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Tuesday, March 1, 2011

Overwhelmed

Yesterday's endo appointment didn't go very well.  I wasn't really expecting it to go great, but I didn't expect it to be as bad as it was.  I had suspected that my A1c was going to increase from last time, but I figured I would land around my usual 6.5 that seems to follow me without much effort. 

My appointment was at 8:30 AM across the interstate in downtown, so of course I visited the closest coffee shop on the way to grab an Americano for the hour-long drive.  Armed with my Dexcom software graphs and coffee, I took a seat in the lobby and snapped a pic of the freakishly-empty waiting room.  (For those who know my endo or go to him for his care, you know the waiting is usually very full!) 

Not 20 minutes later, my name was called and the nurse led me to my room.  She took my weight and my blood pressure.  She was putting the sleeve back in its holster when I asked, "What was it?"  "130/90," she said.  Another elevated reading, this was something I was definitely going to bring up to my endo.  She also took my blood sugar (168 mg/dL) and began spinning my A1c.  What kills me about the A1c machines at me endo's office is that you can see the timer!  I was tortured watching the 5-minute clock slowly make it's way down to 0:00 waiting for my number.  During that time, the nurse downloaded my pump data and made sure all my medications were the same.  Finally, the clock goes down to 0:00 and I see the number before she does:  6.8%. 

I felt defeated.  I couldn't help it.  I know most people would be content, even happy, with this number.  But for me, this number is way too close to that 7.0% threshold required for pregnancy.  I immediately started thinking of changes I needed to make, but I barely had any time before the endo came in the room. 

He shook my hand and took a seat beside me, and he starts going over my Dexcom graphs with me.  This really surprised me, because my endo has been reluctant to the whole CGM thing so far.  So it was nice to see him wanting to use the tool I wanted for so long.  He said it looked like I was correcting too many times after a meal, resulting in a lot of lows.  He thinks my overall basal rates were too low, so we increased my total amount by making my basal rate one rate for the whole day.  I'm not sure I agree with this right now, but I know my basal rates are messed up, so it's best to start over with a single rate for now.  He also wanted me to increase my IOB time by 2 hours and make my target BG 120 mg/dL.  I compromised by increasing it to 1 hour and keeping my range at 100-120 mg/dL; I don't mind being at 120 mg/dL, but I refuse to treat 100 mg/dL as "low". 

Then I addressed the elevated blood pressure reading with him.  I told him I had been having a lot of appointments lately with my knee, and each time I was having elevated readings.  He agreed that he doesn't like this trend, so he took a look at my history with his office over the past 4 years and notice another upward trend:  my weight.  I've never had a huge gain all at once, just a few pounds here and there.  But a few pounds over a couple of years can sneak up on you.  He said the best thing I could do to reduce my blood pressure was to lose 10 pounds, or else we'd have to do "something".  I'm assuming he means I'll get put on blood pressure medication, which wouldn't be terrible because they could also protect my kidneys.  But I don't like knowing that I didn't do all that I could to be healthy on my own. 

So to recap:  increased A1c, weight, and blood pressure.  I debated calling Trey immediately after the appointment, because I knew it would result in tears.  And it did.  My poor husband can read me like a book, even over the phone.  And when he said, "I know you're about to cry . . ." I lost it.  "It's not the end of the world, Babe.  You're still doing great.  We just need to change some things."  We agreed that we had been calling the local pizza place too many times over the last few months when we had no plans for dinner.  And even though I've increased my physical activity over the past couple months, I need to bump it up.  I've decided to give the spinning class a try (now that my knee is feeling better.  Thank you, physical therapy.), and softball is about to start up again.  Hopefully these things will help in the weight department. 

I really don't know how to end this post other than to say I'm feeling very overwhelmed right now.  Ten pounds seems so impossible, seeing as I'm struggling to keep 2 lbs off on a weekly basis.  I can log my food with some consistency and keep up a reasonable workout routine, but more than anything I need encouragement.  I need hope that this is not an impossible feat.  I just need to find something that works for me, but first I need to know that everything will be OK.  I need to stop freakin' crying about this and find some joy again. 

Sorry, guys.  I know this isn't how I wanted to end this post, but sometimes I need to be real.  And I hate this, period. 

14 comments:

  1. Aw, I'm sorry, Holly.

    I had the same kind of d-related "Holy crap I'm so overwhelmed" breakdown last night, so I feel you. They happen, and they suck.

    You can do it, though. You're going to be okay. We all are.

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  2. I'm sorry it didn't go well, and I completely understand the overwhelm of it all. I'm struggling with weight right now too, on top of other diabetes shi...um, stuff. Cycling season is starting, so I know that will help, but my goal still seems like it is a long way away. Speaking of pizza, @DrJonathan sent me this recipe for pizza dough made out of cauliflower. It is SO GOOD (and low carb!). I'm slightly addicted to it.

    http://www.lowcarbfriends.com/bbs/lowcarb-recipe-help-suggestions/543510-you-wont-believe-its-cauliflower-pizza-crust.html

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  3. Oh you ARE doing great - Trey is SOOOOOOO right! Hugs.

    I hope the adjustments help and don't make things wonkier. Fingers crossed.

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  4. Hi Holly,
    You are awesome! I mean this. I have been reading your blog for awhile now and I am always so amazed at your diligence and perserverence both with diabetes & exercise. We all go thru these times when things just suck and we dust ourselves off and try again. That's all we can do.

    I assume you might have seen this in the past, but I shared it on my blog from the diabetesdaily.com emails I receive. I promise this zucchini pizza is really really good! Low carb, lower fat and gluten free (in case anyone needs that like I do).

    http://www.glutenfreeedmonton.com/2010/11/home-made-gluten-free-zucchini-crust.html

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  5. Oh, Holly, I hate the overwhelms and it sounds like you've got a big case of them.

    This CAN be done, you know - even the impossible-sounding 10lbs part. Just gotta take things one day at a time.

    (And in a more practical application two-cents vein, I finally dropped my nagging 10lbs as my insulin averages started dropping. And it was a cycle - I'd use less insulin (and I'm talking just a few units) and then I'd need less insulin because I'd have dropped a couple pounds.)

    We're rooting for you!

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  6. Holly, I just started reading your blog a few weeks ago, so I haven't commented much. Don't give up! I know how you feel. My endo said I needed to lose 10 lbs back in Dec, it can be a struggle. You can do it though! I have only lost 5 lbs but lots of inches :-) It takes a lot of hard work but it is well worth it! We are all here to support you! Thanks for being so real and honest!

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  7. Sorry to hear your appointment didn't go quite as expected. Despite all the effort you (and all of us PWDs) typically put into living it 24/7. Sounds like you need an "I'm tired of diabetees" bracelet (I bought 2 for the days I really need to ditto that sentiment).

    And hey, lean on us. What you feel like you can't do on your own gets a lot easier when you let others share some of the burden. Like losing weight. Programs like Weight Watchers are really effective and having friends in the same boat does make a difference! Best wishes.

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  8. Holly -
    Your doing great in your diabetes, 24X7 existence and you need to be commended!
    We all know it's rough and diabetes burnout is always looming just around the corner. Like K Rawlings said: LEAN ON US!
    HUGS!

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  9. Holly, I know it seems so overwhelming, but you really are doing a great job. And yes, 10 pounds does seem like quite a feat to accomplish (because it IS!), but it is definitely doable. Might I suggest WeightWatchers? The new program they have is AWESOME! I've been trying to follow the guidelines (as much as a preggo woman can) and it has actually helped me since these second trimester cravings are AWFUL! I would just do the online program so that way it doesn't cost as much and you can use it on your phone to keep track of points. Oh, and if you have a Wii, Just Dance and Just Dance 2 are very cool games that give you a heck-of-a workout and you don't really realize it. Just a thought. :-)

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  10. Alright lady, I'm tracking right along with you! (event the waiting room thing... shocked!!) I've gained weight and my A1cs are high. (higher than yours, but it's all relative). So we are going to be accountable together! How's that sound? I need to drop a few pounds, so let's do it together. We live on opposite sides of town, but we can meet somewhere a particular amount each week and lean on one another! We can even walk the dogs together!! What do you say? Plus, it gives us weekly D-Gal time!! I want to help, and I need help, so let's do this! Sending so much love your way...

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  11. The weight creep is a bitch, I'm battling off some (per endo instructions) myself and even gave up my long standing refusal to join a gym out of desperation. I took my hit on the weight thing in January and a couple of things I've learned in the meantime are: variety is important in an exercise routine, so try the spinning class, try the various machines in your gym, play softball, do the Wii, sample it all, that way you don't get mentally bored and your body doesn't get complacent. Also, be cautious with your insulin, in my case, my increased activity caused my insulin needs to go well before I saw any results on the scale. And, keep an open mind about food, try new things and then it won't seem like so much a diet, more like adventure eating!

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  12. I'm with the others - you're doing a great job taking care of your body. Weight - I'm sure you can take off the 10. I know I've gained some this winter and am looking forward to spring and being able to get outside.
    I like Fiona's idea of adventure eating!

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  13. We aren't all saints - I know I'm not in my management of diabetes from time to time (patting my buldging tummy which by the way is great for infusion sets / needles ).
    BTW, I am really envy you at how your endo goes over all your records. Mine doesn't really get pumping - so never ask me for results, etc. I'm actually seeing a pump endo in 2 months time after a 1 year wait to see one! Remember, this is Canada - cold weather slows everything down.

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  14. Just one question on the blood pressure... do you typically have coffee in hand when you go to an appointment? My dr's always recommend no coffee for some amount of time before a BP test. The coffee you mentioned having in the waiting room might be giving you falsely high results.

    On all of it, regardless of cause, hugs from me to you! You're not alone.

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DISCLAIMER: I am not a doctor, nurse, certified diabetes educator (CDE) or any medical professional of any kind. (But I did stay at a Holiday Inn Express!) Therefore, please do not use any of my postings as medical fact. I am simply a blogger expressing my highs and lows (pun intended) with diabetes. For changes in your medication, exercise regiment, or diet please consult a qualified physician.

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My name is Holly and I live in north Alabama with my hubby, two cats, and a dog.