Showing posts with label adjusting. Show all posts
Showing posts with label adjusting. Show all posts

Thursday, November 3, 2011

In The Meantime...

I'll talk more about the initial adjustments when I give you installation four of "Xander's Arrival Story," but let me tell you, delivering a baby is like hitting "reset" on your insulin needs.  I still need far less than before pregnancy, let alone compared to needs during pregnancy!  But it's all in flux.  My one month average blood sugar?  116.  My most recent one week average? 145.
Can you tell by looking at those numbers that I started back to work almost two weeks ago? Yeah, pretty clear what's thrown a wrench in the gears.  I've had a few 200+ numbers sneak in there during work hours.  I finally took 20 minutes this morning to look at time of day averages and adjust my overnight basal rate and up the insulin on my breakfast and lunch I:C ratios. With both a baby and work to keep up with Time to get this under control.

I only have one set of organs, after all.  It's kind of important to take care of them!

Tuesday, February 8, 2011

Tantrum

I was wandering the supermarket, which means that I was thinking about carbs.  By the time I wandered onto the "lunchbox" aisle, my thoughts had begun to turn sour.  All of those adorably portioned carby goodies stared at me.  Cookies, crackers, little crunchy bread sticks that come with their own suspiciously shelf-stable fake cheese dip, boxes containing cute little 100-calorie pack snacks.

A friend's old criticism bubbled to the surface of my memory...  People think those 100 calorie packs are a good idea, but they're not.  They're still not healthy, and you can just take a portion out of a regular sized box.

I (and she) did not know that I was diabetic at the time (I'm fairly sure it was already developing then), but now I realize that individually packaged snacks make it easier to eat snacky stuff with diabetes.  No counting crackers necessary, just grab a pack and punch the listed carbs into the insulin pump.

But my slightly sour thoughts didn't lead me to find this fact interesting.  Instead, I found it infuriating.  Other people eat straight from the box of crackers, no counting, no calculating.  That's how almost everyone else does it.  Why do I have to do it?  Why do I?  Why me?!?!

The words rang in my head with the sort of angry, distraught tone I used as a child, the one that I felt certain would illustrate to my parents just how grave an injustice it was that I couldn't do what I wanted to do, the one intended to pull at heart strings, infuse guilt, and drive home just how incredibly strong my emotions on this subject were.

Whoa.

I was so taken aback by this inner tantrum that I stopped right there in the aisle.  Where had that come from?  I normally don't ask "why me?" when it comes to diabetes, because I don't think there's any kind of answer other than genetics.  It occasionally strikes me as very strange to think of myself as diabetic, because I spent so much of my life without serious health concerns, but it usually ends there.

And all because I miss eating out of a full box of crackers?  I'll admit that I am readily frustrated by anything that makes simple tasks like eating more complicated, but was it really this that inspired the strongest emotional reaction I've had to diabetes in quite some time?

It's no secret that I'm under a lot more stress than usual and that my mood swings more easily, because I'm pregnant.  Maybe it was this added volatility.  Maybe I was really throwing an inner tantrum over my pregnancy being 100 times more complicated due to diabetes (as in "oh my gosh this is complicated," not "this pregnancy is full of complications").  Or maybe this tantrum was buried deep beneath the conscious logic and practicality I've held to since diagnosis.  Maybe that was my inner child finally shouting loud enough for me to hear her, finally striking that exact tone that would make the adult me stop, pay attention to her, and reconsider.

Only, dear Inner Child, I cannot reconsider diabetes.  I'd gladly change this for you if I could, because I agree, diabetes isn't fair.  It does suck.  And that big box of crackers?  I do want to blindly eat fistfulls of them on the couch without even thinking.

*tantrum*

Wednesday, September 15, 2010

Don't Knock the Bad Habits

You know, bad habits get kind of a bad rap... But I've found that some bad habits have occasionally been what's needed just to keep me going. Like for a while, I almost totally stopped prepping my skin with alcohol before shots. But OMG, I was so completely sick of shots at that point! But that bad habit, which I knew plenty of other veteran diabetics did safely enough, made the shot process more tolerable during that difficult phase... and I got back on track before too long.

And then, there was when I got way sick of spending so much time doing test after test! I stopped properly washing my hands or cleaning my finger before hand and resorted to just licking it and wiping it off (maybe marginally better than just sticking your dirty finger). But at least that kept me testing, and now that habit is gone as better control and my Dexcom have helped reduce the "extra" tests and as I've learned better shortcuts (like dunking the finger in a glass of water instead of licking it, or rubbing soap and water between just one finger and my thumb if I want to take less time and mess than a full hand washing).

So while breaking them is advisable, don't always knock the bad habits, especially when you see them in others. Maybe it's an alternative to a much worse habit... like not injecting or testing at all!

Monday, August 9, 2010

Smoothing Out the Seams

I think I’m beginning to incorporate diabetes treatment into my life more smoothly. Even with the pump being so new, and even with other new things (CGM) on the way, it’s all starting to blend in. All of the actions are inspiring less, “Let me stop my life for 5 minutes to test my blood sugar and take an injection,” and more, “I hope I don’t look too inattentive while I test my blood sugar and listen to this person talk at the same time.”

The most invasive daily activity at this point is counting carbs, even though the pump takes care of some of that for me. Even if the database were easier to browse, some foods are just always a mystery unless you make them yourself. There could be sugar in your sweet corn, flour in your omelet, or (on the flip side) far more fiber in that dinner roll than is typical. And what is the tuna-to-pasta ratio in that tuna casserole??? It helps, when dining out someplace without a nutritional guide, to stick to simple foods. I’ve been eating a lot of poultry and seafood with rice and veggies or salad lately... The meat has little to no carbs (as long as it's not battered, and depending on sauces and glazes!), I can pile rice or veggies into a mound and judge which of my measuring cups it would likely fill, and side-salads with creamy dressings (ranch or Caesar), a few croutons, and no fruit have pretty reliably acted like about 10 or 15 carbs (depending on size). I’ll probably branch out into more combination foods as I get a better feel for carb content, but simple and familiar foods make life a little easier when there are no hard numbers to rely on.

Making food at home is easy. Meals for just myself are usually packaged and frozen (I love Kashi meals for lunch!) or routine enough that I know exactly how many carbs are in the final product as I always make it (my usual PB&J sandwiches are 34 carbs). If it’s a more complex meal for my husband and I, I usually try to cook exactly enough for both of us. I jot down carbs on a scrap of paper as I choose ingredients, total it up, then divide by two to determine the carbs in my half of the meal. (Or, more likely, I take a look at the carbs for one serving of a frozen “meal for two” I’ve just sauteed!) I test my blood sugar while the food is in the last couple of minutes of cooking, then punch the carbs into my meter-remote for my bolus calculation as soon as we sit down to eat. I’m already eating the first bite before the pump has finished its bolus. (So much faster than taking a shot!)

So it’s all falling into a rhythm. I’ve had to make some adjustments to my routine to more seamlessly incorporate treatment (eating simple foods at restaurants without nutrition guides, taking a few extra minutes every third day to put insulin in my pump and insert an infusion site so I don’t have to take a shot 5+ times a day, buying a more organized purse to easily carry and find my gear, buying some 1-cup tupperware bowls so I know exactly how much cereal I’m eating without breaking out the measuring cup...), but the treatment itself is also becoming easier to adjust (the pump means less time and mess before meals, I can use my glucose monitoring kit more quickly and without taking every little thing out of the case now that I’m used to it, and I don’t have to do as much math to give myself insulin anymore).

I still have these surreal moments when I realize, “I’m diabetic. I have a chronic disease. I have to take medicine multiple times a day to stay healthy and alive.” This strikes me especially hard when I wrestle with the tube of my pump while changing clothes, but then the pump disappears quite effectively under the front of my bra, and I only occasionally talk to it for the rest of the day through what looks pretty much like a fat little PDA... and it talks back to me from beneath my shirt through the quietest whisper of a *click* when it gives me a basal dose of insulin, and through a rhythmic vibration that translates into, “Bolus insulin for 41 carbs coming right up!!!” And I can hear the quiet twist-and-deliver as I enjoy the first bite of my meal... and then I think about other things.

Every now and then, I’m amazed by the things I do automatically. The seams are smoothing out...

Sunday, August 8, 2010

Pumping It Up!

OK, so here's the pump update!

I started on Wednesday. The frustrating thing is that the CDE, who I had never met before, kind of started from scratch on a lot. Like, though I knew I needed lower basal rate in the afternoons and evenings, she still set the same rate all day. Maybe that's standard for starting on a pump, but I kept wishing my usual CDE were there instead.

But, over two hours (which could have been more like one hour, if she weren't such a chatter!), she got me started and set up. I was nervous about inserting the needle/cannula for the infusion set, but discovered that it hurt less than some of my insulin shots do! It was a little awkward, but generally easier and less invasive than I thought it would be. My mom, who went with me and is a nurse, was concerned that the cannula was too shallow and started making suggestions about angling it differently next time... But the CDE assured her that it was in exactly right, and my later numbers showed that the insulin was indeed getting into my system properly. Pretty cool.

This really is kind of like starting from scratch, though. The CDE seems pretty happy with where my numbers have started (some people's blood sugar does crazy stuff when switching treatment methods!), but we're still having to adjust for evening and afternoon lows. A total pain. But it's interesting to watch my insulin needs go down so much on the pump! She commented that they start a new pumper on a slightly lower basal rate than they'd had because most people weren't getting every little last drop in their system when doing shots. And I believe that, because I usually saw a remaining drop (maybe two) come out of my pen needles even after the recommended count-to-ten.

Wearing it has been no problem. It's a little surreal to be hooked up to a medical device, but it's small and cute. So far, I've worn it:
  • Clipped under the middle of my bra (I'm glad I'm endowed, now!).
  • Under my waistband.
  • In my pocket.
  • Clipped inside the front of my nightgown (around the house and in bed).
  • Clipped to the side of my underwear (in bed).
(Under my waistband.)

Pretty simple. I dig it!

Thursday, July 1, 2010

A Need to Return to Normalcy

Long time no post, but I've been a wee bit busy.  I'm sitting in a new house full of cardboard boxes.

Also, I went through a dark patch there.  I was very, very down about life, including diabetes.  Not that I'm totally over that, but I feel a little more in control again.  And I want to get back to blogging, but I feel bogged down by everything I want to say when I do...  So, I'll just type.

Moving plus my period did a number on my blood sugars.  I had a lows four days in a row, including a 40!!!  So today begins a slightly new routine with the Lantus ("basal" or long-acting insulin):  A smaller shot every 12 hours, instead of a larger one every 24 hours.  My educator thinks it'll help prevent my evening numbers from going so low.

The honest truth is that this has been trickier than I thought.  I wasn't going to have crazy lows like all those other diabetes bloggers!  I wasn't going to have mystery blood sugar numbers that logically shouldn't have occurred!  But alas, I am no VIP to diabetes.

I think one of the most important things I can do for myself right now is take control of my life.  I may not have perfect control of my diabetes yet (it'll improve, though it will probably never be "perfect"), but maybe I can take control of other areas.  For various reasons, I've felt like a passenger in the process of finding, moving into, and buying this new house.  I need to make it mine.  My job is not where I want to be.  I need to make the best of it for the moment while taking steps toward where I do want to be.

Some other areas aren't as easy.  Diabetes has its claws in my diet and, to some extent, my physical activity.  This is necessary, at least in these early stages when we're still "figuring it out."  But I have to say that the psychological effect that has on me is very negative.  The first month, no problem, I was surviving.  Now, I need to start living.  I need to reclaim these areas to the extent that I can.  I'm eating more fruit again, for example, which I avoided at the beginning simply because I wanted labels and things I could measure.  But now I'm branching out and letting myself use my best judgment on portions/carbs.  Exercise?  Well, moving certainly was exercise.  Unpacking is too, as far as my blood sugar numbers are concerned.  After all this is winds down, I'm going to go do the exercise I always enjoyed most, damn it!!!  If I have to do shorter or lighter sessions, so be it, but I'm tired of being scared to walk-run on the treadmill or go to my favorite yoga class.  I'll be extra cautious, but I need to return to a little normalcy.

Phew!  There's my lunchtime post.  Back to work!

Sunday, May 16, 2010

"You have to live, and you WILL live."

I've been monitoring and using insulin for over a week now, and really calculating my insulin needs for about half a week.  I'm not going to lie; I've had my frustrations.  But I can say that it's doable, the shots don't hurt, I've had enough flexibility since getting clarification on scheduling, and can already tell it's getting easier.

Every now and then, it strikes me as so strange that, unless they perfect something like an artificial pancreas, I'll never again be able to just eat without adding up carbs in my head and somehow delivering insulin (whether through injections or through a pump).  The dietitian said it'd get easier;  I'll know about how many carbs are in a piece of cake in the work break room by simply judging the size of it.  I hope that's true, but I also know there will always be variables.

Another great frustration is that my husband and I had been trying for a baby, and now we have to wait until my blood sugar and A1C reach certain numbers and stay stable.  I'm reasonably confident I can tightly manage my blood sugar once everything settles down and we have my insulin at the right doses, but it sounds like the A1C could take a very long time to get down to normal numbers no matter what I do.  And I may not be at the end of my childbearing years yet, but I am 30 and don't feel that I have oodles of time left. My husband and I want two kids, and neither of us are spring chickens.  We're both open to adoption, but that can also take a great deal of time.

Everyone keeps reminding me that diabetes isn't a death sentence, but it sometimes seems like a life sentence.  I know it'll get better.  A friend of mine who has had type 1 since she was 8 recently said to me about not having a doom and gloom attitude like some people do, "You have to live, and you will live."

Wednesday, May 12, 2010

See You Later

I went to my "Intensive Insulin Therapy" training today.  I learned how to give myself appropriate amounts of insulin for meals and for corrections.  They also started increasing my long-acting insulin dose, and told me it'll probably be increased a few more times.  I'll talk about this more later, but I'm afraid I need to keep my computer session short.

There's been a lot I've wanted to write about, but being on the computer for too long hurts my eyes... which may be partly related to my insulin therapy!  Weird!

Having high blood sugar for an extended period of time makes your lenses bloat, and starting medication for diabetes brings your blood sugar and that bloating down.  This can cause temporary vision changes.  Sometimes that means blurry vision, but it is rumored to have occasionally improved vision!

How bizarre is that?

Personally, I'm far-sighted and sometimes get eye strain after reading or sitting too closely to a computer screen for a very, very long time.  Right now, that eye strain is happening more easily than usual.  I've been having to lower the resolution on my computers to use them comfortably.  I even picked up a bookmark style magnifying glass in case it starts becoming tough to focus at work.  Man, it makes me feel old!

What's next?  Seriously!  The past week and a half as been one of the most life changing times of my life.