Dblogweek reflection

Last day linking up for diabetes blog week.  Today, the topic is supposed to be a reflection on the week, sharing our new favorite things we discovered.  I only discovered the host blog and the link up on Friday, so I haven’t had much time to surf through everyone’s posts, although I plan to go back and read all of them as I get the chance.  Given that I discovered all of this so late into the game, I haven’t had the chance to notice as much as I’d like.  I think for me the neatest thing was just discovering all the other diabetic bloggers out there.  This disease is isolating.  Blogging is actually kind of isolating too when you first start.  How do you find other people out there that seem like real people?  So many of the blogs I come across randomly are pretty weird blogs or business blogs, and all they’re trying to do is teach you how to make money from your blog.  It’s been so nice just to discover all these other blogs out there written by real folks about their experiences.  I can’t wait to keep reading.

Unrelated to diabetes blog week, I’m going to start posting some of my sugar waves and how I corrected for abnormal situations.  The interesting thing about these sugar-waves for non-diabetics is that they give you a glimpse of how a body responds to different foods.  The more insulin it takes a diabetic to get rid of the sugar in the bloodstream from a particular food, the more insulin it’s going to take a normal person.  The more insulin something takes, the more energy is being stored into your cells, so it’s a pretty good approximation for how different foods are affecting your body apart from their calorie indication. 

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Dr. Stephen Ponder workshop on “Sugar Surfing”

Wow.  I learned some mind-blowing things from the workshop this morning.  So much, in fact, that I’ll probably have to divide it up into posts.  I’ll just write a quick, broad summary of my notes from the presentation, and then delve into interesting details of different tricks in different posts.  I think the main point of Dr. Ponder’s workshop is that nothing is truly predictable.  Even if we look up the number of carbohydrates in a particular meal, the portion size might be off, or our body might react to carbs from one source differently than it reacts to carbs from another source.  The idea, then, is that you keep things as normal and predictable as possible, but you know how to be proactive early on when you notice that things aren’t panning out the way you planned.  In order to be properly proactive, though, you have to have some baselines tied down.

Dr. Ponder began the workshop by giving some examples of the way traditional diabetes wisdom doesn’t always make the cut.  He explained, for example, that the amount of sugar in your body when you bloodsugar is 110 varies person to person based on weight and other factors.  Because of this, traditional wisdom, like 15 grams of carbohydrate per low doesn’t do the same thing in everyone.  He explained that by experimenting and varying, each individual diabetic can better learn how to react to her own life situations.  In order to do this, you need a cgm that is well-calibrated and a basal rate that you know works.  The cgm is imperative because different trends mean different things.  A bloodsugar of 125, for example, could be a quick stop at 125 en route to a spike of 400 or en route to a low.  You need to know which way your bloodsugar is moving and how quickly in order to take the correct action, if action is needed, when you see the number.  You’ve also gotta be able to isolate the variables by having a basal rate that isn’t affecting things.  To test your basal rate, skip a meal, or eat a few hours later, and check to see that your bloodsugar is stable.

Once you know you’re well-calibrated and the basal rate is accurate, you can begin to play with intervention.  Intervention may not look the same in each situation.  For example, if you’re rising and you’re already at 300, it may take you far more units of insulin to bring the number down than if you intervene at 160.  It’ll also take more time as inertia is at play.  You have to be careful, it takes awhile for the insulin to really be on board working, but you can eventually, by testing out different scenarios over and over again, learn the amount you need to react to any specific situation.  Because you have the cgm, you can observe how quickly you’re dropping and take action to prevent a low from an over-correction earlier.  The key to making this work, though, is accurate data, consistent data, and patience with your data.

The other big thing you can learn by analyzing the data is timing.  How long does it take your insulin to hit your bloodstream?  Insulin interacts differently with different foods, but it generally does not peak while the food you’re eating peaks.  By watching different patterns, though, you can learn when to take insulin for the ever-impossible pizza or sushi meal.

I re-attached my cgm after the presentation.  I think that basal rates are correct, but want to pay more attention to testing this around every meal for the rest of the weekend and noticing if my bloodsugar stays stable when I don’t eat.  My next goal is to develop a comprehensive system for recording.  If I want to know what to do when I eat a heavy breakfast and then go to spin class, I need to understand that type of breakfast independently and the effects of spin class independently.

Dr. Ponder has been diabetic for over 50 years and has been able to achieve A1Cs in the 5s.  My current goal is only to make progress on my current A1C, which is 6.9.  Let’s see how the experiment goes!

t1 snapshots

Another link-up with diabetes blog week.  Today’s topic is just snapshots from life with diabetes, a shout-out to the diabetes 365 project.  The photo I sent in for the 365 project is actually the photo that I snapped yesterday of my insulin pump and my wedding dress.  To avoid repeating, though, I have some everyday photos  from this week of my supply closet (a bit empty right now, supplies (and bill, ugh) are en route from Medtronic!)), my meter, a text after a run earlier this week, and then some photos from last year’s Tour de Cure.  A few days back the topic involved dealing with the inevitable mental blues of diabetes.  I’ve always been a fighter.  My answer to that is to try to fight for what I really want in the only way I know how – – fundraising for a cure.  A bit of an awkward task for sure, but it’s how I fight off the hopelessness.   In my last post, I mentioned the top “life hack” for dealing with diabetes is marrying a great guy.  As anyone who follow this blog knows, my husband, A, is battling leukemia.  As part of that, he’s developed avascular necrosis, which is very intense hip pain.  He’ll undergo hip replacements for both hips to end the pain, but he can’t have that surgery until he finishes chemo, which won’t be for another six months.  In the meantime, while on chemo, and battling cancer and hip replacements, he is going to ride in Houston’s Tour de Cure with me this year.  His page is here.  Help support us in our fight for the cure! Image48097_10100249330711082_188718576_n ImageImage

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t1 life hacks

Okay, I’m linking up for diabetes blog week.  What a fun way to connect and share posts about diabetes.  Today the topic is “diabetes life hacks,” which are basically supposed to be non-medical tips & tricks for handling a life with diabetes.

My immediate thought is that I have no life hacks, but that must not be true.  Things that are natural to me I wouldn’t even think of as hacks.  Anyway, in no particular order:

Professionalism/clothing: Sometimes it can be hard to be diabetic and professional at the same time.  How to wear a suit?  What do I do when I’m in court and my bloodsugar starts dropping?  How to handle the business lunch or interview where I can feel my bloodsugar skyrocketing but I’m not sure how to get away?  I don’t have answers to all of this, but here are a few times where I won rather than lost:

1. My top clothing victory was probably my wedding dress.  As you can see, I had the lovely woman doing my alterations sew a pocket into the side of the dress for my insulin pump, which made everything accessible throughout the wedding, which was key.Image

 

 

2. I try to wear pants suits to business lunches and meetings rather than my typical dress suits.  I know that you can buy devices that allow you to wirelessly program your pump through your clothes, but I just want things to be simple and easy in business situations, so I opt for the pants suit and throw the pump into my pocket.

3.  When I’m wearing a dress or dress suit, I press the pump up flush against my boob and leave it in my bra.  I always make sure to turn the end where it connects to the tube closer up to my neck so that it won’t look like a nipple if the pump somehow moves around.  Yikes.

4.  When I’m running, I like to keep my insulin pump in a SPI belt.  This keeps it from bouncing around and the CGM works easily through the belt and there’s plenty of space for glucose tabs as well.

Inserting the pump/CGM:

1. For awhile I was tensing up while inserting and having difficulties as a result of it.  When my husband first suggested that I let him insert my pump and CGM I flatly refused.  But, after an episode of him chasing me around the bathroom, I finally relented and let him try it once.  Okay, so much easier/less painful.

Everything else:

1. Marry a great guy.

 

 

In anticipation of Dr. Steve Ponder’s workshop

I attending Dr. Steve Ponder’s “Sugar Surfing” workshop tomorrow.  At the workshop, he is supposed to present a new, controversial, according to my doctor who encourage me to attend, method of controlling diabetes using the cgm.  In anticipation of the workshop, I read up on Dr. Ponder’s general research and theories.  He makes some interesting statements.  He says that there is a very small group of diabetics who have lived with the disease fifty years without complications.  His hypothesis is that this group has retained its ability to make beta cells despite the war waged against the pancreas by the immune system.  He opines that maybe beta cells have some protective qualities that prevent complications and that they are effective independently of bloodsugar control.  He suggests that maybe a cure could come from evening out that balance in those patients by suppressing the immune system some.  One interesting point, although it isn’t clear how it’s related to the rest of this, is that diabetics who go 17 years without blindness rarely develop any worsening in their eyes.  I have hit 18 years so I guess that’s good news.  At the same time, reading how few people make it out of this disease without complications is a little bit depressing.

 

perfectly normal weekend

A is in the shower.  I’m in bed with my laptop propped against my knees.  We are ready to put another perfectly normal weekend to rest.  My friends send e-mail chains full of interesting updates, stories of intriguing dates, and new adventures.  I have nothing to write back.  I am doing nothing.  I have no new goals I’m pursuing.  I’m not making any life changes.  I’m not even trying to make new friends at the moment.  I am drinking in these normal weekends like they are the nectar of the gods.  I am doing nothing and I would not change that for the world.  I am so in love with stillness.  So in love with A.

Sushi

I was remembering that Friday night.  My friend was in town.  My mom had come over.  We all had plans to go downtown for sushi.  A loves sushi.  And my mom.  And hanging out with my friend.  (Yeah, he’s a dream husband.)  But, this particular Friday, he wasn’t feeling well, just wasn’t up to it.  That was the Friday I became concerned that the lingering cough wasn’t just the result of sleep deprivation due to playing too many videogames . . . and the rest of the story is how the rest of the story goes.  

Sometimes I forget, in the midst of paying bills and cleaning the house, I forget how happy I am and how grateful I am that A is here with me.  So, I called and asked if he wanted to go get sushi.  “Shouldn’t we be saving money?” he asked.  “Yeah,” I said.  “We should.  Let’s do it anyway.”  We did.  It was lovely, both of us smiling and laughing and ignoring everything else.  A’s PICC line neatly tucked away in the armband I knit for him to cover it.

Test results

Today, I received two test results.  First, and most anxiety-provoking, my name was on the “pass” list for the Texas Bar Examination. This marks my third law license since graduating in 2012, but it was the first exam I really thought I might actually fail.  I knew I blew my first exam out of the water, but this was a completely different story.  It’s traditional for law students to graduate and then spend all day for the entire summer studying to pass the bar exam.  It’s traditional for attorneys to move to a new state and then spend time studying to take the exam.  It’s a bit rarer to move to a new state, start working and then study and take the bar exam while working.  I wasn’t quite sure I was able to put enough time into preparing.  I took a few days off from work toward the end to really try to make a final push towards nailing the exam.  The knowledge I crammed into my head the last few days may have been the biggest academic feat of my life.  In any event, it’s over, it worked out, thank God.  My life can stay normal.

My second test result was a slightly improved A1C.  My results are down by .2.  I was hoping that would be the case as I have done a much better job using my CGM and I’ve really increased my amount of exercise every week.  Sometimes these changes don’t pay off in an improved A1C but I was very happy with the result.  My main goal for the next few months is to work toward eliminating post-meal high bloodsugars.  The goal will be bolusing 15-20 minutes before a meal in order to get my insulin to peak at the same time as my carbs peak.  Hopefully this will help to knock out a lot of the bad bloodsugar time period.  I think this is the smallest amount of change I’ve ever had after visiting the doctor, so hopefully I can fix it.  In the meantime, I have a few more insurance battles to fight.  Major sigh, but, oh well, what’s new, right?