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Friday, July 30, 2010

Friday Five: 30 July 2010

Welcome to another edition of Friday Five.  (CAUTION:  This post is heavily diabetes-related, and I didn't intend it to be that way.  Usually for FF, I just start writing random thoughts that come to mind, and my mind has been on D a lot lately.  See my note below for my official apology.)  

  1. I've been having some severe hypo-unawareness lately.  The other night I was treating a 49 mg/dL with no symptoms, and this morning after I got out of the shower, Constance was shouting at me for being under 55 mg/dL and a finger test confirmed I was 54 mg/dL.  I didn't have any symptoms with either one of these, and that's scary.  
  2. My doc who got on my nerves apparently thinks I might have some thyroid issues.  Thyroid issues and diabetes have been related before, so it wouldn't surprise me.  And it definitely explains why I can't be in any building without bringing a jacket (cold intolerance).  She sent a request to my endocrinologist for my last blood work, and I'm waiting for them to call me with the results. 
  3. Kerri posted a great article featuring her and BSparl in Diabetes Forecast.  A related article described in great detail the risks, processes, and tests involved with pregnancy and type 1 diabetes.  Even though Trey and I still far from trying to get pregnant, it's constantly on my mind.  And this article, I must admit, overwhelmed me.  It was 4 pages of things to do (and not do) while I was pregnant along with maintaining good blood sugar control.  Even though I received some great words from Kerri, Dayle, and Cara (trust me, I've read and reread your replies to me for comfort), it didn't stop me from crying in the bathroom at work.  I know it's not an impossible feat, but it's not going to be easy, which takes the romanticism out of wanting to be pregnant. 
  4. Yesterday I got an inquiry in the mail from our FSA (flexible spending account) company regarding my recent transactions for my Dexcom starter kit and my recent pump supplies order.  Ever since the pass of the federal health care bill, our insurance company is getting tighter on what we can use our FSA card for.  Basically, unless it's something prescribed by a doctor, it's not approved.  So I have to provide validation after ever transaction, which is like paying for it twice.  Even though it's still nothing out of pocket for me, it's quite annoying to fax the same letter stating "Yes, I'm diabetic.  Yes, I need this.  See attached invoice." 
  5. And just so I can end this Friday Five on a happy note, I'm looking forward to this weekend because we're getting together with some friends to make homemade Greek pizza, drink beer, and play cards.  Hopefully I won't have the "diabetic beer" that April talked about.  ;-)  
Sorry this was such a downer post.  I didn't realize how much diabetes has been such a buzz kill this week, but I guess it has.  Sometimes D stays silent for weeks or even months, then it all comes crashing down at once and reminds me that I've got a very annoying, frustrating disease.  

Thursday, July 29, 2010

One Month Review with Constance

So it's been 4 weeks since I got started with constant glucose monitoring with Dexcom.  Tuesday night, I downloaded all my readings using the Dexcom software.  I've already noticed it starting to have an effect on my numbers.  My average BG over the past month is 139 mg/dL which corresponds to an A1c of 6.5--the exact same I had back at my endocrinology appointment.  But I'm noticing this average has less peaks and valleys around that number, so I'm actually staying closer to my average as opposed to rising and dropping around it. 

And now for the nerdy portion of this post:  the graphs!  As a climate data analyst by profession, looking at loads of data and trends is my bread and butter.  I love seeing how my trends have changed since having Constance

First, here's a graph of the last week of readings.  You can even see here how my variations get smaller towards the right side of the graph.

Weekly BG readings from 21-27 July 2010.  (These pictures may appear small in the post, so click on them to get a bigger, nerdier view.)

The next graph I have found to be the most valuable.  It is my average BG readings per hour.  I used this graph and the numbers to alter my basals.  I'm trying not make a lot of changes at one time, so the only thing I changed for now is I upped my sleeping basal to bring down my average of 160-180 mg/dL (ewww!).  I also added a lower basal from 4:00-9:00 PM because I've noticed that I go low due to increased activity.  

Hourly averages for the last 2 weeks.

And here is the table with that plot along with all the statistical information you'd ever want:  

<3 Numbers!!!

So that's the gist of using a CGM in the numbers.  I've found it to be an incredibly invaluable tool, and I look forward to more improvements in my numbers over the next several months.  However, one hurdle I'm still getting used to is keeping the sensor actually on for a full week.  I've ended up using so much medical tape that I look like I got shot and there's this probe sticking out.  A diabetic coworker of Trey's gave him some Tegardem for me to try.  I put it on after I changed my sensor last night, and it seems to be working so far.  It's basically a clear adhesive that keeps the tape and sensor encased in this kitchen-clear-wrap-type material.   We'll see how it holds up during the week, but I definitely think this will come in handy for our beach trip in September to keep the salt water out of my tape.  

 This thing ain't going nowhere!

Wednesday, July 28, 2010

No Good, Very Bad . . . Morning

Did anyone read the children's book Alexander and the Terrible, Horrible, No Good, Very Bad Day?  I somewhat believe this book was written for adults as a way to relate to kids when they have bad days. 

Case in point:  this morning.  Actually, it started last night.  I looked at the Dexcom software for the first time since it's been almost a month since I've had Constance and I wanted to see how my averages were doing.  I was floored at how bad my nighttime numbers were, especially from midnight to 3:00 AM.  So I bumped up my nighttime basal 0.1 units.  But dinner for the evening was chicken parmesan with rotini pasta.  I thought I had my pasta bolus down (square bolus over 3 hours), but boy was I wrong.  My numbers were good for the first 2 hours, in fact my peak was only 129 mg/dL.  But as soon as the bolus stopped and I was ready for bed, I saw a southeast arrow heading towards my 70 mg/dL alarm.  Sure enough, around 10:30 PM, BZZZZZZZZZZZZZZ!!!  Test:  67 mg/dL.  Chomp 5 glucose tabs and head back to bed.  I was dead tired, but I was afraid to go to sleep.  My <55 mg/dL was going off, too, at 49 mg/dL.  I tried to stay awake long enough to know I was going up.  I wasn't "feeling" low.  I never experienced rapid heart beat, shaking, sweaty, or even dizzy which is usually my first symptom.  But my meter and Constance were telling me I was too low to feel comfortable going to sleep.  I finally saw 63 mg/dL with an arrow going up, so I felt confident enough to fall asleep. 

The tabs bumped me up to the mid 80s where I stayed most of the night until 3:00 AM when my morning basal kicks in, so I was greeted with another low alarm at 68 mg/dL.  However, I know my numbers take a kick up when I wake up (stress?), so I went back to sleep until my alarm went off two hours later.  After my alarm went off, I hit the snooze but not long before Arnold started beeping with a "Low Reservoir" alarm.  "For crying out loud!" I thought. 

When I finally got up to test, I was 90 mg/dL (thanks, dawn phenomenon).  I programmed my insulin for breakfast and hopped in the shower.  After eating and getting ready, I packed my lunch and hopped in the car (also noticed this is the 2nd time I've used the word "hopped", but I was really doing anything but, more like dragging).  My commute usually takes 25 minutes, and I made it all the way to my parking lot before I noticed . . . no wallet, no meter.  "[expletive] [expletive] [expletive]!!!"

I could do without the wallet until I got home, but not my meter.  Even with Constance, I still need finger sticks to calibrate, and I simply don't feel comfortable going 9 hours without a finger test.  So I pull back out of the parking lot and make the 25 minute commute back home, run into the house while leaving the car running, grab my wallet/meter, and run back to the car.  An hour and a half later, I finally walk up to my office and retrieve the necessary caffeine. 

At the end of Alexander's bad day, he wants to move to Australia.  I want to move to Jacquie's island of bad pets, because at least someone there would have had a meter. 

And y'all, it's only 9:00 AM . . .

Monday, July 26, 2010

No, Doc, YOU Could do Better!

It was a new doctor's office located a convenient 5 miles from the house.  I had been having problems with my right knee and wanted to get it looked at, plus I needed to find a new general practitioner.  I waited about 10 minutes before my name was called. 

Since I was a new patient, I had to fill out all the standard new patient stuff including mother's maiden name (how is that medical info?!) and previous hospitilizations (including my DKA, only 2, I got severely dehydrated once when I was 3).  They also had me fill out this survey of current health status.  Allergies, current medications, and current illnesses.  I sighed and circled "Diabetes" and thought about writing in "Type 1" in the space next to it. 

I met the nurse, dressed in hot pink scrubs with a smile just as bold as her attire.  "What brings you in today?"  "My right knee.  It hurts when I walk upstairs or cross my legs for a long time."  "OK, we'll get that X-rayed then you'll meet the doctor."  I was summoned by the X-ray tech who walked me back to the X-ray room.  I shut down Constance temporarily so he could do the scan (note:  I wasn't sure that I needed to do that, because I remember reading no MRIs and such.  So I just thought better be on the safe side.)  He scanned my right leg once laying on my back, and once on my side.  Then, I walked back to my room and waited for the doctor. 

She came in and greeted me, told me she didn't see anything on the scan but would wait to get the official word from the radiologist (who said she didn't find anything either, wasted visit).  Then she started going over my chart.  "Diabetes?  What was your last A1c?"  "6.5", I said.  "Hmmm,"  she mummed.  "That's good," she said looking down at the chart, then she looked up at me and said, "but it could be better." 

Blood . . . boiling . . .

"Well, the ADA just wants me to keep it under 7.0.  So I try to maintain that."  She went on to the next item which I don't remember what it was because all I could hear and see was RED.  All I could think about was how that number was followed my a "well done" from my endocrinologist last month.  Now, I'm getting a "it could be better"?!  Let's see, what else could I do other than: 
  • Test my blood glucose at least 6 times a day. 
  • Wear a CGM that alerts me when I go high/low. 
  • Count every single gram of carbohydrate that goes into my mouth. 
  • Try to get 30 minutes of activity in everyday after working 9-hour work days. 
  • Prepare less processed, less salty meals at home because heart disease and diabetes are BFFs. 
Could my A1c be better?  Sure, it could.  But a lower A1c means more lows, not necessarily more "in-range" numbers.  If my whole life revolved around my A1c, then I would go back to MDIs when my A1c was 5.1-5.3 where I was living in the 60s and streamlining grape juice 24/7.  That could give me a better A1c, but not a better life. 

This disease is so freakin' personal, that it's hard not to take comments like that personally.  I'm a pretty patient gal until someone starts giving me a guilt trip on my diabetes.  I already experience that everyday whenever I go over 200 mg/dL and wonder if I didn't bolus enough or go below 40 mg/dL in the middle of church and have to chomp raspberry glucose tabs putting my row into a pink fog from the dust.  Guilt--it's the ultimate complication from diabetes. 

I left the office feeling bummed out and furious at the same time.  I couldn't believe that I was treated like a number, not a person.  Then I felt silly for getting so worked up over a doctor just trying to do her job.  But then I felt like I don't want to be someone's "job", I want to be a personal patient.  If you want me to have a better A1c, how about a cure?  Because at this point, that's the only way my number is going to get any lower. 

By the way, my right knee still hurts. 

Friday, July 23, 2010

D-Feast Friday Five: 23 July 2010

This is a special edition of Friday Five because Karen, Elizabeth, and Lorraine arranged for the DOC peeps to blog about their favorite foods and recipes.  I love when we help each other come up with blog ideas!  Especially ones that can be so helpful.  So for this Friday Five, I'm going to go through my favorite meals to have for breakfast, lunch, dinner, and 2 snacks!  Try not to drool.

1.  Breakfast--Cereal.  Doesn't matter what kind.  I love cereal!  When I was a single gal, making an elaborate dinner for one person was never fun.  So, most nights I would have cereal for dinner.  But with diabetes, my cereal choices require some thought.  First of all, the carb content needs to be conservative.  On average, most cereals are 25g carbs/serving (which is 3/4 cup), add in milk and I'm pushing 40g already.  I try to look for cereals that will keep me somewhere around 30g +/-5.  Second, the cereal has to have a significant amount of protein.  This is the hardest thing to find in a cereal, because most of the cereals in aisle #2 (aren't they all in aisle #2?!) are colorful and sugary with barely any protein.  And protein helps to keep my BG more stable, so I try to have at least 10g protein in my cereal.  Lastly, it has to taste good!  I've found some cereals that meet the carb and protein requirement, but taste like wood chips.  I can handle them for about a week before I steal a bowl of my husband's Cookie Crisps (shhh, don't tell him).  I have found one, though, that meets all this criteria:  Kashi GOLEAN Original!

 Click on picture for nutritional information. 

Even though the serving size is 1 cup, I limit it to 3/4 cup for the carb content.  I also like Kashi because their ingredients are natural (I'm pseudo-organic).  And it has a nice honey taste to it, too!  Mmmm . . . 

2.  Snack #1--Greek yogurt.  I usually have this snack after I've been at work for an hour (and after my first cup of coffee).  I first heard of diabetics eating Greek yogurt when I started twittering and wondered what all the fuss was about.  Turns out, Greek yogurt has twice the protein of regular yogurt!  I had always liked yogurt, especially as a breakfast side, but most yogurts had too much sugar that I would end up crashing before lunch.  So, I bought one Greek yogurt to try, honey and vanilla flavor.  The texture is a lot different than regular yogurt--it's thicker and gummier (sp? word?).  But I loved the taste and the reaction it had on my BGs, nice smooth line until lunch time.  But in order to get some fruit servings into my day, I like this brand.  The fruit flavors have real fruit in them, and it's all natural (yay!).  These usually have 20g carbs and 14g protein; I like when they almost match.  My favorite is strawberry:  

 3.  Lunch--This meal is tricky because I don't really have a favorite that I eat a lot.  Usually lunch is leftovers from dinner the night before or a turkey sandwich.  However, if I have the time to make it, I like to make a salad that's from the Abs Diet recipes. It is a dark, leafy green salad with almonds, sliced ham, craisins, feta cheese, 1 chopped green apple, and raspberry balsamic vinaigrette.  The almonds and sliced ham give protein while the craisins and green apple provide the carbs.  I ate this 3/5 days during the week in grad school.  I just loved the taste of it.  But I ate it so much that I got sick of it.  Now, I'll make it every once in awhile if I have time.  Lunch is usually a "whatever we have" type of meal because I'm not ravenously hungry.

4.  Snack #2--Popcorn popcorn!  Popcorn popcorn YAY!  That's what I sing on the way to the microwave.  I love popcorn.  And popcorn loves me!  The graininess (again, I'm making up words) of popcorn makes me BGs slowly digest it and keeps me stable well into the afternoon.  I could eat a full tub of popcorn everyday (and I have . . . at movies.  Trey usually says, "OK, we need 2 large popcorns.  One for everybody to share and one for Holly.  :->)  So I buy the single 100 calorie (20g carbs) pack in this delicious flavor:

Lime & Salt!  Tangy & Crunchy! =P

5.  Dinner--Say it with me, salmon caesar salad . . . salmon caesar salad.  Hard to say, a pleasure to eat.  Whenever I tell Trey we're having SCS for dinner, he looks at me with hope in his eyes and says, "Really?  Don't toy with me!"  OK, I might be overexaggerating its awesomeness, but my mouth begins watering if someone says salmon, caesar, and salad in the same sentence.  

This meal is quite involved, so let's get started, shall we?  (I feel like a should do a vlog in a cooking-show like fashion.  Where's my white coat and funny looking hat?)  We begin with roasting the salmon, which I kind of follow the directions from this dLife recipe.  It uses snapper, but I've yet to find snapper. 

First thing to do is marinate the salmon in a citrus marinade described in the recipe for about 20 minutes in the refrigerator.  Preheat the oven to 425 F.  After marinating, rub the salmon with the oil and garlic mix:

Next, place the salmon on a baking rack above a roasting pan filled with tomatoes, white wine, and water: 

Roast in the oven for one hour, flipping the fish over once: 

Finally, decorate your salad with dark, leafy greens, olives (green & black), croutons, Parmesan cheese, Caesar dressing, and of course, salmon:

My phone camera really doesn't do it justice.  It is delicious!  

There are usually no leftovers from this meal.  I don't know the exact nutrition information, but I do know that I don't bolus for this meal unless I'm high and want to take care of those croutons.  But this meal has so much protein that bolusing is unnecessary.  

Even though I only listed five things for this list, there is one more snack that I'd like to sneak in (consider this a bonus).  When I was first diagnosed, I struggled to find an ice cream that had reasonable carb and fat content because usually low carb = high fat and vice-a-versa.  I needed to find a good balance of both, then I was introduced to this ice cream (more like ice DREAM!): 


I have a feeling that today's DFeast Friday Five blog entries will make for a lot of hungry diabetics.  =P

Thursday, July 22, 2010

Is this Bad?

Last night I changed my sensor site for Constance, and I decided to put the site on my arm.  Trey actually suggested this site because I was having problems keeping the stomach sites to stay on my for a full week, and he thought my arm would have less pulling on it from clothing and moving around.  I've been using my waterproof medical tape to keep a site down towards the end of its run. 

At first I was apprehensive because I wasn't sure I wanted to put my diabetes "out there" for all the world to see.  For the most part, this is an invisible disease minus the few seconds it takes to test and program my pump for my incoming carbs.  But putting the site on my arm would welcome the obvious questions like "What's that?" and "What's that for?"  I felt prepared and proud enough to explain Constance's presence.  But I also wanted it to look somewhat presentable, this sensor on my arm.  Not the case because . . .

the site was a bleeder!  

As soon as I inserted the needle I could feel the blood gushing from underneath the tape.  I wiped up the streaks (you can see in the photo) until the blood stopped.  Once it stopped, I put the transmitter back on and began the 2-hour calibration.  

I was somewhat concerned that this site might be bad.  So I tweeted the photo and asked, "Is this bad?".  I received 2 comments, one from DexcomClub and they told me as long as the bleeding stopped that it should be OK, but of course they recommend the stomach.  I'm 5'2'', so real estate on the stomach was running out.  I spent a good while last night rubbing alcohol on my stomach so it wouldn't look like a dart board with my belly button as the bulls eye.

After the calibration and the (seemingly) standard overnight "???" readings, I am once again streaming readings.  The site doesn't hurt, I even pressed on it after it stopped bleeding to make sure it didn't hurt and the bleeding had indeed stopped.  Is it weird that I just had blood gushing out of my arm and it didn't even phase me?  I was more worried that my CGM sensor would be bad that anything that could be wrong with my arm.  I guess such is life with diabetes--you get used to the sight of blood.  

Has anyone else had this experience?  I've had pump sites gush blood after I've pulled them, but none that gushed as soon as I put in the canula!  And is this just an arm thing or has this happened on a standard stomach site before?  I'm curious and perplexed at this whole situation.  

Also, since I have a nice brown blood stain on my site now, I didn't have the courage to go sleeveless today.  I'm wearing a cardigan.  :-/

Wednesday, July 21, 2010

First Adventure

 I originally posted the story of our honeymoon on my Facebook profile on September 7, 2008.  So this is a slightly edited version of that.  This is 2 weeks after our wedding, so the newlywedness is oozing off the page.  Enjoy! 

Definitely one to tell the kids about. I know people tell you marriage is not a destination but an adventure, but I didn't think I'd be experiencing one during our honeymoon. Our adventures ranged from being evacuated out of our first destination to watching a lady die on the interstate.

On Saturday, August 30th, we got down to Gulf Shores around 4:30 p.m. We managed to have dinner, watch the Auburn game, and eat breakfast before our realty agent called us at 9:00 a.m. the next day to tell us we needed to evacuate immediately because of Hurricane Gustav. I was totally ticked off because I didn't want to leave. I was rather looking forward to being in the middle of a Cat 3 storm during my honeymoon. So, as we were packing to leave the condo, Trey was in the kitchen packing and I was in the bathroom brushing my teeth. I very calmly proceeded to walk across the condo, through the kitchen and living room, opened the balcony and screamed, "You suck!" to Gustav. Then, very calmly walked back to the bathroom. Trey was laughing so hard he almost cried.

We stopped for lunch at Lambert's, Home of Throwed Rolls, because no one can be in Foley, Alabama and not eat at Lambert's. Luckily, my parents only lived 2.5 hours away; however, since everyone and their Labor Day holiday dog were trying to evacuate, it took us 5 hours to get there.

Monday, Labor Day, we just hung out at my parents' house and let Gustav do his thing to the Gulf coast. We looked for condos in Panama City Beach (PCB) for the rest of the week since it is only 90 miles from my parents' house.

We left on Tuesday morning headed to PCB, and I used to go there all the time as a kid. But ever since PCB got MTVed, we stopped going. So, I haven't been there in years and it has really changed! The condo at Honeymoon Destination #2 was brand new; the complex itself was so new that they were still painting the stairs in the lobby! The weather was perfect the whole time we were there and the waves were just big enough to have fun! I couldn't ask for anything better, so perhaps it was best that we left Gulf Shores (which experienced multiple tornado warnings during Gustav, eek).

The only thing bad about PCB was for about 18 hours I experienced some stomach problems (I'm never eating oysters again, thanks for nothing SHUCKUMS!!!)

Anypoo . . .

We went to fabulous places to eat like Angelo's Steakhouse and Margaritaville and shopped at Pier Park and unfortunately had to leave Friday morning. However, the night before we left Trey surprised me with tickets to the Auburn/Southern Mississippi game!

So, we made the trip back up to my parents house where we spent one night before going to Auburn the next day. I think we repacked my car so many times we had it down to a science.

We all got up and went to Auburn for the game and I was like a kid at Disney World. I had the best time ever at a game! We had tickets 30 rows up on the 45 yard line, and Tiger flew right over our heads during the pregame festivities. It couldn't have been more perfect. Not to mention we got drenched on during the 3rd quarter; we only had 3 ponchos so Trey and I attempted to share one, which didn't work very well but I didn't mind getting cozy with my hubby during a thunderstorm. ;-)

On the way back towards Montgomery we stopped at the first rest area to use the restroom and get drinks. As we were parking I saw a very large lady on her side in front of the entrance. My mom is a registered public health nurse, so she jumps out of the car to go check on her. The lady was talking and still breathing, so mom and I went into the bathroom. By the time we came out she was unresponsive. Mom rolled her on her back and proceeded to administer CPR to her. My dad knows CPR also, so he, my mom, and another physician were rotating giving CPR to her lifeless body until the ambulance got there. She had about 4 other friends/family members there with her who were inconsolable at this point.

Trey got to the point where he couldn't take it anymore, so we walked off together. He told me that he had the same feeling of helplessness when I was in the hospital. It kind of put things into perspective when I saw how other people were responding to this lady.

They did CPR for 30 minutes until the ambulance finally got there. The put her in the van and went to a hospital in Opelika. Mom and Dad told me that they have to continue CPR until someone gets there, but she had probably been dead for the last 20 minutes. It was a total bummer. I couldn't do anything except pray for her and her family.  After that we drove back to Montgomery to retrieve our car.  

I told Trey I hope our honeymoon is not a foreshadowing of how adventurous the rest of our family vacations will be, he just laughed and said, "Probably . . . ". We made the final trek home to Huntsville, and I was so glad to be home and see my kitties (Roscoe and Missy hadn't joined our family yet).

There were some great parts of our honeymoon like connecting to the person who means the most to me in this world, and we definitely got closer as a couple through the whole experience.

Hurricane Gustav
And that, ladies and gentleman, was our honeymoon.  We are planning to go down to Cocoa Beach in September, and we're already calling it our 2nd honeymoon because . . . well . . . we need a redo. 

Tuesday, July 20, 2010

First Kiss

Per some requests via Twitter yesterday, I've decided to post the story of my first kiss with Trey and the adventure that was our honeymoon.  My blog has been very Constance heavy lately, so it might a good time for a little break. 

First Kiss

I've already told the story about how God brought Trey and me together, but our first kiss wasn't as passive on my part.  We were freshmen in college and shared a physics class together during the spring semester.  My high school boyfriend and I had just broken up the month before, so I was perfectly content with throwing myself into my schoolwork.  But there was something about Trey. 

He and I had actually met the semester before.  We shared a table at the cafeteria among several of our friends who resided in the same dorm.  The first thing he ever said to me was, "You gonna finish that," referring to my half-eaten calzone.  I was slightly annoyed with this odd request, but I gave in because . . . well . . . I wasn't going to finish that calzone. 

Over the new few weeks until Christmas break, I would always find myself sitting next to him in the cafeteria.  He made me laugh.  He was comfortable to be around.  I'm normally very shy around new people, but being around Trey made it seem like he was an old friend.  And after my intense break-up, I was so glad to find comfort in his company. 

Fast-forward to our physics class.  We sat beside each other in this huge lecture hall where the chairs were connected to these really long, rainbow-like tables.  Each chair was connected to it's own leg, alternating which side of the chair it was connected to, right or left.  So, in some instances, if two people were sitting next to each other and got up at the same time, they would nearly hug each other while getting up.  This made for some interesting encounters between us (though, I think he did this on purpose).  I knew I was liking him, but I actually forced myself from that thought.  It was too soon for me, and he was kind of dating someone else--in Utah. 

Fast-forward again (feel dizzy yet) to the night before our first test.  I'll always remember it because it was the day before Valentine's Day, February 13, 2004.  The same cafeteria group had formed a subset study group for going over our notes.  We met in someone else's dorm, went over and over and OVER the study test.  "I'm hungry," I said without looking up from my notes.  "I could make you some ramen," I heard Trey say.  Surprisingly, I had been a college student for almost 7 months by this point and had yet to discover ramen.  So, we left our study group and went down to his dorm where he made me our first meal together--ramen.  After I finished, I decided it was time for me to go to bed.  As Trey opened the door for me he said, "Let me know when I can take you out sometime."  I grinned, "OK," and walked back to my dorm. 

"That was weird," I thought.  "He said he was dating someone else."  Granted, it was online, and granted, it was long-distance (also granted, it was fairly new).  I walked into my dorm where my roommate said, "You OK, Holly?"  "I think I just got asked out."  "By Trey . . . ?"  Apparently, our friendship was somewhat obvious to people. 

I was wide awake laying on my bed.  I couldn't get the thought out of my head.  "I think he likes me, but the ball's in my court now."  I can never "sleep on" anything.  I had to know where this was going, right then.  I called Trey and asked what he was doing.  He was still up studying in the cafeteria, this time for calculus.  But he was actually helping a friend study.  "Can I join you?"  "Sure, you might can help, too."  I knew my power of mathematics would come in handy one day.  We helped our friend Josh for about an hour before finally calling it quits on studying.  "What do you want to do now?" Trey asked.  We both obviously didn't want the night to end.  "We could watch a movie in my room." 

We go back up to my room and I put in a movie that had Robin Williams in it.  I didn't want to risk a romantic comedy adding to the already-built tension.  If our feelings for each other were real, then I didn't want them clouded by the mood of the movie.  We watched the movie, his arms around me, sometimes tickling me.  After the movie was over, he said, "What are you thinking?"  And, ironically, without thinking about it I blurted out these words,

"I'm thinking you can't leave until you kiss me."  

And there it was:  passive, shy Holly had become assertive and . . . demanding?!  The longest second passed between us before Trey smiled, pulled me to him, and kissed me.  I knew what this meant to me, but wasn't going to tell it to myself. 

I didn't know what to think afterward except that this was totally impulsive, somewhat wreckless, and completely unlike me . . . and I liked it!  And I liked Trey, maybe even loved him (obviously, we know the ending to that one).  I was giddy, school-girl happy for the first time in a long while. 

You might think that we started dating immediately after that, but we didn't.  Even though we obviously liked each other, and I knew what having Trey in my life meant, I wasn't ready.  He wasn't ready either, because he had made plans (before our kiss) that he was going to see his Utah somewhat-girlfriend over Spring Break.  And I didn't want him to feel chained committed to me.  I wanted him to choose me because HE wanted to.  

Fast-forward (sorry, I know you're getting dizzy now) one month to Spring Break.  He and I agreed that we would take the week apart to think about everything, about us.  I went down to Sarasota, Florida to visit my brother's family, and he went to Utah.  I didn't know what to think when I got back to college.  I was scared of getting my heart broken, again.  But then, when Trey arrived back at our dormitory around 10:00 PM, he didn't go to his room first.  He showed up at mine.  

And the rest, as they say, is history . . . 

Tomorrow I'll post about our adventurous honeymoon (no, not in that way, mind-gutters people!)

Monday, July 19, 2010

How Do You Know Your Insulin is Bad?

When you have a bad low (and I mean a BAD low, like this one):

Ummm . . . help?! 

And you end up over-overcorrecting and you take roughly a unit of insulin every hour but you still can't get down:

Notice this is a 24-hour graph.  I spent most of it over 250 mg/dL.  Crappy day.  

After the 10th (or 11th?) correction and I was still in the 300s with a northeast arrow on Constance, I called my pharmacy and said, "Hey, how long are y'all open?  Can I get my insulin refilled?  I think my vial has gone bad."  Of course, they could refill it.  It had been more than a month since I had refilled my last prescription, but I still had one more reservoir left on my vial.  I like to be incredibly efficient in my insulin use, it's the engineer in me.  However, I've noticed that whenever I travel with a vial (which I did with this one over the 4th holiday) that it tends to go bad before all the insulin is used.  But I can usually get some use out of the whole vial without living in the "HIGH" zone for multiple hours.  

When I got my prescription refilled, I threw away the vial without looking at it.  But I should have because I might have seen that it had a milky white fog to it, signaling it had gone kaput.  I think this is the first time I have ever thrown away a vial with some significant amount of insulin left.  

I changed my site and it has been smooth sailing ever since--meaning the only highs I've seen have been my own doing, which I'm OK with.  I'd much rather to be able to explain the highs when I have them.  Having bad insulin or a malfunctioning pump just adds to the chaos.  I'm clumsy and ungraceful enough on my own; I don't need outside errors adding to it.  

Even though this happened on Friday, I thought this post would be appropriate because:

Friday, July 16, 2010

Friday Five: 15 July 2010

It's the end of another week, which means another edition of the Friday Five:

  1. I changed my Dexcom sensor yesterday, you know, the one that didn't want to stay on.  When I finally pulled it off my skin, the transmitter was floating above my stomach and the sensor was barely underneath the skin anymore.  The tape was just keeping the left side down.  However, I was still getting good numbers until I stopped the sensor.  I put the new sensor on my lower back and this location appears to be a sweet spot.  I didn't get nearly as many ???s last night.  
  2. A Senate committee approved a new NASA budget to be sent to Congress.  This budget is considerably better (IMO) than the originally proposed budget back in February.  It extends existing programs like the ISS and Shuttle until a suitable replacement is built.  It also charges NASA with building a new, heavy-lift launch vehicle (HLV) that could be operational by 2020.  This is great news for the area where I live because we thrived during the building of the Saturn V, so no doubt a lot of the building for the HLV will come here.  Finally, some money will be given to commercial space groups, but on a prove-yourself basis.  NASA will have a lot more say on when those vehicles will be deamed safe. 
  3. Last weekend we began a trial of Netflix.  We've been talking about this for awhile because we don't take advantage of cable TV as much as we could (except for football season, less than 2 months!!!).  And I've been using it all this week to watch every season of The Office.  I don't know why I didn't get into this show sooner, but I love it!  I guess I feel that my days are so similar to The Office (minus a boss like Michael Scott).  I'm currently half-way through Season 3.  
  4. Holy cow bells it is HAWT!  The high for the last two days has been over 100 F.  I worry about my dogs being outside for 10 hours, but I make sure they have plenty of water and our back yard is pretty heavily shaded.  I usually find them staying cool underneath our deck outside.  But that doesn't meant I still don't worry.  Yesterday when I got home I took out the garbage and I had sweat rolling down my neck by the time I walked back inside.  It's also wreaking havoc on my hair.  The increased humidity is making my usually layered, flipped-out hair look very flat and straw-like. 
  5. Once again, Alabama is in 2nd place (tied with Tennessee) for the fattest state in America.  Colorado wins for being the fittest (which is where I wanted to live . . . at one point . . . OK, maybe I still do).  Mississippi wins first place for having an average BMI of 33.8.  Even though most of the states in the top 10 are southern states, they are the ones who always win the college football national championship.  (Seriously, I need therapy, this isn't healthy.)  
Have a great weekend everyone!  =)

Thursday, July 15, 2010

It's Not Sinuses, It's Diabetes

Yesterday, my friend April posted an entry about her latest endo visit.  Since she and I live in the same region, we go to the same endo.  And I always like comparing who waited the longest!  The office is so overloaded with patients that it's not uncommon to wait 2 hours after your scheduled appointment time. 

Anyways, I made a comment on her post about how sometimes I feel that the endo visit is just a 3-month A1c check where I have to go to an offical doctor's office.  Diabetes is such a personal, daily disease that we can come to not trust our doctors' opinions because we wonder, "How can someone who I only see once a quarter know what's best for me and my diabetes that I deal with everyday?"  I've certainly felt that way in the last few months because I feel like I'm taking my diabetes into my own hands, trying to understand it more, and (for brief periods) making it do what I say. 

And daily life with diabetes can seem so monotonous, boring, just same-ole same-ole.  It's like dealing with sinuses, especially in Alabama, because no matter what time of the year you're here you are going to have an allergic reaction to something.  In the fall it's peanuts, in the spring it's pollen.  We never get a true winter here, and summer and spring are usually the same--HAWT!!!  So, everyday here is another day dealing with sinuses of some kind. 

And for me, everyday is another day dealing with diabetes. 
  • I get up every morning and the first thing I do is check my blood sugar, and it's the last thing I do before I go to bed.  
  • Taking insulin is something I can do without looking, and apparently try to do in my sleep!  
  • I keep stashes of juice boxes in my desk, making this 25-year-old feel much more like a 5-year-old.  
  • I have two rolls of glucose tabs in my Myabetic wallet, along with 3 syringes, 2 batteries, and an extra lancet (I could parody a Christmas song from that one line). 
  • As I'm preparing my lunch for the day, I'm keeping tabs in my head of how many carbs I just packed, so I know what to bolus later.  
  • I keep apple juice in the fridge because it's easiest to chug for those paralyzing lows
  • I have an extra meter and a jar of glucose tabs on my bedside table because I'm too lazy to get up and walk to the kitchen in the middle of the night.  
  • An entire shelf is dedicated to pump and CGM supplies in my bathroom linen closet.  
  • My stomach is riddled with previous pump site markings and sticky residue, along with my current site and CGM sensor.  
  • And my calloused fingertips show countless blood sugar tests. 
All of these evidenes of diabetes in my life seems to fade in the background after awhile.  It's like hearing a really loud noise for a long period of time.  Eventually, you learn to tune it out and, if you listen long enough, you don't hear it anymore.

But then we have these 3-month check-ups that show how well we're tuning out diabetes.  Every 3 months is like a wake-up call that this is a real disease that people get complications from, and die from.  People spend millions of dollars in research trying to find a cure, I doubt they're doing the same for sinuses.  It affects our health--physically, mentally, and emotionally.  Our everyday lives become an everyday treatment.  It's so serious and monotonous, it's seriously monotonous! 

We have a good friend who is expecting her first child in August (yay!) and she has gestational diabetes (boo!).  She recently sent a message to Trey telling him how much she admired me for dealing with this disease everyday and how tiresome it is to think about all these things like blood sugar, food, and exercise all the time.  It's weird to hear someone say they admire me for simply being me, and doing what I do everyday. 

But then again, I think the same about people like my nephew who has cerebral palsey.  I admire that kid so much!  He has such a zest for life and a pure heart.  You can't lie to him because he has this sixth sense about reading people's emotions.  And when you ask him what he has, he joyfully says, "I have cerebral palsey!" like it's his badge of honor that makes him special. 

I don't know if having diabetes is a badge of honor or a sign of being special.  I just know that God thinks I'm strong enough to handle it, and that's kind of cool to think about sometimes.  That He knew I could handle a disease that required constant attention.  It's a daily occurrence, like sinuses. 

Wednesday, July 14, 2010

Stick With It

Dexcom sensor, Day 6.  You can also see the sticky residue from the last sensor and my pump tube.

This poor little guy doesn't get changed out until tomorrow, and he's barely holding on (especially on the right side, I'm not sure it's technically sticking to me anymore).  I am loving Constance's ability to always know what my blood sugar is doing, but the willingness for the sensor to stay on my body has turned into a sticky situation (PUN!). 

When I first saw the right side wanting to detach a little, I tried putting a single bandage over the lip.  But that didn't really do much because the bandage isn't sticky in the middle, so I still had exposure.  Then, per the DOC and their always helpful tweets, I tried some waterproof first-aid tape.  That worked for about 2 days before it started to peel.  Now, I'm just hoping this thing doesn't come off in the middle of the night or when I happen to run into a wall corner (it's bound to happen). 

I'm contemplating my next placement, because I want this thing to be as secure as possible.  Right now it's in the groove between my love handle and my belly button, which is actually nice and indented but not smooth enough for 7 days worth of tape. 

I'm contemplating my next site.  My love handles work the best, but I try to give them a break once in awhile.  I don't want to do it on my thigh because my clothing would rub on it too much.  The ideal place right now would be my arm because I tend to wear mostly sleeveless shirts during the summer.  But am I ready for that?  To have my diabetes exposed to the world in such a manner?  Not that having a pump or a CGM is discrete, but those are just pieces of technology that I "carry" with me.  This thing will be attached to me underneath my skin for the whole world to see.  I'm not sure I'm ready for that or the random questions, yet. 

So, does anyone have any good experiences with keeping a sensor securely attached to you for 7 days or more?  I'm able to keep my pump site secure for its mandatory 3-4 days with the sticky alcohol wipes from Medtronic, but it's tape size is smaller and its lifetime is shorter.  I'm mainly worried about our beach trip in 2 months (Yay!) with the salt water and sand.  I may just get a cast wrap around the sucker for a week and be done with it.  Sexy!

Monday, July 12, 2010

The Perfect Storm

The title of this post is kind of ironic because I actually sleep the most soundly during a storm.  And there's one passing over us right now, making for a very sleepy Monday morning.  Especially after yesterday morning's "storm".  

It had been a fun night the night before.  I made homemade pizza, and we had some friends over for pizza, beer, and Phase Ten.  We stayed up until 10:30 PM; Trey was the victor in the Phase Ten game.  But it was still fun, one of my favorite ways to spend a Saturday night. 

However, the pizza/beer combination wreaked havoc on my blood sugars as soon as my head hit the pillow.  I'm learning so many things aboug my BG trends with Constance.  For example, the combination of high fat, high carb, and alcohol lingers in my blood stream for not just four hours, but six.  Therefore, my square bolus of 4 hours worked great while we were awake.  But my bolusing ended as soon as our evening did, which meant my BGs began their mountainous climb, blessing me with high alarms every hour starting at midnight.  As I've mentioned before, I'm horrible at actually waking up with the alarms.  I snooze at least once, usually twice, before I finally get up and correct.  This means that I woke up to a nice BZZZZZZZZ every hour until 3:00 AM when my BG was well over 300 mg/dL.  I corrected and tried to savor the 5 hours I had to sleep until we had to get up for late service. 

But not only do I live with a disease that never sleeps, I also live with 4 animals (2 cats and 2 dogs).  Our latest edition, Missy, is a 1-year-old lab/boxer mix.  She's a lovable little thing, but she has her own clock that wakes up everyday at 4:30 AM.  So, after finally sleeping for an hour and a half following my correction, I get up and let both dogs out for their morning potty and play time. 

Back to bed, but not for long until my long-haired tabby Elvis comes into our bedroom meow-screaming his head off.  "Did I give him water last night?"  In the chaotic fun that was our evening, I don't think I filled up his water bowl, which means he was surely letting me know I forgot.  Several attempts to shush him went by the wayside, he kept coming back. 

It's about 6:30 AM now and the dogs have arrived back from their time in the yard, and Roscoe is whining at the back door.  About this time, Constance goes off with a low alarm--can't really snooze on those because a low is a very unpleasant adrenaline rush to wake up to, sweat and all.  *sigh* "I guess I'm up," I groaned. 

After chugging some juice, giving Elvis some water, and letting the dogs in for their breakfast, I made some well-deserved coffee.  I grabbed my sugar-free French vanilla creamer and the biggest mug in our cabinet, filled the cup up to the brim, and shuffled to the couch.  The dogs were already passed out on the couch for their post-breakfast nap, and the cats were content in their tower once again. 

The storm was over, and the house was quiet again, minus the sound of the hubby and I chomping on our cereal.  Still an hour before the scheduled alarm. 

. . . 

Time for a second cup. 

Friday, July 9, 2010

Technology Troubles

On a daily basis, how many pieces of technology do I use?  Let's see:  phone, meter, pump, CGM, computer, and TV.  Not to mention all those shiny appliances in the kitchen that are used to make food.  So, when one or more these gadgets decide to malfunction, it can totally throw off my day. 

Take yesterday, for example.  I had put in a new sensor for my CGM, hoping for another stellar week like before.  Everything began like last time:  put in the new sensor before bedtime, dealt with false highs and "???" most of the night, start getting "real" data around 5:00 AM.  I know that technically the data is supposed to come as soon as the 2-hour calibration is done, but from what I've heard via the DOC and twitterverse it takes the sensor almost a full day to get "wet".  But after 2 hours of "real" data yesterday morning, the "???" began staring back at me . . . for 2 hours!!!  I knew this meant there was something wrong with the sensor.  After consulting with several tweeps, I decided to call Dexcom and see what's up.  The very energetic lady told me that if the sensor continues to give "???" for at least 3 hours, they will ship another sensor as a replacement and told me that I should rip that one out.  I gave it until I got home from work, but after 6 hours of "???" I decided this sensor was toast.  Ripped out said sensor and started a new one. 

I think there may have been some user-error going on ("No, really?  Not you, Holly!"  Yes, reader, I'm quite non-graceful.  Please contain your surprise.).  When I inserted the new sensor, I noticed the insertion was a lot smoother following the two clicks of the insertion plunger.  "Hmmm, did that happen last time?  I don't think it did."  Also, the old, bad sensor experienced some . . . ahem . . . activities between the hubby and I that may or may not have been detrimental to its placement (BTW, this isn't the first TMI post of this week.  Right, Elizabeth?)  So, between a not-so-smooth insertion and some non-purposeful tape pulling, the sensor was a dead man walking . . . on me, anyway. 

So, after a new sensor and the typical 6-10 first hours of "???", I'm a real-time diabetic once again.  But thanks to the always helpful DOC, I'm learning all the secret tricks of the CGM trade.  For example, it typically takes a sensor several hours to get "wet" even after the calibration.  Some folks even let theirs sit for 24 hours before data processing, just so they know they're getting good results.  And isn't that the whole point of this little gizmo?  Also, if the placement of the sensor becomes an issue again *blush*, then I might need to invest in some medical tape.  I tried using some band-aids to hold the lifted edges down, but they don't last past the first shower which would be extremely inefficient and expensive. 

My next technological blunder happened to me this morning when my work computer greeted me with the blue screen of death.  After several attempts to reboot, nothing happened.  A call to computer services, 2 hours of conversing with the world via my BlackBerry, and 30 minutes of troubleshooting and I'm back on!  But how frustrating that I literally didn't get any work done for 2 hours because I had no computer access.  Just goes to show how dependent we've become on using technology just to get on with our daily lives. 

We have a beach trip coming up in September, and I'm debating how we'll survive without some of our technology just to make the vacation memorable.  I mean, if all we do is go down there with our laptops and watch TV the whole time, we might as well save the gas money and stay here!  /soapbox 

Anywho, this post just goes to show how dependent we are on technology.  Especially for us diabetics with our meters, pumps, even CGMs.  Now if I can just find an electronic pancreas with an extension cord . . .

 No kidding, annoying paperclip!

Wednesday, July 7, 2010

tobybuckeye, I think I love you!

As I was perusing some local news sites during my lunch break, I came across a familiar acronym:  "JDRF opens new Huntsville office." 

"Sweet!  This is great!" I thought.  I was all to excited to begin reading about the new office in my hometown and the subsequent walk to be planned, but then I skimmed down the comments section: 

1st commenter, jarhaid, said, "Teaching the little darlings not to cram food like they're on some mission from God would be a good start." 

"WHAT?!  Are you serious??!!"  I could feel my blood beginning to boil and starting my not-so-rational response, until I read down to the following commenter, tobybuckeye: 

The old saying is: Ignorance is bliss. This country would be in much better shape if folks like jarhaid would get "educated" before spouting off the first thing that comes to their mind. Juvenile Diabetes is also known as "Type 1" Diabetes. A common "MYTH" is that high amounts sugar consumption causes this. Research has NOT found the cause of this "Type 1" diabetes. Although many times it is found in children, even older folks are not immune to this disease. Juvenile diabetes is when the pancreas quits working entirely. Type 2 on the other hand is when the pancreas is working but the body doesn't remember how to distribute this insulin. Which is what YOU or I Jarhaid could end up with. Please get educated before passing a judgment on children. An organ in the body has stopped working and the medical profession still has NO IDEA why. Do something useful and donate to the cause of finding out why.

Followed by:

Type 1 Diabetes
Type 1 diabetes occurs when the body's own immune system destroys the insulin-producing cells of the pancreas (called beta cells).

Normally, the body's immune system fights off foreign invaders like viruses or bacteria. But for unknown reasons, in people with type 1 diabetes, the immune system attacks various cells in the body. This results in a complete deficiency of the insulin hormone.
Some people develop a type of diabetes – called secondary diabetes -- which is similar to type 1 diabetes, but the beta cells are not destroyed by the immune system but by some other factor, such as cystic fibrosis or pancreatic surgery.
Understanding Insulin and Type 1 Diabetes
Normally the hormone insulin is secreted by the pancreas in low amounts. When you eat a meal, sugar (glucose) from food stimulates the pancreas to release insulin. The amount that is released is proportional to the amount that is required by the size of that particular meal.

Insulin's main role is to help move certain nutrients -- especially sugar -- into the cells of the body's tissues. Cells use sugars and other nutrients from meals as a source of energy to function.
The amount of sugar in the blood decreases once it enters the cells. Normally that signals the beta cells in the pancreas to lower the amount of insulin secreted so that you don't develop low blood sugar levels (hypoglycemia). But the destruction of the beta cells that occurs with type 1 diabetes throws the entire process into disarray.
In people with type 1 diabetes, sugar isn't moved into the cells because insulin is not available. When sugar builds up in the blood instead of going into cells, the body's cells starve for nutrients and other systems in the body must provide energy for many important bodily functions. As a result, high blood sugar develops and can cause:

I realize his 2nd comment was probably copy/paste from a reputable diabetes website, but I was so glad that he/she took the time to do (especially considering he/she isn't diabetic, as alluded to in the first comment).

I normally don't engage in the type 1/type 2 debate.  Mainly because pre-Dx, my family history foreshadowed me to have type 2.  So I tried my darndest to eat well and keep active.  I understand that being type 2 is not always lifestyle, sometimes genetics just mess with us regardless of our eating habits.  Also, my dad is a type 2, so if I start bashing those with pseudo-working pancreii, I would be bashing Dad.  And that's never gonna happen. 

HOWEVER, there should be some, SOME (for the love!) type of education on the difference between type 1 and type 2.  The first commenter, jarhaid, obviously had no idea what juvenile diabetes is, and yet he bashes parents and children for "Teaching the little darlings to cram food like they're on a mission from God."  The only time I'm "eating on a mission" is when I'm coming up from a low with a mission of not passing out.  I realize there is some form of "internet courage" going on here because he can take a stab at children with type 1 with no repercussions (save tobybuckeye's responses), but there should be some common sense politeness if you don't know anything about the subject! 

I know this blog is mainly for connecting with other diabetics, but my hope is that this little rant will inspire other non-D readers of my blog to go out and educate yourselves (that is, if you must comment on a subject you know absolutely nothing about).  But sometimes it just makes me furious the ignorance of the general public about this disease.  And I can be patient with caring questions here and there, "Does it hurt?" "Can you ever just eat and not worry about insulin ever again?" "Are unicorns real?"  OK, the last one is not D-related, but I'd like to think yes.  But the question that I get that makes me turn Hulk-ish is, "What did you do to get this?"  Me?  Well, I was studying for a Dynamics final, so don't ever take Dynamics and you won't get diabetes.  /rant

So, thank you, tobybuckeye, for educating yourself enough to know the difference.  I suspect you are either a medical professional or a type 3, but I'm still grateful all the same.  Now, I will go and eat my 20 g of almond salad and apple "like a mission from God". 

By the way, jarhaid finally responded, "Well, excuuuuuuuuuuuuze me!".  To which someone replied, "It's tough when you expose your ignorance, isn't it?"

Isn't it?   

Tuesday, July 6, 2010

The More You Know . . . about a CGM

So I'm half-way done with my first Dexcom sensor.  I have learned so much in the past few days about my diabetes and how food affects my numbers.  I couldn't pin-point one particular nugget of knowledge to focus on for a blog post, so I'd thought I'd go bulleting with all my knowledge nuggets: 

  • My Novolog takes about 30-45 minutes to actually start affecting my BG.  The first 2 days I noticed that I was spiking to 250 almost 300 mg/dL when I bolus at the same time as I start eating.  So, this weekend I started testing, bolusing, and waiting 30 minutes before eating.  This is really easy to do on the weekend because I can enjoy a cup of coffee while I'm waiting on my insulin to kick in.  But I had to start a new routine this morning before work to give it the same amount of time.  I have begun testing and bolusing before my shower, then after my shower and getting dressed I will eat--giving my insulin at least 30 minutes.  I feel like this change alone will affect my A1c the most. 
  • It takes more than 15 grams of carbs and more than 15 minutes to bring me up from a low.  My current low alarm setting is set at the default of 80 mg/dL.  I like this setting because I feel safer catching the lows before they get too bad.  I understand the 15/15 rule is the same for any person experiencing hypoglycemia.  However, when insulin is involved (type 1 or type 2), you're fighting more than just a lack of sugar in the blood.  It's a lack of sugar combined with sugar-fighting insulin on board.  I'm noticing it takes like 30 grams of carbs and 20 minutes before I start to feel normal again.  Everytime I do the standard 15/15 rule (which states, "After 15 minutes, if your BG is still not normal, take 15 g more of carbs."), I always end up taking more. 
  • My nighttime numbers are crap.  I've only had one evening where I stayed in range around 140 mg/dL the whole night.  Otherwise, I ususally start out going to bed with a low alarm, correct, and end up high around 3:00 AM (which does not a happy Holly make).  I'm thinking some basal tweaking is in order, but I'm waiting the full week to get a better idea.  
  • Speaking of nighttimes, I am not very good at getting up when an alarm goes off.  Everyone hears it--my husband, both dogs, and the cats scatter, but I have already developed the bad habit of grabbing the receiver, hitting "C" for cancel, and going back to sleep.  The ultimate goal is to get my basals down to perfection so these alarms don't happen, but until then I need to get up and correct for the alarms.  Last night, I snoozed 3 high alarms before finally getting up--meaning I was high for 3 hours before finally getting up, not good.  
  • I need to also do some more tweaking for bolusing for high fat/high carb meals like lasagna and mexican (which I had for the past 2 nights).  My standard bolusing is to do a dual bolus 40/60 ratio with a 2-hour square bolus.  This usually puts me back at normal 2 hours later, but Constance has shown me that I continue to drop for another 2 hours.  So, I need to extend my square bolus for longer or just do a square bolus throughout the whole duration.  
  • Finally, this little device and all its fixin's, is expensive!  See the following:  
 Good thing because . . . 

it's over $1600 out of pocket.  Thanks, insurance!  

This also means between my pump (including tube, reservoir, and insulin), Constance and her sensor, and my phone, I'm easily walking around with close to $10K just on my hips!  Bionic woman, indeed!  Plus, with all these attachments, I feel like I need a toolbelt just to walk around. 

Friday, July 2, 2010

Friday Five: 2 July 2010

Today is a special edition of Friday Five because it's my parent's 39th wedding anniversary.  So today I will give 5 fun facts about my parents, their marriage, and our family.

  1. When my parents first met, Dad was actually dating someone else.  They met at a church cookout where Dad asked Mom to make him a hot dog, to which Mom replied, "Why don't you get your girlfriend to make you one!"  Ahhh, I love that story.  
  2. My Dad was almost late to their wedding.  He had just started his job at the radio station the day before, and he had to wait for the afternoon guy to come take his place.  I'm not sure how late he left from the radio station, but he obviously made it in time.  I'm sure my mom was sweating.  
  3. Shortly after they were married, Mom's engagement ring's band broke.  So she just wore her wedding band for a long while.  For their 25th wedding anniversary, Dad bought her a ROCK!!!  But Mom eventually had her engagement ring fixed, and now she wears that ring instead of her 25th anniversary ROCK, even though her engagement ring was a fraction of the size of her ROCK.  Just goes to show how special that ring was to her.  
  4. About 4 years ago, my dad had to have knee surgery.  Mom had to take care of him in more ways than a lot of people have patience for.  Including picking his leg up and off the recliner over and over and over.  At Thanksgiving, Dad made this speech that had everyone in tears about how much he loved my mom and couldn't have made it without her.  This was one month before my D diagnosis, and I learned what it meant to say "in sickness and in health". 
  5. After 39 years, 2 kids, 2 kids-in-law, 2 grandsons, and retirement after 30+ years in their careers, they are still very much in love.  It's so rare these days to meet a couple who's been married this long.  But it's even more rare for a couple to still love (and like) each other.  They are enjoying their time alone together camping and boating and spoiling one crazy Shih-tzu.  
 Riding bikes together.  (Yes, that's a dog in a stroller--their 3rd child and my dog-sibling, Bo.)

Happy Anniversary, Mom and Dad!  May you have many, many more.

May your fountain be blessed, and may you rejoice in the wife of your youth. ~Psalm 5:18

Thursday, July 1, 2010

First Impressions from a Bionic Woman

Yesterday around 4:00 PM I received an automated email from FedEx telling me that my package, my Dexcom CGM starter kit, had been delivered to my house.  I had already alerted some coworkers that I was going to leave whenever I got this email.  I gathered my things and began my commute home, which seemed twice as long as it normally does. 

When I arrived home, the package was sitting on the doorstep.  "Rather small box," I thought.  I went ahead and requested to have 3 months worth of sensors, and the box was smaller than my Medtronic refills.  I took the box inside and began opening it.  All of the sensor boxes were on top (or bottom, I may have opened it upside down), so I dug down until I found the box holding Constance.  The egg, as Kerri affectionately calls it, was a lot smaller than I had imagined.  I don't know why I expected it to be like a little Nerf ball, but my Blackberry is bigger than this little device. 

I already knew that the receiver needed to be charged for 3 hours before I could use it.  So, I plugged it in next to the coffee pot and proceeded with my daily ritual chores.  I took care of the cats, fed the dogs, emptied out the dishwasher, and took out the trash.  All the while, I'm checking the receiver to see if it was charged (as if it would be fully charged in one hour, but I was kind of hoping).  I then flipped through the User's Guide and Start-up pamphlet.  I had already watched the tutorials online and Kerri's video for several weeks before Constance's arrival.  Now I just had to wait for it to charge (longest 3 hours, ever!).

I had some distractions in the form of going to pick corn and visiting some friends who recently adopted 2 adorable kittens.  Finally, 3.5 hours after I plugged it in, we arrive back home.

Next, I programed the date/time, made sure the transmitter ID was correct, and prepped  myself for the sensor insertion.  I grabbed a sticky alcohol wipe from my pump stash, pulled out a sensor from the FedEx box, and took a deep breath.  Opened the sensor packaging, peeled off the tape (I concur with Kerri, very tricky that sticky tape), and placed the sensor on the left side of my stomach parallel with my belly button.  Pressed down on the tape to make sure it was stuck to my skin, and took off the safety.  Using my right hand, I pressed down with my thumb on the plunger to insert the needle, and pulled up the other plunger with my index and middle fingers removing the piercing needle.  It kind of hurt going in, but I think it hurt because I was nervous about it, making my muscles tense.  After I took out the piercing needle, I barely felt it.  The hardest part for me was putting in the transmitter!  It took me several tries before the latch inserted the transmitter into the sensor.  Go figure, it wasn't the whole inserting a needle into my body thing, it was putting the transmitter in (but I was never that good with Legos, which is what it's like).

Next, I began the sensor calibration which takes 2 hours.  This happened about 9:15 PM, which is typically my bed time these days.  I tried staying awake by watching The Office and Family Guy, but alas, I fell asleep on the couch before the end of the Family Guy's intro.  Luckily, I woke up with 10 minutes left in my calibration.  I started watching the receiver like a hawk anticipating the two blood drop calibration request screen.  BZZZZZZZZZZ!  "Enter two BG readings."

I entered two readings from the same finger (and the same prick, too. yay, a bleeder!):  216 and 201 mg/dL (I'm not sure why I was high because it had been over 6 hours since I ate dinner, but like I've mentioned before, I test at the same every day.  And 11:15 PM is not a typical test for me; therefore, I have no idea what goes on during this time.)  Immediately after I entered the two BG's, the tracking screen came up with 204 mg/dL followed by a High alarm.  "Well, the alarm works."   

Exhausted from it being after 11:00 PM and the general excitement from it all, I headed off to bed.  However, almost as soon as walk to the bedroom, I get the "???" error on the screen.  "Great, what did I screw up?"  I get back up and go look at the starter pamphlet and read the "???" error description.  It said that this error is normal and to just wait.  No problem.  Sleepy time! 

I vaguely remember waking up in the middle of the night to a High alarm:  323 mg/dL.  But since it was just a few readings surrounded by "???", I ignored it.  The sensor came back to life around 3:00 AM and showed a little snake-like action around 250 mg/dL.  I'm not sure how much stock I'd put in the numbers, but it did show a trend where my BG starts to spike (thank you, dawn phenomenon).  This made me happy, and hopeful, that I could eventually conquer this DARN phenomenon!  It went back out again to "???" until about 5:30 AM after I started eating my oatmeal breakfast.  It was kind of perfect timing, because I started seeing a major spike about an hour afterwards around 280 mg/dL and a decrease starting about 30 minutes after that.  "Hmmm, I guess I SHOULD take my insulin a little while before eating." 

 Kind of crappy resolution and glare, but you can see the spike from my oatmeal.

First impressions:  it was a little frustrating when I couldn't even put the transmitter in!  I called my engineering husband over to help me investigate, but immediately when he started walking towards me I got it in.  (He's my force field of positivity. *smile*)  I also didn't anticipate having so many "???" for the first 6 hours or so, but I've heard this is pretty common and the numbers are more accurate after 24 hours (or so I've read via the DOC).  But once it started working this morning, I was giddy.  I was checking it after every step in my routine.  Brush teeth, check Constance, dry hair, check Constance, pack lunch, check Constance.  On the phone with Trey going into work I said, "I am such a nerd right now."  I could hear him rolling his eyes on the other end of the phone.  "Bionic woman, eh?"  "Yep," I exclaimed. 

 The obligatory belly picture:  Dexcom sensor and receiver on the left, insulin site and tube on the right.

Bionic woman!

P.S.  Just did a test.  Meter:  96 mg/dL.  Constance:  121 mg/dL.  I'll take that.  =)

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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.