Sickity Sick-Sick

Friday night, I started wearing out well before our D&D game was over. Half snoozing on the couch, those still conscious took pity on me and another couch-snoozer and shut the game down. After everyone went home, I went to bed.  I eyed my Dexcom, unhappy to see a 175, and tested... Yep, high.  I bolused, but not too aggressively since I was about to sleep, and settled down for sleep.

Sort of.

My stomach started to rumble and my blood sugar would not go down. If Dexcom wasn't beeping at me, I was waking up to try and find a better position for my stomach or to drink water, pee, and try to get a handle on my blood sugar.  I finally got up around 7 am with a headache, bolused again, checked for ketones (negative) just because I had so much time trying to get my numbers down that I had to wonder, and really started trying to hydrate myself.  I then went out on the back patio with a big glass of water and a small cup of coffee.  It was a tiny bit warm, but not bad... then suddenly I had the "sweats" that I normally associate with a low blood sugar (but I certainly wasn't low) and had to run for the bathroom.  (Sorry for the TMI!)

Ohhhhh, I was sick!  That explains so damn much.

(As a quick detour for anyone going, "OMG, listeria!!!"  No, the symptoms were not a match and there hadn't been any time for an "incubation period" since I'd only just had deli meat that day at lunch and listeria takes at least 2 days to manifest symptoms. Plus, Chad got the same symptoms later in the day and hadn't eaten the deli meat I had eaten.)

I know that my blood sugar tends to run high when I have any kind of stomach upset, so I cranked up my basal insulin by 50% and sat inside in the nice air conditioning and felt sorry for myself until my blood sugar was under control again.  My stomach discomfort went away quite quickly, thank goodness, so I made a healthy but easy breakfast for us when Chad got up.  I kept feeling exhausted and headachy, I attempted and failed to nap, then I finally gave in and took some Tylenol.  Unfortunately, this meant turning off Dexcom for the rest of the day.  CGMs just don't work with Tylenol in your system, and Tylenol is all a pregnant woman can take for everyday pain.

Night-night, Dexcom:

I dislike not being able to see what my blood sugar is doing at a glance, especially since pregnancy has made things so unpredictable....  It. Was. Worth it.

I ended up feeling well enough to go to a birthday party for three good friends of mine.  I did, however, tell Chad to just go ahead without me because I knew I was going to take a looooong time getting ready with so little energy.  I felt pretty decent most of the evening, though I was tired and spacey and never got rid of my headache 100%.  Chad and I ended up leaving at the same time despite our plans that I'd head home early and he'd probably stick around.  Right around the time my headache was coming back, he said his stomach had been rumbling and he got the sweats.  Either he caught the same bug from me or we'd both picked something up from the same source and his immune system had simply held out a little longer than mine.

I went to bed with a headache again, because I just wasn't willing to take Tylenol and keep Dexcom turned off overnight.  My blood sugar had crept back up during the evening and I had to bolus not long before bed. 
I really just wasn't confident that my BG would react predictably.  Luckily, this one wasn't a constant headache but one that only throbbed with added pressure or a lot of movement.  It only nagged me whenever I rolled over, so I could actually sleep.

I'm feeling a hell of a lot better this morning.  My head still hurts with pressure (like when I sneeze, OUCH!) and my BG was a tiny bit above my below-100 fasting target when I woke up, but I'm just taking it easy and staying hydrated.

I was kicking myself repeatedly over those high BG numbers that first night, but this is yet another example of how you can do everything right and diabetes will still screw with you.  It's a manageable disease, but that doesn't mean pure dedication is going to keep it in check every single day.  Sometimes things just happen.

Flying in the Face of the APA

I've officially decided to do something that flies in the face of an American Pregnancy Association recommendation.

I'm going to eat cold cuts and deli meat.  And I'm not going to heat them all until steaming first.

Right now, the majority of you are having one of two reactions:

1. Most of you are saying, "Uhhhh, what's wrong with cold cuts and deli meat?"
or
2. A few of you are thinking, "Ohhh, but there could be bacteria, and that could be bad for the baby!"

It's not that widely known (you'd be amazed by how many blank stares I've gotten when turning down cold-cuts in the past few months!), but yes folks, pregnant women are advised by the APA to avoid eating deli meat (any cold meat that hasn't recently been heated to at least a "steaming" temperature).  The theory is that there is a slightly higher chance of food poisoning with meat that's stored and eaten cold, and if that food poisoning were caused by listeria, it might also cross the placenta and make the baby sick (sometimes dangerously so).

Is it that listeria infection is rampantly common?  Nope.  About 2,500 Americans get it a year, which is 0.0008027371616142571% of the population.  Then, is it because pregnant women are more susceptible to listeria?  A little bit, due to weakened immune systems.  27% (about 6750 people) of those 25,00 Americans who get listeriosis each year are pregnant and, since there are about 6 million pregnancies a year in the States (and just assuming that means roughly 6 million women are pregnant a year), then about 0.11249999999999999% of all pregnant American women get listeriosis.  I know that looks like a big number with all those digits, but it's actually tiny.  It would round to 0.1%.

Holy crap, I did math!!!  And I'm reasonably sure I did it correctly!

Anyway, my point is that there's a pretty slim chance of contracting listeria, and then it might not even cross the placenta to my baby.

But during the work week, what have the chances been that I would forget or neglect to pack a lunch and end up buying fast food which raises my blood sugar way out of the pregnancy target range?  I'd say those fast-food high numbers have been happening about 80% of the time, lately.  I've tried a dozen different methods to get myself to pack a reasonable lunch, and I beat myself up over every high number, but to no avail.

But before pregnancy, and before my resulting (self-imposed) deli meat ban?  I'd say I made my lunch about 75% of the time, which generally meant throwing simple, pre-made foods into my little lunch cooler with a baggie of veggies and/or fruit.  There were always some sort of deli meats in there, often as part of one of those little lunch combos I call "lunchables for grownups."

So I've made the decision based on the statistics around a possible danger for my baby vs. a verified, daily danger for my baby.  My OB harps on about my blood sugars at every single appointment, but she has never once, either in person or on the dos-and-don'ts list I was given, said that I shouldn't eat deli meat.  No, not all OBs are as concerned about listeria as the APA.  My OB is pretty chill about "restrictions" in general.  Tylenol in indicated doses, up to two servings of caffeine a day, up to two servings of nutrisweet a day, hair dying is allowed in a well-ventilated area, etc.  And what she always emphasises with me is: good blood sugar levels, above all else!

If throwing a lunchable-for-grownups in my lunch bag every day keeps me away from Sonic and therefore keeps my blood sugar down, so be it.

Well, That's Embarrassing...

I don't use any fancy pump accessories.  I didn't get the "thigh thing," the "waist-it," or any kind of special clip or case.  I just use the clip that came with the pump and I have a couple "skins" (which I got for free) in case I'll be doing something that is more likely to knock my pump around.

Typically, I do one of the following:

1. I put it in my pocket.  Most of the time, this means it's visible.  I do, however, have a couple dresses with pockets that allow me to hide the pump entirely by running the tubing through a tiny hole just inside the pocket.  (I just cut a hole big enough to run it through then dab some "no fray" on the edges.)
2. Clip it to the underside of the front of my bra.  I'm busty, so this normally hides the pump-bump entirely if I'm trying to go for a more sleek fashion look.  (When I do this, I first slip the pump into a little fabric pocket I sewed myself [some people use baby socks!] so it doesn't get all sweaty against my skin.)
3. I clip it to the side of my underwear, slightly toward the front or back so I don't have a "lumpy" looking silhouette.  This is what I almost always do when wearing a dress to work.  (This also happens to be how I always wear it when I sleep.)

So, as usual, I had my pump clipped to the side of my underwear yesterday since I was wearing a dress.  No problem.  I really don't even notice it.  But then all of the sudden, there was a tiny little...

Snap!!!

And then things just felt a little different.  I continued walking and felt my pump slowly drooping...  Huh, odd... Oh, crap!  The elastic in my waist snapped!

It normally wouldn't have made much of a difference, but the weight of my pump kept inching it downward, and I had to keep trying to subtly pull it back up.

Droop, droop, droop, subtle hike!  Droop, droop, droop, subtle hike!

At least, I hope it was subtle...

Nice.  Who'd have thought my underwear would matter that much?

Luckily, it wasn't long until lunch, so I just slipped out to the Dollar General and bought a pack of underwear.  Problem solved!

San Antonio and the Death of Dex

I spent a long weekend, out of my usual routine and either walking far more than usual or sitting still far more than usual, without Dexcom (a continuous glucose monitor).  And I was just fine.

You see, last Wednesday night (or early Thursday morning!), Dexcom vibrated to wake me and tell me I was low.  I felt OK, but tested... and I was 90.  Perfectly fine.  So I calibrated Dex and laid my head back down to sleep... only to be startled awake by an incredibly shrill BEEEEEEEEEP!!!!

I've seen other D bloggers complain that Dexcom is too quiet and won't wake them up at night.  Yeah, I don't have that problem.

I grabbed it and saw that Dex was initializing, and then that it had recovered a session.  Okayyy...  I put Dex back on the nightstand and settled back in, trying to relax...

BEEEEEEEEEP!!!!


Initializing and recovering again!
 
I went through this two more times before I turned Dex off and got out of bed, wide awake.  3:30 am.  Great.  No way I could get back to sleep, as wired as I now was.
 
I called the Dexcom service line as soon as business hours arose and they confirmed that, yeah, something pretty bad had gone wrong with the receiver, and they wanted to just replace it to be safe.  They offered to overnight it, but I asked them to wait and send it so it would arrive Monday, since I was leaving town early the next morning.  (They were, by the way, extremely awesome and offered to just overnight it to where I was going.  I didn't really feel secure about sending it to a hotel when I surely wouldn't get there until well after delivery.)
 
Friday morning, after stopping for the #7 breakfast at Cafe Antigua (this particular meal is both incredibly delicious and miraculously easy for me to bolus correctly!!!), Chad and I made the long Trek down to San Antonio for my grandmother's memorial service.  As a straight shot, it's about an 8 hour drive.  It's much longer when you're pregnant and need to make frequent stops to use the restroom and stretch your legs.  The drive wasn't bad though (especially since Chad was awesome and happily drove the whole way!), and we met up with my family on The Riverwalk when we arrived.
 
I had few blood sugar issues.  I went low twice over the weekend, but neither time was bad at all.  I probably went a little higher than I might have with Dexcom once, but it wasn't really out of my typical range, either.  Basically, I just tested more often... A lot more often.  And it was fine.  But still, there's so much that Dexcom gives me.  For example, I ate most of a sugar free fried pie and felt like maybe I'd given myself too much insulin for it.  We Dexcom, I could have just kept glancing to make sure my blood sugar wasn't dropping.  Without it, I tested like 45 minutes after eating to make sure I was going in the right direction at the right rate (I was), but I still felt kind of paranoid until the two-hour test.  And with Dexcom, I didn't feel the need to test my blood sugar before sleeping.  I just glanced to make sure it was in the right range and fell asleep with confidence that it would wake me if I went too low or too high.  Without it, I tested before sleep (a good thing too, as I was a little low at that test on Saturday night) and still worried as I fell asleep... In fact, I let myself run a tiny bit higher during some of the weekend than I normally would while pregnant and with the safety net of a CGM.
 
Things have been fine, but I'll be really happy to see that Dexcom box this afternoon!

"Diabetic"

I'm definitely not militant about saying "person with diabetes" instead of "diabetic."  I don't care much if people call me diabetic (either as a noun or as an adjective).  I try and respect that others might not like it and at least won't refer to anyone as "a diabetic" unless they've called themselves that.

But, I'm beginning to really see why some people dislike the very word "diabetic."

When I visit my OB, it's like diabetes labels everything about my pregnancy... in a way that I don't think is accurate.

For example, she keeps saying "diabetic placenta."  I know that what she means is "the placenta in a pregnant mother who has diabetes," so I'm not offended or going to go on about how a placenta can't be diabetic.... but I feel that calling my placenta "diabetic" feels like calling it "broken down and incapable of supporting a baby properly."  And that isn't true.

It is true that a placenta is more likely to break down too fast in a mother with diabetes.  I definitely won't deny that, or deny that it could happen in my case.  But the placenta does not break down faster simply because you are diabetic.  It breaks down faster in the presence of higher than average glucose levels.  Therefore, a very well-controlled diabetic mother might have a perfectly healthy placenta that is in tip-top shape all the way through pregnancy.

I accept that I am at a higher risk of needing interventions, but I dislike such suggestions (however unintentional) that I and my baby are doomed merely because of my diagnosis.

So, I now kind of get why some people dislike the word "diabetic."  I understood already that it comes across as a label, which many people dislike, but now I also get that it suggests a state of being more than "with diabetes" does, and a "diabetic" state suggests poor health.  Whereas, plenty of people with diabetes are actually healthy.

I am continually fascinated by the power of words.  Thoughts shape language, but language also shapes thought.

Diaversary: Celebrating the Best Bad News of My Life

Yesterday was my one-year diaversary, and how did I celebrate?  With cake!  Yummy, sugary, properly-bolused cake!

Chad was awesome.  I was feeling crumby from an earlier low BG and I tried extra hard to look all pathetic and tired and pregnant on the couch while I said I should eat cake for my diaversary.  So Chad went to the nearest market with a bakery and brought back both red velvet and carrot cake!

They're individual slices of cake, but still just huge!  I bolused (generously!), made marks in the icing to indicate how much I would eat so I wouldn't get carried away, and thoroughly enjoyed my treat.  Chad had some of what I didn't eat and we still had plenty of cake leftover.  That's how big these stupid (but tasty) slices of cake were!  Supposedly two servings, but really more like 4.

And this was a little celebration, as far as I'm concerned.  We weren't celebrating diabetes, we were celebrating the diagnosis and the fact that the disease is about as under control now as it could possibly be.  (But let's not fool ourselves. There's no such thing as 100% control when it comes the the big D.)  One year ago, I got the best bad news of my entire life.

My blood sugar behaved with the cake, and I went to bed feeling pretty much OK about life.  Yeah.  Life is pretty good.