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. 

Birth Story: Part 1

It's been a week since my daughter's birth.  And I finally feel ready to blog about it.  Partly because I've finally had time to collect my thoughts on it, but mostly because I've had time to deal with it emotionally.  Let's get one thing straight first:  I have a perfectly healthy little girl sleeping in my lap right now and that was always the priority.  But I want to be sincere about how things went, that's always been my goal with this blog.  If you wanted to stop by and read a pleasant birth story that ended in rainbows and unicorns, then I suggest you search on.  I also will not spare the gruesome details (Sorry, guys.) because I am writing this story as if I'm writing to myself from a year ago.  I wanted to know all the gritty details, emotions included.  With all that said, on to the story!

My doctor scheduled my induction beginning Monday night the 21st.  Trey and I went in to the hospital around 9 pm to check in.  My nurse K instructed me to lose all my clothes (but I was given the option of keeping my bra, which I took) and gave me a smock to wear that tied on the side.  Then she set up the fetal monitors on my belly that would keep track of baby's heartbeat and my contractions.  As soon as she set up the monitors, she could see that I was already having contractions of my own!  Really small ones, about 5 minutes apart, that I couldn't feel at all.  So that was encouraging to hear.  Because I was already contracting on my own, I was only give a half dose of cytotec to soften up my cervix (which was still at 1 cm, 80% effaced).  She put in my IV, which was the worst part for me to get through.  Trey held my right hand while she inserted the needle into my left vein.  My blood pressure rose during this part, but that was the only time it gave me any trouble.  

Finally, we were left to sleep for 4 hours until she would come back and give me the other half dose of cytotec.  At this point, I still have my pump on and keeping track of my blood sugars myself with testing and my CGM.  About 15 minutes before I was to get my second round of cytotec, I had a bad low blood sugar of 44 mg/dL.  The contractions I wasn't feeling were starting to have an effect on me.  I brought my own juice boxes, so I drained 2 and turned off my pump (it stayed off until about 9 am the next morning).  I took the second dose of cytotec and started feeling mini contractions around the time I woke up at 5 AM.  They weren't painful, just exciting because I was started to feel something.  

At 7 am on the 22nd, I met my day nurses W and M.  They would be by my side during the entire labor process.  They checked me again and I was now 2 cm but still 80% effaced, the goal of cytotec was to get me to 3 cm.  They went to consult my doctor to see if they wanted to administer another round of cytotec, which would delay starting the pitocin another 4 hours, or if we wanted to get the show on the road.  The result was to go ahead and start pitocin.  So by 7:45 am, I was on the pitocin IV drip.  I asked W when I would start feeling anything, and she said it usually takes about an hour.  At this point, things were not painful and, honestly, kind of boring.  I practiced breathing through the mini contractions that I did feel while listening to the radio on my iPod.  

The nurses contacted my endocrinologist about putting me on an insulin drip, but he made the call to let me keep my pump on and check myself every hour.  I was forever grateful that decision was made, because it gave me control in a situation where everything else was out of my control.  So I was checking myself every hour, and the nurses would record it.  I was cruising in the 150s for most of my labor, but my endocrinologist said that was fine as long as I didn't go over 200.  I think the risk of me going low during labor was more important than trying to keep a perfect 100 the whole time. 

At 9:30 am, my OB came in and greeted me.  He gave me the option of continuing with my labor as it was or going ahead and breaking my water.  I chose to break my water because I still wasn't feeling the contractions and I was still at 2 cm, so I figured we needed more momentum.  After my water was broken, I got on an aerobic ball and started breathing through my contractions that started to be noticeable.  Nurse W asked what would be the best care for me, and I said I just didn't want to stall out on my labor.  I wasn't afraid of the pain because I have  pretty high pain tolerance.  I was only worried about my endurance and being in labor for days!  So W wrote on the white board on my wall:  "Keep things going" as my goal for care.  

About an hour later, I hit active labor.  My contractions were coming in waves and becoming more intense, but still nothing I would consider painful or something I couldn't get through.  So far, Trey has just been hanging out with me and eating breakfast.  I told him I would let him know when he needed to come into the game.  All I said was "I need you" and he jumped in like a pitcher coming out of the bull pen.  He applied counter pressure to my back and hips through each contraction.  And in between contractions he rubbed my shoulders and feet to give me comfort.  The ball worked great for me in working through the contractions.  The best position for me was being on the ball, rocking back and forth, with Trey behind me on the edge of the bed or in a chair.  Also at this time, my contractions required all my concentration.  So when it was time to check my blood sugar, I would just stick my hand out and Trey would check it for me.  I know I wouldn't have made it through labor without his support.  

Around lunch time, my doctor came to check me again and I was at 4 cm.  I was starting to get a little frustrated with how slow this whole thing was going.  So M suggested that I labor on my sides for awhile to help the baby move down into my pelvis.  This was not a comfortable position at all, but it seemed to intensify the contractions.  Trey got out the heating pad we brought and applied it to my back during my contractions with pressure.  He eventually had to go eat lunch, so W and he rotated out during back compressions.   The pain was increasing, and I started low moaning.  I thought I would feel embarrassed doing this, but the nurses actually coached me through the breathing so I didn't feel so awkward. 

Sometime in the afternoon, M was keeping an eye on baby's heartbeat.  She was fine, but she wasn't responding to the contractions like they wanted.  So they gave me an oxygen mask to wake her up.  The mask was great because it gave me cool air to breathe and was very relaxing during this whole process.  At this point, I'm laboring on my knees on the bed, leaning over the back of the bed.  So imagine this picture:  a woman in labor, wearing a smock, low moaning every 2-3 minutes like a cow, with an oxygen mask on her face.  I had officially lost my dignity.  

Around 5 pm, things really picked up because I was at 7cm, 90% thinned out.  "Sweet!"  I remember sighing.  Trey laughed.  This meant I had made it.  I was at the point of no return for pain meds and it looked like I would be delivering my baby soon.  However, the contractions were increasing in intensity.  It took all my strength to moan and breathe through them.  Only once did I say, "I can't do this!" to which Trey quickly responded "Yes, you can.  You are doing it!"  I just had to get through each contraction and rest.  I felt enough relief in between each contraction to refill my energy tank.  

It seemed like I went from 7 cm to fully dilated within an hour, so the nurses went to call my doctor and have him come over for delivery.  Meanwhile, my contractions were stretching my pelvis to the max.  It felt like I had a 25-lb. medicine ball that was being stretched to a 50-lb. ball and deflating back down to 25-lbs.  I wasn't getting the full relief of the contractions I had at 7 cm.  Also, M told me that my doctor got called to an emergency surgery, so I had at least an hour before I could start pushing.  I went from low moaning to grunting/screaming during contractions, squeezing the bed rails like I was going through an exorcism.  They turned off the pitocin to hopefully give me some relief before my doctor could get there.  It didn't help.  My contractions went from every 2 minutes to every 3 minutes, but still no downtime from the pain.  

After an hour of being fully dilated, the nurses decided that the baby was coming soon and someone needed to be there to catch it.  So they got the on-call doctor and my room doubled in audience almost immediately.  I initially requested that Trey be the only family member in the room when the baby was born, and I'm glad because I'm not sure where anyone else would go!  I had my 2 nurses, the baby's nurse--who I would officially meet the next day--prepping the incubator table right next to me, and 3 delivery nurses (not sure, but I think one was an observing student).  They brought up the stirrups for me to start pushing.  I was so exhausted from being in labor for 10 hours, but I felt relieved that the end was in sight.  I just needed to muster the strength to push.  

The on-call doctor comes in and introduces herself while I'm fully naked (minus my sports bra) with my goods pointing straight out to the world, sweat pouring out from every surface I had.  "Hello, I'm Dr. P and I'll be delivering your baby." 

Part 2 . . .

38 Weeks: Ready or Not, Here She Comes

This week has been a real busy week in preparing for our daughter's arrival.  I had so much anxiety about my OB appointment on Wednesday because I was worried about her size and being induced earlier than I wanted.  This appointment would also be my last regular appointment before the 39 week goal that my doctor set for me.  I wanted to end things on a good note and go into my induction with hope and optimism.  I also had my last endocrinology appointment on Thursday, so I was rounding things out in my last week as a diabetic pregnant woman.  

My OB appointment started out with an ultrasound again to check on baby's size and fluid levels.  Last week, she was measuring around 8 lbs 10 oz, and my doctor was worried about her getting over 9 lbs and being too big for me to push out.  Thankfully, it seems my daughter has ceased growing and is just chilling out in there because she came back at 8 lbs 11 oz this week.  My fluid levels were still good, too.  My doctor still seemed puzzled by the fact that I was carrying a large baby when my diabetic control has been as good as it's been.  I explained to him that Trey and I were both 9 lb babies when we were born.  And it was as if a light bulb went off in his head and he exclaimed, "Oh, well that explains it!  You just breed big, healthy babies.  That's all!"  So it turns out that I'm a "big breeder", nothing more.  But it does give me more pressure to keep stellar control for other pregnancies since my kids will more than likely land on the larger side anyway.  

My blood pressure came back fine.  Not great, but it wasn't higher than last week, so my doc didn't seem worried about it.  Next was my first internal exam.  I have to admit that I was really worried about this.  I had read horror stories about how painful they were and they could accidentally strip your membranes and put you in early labor!  Well, it wasn't nearly as bad as I thought, just went to a happy place and counted the tiles on the ceiling.  Right now I'm 1 cm dialated and 50% thinned out, which my doctor said is very optimistic before being induced.  Looks like my dedication to walk 2 miles everyday in these last few weeks might have paid off.  

The plan is if I haven't gone into labor on my own by Monday at 10 PM (which I highly doubt), I am to go to the maternity center and check in to start the induction process.  They'll start with something called cytotec that will thin out my cervix even more overnight.  The nurse told me that sometimes it is enough to send some moms into spontaneous labor.  Then we'll start an IV of pitocin, the drug that kick starts labor, early Tuesday morning.  After 3 PM on Monday, I can only have clear liquids (water, sports drinks, jello, chicken broth, etc.) because the drugs can cause some nausea.  

Yesterday, I had my final endocrinology appointment before having my daughter.  The nurse checked all my vitals while my A1c was spinning.  I asked for a refill on all my prescriptions, just in case I might be close to running out and I wasn't coming back to the office for 4 months.  I have been spoiled a little bit by coming in once a month, I don't worry about checking my prescriptions before I come in for an appointment.  My A1c came back at 5.3%, which makes my overall pregnancy range 5.1 to 5.6.  I was quite proud of myself at this fact and feel confident that I did the best I could, diabetes wise, to give my daughter the safest place to grow.  My endocrinologist and I discussed the plan for me during labor.  I'll keep my pump on until they start the pitocin, and I'll keep it off until she is born.  "And I can put it on right after, right?"  I'm not a big fan of IVs, so I have this image of immediately ripping them out (a la the Hulk) right after I hear her first cry.  They will check my blood sugar once every hour while the IV is in, but of course I can check at my leisure as well as having my CGM.  Then I can reconnect the pump using my pre-pregnancy basal rates and bolus ratios, because once she's out and the placenta is delivered my insulin needs will dramatically decrease.  

So everything is set in place.  My daughter will be here by this time next week.  I got a little emotional leaving my OB's office after scheduling the induction.  I wasn't scared or anxious, just overall emotional from the culmination of "This is it!  She's coming!"  This weekend, we're busy doing last minute things and preparing for incoming family.  We're also planning a last date night that involves a movie trip (Battleship) and a trip to Babies-R-Us to pick up last minute things.  I've also been busy putting things in the hospital bag, most of it we may not need.  The car seat is in the car, along with the essential Boppy.  

I'm excited to meet her, but I'm more scared and anxious right now.  I'm mentally putting on my game face and getting ready for what the labor process will be like (and how long it will take).  I'm afraid I'm not strong enough to handle it.  But at the same time I have no idea what to expect, so I'm hoping I surprise myself.  I just keep imagining that moment when the doctor says "She's almost here!" and I hear her first cry and we get to hold her, finally.  That moment is my trophy that I'm running towards. 

Tough Weekend with Arnold

In the 4.5 years that I have been on an insulin pump, I've had very few instances where the pump had a malfunction.  Usually, I can contribute any random highs on operator error.  But this weekend, I had several instances where I was so frustrated with my pump that I want to call my endocrinologist to go back on MDI (haven't yet, but I'm still considering it).  

I guess it all started when I noticed that my most recent box of infusion sets seemed to be made of flimsy plastic because I would have little bits break off when I would insert the cap into the reservoir.  It never caused any trouble with the pump working, so I brushed it off.  But Saturday morning, I woke up to a high BG of 219 mg/dL, which is a far cry from the 100ish average I try to maintain in the last month of my pregnancy.  I got up to confirm the high alarm, and noticed that the tube on my pump was dangling towards the floor and not connected to the site on my thigh.  "Oh, well that explains it."  I reconnected with a new infusion set, and bolused a correction.  

The problem was that I was never able to get back into normal range, despite dialing in correction after correction.  I feel into a heap on the bathroom floor because I was so frustrated.  Even rage bolusing wasn't working.  (And by rage bolusing, I mean 5 extra units "just because".)  I finally come down after 5 hours of being above my preferred line.  The rest of the day went on as normal.  

Then yesterday, I laid down to take a nap (random occurrence for me these days) and when I woke up I started going high like I just ate a cupcake sprinkled with sweet tarts.  But I hadn't eaten anything in 4 hours!  I got up to 297 mg/dL and three failed correction boluses before I finally gave myself an injection, ignoring all of my active insulin.  I finally came back in range 2 hours late to 125 mg/dL without a crash, which should have been inevitable considering I gave double what I needed.  

After 2 calls to Medtronic, we decided that I have a bad box of infusion sets.  So I changed my site for the 3rd time in two days with a new reservoir and infusion set from a different box.  I bolused for dinner after not eating for almost 8 hours and waited to see if my blood sugar would actually come down before I took a bite.  Thirty minutes later, I was cruising towards my low threshold, so I concluded that the new site was working.  

Even today, I'm still not happy with how quickly my insulin takes to work.  Everything with my site change yesterday was new, including a fresh, cold vial of insulin from the fridge.  But so far I've had to give 2 additional corrections following breakfast.  It might be that my insulin:carb ratio needs adjusting (again!), but I still am not happy waiting over an hour for my insulin to bring my blood sugar down.  

I feel absolutely hopeless when this vital technology fails me.  I don't want to go back to MDI, but the time it takes for insulin to kick in is considerably less than waiting on a bolus from the pump.  It may save me from lows, but I'm spending far too much time over 100 mg/dL to justify it.  Even thought my last A1c was fine (5.6%), I don't want to let up in these last 4 weeks of pregnancy.  I want to keep the same steam that I've had the whole time.  And I can't do that when I don't trust the technology that I rely on to keep me there.  

It's the final lap, Arnold.  Do we need to come in for a quick tire change and fuel up before we win this thing? 

Settling Out

I like this view.

Thanks to some recommendations that I received on my last post, this last week of blood sugar management has been a lot better. In fact, I went a whole day without crossing my high threshold on my Dexcom (160 mg/dL). So I want to thank everyone who offered great advice or simply said, "It's OK. You can do this."

The main suggestion that I'm following is keeping my old site in even after I put in a new one. I take the cap from my new site packaging, put it on the old one, and keep it on there for at least 12 hours. Ideally, I would like to change my site before bedtime to give it the most time to get "wet" before I try to bolus for a meal. But of course the units don't always line up that way. I have succumbed to giving myself injections when I have to change my site right before a meal, but I'm weary of doing this because I really like the "Active Insulin" feature on my pump. I like knowing how many units I have on top of my basal rates, especially before I go to bed. Because despite the huge amounts of insulin I'm taking compared to pre-pregnancy, I still struggle with nighttime lows.

Speaking of basal rates, I'm currently streaming over 32 units/day (my pre-pregnancy rate was 18 units/day). It seems I need a good increase in my rates at least once a week. So I've been increasing my rates by the lowest amount (0.05 units/hour) every 3 days. Combined with my current insulin:carb ratio that is set at 1:6, I'm going through cartridges every three days or less. I've learned to keep a site change set with me at all times because I tend to forget about it until I get my "Low Reservoir" warning, which doesn't leave me much time to cruise on the units I have left. I expect these increases to continue until the last month of my pregnancy, based on what I've read from other type 1 pregnancies.

On the regular pregnancy front (as if there is such a thing), I am getting bigger and definitely more uncomfortable. As of this morning, I broke the 25-lb. threshold from my pre-pregnancy weight. I told myself in the beginning that I wouldn't worry about the number as long as I and baby are healthy, but it is really hard to see that number (and to think about losing it all later, eesh). I have to sleep with a body hug pillow every night to ease the middle-of-the-night cramps that have plagued me for the past few weeks.  Also, I believe I felt my first Braxton-Hicks contraction last weekend. It wasn't painful or uncomfortable, but I definitely noticed it. I've got another appointment on Monday for my 28-week checkup that will include another ultrasound. And I'm very excited about this appointment because it's been 10 weeks since I've gotten a look at our little girl. After this appointment, I'll start going every 2 weeks. So I need to restock my Nook for all that time I'll spend in the waiting room.

I'm officially in the third trimester now. The home stretch, the light at the end of the tunnel, the final lap, etc. I'm getting less freaked out about this whole pregnancy thing, and more freaked out about the whole parenting thing!

High Days are Low Days

I don't know what's going on. But every three days, like clockwork, I keep having these extreme highs. Not coincidentally, these highs line up with my site changes, so I feel like there's some time that my body needs to get used to the new site area. The first meal that I have following a site change will have me soaring into the 300s like the insulin I gave was nothing. And I spend the next few hours either crying, frustrated, and rage bolusing or some combination of all three.

So I'm contemplating not changing my site immediately when I run out of insulin like I usually do. I'm thinking of changing the reservoir but keeping the site in my skin to avoid the time my body needs to get used to a new site. I know some people change their site every 3 days to avoid absorption issues, but I seem to be having the opposite effect. Pre-pregnancy, I could fill up my 180cc reservoir and make it last 5-6 days, and I've never had a problem with absorption on the last day. With my basal rates up to over 27 units a day and my insulin:carb ratio at 1:6, I'm barely making it three days. As for when I do change my site, I'm thinking I will switch to injections for the first 12 hours for meals because insulin always reacts more quickly to an injection. These are all just tentative plans. I have no idea if this will work.

I know that having rogue 300s now and then are not that dangerous in the long run, but rather the sustained highs for several hours. But it is so, SO hard not to feel emotional when I see that number staring back at me. It might as well have said, "You failed." The emotional aftermath of having type 1 diabetes and being pregnant was something I was not prepared to handle. Trey and I talked last night about spacing out our kids (if God-willing we're blessed with more), and I said I feel like I would need time to recover emotionally more than physically. The guilt, the shame, the frustration with each bad number has drained me. I can't help but feeling like each bad number is hurting her, and I want to fast-forward to getting her out of me.

In the meantime, I'm trying to keep my eye on the prize. I know she's in there because she kicks all the time! The nursery is prepared, and the car seat and stroller have been purchased. I want to know that she will be OK and that I will survive this emotional roller coaster.

I'm ready to put her in here and run away!

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). 

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. 

20 Weeks

20 Weeks, a photo by Arnold_and_Me on Flickr.

Things are really starting to pop around here!

16 Week Goodies

There has been a lot going on this week pregnancy-wise, even though I didn't have an appointment this week (shocking!). I'm starting to feel like I should get paid for going to the doctor, because I'm there enough for at least some part-time pay. Maybe if I learn to do some filing I can save on some of the copays?

First of all, I've really started to pop this week. All of my pre-pregnancy pants cease to button anymore, and I bought my first pair of maternity jeans last weekend (which I L-O-V-E!!!). I'm starting to walk around with my pants unbuttoned with a shirt over the zipper, hoping that no one will point out that my fly is constantly down. I'm kind of glad that I'm finally start to feel pregnant on the outside, instead of from the inside out. Speaking of morning sickness, my pukies have definitely subsided in the past week. But I still have the occasional morning upchuck, which I've come to accept as part of my routine. 

 

My 16-week pot belly.

Also, insulin resistance has started to rear its ugly head. It started out sporadically, so I wasn't sure if it was the real thing or not. But after 2 days with lunch post-prandials in the 200s for a couple hours, I knew something wasn't right. And after a post dinner high of 180 mg/dL that stayed with me for 5 hours, I decided to make some changes. I've upped my insulin:carb ratio from 1:10 to 1:8 and increased my daytime basals by 0.1 units. I don't go back to my endocrinologist until after the New Year, but I can't wait on his guidance to wrangle in these numbers. My changes seem to be working so far, but the lows still plague me. But I'd rather they plague me than any stubborn high.

And finally, I'm getting kicked! I felt what I thought was the first kick last week while Trey and I were out to dinner. However, it didn't really feel like a kick, but more like Ferbie was doing flips inside me. Like when you dive into a pool and do a flip in the middle of the water. They like to do it a lot in the mornings, right after I get to work. For a good 30 minutes or so, I can feel them their doing gymnastics's routine. They also like to do it when Trey gets home from work. It's like they hear his voice and go crazy in there! I know it will be awhile before I feel them on the outside, but I'm loving these little flips.

I don't have any more appointments until after Christmas, so hopefully Ferbie and I can endure the holiday festivities without totally succumbing to the insulin resistance nightmare. In the meantime, I'll be here--getting kicked.

Happy Birfday to ME!

So today is my birthday, and I had an endocrinologist appointment this morning. I didn't exactly want to go to the doctor on my birthday, but my endo's office has very little wiggle room in their schedule. So I went with the hopes that my 8:30 AM appointment wouldn't ruin my first day on my 27th year here on Earth.

The one happy thing I got for waking up that early: SNOW!!! I don't know if we've ever gotten snow this early in Alabama, but it was a beautiful site to wake up to this morning.


I got ready and headed out the door with my thermos full of decaf coffee and freshly place antlers and red nose on my SUV (What?! It's Christmas season, right?). I knew today was definitely my birthday because I got a parking spot on the lobby level of the parking deck, which means I didn't have to travel the four levels, uphill on wet pavement to find a spot.


I signed in and took my spot in the very empty waiting room. Apparently, some patients canceled their morning appointments due to the snow. They called me back right at my appointment time and took my weight. So far, I've only gained 2 pounds since I found out I was pregnant, and I'm 14 weeks along. I'm not sure how I feel about that yet. I mean, I fear the overall weight gain and trying to lose it when the baby is here, but I want to make sure the baby is well-fed while he/she is being baked. My nurse assured me it will go up and I'll certainly be miserable about it by the end of my pregnancy.


Next came the blood pressure check, which I have come to absolutely dread. I've had "above normal" readings for almost a year now that I just come to expect it and justify it with white coat syndrome and move on. But to my surprise, my reading was . . . normal, on the low side: 108/72. "That's good," I said as the nurse put the sleeve back in its holster. Either I'm starting to master white coat syndrome or the lack of caffeine is having a positive effect on my blood pressure.


She started spinning my A1c while downloading the readings from my new pump. We made small talk about Black Friday and baby stuff while I watched the timer go down on the machine. Finally, the machine finished and I got my A1c:

I'm proud of this number, but I'll admit that most of that number has been from lows. I've been tolerating them for the sake of baby, but I don't know how normal diabetics (ha! that made me laugh) tolerate this number all the time. I can't wait until I can get back to the 6s without guilt. My endo agreed that I was having too many lows, even in the short number of readings from my new pump. So we increased my basal rates for now, but we're expecting it to go back up in the next few weeks when insulin resistance hits.

So to recap: snow, killer parking space, stellar BP and A1c reading. All of this before the snow melted. I think 27's gonna be a great year.

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. 

Tube Meet Wires

Tube meet wires, a photo by Arnold_and_Me on Flickr.

How in the world does this happen?! The wires for my earbuds get linked with my pump tubing that's tucked into my pants. Two pieces of technology, reaching out for each other?

Send Me to the Stratosphere

Diabetes is tricky.  ("Duh," you say.)  The math itself is complicated enough to make this gal who has a bachelor's degree in physics and a minor in mathematics bang her head against the wall.  It's non-linear and seemingly has no formula solution.  Nothing is more frustrating!

Such is the case when I forgot to program Arnold for my extended bolus for pizza this weekend.  I must have had my ratios wrong or something, because the first hour after I ate I was chugging juice to keep from going low.  So I decided to forgo the extended square bolus following the initial bolus because I kept going low.  And when I tested before bed at 103 mg/dL, I thought I was set.  I was only missing 1.0 units from my original bolus, no big deal. 

Uh uh.

I woke up at 4 AM with Constance blaring at me, dry mouth, and a slight headache.  She said I was 335 mg/dL and a test confirmed I was 300 mg/dL.  My correction bolus was a little over 3 units of insulin!

How in the world does 1 unit missed equal 3 units for correction?!  It boggles my mind!  Is it like going into orbit away from the force of gravity?  The further away you are from the central force, the less effect it has.  Thus, sending you into a momentum of climbing higher and higher into the stratosphere.  That's my engineering/physics mind trying to figure this out.

Has anyone else noticed this?  Diabetes can get so out of control in a hurry.  Just goes to show how important that initial bolus (before eating) is to keeping a nice streamline on my numbers.   The fact that we can maintain numbers the way we do with a body that wants to live in the stratosphere goes to show how awesome we diabetics are!

I'll Take That A1c!!!

This morning I had my quarterly endo appointment.  But today didn't start out very optimistic and sunny, quite the opposite.  Severe thunderstorms were entering our region and causing power outages across the area.  It's really freaky to be driving on the road and watching the street lights go out!

Anywho.

I get to the parking garage, check my blood sugar (118 mg/dL), and head to the office armed with my Dexcom printouts.  I only wait 30 minutes (woo!) before my name was called.  The nurse takes my weight (I didn't ask her if it had gone down since last time, I didn't wanna know), my blood pressure (122/86), and my blood sugar (118 mg/dL, yay for accuracy!) and A1c draw.  I've written before that it is torture to get my A1c taken at my doctor's because I have the pleasure of watching the timer inch its way down from 5 minutes to 0:00.  My heart felt like it was about to jump out of my chest before I saw the number.

I'll take that. 

"Good job," the nurse said.  "The doctor will be in shortly."  I immediately texted Trey the number, to which he responded, "woohoo!"

My doctor walked in and excitedly said, "Hi, Holly!"  He was obviously pleased with my decrease in my A1c from 6.8% back in February.  He asked me how I thought my blood sugars were doing, and I said I was pleased with them but just trying to avoid the lows with working out.  We also discussed the possibility of me getting pregnant, and my doctor made the point that even though I'm doing well with my control now, that it's much easier to be in control when you're doing it for someone else.  That is so true!  There have been plenty of times where I SWAGed for a piece of cake or didn't wait 30 minutes after taking a bolus to eat because I didn't care about the consequences.  If I were pregnant at those times, I guarantee that I would think twice about SWAGing for the key lime pie.

I was also given a copy of my lab work that I had done last week, and this is the first time I've ever been given a copy of the results.  It's quite extensive, but my doctor said my results were stellar.  I can spend time deciphering all the codes later.  He scheduled my next appointment and left.  I grabbed my mounds of paperwork (Dexcom graphs, pump downloads, and lab work results) and made my way to the receptionist to checkout.

I started getting a little choked up thinking about all the hard work I've done, the hope of a successful pregnancy, and the peace that my body is perfectly healthy despite having a chronic illness. I celebrated my success my grabbing a caramel macchiato on the way to work.

Now, about that coffee addiction . . .

Personal (Under)Wear

The temperatures this week have brought summer ROARING into the southeastern United States.  During these hotter months, I like to wear really comfortable cotton sundresses, complete with a pony tail and flip flops--classy.  However, this presents an issue when it comes to wearing my pump Arnold.  I know some of my gal pal diabetics like to wear a thigh holsters or some Spanx-type shorts with a pump pocket.  To me, both of those options add an extra piece of clothing that I can't handle with the heat and sweat.  So what's a girl to do?

Enter hiphugger underwear!  I'm a rather hippy girl to begin with (and not in the "groovy" kind of way, but in the I've got a nice set of "birthin' hips" as my mom would say), so underwear choice is a very important decision for me.  Not long after I got Arnold, I noticed that the amount of fabric covering my hips was exactly enough to hold Arnold in place in his long-rectangular form with the tube parallel to the floor (have you got the image? because I'm not taking a picture for you).  This set-up is perfect for wearing flowy sundresses because you can't see the pump outline on my hip.  Even though I favor the hiphugger shape in underwear, this also goes for briefs or "granny panties" if you please. 

So why am I sharing this extremely personal information with the entire internet?  Well I just wanted to make sure that every girl sporting a pump is privy to this information because it would be the type of nugget that I would want to know.  Also because this type of information is also great if you don't have PJs that have pockets (which dictates my PJ purchase nowadays).  And if you have another tip for hiding a pump in your everyday wear, then let me know in the comments! 

The Rest of That Week

About 2 weeks ago, I promised to recap the rest of the week after the April 27th tornadoes that came through our area.  So what has happened since then that has prevented me from doing so?  I've been locked away in a lab doing some high voltage tests on flight instruments, unable to keep up with the social media world.  (I'VE MISSED YOU GUYS!!!)  But I do want to give you guys a small recap, because diabetes was in the mix during all that mess. Then I can get back to regular diabetes shenanigans.

The morning after the storms was like camping.  We broke out the Coleman stove and our camping kitchenware and made fried eggs and oatmeal.  We were also able to make coffee using boiled water and our French press (I knew that thing would come in handy one day).  After breakfast, we attempted to begin the cleanup process.  Trey began cleaning up the yard, and I proceeded to cleanup . . . the house?!  As strange as it sounds, it made me feel better during all the chaos to keep a clean house. 

Soon after we cleaned up, we got a call that a relative of ours had an extra generator they could lend us.  So we hopped in the car with barely enough gas to get us there and back.  We attempted to get gas while we were out, but most places were either without power or had lines over 2 miles long.  You'd waste more gas sitting in line than what you would get.  While we were out, I got in touch with most of our friends to make sure they were OK, but cell phone connection was spotty at best. 

Back at home, we hooked up the generator and plugged in all our necessary appliances:  refrigerator, freezer, coffee pot, the essentials.  We also plugged in the radio, which was our main source of communication to the outside world.  Callers would tell the DJs where there was gas, generators, food, etc. 

And when we weren't outside cleaning up debris, we were inside listening to the radio and getting by on our own entertainment.  Trey would play one of his non-online games on his laptop, and I would lose myself in the book Helter Skelter.  I've always wanted to read this book, and this week provided the perfect opportunity.  It's been such a long time since I read a book for fun, and with nothing else to do all day, I would camp out on the couch and read until there wasn't anymore light.  I would even go outside and read on the patio to get the last few minutes of daylight that I could.  I finished the book on the last day before we got power back. 

We eventually settled into a routine each day where we would get up, turn on the generator, make some breakfast, clean up our yard or help out our neighbors with their yard, fix some lunch, hang out listening to the radio while reading or playing, make dinner, and go to bed with the sun around 8 PM.  Showers became something I looked forward to and feared at the same time with temperatures around, oh, freezing.  As some restaurants became open (on generators), we would spend most of our meals out just to escape the house for awhile.  This lead to the decline in my diabetes control. 

The first part of the week, my numbers were awesome.  We were spending most of our time pretty active in cleaning up the branches and tree limbs in our yard.  But towards the end of the week when were just hanging out and going out to eat, my numbers started creeping up.  Also, I was missing one thing pretty vital to my diabetes management--routine!  I was so out of sorts without exercising and carb counting.  I bumped up my basal rates towards the end of the week to account for the creeping, and they've stayed there ever since.  I'm hoping that they can start to come back down now that I can keep a steady routine. 

Six days later we got power back, and 13 days later we got cable/internet.  The debris is (mostly) gone and life has gotten back to (somewhat) normal.  And I've learned several things that I need to be better prepared for another natural disaster:  a battery-powered or hand-crank radio, back-up to my back-up D supplies (thankfully, I just did a pharmacy refill right before the storms), and always ALWAYS have a good book on hand. 

As the cleanup here still goes on and we see the saddening effects of other storms in Joplin and other areas, I hope we all take a moment to be better prepared and remember those who lost their lives.  We were EXTREMELY lucky during all this to only have lost a tree and some meat in the freezer.  Some people lost everything!  I still get a little choked up on my ride home where the horizon of pine trees has been lost to what looks like toothpicks with no branches.  Thanks to everyone who sent me texts and emails asking if we were OK.  Above everything else, I'm so glad to have the love of the DOC! 

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 . . . " 

Hardware Department

I've had my trusty insulin pump Arnold for about 3.5 years now. But about 3 years ago, I noticed that changing the AAA battery out became quite a physical feat. You see, the general directions state that you can use a nickel or a quarter to open the battery cap. However, that little booger would not budge no matter how hard I pushed with George Washington's little head.

So I eventually had to use a flat-head screwdriver to open my battery cap. This works pretty well, except my battery cap gets more stripped each time I change my battery. I keep wondering if I'm ever going to get to a point where I will never be able to open the battery cap and will have to order a new pump, but I always get it open somehow.

Until recently.

This past Saturday, after a rainy day spent indoors cleaning the house, I was applying some lotion after drying out my hands with cleaning solution. When all of a sudden, "BOOP-BEEP-BOOP!" "Huh?! I should have plenty of insulin," I thought. I look down at Arnold and saw the empty batter symbol and "Low Battery" lit up by a green backlight. "Fantastic!" Nothing like trying to open a stubborn battery cap with a screwdriver with lotiony hands. It's like trying to put a cat covered in butter into a bath. Impossible!

After several attempts to open the battery cap, nothing was budging. Of course, my mind immediately goes to, "OMG, I can't get it open! I am going to die! Or at least have to give myself a shot every 2 hours until Monday because I don't have a prescription for Lantus!" I was freaking out . . . a little.

I run out to the garage where Trey was working on one of our cars with black, oil-stained hands. "HELP!" I said, holding my pump in one hand and the screwdriver in the other. "My hands aren't clean," he said. "I don't care. I can't get it open because I have lotion on my hands and I'm freaking out . . . a little." So he takes my pump and unscrews my battery cap while I held the new battery in my hand. He puts the new battery in, screws the lid down, and the screen comes back to life. "Thanks," I said, sighing at the same time. He smirks at me, knowing I was freaking out over something so simple, or to him at least.

Screwy insulin pump.

I do this every time it takes more than 2 attempts to change my battery. I am easily convinced that my life will end because I can never open it. I just need to keep in mind that I have the ultimate Hardware Department just a "Honey . . . " call away. Or maybe I'll just forgo the lotion next time.

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!