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Thursday, February 11, 2016

Improvements!



I had an appointment with my endocrinologist yesterday and just got all my labs back. I am pleased to say, that although I am still not 100% satisfied with my A1C, I was able to reduce it by 1.3% since my last visit and all my other labs are normal! I am happy to see the improvement to say the least J I wish I had time to write more, but life.

Love you all!

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