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

#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?!

#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

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:

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