24 Weeks: Tunnel Vision

I am 24 weeks pregnant this week. And the cruel reality that I'm 6 months pregnant but I have 4 to go has hit me. Even though I'm over halfway through this pregnancy, I feel like I have a long way to go. Namely because I discussed my labor plans with my OB and endo this week, which means I have to think about her actually being here and that stresses me out because the only thing we've done is paint her room. (Actually, Trey painted. I'm banned from all paint fumes, and thus her room for the next few days.)  This post is rather long, so I'll try to break it up into each appointment to give any readers proper intermission breaks.  

OB: 

My OB appointment last week was filled with more questions on my part.  I'm pretty sure I talked more than my OB, but he's a patient guy and willing to indulge me for my sanity.  The appointment started out the same as all the others:  pee in this cup, step on this scale (I'm up 20 lbs total), sit here while we take your blood pressure (122/70).  This was the first appointment where Trey didn't accompany me, and it felt weird.  I told him he was welcome to come to any appointments he wanted, but he was busy with grad school shenanigans so I was flying solo this trip.  The nurse used the Doppler to find my little monkey's heartbeat, which was whump-whumping at 163 bpm.  She cooperated a little more this time, but I think she's running out of room to escape the intrusive wand.  

The doctor came in and he immediately noticed my list of questions on my iPod sitting in my lap.  "Go ahead.  Fire away."  The first thing I asked him was the plan for the rest of my appointments going forward.  He said the plan is to keep seeing me once a month until 28 weeks, then I'll go to every 2 weeks until 36 weeks.  After that I'll be going once a week to check my cervix (sorry, TMI) and baby's position for upcoming labor.  In addition, I'll also be doing non-stress tests 2-3 times a week starting at 37 weeks.  So for the last month of my pregnancy, I'll be camping at the doctor's office at least 3 times a week.  (I think I'm gonna go ahead and start my maternity leave then, because I'll be spending more time with the doctor than at my own office.)

The next thing I asked about was the plans for labor.  My OB said the current plan for me is to get to at least 39 weeks, but he will not let me go past 40 weeks.  He doesn't want me going into labor on my own.  Considering my mother didn't go into labor with me and my brother until 43 and 42 weeks, respectively (What were doctors in the 70s and 80s thinking, anyway?!), it's a good assumption that I will be induced.  His reasoning for this is that he wants to keep an eye on my numbers from start to finish.  I'm sure I'll do that on my own, especially with a CGM, but he'll be able to give me guidance on insulin dosage depending on what stage of labor I'm in.  He also wants me to keep my pump on during labor (thank you! thank you! thank you!), and I'll be allowed to treat lows at my leisure with juice or whatever to eat (so no glucose drip, yes!).  

At first, I was kinda "eh" about not being able to go into labor on my own.  I'm not a natural childbirth advocate or anything, and I've already said that is not the most important thing to me.  But I hate feeling like I don't even have the option.  But such is the life with diabetes.  Bottom line:  there are certain things I'll never be able to do because of this stupid disease like join the military, become an astronaut (even though my friend April is going to break that rule), and be allowed to have a granola experience with child birthing.  Now that I've had a few days to think it over, I'm at peace with this plan.  I'm more comfortable with things being planned in advance, and I know my doctor won't force my body to do something it's not ready for (I do trust him, by the way).  And I'd rather have time to get used to being induced and research it before that day arrives.  So it looks like May 28th is the absolute latest for my girl's birthday, or earlier depending upon induction date.  

ENDO:  

I also had an endo appointment yesterday.  I knew my numbers were still solid, but I didn't expect to hover around the 5.1% A1c I had last time.  In fact, my A1c crept up to 5.4%.  The nurse assured me that this is still a good number for pregnancy, but it's obvious that my insulin resistance is beginning.  I've increased my basal rates by 3 units this week alone.  But I also know that my number of lows has decreased dramatically.  So I'm taking this increase as a sign that things are settling out more than "OMG, need more insulin now!"  And I'm all for less lows.  

My endo and I discussed my numbers and my recent ER visit.  I told him my OB's plan for inducing me, and I asked him if he had any plans, insulin wise, that I should be aware of.  I was a little surprised, because my endo told me that once I start having contractions I should suspend my pump.  *insert confused face here*  He explained that the uterus is one big muscle, and once it starts contracting it's like going through one long workout.  And I always suspend my pump if I'm going to workout, so the logic makes sense.  I just can't imagine going through such diabetes maintenance for 9 (10!) months just to say "Goodbye, pump!  See you in a few hours!"  He said even if I suspend my pump, it's still possible for me to see a lot of lows.  I'm still wrapping my head around this plan, and a lot of it will be making decisions hour-by-hour.  But right now I'm still walking around whispering "No pump?  No pump?"  I'm sure people think I need a white jacket. 

FINALLY: 

And finally, I have one big concern that's bothering me:  my belly button.  I've always been sensitive about my belly button.  I don't like anyone to touch it because it feels weird, like a dead sensation where there's no nerve endings but I know someone's touching and I don't like it!  It drives Trey crazy because he thinks I have a cute belly button, especially now because it's pushing out into an outie.  Well, it's like a half-outie at this point.   The top part is pushing out, making my stomach look like a face with no eyes or mouth and a weird looking nose.  And so that dead feeling is a constant because my belly button is rubbing on my tight shirts and maternity pants.  I know that pregnant bellies are beautiful and people want to touch them, but I'm not liking this, not one bit. 

 

My (whoa!) belly with said half-outie. 

So to recap:  baby is still in there (she moves all the time!) and doing great, both of my doctors are aware of the plan for the rest of my pregnancy and potential labor, and my expanding belly is sporting an outie belly button.  I hope you've enjoyed this super long post, because I need a potty break (something I'm doing every hour I'm awake). 

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. 

Things on My Radar

Yesterday I had my yearly female appointment with my gynecologist.  Even though his office is labeled as OB/GYN, I like to invert the two and add an "O" making him my "GYNOOB" (pronounced "guy"-"noob"), cuz I'm mature like that. 

I know most women can't say this, but I love my gynecologist!  Of all my doctors, he is definitely the nicest and most encouraging one I have.  Yes, you may have to wait over an hour past your appointment time to see him, but it's worth it when he takes your time with you and treats you like you're the only patient in the world.  (And especially with this kind of appointment, sensitivity and patience is key.)

He always makes a point to ask me, with genuine sincerity, about my diabetes.  I usually tell him, "Fine," but I know I could say, "It's a pain in the arse," if I wanted to.  When he asked me what my last A1c was and I said 6.3, he looked up from his chart and smiled, "Good for you!  That's awesome!"  "Thanks, I just try to keep up with it," I shrugged. This (A1c) point led to an interesting topic between us:

Me:  "So, what would be your threshold for, say, pregnancy?"

Dr. (smiling):  "Oh that's a great topic!  I would want you to stay under 7.0, but that will be controlled by you and your endo.  Who are you seeing for that?"

Me:  "Dr. [insert name here], the one with the 'special' sense of humor."

Dr. (stomping his foot and laughing):  "That is so true, he's definitely unique."

Nice to know even another doctor notices my endo's dry personality.  Should make April feel better.  ;-)

So after this nice little chat and my *ahem* exam, he looked me in the eye and told me I was just as healthy as any other woman who desires children.  "That's what I wanted to hear," I said and he walked out the door.  And before I left the room, I paused and held onto his words like they were charms on a bracelet:  "just as healthy".  Even though we're not trying for a baby right now, I like knowing that we could.  Like the power of my diabetes is harnessed and chained, under my control.  I couldn't help feeling a little empowered, like some goddess of femininity wielding a pump and CGM.

Trey and I talk about having kids all the time, like they're already here or something.  And sometimes I forget that having diabetes makes that dream a little more of a nightmare.  I'm not afraid of the lab-rat-type testing I'll undergo, or even the constant warnings of complications due to high blood sugars.  The one thing I'm afraid of more than anything:  motherhood itself.  I know I want kids, and I desire them more than anything.  I get all teary-eyed at posts like this one and get chills thinking about someone calling me, "Mommy."  But I'm a little anxious about the 180 life-change that will follow.  It's the same anxiety I felt before college, getting married, buying a house, or adopting another dog.  It's the anxiety of not being prepared for something very important, only to realize there's NO WAY to be fully prepared to begin with.

It's so strange to desire something that you're terrified of, like WANTING to be bitten by a snake (who would want that?!).  To be responsible for a life, a soul, that will rely on you to know how to walk through this life.  Hoping that they find God's love, and praying you're not going to screw it up!  And wondering how can you love someone so much that you haven't even met!  (CC:  Facing the Giants)

I don't know, we're so far ahead of the literal pregnancy/diabetes stuff that I'm still focused on the big picture.  All I can say is that I'm excited and terrified, especially now that I've added a new label to my blog:  pregnancy.

Whoa!  Things are starting to get too real around here.  So to level things out, here's a picture of my dog gassing me with one of her rancid farts. 

Aaaaaaaand, we're back!  =)

Goodbye, Constance v1.0

Sunday morning after church, Trey and I headed to Target to get the things we needed for our Valentine's Dinner at home (which was awesome, by the way!).  As soon as we got in the car, Constance was blaring from my pocket like she was just being turned on.  "Holy random restart!" I said.  This was the 3rd time in twelve hours that she had voluntarily restarted herself.  She always got back on track when she came back on, but it was still weird, loud, and inconvenient. 

Halfway through our Target trip, she let out a loud, long shriek like she was screaming out her last breath.  I look down saw this weird error message:

The low prices were to die for!  *wah wah wah*

So I called Dexcom and before I could get to the 4th character in the error message they said, "Oh yeah, that's a hardware error.  We'll overnight you a new receiver."  Apparently, this error message is not all that uncommon.  I confirmed this with some conversations with my Twitter D-peeps yesterday. 

I've kept my sensor in my abdomen during this time because it was still going strong before Constance died, so I'd like to already have a "wet" sensor when my new receiver comes this afternoon.  And it's been a little weird going without a CGM these past two days after being a "real-time" diabetic for the past 7 months.  And it's been nice to not have that constant reminder that I'm diabetic or the incessant BEEEEEEEPing. 

But it didn't take long to remind me why I wanted a CGM in the first place.  I had to mentally take stock of how I felt anytime I had the urge to reach for my phantom CGM.  I was reminded of the cartoon flyer I received when I got out of the hospital, explaining the symptoms of hypoglycemia: 

I'm pretty sure this is in every "diagnosis packet". 

I started to develop what I call "Low-CD", which basically means having OCD anxiety about going low.  Anytime I had one of these symptoms, I wanted to check.  I was quickly running out of test strips (and patience).  One time I was sure I was low, but a test proved me wrong at 128 mg/dL.  Now, it could have been that I was falling from a higher BG, thus prompting some mild low symptoms.  It's for this reason that I want my CGM back, regardless of the constant BEEEEEEEPing. 

The Not-Fun Kind of Roller Coaster

I love roller coasters!  There has never been a roller coaster that I've glanced at and thought, "Nah."  Oh no, I will take 3G (gravity, not cell phone network) turns with upside-down flips, all while hanging from my pony tails.  I am a lover of adrenaline and danger!  (And for the record, my favorite roller coaster is the Superman at Six Flags Atlanta.) 

One roller coaster I am not fond of, however, is the glucose roller coaster (also known as the "glucoaster").  And for the past 24 hours, that's where I've been.  I'm currently on the last reservoir refill from my latest insulin vial, which means there is a good possibility my insulin is going bad.  This has happened to me several times before, and I've thought about chunking the vial once I get down to less than a reservoir's worth of insulin.  But the conservative side of me begins screaming, "That's wasteful!"  So I refill my reservoir like I always do, and spend the next 3 days coasting out some major BAHs.  It's not that the insulin has completely crapped out, it just takes longer for the insulin to really kick in to my bloodstream. 

The other side of this glucoaster involves some homemade eggrolls I made last night.  In my humble opinion, I make the best eggrolls.  I can't stand ordering them from a Chinese restaurant because I'm very picky.  So when I feel the need to fulfill that eggroll hole in my heart, I make them myself.  Each eggroll only contains 12 grams of carbs, but they pack a mean delayed punch.  I forgot about this.  So when I bolused and ate 4 eggrolls while watching Date Night for our date night, I went to bed with a perfect reading of 100 mg/dL (score!).  But I woke up this morning to 298 mg/dL, with Constance showing that I had been over my high threshold for more than 3 hours.  (Why, oh why, do I never wake up?!) 

So I dialed in a correction before my shower, and downed a bottle of water while I was getting ready.  Keeping an eye on Constance, it seemed I was dropping, FAST.  I checked an hour after my correction bolus and saw that I was 120 mg/dL!  (So much for the insulin being bad.)  So I quickly scarfed down some cereal between putting on my blush and mascara.  (Don't worry, I totally didn't try to eat my mascara brush and put the spoon to my eye.  Nope, nuh uh.)  Things seemed to have settled out now.  I'm currently 99 mg/dL with a straight arrow.  But I did delay leaving for work for 20 minutes to make sure I didn't crash. 

I'm ready to get off. 

I'm so exhausted after these last 24 hours, and all I've done is live my life!  Most roller coasters are fun, but sometimes I need a break.  Now, where's the funnel cake stand?

Guess Who's Behind Door No. 2?

Yesterday I had a doctor's appointment to get a physical done so I could use the gym at work (yay, free gym!).  I went to the same office where the bad doctor works, but I requested to see another doctor.  Well, in the frenzy of traveling for my grandfather's funeral, I had to reschedule the appointment.  But when I rescheduled, I didn't make a point to say I wanted to see another doctor.  I thought they would give me the same "new" doctor from my first scheduled appointment. 

I signed in, and managed to snap a pic for the Waiting with Diabetes Flickr group before my name was called. 

The nurse in bright pink scrubs (seems to be the dress code for this place) took my weight and lead me to my room.  She asked me about my current medications, and when I said, "Novolog," she asked me how much.  "Oh, I think like 40 units/day, whatever my pump gives me."  "Oh, you're on an insulin pump?" she asked.  She made a few more notes and told me the doctor would be in shortly. 

I waited a few minutes before I hear a knock on the door.  "Hello."  And there she was, the same doctor who gave me grief for having an A1c of 6.5!  At first I couldn't believe it, I just felt my eyes get wider and wider.  I kept thinking about how I was going to complain to the office when my appointment was over.  I had specifically requested a different doctor, and I ended up with the same one! 

But. 

I still needed to get my physical done, and I figured she could at least do that without berating me about my diabetes.  She went through the little checklist:  checked my BP (which was 128/84--I totally blame white coat syndrome along with it being THAT doctor again), ears, stomach, nerves, etc.  She saw the nurse's chart about me being on an insulin pump and became very gentle and sincere.  "You know you need to carry something when you work out.  Do you wear a medical ID?"  I pulled up my sleeve and showed her my medical bracelet that I've been wearing since I got out of the hospital.  "Good.  Just be careful." 

Wow, so we go from passive-aggressive, berating doctor to overly nice, mothering doctor?!  All because it dawned on her that I wear an insulin pump?!  I don't know if it's because she already put a bad taste in my mouth from the last visit, but I still didn't like the way she asked me if I carried something with me, like I was diagnosed yesterday.  I guess it just comes with the territory of not having a GP that knows me yet, but I didn't like feeling "mothered" by my GP about carrying sugar with me at all times.  Either way, I want to feel comfortable with my GP, and I just don't feel comfortable with her. 

I don't plan on seeing that office again anytime soon, but when I do, I will make sure to say, "I, Holly, 26-years-old, type 1 diabetic-diagnosed for 4 years, DO NOT want to see Dr. XXXXX XXXXXXX.  Even if she is the only doctor there!"  I'm all for second chances with anybody, but sometimes you also just need to go with your gut feeling.  And my gut is not happy with this doctor. 

Thanks (and an Update)

This past week has felt like it has gone by in a blink.  But first, I want to give everyone a HUGE thank you for all the comments on my Dear Papa post, text messages, and emails for the passing of my grandfather.  I felt so much comfort from my online family, you guys certainly deliver.  I also wanted to give you guys a quick update on what's been going on this past week.  

Trey and I traveled to south Alabama for my Papa's funeral.  We met with my family and extended family shortly before the funeral, and it was amazing to catch up with some relatives that I hadn't seen in 10 years.  Then it was time for the funeral, and I still don't know how that many people fit in that tiny church.  My Papa had been going to the same little Baptist church for over 40 years, and the pastor was also his neighbor.  He talked about how my papa never said a harsh word to anybody and praised him for his gentle spirit. 

I didn't cry until they presented my aunt with Papa's US flag for his service in the Navy.  The tears flowed all the way until the grave site.  The pastor gave me a hug and said, "Don't you worry about him, he's in a better place wearing smile.  He's not saying much, but he's wearing a smile," again referring to my Papa's quiet nature.  We said our goodbyes to him and the rest of our family, and the funeral was over. 

The rest of the week we spent going through Papa's house, visiting with family, and just relaxing.  Mom's home cooking contributed to me gaining 2 lbs during our trip (but I'm not complaining).  I also experienced my usual traveling/stress high BGs.  So as much as I enjoyed visiting with family and getting some time off, I'm looking forward to getting back to my normal routine--including more precise carb counting (i.e. not SWAG bolusing) and exercising. 

I've got a doctor's appointment this afternoon (but not with the bad doctor) to get a physical done and have my knee looked at again.  I'm also looking forward to getting started with the Wii Fit Plus, so look for my opinion on that later.  I'm looking forward to getting back to regular diabetes blogging (and catching up on all the blogs I've missed, whoa!). 

But again, THANK YOU!!!

Nothing to Fear

I had my very first eye appointment as a diabetic yesterday.  (Reader:  "Wait?  Haven't you been diabetic for 4 years?!")  Yes, reader, I have.  I know that going to a yearly eye doctor is something I'm supposed to do, but I had such a bad experience with my one (and only) eye appointment about 6 years ago.  Long story short, the doctor I saw was extremely forceful and unfriendly. 

So I've been putting this appointment off for as long as I could, until I started noticing that it was becoming more difficult to read words on the TV from the couch and reading presentation slides from the back of the conference room.  Trey kept noticing me squinting and said, "You're going to the eye doctor."  I reluctantly agreed, because I knew this was something I need to do. 

I arrived at the office yesterday afternoon, signed in, filled out the standard new patient form, and sighed as I circled "Diabetes" under current illnesses.  While I was waiting to be called, I was able to snap a picture for my D365 project and the Waiting with Diabetes group: 

I sat next to the tile foyer, ready to make my escape.

I got called back and made my way into a dark room with several chairs with chin rests.  The tech told me to look into the little black box where I saw a picture of a green field with a red box in the middle.  She did some adjusting to the lenses, then all of a sudden . . . PSSHT! . . . I get sprayed with this stuff into my left eye!  WTH?!  I had no idea what that was, the tech told me it was some type of spray, but I couldn't understand her.  Perhaps I should have told her at the beginning that this was my first appointment in 6 years, maybe she would have told me what to expect. 

Then I was escorted into a smaller room with one chair.  The tech gave me a huge black spoon to put over my eye and told me to try to read the letters in the mirror in front of me.  I really struggled with the first few lines she gave me, which kind of got me down.  I thought I would get the easier letters first and then go down, but apparently we were going backwards.  So the later lines she gave me I could read a lot better.  She sat down at the computer and asked me what medications I was taking.  "Novolog and Prilosec."  This was the first time diabetes was even mentioned in this appointment.  She asked me if I was type 1 or type 2, then told me how important it is to come in for a yearly appointment.  I kept feeling like I was saying over and over in my head, "I know, I'm sorry, I know." 

She told me the doctor would be in shortly and left me in the room by myself.  Two seconds later the doctor came in, and she was unlike any doctor I've ever had.  About my height (5'2"), a little portly, wearing a leopard print skirt and textured tights.  I smiled and thought she must be really cool.  She introduced herself and looked at my chart.  "How long have you had diabetes?"  "Just passed four years," I said.  "Well even with controlled diabetes, it's still very important to get your eyes checked once a year because we want to check to the back of your eyes and look at your nerve function, not necessarily your vision."  Repeating in my head, "I know, I'm sorry, I know." 

Then she dilates my eyes, and I go pick out some glasses to cater to my near-sightedness brought about by my eye exam.  I pick out some frames, and sit back down in the lobby waiting for my eyesight to get fuzzy.  She calls me back in and she shines a light in my eye as I my a circle looking around the room.  "OK," she says as she rolls back from my chair.  I was thinking, "OK what?!  What?!  Tell me!!"  She finally says, "Your eyes look perfectly healthy."  "Oh," I said,"that's a relief."  "Yep, I see nothing wrong."  She leads me out and I head out on my merry way. 

It was in that moment that I realized that we don't get a huge prize in avoiding complications, other than the avoidance itself.  I felt elated that I dodge a huge bullet in avoiding this appointment for four years, but all I could do was sit in the chair in the dark room and breathe a huge sigh of relief.  I called my mom and told her, and told Trey when I got home and they were both happy for me.  I just hate that I feel like I'm getting congratulated for something that's supposed to be mine at some point in my life.  I don't want it, and I'll keep passing that plate each time it comes by me.  Until then, I'll be rocking some sexy kitten-heel frames. 

Plans for 2011

Welcome to 2011!  I hope you all had a great New Year's celebration and bolused appropriately for that sparkling grape juice.  I have a couple of plans (resolutions, if you will) for 2011 that I wanted to share with you guys to start out 2011 for A&M. 

• I am planning on reading the whole Bible this year.  I have settled on the Christ's Church of the Valley reading plan.  I chose this plan because it has an Old Testament and New Testament reading for each day, and it follows a plan of reading just during the weekdays.  This reading plan will hopefully allow me to catch up on days that I miss and establish a reading schedule during the week.  Let me know if you're doing this plan or any other "Bible in One Year" plans; I could sure use accountability/support. 
• Establishing something of a food diary and workout routine.  We all know how important these things are to good diabetes management, but I admit that I really slacked off on both of these in 2010 between working on the house (which I tried to count as working out) and getting used to 40-hour/week job schedule.  I was never able to establish a schedule to work out nor did I have the energy.  But thanks to my handy dandy iPod, I am using the MyFitnessPal application to track my food and workout routine.  I've been using it sparingly since the summer, but more so in the last month to get in the habit.  After I write this post, I plan to go start up the Wii and get yelled at by my virtual trainer (yay?).  
• I am so excited to participate in the D365 project this year.  Since I started my blog in April, I didn't get too into the project.  But I set a reminder on my iPod for everyday at 6 PM to take a picture for the D365 project.  I'll keep the set on my Flickr account for viewing, as well as keeping the D365 tab on the top left column of my blog.  I've already taken the first picture for this year!  

You can see the excitement in my eyes. 

Hope you all have a great, healthy start to 2011!  

Meme for 2010

So 2010 is coming to an end.  I have thought about all the things that have happened this year, and there's been enough to make even a normal person go "Whew!"  I'm also thinking about what I have planned for 2011, diabetes-wise and not.  I'm also extremely scattered brained from coming down from the holidays and all the food, so my 2010-ending post will be a year-recapping meme. 

1. What did you do in 2010 that you'd never done before?
Ummm, help remodel a house!  I mainly helped in the clean-up process, but I also learned how to tape, mainly trim, and apply painter's tape. 

2. Did you keep your New Year's Resolutions from last year and will you make any for 2011?
I don't think I made any concrete ones for this year, but I am planning some for 2011 like reading the Bible in one year and creating my own D365 photo set. 

3. Did anyone close to you give birth?
I had a lot of friends give birth this year, but no one in my family. 

4. Did anyone close to you die?
Not that I knew personally, but I always get sad when another T1 dies regardless if I knew them or not. 

5. What countries did you visit?
LOL, no countries, but I did go to Colorado and Florida for vacations

6. What would you like to have in 2011 that you lacked in 2010?
I honestly can't think of anything that I truly need that I didn't have in 2010, guess I'm blessed. 

7. What date from 2010 will remain etched upon your memory...and why?
January 25, 2010, the day we closed on the house. 

8. What was your biggest achievement of the year?
Traveling down to KSC for my job and seeing the Shuttle in person.  It was so surreal and I reflected on how much I had come in my education/career. 

9. What was your biggest failure?
Never fail, just keep trying.  ;-)

10. Did you suffer illness or injury?
I'm still getting over a cold, but other than that just the usual cuts and bruises from my own clumsiness. 

11. What was the best thing you bought?
Probably my Dexcom CGM.  OK, insurance bought most of it, but I'm making the quarterly copayments for the sensors. 

12. Whose behavior merited celebration?
I definitely have to Kerri because of her post from yesterday.  Her real perspective of being an adult with type 1 diabetes is so refreshing because it's not all good all the time.  But it's something we can all relate to, and I appreciate anyone who keeps a raw perspective about this beautiful mess called life. 

13. Whose behavior made you appalled and depressed?
There's always the groups of people who continue to display their ignorance about diabetes, but it's become so commonplace that I don't feel appalled anymore. 

14. Where did most of your money go?
House stuff, house stuff, and more house stuff. 

15. What did you get really, really, really excited about?
My CGM, I freakin' cried when I heard that my insurance would cover 90% of it. 

16. What song will always remind you of 2010?
I don't know about all of 2010, but I'm really digging "Avalanche" by Manafest. 

17. Compared to last year, are you...
...happier/sadder? much happier
...thinner/fatter? truthfully, fatter, but by like 5 or 6 lbs, meh. 
...richer/poorer? both, poorer because of house, but richer from the investment. 

18. What do you wish you'd done more of?
Ride my bike.  I really missed it. 

19. What do you wish you'd done less of?
Stressing, I feel like I didn't sit down enough and relax this year. 

20. How will you be spending New Year's Eve?
Shooting fireworks and hanging out with our marriage mentors and their family. 

21. Did you fall in love in 2010?
I always fall in love with my husband again and again and again.  ;-) 

22. How many one-night stands?
Ummm, this meme knows I'm married, right? 

23. What was your favorite TV program?
I must confess, Teen Mom, I was totally addicted to that trashy show. 

24. Do you hate anyone now that you didn't hate this time last year?
I didn't hate anyone last year, and I don't hate anyone now. 

25. What was the best book you read in 2010?
The two books I read were Midnight in the Garden of Good and Evil and The Devil in the White City.  Between those two, I liked Midnight more, but I've heard that Leo DiCaprio is making a movie of Devil, and that excites me!

26. What was your greatest musical discovery?
My favorite band of this year was definitely Skillet. 

27. What did you want AND get?
Constance.  =) 

28. What did you want and NOT get?
If there was anything, I can't remember, so it must not have been that important. 

29. What was your favorite film of the year?
I can't remember all the ones I saw, but the first one I thought of was Eclipse. 

30. What did you do on your birthday and how old were you?
On my actual birthday, I went straight home from work to avoid the rain, and hung out watching movies on Netflix, I am 26-years-old. 

31. What ONE thing would have made your year immensely more satisfying?
Getting to meet more people from the DOC in person. 

32. How would you describe your personal fashion concept in 2010?
Slowly transitioning from poor grad student to young professional. 

33. What kept you sane?
My husband, but he always keeps me sane. 

34. Which celebrity/public figure did you fancy the most?
I kind of developed a crush on Eddie Izzard, which is weird since he's an executive transvestite. 

35. What political issues stirred you the most?
The main one that stirred me was a local law saying all dogs deemed "dangerous" needed to be leashed or fenced.  I don't like knowing the government is defining "dangerous" and how they're going to implement it. 

36. Whom did you miss?
A certain gal pal in Denver.  ;-)

37. Who was the best new person you met?
Everyone in the DOC.  Seriously, y'all are the best. 

38. Tell us a valuable life lesson that you learned in 2010.
It really doesn't help to stress, it's better to either tackle the problem and if you can't, let it be.

39. Quote a song lyric that sums up your year:
From "More Like Falling in Love" by Jason Gray, "Cause all religion ever made of me was just a sinner with a stone tied to my fee."  I've been really reflecting on this song because I've been wanting my faith to be more real in my life, not just Sundays.

So if you're feeling burnt out from the holidays and all the food, take this meme to finish out 2010!

Blood Work

It was a crisp fall morning.  Most of the cars were heading east towards town, but I was the only one heading west towards the medical center to get my blood work done.  This was the first time going to this new medical center since we moved back in the spring.  It took me turning around once and refreshing myself on the map to figure out where I was supposed to go. 

Once I found the right building, I walked in and took my number.  I was the third person in the tiny room.  The other two occupants were a middle-aged woman with glasses and an elderly woman walking with a cane.  In our small talk, I found out she had knee surgery nine months ago and was using the cane to help during her recovery.  Even though I've done this same song and dance half a dozen times since being diagnosed with diabetes, I felt a little out of place being as young as I am. 

After both women were called back, I was left in the waiting room by myself.  I took the opportunity to snap a photo for the Waiting with Diabetes Flickr group: 

Good thing I didn't have to wait long.  Those chairs were not very comfy. 

The young nurse called my number.  She was dressed up in Auburn scrubs, so we immediately had something to talk about.  We discussed the Arkansas game coming up (which we won! woo!) while she took my insurance card.  She began setting up her things, and I noticed the huge needle about to make its way in my arm.  She looked at my blood work request form and said, "Oh, we also need a urine sample from you.  I didn't notice that."  Peachy, apparently giving a urine sample is some sort of honor.  So I made my way to the bathroom down the hall and . . . donated. 

Walked back into the nurse's office and sat back down in the chair.  "Which arm do you want to do do?"  I motioned toward my left arm and said, "I guess this one."  She tied the rubber ribbon around my bicep and began flicking my vein.  She kept flicking, and kept flicking, and kept flicking.  "Hmmm, it doesn't want to come up does it?"  "Yeah, my veins are always hard to find."  I was just praying that she got it on the first try, I didn't want to go through a failed vein prick and have to start all over.  She picked up the needle from the table, and I turned my head to the right and closed my eyes.  "Little pinch," she said.  I felt the needle go in and shut my eyes even tighter.  "You OK?" she asked.  "Yeah, I just don't like to look." 

A few seconds passed and she said, "Hold this and apply pressure."  I looked over and the needle was out and she was holding a cotton ball on my vein.  I let out a sigh and put my right index and middle finger over the ball.  Then she wrapped up my elbow with flesh-colored wrapping and said, "OK, you're all set." 

"Thanks." 

"Now go get you some breakfast."  Gladly . . .

Friday Five: 8 October 2010

Welcome to another edition of Friday Five!  Today's post is about diabetes management with the cooler weather which involves more rotating site changes, new sensors, managing insulin sensitivity, and getting some diabetes nirvana. 

1. With the cooler weather upon us, I have taken out all my long-sleeve shirts and sweaters in my closet.  This also means that I get to take advantage of the 4' pump tubes for some arm sites.  I had great success with my arm site a couple months ago, and I know I need to rotate my sites more in order to avoid dead absorption sites.  
2. I got a new order of Dexcom sensors last week, which means I've been wearing Constance for 3 months now!  I really can't believe how fast the time has gone.  One of the things I'm looking forward to is using the software in my upcoming endo appointment and see what my doctor things about this software.  He was rather reluctant to CGMs, so I'm hoping I can help other patients have success in getting approval from him.  
3. A new project for me is in the works for my job.  I'm really excited about this upcoming opportunity, but it does involve some lab work, which includes 10-hour days in a lab with no food or drink (I get a lunch break, at least).  I expressed some concern with my boss about being in a lab that long without food, so we're looking into having a sealed bottle of juice for me in case I get low in the lab.  I am excited about the work, but the diabetes limitations still worry me at this point.  
4. I'm still having issues isolating my increase in insulin resistance that seems to be in sync with the fall season.  It seems I need to increase every single one of my basal rates by 0.1 units, and my insulin:carb ratio has increased from 1:12 to 1:10.  Constance is helping me isolate these incidents, but my total average (from Arnold and Constance) is still around 140 mg/dL so I'm not totally frustrated. 
5. But sometimes, all this maintenance and frustration leads to something known as diabetes nirvana, when everything seems to line up and diabetes behaves:  

Like getting matching Captain 100s with a nice streamline on the Dexcom.  =) 

 Have a great weekend, everyone! 

Bigger Tegaderm Patch

My order for my bigger Tegaderm patches came in yesterday, and I immediately put one on to see how much it covers my Dexcom site.  I really like the Tegaderm patches because they stay on like they're part of my skin but it's flexible enough that I don't notice it's there.  Some medical patches are great for keeping things on but leave your skin red as a beet afterward. 

Because bigger is better when it covers the whole site. 

The real test for this will come tomorrow night when I have a softball game.  Because I'm noticing that the Dexcom tape is impervious to water (as advertised), but it's a whole different ball game (pun!) when I sweat.  It's hard to keep the tape sticky when warm salt water is coming up from underneath it.  How do you keep things sticky when you're sweating from underneath it?  That's my challenge right now.  I'm hoping with the less humid weather that the overall air moisture will be less.  Because keeping this thing on for a whole week without intervention is proving to be a challenge. 

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!

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.  :-/

A Picture is Worth 1,000 Readings

Saturday 5/15 - Diabetes snapshots. Inspired by the Diabetes 365 project, let’s snap a few d-related pictures to share today. Post as many or as few as you’d like. Be creative! Feel free to blog your thoughts on or explanations of your pictures. Or leave out the written words and let the pictures speak for themselves.

Evidence of diabetes in my life:

Showing off my medical ID bracelet.  A potential lifesaver that's only $50.

Bathroom linen closet.  Middle row has been dubbed "Diabetes Only" stuff.

Insulin in the fridge (can you see it?). I keep it in a plastic bag for traveling so the box doesn't get wet from the cooler.  Oh yeah, and I made quesadillas last night.

How serendipitous that I would get a perfect reading for today's blog post. 

Some of the following pictures I did not take, but I think they're perfect for today's post: 

Can apparently make your eyes glow? 

 Diabeetus cat says, "Have you ordered your testing supplies from Liberty Medical?"