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.

My First Scare with Diabetes

I had a really weird encounter with possible diabetes once before in my life.

It wasn't me.

It wasn't a relative.

It wasn't a friend.

It was... My cat.

  

Meet Ali (pronounced like "Ollie").  She's an adorable, spunky, defiant, hyper little princess of a cat.

She's also one of my favorite photography subjects, so excuse me while I indulge a little.

But back in September of 2007, we noticed over the course of a couple days that she was barely eating or drinking and had became less hyper... then less spunky... and she finally didn't even have the energy to be defiant, so we knew something was very wrong.  I got up early to take her to the vet and Chad pulled her out from under the bed and put her into the carrier with no more objection than one of the most miserable meows I'd ever heard from her.  It broke my heart.

The drive to the vet was horrible for me, and filled with tears.  Could it be cancer?  FIV?  Leukemia?  Should I have taken her in earlier?  Was it now too late for her?

She had no symptoms other than the lethargy and lack of appetite.  The vet ran bloodwork and said that her blood sugar was higher than usual.  A urine sample also showed slight ketones.

The diagnosis: diabetes.

She stayed at the vet overnight to make sure the insulin dose the vet chose was OK, and the next day they taught me how to give her insulin and sent us home with a vial, box of syringes, and special diabetic food... and one still lethargic and unhappy cat.  She was slightly better than before, but all I could get her to eat were a few bites of her favorite people-food (turkey cold cuts).  Over the next three days, she continued to get worse and worse even though I did everything the vet had told me.  I spent a lot of time on the Feline Diabetes Message Board, which was full of helpful and knowledgeable people who told me about glucose monitoring (not something vets push with diabetic pets), diet, etc.... and they started telling me that things with Ali just didn't add up.  She didn't have high BG numbers, she was getting worse despite the insulin, and she had never had the classic symptoms of diabetes.  Several of them told me to take her back to the vet, and I agreed once I realized she was definitely getting worse, not better.

I went back to the vet 4 days before her 1-week follow-up visit was supposed to happen, armed with a little log book of glucose readings.  A different doctor (at the same clinic) ran bloodwork again and, this time, what stood out was her astronomical white cell count.  She was absolutely septic, and the vet was amazed she could even lift her head.  She was put on IV antibiotics, taken off of insulin until there was evidence of real need for it, and kept for a couple days.

When we visited her, we could tell we were finally on the right track.  She was moving, struggling to get to us, and very vocal.  When we brought her home, she was almost her old self... only very, very thin and much weaker.

But that IV wrap came off only moments after we got her home, she chowed down on food, fought with renewed strength against being fed antibiotic pills, and slowly regained her normal weight and spunk...  And defiance!

On our follow-up appointment at the vet, I was once again armed with a little log of totally normal blood sugar numbers... and insisted they refund me for all of the diabetic supplies (which they did).  She was a happy, healthy kitty with a happy, healthy pancreas.  Her blood sugar was merely elevated from such a horrible infection (that's common).

And thank goodness, because testing her blood glucose was not an easy task!

Something rather sweet was, after she came home from her extended stay at the vet, she became incredibly affectionate.  She snuggled every chance she got, and she never wanted to be away from us.  We think it made her a sweeter lap cat, to this day.

But don't underestimate her... There's a reason we don't let her be DM in our Dungeons and Dragon's games!  She is, at heart, a fierce killer!!!!

Rocks fall, everybody dies!!!!

Hind Sight...

I'm pretty sure that I actually had diabetes for a couple of years before diagnosis (which has also lead me to wonder if I have 1.5 or LADA rather than plain type 1).  There are a couple reasons I'm so sure of it, but I won't go into it right now.

So, knowing what I know now, I look back at so many things and shake my head.  Getting up in the middle of the night to pee, when I never had before?  *shakes head*  Having days when I absolutely couldn't quench my thirst?  *shakes head*  Eating tons of food and feeling physically full, yet still ravenous?  *shakes head*

One thing I've been thinking about lately, because I've been considering going on a Diet with a capital D, is when my husband talked me into doing South Beach with him.  As we did phase 1, which means no carbs other than most vegetables (and beans, I think?), I started out hating it... but then I got to the end of the week and felt so much better!  In fact, look at the following portion of an entry about South Beach from my now-defunct livejournal:

"I think this is a good experience for me, because I've never known what it's like to not eat grains. Seriously, I don't think I'd gone a whole day without some sort of grains since infancy, and I tend to eat a lot of them. Now, without them, I'm amazed to discover the beneficial changes in my hunger patterns. I've never in my life understood people who claim they "just forget to eat," because I'm normally thinking about food an hour after I finish a meal and my blood sugar drops not too long after that (even though we're pretty good about sticking to whole grains most of the time). Now? None of that."

And there are other entries in that general time period about how I'm ALWAYS STARVING.  I think my body was already unable, in 2008, to really regulate my blood sugar levels.  Doing South Beach gave my body a respite from allllll the carbs I was normally eating, and my blood sugar must have been lower than it had been in a long time...  So I felt better.  (This makes me think about the fact that, back before the days of extracted insulin, people with type 1 diabetes were put on a "starvation diet" that was very high in protein and pretty much zero-carb.  This allowed them maybe another year or two of life.)

And I never went to the doctor about it, even though I knew more about diabetes than the average person.  To be honest, I often had the thought, "Maybe I'm pre-diabetic."  But pre-diabetes?  You can fix that through diet and exercise.  Oh, little did I actually know!

Awkward Moments with the 'Betes

Low blood sugar while shopping plus discovering you forgot to refill your glucose tabs means getting stared at by little old ladies while you rip into a package of juice boxes without even trying to get through the line and pay first (with the full intent to pay after, of course).

Lady, STFU.

-----------------------

Me: *tests blood sugar*
Coworker: That's not... for... diabetes?
Me: Yeah, it is.  I have type 1.
Coworker: Oh...
*insert awkward pause here*
Coworker: Well, thank goodness it's at least not type 2.
Me: *blink*
Coworker: Isn't that the bad one?

----------------------

Various people at various times with various sugary treats: "Here, would you like a... oh wait, you can't eat these, can you?"

-----------------------

For no reason other than seeing me and knowing I'm diabetic: "How's your blood sugar?  Are you OK?  I have food if you need it.  Do you need to test?"

-----------------------

Former coworker seeing going-away cake on my desk: "Now, you know you can't be eating these things anymore."

Yes, diabetes sure has its fun moments.  And while we're at it, why don't you check out this video on the Big Blue Test, in honor of World Diabetes Day, coming up on November 14th?  Every time it is viewed, money goes to help give insulin to children who need it.

Victory!

Less than six months after diagnosis, I had another appointment with my endocrinologist yesterday…  And it was full of awesome!

It addressed a lot of things that have been frustrating me since my diagnosis.  The most obvious issue is wanting to be healthy and have my blood glucose under good control, and I found out that my A1c has come down to 6.1!!!  That’s down from 13.4 when I was diagnosed!!!

*happy A1c dance*

Another huge issue for me is being in control of my own health... and I don’t necessarily mean “in control of my health despite diabetes.”  I mean something more along the lines of, “In control despite the fact that my life now contains a menagerie of medical professionals telling me what to do.”  I am so glad those medical professionals are there, and I know I could not have gotten so under control so quickly as I did if I hadn’t followed their instructions to the letter, but I couldn’t help but feel that they were in control of my health... and sometimes, I was waiting and waiting for confirmation on a change that I already knew I needed.  So I thought, once and for all, that I was going to ask my endo for official sanction to make adjustments to my treatment myself.  I went armed with a bookmarked copy of Pumping Insulin and lots of explanation as to why I could safely and effectively make my own decisions.  When she asked if I was still working with my CDE, this gave me the opportunity to explain that I was still working with her, but I wanted some more freedom to make my own changes.

“Oh yes, absolutely!”

Oh.  OK.  That was easy!

She gave me some guidelines for making decisions, told me I can fax her numbers anytime I need help, and said she was completely comfortable with me making these decisions.

*happy victory dance*

And another biggie…  Something I was sure I wouldn’t hear her say considering the numbers I was showing her included two highs over 200 and one bad low of 43 this past week…  She told me that it’s safe enough for me to go ahead and start trying for a baby whenever my husband and I decide to!!!  (She understood that last week was a weird one for me, and said, "With type 1, it's never going to be perfect.")

*happy baby dance*

I feel like I’ve reached important goals and blown hurdles right out of my path.  Life is good, and I believe I have the ability to shape my future the way I see fit instead of around my disease.

Not the Only Villain

Sometimes I forget that I struggle with more than just diabetes. There's also chronic depression. And, honestly, I forget it largely because I'm so much happier than I was about six months ago. I have a job I like more, I have a career goal and am working toward it, I no longer feel crappy because of undiagnosed diabetes, and getting diagnosed with diabetes has honestly given me a lot of perspective and direction in life.

But chronic depression isn't a direct result of the state of your life, it's a direct result of your brain chemistry. (Though it's admittedly also affected by the state of your life).

So when I started feeling almost weak on my feet, unsteady, and almost unwilling to take the next step and then another, I kept repeatedly checking Dexcom and my meter to see what my blood sugar was doing. I really felt that it must me low or plummeting, but how could two separate meters and a CGM be wrong? I did eventually sink to the 70s at one point and, still feeling awful, I opted to go ahead and drink a juice box since I was slowly moving downward...

But that juice box and my rising blood sugar did not help the way I felt. Searching for my stupid devil horns in boxes we still haven't unpacked since the move was an effort in that my hand barely wanted to move items aside, and my knees wanted to let me sink to the ground. I should have known what was going on when I finally lay in the middle of the floor because I didn't even want to drag myself to the bedroom or couch to lie down... That's something I used to do all too often, when things were much worse in life.

And when friends arrived to pick Chad and me up for Ghouls Gone Wild, I found myself almost in tears over wanting to go enjoy the parade yet knowing that I would not enjoy it and quietly blaming myself for letting some sort of mysterious diabetes symptom keep me from having fun. Walking three or four blocks? How would I put one foot in front of another so many times if I barely had the energy to move from one room to another in my own home? Standing there for an hour watching floats and costumes, many of which are very cool and impressive, how could I focus on anything like that while trying not to freak out about the crowd and the noise? I'd have to stay home... but maybe I shouldn't stay home alone--because what if something was really wrong with me--but how could I ask my husband to also stay home because of my disease?

That irrational argument against asking Chad to help keep me safe is what caused my confusion to lift. This was not some mystery symptom of diabetes, this was a far more familiar companion: depression.

Oh yes, hi, I know you all too well. I had not thought to look for you, because you are not the greatest villain in my life anymore, but I recognize you. You are sneaky, conniving, and cunning. You caught me off guard, but I am much better equipped to deal with you now. You know what I've learned from my diabetes? Management, and the acceptance of What My Life Is. I'm always diabetic, but I keep my blood sugar under control without despair at the thought of having to do test after test, bolus after bolus... and the thought that diabetes will still throw me a curve ball every now and then. Likewise, I am always dysthymic but will keep my depression under control without despair at the thought of having to manage it for the rest of my life... and that you will still throw me a curve ball every now and then.

But neither will get the better of me ever again. Period.

This is one of the many positive ways that diabetes has impacted my life; it's made me better equipped to face long-lasting struggles and not feel like I'm struggling. It also caused me to go to counseling to help adjust to the changes in my life, which has taught me how to look at my thoughts from the outside and recognize that I am not my thoughts. (An odd concept, I know, but it made perfect sense as I recognized that totally irrational thought.)

So hi, depression. I acknowledge you. Now I'm going to manage you, and this time, I am going to get the better of you.

Brownies = Better than Pigs.

Brief attempt to be healthy at the Target food court:

A turkey & provolone sandwich, please. What? The only sandwiches you have left have pork?

Ew....

I'll have that bigass brownie.

*bolus*