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

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".

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

"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

10 things I (don't) hate about D

In an effort to reassess and gain perspective: It might be hard to come up with 10 but here goes - the 10 things I don't hate about (dealing with/life with/ current events with) Type 1 Diabetes.

1. I have an awesome blood glucose meter that I can use with the tiniest ever drop of blood to gather important information about the current status of my (imbalanced) body (sidenote: I cringe when I read about the old-school days of urinalysis and the very old bg meters).

2. My current insurance plan covers an UNLIMITED number of test strips per time period. I pay $125 for a 3 month supply (my last script was written for 1300 strips!) I know that I am very lucky to say this (from both personal and others' experiences).

3. I just had all my labs and eye exam done and I appear to be generally healthy (the Diabetes itself notwithstanding).

4. On some days, I have a really good handle on my management and I feel extra happiness because of my ability to maintain a steady "normal". Basically I'm talking about the days where I don't spike past 180 and have no lows and generally feel great all day/night long. There may not be many, but the happiness they bring to me makes me want to work harder towards more and more of them.

5. My A1C (although I am unhappy with it) could be much, much, much worse.

6. I have never let having diabetes stop me from doing anything. (such as living abroad, hiking alone, etc).

7. I always have snacks in case anyone needs any... (self-explanatory)

8. Although I am a bit of a (self-proclaimed) "hardass", dealing with diabetes has instilled in me a lot of compassion (towards myself and others).

9. Patience. I don't have any (still). But it looks like I will have to learn some (in order to not over-treat lows or rage-bolus as much, etc).

10. I am resilient. According to my therapist - that's just the way I am. But I know that having diabetes has a hell of a lot to do with that.

Hang tight, spring IS coming <3 -MM

diabetes burnout vs. general burnout

I realized that in my last post I alluded to some life events that made my "D care suffer". It made me wonder whether I was just making up excuses for not dealing with Diabetes the way I *should recently. The truth is when your A1C jumps up almost two points to it's highest ever after dx, one must admit to herself that "something's up!". I admit it- something is up. I guess something about being 8 years in all of the sudden makes you realize that it's forever and care less. I DO care, I care a lot, of course I care! But just exactly WHY did my D-care suffer so much? Because I realized that's it's forever and felt apathetic (THEREFORE prioritizing other things in life over D-care)? Because (as my endo kindly put it) "I'm in a transition period in my life"? Because I just am sick of it (by it I mean worrying about lows at all)? I admitted to my endo that one of my worst fears is being "low-stupid" at work. He attempted to help me through this, blah blah blah. Sometimes we just get sick of it (you know?) Sometimes I want to just get shit-faced drunk, eat a ton of carbs and not worry about it. And sometimes I do. The trouble is (I think) when "sometimes" becomes "most times". This is my official admittance of being both self-negligent and apathetic (more than) recently. This is my official admittance that I need some fucking help. Also, knowing that I (I!) am in charge here (in my life) places all the responsibility on me (which can lead to more apathetic and self-negligent behavior). This may sound pretty depressing (even for me), but it's just something I am working through. It's transient. Changeable. Non-conforming. It's controllable, changeable, malleable. Not permanent. Because nothing is. Diabetes burnout, general burnout - a bit of both? It will not always be here.