Just Call Me Bessy

Before I had my daughter, I knew I wanted to try breastfeeding.  I didn't put a lot of pressure on myself to absolutely breastfeed because I didn't want to be stressed out if it didn't work.  I knew I couldn't be a good mom if I felt like my baby wasn't getting nourished.  But I wanted to give it my best shot.  And so far it is working out great, and I've got a chunky little baby sleeping next to me for proof.  

The first time I tried to feed her was in the mini recovery room following my surgery.  She was tired and sleepy after just being born, and I was tired and groggy from the anesthesia.  So she didn't latch on very well, but it was at least an attempt.  She stayed in the nursery her first night and had some formula to feed her something and to make sure her blood sugar didn't drop (it did slightly, so they had to supplement with sugar water but she bounced back immediately).  The morning after her birthday, we requested that she be brought to our room as soon as they could bring her.  She was brought to our room around 6:30 am, and she stayed with us the rest of the time in the hospital.  

The first 12 hours after her birth, breastfeeding was challenging because newborns tend to go into a deep sleep following birth (it's a rough day, after all).  But around lunch time the next day, she and I finally got the hang of it and she fed for a good 20 minutes.  Coincidentally, this was the same time that we started receiving visitors, so anyone that came into our room had to be OK with a slight boob shot or give me time to put on my nursing cover.  They checked her blood sugar every few hours for her first day, but once we got the hang of feeding, her numbers were stellar and they stopped checking. 

The day that we were released to go home was the same day that my milk came in.  And holy frijoles it felt like I was carrying softballs in my chest!  Pumping or feeding seemed to help the engorgement issue, but those first few days were rock solid (pun!).  She continued to be a great nurser, though.  However, she tended to favor my left side.  For the next 2 weeks, she only wanted to be on that side, so I would pump the right side so I wouldn't look lopsided.  The hospital lactation consultant contacted me a week after she was born to see how things were going, and when I told her about her one-sidedness, she said to keep offering her the right side and she would eventually take it.  So I would feed her on my left side, pump the right, and keep offering the right side to her at various times.  It took awhile, but she will finally take both sides.  

Diabetes wise, I've had to run a more conservative basal rate because she eats so much that my overall insulin needs have decreased.  The one thing with feeding her breastmilk is that it is digested more quickly, so she eats every 2 hours or less.  So it is not an unusual site to see me feeding her while chugging a glass of juice.  Things seemed to have settled out now, but I have no idea if my basal rates or bolus ratios are accurate but they are keeping me from going low.  

I am very happy that breastfeeding is working out for us, and I hope to continue it as long as we can.  The problem we face now is that she like breastfeeding, literally, too much.  We've only had a few successes with a pumped bottle, she much prefers the boob.  This makes things a little awkward when we're at someone's house and she gets fussy.  "Excuse me, do you have a room I could borrow?"  I'm not the most outgoing person, but my daughter needs to be fed.  The true test comes when I will have to nurse her in public.  I just hope she's better at taking the bottle by then. 

Midnight Low Etiquette with/as a Houseguest

Late night lows are no fun.  They make me lose sleep, I consume extra calories that I don't want to, and I worry afterward about over-correcting.  My usual routine for late night lows is to shift out of bed, stumble down the hallway to the kitchen, drain some juice until I stop shaking, and follow it with some peanut butter (the only tasty saving grace from a low).  This stumbling routine is fine with just me and my sleeping husband in the house.  However, it's a whole different game when we have guests at our house or we're guests at other people's homes.  

We normally have guests sleep over about once a month, usually out-of-town family members.  Most of the time, guests stay in our guest bedroom that is closed off from the hallway and my stumbling ways.  However, we sometimes have enough guests that a few people have to snag a couch in the living room, right in the path to the kitchen from our bedroom.  So handling lows during this situation requires a little more thought, something that's hard to do with low brain.  

First of all, I have to remember to get appropriately dressed before I walk through the house.  I don't like pajamas, never have.  But I try to remember to wear . . . something . . . when we have people over, but it's hit or miss.  But that's why God (and The GAP) invented robes.  But putting on a robe is exactly what I want to do when my body is drenched in sweat (/sarcasm), but I do in case I happen to wake anyone sleeping on the couch.  I also have to be careful about turning on any lights, which I tend to do at each turn when it's just me walking through the house.  This is where that trusty light function on the pump comes in handy.  And to avoid that bright refrigerator light, I will go for a banana sitting on the counter top instead of juice.  Then I stealthily grab the peanut butter from the cabinet and a spoon from the drawer and head back to my bedroom.  Thankfully, I've never woken any houseguests (that I know of) or they haven't mentioned it the next morning.  

The other side of this scenario is when we're staying at someone's house as a guest.  Most of the time, this scenario is either at my or Trey's parents' house.  In both cases, the guest room is closest to the kitchen.  So I do the same SEAL-like operation but in somewhat unfamiliar territory.  And I usually settle for whatever I find to treat my low--cranberry blackberry juice cocktail with a granola bar?  Sure!  One time, I was looking for a piece of bread to munch on after drinking some juice at my in-laws.  I happen to wake up Trey this time and he walked into the kitchen, sleepily looked at me and said, "What are you doing?"  I was trying to open a pantry with no handles.  "I'm trying to open this thing but there's no handles and I'm really low and want to sleep where's the peanut butter sad face."  He helped me open the magic pantry and we found some bread on the middle shelf. 

Now, some people may ask why I don't just resort to glucose tabs in these situations.  Here's the thing:  those chalky tabs don't work well enough for me.  Even if I can get up from a low with those things, I still need some good protein to follow them to keep me from crashing again (hence, peanut butter).  I have a jar of those in my purse, but I save them only for when I'm trapped somewhere without juice or money and access to a vending machine.  There are truly a last resort treatment option for me, and it's worth the risk of pouncing through the house in the middle of the night in my underwear to avoid them. 

I'm jealous of those who can finish their workouts

I've always had a little insecurity about going to the gym.  Most of the time, I'm content to do 30 minutes on the elliptical or follow along with a class.  I've never known my way around the gym completely.  Between all the different machines and my perfectly-built gym goers, I'd much rather stick to doing something by myself at home either on the Wii or the Total Gym.  I don't have to worry about how I look or forgetting my shoes, hairband, or glucose tablets.  

But I do have a free gym membership through work, so I might as well take advantage of it.  It at least gives me a different scenery for some cardio stuff.  And the other day, I happen to meet someone from my office there at the same time.  She's a great lady and someone I look up to as far as a professional, but she's also one of those people that make me dread going to the gym.  You know who I'm talking about:  perfect body, perfect hair, and somehow after having 3 kids.  We showed up at the same time and left at the same time, but our workouts were vastly different.  

I decided I wanted to do a cardio circuit:  10 minutes on the treadmill, 10 minutes on the bike, and 10 minutes on the elliptical.  Even though I had set a reduced temporary basal before I left from work, Constance said I was 73 mg/dL before I started my workout.  I decided to ignore it because, darnit, I wanted to get in my workout.  By the time I was done with the treadmill, I was below 55 mg/dL.  Nevertheless, I kept going and said I was at least going to get in 2/3 of my workout.  I started the bike, which was very uncomfortable due to my growing belly--my knees kept hitting the bottom of my belly with each turn.  After 5 minutes, I felt my legs getting heavy and my mind getting foggy.  I knew I wasn't going to get to the elliptical.  Finally, the 10 minutes were over and I sludged my way to the locker room and tested:  29 mg/dL.  

I felt frustrated, defeated, and mad at myself that I didn't stop sooner or took some glucose tabs before my workout.  I started chomping on my glucose tabs.  I don't even remember how many I ate, 10 or 15 at least.  I sat in my car and listened to my audiobook while I waited to come up, which was also a stupid move because I could have passed out in the car and no one would have noticed.  I concentrated on listening to the rest of the book, and 10 minutes later I was coming out of the fog.  I waited a few more minutes before I started the car, I at least had enough sense to tell myself, "Don't you dare try to drive right now!"  A few more minutes passed, and I was finally high enough to drive.  

As I was pulling out of my spot, I noticed my colleague coming out of the gym after her workout.  Now I had a new reason to be jealous of her--she got to finish her workout. 

The One where Firemen Rescue my Diabetes Supplies

Here's a fun diabetes tip to remember:  When evacuating your work building due to a fire alarm, make sure you grab your diabetes bag (a.k.a. my purse) before exiting the building.  Otherwise, it will end in an awkward situation of asking a fireman to rescue your bag because you're having a low episode in the middle of the parking lot.  

A couple days ago, around 10:30 AM, the fire alarm starts blaring in my building at work.  I was in another part of the building at the time, away from my office.  I should have gone straight outside in case it was a real fire instead of walking back up to my office to grab my coat, but I was not standing outside in 30F weather without it.  Normally fire alarms in our office only last for 5-10 minutes tops.  But after 15 minutes in the shivering cold, we realized that this was no drill--something was really smoking or on fire.  Then the rumors circulated that someone saw smoke in the A-wing of the building and that we would be outside for awhile.  

By this time, it's getting close to lunch (yeah, NASA people have lunch at 11 AM) so people began getting in their cars and leaving.  A couple of my officemates proposed the same idea, but as soon as we got in the car to leave I got a BZZZ-BZZZ-BZZZ from my pocket.  "59 mg/dL" heading southeast.  "Crap!  I can't leave.  I'm low and my stuff is still in my office."  At this point, they weren't letting anyone back in the office yet, so I had to put on my pitiful diabetic face and ask the firemen to rescue my diabetes supplies.  

I walked up to the first firetruck where a fireman was leaning on the bumper.  

Me:  "Hi, I left my diabetic supplies in my office.  Is it possible for someone to go get them for me or escort me in there?  I'm in C-wing, so I'm away from the danger zone."  

Fireman:  "Well, they're going to start letting people go inside in 5 minutes.  Can you wait?" 

Me (feeling sweaty at this point):  "Ummm, I'm having a low blood sugar right now . . . "  

Fireman:  "Just a second." 

The very nice fireman got into the truck and radioed his captain (I'm assuming) and agreed that 2 firemen could escort me to my office.  So it must have been a sight:  a pregnant woman being escorted by 2 firemen into a building wailing with fire alarms.  I retrieved my purse and starting chomping away on my glucose tabs, and one of the fireman asked, "Are you OK?"  "Yeah, just having a low blood sugar.  I'll be fine in a few minutes."  

The alarm went off.  My officemates and I went to lunch.  My blood sugar came up.  Crisis averted. 

I kind of wish every time I had a low that I could be surrounded by such nice firemen. 

My Worst Night Ever

Last night was, by far, the worst night I've ever had with diabetes.  I set a new record for myself for a low, not that I'm bragging in the least.  I still feel scared writing this down, because I'm not really sure how I'm alive. 

It all started when I was battling a high for 3 hours before bed.  It was a nice Bell curve high that made me want to use my CGM for target practice.  I stacked bolus on bolus as well as having an increased basal to make this high go down.  Normally this practice results in me going low, in fact it usually does.  But it's usually nothing I can't handle, and I'd rather be low than high right now.  So when I finally when to bed at 160 mg/dL with an arrow going down, I thought I would coast to a landing around 100 mg/dL and have a nice flatline that I normally do overnight.  

I woke up at 1 AM completely drenched in sweat, the only thing waking me up was Constance blaring at me.  I don't remember walking to the kitchen, but I got there somehow.  I put the strip in the meter and pierced my left index finger.  Five seconds later . . . 

22 mg/dL 

That's the first time I've ever had a number lower than my age.  Surprisingly, I didn't really get scared at the number.  I just remember thinking, "Uhhh, I probably need to correct that."  I ate a banana while making a peanut butter sandwich.  I finished it off with some cranberry juice.  I considered that it was probably an overcorrection, but I was freaking 22 mg/dL!  I was in survival mode.  So when I woke up again at 2 AM to a high alarm, I laced in 2 units for good measure.  It was hard to go back to sleep at that point, but I finally did at 3 AM.  

My alarm goes off at 5 AM, and I decide to snooze due to last night's festivities.  I also decided to go ahead and bolus for my breakfast so the insulin could be working while I snoozed.  Bad idea!  Trey and I slept through the 2nd alarm and neither one of us woke up until 6:30 AM.  Actually, Trey woke up and was standing over me with a glass of juice.  "Baby, you're sweaty.  Here."  I mumbled and eventually woke up, but Trey had to pull me up into a sitting position.  I drank the juice while he walked me to the kitchen.  I tested, this time on the left middle finger:  22 mg/dL.  I heard Trey gasp, and I whispered, "That's what I was last night."  "What?!"  I made my cereal and sat down on the couch, all while Trey was following me like a hawk.  "I'm hovering until you come up."  I smiled, finally feeling better but cold from all the sweat.  

How could this happen?  I reached my lowest threshold twice in 6 hours.  I'm grateful for my CGM and my husband, because I honestly don't know if I would have woken up without them.  I feel horrible this morning, even thought I should be looking forward to our gender ultrasound later this morning.  The last 24 hours have been the worst ever for me with diabetes.  At this point, I don't care if our child is a goat, as long as their healthy and haven't felt the effects from all this.  That's what makes this post so hard. 

Disconnected

This past weekend, my husband and I took advantage of the long, cool weekend and went camping. For us, camping means sleeping in a tent and cooking over a fire or a propane-fueled grill. It was the perfect weather with cool 30 degree nights and calm 70 degree days.

Each day we took a hike through the beautiful scenery. The first day was only a 1.5 mile walk that left me at 38 mg/dL and draining a can of lemon-lime soda. The second day we planned for a 3.5 mile hike, so I did a little more pre-planning before the walk. I disconnected my pump completely about 30 minutes before the hike and packed some granola bars and glucose tabs to have just in case.

About halfway through our hike, we found this ginormous oak tree! Pretty sure it was the biggest tree I've seen in real life.  Trey got a picture of me at its base for a nice perspective. 

Holy Oak Tree!!!

At this time, we took a break to split a granola bar and a mini-bag of pretzels. Still un-pumped, we continued our walk back to camp. By the time we got back, I had been disconnected for over 2 hours, with a granola bar and a handful of pretzels, and my blood sugar was 133 mg/dL. Seeing that number was almost as beautiful as the fall leaves. Almost.

There were some scary moments during the trip, too. Like getting my first ever "TEMPERATURE WARNING" on my meter after the first night of 30 degree temps. I had to keep my meter in my jacket pocket so it would keep warm. There was also the time I woke up drenched in sweat (at 31 F, that's a cool wake up) and finished off my jar of raspberry glucose tabs and a bar of chocolate that was reserved for smores. I woke up later at 95 mg/dL, thankful that I decided against bolusing for the chocolate bar.

Camping also seemed to agree with my pregnancy symptoms, or lack thereof during the trip. The relaxing atmosphere and fresh air pretty much ceased my nausea and fatigue. If I could live in the woods for the rest of my pregnancy, I would. So long as there's a fire.

A1c Thoughts

When I found out I was pregnant and excitedly told my endo, the first thing he did was increase my basal rates 0.1u/hr.  This increase made my daily total jump from roughly 16 units to almost 20 units.  This puzzled me at first, because I had only heard of the plaguing first trimester lows associated with a diabetic pregnancy.  So I thought my basal rates should decrease or at least stay the same.  My endo warned me that I needed to arm myself constantly with fast-acting carbs for these oncoming lows. 

For the first few days after that appointment, I followed my low-treating guidelines by the book.  I religiously corrected using the 15/15 rule with scary precision.  But I kept correcting, and kept correcting, and kept correcting.  Eventually, I got tired of constantly correcting with oh-so-perfectly measured glasses of juice or exactly 4 glucose tabs.  Especially in the middle of the night, low correcting rules go out the window.  My low treating method became something like this:  drink enough juice that gets rid of the shakes, eat a tablespoon of peanut butter, chase with more juice or chocolate milk.  I'll admit that this resulted in some scary rebound highs that left me crying and vowing never to go outside the rules again. 

Things seem to finally be settling down and my 24-hour window on my CGM doesn't look like the cutting side of a bread knife.  Part of the resolution is learning my limits when correcting lows (like filling a glass of juice is always less than drinking it straight from the jug) and maintaining a constantly grazing schedule (like every 2 hours or less, seriously!). 

I know that being friendly with lows is good for Ferbie at this point in my pregnancy, and I'm quite proud that my A1c is in the 5s for the first time since I went on the pump.  But I must admit I could not do this everyday for normal diabetes management.  I know that everyone's comfort zone for A1c is different, but I feel the best when I land between 6.0-6.5% for my A1c.  Higher than that means I am hanging out on my higher end too much, but lower than that means I am spending a good majority of my days being low. 

I am coming to the conclusion, though, that the A1c holds a lot more value than it should.  My endo might give me a "Good job!" with an A1c of 5.5%, but looking back at the past month in my meter log shows that my body is roughly 50% apple juice.  I really put more value in my quarterly blood work for my kidneys and cholesterol, my yearly eye exam, and my overall "feeling" of health.  As long as those things get an A+ from all the medical personnel, I don't think it should matter what my A1c is when they happened. 

Pregnancy Update and Morning Sickness

First of all, I want to thank everyone for all the wonderful comments on my pregnancy announcement. I still go back and read all of them multiple times throughout the day. I definitely feel the support and love of the DOC. Now that I'm "out", I wanted to give you guys a quick update on my pregnancy so far these past 9 weeks.

When I first found out I was pregnant, I didn't really have any symptoms. I had some soreness and cramping, but nothing that was discomforting. But once I hit 6 weeks, it was like the plethora of pregnancy symptoms hit me like a ton of bricks.

I had heard about the pregnancy lows accompanied with a type 1 diabetic pregnancy, but I didn't realize that they were on a completely different scale. It's like my body wants to be at 60 mg/dL all the time without any symptoms. All I can say is THANK GOODNESS I have a CGM. The majority of the time, Constance catches my lows before I feel them. I honestly don't know how low I could be most of the time without her alerting me. The only problem with this is she seems to go off all. the. time! Especially when I (try to) sleep, she keeps beeping at me every hour that I'm below 70 mg/dL. And when she woke me up last night at 1 AM for the 5 millionth time, I busted out into tears because I just freaking wanted to sleep. I know these lows are manageable and it's better for me to hang out in the basement end of my range for the next few weeks, but I'm looking forward to getting back to the 100s as "normal".

Another symptom that hit me in the gut is morning (umm, all day) sickness. I've always had a pretty strong stomach. Even if I get a whiff of something that turns my stomach, I can usually hold it in and still eat like nothing happened. But it seems that pregnancy has turned my iron stomach into mush. And the main culprit that makes me run to the bathroom? Ground beef. Even just typing that makes me try to think of something else. But as it stands right now, I can't even look at a hamburger right now without turning the other way (towards the bathroom).

This pregnancy side effect actually caused me to lose 5 pounds the first three weeks I was pregnant. But it seems I have turned a corner recently because I can eat something larger than a tennis ball. The nausea is still there, mainly when I first wake up and if I go more than 3 hours between meals.

At my 2nd appointment with my endo since I found out I was pregnant (where my A1c was 5.5%! Woo!), I asked him what was the standard procedure with insulin and puking. Because I mainly worry about "eliminating" something I just bolused for and the oncoming low. He said the best thing I can do is either suspend my pump or put my bolus on an extended square for an hour or two to make sure I keep most of my meal down.

I've got roughly 3 more weeks of the pukes before it hopefully gives up altogether. Until then, I'll keep my diabetes supplies stashed with diet ginger ale and whole wheat crackers.

My new love.

Diabetic Nightmares

Shortly after I was diagnosed, I had a nightmare that involved diabetes.  I dreamed that I had snuck out in the middle of the night to go to a bar.  But not just any bar, a bar that served nothing but CAKES!  I remember being drawn to this one in particular, an Oreo cake--a circular white cake with Oreo cookie crumbles all over it.  I felt guilty for even being there, being diabetic and all.  Even though I was told at my first meeting with my CDE that I could have cake, as long as I take insulin for it.  Diabetes was taking over my subconscious!  

And last night, I had another nightmare.  I dreamed that I sat down at a nice Italian restaurant when Constance starting blaring at me that I was HIGH.  I went to the bathroom to check and apparently I was so high that my ketone strips started BEEEEEEEPing, as well!  I tried to discretely walk back to my table, but my CGM kept beeping and I felt like crap (in my dream).  I remember thinking I didn't care how high I was, I was going to enjoy my big bowl of pasta and would deal with the consequences later. I was relieved when I woke up this morning to find out I was a little low, 65 mg/dL. 

Has this ever happened to anyone else?!  Please tell me so that I don't feel like a complete looney.  Diabetes seems to be at the center of my attention every waking moment.  But does it have to be so in my sleep, too?! 

Ready to Run

So in the ongoing effort to keep up my dedication to exercise, I am taking the plunge to start a running routine.  But here's the thing:  I HATE/LOATHE/DESPISE/whatever-word-you-choose running.  The impact on my legs and knees as I hit the pavement is extremely uncomfortable.  Not to mention the fact that I feel like I'm swimming through the Alabama humidity. 

I've attempted to go running with Trey a few times (because he actually enjoys running, what a strange man!), but my gym sack that contains all my diabetes junk (meter, glucose tabs, syringes, glucagon) bounces against my back and makes it even more uncomfortable to run than the impact.  The only time I've ever had a successful run with all my diabetes junk is when I can stash them all in my windbreaker.  But there's no way I can do that with temps in the upper 90s and heat indexes in the 100s. 

Enter my SPIbelt! 

It's like a fanny pack, but cooler! 

This SPIbelt (small personal items belt) contains my OneTouch mini meter, lancet, and strips vial (because putting the whole meter case in there was too bulky), a sleeve of glucose tabs, and of course my CGM.  I'd like to be able to fit a few more things in there, like my glucagon or cell phone, but these are the essentials for running. 

So yesterday morning I wanted to give this new accessory a try.  Trey and I decided to get up for a morning run at 7 AM, when the humidity would only be stifling instead of unbearable.  The belt did great!  I could hear the zipper bouncing on the outside of the pack as we ran, but the pack wasn't bouncing against me--and that was the main goal.  I already noticed that the pack works the best slightly off-center from my spine, so there's no gap between the pack and my body. 

The run was fun, too.  We only went 2.0 miles, which was enough for me as a run-hater.  But I could slowly see myself getting into running, as long as as I have my SPIbelt and a running buddy.  =) 

Disclaimer:  SPIbelt did not ask me to write about their product, nor did they provide any compensation.  I had to buy this sucker myself, so all opinions are my own. 

How NOT to Correct a Low

I know I promised you guys a post about the rest of the week following the tornado (and I promise I'm working on it), but I decided to split up the seriousness with a how-not-to guide to correcting a middle-of-the-night low blood sugar, which was inspired from events last night.  

How to Correctly Address a Low Blood Sugar:  

• Respond to CGM alarm or low blood sugar symptoms.  
• Test blood sugar.  
• Eat 15 grams of fast-acting carbohydrates.  
• Wait 15 minutes and test blood sugar again.  
• If blood sugar is in-range, eat a protein-filled snack.  If not, repeat steps until blood sugar rises.     

How to NOT Correct a Low Blood Sugar:  

• Remove itchy CGM site and resolve to put on a new one in the morning rather than stay up 2 hours to calibrate and more than likely be awoken all night to false readings.  
• Wake up at midnight, drenched in sweat, heart pounding out of my chest, legs refusing to move.  
• Stumble to bathroom to test blood sugar:  42 mg/dL. 
• Decide that wiping sweat off of entire body is more important than getting to the kitchen for juice. 
• Shuffle to the kitchen and turn on the light.  
• Fill a glass full with mango juice and suck it down in 2 seconds.  
• Decide that one glass isn't enough and suck down another. 
• Eat about 3 handful of M&Ms. 
• Eat 10 pepperoni slices (I have no idea on this one, but I was on low brain so . . . yeah).  
• Drink a glass of milk.  
• Finish off a bag of dried apricots of which there were about 20 (I think) left.  
• Eat a few more M&Ms.
• Walk back to the bathroom to wipe sweat off of hair.  
• Fall back in bed to a slightly awoken spouse, "You OK?" he asked.  "Yeah, I just ate about half the kitchen.  I hope you didn't want any mango juice."  
• Decide that the low was extremely over-corrected, but don't care and just want to go to sleep.  
• Wake up to a fasting blood sugar of 316 mg/dL and curse at diabetes.  

And now you know.  =)  

Identify Yourself

As I mentioned in my post last week, my first medical ID bracelet broke when it got caught on a loose string.  Here is the broken bracelet:

You can see the broken lobster clasp in the upper right corner. 

So I got online that night to order a new one.  Why the urgency to buy another bracelet?  I know some diabetics wear a medical ID, some don't, and some rely on their insulin pump to be their ID.  My mom ordered my first ID before I even got out of the hospital, so she obviously believed in the power of the medical ID.  And I can't count how many times I've heard of car wrecks where the driver experienced "diabetic symptoms" (as the radio announcer calls it). 

But what really put me over the edge to have a medical ID at all times is a conversation I had with an EMT friend last year.  He noticed my bracelet and praised me for being responsible for wearing one.  I honestly asked him if wearing this thing was even worth it, or was I wasting good wrist space for a cuter piece of jewelry.  "Oh no," he said, "It's definitely worth it, especially if you wear it on your wrist.  If you're debilitated, an EMT will check your pulse on your wrists' first as part of a vitals check.  And if they see you have a chronic disease that could be contributing to you being out of it, the faster we can treat you."

So there you have it, from the mouth of the one person or party who would actually use my medical ID.  It's worth it.  By far, it's the cheapest life-saving device you can buy. 

But that doesn't mean my medical ID can't be cute, either.  So back to my online hunt.  I wanted an ID that would be cute but also obviously a medical ID.  I eventually stumbled upon StickyJ where I found pretty decently priced IDs with a plethora of bracelet options.  I settled on a heart-shaped charm with my full name on the front and my conditions on the back. 

I have diabetes in my heart. 

I wear this ID at all times, even during softball games when we're technically not supposed to wear any jewelry.  No one's ever given me trouble about it, but I will argue that this is not a piece of jewelry to me.  This small piece of sterling silver is just as vital as my insulin pump or CGM in my diabetes management. 

I try to tell as many people as I can that I'm diabetic when safety situations call for it (like my spinning instructor, softball coach, and lab coordinator), but this bracelet would be able to tell the world when I can't. 

Freakin' Out!!!

I have a confession to make:  I'm not the most graceful, organized person (please contain your shock), especially when I'm stressed.  And when it comes to the devices of technology that I rely on to keep me alive, I am particularly anxious.  If one of them goes missing, I pretty much become a basket case. 

Yesterday I started a new project at work, which wouldn't be an incredibly stressful thing except I also had my first softball game yesterday.  So I was at a new place and out of my routine--something that diabetics thrive on.  I had already missed my afternoon snack, sending me low in the middle of a lab test, so I was already frazzled.  With 15 minutes left before I needed to leave, I went to the bathroom to change from my work clothes to my softball clothes. 

I was wearing a really pretty peasant dress yesterday that had no pockets.  Arnold was securely tucked away in my undergarments, but Constance would switch from my purse to my jacket pocket so I could keep an eye on her.  In my hurry to get dressed, I put Constance in my shorts pocket when my medical ID got caught on a loose string.  I pulled with one, swift jerking motion and *SNAP* the lobster clasp broke.  "Fantastic!" I sarcastically retorted.  I had this bracelet since my diagnosis, so it was bittersweet to know it was broken (even though it was still sporting my maiden name).  I threw my broken bracelet into my bag, threw my hair into a ponytail, and headed out to my car. 

I called Trey on the way, and he asked if I was going to eat before my game at 6 PM.  "I'm stopping at a gas station right now to get a candy bar or something."  I was about to get out of my car when I reached for Constance in my pocket . . . except she wasn't there!  "Nooooooo . . ." I whispered.  I immediately freaked!  I frantically started going through my gym bag, purse, jacket where she hung out most of the day.  I got out of the car and thoroughly inspected underneath the passenger and driver's seats.  I forgot the candy bar and jumped back in my car headed back to the lab where I just came from.

 I ran back to the lab the same way I came out, scanning the parking lot for my black-colored egg, starting my Easter celebrations early.  I went back to the bathroom where I got dressed and got on the floor looking for my trusty CGM.  I made 2 more loops around the parking lot (I considered this my "warming up" for the game) before giving up and deciding that my poor little CGM was lost somewhere in a dark place, crying and BEEEEEEEPing for me to find her.  I fell back in my car, exhausted and crying, I kept saying "No, no, no!!!" over and over. 

I was already considering making some of these. 

I immediately called Dexcom and inquired how much a new receiver would be.  They told me that since my receiver was still under warranty that I would only have to pay half of its normal value (just FYI if you've ever wondered).  I decided to wait on ordering another one because I'm not the greatest at finding things, especially when I'm running late/stressed/tears running down my face.  I told myself I would wait until I got home and Trey and I could take apart the car together. 

I parked at the softball fields, already running 10 minutes late, I decided to go through the car one. more. time.  I go through my gym bag, purse, and jacket on the passenger's side as well as looking underneath the seat (also note to self:  Holly, clean your car!  Pretty sure I interrupted some dust mites having dinner).  Then I go over to the driver's seat and looked between the seat and the center console . . . and there she was, neatly tucked between the seat belt clasp and the center console department.  I could barely see the familiar opening where the charger cable plugs into.  It was as if I put her there on purpose.  

I pushed my monstrous hands (yes, for a girl, I have big hands) pass the seat and grab my long-lost CGM and actually kissed it!  "Thank you!" I said as a prayer back to God for the many, many "Please help me find it!"s I said on the way to the ballpark.  I breathed a sigh of relief and headed to the field, contemplating using duct tape to tape the receiver to my leg.  Constance showed that I was 153 mg/dL headed straight up (hello, stress). 

So I ended up having a great game, including scoring a nice welt on my left leg from a slide.  I went home and Trey and I ordered me a new medical ID.  All the while I kept patting my pocket every 5 minutes seconds to make sure that Constance didn't decide to fall out again. 

Something's Working

So 5 weeks have passed since my endo appointment where I was told to lose 10 pounds in order to help my elevated-but-not-high blood pressure issues.  The first week, I upped my workout routine and decreased my diet mainly be getting rid of snacks and alcohol, and I lost one pound that week.  After that, I was stalled, stuck, not moving, etc. for 3 weeks!!  I stayed at the same weight for 3 weeks, battling lows after workouts, and constantly adjusting my basal rates.  Luckily, I never gained, because I'm unsure if that would have made me give up. 

It finally seemed like I found something that worked, BG-wise, for my basal rates because I stopped having so many unexplained lows and tweaked temporary basals for workouts.  For example, for spinning class, I disconnect Arnold an hour before the class and don't bolus for my afternoon snack, which has to have a good combination of carbs and protein in it.  I was finally able to go a week without having a low after working out.  After that week, I broke my plateau and lost half a pound!  It may not seem like much, but after 3 weeks of no change, I was happy to see any change at all! 

This past week, I decided to change up a few things and do some different workouts via Netflix (other than the Wii.  sorry, virtual trainer.) and increased my intensity at spinning class by increasing my resistance on the bike.  And I did my best to maintain my diet during the week with some splurging on the weekend (I have to, or else I'll go insane!).  I figured all this would (hopefully) lead to another half pound loss, but when I got on the scale this morning I saw a loss of one pound!!!  A whole pound!  I couldn't believe it!  I actually smiled and said, "Huh," which is a lot of emotion for 5 AM in the morning. 

So since my appointment, I have lost 2.5 pounds.  But personally I have lost 4 pounds since the beginning of this year.  Some people might not consider that a big deal, but for a type 1 diabetic having to balance cardio with insulin it's a huge deal!  Plus, I'd rather not lose a whole bunch at once because I'll be more likely to bounce back up.  I would love to keep up a one pound/week loss, but I'd feel safer with half a pound/week.  Besides, it took me about 8 years to gain 20 pounds (hello, Freshman 15 plus five), so it's going to take some time for my body to get used to being lighter and stay that way. 

I still have a ways to go:  7.5 pounds to meet my endo's goal and 14.5 to my personal goal.  I really think the spinning class has a lot to do with it, honestly.  I burn over 300 calories in 45 minutes in that class alone.  One of the things that's a challenge right now is changing up my diet to keep my body guessing.  It's so easy, diabetes-wise, to eat roughly the same thing everyday because I know how my body reacts to it.  I'm slowly introducing different foods into my diet other than Greek yogurt, fiber cereal, and popcorn.  All of those are fine, but I have all of those multiple times during the week.  So I'd love any suggestions for changing up my food wardrobe if you have any. 

I'm feeling really good today, not just because of the weight loss, but because I've found something that I love doing even if my weight loss stalls.  I keep saying to myself, "Just keep spinning, just keep spinning.  Spinning, spinning, spinning . . . " 

Not Suppose to Happen

Ever since I've had Constance, I haven't had a lot of lows below 50 mg/dL thanks to its handy alarm that goes off when I go below 55 mg/dL.  And she's great about alerting me before then if I go below 70 mg/dL (my preset "Low" alarm).  Needless to say, I was getting pretty good at feeling my lows and not letting them sneak up on me (hello, hypoglycemic unawareness).  That is, until this past weekend . . .

This past weekend we were hosting my parents and nephews during their Spring Break (My nephews' Spring Break, not my parents.  Retired people don't have Spring Breaks, do they?).  So we spent most of the time trying to find activities that would keep a 9- and 11-year-old boy busy, active, and happy.  We went bowling, played pool, played on the Wii, and chased our 2 dogs around in the yard.  The combination of being a full-time aunt and hostess made for little diabetes management.  One day I only tested my blood sugar 3 times the whole day!  (Preview of motherhood?)

So I pretty much relied on Constance to keep me alert to any out-of-range happenings in my blood sugar.  I know that's not her purpose, but I felt confident in her keeping me on track.  And one afternoon, after a series of movies and Wii time, I felt a little "off".  Nothing crazy, just a little shaky and feeling fuzzy in the head.  Constance said I was holding steady in the low 80s, so I didn't worry when I tested expecting a reading between 70-90 mg/dL.  However, a gleaming 35 mg/dL welcomed me on my screen!  I didn't want to alert or scare anyone, so I stealthily grabbed a glass of juice and filled it to the brim.  I sucked it down and grabbed an ice scream bar from the freezer (which we don't normally have, but we were spoiling our nephews . . . and ourselves).

I walked out to the garage where Trey was working on something, and sat down beside where he was working.  Even though my parents and nephews know I'm diabetic, I didn't want to make a scene.  But I needed to let someone know how low I was in case things got worse.  "I'm 35."  "Whoa, really?!" Trey exclaimed.  "Yeah, I didn't feel that one coming."  I just sat there for 30 minutes, eating my ice cream bar while Trey continued working.  "This sucks," I said, finally gaining enough composure to speak.  "How am I going to be able to keep up with our kids when a weekend with our nephews wipes me out?"  Trey jokingly said, "Maybe having kids can be your cure?"  I smiled, and went back inside to test, 110 mg/dL.  I knew I was coming up fast and over-corrected, but a 35 mg/dL scares the crap out of me too much to be conservative. 

This incident only confirms the fact that I shouldn't rely on my CGM in place of finger stick tests.  Had I not tested because Constance thought I was in the low 80s, there's no telling how low I would have gotten!  At the same time, I expect her to alert me well before a 35 mg/dL when I'm low.  That sensor was fired and changed out on its 8th day, because I do not consider a 50 points difference a passing grade.  The current sensor is working like a champ the way I expect it to.  Regardless, incidents like these shouldn't happen.

Lows with Lowering Weight

So it's been 2 weeks since my endo suggested that I lose 10 lbs in order to lower the elevated blood pressure I've been having.  And I've stuck to my diet for the most part (usually within 100 calories of my goal) and have kept up a good workout routine including 2 spinning classes a week, jogging 2 miles around my neighborhood, and frequenting my Wii Fit Plus. 

I knew once I started losing weight that my insulin needs would decrease.  This has been evident by the increased number of lows that I've been having.  As far as the scale goes, I've only lost one pound since my appointment, but my body feels like it's more.  But I need to something about these lows because the calories spent correcting them will only hinder my weight loss.  For example, an 8-minute ride on the stationary bike at physical therapy had me at 47 mg/dL?! 

I don't think my basal rate(s) need to be messed with at this time, because my nighttime numbers are spot on if I go to bed in range (80-130 mg/dL).  The majority of my lows seem to occur after working out, which means I'm not disconnecting Arnold soon enough or I'm jacking up my IOB from my meals.  And my insulin:carb ratio seems to have my post-prandials a little lower than I like for them to be.  So I decreased my I:C ratio from 1:12 to 1:15 in hopes of avoiding these lows, and I'll make a point to disconnect Arnold (or at least turn him down) to avoid the post-workout lows. 

But I would love to hear from another type 1 diabetic who has successfully lost weight!  Please, help me figure out how to avoid these lows so I'm not wasting a spinning class on glucose tabs.  And as delicious as it is, I'm getting tired of eating spoonfuls of peanut butter before bed.  Any advice/suggestions would be extremely helpful! 

Using Diabetes to My Advantage

We all have to manage our diabetes.  We test our blood sugar, take insulin, and try to get some exercise, all for the sake of better blood sugar management.  But sometimes we can actually make diabetes work for us. 

I came across this idea when I woke up this morning to a blood sugar reading of 67 mg/dL.  Yeah, it's low, but it's not a fall-down-inject-me-with-juice low.  I can still function at this number.  The past few days I have woken up on the lower end of my fasting range, mostly due to being more active in an effort to lose weight.  I've only lost one measly pound (grrr!), but I know my body is getting stronger and building more muscle.  So I expected that my insulin needs would decrease.  Anyway, back to my point . . .

My usual routine when I wake up is to test, bolus for breakfast, and take a correction bolus to account for the dawn phenomenon (DP) and time spent in the shower.  Yesterday, I woke up to a similar number (65 mg/dL, I believe) and scarfed down 4 glucose tabs before jumping in the shower.  Well, I forgot about the whole DP thing and ended up jumping up to 153 mg/dL before I even ate breakfast.  So I decided this morning to forget the glucose tabs and the correction bolus altogether, just to see what happened.  (Note:  Please do not, under any circumstances, take this story as an example to be followed.  You should definitely treat a low with glucose as the "official" treatment.  See also:  Disclaimer.  See also:  Your diabetes may vary.)  I get out of the shower about 20 minutes later (yeah, it's wasteful but I like to "wake up" in the shower) and test again:  81 mg/dL!  Woo hoo, back "in range"!  So I bolus for my upcoming cereal and go about my day. 

It's not often that I can actually use the fact that I'm diabetic as an advantage.  It reminds me of the possibility of having an artificial pancreas, where I can manually insert glucose from my pump at any time instead of relying on glucose tabs or DP to do so.  (Pssss, take a note, pump companies!)  Besides, the less incidents of waking up chewing glucose tabs, the better. 

Have a great weekend!  (And please keep the people of the Pacific in your thoughts and prayers, especially those in Japan.) 

(Not So) Ruined Workout

Yesterday afternoon I went to my second (ever) spinning class. I'm still trying to figure out my insulin levels before this workout, because my greatest fear is going low during the class. Well, that fear came true yesterday.

It all started when I decided to have a snack (Fiber One Oats & Chocolate bar) in the afternoon. Dumbo me actually bolused for the whole bar (29 g) and I forgot to subtract the fiber for the net carbs, which seems to help me avoid lows on a regular, non-workout day. Also, I didn't disconnect Arnold until 30 minutes before the class. Last time, I disconnected an hour before, and even though I went for a half-mile walk beforehand to warm up my legs, I still didn't crash. So all these forces combined (like Captain Planet?) to have me at 83 mg/dL going south before the class according to Constance. I downed 5 glucose tabs as fast as I could, said a prayer, and hopped on the bike.

The class gets started. We warm up with our "leisurely stroll through the countryside", followed by sprint intervals. I checked Constance after the sprints and she said I was now 52 mg/dL heading southeast! I didn't hear her alarm over the blaring music, so I'm going to have to figure out a better scenario for having Constance in plain view rather than relying on hearing her. Frustrated, I threw my little bag down on the floor, almost to say, "Screw you, diabetes, I'm gonna keep spinning until I pass out." We start doing climbs in the standing position, and I notice that I almost lose my balance. "Hmmm, something must be wrong with this bike," I thought. Or your blood sugar, silly.

After the climbs the instructor told us to take a water break. Most people stay on the bike and keep pedaling while they grab their water from the holster below the handlebars. I finally got a level head and decide to jump off the bike and test. I could feel the 6 pairs of eyes on me all at once, but I had to do it for my own safety. By this point, Constance said I had leveled out to 55 mg/dL, so it seems my glucose tabs were finally kicking in. A test confirmed I was at 70 mg/dL, a little higher than my CGM. After that test, I felt confident enough that I could finish the rest of the 20 minutes of class. I jump back on the bike to finish out the class with some jumps.

The class ends, we stretch it out, I put my bike up, and walk back to the locker room to test my blood sugar again: 61 mg/dL. I eat 4 more glucose tabs, and call Trey, "Yeah, I'm gonna be a little while. I can't drive yet." With a mouth full of chalky remnants, I take a seat on the gym couches (really?! in the gym?) and wait out my low.

I love having couches at my gym. 

At this point my instructor comes out of the locker rooms, and she stops to say how good I am doing for being so new to the class.  "You're really keeping up with the rest of them," she smiles.  "Thanks," I said back.  "So, you're diabetic . . . " she inquires.  "Yep, type 1."  Then I go into how I wear an insulin pump and a CGM, the gizmo I was checking during class.  She seemed to be comprehending what I was attempting to explain, and finished with, "Well, you're doing great, so keep it up."  

Even though I completely wasted the calories that I burned with the amount of glucose tabs I ate, I know I'm doing more good for my leg muscles, lung capacity, and endurance.  That's the positivity I'm clinging to right now, because if I focus on the fact that diabetes stole my calorie burn for the day I would never return to the gym.  I know I'm building muscles that keep burning calories long after the workout is over, which increases my base metabolism.  And I'll keep figuring out my insulin needs, and perhaps I'll forgo the insulin for the afternoon snack altogether.  Either way, I can't give up on this.  I won't give up on this! 

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. 

Knee-Jerk Experience

So today's blog post is installment #4 of the saga that is my knee pain.  (You can read the other installments here, here, and here.)  This week's episode is about my visit to the orthopedist to see what he thought about my nagging knee.

I kind of started out in a bad mood, because my appointment was at 10:15 AM, which meant that I was going to get up and go to work for 2 hours then drive all the way back to this office.  (I normally like to make my appointments either really early or really late because of work, but this appointment was made for me by my PCP after my MRI appointment.  /digression)  And I found out that there is only one majority group of people who come to appointments like this in the middle of the day:  slightly older retired people. 

Most of the people I sat next to in the lobby sported a cane and white hair (if any).  I overheard some of their conversations about having their knees scoped, recovering from surgery, and (my favorite) "there's no arthritis in titanium".  The thought of having my knee scoped is about as pleasant as a root canal without a numbing shot.  I felt like I was looking into my very depressing future.

I sat there for over an hour, filling out paperwork, playing with my iPod, and waiting for my name to be called.  (However, the office did have free Wi-Fi, during which time I was able to download the Starbucks app.  I'm thinking we should petition all doctors' offices to have free Wi-Fi, no?)  They finally called my name, and I was escorted to another room.  During this time, I had a mild low (67 mg/dL) from the waiting and the fact it was getting close to my lunch hour.  I just knew I would meet the new doctor while chomping on some raspberry glucose tabs, but no such luck.

Then the doctor came in (with a medical student shadow, cool) and pulled out my MRI images.  He asked me about my pain, and I explained to him that I used to be a catcher and had been having pain off and on for about 8 months, mainly during cold weather, walking up and down stairs, and sitting still with crossed legs for a long time.  He said this pain is fairly common, especially in women because we generally have wider hips.  (Which is extremely evident on me, if you've ever seen my hips.  Which would be weird if we met and you remember what my hips looked like.  OK, nevermind, this is just getting awkward.)  And having wider hips makes the pressure on the knee disproportioned, and being a catcher probably didn't help either.  He showed me on the MRI where the radiologist thought my pain might be coming from, but he wasn't entirely convinced that it was degenerative meniscus.

"It hurts right here."  Around the bright white spot. 

So he prescribed that I do physical therapy for 4 weeks to try to correct the pressure on my knee, and a follow-up in 6 weeks.  This is where things start to get bad.  I go to the physical therapists' office next door to try to set up my times, and all they had available were "in the middle of work day" times.  I asked if there were any offices close to where I work and how long the sessions would be.  She told me they had offices downtown but the sessions are usually an hour or longer.  An hour or longer, for 3 times a week?!  I hardly have any sick time left due to usual diabetes management, I couldn't tack on physical therapy, too.  I told her that I would just have to call them later for some better times.

Between that, my glasses, and worrying about some blood pressures issues I've been having lately, I started to feel vulnerable and break down.  I called Trey after my appointment and, through my tears, attempted to tell him my diagnosis.  When he asked what was wrong I said, "I'm just tired of falling apart."  "OK, well just drive and collect yourself.  I'll talk to you later."  He knows that only continuing to talk about it was going to make me more upset.  So I took the 30 minute drive back to work to clear my mind and figure out what I wanted to do.

I got back to work, and while (finally) eating my lunch I tried to call some of the other physical therapy places listed on my prescription.  On the second place I called (the first was out to lunch), the nicest voice answered the phone.  When I told her I needed physical therapy but needed to do it either really early or really late, she informed me that they're open until 6 PM everyday and I should be able to get in.  Then she transferred me to the physical therapist who briefed me on what to do when I came in.  Even though it was only a phone call, it really lifted my spirits because they seemed so willing to work with me and around my schedule.  It was quite refreshing after the "you need to work around us" therapy center I came from. 

So that's the latest on le knee that's being a jerk right now (hello, post title).  I'm really hoping that I can fix this without scoping or surgery, and that I can learn some things I can do if the pain comes back again.  However, having titanium knees might be cool (and add to my bionic-womaness)!