Man. Last night, we went out for our four year anniversary. Just a nice dinner at a nice local Italian restaurant. I ordered foods I thought were fairly easy to bolus for, and I had extra glucose tabs and starburst in my purse since I planned on getting some sort of pasta and bolusing generously for it. My theory? If I'm going to eat a high-carb meal (while pregnant) on a special occasion, I'd rather start to go low and have to snack/treat. Much better than risking my blood sugar going high and spending an hour hour two trying to get back into range. With the bolus I gave, I expected a decent post-meal number followed by a late evening of snacking on sugary things to keep from going low.
My body had other ideas.
Maybe it's because my blood sugar was going low when the meal began (so my body decided to throw some glucagon into the mix?), but Dexcom buzzed at me as we sat over our empty plates discussing some of our favorite Star Trek episodes (and some of our least favorite retcon moves in the Trek universe). I pulled out Dex to see what he was telling me. I was still at a decent number, but I had double arrows pointing up. As I was confident I had enough sugar with me if things backfired, I bolused a little bit.
Repeat.
Repeat.
Repeat.
My blood sugar went over 200, despite a generous beginning bolus followed by several smaller boluses meant to try and keep things from getting any worse. I did a little bouncing around in that range for a good hour or so... before double arrows pointing down. I was prepared for this, though. We were home by then, so I drank 25 carbs of juice, still ended up low, and topped myself off with four Starburst (17 carbs).
So, yeah, that didn't go quite as planned.
What frustrates me about this is that, pre-pregnancy, I don't think that would have happened. I occasionally treated myself to properly-bolused servings of pasta, and the post-meal number was rarely a surprise. But while pregnant, there's no telling how food will act in my system. Even if I know the exact carb count in a food, and even if I ate the exact same meal yesterday, I wouldn't bet money on the outcome. The best I've been able to do is avoid things that are really high fat or high carb, which is probably part of why everyone at my OB's office doesn't seem especially thrilled with my level of weight gain.
Showing posts with label frustration. Show all posts
Showing posts with label frustration. Show all posts
Friday, April 15, 2011
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*
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*
Thursday, January 27, 2011
Better Than Therapy
Going to the endocrinologist is good for me. I don’t just mean it helps me stay healthy, I also mean that it helps me stay sane.
I’d gotten reasonably zen about diabetes management, especially since I was doing really well. Then I got pregnant, and zen immediately slipped from my grasp. My control on my blood sugar suffered, not due to any lack of effort or education, and my stress went through the roof in response.
In a zen state, I’d have said, “OK, my blood sugar is going higher than it should. All I can do is what I can do. Crying and feeling guilty just wastes energy.” But I was not in a zen state. You see, not only was I hormonal and dealing with life changes, but I was also reading blogs, forums, websites, and books on pregnancy with diabetes. Everywhere I turned I read about all the horrible things that can happen if your blood sugar is high, and a high blood sugar seemed to pretty much be anything out of that super tight range for pregnancy. I seemed to absorb other women's obsession or anxiety over this, as if I didn't have enough of my own. Though my endo’s office had called me back right away with my new blood glucose goals (under 100 before eating, under 120 two hours after), it was the internet that made me scared of higher numbers. Not even counting the occasional and mysterious 200+ number that happened even when I did everything by the book, I felt like a horrible mother who was actively mutating my own baby whenever I decided to indulge in a treat (say, a small ice cream?) and came in somewhere closer to 150 two hours later.
*cue internal freak-out and self-guilt-trip*
But visits to my endocrinologist have put things in perspective every time, so far. Never once has she criticized me, never once has she told me that a number is dangerous, never once did she suggest I need to try harder. No. She even told me the first time I came in with numbers that upset me, “I’m not worried.” She doesn’t worry, she deals. “Numbers like these will happen, but we need to figure out how to keep them from happening too often.” Then we’d discuss a game plan.
Yesterday’s visit with her was fabulous. I handed her a sheet with numbers that were much improved, but definitely not even close to perfect. We were both on the exact same page about how to fix them, and she made some adjustments to my morning basal and evening I:C. She said that I was really doing well overall, and I walked out feeling not like I had failed with those less-than-perfect numbers, but that I had done a great job of improving them and was leaving with a plan to make them even better, maybe even get them in line once and for all… Well, once and until my insulin needs change again! Damn hormones!
I’d gotten reasonably zen about diabetes management, especially since I was doing really well. Then I got pregnant, and zen immediately slipped from my grasp. My control on my blood sugar suffered, not due to any lack of effort or education, and my stress went through the roof in response.
In a zen state, I’d have said, “OK, my blood sugar is going higher than it should. All I can do is what I can do. Crying and feeling guilty just wastes energy.” But I was not in a zen state. You see, not only was I hormonal and dealing with life changes, but I was also reading blogs, forums, websites, and books on pregnancy with diabetes. Everywhere I turned I read about all the horrible things that can happen if your blood sugar is high, and a high blood sugar seemed to pretty much be anything out of that super tight range for pregnancy. I seemed to absorb other women's obsession or anxiety over this, as if I didn't have enough of my own. Though my endo’s office had called me back right away with my new blood glucose goals (under 100 before eating, under 120 two hours after), it was the internet that made me scared of higher numbers. Not even counting the occasional and mysterious 200+ number that happened even when I did everything by the book, I felt like a horrible mother who was actively mutating my own baby whenever I decided to indulge in a treat (say, a small ice cream?) and came in somewhere closer to 150 two hours later.
*cue internal freak-out and self-guilt-trip*
But visits to my endocrinologist have put things in perspective every time, so far. Never once has she criticized me, never once has she told me that a number is dangerous, never once did she suggest I need to try harder. No. She even told me the first time I came in with numbers that upset me, “I’m not worried.” She doesn’t worry, she deals. “Numbers like these will happen, but we need to figure out how to keep them from happening too often.” Then we’d discuss a game plan.
Yesterday’s visit with her was fabulous. I handed her a sheet with numbers that were much improved, but definitely not even close to perfect. We were both on the exact same page about how to fix them, and she made some adjustments to my morning basal and evening I:C. She said that I was really doing well overall, and I walked out feeling not like I had failed with those less-than-perfect numbers, but that I had done a great job of improving them and was leaving with a plan to make them even better, maybe even get them in line once and for all… Well, once and until my insulin needs change again! Damn hormones!
Tuesday, January 4, 2011
It Looks Easy, Until You Look Closer
I recently had a moment when the gulf between me as a type 1 diabetic and someone else as a non-diabetic widened significantly.
A coworker started trying to figure out a food alternative for me. She'd planned on pizza for a staff lunch, and I told her I couldn't eat delivery pizza and would just go pick something up for myself. (Pizza isn't on some diabetic no-no list, but it's a tough food that doesn't work out for me.) She immediately said, "Well, what can you eat?"
Enter another complication: my own fear of being an imposition. I'm pretty much never going to say, "Let's get such-and-such food instead of pizza," in a situation like this, so I ventured, "Where are you ordering from? I can look at their online menu and see if they have something like a good salad."
But she had no clue where she'd order the pizza from yet, and really just sought after a more general answer that would basically let her order like, "Hi, random pizza joint I picked about 5 seconds ago? I'd like three pizzas, and do you have any salads? OK, yeah, send a salad."
So I explained, "Well... it's just that I have to know what I'm getting, because I have to know how many carbs are in it."
So she asked again, "Well, what can you eat?" And I think, fine, I'll give you a shot. And I attempted to explain what, to me, has become a subtle and mostly quick process...
"There are a lot of factors, but it helps if it's not both high carb and high fat. It's even better if it's not either." Already her eyes started to glaze, probably from trying to think of convenient foods that are neither high carb or high fat. "But the most important thing is that I know how many carbs are in what I'm eating, so I have to be able to either look up the nutrition or order something simple enough that I can make a really good guess based on the portion size."
Her eyes glazed further, and I knew it was time to stop. She was staring at me across this great gulf of diabetes management that suddenly made me feel rather... separate and different. I don't really expect others to know what my food and insulin involve, but I also didn't expect someone to look utterly at a loss when told the basics. (And, honestly, I also wonder if she thought I was intentionally being difficult.) So I let her off the hook (the hook she'd asked for!) with, "I can eat almost anywhere. If you just tell me where the pizza's coming from, I can pick something else off the menu."
But she backed off of that hook even further with, "Why don't you just go pick something up?" To which I gladly agreed.
The fact that this woman knew I'm diabetic and had eaten meals (which includes testing and bolusing) with me before yet seemed baffled by the simplest explanation of how I choose my food reminded me that, when I was first learning this stuff, I was so impressed by the people with T1 diabetes that I've known; they made all that stuff look so easy! But the truth is that they'd simply incorporated it into their lives. The decisions and calculations that were so new and awkward to me were just a part of their routine, so I had no idea how much went into them. Had they started explaining everything to me (before it applied to me), maybe I'd have glazed over.
As I've said many times, diabetes management is doable. I can do it, and you can do it if you have to (and I know some of you do!). But it's still complicated and difficult, and even those people who make it look easy have a hard time of it once in a while.
(I wonder how my coworker would have reacted if I'd mentioned fast-acting carbs vs. slow-acting. Her head might have exploded right then and there!)
A coworker started trying to figure out a food alternative for me. She'd planned on pizza for a staff lunch, and I told her I couldn't eat delivery pizza and would just go pick something up for myself. (Pizza isn't on some diabetic no-no list, but it's a tough food that doesn't work out for me.) She immediately said, "Well, what can you eat?"
Enter another complication: my own fear of being an imposition. I'm pretty much never going to say, "Let's get such-and-such food instead of pizza," in a situation like this, so I ventured, "Where are you ordering from? I can look at their online menu and see if they have something like a good salad."
But she had no clue where she'd order the pizza from yet, and really just sought after a more general answer that would basically let her order like, "Hi, random pizza joint I picked about 5 seconds ago? I'd like three pizzas, and do you have any salads? OK, yeah, send a salad."
So I explained, "Well... it's just that I have to know what I'm getting, because I have to know how many carbs are in it."
So she asked again, "Well, what can you eat?" And I think, fine, I'll give you a shot. And I attempted to explain what, to me, has become a subtle and mostly quick process...
"There are a lot of factors, but it helps if it's not both high carb and high fat. It's even better if it's not either." Already her eyes started to glaze, probably from trying to think of convenient foods that are neither high carb or high fat. "But the most important thing is that I know how many carbs are in what I'm eating, so I have to be able to either look up the nutrition or order something simple enough that I can make a really good guess based on the portion size."
Her eyes glazed further, and I knew it was time to stop. She was staring at me across this great gulf of diabetes management that suddenly made me feel rather... separate and different. I don't really expect others to know what my food and insulin involve, but I also didn't expect someone to look utterly at a loss when told the basics. (And, honestly, I also wonder if she thought I was intentionally being difficult.) So I let her off the hook (the hook she'd asked for!) with, "I can eat almost anywhere. If you just tell me where the pizza's coming from, I can pick something else off the menu."
But she backed off of that hook even further with, "Why don't you just go pick something up?" To which I gladly agreed.
The fact that this woman knew I'm diabetic and had eaten meals (which includes testing and bolusing) with me before yet seemed baffled by the simplest explanation of how I choose my food reminded me that, when I was first learning this stuff, I was so impressed by the people with T1 diabetes that I've known; they made all that stuff look so easy! But the truth is that they'd simply incorporated it into their lives. The decisions and calculations that were so new and awkward to me were just a part of their routine, so I had no idea how much went into them. Had they started explaining everything to me (before it applied to me), maybe I'd have glazed over.
As I've said many times, diabetes management is doable. I can do it, and you can do it if you have to (and I know some of you do!). But it's still complicated and difficult, and even those people who make it look easy have a hard time of it once in a while.
(I wonder how my coworker would have reacted if I'd mentioned fast-acting carbs vs. slow-acting. Her head might have exploded right then and there!)
Thursday, December 30, 2010
WTF?
A lot of pregnant women with diabetes discover lots low blood sugars in the first trimester. Then the numbers start to rise until their insulin demands skyrocket later on. It's a common pattern.
So far? My body's like, "screw common patterns!"
Like last night, I was craving seafood fried rice something awful. I often make my own brown fried rice with fresh veggies, and a very small amount of oil at home... But that's so not what I was craving! I wanted oily, over-seasoned, totally unhealthy fried rice with a mix of oily seafood including unidentifiable bits that are probably squid or octopus, but maybe not. You know the stuff, if you've done a lot of oriental food joints! So we slipped down the road to Thai House and I ordered up that giant plate of Seafood Fried Rice.
But that's a lot of carbs and fat, so I was very deliberate about this. I looked up the average carbs for shrimp fried rice before it arrived, evaluated the food when it got there and determined it probably didn't have as much seafood in it as the average shrimp fried rice and bumped the carbs almost all the way up to what a cup of what nothing but rice would be, delivered an 85/15 combo bolus (going closer to the 50/50 I was taught usually makes me go high), carefully spooned a two-cup portion onto my plate (in two piles, until each looked like the size and shape of my over-turned 1 cup measure), and dug in.
I suspected, if anything, that I'd go low. I'd definitely erred on the high side of the carb count because I did not want to go high. I feel, right now, that having to drink a box of juice to head off a low is worth avoiding highs.
But by the time we got home, probably only an hour later, I'd spiked to over 200 and dexcom was showing me a straight upward pointing arrow!
I had a lot of insulin in my system and had only eaten a short time before, but I just couldn't stare at that and do nothing! I took another very small bolus and didn't allow myself to slug out on the couch. I didn't feel I could exercise (I felt pretty crumby), but I tried to keep moving around and working on this little gift project for some friends.
And within like another hour, my blood sugar was perfect.
What?
Yeah. This one may have been extreme, but these spikes and drops are my common pattern right now, and they are killing me. It tends to happen even when I do everything right by choosing foods that have a good balance of healthy carbs, protein, and healthy fat (unlike the seafood fried rice!) and waiting 20 minutes between bolusing and eating.
FRUSTRATING.
It seems like I'm slowly eliminating foods that are mysteriously worse than others (goodbye fried rice), and relying a lot on foods that have the least spike (hello salad with protein and fat, but no cheese, because for some reason shredded cheese is totally gross to me right now). I'll get this figured out... and then it'll probably all change!
So far? My body's like, "screw common patterns!"
Like last night, I was craving seafood fried rice something awful. I often make my own brown fried rice with fresh veggies, and a very small amount of oil at home... But that's so not what I was craving! I wanted oily, over-seasoned, totally unhealthy fried rice with a mix of oily seafood including unidentifiable bits that are probably squid or octopus, but maybe not. You know the stuff, if you've done a lot of oriental food joints! So we slipped down the road to Thai House and I ordered up that giant plate of Seafood Fried Rice.
But that's a lot of carbs and fat, so I was very deliberate about this. I looked up the average carbs for shrimp fried rice before it arrived, evaluated the food when it got there and determined it probably didn't have as much seafood in it as the average shrimp fried rice and bumped the carbs almost all the way up to what a cup of what nothing but rice would be, delivered an 85/15 combo bolus (going closer to the 50/50 I was taught usually makes me go high), carefully spooned a two-cup portion onto my plate (in two piles, until each looked like the size and shape of my over-turned 1 cup measure), and dug in.
I suspected, if anything, that I'd go low. I'd definitely erred on the high side of the carb count because I did not want to go high. I feel, right now, that having to drink a box of juice to head off a low is worth avoiding highs.
But by the time we got home, probably only an hour later, I'd spiked to over 200 and dexcom was showing me a straight upward pointing arrow!
I had a lot of insulin in my system and had only eaten a short time before, but I just couldn't stare at that and do nothing! I took another very small bolus and didn't allow myself to slug out on the couch. I didn't feel I could exercise (I felt pretty crumby), but I tried to keep moving around and working on this little gift project for some friends.
And within like another hour, my blood sugar was perfect.
What?
Yeah. This one may have been extreme, but these spikes and drops are my common pattern right now, and they are killing me. It tends to happen even when I do everything right by choosing foods that have a good balance of healthy carbs, protein, and healthy fat (unlike the seafood fried rice!) and waiting 20 minutes between bolusing and eating.
FRUSTRATING.
It seems like I'm slowly eliminating foods that are mysteriously worse than others (goodbye fried rice), and relying a lot on foods that have the least spike (hello salad with protein and fat, but no cheese, because for some reason shredded cheese is totally gross to me right now). I'll get this figured out... and then it'll probably all change!
Saturday, December 25, 2010
Merry... Merriness! (And not so merry highs.)
Merry Christmas, or whatever holiday you choose to celebrate!
Our Christmas day has been quiet and lazy. We spent Thursday night with Chad's family, and last night with my parents. The baby received it's first gifts from Chad's mother (diapers, wet wipes, and a box of gender-neutral linens). The two big gifts Chad and I received were Rock Band (from my parents), and vent-free gas logs for our fireplace (from Chad's parents). Two awesome practical gifts I received were a Waterpik from Chad (because even my dental hygienist said it's tough to floss my teeth!) and a food scale from Mom. There've been many times where I had to do some tricky stuff to figure up serving sizes while counting carbs, and this will really help me measure the stuff that's listed in grams.
I also had a Christmas Eve gift I did not want: A bad infusion site and a blood sugar of over 280.
see more Lolcats and funny pictures
Normally, something like that frustrates me. While pregnant, it makes me question every single little action I've taken all day, blaming myself for the high blood sugar that could do harm to the baby. Even though I logically know that no pregnant woman with T1 diabetes is safe from mistakes or accidents, it sure makes me feel like a failure. And though I've read that an occasional, brief high blood sugar won't hurt the baby, I can't help but feel that it's really horrible at such an early stage. After all, women with diabetes have an increased risk of miscarriage. Even though she'll probably be understanding and simply talk to me about future prevention, I'm embarrassed for my endocrinologist to see that BG number on Monday.
But on the flip side, my numbers are normally fabulous and I've done a good job of avoiding the things that really give me trouble. On the whole I'm doing a great job, but a high like that makes me wonder when I qualify as not doing a great job. One high? Two? Ten? Once a month, once a week, once a day? I know there's no set answer, but I fear crossing this imaginary "line."
So far, no crazy symptoms, diabetes related or not. My blood sugar hasn't started going low like it apparently does for most, and I haven't started having the typical morning sickness. My mom told me last night that she never had much morning sickness, so I'm hoping I take after her in that respect!
No mystery food cravings or aversions, though I'm definitely more hungry than usual. I'm trying to avoid the whole "eating for two" thing while still letting myself have a little bit extra. Everyone has to gain weight while pregnant, but the fact is that I'm already overweight and need to keep my weight gain to whatever range my OB will recommend.
I do know that I need to start getting more active again, too. My walks have become less frequent as the days have gotten colder, so maybe it's time to keep sneakers at the office and go walk the treadmill during lunch.
Our Christmas day has been quiet and lazy. We spent Thursday night with Chad's family, and last night with my parents. The baby received it's first gifts from Chad's mother (diapers, wet wipes, and a box of gender-neutral linens). The two big gifts Chad and I received were Rock Band (from my parents), and vent-free gas logs for our fireplace (from Chad's parents). Two awesome practical gifts I received were a Waterpik from Chad (because even my dental hygienist said it's tough to floss my teeth!) and a food scale from Mom. There've been many times where I had to do some tricky stuff to figure up serving sizes while counting carbs, and this will really help me measure the stuff that's listed in grams.
I also had a Christmas Eve gift I did not want: A bad infusion site and a blood sugar of over 280.
see more Lolcats and funny pictures
Normally, something like that frustrates me. While pregnant, it makes me question every single little action I've taken all day, blaming myself for the high blood sugar that could do harm to the baby. Even though I logically know that no pregnant woman with T1 diabetes is safe from mistakes or accidents, it sure makes me feel like a failure. And though I've read that an occasional, brief high blood sugar won't hurt the baby, I can't help but feel that it's really horrible at such an early stage. After all, women with diabetes have an increased risk of miscarriage. Even though she'll probably be understanding and simply talk to me about future prevention, I'm embarrassed for my endocrinologist to see that BG number on Monday.
But on the flip side, my numbers are normally fabulous and I've done a good job of avoiding the things that really give me trouble. On the whole I'm doing a great job, but a high like that makes me wonder when I qualify as not doing a great job. One high? Two? Ten? Once a month, once a week, once a day? I know there's no set answer, but I fear crossing this imaginary "line."
So far, no crazy symptoms, diabetes related or not. My blood sugar hasn't started going low like it apparently does for most, and I haven't started having the typical morning sickness. My mom told me last night that she never had much morning sickness, so I'm hoping I take after her in that respect!
No mystery food cravings or aversions, though I'm definitely more hungry than usual. I'm trying to avoid the whole "eating for two" thing while still letting myself have a little bit extra. Everyone has to gain weight while pregnant, but the fact is that I'm already overweight and need to keep my weight gain to whatever range my OB will recommend.
I do know that I need to start getting more active again, too. My walks have become less frequent as the days have gotten colder, so maybe it's time to keep sneakers at the office and go walk the treadmill during lunch.
Saturday, December 18, 2010
Life's Never How You Picture It.
I haven't been to either of my doctors yet, but I've made appointments with both (already well over a dozen with my endo!) and spoken to my endo's nurse. My blood glucose goals are now below 100 before meals, and below 120 two hours after meals.
I'm actually very close to those goals even when I don't quite meet them (and I've just made a change to my insulin pump's "target" that should finally nudge the less than perfect numbers under), and I've managed to get my spiking blood sugar to chill the hell out. Primarily, I'm figuring out that I need to have a little more protein and healthy fat with my breakfast (when things are most likely to spike), and the same true to a lesser degree with lunch. Dinner is never a problem. If I eat pretty well, my evening numbers are always fabulous.
I can totally do this.
For the most part, I feel pretty good about things. I had one night where I felt very sorry for myself... I was realizing that this pregnancy isn't going to be "what I always wanted." Not that I've ever been the "daydream about pregnancy and babies" type, but I always had a basic picture of how things would be:
I'd enjoy my pregnancy, dealing with whatever minor inconveniences (like morning sickness) come my way and feeling a little like an earth goddess as I bask in the miracle of creating life and letting my body do what it was designed to do. Then when delivery came around, I'd labor at home for as long as I could, go to my hospital, and labor naturally until my doctor said, "It's now or never for the epidural." (You see, though I fully believe the female body knows how to do this stuff on it's own, I'm way too much of a wimp to accept the level of pain that comes with pushing!!! :p )
That's not the picture I see before me now. I'll probably have something like 20 or 30 doctor appointments between now and then, tests that aren't normally done on "healthy" mothers, there's probably no way any OB will let me carry to full term and labor when my body decides to do it naturally, and there's likely to be much more monitoring and a higher chance of a C-section. It's like my body is a liability instead of a miraculous tool for creating life.
Sounds crappy, doesn't it? But it's the most bleak view (short of imagining all the things that could go wrong will go wrong). I totally let it get to me the other night and I cried all over Chad. (He's so sweet.)
But now, I'm realizing that everything's been pretty normal so far, so and I don't have a reason to believe that everything will be horrible the second I set foot in a doctor's office. Yes, things are likely to be more medicalized than I want. I accept, grudgingly. But I can't focus on that; I have to keep it all a part of what supports me and a healthy baby. Just like diabetes management isn't the focus of my life, but part of what supports it.
I'm also looking into having a doula, a trained professional who is there to support mom, dad, and baby through pregnancy and delivery (and sometimes for a while postpartum). I think it would both help me focus on the wonderful things that are happening, and stay more informed and in charge during delivery.
As everyone says, the thing that counts most is having a healthy baby in the end. I agree with that, but I also believe that is most likely to happen if the pregnancy and delivery are no more medicalized than actually necessary. (Thank god we have OBs and the interventions that are sometimes necessary, but the US has both incredibly medicalized births and some of the worst birth statistics of the industrialized countries.)
I'm saying all this like I'm afraid I'll be swept into an O.R. the second I arrive at the hospital, but the truth is that I'm going to do everything humanly possible to keep my blood sugar normal and my OB has never given me the impression that she's big on intervention for intervention's sake. For all I know, she'll support me in my desire for normalcy to every extent she is able. I meet with her nurse practitioner on the 5th of January, so I'll have a better idea then of what is in store.
I'm actually very close to those goals even when I don't quite meet them (and I've just made a change to my insulin pump's "target" that should finally nudge the less than perfect numbers under), and I've managed to get my spiking blood sugar to chill the hell out. Primarily, I'm figuring out that I need to have a little more protein and healthy fat with my breakfast (when things are most likely to spike), and the same true to a lesser degree with lunch. Dinner is never a problem. If I eat pretty well, my evening numbers are always fabulous.
I can totally do this.
For the most part, I feel pretty good about things. I had one night where I felt very sorry for myself... I was realizing that this pregnancy isn't going to be "what I always wanted." Not that I've ever been the "daydream about pregnancy and babies" type, but I always had a basic picture of how things would be:
I'd enjoy my pregnancy, dealing with whatever minor inconveniences (like morning sickness) come my way and feeling a little like an earth goddess as I bask in the miracle of creating life and letting my body do what it was designed to do. Then when delivery came around, I'd labor at home for as long as I could, go to my hospital, and labor naturally until my doctor said, "It's now or never for the epidural." (You see, though I fully believe the female body knows how to do this stuff on it's own, I'm way too much of a wimp to accept the level of pain that comes with pushing!!! :p )
That's not the picture I see before me now. I'll probably have something like 20 or 30 doctor appointments between now and then, tests that aren't normally done on "healthy" mothers, there's probably no way any OB will let me carry to full term and labor when my body decides to do it naturally, and there's likely to be much more monitoring and a higher chance of a C-section. It's like my body is a liability instead of a miraculous tool for creating life.
Sounds crappy, doesn't it? But it's the most bleak view (short of imagining all the things that could go wrong will go wrong). I totally let it get to me the other night and I cried all over Chad. (He's so sweet.)
But now, I'm realizing that everything's been pretty normal so far, so and I don't have a reason to believe that everything will be horrible the second I set foot in a doctor's office. Yes, things are likely to be more medicalized than I want. I accept, grudgingly. But I can't focus on that; I have to keep it all a part of what supports me and a healthy baby. Just like diabetes management isn't the focus of my life, but part of what supports it.
I'm also looking into having a doula, a trained professional who is there to support mom, dad, and baby through pregnancy and delivery (and sometimes for a while postpartum). I think it would both help me focus on the wonderful things that are happening, and stay more informed and in charge during delivery.
As everyone says, the thing that counts most is having a healthy baby in the end. I agree with that, but I also believe that is most likely to happen if the pregnancy and delivery are no more medicalized than actually necessary. (Thank god we have OBs and the interventions that are sometimes necessary, but the US has both incredibly medicalized births and some of the worst birth statistics of the industrialized countries.)
I'm saying all this like I'm afraid I'll be swept into an O.R. the second I arrive at the hospital, but the truth is that I'm going to do everything humanly possible to keep my blood sugar normal and my OB has never given me the impression that she's big on intervention for intervention's sake. For all I know, she'll support me in my desire for normalcy to every extent she is able. I meet with her nurse practitioner on the 5th of January, so I'll have a better idea then of what is in store.
Wednesday, December 1, 2010
Too Good to Last
Despite having a lot of insecurities, I also tend to be very proud of the things I do well. Just recently, I got into a very comfortable, pleased-with-myself state of mind regarding my diabetes care. I do this stuff really well. Not only was I on top of things, but I significantly improved my morning numbers by myself, through two morning fasts and two basal adjustments. I was coasting for a couple of weeks on numbers that never seemed to rise much above 140. Things were... too good to last. :(
Yep, that's a 286 staring back at me. The past week, maybe two, have sucked. That's the second 200+ number I've had, and possibly the highest number I've had since starting intensive insulin therapy (certainly the highest since they got my initial ratios close to what I needed).
What the hell?! Things have been running generally higher, as they always tend to when hormones change at about the middle of my cycle, but worse than usual this time... and the past couple of days have gotten even worse... then a 286 for this morning for the exact same breakfast and bolus that went over perfectly yesterday morning?! And I thought, hmm, maybe it's the infusion set or site, but no! Everything appears fine, and my correction bolus is bringing my BG down at a rate that I would expect. Bad insulin? Well, it seems to work just fine on correction boluses, and I've had a couple mealtime boluses with perfect results... but I may try a new batch if things continue to look bad.
I may uncover some underlying reason, but until I figure it out, I'm just using a stronger basal dose and watching Dexcom like a hawk... and believing my fellow D bloggers more and more when they say things like, "Sometimes, this disease just makes no sense."
------
On a related note, while waiting for my BG of just over 200 to come down last night, I was talking to my husband about having read that a lot of PWDs tend to have some control issues, maybe even some OCD. I totally get that now. If I'd grown up putting so much importance in a number on a screen multiple times a day, feeling like that number is a pass or a fail, I'd probably have some sort of control issue, too.
Yep, that's a 286 staring back at me. The past week, maybe two, have sucked. That's the second 200+ number I've had, and possibly the highest number I've had since starting intensive insulin therapy (certainly the highest since they got my initial ratios close to what I needed).
What the hell?! Things have been running generally higher, as they always tend to when hormones change at about the middle of my cycle, but worse than usual this time... and the past couple of days have gotten even worse... then a 286 for this morning for the exact same breakfast and bolus that went over perfectly yesterday morning?! And I thought, hmm, maybe it's the infusion set or site, but no! Everything appears fine, and my correction bolus is bringing my BG down at a rate that I would expect. Bad insulin? Well, it seems to work just fine on correction boluses, and I've had a couple mealtime boluses with perfect results... but I may try a new batch if things continue to look bad.
I may uncover some underlying reason, but until I figure it out, I'm just using a stronger basal dose and watching Dexcom like a hawk... and believing my fellow D bloggers more and more when they say things like, "Sometimes, this disease just makes no sense."
------
On a related note, while waiting for my BG of just over 200 to come down last night, I was talking to my husband about having read that a lot of PWDs tend to have some control issues, maybe even some OCD. I totally get that now. If I'd grown up putting so much importance in a number on a screen multiple times a day, feeling like that number is a pass or a fail, I'd probably have some sort of control issue, too.
Monday, September 6, 2010
In Which I Say BACK To Dexcom, "???"
I've had my (non-trial) Dexcom since Thursday evening. The first sensor was crap, apparently. The trial one from the previous week had gone so well (after the first night, which was crazy), but this one seemed to give me numbers not even remotely related to the ones my meter showed me (Dexom 44, meter 126?! Dexcom 250, meter 160?! ), and it gave me ??? errors a couple times, plus a long and inexplicable out-of-range error... so after another insanely inaccurate reading followed immediately by ???, I finally ripped it off and started a new one Sunday afternoon.
I also wasn't especially pleased with the new sensor the first day and started wondering if it could be the transmitter or receiver... until that evening, when everything started going smoothly. And now, it's damn near perfect, staying well within the acceptable variations (20 points off on the low side, 20% off on the high side). Even over the first night (which gave me trouble on the trial sensor), it didn't throw me any usual numbers, and my fasting numbers matched pretty closely.
Ahhh, CGM bliss. I'm hoping Dexcom will replace that crazy sensor (I tried contacting them, but you know, it's Labor Day weekend). In any case, I'm once again so glad to have this tool. It's just too useful... when it works.
I also wasn't especially pleased with the new sensor the first day and started wondering if it could be the transmitter or receiver... until that evening, when everything started going smoothly. And now, it's damn near perfect, staying well within the acceptable variations (20 points off on the low side, 20% off on the high side). Even over the first night (which gave me trouble on the trial sensor), it didn't throw me any usual numbers, and my fasting numbers matched pretty closely.
Ahhh, CGM bliss. I'm hoping Dexcom will replace that crazy sensor (I tried contacting them, but you know, it's Labor Day weekend). In any case, I'm once again so glad to have this tool. It's just too useful... when it works.
Tuesday, August 31, 2010
OW!
Nap? Check.
Snuggles with the cat? Check.
Lingering too long in the shower listening to Radiohead? Check.
Most painful freaking moment since starting insulin treatment, followed by blood? Fraking CHECK.
Screw you, Diabetic Powers That Be, for throwing a major kink in my nice, relaxing evening in.
To hell with it, I'm having ice cream... After I bolus. I'm such a rebel.
Snuggles with the cat? Check.
Lingering too long in the shower listening to Radiohead? Check.
Most painful freaking moment since starting insulin treatment, followed by blood? Fraking CHECK.
Screw you, Diabetic Powers That Be, for throwing a major kink in my nice, relaxing evening in.
To hell with it, I'm having ice cream... After I bolus. I'm such a rebel.
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!
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."
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."
Friday, May 14, 2010
Tough Day
I got really frustrated today because of all of the "correction" doses of insulin I've been having to do between meals, and because I thought my meal schedule was too inflexible due to them... Then everything in the world was suddenly so overwhelming, and I just let myself cry. But after faxing my blood sugar records into my Educator and Dietitian (and after expressing my frustration), they changed my carb-to-insulin ratio and set me straight about my meal/insulin schedule. I can eat any dang time I want and take the right amount of insulin to cover it. It's only the insulin I take based on my existing blood sugar that I can't take too close together.
*big sigh* I feel so much better now, but everything caught up to me for a little while, there.
Seriously, if you are a newly diagnosed diabetic, go to a diabetes educator. And try to find one who'll do more than just teach you in a class then tell you numbers without explanation. Yvonne, my educator, has been so totally awesome. She clearly cares, explains the "why" for everything, and gave me her cell phone and email so I can always get in touch with her.
On another front, my mom has been talking to the Diabetes Educator at the hospital where she works. She went ahead and asked about insulin pumps (a topic my Educator has briefly mentioned as a future likelihood), and she thinks I'll be able to get one in a reasonably short amount of time. They just have to get me started and make sure I know what I'm doing first. The pens/needles honestly aren't so bad, but I'm already looking forward to the reduced hassle of a pump!
*big sigh* I feel so much better now, but everything caught up to me for a little while, there.
Seriously, if you are a newly diagnosed diabetic, go to a diabetes educator. And try to find one who'll do more than just teach you in a class then tell you numbers without explanation. Yvonne, my educator, has been so totally awesome. She clearly cares, explains the "why" for everything, and gave me her cell phone and email so I can always get in touch with her.
On another front, my mom has been talking to the Diabetes Educator at the hospital where she works. She went ahead and asked about insulin pumps (a topic my Educator has briefly mentioned as a future likelihood), and she thinks I'll be able to get one in a reasonably short amount of time. They just have to get me started and make sure I know what I'm doing first. The pens/needles honestly aren't so bad, but I'm already looking forward to the reduced hassle of a pump!
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