Friday, June 18, 2010

Party Pooper

I have to admit that this learning phase is starting to bug me.

First of all, I'm a little impatient, and a lot independent, so I want to be in control of managing my own diabetes now.

Second, I'm sick of my records dictating some if my actions. I could eat that giant cookie (and take insulin with it) at 4 in the afternoon, but then my before-dinner numbers would be useless to my diabetes educators when they review my records to decide on any changes to my insulin treatment. I could drink at a friend's birthday club-hop tonight, but that'll throw my numbers out of wack for at least a day and, again, make them useless to my educators.

I'm not a drunk and I don't "need to drink to have a good time," and other such cliches... But I do drink, and it is a part of my social life.  I've only briefly mentioned my social anxiety, but it's affects my life a great deal.  I'm no recluse and I don't start hyperventilating the second someone talks to me, but socialization (except with certain people I'm very comfortable with) often brings about more stress than enjoyment for me.  So when I'm in any sort of "party" environment, the relaxation and uninhibition (is that a word!?) that comes along with a couple drinks helps a lot.

Plus... it's fun.

Wednesday, June 16, 2010

Things can't be all doom and gloom!

I have in my hands a wonderful, wonderful thing.

Lab results... Showing my cholesterol significantly improved!

You can't imagine the relief this brings... And the motivation to start taking an active roll in improving my cholesterol!  When my results were so terrible and my GP doctor was telling me that she's never known a diabetic who could get their cholesterol to the levels where they really needed to be on their own, I felt helpless.  Fine, nothing I can do will fix this.  Just give me more medicine, and then more medicine (hormonal birth control) because of that medicine, and then I'll take more insulin because of that medicine!!!  Just whip up a medical cocktail in my bloodstream and kill every delusion I have about control over my body and fate...

But not now!  Bringing down my blood sugar alone brought me to an "OK" level, according to my endo: 170 (down from 238) overall.  My lab results say that below 100 is desirable for diabetics.  I don't know a whole lot about cholesterol, but it doesn't seem unreasonable that I might be able to achieve that through improved diet and exercise.  My GP also said that she wants my HDL ("good" cholesterol) up to at least 70, and it's already improved from 36 to 60.  Again, by replacing bad fats with good fats and getting my self-pitying butt off the couch?  I think I might be able to get to 70!!!

Maybe I'll need cholesterol meds some day, but I don't think today is that day.  Now that my numbers are "OK," I don't feel like my heart is a ticking time bomb anymore.  I just feel like someone who needs to eat better and exercise... which was true before any of this ever came to light.

My current plan:
  • Exercise at least 2 times a week, preferably 3... Even if it's just a walk around the block, DO IT!
  • Do a better job of avoiding trans fats and excess saturated fat. (Please ignore the Burger King chicken sandwich wrapper on the coffee table!  That... that was for my cat!  I swear!)
  • Lose 10 pounds.  Not only does weight loss improve cholesterol, but 10 pounds would put me back into the range where I just feel better!
Now, I'm going to go get dressed for yoga class!!!

Saturday, June 12, 2010

Raw, Open, Beating, and Vulnerable

One of the hardest things for me since my diagnosis is the knowledge that it affects more people than just me, and the way it affects me affects others.  The truth is that I've always had problems with depression, and now is no exception.  I'm actually doing a lot worse than I usually let on.

Not wrist-cutting-bad, but going-to-the-bathroom-just-to-cry-bad.  I have dysthymia, which is basically chronic (long-term) "mild" depression.  People with dysthymia are mostly functional (unlike people generally are when they have full-blown "major" depression), and it's common for them to go without treatment since they think of that mild depression as "normal."  I have sought out treatment, whenever it got to its worst.  I take Wellbutrin and I visited with a counselor briefly last summer.  But, because depression is "normal" for me, I've made a habit of pretty much never reaching out.  My husband, bless him, is very willing to listen and support me.  So is my mother.  I've had numerous friends express a desire to be there for me.  But if I were to talk about the way I feel every single day?  Lay that out--raw, open, beating, and vulnerable--on the table?  Hell, *I* wouldn't want someone to show me that on such a regular basis.  So... I never do.  The two people I'm closest to see some of that when I'm really and truly in need... but they're also the two people I care about most, so I'm always afraid of hurting them in the process.  So, I often hold back when maybe I don't need to.  Hell, during the composition of this entire post, I'm fighting the urge to delete it because I worry about what people will think of me, or that someone close to me might feel bad to discover how I'm feeling.

This, I've found, is one of the things a professional counselor/psychologist/psychiatrist is good for.  There is no fear with a counselor; that counselor isn't there to like me, and he can't do his job unless I'm honest with him.  His opinion of me isn't going to lessen because I always talk about my negative emotions, I'll never scare him off with neediness, and he will never be adversely affected by knowing how badly off I am... At least, no more than the common emotional toll that drives many mental health professionals to also have their own shrink.

So, I am looking forward very much to going back to the same counselor I saw last summer, a week from Monday.  I was hoping for an earlier appointment, but I have no free leave left and had to opt for an evening time slot... of which he does not have many.  I'll soon get to talk to someone who isn't emotionally invested in me or my health, other than wanting to help me get better.  He was also great at putting things in perspective for me, and making me face important issues I'd normally like to ignore (like my social anxiety, and the too-high expectations I have for myself).  I'll be going to talk about coping with my new chronic illness, but god knows I have numerous other problems I need to deal with right now...

Pity Party!

Well, this week sucked.

It was positively wonky on the blood sugar front.  I've had to snack between most of my meals to keep from going too low.  Tuesday was the worst and probably a little influenced by that glass of wine from Monday, but the major culprit for the entire week (and my Diabetes Educator agrees on this) is most likely hormones.

I stopped using the NuvaRing after only a week because it had turned me into a sobbing, pathetic ball of hormonal self-pity.  I'm so glad to be rid of it, but stopping so soon also meant starting my period very early.  Your period can lower your blood sugar, and apparently this one did a WHAMMY on mine.

Though I've successfully avoided actual lows by checking my blood sugar regularly and snacking whenever it's on a clear nose-dive, the chaos made this week awfully hard.  There was little else I could think about and I felt fuzzy-brained (from the fast drops and rises?), which made me somewhat useless at work, and I'm just exhausted.  My boss even sent me an email in which she told me to "go back to the drawing board" and re-prioritize some projects, and she concluded by telling me, "I want you to come back on Monday refreshed, organized, and determined."  I had all kinds of emotions about this:
  1. Guilt, because I know she has valid concerns about my recent performance.
  2. Frustration, for the same reason.
  3. Anger... because she has been very casual, even cheery, about my diabetes.  My mental response when first reading her closing request: "Does she not get that it's possible I won't be able to be refreshed exactly when she demands it?"
People with diabetes live normal lives and work just as effectively at their jobs, but the fact is that there are times when diabetes takes center stage even if you do everything right.  I intend to get to the point where I am living a normal life and putting forth normal (exceptional!) effort toward my job again, but I've only been treating diabetes for just over a month, and I'd say I was barely in control of my blood sugar this week.  I'd told her twice that week, including earlier that day, that I was fighting low blood sugars for the first time.  Her response? She squinted inquisitively with a "Hm!" and moved on.  After that email, I'm starting to think she doesn't understand that treating diabetes isn't as simple and effortless as some people make it look, and that low blood sugars (or rapidly dropping blood sugars, which was my issue this week since I fended off the sub-70s) affect your body and brain.

But then, reintroduce guilt:  She's right in that I'm not delivering like I should.  And also introduce a sense of being trapped... because maybe I just need to take a couple FMLA days off from work to rest, but I can't because of projects at work and because I can't afford it with the new medical bills, the purchase of a house right around the corner, and having finally paid our taxes (yeah, I know, way late).

So, what am I trying in order to make myself more "rested" for her?  Asking to have someone else host our Friday night D&D games for a little while.  Skipping my cousin's wedding shower tonight.  Staying at home while my husband and nephew watch the US soccer game at the local Irish pub.  Not going on my Sunday visit to my parents' place.  Working at home tomorrow (Sunday), because I could not focus enough to finish an article that needs to be finished by Monday morning.  So restful...  I miss the days when I worked jobs that were pretty immediate, meaning I couldn't take work home, like working reference at the public library.

And, honestly, my stress is sky-high.  When I started treatment, I was stressed enough to be dizzy and headachy (which had me checking my blood sugar repeatedly!).  I'm back to that right now.  I don't really have anything that I do on a regular basis for stress releaf.  Exercise might normally be my answer, but I can't do that with already-plummeting blood sugars.  Sadly, I dislike a lot of the things other people do.  Bubble baths are boring, massages are uncomfortable (one masseuse made me cry!), beauty treatments like pedicures make me feel awkward, and my mind has been racing too much for meditation.  Escaping into my third read of Watership Down has been my one resource.  So... maybe I'll go try and read that while I take a hot bath, so it'll be a little less boring.

Monday, June 7, 2010

Because I'll Never Completely Abandon My Vices...

Had my first alcohol since diagnosis, tonight: One decent-sized glass of Pinot noir.  I'm keeping a very close eye on my blood sugars with my sexy little red (cheap cheap CHEAP) back-up meter.  So far, a consistent drop that seems a little faster than I'd otherwise expect.  But since I started with a slightly high number, it's in more-than-safe levels.  I'll test again for my bedtime snack/shot... then once more before sleep, just to be safe.  I just hope that one glass doesn't make things plummet overnight!

Most alcohol causes blood sugar to drop (though it might cause an initial spike), despite the sugars in it.  My initial reaction to reading this was that, hmmmm, Intensive Alcohol Management might be slightly more fun than Intensive Insulin Management.  But... I don't think I'll be bringing that up to my diabetes educator anytime soon!

Friday, June 4, 2010

Better Pace than Expected

While talking to my diabetes educator on the phone yesterday, she said she felt my insulin ratios and doses don't need any changes yet.  I was disappointed, and told her I was eager to really get things down... and she pointed out that the last couple of days had been great.  And it's true.  And after thinking about it for a while, I realized a few things:

  1. My recent numbers aren't that far from what she said will be my eventual goal range.  I occasionally rise above it, but not by that much.
  2. I'll learn to adjust my own ratios and doses for specific situations.
  3. I want "normal blood sugar," but I don't have a normal body.  I don't have a working pancreas, which would normally create both insulin when my blood sugar starts to rise, and glucagon when my blood sugar gets too low.  Until things are a little more predictable and I've recognized a few more lows, staying on the higher side of normal is probably safest.
  4. I hadn't been exercising, and exercise tends to lower blood sugar!
So I went for a brisk, 20 minute walk yesterday evening.  Afterward, my blood sugar read as about 25 points lower than I started... and this morning, my fasting (morning) blood sugar was 20 or 30 points lower than it normally is.  If I have the same results for another day or two, I'll check with my educator to make sure the new trend is safe.  (One of my my fears is having a low blood sugar in the middle of the night!)

In other news:

I'm meeting with an Animas pump rep tomorrow morning.  At Panera bread... I'd better check their nutritional info!

My left arm is randomly sore, like I strained or twisted it.  I know I tend to try and carry too much with that arm, in order to free my right hand for things like unlocking the door, but everything seems like a symptom of doom and gloom diseases these days!

Wednesday, June 2, 2010

Numbers and a trip to the endocrinologist

My blood sugar numbers have gotten pretty good, and I really hope my Diabetes Educator lowers my target numbers.  They're currently 130 (before meal) and 180 (after meal), but the general range I'll be shooting for eventually will be between 70 and 140... or 70 and 120 when I get pregnant.  Most of my numbers are generally between 100 and 150 right now, which isn't too far off from that long-term goal range!

I went to the endocrinologist yesterday, which I'll talk more about later.  But she told me three things that make me very happy:

  1. I should go ahead and start the paperwork necessary to get an insulin pump.  I may not be able to get it until I've met some time requirements set by my insurance (6 months), but starting now means less waiting when I get to that point.
  2. She doesn't see any reason why I shouldn't be healthy enough to start trying to get pregnancy again by the end of the year, maybe even by fall.  (Also, planning a pregnancy makes getting a pump approved much more likely!)
  3. She thinks we should see how much my improving blood sugar lowers my cholesterol before starting cholesterol medication.  She seems to think there's a chance I won't have to take any at all until I'm older.  *This is quite different from my GP's statement that she's never even known a diabetic who had their cholesterol sufficiently under control without medication.  If my cholesterol improves enough that my endo doesn't think I need meds, I may take the middle road:  Wait until I'm done having babies, then take the meds if my GP still thinks it's warranted.)
So far, I'm leaning toward an Animas Ping insulin pump.  (Medtronic's Paradigm is a close 2nd choice.)  I'm already looking forward to the greater precision of a pump!