as she lectured me and handed me a handout of what my vision will probably look like since I'm such an uncontrolled diabetic... UGGHHH... [on the bright side, I learned a lot about how awesome the #doc is that day, as I tweeted about the appointment. I also confronted her; she apologized, and I can only hope I saved even a little aggravation and hurt feelings for her future diabetic patients.]

Him: Here's the thing. We HAVE TO tell you everything that can happen. We (the doctors) are paranoid. Did you know there was actually a diabetic woman who went blind and sued her eye doctor and won?! All because he didn't tell her the blindness would be permanent!!

Me: Wow, I did NOT know that.

The takeaway for me is that they have a long way to go in REALLY understanding - in particular - how difficult management is (sidenote: grad student has a t2 diabetic mother who is controlling with pills and diet currently, she was a nurse/professor of nursing!). The truth is there is a lack of empathy training. I don't know if it's all chronic diseases, or if it extends to oncology, etc. but that's the way it is.

Bottom line of their side is: They hear "diabetes", so they pull out a long checklist, and will rattle off all the necessary information not to get sued...

Sad but true. The good news is I am in position to make (an albeit) small difference - one at a time - and isn't that how it all starts? With anything?

On a completely different note - I am traveling to Europe this week - it's been calling my name for the last 5 years :) I will see you in July ["July - she will fly" - April, come she will by Simon and Garfunkel - lyrics below and if you're not familiar for the love of everything - YOUTUBE!]

Con mucho amor, como siempre
-MM

***
"April Come She Will"

April come she will
When streams are ripe and swelled with rain;
May, she will stay,
Resting in my arms again.

June, she'll change her tune,
In restless walks she'll prowl the night;
July, she will fly
And give no warning to her flight.

August, die she must,
The autumn winds blow chilly and cold;
September I'll remember
A love once new has now grown old.

Friday, May 22, 2015

Update

So I have been eating lower-carb, higher-fat now for about 3 weeks and I am amazed at the stability of bgs (e.g. no 300s or lows ever). I am still struggling sometimes to bolus for things that I used to not bolus for - like salad . Or eggs and coffee (with half+half). BUT I am also consistently learning that I need to bolus for those things (unless I'm about to exercise or something). I am learning more about the impact of other factors on my BGs. Like stress. Or presentations (see stress). I am finding it easier to identify patterns and trends when not quite so much insulin and carbs are involved. And that makes me happy.

I don't have to be perfect. Truthfully, my bgs are still not where want them to be. BUT they are better than before (see post from 2 weeks ago) and I am seriously not interested in burning out by trying to push myself towards unattainable bg perfection that I crash or that I just want to give up if it's not "perfect enough". To avoid this, I am taking things slowly and making very very small adjustments to things like insulin doses, habits, other variables, etc. slowly over time. And that's OK.

I am spending a lot more time in the kitchen. If I haven't made my oopsie bread for the work-week or I don't have any lettuce washed and ready to go - I better get in there or else! (the else being eating out and hidden carbs as I've learned recently). Like this past weekend - I went to Subway and got a chopped salad with tuna on top and a cup of coffee. And well - let's just say there's something carby in that tuna because there's no way that (esp. after taking a walk) that spiked my bg as much as it did (ps. I SUCK because I never looked up the carb count online on the Subway site - I am assuming that info is available? - I still haven't looked it up...)

Anyway - to give some more details, there are things that I do consider free(ish) foods still (albeit in moderation only): pickles, almonds, numerous crunchy veggies, protein/fat-only foods (again, in moderation). Coffee can be free but unfortunately not when I need it most (in the AM!) Then there are the 1/2-1 U bolus foods: big greek salads, meat + veggies (varies), anything consumed  in the morning (see coffee)... Then there are the 1-2 U/ meal bolus foods: any reasonable (e.g. half serving) amounts of rice, bread, potatoes, starchy things like that, etc. Here are some pics:


Still haven't suite figured out those cauliflower bagels (left pic); probably because I substituted a small amount of regular flour instead of the almond/coconut (but they were delicious!) May I just say how much I LOVE having the egg and cheese breakfast sandwich on oopsie bread recently: crack 2 eggs on med-high, add s+p (+whatever spices, I like a touch of cayenne), herbs (I like green onion), and plenty of shredded cheese, fold over, and cook on each side (on Med heat) until cheese is spilling out and almost crunchy; sandwich between oopsie bread (google the recipe, it's soooo easy and yummy!). On the right is a slightly higher-carb dinner option that has some rice and croutons (there's roast chicken on the plate too). 

You may wonder - am I craving real bagels? Real bread? Surprisingly not really. Sometimes I feel hungry for other stuff like berries and corn chips and bbq sauce. And I eat them, just not with a ton of other carbs on top. Makes sense to me as a biologist - reducing my fortified flour intake makes me crave folate/B-vitamin-rich foods (including green leafy vegetables, nuts, and fruit and veggies). I can't say that I am craving bread. I eat small amounts of rice/potato - just a small amount, and it's nice but not my favorite thing about my new meals.

I lost approximately 3 lbs. over the last 3 weeks. As an (albeit former) athlete (I played high school and college tennis, very competitively - pre-diabetes - but that's another story for another time ;) I consider that almost negligible because (back then) I have seen myself routinely drop 8 lbs.  over a 3-day weekend of competition. Since I don't want to lose more than another 5 lbs anyway, I will keep track of it to make sure I don't drop down too much. If I do, I will probably increase my carb intake a bit.

My skin! This has been the biggest surprise - it's very clear. Very clear for me, considering especially that I am on my period now and I used to ALWAYS break out a ton the week before. I know it's not summer-time sunshine or anything like that because I have been struggling with some degree of acne for the last 15 years or so (I'm 27 if you're keeping tabs :) so I'm pretty much 100% certain (can't say that I'm a scientist!) fairly certain that the improvement is related to the dietary changes.

Anyways.. Sorry I fell off the #dblogweek bandwagon half-way through. You know - LIFE! I loved participating as well as reading everyone's entries - although I still have a TON to get through - I always get excited that after #dblogweek there are sooo many new entries to read and "doc"ers to meet :D

Happy (extended) weekend! :D









Wednesday, May 13, 2015

#dblogweek ; The crazy stories (wild-card)

So I knew I was going to write this post waaay before it was selected as a Dblogweek topic (Thanks to Karen being awesome).

I need to preface this by saying that these crazy experiences all occurred at the start (first couple of years) into my adventures with type 1 diabetes. Back then - I just didn't know any better - today I do! All in all, they are all a result of lack of education (surprisingly in three days at the hospital noone told me about diabetes + alcohol and diabetes + exercise, nor did they tell me lows could be as serious as I now realize they can be..) Of course, it's probably my fault for not researching a ton into my new diagnosis, but let these be a reminder to health care professionals not to assume they newly-diagnosed (especially teenage and young adult) patients are know-it-alls.

3) I am in the country on the outskirts of Amsterdam.

Things are great. Except for the part where I am walking 10-15 km per day (that's right!) to go from either our countryside hotel to the bus stop of from there to Edam (where the good cheese is). It is literally the middle of nowhere (beautiful) and I am doing all this exercising, bolusing Humulin R and still on NPH back then with nothing to account for the increased exercise sugar-wise (meaning I did not carry any kind of fast-acting sugar or any food period! on these excursions). In the middle of nowhere. With Diabetes. Not realizing how awful things could've turned out. Gladly, I was rescued by the loaf of freshly-baked white bread we bought in Edam (with Salami and wine to complement all the pot, of course). I must have consumed half a loaf on one of those 7-km walks back from Edam to the hotel that one day. I never tested (because I severely lacked in test strips when I lived in Europe and also because I just trusted myself back then to do what needed to be done without checking often). I just knew that I had to eat! So I did. And I survived. Cause, really - it would've sucked to have just passed out there. In the middle of nowhere. Even the thought that that could have happened and the distress that would've caused to my poor husband still scares me.

2) This one is crazier, perhaps. I am in Costa Rica for a week. I *think I have enough test strips. But, alas, I don't (after an all-time low of 37 mg/dl I have used up a lot more than intended - again extra exercise was unaccounted for). With three or four days left in the trip, I am 100% out of test strips. I try to get some for my meter at the pharmacy, but they don't have that brand - they will "order it" for "later in the week". Won't work. They offer a whole new system that is ridiculously over-priced (like I can't afford it). So what does this girl do you ask? Well - this girl - forgoes testing for four days, continuing to enjoy her vacation, whilst swag-bolusing away. Unimaginable to me today. But I came home with a BG of 176 and no emergencies. Boo yah. (I don't recommend doing such things :)
Here's a pic of Costa:


1) This one takes the cake and it involves first heavy alcohol use since diagnosis. It was in fact my mother's wedding (I couldn't be happier because my parents' divorce was overdue and I was thrilled she found someone she was happy with again). But. It was a Russian wedding, which pretty much always means lots of Vodka. I remind you that I at that time was not aware of the BG-lowering effects of alcohol and the sky-rocketing of insulin sensitivity that occurs. So, after consuming what was probably some stupidamount of very expensive Vodka, I went to check my BG and was in the 200s. I promptly bolused Humulin R to cover it, not accounting for the drinking. And then the shit hit the fan. Within an hour or two I remember crying and that I had real trouble walking (like I would stand up and my legs would just not really hold me up at all). Here's the kicker: Everyone (myself included) thought I just got ridiculously drunk (which I'm sure was true). But we all know that wasn't the whole story. My boyfriend (husband today) and his cousin (we all lived together back then) took me home to "sleep it off". I remember getting into the vehicle. The next thing I remember is sitting up in my bed, leaning over into the provided bucket, and (well you get the point). And then I received a recollection of the events. Apparently, when I got home, I became incredibly belligerent with my boy and his cousin in law. I was told that I was hitting them! And screaming about how I hated them and to leave me alone. And then I was passed out (but breathing) on the bed for "some time". I came to and my boyfriend was so upset - he thought I meant all the nasty things I said to him about how "I didn't love him anymore" which again, I don't remember any of. When I woke up and threw up, I felt shitty and low, and I remember that I walked to the kitchen fridge and chugged some juice and went back to sleep pretty soon after that. As B helped me take off my clothes and put me to bed, he made eye contact with me and said "So - you still love me?" "Of course I do!" I said feeling guilty for getting so shitfaced and stupid, especially on this day. "Good, I'm glad you're feeling better. Man you should've seen yourself - the spitting image of Courtney Lovefor a bit there" he laughed. For some reason I remember that remark vividly. He was right. Looking in the mirror with my hair messed up and makeup smeared with puffy eyes and white button-down shirt wrinkled - I kind of did look like her. The thing is it took me several years to realize that all this craziness was probably a result of very severe low blood sugar, induced by over-doing it on the Vodka, and not "just being too drunk". Scary shit kind of. I talked to B about it too, after I figured it out. Definitely the craziest and scariest diabetes moment ever. I hope health care professionals and D-parents will take time to talk to their kids about alcohol use and Diabetes. I definitely learned the hard way...

Today, I know a lot more and make more responsible decisions. I know that people around me know I have diabetes, and they know what a low blood sugar can look like. I carry Glucagon, and snacks everywhere with me. I am careful about drinking. I know Glucagon won't work if drunk. I am so much more careful. I haven't lost little rebel - she will always be there - but I gained so much wisdom it would be stupid not to use it <3

How about you?!

Tuesday, May 12, 2015

#dblogweek : keeping it to myself

With the exception of this blog and my husband, my diabetes is almost imperceptible to anyone around me. I don't talk about it a lot, I don't test or inject "in public". When I go into a lab meeting or presentation with a bg of 300-something, my boss doesn't know about it. When I am low low low and my hands start to shake I quietly go to my office and stuff my face with candy or juice. I sit there quietly, as patient as one can be, using all of my willpower not to scream "help - I feel like I'm dying" to a coworker. All in the name of keeping D generally well-hidden.

It isn't shame. Nor is it a lack of a desire to educate. It is simple: I just want people to see ME first.

More recently, I shared my (postsecret) fears of complications and feara of pregnancy with diabetes with my husband. I feel better that I did. But I also feel like I lost a part of the happy-go-lucky demeanor I tend to project as a result. So while sharing is healthy, for me, keeping things hidden also works jn my favor by not allowing me to prioritize diabetes (management, fears, etc) over living my life.

#dblogweek : I can, we can

In some ways I think diabetes  kind of lit a fire under my ass. It has made me face my mortality far younger than most probably think about things like death or old age, but its not necessarily a bad thing because now I know that:

The time is now. Time to travel the world (no matter how poor), time to grow the cutest furrriest family, time to pursue my relationships as well as my career with all the passion I have to give every day. Time to make time for what's really important. Now.

No time for: negativity, laziness, sulking, or questioning.

I can because I have since my diagnosis - gotten married, lived in Europe and traveled to Central American numerous times, adopted three dogs we probably cant afford but love to death, gotten into grad school and got a Ph.D., became an auntie, amateur gardener, avid hiker, and a docophile (am I the first ever to use this word? ;) And I am super excited about what's next! Without diabetes it feels like it wouldn't be the full me anymore - its been about 7-8 years with D but there is no denying it's a huge part of who I am - and I can all the things with it as part of me...

I can, we can - thank you doc for all your support, for reading, for putting yourselves out there. We all have an important story to tell <3

Friday, May 8, 2015

Update!

Here's the update on the lower carb higher fat diet:

I feel good, my 7-day bg average dropped by 60 (mg/dL) points, I have had no lows, and my highest pp bg was 240 (this exact # made an appearance exactly 3 times this week, 1.5 hours after a meal, each time the meal was more than 35g of carbs.) I aimed for steady mid-100s for now and I would say that I did pretty well! I am terrible! at pre-bolusing (probably because I often don't need to, especially after exercise), but I definitely need to in the morning and at lunchtime at work when I'm just sitting at my desk.) Another important lesson I learned this week is that veggies aren't "free foods" (although it may seem that way when they make up a tiny amount of daily carb intake). But now I know that when I have a cup of veggies, I better take a half a unit of insulin and that will be perfect and will make all the difference between 180 and 120. This week, my goal is to continue with this eating plan and do my best to range between 100-160 (160 for pp values and 100 for fasting).

The best part isn't better control - the best part is the lack of anxiety about when did I bolus and am I high, and what am I doing, and how much insulin on board, and do I need to eat again, etc. Things are much more predictable, much more stable, and much more close to "normalcy". I realize very clearly now how horrible the feeling is when you have a ton of insulin on board and all you can do is worry (I'm prone to worry sometimes often?) and the roller coasters that can arise as a result that make you feel shitty and depressed really suck even more.

My Humalog use has been between 5-10 U daily, so basically I cut my carbs and my fast-acting insulin dose in half. My weight was recorded incorrectly last week. I actually started at 119ish and am now between 117-118. Alcohol intake was zero this week so that helped with stability of bg very well, especially with overnight control. (My Levemir dose is still set at 6 U twice a day and seems to be working pretty well.)

I don't feel deprived; probably because I ate well-balanced and also I wasn't so anally strict with myself that I didn't incorporate some foods that probably aren't awesome for bg but tasted delicious (like egg-rolls, freshly-fried morel mushrooms that we picked, and some bread as well). I ate out once this week and I got a large Greek salad with a small side of cole-slaw and also some cilantro tuna salad on top - it was delicious!

 I also tried a lot of new stuff like making oopsie bread, and having my first ever burger on lettuce instead of bread! I also enjoyed dark chocolate, full-fat (indulgent) chobani yogurt, nuts&spices kind+ bars (yum!) Here are some pictures of the kinds of foods I ate this week:














Friday, May 1, 2015

Making some changes...

So instead of whining (see last post ;) I have decided to implement some actual changes to my lifestyle that I hope will make a prompt difference in my D management as well as my state of mind. Basically, I am going to alter my diet in a consistent way, while shifting toward lower carb - higher fat eating (although not to an extreme). I have used low-carb meal planning before and found it to aid greatly in weight loss as well as making my bg more predictable (easier to dose for smaller amount of carbs, etc.) Basically, I am planning an adjusted  Bernstein/ Paleo - type diet (look up Bernstein if not familiar - I think he's got a really cool story). And I say "adjusted" because I very-well known that I will NOT be 100% cutting out ALL pastas, pizzas, breads, rices, etc. And I will not be eating as little as 30 carbs/day (probably more like 50-80 I'm thinking). I instead will change the proportions of these foods I eat relative to other things, incorporating greater amounts of veggies and also some fruit (funny thing with fruit - I can never bolus properly for a banana but I can have a berry/milk smoothie like a champ! damn bananas..) I will also not restrict protein/fat intake of any kind - I don't anyway (although I will not go over-board by eating salami sticks and cheese all day long either :) YDMV as they say, as do our dietary needs. But after much research recently (reading science articles, but also hearing about LCHF advantages from PWDs of many walks of life by word of mouth), I have decided that I would like to try to make these changes and see how it goes. And since I'm trying to drop a few pounds/tone up for our upcoming trip to Europe at the end of June, I think it will be good for that anyway, even if I decide that it might not be right for me in the end... You live you learn, as they say.

So - now I start. And I will need to have some accountability. That is not to say that I have to be "perfect" but I hope I   will find as much time as possible to blog here about my adventures trying new things with my diet - so hopefully lots of food pic and recipes, carb counting, insulin dosing, exercise adjustments, and a general run-down of what's working/not working/ how I feel, etc. (none of it medical advice, of course).

I plan to continue to exercise as I have been (1-2 hours of hiking hills with dogs at least 4 times a week :) And (at least until I figure out how the diet changes are affecting my BGs along with continuing exercise, and readjust my basal doses and I:Cs if needed), I am probably not going to be drinking any alcohol at all. I plan to experiment with wine/possibly beer in the future and see how this might incorporate into a life with (hopefully) better bg control, but first things first...

I have to admit I'm a little nervous posting this, because I'm not sure if I will be able to do it and I am really scared that I will feel defeated if I don't see a sudden improvement in my D control or that I just won't be able to stay consistent. But I have to! I feel like this is great preparation for a potential pregnancy, because I'm trying to be healthier in my diet/habits/  bg control in a more concerete long-term way, and having a solid plan of things that I will be doing/ not doing not just in my head but out here now! And I'm glad I have this blog to kind of make me more accountable. I'm excited to share how it's going - let's try every Friday (?) maybe...

So here is "baseline":

weight: 121-122 ish (I'm a shorty!)
7-day BG ave: 228 (cringe!)
estimated insulin usage/ day: 12 U Levemir (spolit to 2 6-U doses; + between 10-20 U Humalog - this varies greatly)
general state of mind: tired but cautiously optimistic




Friday, April 24, 2015

Talking pregnancy and diabetes, aka Dear DOC

Dear DOC,


Today's entry is feeling heavy-hearted but necessary...

I am as of now 27. Years old that is, and not a BG value ;)

And I really want to have a baby (there is a more than good chance I will try to conceive in the next year) Also, my last A1C was 8.6%. Up almost two point from the last 6.8% I had.. This afternoon, I have had a craft beer (7% ABV) + 1 Bud Lite so please bear with me. I recognize that my alcohol use is having detrimental effects on my BG control and I am no longer afraid to state that. Sometimes, it feels good to have a few drinks and forget about diabetes. Sometimes, it's OK. But certainly not when you're trying to prove to yourself that you can maintain long-term stable and "good" BGs (along with, of course, complete abstinence from things like alcohol, etc.) Don't worry - I am physically and mentally capable of not using alcohol or any other drugs, that has been established (I am familiar with addiction and I am familiar with bad habits, and thankfully this is the latter). Although bad habits can be hard to break. Recently, I had to admit to myself that the reason for this particular "bad habit" is a strong desire to neglect my Diabetes management (please don't judge), because life has just been too damn overwhelming. Couple that with a desire to reproduce (and not seeing/knowing clearly what all of that is going to look like and the self-doubt of - "can I do this, do I deserve this, bla bla bla") has left me feeling a little messy in my head to say the least. 27. Its weird fucking age. A part of me still feels 17. Another part sees my 30-year old sister-in-law (who became a mom this year) and I feel like I am being pulled into two opposite directions - work-hard, play-hard grad student/ postdoc vs. responsible, "well-balanced" (whatever that means) adult/soon-to-be mother..

In my "defense" (not that I need to "defend" myself to anyone, except myself perhaps) I have been on a crazy 7+ year journey with not only Type 1 Diabetes, but living abroad, shaping/growing a marriage, obtaining my Ph.D., becoming a mom to three puppies (and a couple of cats), getting a post-grad job, maintaining post-grad job, thinking about future, (oh, yeah - and the diabetes management, cause of course!)

Things change, that's how it rolls - I know that. A year ago today I was not thinking about having children. I was ecstatic about landing a job, busy writing my damn thesis, and not at all concerned with reproduction. And things have changed a lot since then.. I know that in one week, month, year, whatever, things may be very different. The thing NOW though is that I'm terrified: terrified of pregnancy, complications, my own "inadequacies". (Sidenote: although I know some of you guys on FB/IRL/both/whatever, having this blog be semi-anonymous  - as in at lest my employers won't know it's mine - allows me to not even hesitate to express my true emotions and  deepest of secrets - it has become my therapy and for that I'm grateful.) Back to the point: today, I re-read Kerri's early posts before she TTC('d), etc. I was really happy to feel that others go through this too - as in the doubt and fear and lack of accountability. Am I ready to become more accountable? Am I ready to face my fears and be accountable for the highs? I think so. Clearly, I am ready to admit to you, dear DOC,that I have been struggling in some ways and that I want things to change.

I did read Ginger's Diabetes Burnout book last month, and it was very helpful- I highly recommend it. The combination of the whole "I didn't do perfectly this week, so fuck it all" along with the sentiment's expressed on Kerri's blog about accountability for more than a week or two have really struck a chord with me. I need to go easier on myself a little and not feel like a total failure for lack of (the elusive) "perfect" control.

The truth is that I know that I'm perfectly capable of diligently managing D into submission. I have had A1Cs in the low sixes so I know I can do it! The scary past is hearing the friends/sister-in-law's comment of "Hey - let's be pregnant together!" Sounds so exciting, right? - but there's diabetes for me, and they don't have that hanging over their heads!! So when I think about the realities of not only being pregnant, but having to hear about close ones' "normal" pregnancies, I frankly feel like throwing up ;( However, I know that they will be supportive and understanding if I open up about the difficulties of pregnancy with T1 (and although I'm sure I will, that's a challenge in itself for me, on top of everything, because in my life with diabetes, as I was diagnosed in my very late teens, I have always felt like proving to everyone that I can do anything, and diabetes "doesn't affect anything", "I can do anything")...

TRUTH: Diabetes affects EVERYTHING.
BUT: I CAN do anything :)

Sorry for the rant, as I said it was necessary and I feel better now - love ya'll ;)

-MM

P.S. Stay tuned <3

Thursday, April 2, 2015

after treatment.... a look back (aka the power of insulin)

Every April it's my birthday, and also every April I get nostalgic/nauseated thinking about when I checked myself into MGH back in 2008, two days after my 20th birthday, to start treating (once and for all) my type I diabetes.

As I mentioned in my last post, my A1C was "over 18" at that time. I had spent over a year walking (zombying) around Boston, putting on the regular face of a very skinny undergrad who happened to have to pee 2-5 times an hour. I remember when the depression set in (can you blame me?) and I remember the severity of the denial - the food binges at Whole Foods, the endless bottles of gatorade/powerade/younameit as I stood behind the CVS Rx counter pretending to be a friendly and efficient pharmacy tech. {In case you aren't familiar with this blog, stop feeling sorry for me now! Today, I am more than OK!} Nevertheless, every April I can't help but look back to some degree. For some reason, it's hitting me harder this year, 7 years after the fact (7-yr itch I guess).

I think the reason I was able to hold on for that long was the slow progression. One of the main reasons I didn't treat right away was that  oftentimes I would check my BG and it would be in the 90s (without any insulin whatsoever), although it would often be 300+ after meals) So - it was caught early and progressed slowly (did I mention that I really didn't like needles back then - of course, I am now apathetic to them).

That day. I went to lab. I peed. I was trying to do lab work. I peed. I had the most awful disgusting deep cough you could imagine that wasn't going away. And a headache. My adviser suggested I go to health services. I obliged. My bg was "high", my ketones were "through the roof", (should I even talk about my cholesterol, triglycerides, etc. & oh! and my weight of 90-something pounds!) my pcp pleaded with me on the phone to go to the hospital. I obliged.

Standing outside (in the rain) waiting for the taxi (I told HS btw that I was going to "walk there" and they were like "No, We are calling you a taxi!") to go the the ER. Making the phone calls to my mom and boyfriend seemed surreal. "I'm going to the hospital and getting insulin because I'm really sick and I'm done fucking around." I said. Or something to that effect. I pretty sure I described most of the hospital experiences themselves (all two fucking days of them) in my older posts back in 2012.

There was paperwork. There were nurses and doctors. There was a silly student who said - "oh, birth control and diabetes - you must have blood clots and that's why your legs feel crampy! " There was an attending who promptly corrected him (as in "she's in dka so the leg cramping is likely from that, not the birth control [ps. thank god I was on birth control back then"]) In the end, the defining moments were: 1. receiving insulin; 2. administering my own insulin; 3. getting out.

Here's on the getting out part;
The trees were clearer, the sun was brighter, the depression was nonexistent. Non-existent. I was alive again. I walked to CVS to fill my scripts. It was a little strange because I had just transitioned from working as a pharm tech at that one to going to a private Rx to tech, so I knew those who filled my scripts (in fact, the days I was hospitalized were supposed to be my last two days of work there and wow! what a way to exit and then come to fill a bunch on insulin scripts to prove I wasn't just calling out sick).

Looking back, I obviously wish I treated sooner. A lot sooner. But I can't blame myself forever. All I can do is try to give back by raising awareness, making connections, doing the best I can today, and slowly building my career so I can have a lab of my own (which I will undoubtedly end up using for Diabetes research to an extent, regardless of what the grant money's for ;)

On that note - don't worry if I'm out for a while (grants don't write themselves you know  <3

The person, the numbers

Hey there -just a random story today -

Back when I was first diagnosed and struggling to accept the fact, a pharmacist I worked with said to me:

"You? Type 1 Diabetes? Cake! You can do it. If anyone can do it it's you because you're so smart! Seriously - you're lucky; you can do this."

I have to admit I had no idea what he was talking about back then. At the time I was in denial and refusing to treat, even refusing to learn about treatment - and here he was - assuming that because I was a biochemistry student I should be "all over it" (in more ways than one). That's the thing about the emotional impact of a chronic disease diagnosis - it doesn't matter if you're educated, it matters whether or not you're willing to accept it and deal with it. I know there are plenty of people who don't study biology and were more than willing to accept (even be relieved at) a diagnosis and motivated to learn how to best treat. But not me. I spent a year and a half stuck in the mentality that there was no fucking way I was diabetic, walking around with n A1C of "over 18" and lying to myself. No, dear pharmacist, it didn't matter then how "smart" I was (according to you anyway).

I don't know why I am so bitter about that memory. Probably because once in a great while I can't help but think of how pathetic I felt that whole year+ and how I may live to see the consequences. I hope if anyone out there knows someone or is that someone who was in my situation, they will seek treatment sooner.

Because it's not so bad. And he was right - I can do it. I can count carbs in my head (cake), I can keep numerous variables in my head, I can adjust rapidly, and when I/m really diligent and everything comes together, I am in fact full capable of reigning diabetes into staying in the low to mid 100s with no lows (almost) indefinitely. Although, I am human still - and there is the emotional element. No matter ho much of  a diabetes beast I can be, I can be in a rut all the same. Still the same person - whether the A1C is 6.2, 8.6, or "over 18".


Wednesday, March 18, 2015

The day I made control solution for my meter

Last month I bought a meter from Walmart (relion prime) and I really wasn't sure if it was working properly and it didn't come with a control solution... So after some trial and error, including using brown sugar at first #fail (and help from my husband the physicist and another fellow biologist from twitter it worked!) I learned that (I already knew this) science is collaborative and (that which can I did not know already) for this particular meter I can use glucose tabs (dextrose) dissolved in water. Even though I didn't do a great job to get it dissolved 100% (no magnetic stir bar and plate at home :) I got a great result (see below!) the calculated concentration should've been 100 mg/dl so maybe a little higher but within error margin ;) should I go ahead and change my blog name to "sciency diabetic" or something?! :) I was so happy when it finally worked - thanks again to fellow t1 and biologist @randommagic who thoughtfully suggested I go for the dextrose glc tabs (instead of mainly sucrose?(molasses) in the brown sugar which read "lo" each time in case you are wondering)!!! :D


Monday, March 9, 2015

"The Four"

1. Four names people call me other than my real name:
Masha (it's a Russian thing - pretty much my whole family calls me this) - also Mashka, Mashen'ka, Mashun'ka, etc.
Ria (a nickname my husband used to have for me when we first started dating)
Marie (because apparently it's too close to Maria)
Marcia (go figure)
2. Four jobs I’ve had:
Pharmacy Technician
English Teacher/ Nanny
Grad Student/ Laboratory TA
Postdoctoral Researcher
3. Four movies I’ve watched more than once:
Pulp Fiction
Lord of the Rings (Fellowship)
Bridget Jones (both)
Die Hard (1 + 3)
4. Four books I’d recommend:
PIHKAL/TIHKAL
How to Think Like  a Pancreas
Anything by Dan Brown
Anything by Michael Crichton
5. Four places I’ve lived:
Russia (Siberian plain, Samara on the Volga)
Spain (Madrid)
US (Boston)
US (~Columbus, OH)
6. Four places I’ve visited
Costa Rica
Belize
Amsterdam
France (south)
7. Four things I prefer not to eat:
Pasta (it's the carbs)
"Sweet" salads (e.g. pasta salad, overly sweet potato salad)
That's it - I'm not too picky!
8. Four of my favorite foods:
Eggs (cause of course)!
Eggrolls 
Cheesecake
Coffee
9. Four TV shows I watch:
New Girl
House of Cards
Sherlock
Person of Interest
10. Four things I’m looking forward to this year:
Traveling to Italy
Hiking with my dogs all the time
Morel/mushroom hunting
Relaxing!
11. Four things I’m always saying:
It is what it is
You can do this (I may have stolen this from Laddie but it's true!)
Oh Shit!
Oh Well