Pat on the Back

Usually, my relationship with my diabetes and self-care is a rocky one. I tend to focus on the times that I don’t feel well (highs, lows), the numbers that feel like failures, the frustrations of unpredictability and feelings of body betrayal & lack of control. Some of that is a result of my barely-beneath-the-surface perfectionism and just human nature. When things are going well, we hardly notice. When something goes wrong – whoa!

someecards-mind

Change “men” to “people w/o diabetes” and “woman’s” to “PWD’s”

Yesterday I had a regular appointment at my endocrinology office. It’s a fairly new office for me; yesterday was only my third appointment at this practice. I ‘ve seen the endo once and the NP twice. I’m happy with the NP – and I especially noticed yesterday how good she is at reading the download reports from the Omnipod & Dexcom. I can’t quite put my finger on it, but she manages to balance out the big picture and fine detail views so that patterns are easier to see and think about. When I do downloads at home (not as often as I “should”) I get mired in irritation over how many highs I see, ignore the lows, and generally go straight to my own biases. I still may work on a pattern or two if I see them, but I always end up feeling badly.

The first time I saw the NP, we made a lot of changes. I was very skeptical but had committed before the appointment to try at least some suggestions. I had about 8 different basal settings in the 24-hour period and 5 correction factors (sensitivity). We cut the basal settings back to 3 and correction back to 2.  I fully expected to switch back after a couple of weeks, believing that my micromanaging was necessary. I was really wrong.

fig1Yesterday (and yes, some “good” numbers & results are coming up!) my downloads showed that I was in range 78% of the time. That’s seventy-eight per-cent… whaaat?? Unheard of. And, lows (below 70) were only 8%. And, lows under 55 were only 1%. My A1c (and I almost never share this number) was 6.4. That’s .1 higher than last time but last time I was in the low range about 25% of the time. I was ready to think that maybe they got my downloads mixed up with someone else’s :)

But, thinking about the past 3 months, I have been feeling better. I’m exercising regularly (yay running!), eating sensibly (foods & portions), using my CGM responsibly (testing before treating, not jumping too quickly on highs or up arrows), and cutting myself some slack rather than always playing the blame game. So maybe those really are my results.

We went over the daily downloads for patterns and only found one that looks like slightly too much dinner mealtime insulin. We changed that I:C ratio by 1 which now gives me only two I:C ratios. For once, my settings are pretty close to the calculations she always does to see what is “suggested” based on my total daily dose, etc. When we looked at the other things that have been frustrating me — having the same breakfast every day but getting different postprandial results and the variability in post-exercise blood sugars — there just weren’t any patterns. Of course, that’s what drives me crazy, but she framed in a different light that was very helpful — obviously there are factors there that aren’t in our control. I’m using the CGM well to catch any excursions before they get completely out of hand and that’s working overall. Not my fault?? What a concept.

So, normally I don’t take any time to think about what I might be doing right, or take any credit for maintaining or improving my health. This time, I just want to. It’s not my diaversary, but it’s a good time to pat myself on the back and say “good job.” I texted the BHE after the appointment to say “If the endo had gold stars, I would have gotten one.” Really though, I need to give that gold star to myself.

Disclaimery Thing: I cringe to post actual numbers. I don’t want to be judged in any way for them — And judgements that come from people when they think your numbers are “too good” or that you are making other people feel badly, or that you have “no right” to complain when your numbers are better than someone else’s are the worst for me. I just want to say that everyone’s experience with diabetes is individual and I haven’t posted anything here as a way to compare to anyone else — only myself. 

Posted in Endocrinologist, Living with Diabetes | Leave a comment

Diabetes Day Camp, Take 1

It has been an eventful week. Of course, “eventful” is useful in the same way as “interesting,” — it can represent many different shades of good, bad, and in-between.

The Bear had her first week of diabetes camp. She’s only 7, so it was day camp. She went to a one-day event at this camp last fall and really liked it. When I saw that they had summer day camp (1 week), I was pretty excited but we were waiting to hear whether she got into another camp (that runs by a lottery system) that could have been the same week so we didn’t register for diabetes camp right away. In fact, I didn’t even remember it until the Friday before the camp was set to start :) I called, they made room, and come Monday she was off to Camp Hot Shot.
onlycoolkids

The awesome: Everything I have read about any diabetes camp applied here — huge peace of mind knowing that most of the counselors & some of the organizers have T1 and/or have a lot of experience with managing T1. Even though this camp did a lot of the same things as the rec camp she got sick of last summer, she had fun doing those things here and I think the counselors & other kids were the biggest reason. She didn’t have any comments on what it was like being in a group where everyone was testing bg and taking insulin (rather than being the only one doing those things, like at school), but I’m sure it was an incredibly normalizing experience for her. She has already said she wants to go again next year and someday she wants to be a counselor. The pool at this facility is a non-swimmer’s dream come true with buckets that randomly drop water, and a waterfall-like thing.

The same-old-same-old: The camp had a “veggie challenge” on one of the days. Each camper was assigned a vegetable and had to come up with a recipe that they could make and bring in for everyone to try. The camper who tried the most things was recognizeveggiesd and the campers voted on which recipe was their favorite. Ahead of time, I told the camp director that the challenge would be getting the Bear to try anything. She laughed and said that did sometimes happen but often parents are flabbergasted at what their kid did try. Well, color me unflabbergasted. Our kid tried exactly zero veggies. But, she did say on the way home that there were two things that she kind of wished she had tried, so maybe there’s hope. We’ll be buying some fresh green beans to be dipped into ranch dressing (so creative! so innovative!) and looking for a good muffin recipe using butternut squash (please comment if you know of one!).
The not-so-good: and this has nothing to do with the camp per se. After a very long day at the beach on Thursday (well, that has to do with the camp. I think 5-6 hours in the sun on the beach is a bit much, especially for a 7-year-old), our Bear came home exhausted, over-sunned (though not burnt, thanks to good suncreen), and with a headache. We chalked it up to the long, sunny day. She slept most of the evening, didn’t eat any dinner, and stayed mostly in the mid-200s. Changed her pump site a bit early and at 2 a.m. she had come down to 94 and when she woke up she was 106. She was still tired though, and more emotional than usual. At first she didn’t want any breakfast either. When she tested at 260-ish before we left for camp, we checked for ketones which came back at 0.8. She has never had ketones, not even at diagnosis since we caught it so early. She still wanted to go to camp though and ate a couple of pieces of toast so we covered for that & by the time we got to camp she was coming down. We let them know what was happening & knew we would be back in only 3 hours for the family lunch & games, etc. so it wasn’t a full day. When we got back they told us she had been running in the high 200s & around 300 & corrections didn’t seem to be doing much. She was still testing at small ketones as well. As soon as we sat down she snuggled up to the BHE. Didn’t want to eat or do anything else, but also didn’t want to leave. We ate our lunches (she didn’t have anything) and hung around for a bit before she finally gave up & said she was ready to go home. Long story, long: she slept on the way home, vomited at home, tested at 0.5, 0.4, 0.8 ketones but with bgs at 106, 114. No more vomiting after an anti-nausea dose, but lots of sleeping and refusing to eat or drink anything. Then the usual sick day procedures, temp around 101, insulin via syringe just in case, talked to the CDE on call, blah, blah. Real-person sick.

Crummy way to end a great week.

By the time I am writing this though, it is as if someone flipped a switch. She has perked up, ate a bit, had a popsicle, and is clearly feeling some better. We didn’t have the afternoon we were expecting, but it could have been worse. Tomorrow is a 5K in the morning for me, & probably a bike ride for the BHE and the Bear if she is up for it. Then in the afternoon maybe a longer bike ride for the 3 of us. Back to normal.

We are so lucky. Myself & the Bear get sick very rarely. We made it through the whole winter without anything more severe than the sniffles. The only downside to that is when one of us does get sick, I feel totally inexperienced. There’s no other times to compare it to or to help know what to expect.

I hope that over the year she will remember diabetes camp for all the fun she had and not for how it ended. Someday, I hope we’ll be dropping her off for sleepaway diabetes camp and for that to happen, these earlier experiences need to be positive. I think we’re good, but I wouldn’t be a mom if I didn’t worry a little. :)

momworry

 

Posted in Camp, Illness, Living with Diabetes, Others caring for your T1 kid | Leave a comment

You Say It’s Your Birthday

For your listening pleasure: The Beatles, Birthday Song (via YouTube)

Today is my birthday! I like birthdays – my own and other people’s. I don’t care about parties or presents but the idea of celebrating someone’s birth, their presence in our lives is just grand.

30-40-50-60-thirties-forties-fifties-old-birthday-ecardToday, I turn 44. 4 is my favorite number so this age is nice from that perspective. But, much nicer was waking up this morning in a wonderful life. The best hubby ever (BHE), a sweet (pun both intended and not intended) little girl, vacation next week, home in a wonderful town, good friends nearby, a job that I love and feel passionate about…

This year I’m also thinking about my health. I feel lucky – which may seem like a strange thing to say in a T1 diabetes blog. Today, I feel like I am healthier than I have been in my adult life. My diabetes is well-managed (mostly), I am exercising regularly, I lost the weight I needed to, my diet is reasonably healthy & balanced, and my emotional health is on a really even keel.

Sometimes I think I need these little celebration days to get my head up above the waterline that is the daily distractions, irritations, and real frustrations. I would like not to have T1 Diabetes and I would especially like my daughter not to have it, but we do and yet we still keep ourselves healthy. That’s a good thing.

So, happy birthday to me! And, here’s to many more healthy years!

[And an even better (IMHO) birthday song: Older, They Might Be Giants]

 

Posted in Balance, Living with Diabetes | 2 Comments

News Flash: Diabetes is Making Me Crazy

I know, not really a news flash! But, it is part of a larger story that is about a lesson I have to keep relearning.

Sometimes, when a pattern of bg readings starts to emerge – whether for myself or the Bear – I start to adapt to it by lowballing carb counting, overriding the bolus suggestions, or overusing temp basals rather than figuring out what is going on and changing pump settings accordingly.

We’ve had a few nights where the Bear is lowish or has CGM arrows down after dinner, around bedtime. So, she will have a snack and we won’t cover the carbs, or only cover part of the carbs, or I’ll set a lower temp basal for an hour or so. Then at 10 p.m. when we test her before we go to sleep, she’s in the mid to high 200s and I grumble and mutter under my breath, set one or two alarms for overnight, and start the whole process over again the next day.

When I get sleep-deprived enough, I start forcing myself to try to do some real testing — cover carbs by the book, treat lows, log what’s happening, with the intention of getting to those settings changes. At which point, the pattern goes away. Is there for one night, but not the next. Or there is so much snacking or bolusing that it is next to impossible to test the existing settings.

[side note: this is a pet peeve of mine with our CDEs… they are always asking me about basal testing, or saying it would be “nice” to have a few nights of testing where she went to bed in range with no food or insulin on board. I agree, that would be “nice” but it seems like those nights come along about once every two months so it’s pretty unlikely for it to happen in the 7 days before our appointment.]

So this is where we’ve been the past week or so. And with a couple of nights of one of us out at a meeting or something we had nights where we went back to under carb counting, etc. just to get through. I could upload her data but of course it won’t show all the work-arounds we’ve been doing.

So, Diabetes, you are driving me crazy. I know that I need to change the Bear’s I:C ratio at dinner, or for evening, or her basal at one of those times — but I don’t know which needs to be changed, or by how much. I’m tired from getting up twice each night and still no closer to having good numbers.

Posted in Carb Counting, Living with Diabetes, Pump Management | 2 Comments

Pleased To Make Your Acquaintance

Day 7: The very first inspiration for Diabetes Blog Week was to help connect our blogging community, and that continues to be the most important reason it’s held every year.  So let’s help foster and continue those connections as we wrap up another Dblog Week.  Share a link to a new blog you’ve found or a new friend you’ve made.  Or pick a random blog off of the Participant’s List, check it out and share it with us.  Let’s take some time today to make new friends.

I’m still catching up on posts for Day 5 and Day 6 so I’m sure I still have new friends to meet and new favorite posts to find…

I have added some blogs to my Feedly list (up over 65 D blogs on there now!):

  • Celine at Running on Carbs had a great re-post for yesterday’s “favorites & motivation” topic. I’m excited to find a diabetes + running blog given my new-found interest in running.
  • To continue with the running theme I loved the “I Can” post at Running without Sugar. It was great to read how supportive and encouraging her doc was at diagnosis – and then all that she went on to achieve (like marathons!).
  • Pretty much every day I was impressed with the writing on I am Type One. Day 4 she tackled the topic of Changes and her recent decision to try an insulin pump. She started off the week talking about how she doesn’t usually share her feelings or personal thoughts but I thought every post did a great job of expressing herself.

Things that I definitely felt so many of us were connected on:

  • Cleaning Out – we all have a closet, drawers, etc. that are just filled with so much diabetes supplies! I’m glad it isn’t just me who needs to do a purge :)
  • Keep It To Yourself – I’m also not alone in finding that sharing specific numbers (like A1c) is tricky. It was interesting to read the reasons various people have for arriving at the same conclusion.
  • DOC Love & Support – Throughout all the topics, people kept saying how their lives had changed for the better once they discovered the DOC. The comments on blogs, RTs on Twitter… all equal the kind of support we all need.

Thank you to everyone who blogged this week and shared your feelings, experiences, wisdom, humor, and support! I’m grateful to “know” you all :)

Posted in Blogging About Blogging, DOC | 3 Comments

I Wish You Hope (D Blog Week day 6)


Day 6 Topic: If you have been blogging for a while, what is your favorite sentence or blogpost that you have ever written? Is it diabetes related or just life related? If you are a new blogger and don’t have a favorite yet, tell us what motivated you to start sharing your story by writing a blog? (Thank you Laddie of Test Guess and Go for suggesting this topic.)

I have been blogging for a while but don’t post enough for it to feel like a long time. I was curious about what I would do for this topic. I’ve written more than once about my motivations for starting a blog and it’s hard to think about having a favorite post or sentence (I’m my own worst critic). The topic is a good excuse to read back through a couple of years of posts though, and I did find something in a post that I decided was worth restating.

It doesn’t even go all that far back — just to January of this year. We attended a brief talk by Ed Damiano about the Bionic Pancreas. One thing I said in that post was:
I still don’t think I can believe that it might be available in the fall of 2017 (when Damiano’s son is due to go off to college – his goal) – but it’s hard not to believe that it will be available. That is more than I have hoped for a long time.

It’s hard to lose hope. I find myself cringing whenever people try to tell me about some amazing new discovery they have heard about. They are excited to tell me something positive and want so much to be the bearer of good news. And I’m lucky, it’s never about cinnamon curing diabetes or how Halle Berry weaned herself off of insulin. It’s always a report they read or heard about encapsulation or a cure in mice or the artificial pancreas or islet cell transplantation… What is discouraging is how discouraged I feel in the face of all of that hope. Truly I think the research that is happening is some of the most exciting ever – people are making huge strides in understanding so much about diabetes and that leads to new and innovative approaches to both managing it and someday finding a cure. I get that. But, despite how promising a report makes an advance sound, it isn’t going to make any difference in my daily life tomorrow or next week or even next year. So this person who is only telling me about it because they care wonders why I’m not happier at the news. They don’t understand that I was told in 2001 that there would be a cure in 5 years and other PWDs were told that 20 and 30 and 40 and 50 years ago. They don’t understand just how far away we are from getting that mouse cure to work in humans (if ever). They don’t understand how hard it is to get excited about “someday, maybe” ideas when every day we are watching our 7-year-old go through the literal highs and lows, and we worry about her living through the night, and I know that every day raises my risk just a little bit more for serious complications. Every day is filled with carb counting (or SWAGing), finger pricks, and getting things wrong all the time – things that when you get them wrong make you feel lousy at best and could land you in the hospital (or worse) at worst.

I really don’t like being negative. I usually say “yes, the science has come so far,” or “it’s exciting to have so much research going on.” And if someone asks more questions or pushes for a more enthusiastic response then I might try to explain a bit about how long such things take, how much we still don’t know, how expensive new treatments can be even if they do make it… I doubt it helps people be less disappointed that I’m not more excited, or (perhaps even more commonly) that I already know about this “new” advance they just heard about.

Anyway, enough ranting about that. That is just one of the big places in my life where my hope, now pretty ragged, gets highlighted for how many holes it has in it these days. I can’t get my hopes up to a high level because the waiting and disappointment is just too hard. For my own sanity I need to try to stay interested and curious without actually pinning my hopes on any particular “cure.”

But, Ed Damiano’s presentation was something different*. As I wrote in my post:
I had tears in my eyes during parts of his talk. I felt that scary feeling of daring to hope for something.

But, it is the paragraph at the end of the post that most made me want to share again. My hope that all of us touched by T1 Diabetes get moments when we can feel hopeful. Here’s that paragraph. I wish you hope.

I hope that every person with or affected by T1 gets to experience something this year that makes them feel hopeful about better days ahead. Whether it is a scientist talking about advances, a new friend who gets it and makes them feel less alone, or a no-hitter on their CGM — we all need to feel better about the future.

*If you don’t know about the Bionic Pancreas project, or want to learn more, check out the web site or this video. And if you are a person who has the means to donate to a cause and this is important to you, please consider donating to the project.

Posted in Blogging About Blogging, Diabetes Tech, Hope, Living with Diabetes, Research | Tagged , | Leave a comment

Yum! Friday Food (DBlogWeek Day 5)


Taking a cue from Adam Brown’s recent post, write a post documenting what you eat in a day! Feel free to add links to recommended recipes/shops/whatever. Make it an ideal day or a come-as-you-are day – no judgments either way. (Thank you, Katy of Bigfoot Child Have Diabetes for this topic.)

Just to make what is sure to be a long post even longer ;) I’ll blog my Friday food in blue and my daughter’s (also T1) in green :)

Pre-Breakfast:
Some mornings my food begins before the most important meal of the day. I’ve been having frequent low bgs between 2 a.m. and 6 a.m. so it’s not unusual for my food to begin with a juicebox, glucose tabs, or a granola bar. Not today though — made it to wake up at #bgnow 121 (thanks to recent endo appt & some changes hopefully).

Breakfast:
During the week it is the same every day (though my post bgs are not the same* — why???): 1 piece of toast (Arnold bread; I like the nutty almond the best but the last few weeks it has been Oat Nut), 20g CHO, with butter (mmmmmmmm… butter). Since my endo appointment I am trying prebolusing by at least 15 minutes (phone timer!) before eating. I should have taken a toast pic but didn’t think of it – will try to do better at lunch.

If the Bear could eat cookies or candy for breakfast, she would. She often has dry cereal (some kinds might as well be cookies) but today we were out so she had a scrambled egg (!). She is a terrible eater so I nearly fell over when she requested an egg. She ate the whole thing too. Along with ketchup. Then had 8 “club” crackers (18g CHO). She will next eat at snack at school around 10 a.m.

*note: at endo appt we identified that though my 1-2 hour pp tests were wildly different after the toast, my 3-4 hour numbers were strikingly the same –> low. I really hate hyperglycemia so I had my I:C ratio for breakfast set more aggressive than I probably need trying to combat the spike in bgs — so, we backed off on that and are trying the pre-bolus idea instead. I could also try either slower carbs or more protein in the morning, but this is easy & habitual. 

Snack:
I had a blueberry scone from my local coffee shop. I bolused at 10:49 a.m. (called it 60g CHO, but who knows) waited 20 minutes and then ate it. It. was. delicious. Now, it is 12:36 (almost 2 hours) and my CGM has an arrow diagonally up and reads 204. Wait, I just checked again and it reads 218 with one arrow straight up. The first two hours on the graph are in range and steady. I’m sure I should know what this tells me about scones but it probably just tells me I can’t eat big scones and expect to maintain in-range, stable bgs afterwards. Or that my SWAG for the CHO in the scone was bogus.

Sent the Bear to school with some goldfish crackers (10g CHO), a few sugar snap peas (0g CHO since she will only eat the peas out of the pods, and only maybe), and a fruit roll up (12g CHO). Not the healthiest or unhealthiest snack ever. She was having grapes for a while but this week told me she was tired of grapes. Her snack is important since the first graders have the latest lunch — not until 1:05 p.m.! She also has baby bell cheeses in the classroom in case she has days where she is just starving.

Lunch:
Amy’s Spinach Pizza in a Pocket (37g CHO). Pre-lunch bg = 267 (d*mn scone) at 1:45 p.m., bolused/corrected & now waiting 20 minutes before eating. As I have been doing for the past few days, I went through the process of heating up my lunch before remembering to pre-bolus. So I will probably have to re-heat it once the timer goes off. Yup, I really wish eating could just be eating.20150515_135246
The Bear brought a pepperoni pizza lunchable (30g CHO, mostly in the crusts), a small bag of cheetos (13g CHO), and 2 oreos (18g). [OMG, I am a terrible parent… these are the kinds of lunches that make me feel guilty and terrible. But, I also feel guilty and terrible when she comes home with an untouched lunch – literally, untouched – for days or a week in a row.] Usually I try to make one of the “sides” something remotely healthy and about 60% of the time the healthy thing comes back home with her. I know that everyone says to just keep giving them what you want them to eat and eventually they will be hungry enough to eat it, but I can’t deal with the morning battles so here we are. Some weeks I only let her have a lunchable on 2 days and that plus the one healthy thing is my best compromise. 

Afternoon snack:
Not really a thing. But since my CGM was 103 and dropping around 4:30 I ate a half a slice of banana bread that a co-worker made. I didn’t test and didn’t bolus so I don’t know exactly what time it was. And I didn’t pre-bolus. 

Got a text from the babysitter at 5:30 p.m. that the Bear had eaten a Clif Bar (44g CHO – whaat?!) and a juice box (21g) so she was covering her for 65g CHO. That’s a lot all at once. I need to give the babysitter more guidelines as to what is ok for a snack but haven’t gotten my thoughts together on that yet. It is so variable depending on activity level and whatnot. And there is just the whole complication of setting limits around food [see dblogweek day 4]. When I got home (I work late on Fridays), the hubby said that the Bear was around 55 and CGM had double arrows down. Great. So she had 1 glucose tablet and a juice box (19g CHO total).

Dinner:
Friday is pizza night. We tried a new place tonight, so I couldn’t count on past experience completely. Plus I forgot to pre-bolus so once food was on the table I had to wait – set the timer for 20 minutes. The poor Bear was feeling lousy from the low anyway so we snuggled while her bg came up. But for some reason, the timer on my phone kept resetting so I’m not sure how long I actually waited before eating. Just as I was finishing 1 piece of pizza and some salad, CGM started alarming low. blah, blah, blah. Still low now and did an extended bolus hoping to catch the later rise. Pizza is stupid.

The Bear ate about 1/4 of a large slice of pizza before deciding she didn’t want pizza. Ended up with a PB + Nutella sandwich. More health food. A glass of milk topped that off and she’ll be deciding on some dessert next. 

I know that Friday isn’t officially over but I’m wiped out from all this food talk & thinking :) I can’t say that today was a very good example of my usually healthy diet — Mostly I cook veggies at home, take leftovers for lunch, etc. But, Fridays are a long day for me after a long week (and I’m working tomorrow too!) and … excuses, excuses :) I’m looking forward to reading what everyone else had to eat today and maybe pick up some new ideas for snacks and meals. You can read all of the #DBlogWeek Day 5 posts here.

Posted in Endocrinologist, food, Living with Diabetes, Pump Management | 1 Comment