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? 

High Risk Outcast

For the past month or so, I'm thankful to say that my pregnancy has been fairly boring.  My weight gain has plateaued (34 lbs.) and so has my insulin resistance (42 units basal, and 1:6 bolus ratio).  The last 2 OB appointments have gone very smooth; in fact, I've spent more time in the waiting room than actually seeing my doctor.  My blood pressure and urine have all come back fine, which I count as a huge blessing.  For most of my formerly-pregnant friends who ended up getting complications such as preeclampsia, the symptoms started showing by now.  So I feel like I've beat some personal goal by making it to 34 weeks and everything about me seems like a normal, non-diabetic pregnant woman. 

But I feel very at home with my OB, and he treats me as a unique patient and doesn't generalize me for my type 1 diabetes.  That hasn't been the case everywhere else.  For example, at our prepared childbirth class last weekend.  Initially, I was very excited about this class because I wanted to get an idea of what to expect during labor (either naturally or induced) and I was anxious to tour the maternity center where I would be giving said birth.  

The class started out great.  We went through the overall process of labor from early labor to transition to PUUUUUUUUSHing.  The morning teacher made me feel like I could handle the type of labor I wanted because it is 90% mental anyway.  Plus, she said regardless of how long ago it happens, every woman remembers the details of her child's birth.  So it's so important to mentally prepare yourself and fight for what you want.  We broke for lunch, and I felt great.  At this point, no one knew I was a type 1 diabetic or that I was considered "high risk".  

Then came the afternoon, and a different teacher took over.  Her job was to talk to us about medical interventions like inductions, epidurals, and C-sections.  I wasn't scared of this part because I figured some of these interventions might be in my future.  Before we got into the part on C-sections, the teacher threw out this random statistic because she had just got back from a conference on diabetes and pregnancy.  "Did you know that 85% of all diabetic pregnancies end in a C-section?"  And she starts the video.  

I lost it.  I looked at Trey and said, "Well, isn't that wonderful?"  Tears began falling down my face.  Snot was running down my nose.  And I had to muffle my mouth from the heaves that were coming up.  Really?!  85 percent?!  So even if I do everything right, I only have a 15% chance of having a vaginal delivery?!  I was distraught and could barely pay attention to the video.  It ends and the lights come on.  I calm myself enough to listen to the cord blood banking guy, the last talk before the maternity center tour.  

I tried pushing that number out of my mind while we went on the tour.  I reserved that I would deal with it later.  One of the reasons I chose the hospital I chose is because a) my doctor is right next door and b) they have these LDRP rooms where every process of labor is done in one room.  I wouldn't have to labor in one room and then be escorted to another room for recovery.  These rooms are great, they're set up like your grandmother's bedroom with a quilted bed, rocking chair, and warm decorations.  The same afternoon teacher told us that these rooms have everything that a typical LDR room has, but you get to stay here the whole time after baby is born.  "However, we typically only use these rooms for our low-risk patients."  I raised my hand and revealed myself to the whole class.  "So with me being type 1 . . . "  She responded, "Yeah, it's unlikely you'll get to use these rooms."  Again, I was shot down due to my category and nothing to do with me.  

Trey and I got in the car and headed home, and I felt like I had completely wasted the entire day.  I felt so defeated.  I don't care if I have to have a C-section or have to be quarantined to a room deemed suitable for high-risk patients if my daughter comes out healthy and safe.  BUT.  I feel like my story has already been written even before I'm there.  I want to have some say in how my body is dealt with, but right then I felt like I was just at the doctor's will.  I cried the whole way home, and that's a long 30-minute drive.  

Thankfully, I had an OB appointment this past Monday, and I basically told him everything that happened at the childbirth class.  I told him I felt very discouraged.  My doctor, always the sensitive guy, looked me in the eye and said, "That's not true.  That 85% MIGHT be true for uncontrolled diabetics, but definitely not for you.  And you have the choice to use the LDRP room, I'll see to it.  As far as I'm concerned, you have a good chance at a vaginal delivery."  I dried my eyes that had been wet for the past 2 days, and made my appointment for 36 weeks.  My endo even told me that given how good my pregnancy has gone, he would let me go to 40 weeks no problem.  

I know I shouldn't let these things get to me.  I should be used to people generalizing diabetics into some doomsday category.  My story is still unwritten.  I want every pregnant type 1 to know that they don't have to submit to anything that "should be" just because of our category.  We are high-risk, not "high maintenance enough that we don't want to give you a chance".  Several people have already asked me if they were going to take my baby early or if I have a C-section scheduled.  No and no!  If you take away this stupid disease and just look at ME, I am 100% healthy and so is my little girl.  Let's take off the vial glasses and look at ourselves as individuals.  Because as one of my good friends says, "Diabetes doesn't define me (!), it just explains me." 

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!

Don't be Afraid to Pee

Well, this post is by far the most embarrassing post I've ever written.  It seems that everything is on high alert with a diabetic pregnancy, or maybe just in my mind.  But the two questions my OB always asks me at my appointments are "Any bleeding?" and "Any loss of fluid?"  I didn't really understand what "loss of fluid" was, so I asked a nurse to clarify.  "Oh, it will feel like you peed yourself."  Lovely.  So be prepared for an extremely TMI post. 

This past Sunday, I was sitting in church and listening to the sermon, which was titled "Do Not be Afraid".  We're currently doing a sermon series on trusting God and not being afraid of death, rejection, etc.  When we stood up to sing the last song, I felt this "gush" of liquid.  I turned to Trey and said, "I'm going to the bathroom".  I'm sure he thought I was doing the typical pregnancy thing of going to the bathroom every hour or something.  

In the bathroom, I checked but couldn't tell if anything was wrong.  I called the on-call doctor as soon as we got out, and he said it might be urine but said to keep an eye on it for the rest of the day.  If it was my water leaking, it would be continuous and not one time.  Having my water break this early is a scary thing because it means my baby would have to be delivered within 24 hours, not OK with me!  So I cautiously went about my day, cleaning the house for a Super Bowl party.  I also laid down for a nap later, and still no more "gushing", thankfully.  

I called my doctor's office the next day (yesterday) to see if he confirmed the on-call doctor's instructions.  And I wanted to at least let him know that I had this issue.  He said if it happened again to go straight to the hospital to be monitored.  I wasn't sure if I could take this as a relief or instruction to be more cautious and aware.  

Yesterday, I went about my day, trying to ignore what didn't happen the day before.  I took the dogs for a walk, and Trey and I went to dinner with some friends.  When we got home, I tried to decipher if things were more "wet" than normal.  It could have seemed like more from sweat from my walk or more pee or more whatever.  I finally settled to just go to the ER and have them check me out, since that was my doctor said to do if I felt that it occurred again.  

After being admitted, putting on a gown, getting hooked up to a fetal monitor, and answering the bazillion questions required to be admitted as a patient.  They took a swab to test to see if what I was experience was my water leaking or something more embarrassing but less scary.  

I hung out in my labor and delivery room (somewhere I didn't expect to be for very long time) and watched Castle while I waited for the results.  It was getting really late at this point, and I started to feel silly for creating an ordeal for something that is probably all in my head.  The nurse came back and said, "Well, it's not amniotic fluid."  

So they let me go home with instructions to come back if I felt anything like that again and assurance that I did the right thing.  That helped, because I was feeling extremely embarrassed for spending two hours in the ER over the fact that I simply peed myself. 

I Still Get Scared

You'd think being 23 weeks pregnant with a lively, kicking baby would make me feel like I'm "in the clear" as far as anything happening to her or losing her.  But I admit that I still get scared, of what I don't know.  I just never fully shook the feelings of the first trimester when I was in the "danger zone" until that first appointment.  I felt good after that appointment, until a few days before the next one.  The day and morning before an appointment, I'm a wreck.  I am so overcome with anxiety and worry.  "Is she still OK in there?  Is she getting too big?  Is she too small?  Why haven't I felt her move in awhile?  Is that stubborn high from last night going to do something to her?"  

But as soon as I hear her heartbeat, my fears are instantly eased.  My mood leaving the OB's office is a 180 degrees from coming in.  I'm good for a few days, feeling confident and less like I'm a high risk pregnant woman.  But then the cycle starts all over until my next appointment, which is tomorrow.  So you understand where this post is coming from now? 

The other thing that makes feel scared all over again is if I have a bad day with diabetes.  Like yesterday, I got to work and glanced at Constance before I ate my yogurt, and I also looked at my 24-hour graph and I had only gone high once in the past day (and just for the record, my high threshold is currently set at 160 mg/dL, tight control is a beast).  I was feeling pretty good about everything.  The little monkey inside me was extremely active the day before, my numbers were good, and I am sporting a nice baby bump that feels huge to me but everyone else says is "so little".  Then I went to lunch with my husband and a friend and we picked a Chinese buffet.  (You can see where this is going.)

I didn't go crazy at lunch.  The most carb-heavy things I had were some fried rice and some ice cream for dessert, other than that I stuck to my obsession when it comes to Chinese food--egg drop soup, delicious and low carb.  I SWAG bolused for the meal and added a few units that I call the "pregnancy factor", but I still ended up with a stubborn afternoon high that took me several hours to come down from.  I got scared, and the first thing I want to feel when I'm scared is her kicking me or jabbing me or anything that says, "Hey, Mom, I'm right here and I'm OK."  

It seems that I need to be on my game everyday to avoid these episodes.  Test my blood sugar, take my insulin at least 30 minutes before I eat, know the carb count, correct for lows without over-correcting, exercise.  I feel like if I slip in any one of these areas that everything falls apart.  I didn't get back on track until this morning, and I'm carefully watching my CGM like I did the first week I had it.  I don't like feeling like I can't handle one slip-up without a major emotional breakdown.  

I'm hoping my appointment tomorrow will put me at ease, that I can get back to feeling confident with this pregnancy and ready to do my victory lap of conquering a diabetic pregnancy once she's here.  Because after tomorrow's appointment, I can officially pack the hospital bag.  Not that I'll be expecting to use it for a very VERY long time, but her rate of surviving outside the womb goes up after 25 weeks.  Maybe once she's here I'll stop worrying . . . right . . . RIGHT?!?!?!?!?!!?

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. 

Cry Me a River

I've always been a pretty emotional gal.  It doesn't take a lot for me to shed a few tears, especially when I'm stressed out.  So when I got pregnant, the gamut of my emotions hit a whole new level thanks to all the lovely hormones.  Here is a list of things just in the last month that have left me shedding enough tears to fill a trough: 

• My vacuum broke.  I've had this thing for over 5 years (hey, it's a Hoover) and it's served me well between my apartment and the two houses I've lived in since being married.  But recently it refuses to pick up anything.  I will spend 45 minutes vacuuming the whole house, only to still find a layer of dog hair on the top of the carpet.  I broke down and swore to make all our pets outdoor inhabitants for the rest of their days. 
• I literally have not had time to go grocery shopping.  I don't know what it is about this time of year, but we have something going on every weekend for the rest of 2011.  So I spend my week nights catching up on laundry and taking care of the animals that by the time I think about heading to the store it's already 8 PM.  Plus the fact that it gets dark immediately after lunch, I just want to go home and hide.  
• Any blood sugar over 250 mg/dL.  While my A1c is the lowest it's ever been since birth, it certainly hasn't been without some scary highs that seem to be magnified with being pregnant.  I usually get frustrated after the number doesn't come down after 5 minutes and I put my basal on 200% and stare my Dexcom into falling.

• Feeling the baby "bubbles".  That's right, I'm 15 weeks along, but I'm pretty sure I felt little Ferbie doing flip flops in there yesterday.  I tried to hold my reaction to a smile, but I ultimately started crying.  It seems even happy things lead to tears.  My make-up has no hope of staying on all day.  
• Christmas songs.  I can't handle it!  I freaking tear up anytime I hear "The First Noel" or "All I Want for Christmas is You".  This whole magical season has turned me into a sentimental basketcase.  Thank God I haven't heard "Christmas Shoes" yet or I'm sure I'll just melt into a puddle. 

I know these swinging emotions are just part of the process and ultimately a temporary thing for this little person inside of me.  I just hope he or she is used to having a momma with some wet cheeks, because I think it's only going to get worse when they get here.   The crib bedding we decided on arrived in the mail yesterday, and I'm keeping this thing in the plastic for now to save it from my tears. 

What Makes My Heart Skip a Beat?

I had never been more nervous for any appointment than I was before our first ultrasound appointment.  I don't know why I was so nervous.  I suppose because up to that point, it hadn't been "real" yet.  Sure, I had been puking like a champ everyday for two weeks, but the idea of actually having another life inside of me hadn't hit me.  I was also worried that things weren't going to be 100% perfect--a product of living with an imperfect condition, I guess. 

The nurse called us back to the ultrasound room where I hoisted myself on the table and held my breath.  The entire room was dark except for the screen facing away from me, towards the technician and Trey.  I waited anxiously while she looked for the baby and, more importantly, a little heartbeat.  A few seconds later, she said, "Oh yeah, there it is."  She turned the screen towards me, and what I saw absolutely took my breath away.  It was the tiniest little peanut with a flicker on the left side.  Seeing the heart actually move at its own rhythm caused me to instantly break out some tears.  Instantly, I felt the need to apologize.  "You're probably used to this, right?  Pregnant women crying?" 

She printed out a few snapshots of the little peanut for us to take home (which now are proudly being displayed on our refrigerator).  While we waited on the doctor, Trey and I kept looking at the pictures and smiling at each other.  This was real.  This was happening.  Holy crap! 

The doctor walked in and said, "That's a good looking baby!"  He let us ask a plethora of questions, from who should take over cat litter duties (Trey gets to take it on for the next 7 months. *score*) to how long before the puke fest should subside.  The last question I asked him was the most important one in my mind, "Have you ever done a type 1 pregnancy before?"  I knew my OB was high-risk, but this question was important because it was personal to me.  I needed to know his experience with "my kind". 

He looked at me, one eyebrow up, "Of course!  I've been around for over 20 years, and have certainly seen my share of type 1s."  Actually, he said that type 1s are usually some of his healthiest patients because they're diligent about their health before they're pregnant.  I've always loved my OB, but seeing him that day made extremely grateful to have him as my doctor in this process. 

We got to see little Ferbie (yes, my creative nickname.  better than "it".) again yesterday, and the little teddy graham was dancing in there like it was doing hula hoops.  I'm already proud of this little squirt. 

Sounds Like a Dinasour

Because of my diabetes, I'm automatically put in the "high risk" category for pregnancy. Therefore, I get to enjoy all of these extra tests, beginning with blood work immediately after I find out I'm pregnant to see how "pregnant" I am. The two variables they check are hcg, which basically measures how the baby's growing, and progesterone, which measures how my body's supporting the pregnancy.


They did back-to-back bloodwork to make sure my levels were doubling or at least rising. I'll be honest and say I didn't know anything about these variables or what they should be during pregnancy. All I could think of was that "progesterone" sounded like a name of some dinosaur.


 

"Rawr, I make babies grow."

My first results were fine, right on schedule for where I should be. But my second results were less than stellar. My hcg levels were fine, almost doubling from 500 to 970. But my progesterone levels actually went down from 18 to 12.


The nurse prescribed for me to go on progesterone supplements to get my levels back up above 15. Even though she said it is normal for those numbers to go down, I was still freaked out. If this is normal, why am I being put on supplements? I googled progesterone levels and what they should be at this point in my pregnancy. Big, big mistake. Never ever google anything related to your health, especially pregnancy. I pretty much scared myself into stressing out and crying at random times (of course, that could be the pregnancy itself). I was also dealing with a weird complex of taking these supplements and wondering "Am I not woman enough to carry my own child?"

I went back in for more blood work the next week to make sure my levels were still rising. I had to wait 24 hours for the results: torture! I had less than a day's worth of supplements in me, so I was worried about the time between my last blood work that was 4 days ago. However, I got the best call the next day. "Hello Holly? Your results are wonderful. Your progesterone increased to 25 and your hcg increased to 9,000!" I was so relieved! The next set of blood work they took the next day made the nurse sing, "Your results are out-stand-ing!" Progesterone stayed the same at 25 (the nurse said that was fine) and hcg increased to 18,000.


These results made me so relieved! Also, the fact that my progesterone levels doubled in 4 days mostly from me (and not the supplements) made me feel a lot better. And the fact that the hcg levels (a.k.a the baby) increased out-stand-ing-ly made me feel like he/she is doing great regardless of my shortcomings.


All in all, I'm somewhat grateful to be placed in the "high risk" category because of my diabetes. It means I get the comfort of extra monitoring and testing that lets me know that the baby and I are doing OK. It can be stressful if there are any hiccups, but the doctors can do their thing to help me or the baby before anything bad happens.

Music Therapy

I love listening to music!  I'm not musically-inclined at all (minus that one year I played flute in junior high), but I definitely feel my soul lifting when I hear a good song.  I gravitate towards songs that have some inspiration behind them.  One of my favorite artists right now is Manafest (a Canadian Christian rapper, eh?), and I'm really digging on his new song "Every Time You Run".  I've heard this song a couple times before, but today when I heard the chorus I thought about the DOC. 

Every time you run, every time you hide

Every time it hurts, every time you cry

Every time you run away, every time you hide your face

And it feels so far away, I'm right here with you

I know we all experience some bought of diabetes burnout at some point or another.  When I heard this song today, I just wanted to give everyone in the DOC a big hug and let you know that we are here together.  We are in this together.  You can lean on us whenever you just feel like throwing your hands in the air and saying "Forget it!"  I love you, DOC, and I'm right here with you.  

The Day the Dexcom Died

One of the great advantages of having a CGM is being able to monitor my blood sugar during off-routine times. like a beach vacation.  So when receiver went kaput on me our 2nd day there, I felt completely vulnerable the rest of the trip. 

At least it was serene. 

Let's back up a bit.  One of the things I love to do at the beach is ride the waves on a boogie board.  It's exhilarating and it's a great workout.  Even thought I can't take Constance in the water with me, she can keep up with me when I get back to my chair.  However, the heat of the sun on the receiver sitting on the beach chair is something I didn't consider. 

The receiver was fine the rest of the day, but it did give me some off numbers towards the night.  When I did my nighttime test before bed, I got an ERR1 message.  Not wanting to stay up another hour to recalibrate, I shut down my receiver with intents on calibrating in the morning.  But when the morning came, I couldn't turn on the receiver.  I held down each button multiple times, for longer than I needed to.  I finally called tech support, and they instructed me to try the reset button the back of the receiver.  Nothing happened. 

My receiver was fried. 

Unfortunately, my system was out of warranty.  So that meant I would have to start all over and get insurance approval and chart notes from my endocrinologist.  That was probably the worst news from this whole situation.  The last time I went through this process, I waited a month while the paperwork sat on my endo's desk.  I kind of assumed I would have to go through that all over again. 

But this also meant that I would have to revert back to my pre-CGM management routine, including testing 2 hours after a meal like clockwork.  I know that you're not supposed to rely on the CGM in place of finger stick testing, but I would find myself relying on it more and more, especially if the CGM was proving to be accurate.  My numbers the rest of the week were less than stellar, but not outrageous.  I had high numbers after breakfast, which is typical for me with the absence of exercise.  I did miss being able to monitor my BG when it wasn't in-range, relying on testing every hour or 30 minutes for a correction.  Those gaps in time were excruciating, but I managed the best I could.

On the last day of our vacation, I got the best call.  My Dexcom rep told me that my insurance was still going to cover most of the cost of my new setup and sensors, AND my endo had already signed my paperwork needed to submit to insurance!  I was elated.  And this all occurred on a day that my endo's office is normally closed.  He's really been on his game, especially since I've been discussing the idea of pregnancy. 

I should receive my new Dexcom system next week.  I can't wait to get back to being a real-time diabetic.  Next time, though, I think I'll leave the receiver in my room, or at least get it its own hat. 

Stress and Diabetes

The past 2 weeks have been super stressful, feeling like I've been stretched at every limb.  Multiple projects at work combined with house renovations going on at home has me searching for a hole to crawl in to avoid them all.  It literally feels like I have a ball of wires strapped around my neck, and the wires have choked me to point I can barely breathe.  Monday was really bad because I was searching for a boarding kennel for the pups for a trip out of town this weekend.  They've never been boarded before, so I was stressing out about trying to find the best one in town. 

And thanks to the tornadoes that came through in April, we've had the joy of getting our roof replaced and some drywall redone.  For both of these events, I was at home "supervising" the contractors (re: I hid in the guest bedroom with my Nook) while listening to the banging and sawing on all sides.  Then, when I would come out of my escape, I would see the house in a mess.  Nothing stresses me out more than strangers causing a mess in my house.  NOTHING!  After the drywall contractors left, Trey and I had to leave for a movie date (Harry Potter, DH2) so I couldn't immediately start cleaning up like I wanted to. 

I started noticing the stress in my numbers when I was waking up in the 170s.  I knew I had 2 options:  increase my basal or try to reduce my stress level.  I can tell when I get really stressed because I become physically exhausted.  And it hasn't helped that I haven't been able to work out as much with everything going on the work/home fronts.  I was able to make my softball game last night, and even though we lost, I could instantly feel some relief from all the stress.  My numbers felt the relief, too, because I cruised in the 70s overnight.

Unfortunately, the stress isn't over yet.  Between the trip this weekend, family visiting next weekend, and trying to stay above water at work, I need a game plan.  I've decided that I am going to workout on my new Total Gym first thing when I get home, regardless of how much I just want to plop on the couch and not move a muscle.  I need to clean the house.  I need to get the carpets cleaned.  I need to make sure we have enough towels for 8 people being in my house all at once.  However, I first need to take care of me, and that includes taking care of my diabetes.  But I also need to take care of my mental health. 

The correlation between diabetes and depression is too strong to ignore.  I feel so much better when I can strap on my earbuds and jam out to P!NK while busting it out on the elliptical.  I can feel the tangled ball on my neck begin to loosen and I feel like I can handle things better than before.  I just need to keep in mind that this season of stress is only temporary and my beach vacation is only 5 weeks away.  I need to staple that vacation pamphlet to my forehead. 

Surving a Tornado: A Diabetic's Tale

There is so much to be recapped that happened last week.  I've thought for awhile how to try to write about it, and the only way is to give a recap of that day, April 27th.  For those that don't know what I'm talking about, a multiple tornado outbreak struck Alabama last week, killing hundreds and displacing thousands.  Our area was hit pretty hard, but we came out of it extremely lucky.  

Wednesday, April 27th, 2011

Got up that morning and it was already raining.  I let the dogs out to pee and let them eat in the garage.  I get ready for work, all the while the radio breaks in with tornado watches and thunderstorm warnings in our area.  The National Weather Service gave our area a tornado potential of 9 for today (out of 10).  I debated leaving for work until this line passed, but it ended just as I was packing my lunch.

Get to work and continue to watch the radar, which isn't hard with an office full of weather geeks.  Another line was coming through at 10 AM.  I watched its path intently, but it seemed to go north of us.  I called our neighbors to see if our dogs were still OK outside.  They said they couldn't see them, but they barely got any rain anyway.  They asked me if I wanted them to let them in before the next line was to hit at 12 PM.  I said they didn't have to, but it would be a decision I would later regret. 

At 11:30 AM, a tornado warning was issued for our area, and we got an announcement to make our way down to the basement.  I grab my things and head down to the very stinky basement with the rest of my colleagues.  We all crowd around smart phones as we try to watch the radar.  The rain outside was pounding.  We tried to keep ourselves entertained as much as we could with Angry Birds and conversation while the storm passed.  Then someone said something that would make my heart sink, "A tornado has been seen on the ground northwest of us."  My heart sank.  Even though we were safe, my mind immediately jumped to our house and our two dogs outside.  I texted Trey that I was going to leave as soon as it was safe to do so, my hands were shaking I was so worried. 

I was finally able to leave my office at 12:30 PM, but it took me over an hour to get home due to the debris that had already blocked the roads.  It was the longest hour of my life.  With each turn that I made, I saw more destruction.  Five foot diameter trees were uprooted.  Fences blown over.  Powerlines were sagging where the posts were snapped.  The whole time, I was just trying to maintain my sanity.  If that house had their fence torn apart, surely ours wouldn't have made it.  I kept thinking of all the trees in our backyard, and seeing several trees on tops (and through) people's homes.  I felt tears begin to fall down my face as I got closer to my street.  I had to drive in the middle of one street where the sides were beginning to flood.  One more road to go, but in my heart I had already prepared myself for the worst when I got home. 

I was about to turn on my street where a line of cars were being stopped by a policeman.  Most cars were trying to go straight to get to the main road, I was trying to turn left to my house.  "Where you headed?" the policeman asked.  "I live down there, on the left."  "You can try, but it's blocked a ways up there."  I didn't care, I would run a mile if I had to.  I just wanted to get home.  I came over the hill before our driveway, and the powerline across the street had been snapped in two and was draped across the road.  I parked in our neighbor's driveway, and I saw Roscoe coming out of some bushes next to the house, barking at me.  Missy was not far behind him.  "Thank you, God!"  I ran across the flooded ditch in my dress pants and heels, turned the key, and ran to the garage.  I let my dogs in and fell on my knees and broke down.  I probably cried for a good 5 minutes, embracing my soaked, muddy dogs like they had just come back from the dead.  I attempted to dry them off with some towels, but we didn't have much time before the next line was about to come through. 

I gathered all 4 pets, my phone, and a flashlight, and crammed all of us in our bedroom closet.  Trey was still at work, but they had lost power.  He said he would attempt to come home after this next line came through.  I have to give big props to my friend Jessica for keeping me informed through the storm.  I was unable to locate a hand radio before we needed to take cover, so she texted me while I was in the closet and kept me informed of the storm's location.  I was able to peek out of the closet one time, and the rain was coming down so hard I couldn't see past our deck.  It was like being inside a car wash, and all you see is the water streaming down.  The power was already out, so I lied down in the closet with the little LED flashlight. 

At this point, I have to admit, I was scared.  The wind was howling outside, with faint sounds of cracking--I knew it was trees being snapped.  As I sat in the closet listening to the storm, I began to pray.  I had never been through a storm like this before, and I had already seen the destruction from the previous line.  I wasn't scared of dying, but I was afraid of how.  I prayed that if this was my time to go, that God would send an angel to take my body before I felt any pain.  I wanted my soul to be taken just before the tornado would hit our house.  Tears began rolling down my face.  I couldn't believe it, I was ready to die. 

The storm eventually passed, but I was still in the closet.  I was about to fall asleep, using Roscoe as a pillow, when I heard, "Holly!"  I jumped out of the closet and ran down the hall, Trey had made it home safe and sound.  With a few minutes of daylight left, we went outside to check on our neighbors.  Our across-the-street neighbors had a tree fall in their dining room, but they had already tarped over it.  Our next door neighbors also had a tree fall and graze their house.  We had a tree fall on our back fence. 

Now that the storms were over, we geared up for what was already predicted to be a long hiatus without power.  We got in my car to try to drive around our street so we could park it in our driveway.  As we turned the corner down our street, I broke down.  The devastation was overwhelming, and we didn't even know the extent of it yet. 

Next, I'll focus on the following week:  the cleanup, running on a generator, cold showers, rekindling my love of reading, hauling trees, and how my blood sugars played during all this. 

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. 

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.

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.

"Please, sir, I want some more."

The past day has been a whirlwind for me with my endo and getting a new test strips prescription.  It actually all started on Sunday when I went by the pharmacy to pick up a new refill for all things diabetes:  insulin, syringes, strips, and glucagon.  The cashier hands me my bag o' diabetes and I double check the strips amount because a lack in communication has occurred before.  I peek in the bag and notice that I'm short 50 strips.  I asked the pharmacist why I only had 150 strips when my prescription was written for 200x/month.  Turns out my endo wrote in parentheses after 200x, "test 5x/day".  So my insurance company interpreted that to mean only 150x/month. 

I figured this was a simple glitch on my endo's part.  So I called his office first thing on Monday morning to ask the Rx to be rewritten.  I leave a message on the nurse's voicemail, "Hello, this is Holly, birthday eleven twenty-nine nineteen eighty-four, pharmacy is 'such-and-such' Pharmacy on 'blankity-blank' road, and I need Dr. Special (not his real name, but he has a 'special' sense of humor) to rewrite my prescription for strips from 5x/day to 6x/day.  Thank you!"  Well, the little voicemail message said to allow 48 hours for prescription requests.  So I (not-so) patiently waited until Wednesday afternoon to call my pharmacy to see if the prescription had been changed.  "Yeah, I don't see anything from your doctor," the pharmacist said.  So I braced myself for calling my endo's office . . . again.

This time I refused to be sent to a mailbox, so I optioned for the receptionist to get a live person.  "Hi, this is Holly, I'm a patient of Dr. Special, and I called on Monday to have him change my prescription for strips from 5x/day to 6x/day and that hasn't been done yet?" I inquired as if asking, "And why hasn't this been done yet?"  I get put on hold for a few minutes and the receptionist comes back and says . . .

"Well, his nurse said that 5x/day should be enough since you're wearing a monitor and only need to test 3x/day."  

I stumbled for words before I finally said, "Uhhh yeah, that's not going to work for me.  I want to have 6x/day."  Nevermind the fact that CGMs are not meant to replace finger stick tests, what made me mad is that I told my endo at my last appointment that I wanted 200/month and he didn't even blink!  I really didn't appreciate that he was changing my prescription without talking to me first.  Well the little receptionist said, "We'll need to talk to the doctor about this.  We'll call you back."  Yeah, OK.  This was about 2 PM yesterday, and I never heard back. 

I was steaming after that phone call!  Forget about lowering my blood pressure!  Every vein in my body was pulsing with rage, frustration, and sadness.  Three times a day?!  Sometimes I test that many times before breakfast!  I mean I love Constance and all, but she is not accurate enough for me to rely on her 100% of the time.  The fact that my endo would suggest this meant to me that he is ignorant of the purpose of CGMs and was abusing their purpose.  However, this information was being relayed 2nd-hand through his nurse and receptionist.  I could only HOPE this was a huge error in communication.  

I called again today after lunch (giving them plenty of time to call me back) to see if I was about to make the decision to change endocrinologists.  I get the receptionist on the phone and she said, "Yes, a new prescription for test strips was sent to your pharmacy for 6x/day, 200x/month."  "OK, thank you."  So I have my strips, for now.  But I hope at my next appointment in June that my endo doesn't allude to me needing to test less because I wear a CGM.  It's an extra tool, not a replacement.  It would be like trying to use a screwdriver as a hammer, it just doesn't work the same way.  But I should trust my endo to know that! 

As much as this infuriates me, the last thing I want to do is change endocrinologists.  The next closest options for me are another office 45 minutes away or a university hospital 2 hours away!  I know my endo is not the best endo I could possibly have, but he's honestly all I've got.  And I really don't want to go through the process of changing doctors at this time in my life (see also:  planning for pregnancy).  But right now I feel like Oliver in the orphanage asking for more gruel.  I feel like I'm being punished and put through the mill for wanting to take better care of myself than what 3x/day would result. 

"Yeah, I'm gonna need to see a copy of your insurance card first.  Mmmmkay?"

Dealing with Insurace Company Phone Reps

As a PWD (person with diabetes), I rely on having insurance to cover most of my medical bills.  And by rely, I mean I expect certain things to go off without a hitch.  Like getting pre-certification for physical therapy, for example. 

My initial visit with my physical therapist was what was called a "diagnosis/recommended therapy" visit.  This means that my physical therapist (PT) took a look at my knee, how I walked, and muscle structure and submitted a recommendation to my insurance company of what kind of therapy I needed.  Said insurance company then receives the recommendation and submits a pre-certification back to my PT for said therapy.  This process, in ideal theory, should take a business day (two at most) to get done, especially when you're expected to get 3 sessions of therapy a week for 4 weeks before the next orthopedic appointment in 6 weeks. 

But . . .

Unless you stay on top of the insurance company like a rabid zombie gnawing on their neck, this process could take 2 weeks if left unattended.  The initial call to my insurance company from my PT resulted in them telling my PT that this process would take 4 business days.  This was somewhat annoying because it meant I was going to miss half a week of therapy (2 sessions) before I could come back.  Well, 4 days come and go and my PT's office calls my insurance company again, inquiring about the pre-cert. and the very vague just-trying-to-get-you-off-the-phone answer was given, "It's in process."  I hate getting this answer from anyone!  Where in the "process" is it?  How much longer should I expect to wait?  Why would you give a timeline of 4 business days, miss the deadline without notifying us, and cease to apologize?  It's absolutely a slap in the face to say "It's in process"!

So my PT's office calls me to let me know that I would have to cancel another schedule therapy session because they were still waiting on my pre-certification.  I had turned from annoyed to infuriated.  Being the very involved patient that I am, I asked for the number of the authorization office to take this matter in my own hand.  I prepared myself for the inevitable bad mood that was about to follow this phone call, but luckily this comic strip gave me a giggle. 

I called the number, went through the voice-automated responses (several times I got "I'm sorry, I didn't catch that."  Well, learn the Southern dialect Ms. Stick-up-your-butt Robot!) until I finally got a real person, in some department.  I didn't really care which department, I just wanted a live person!  Now, what irks me about calling any customer representative department is that they ask you several questions before you can even begin to ask yours. 

Below is an (exaggerated) retelling of the phone call to my insurance company customer service number:   

CR rep:  "Hello, this is Monica (names have been changed to protect the guilty), can I have your name, address, member ID number, and blood of your first born child?" 

Me:  "Ummm, my name is Holly, my address is . . . , my member ID number is . . . , and I currently don't have any children, would the blood of one of my cats do?" 

CR rep:  "Certainly!  What can I help you with?" 

Me:  "Well, I've been waiting on a pre-certification for physical therapy that my orthopedist recommended for me, and it's been 4 business days since my PT's office called for that.  Where is it?" 

CR rep:  "Let me see . . . *clickity click click* . . . hmmm, I don't see where that request was made." 

Me:  "No, it's there.  I just got off the phone with them, please look again." 

CR rep:  *clickity click click* . . . Ahhh, yes, there it is.  I just had actually LOOK at the computer!  Haha, silly me.  Yes, it appears the request is in process (grrrr!!!) and it usually takes 7-10 business days to fulfill this request." 

Me:  "7-10 business days?!  My PT's office was told 4, why is it taking so long?" 

CR rep:  "I don't have that information in front of me, that would be with the Authorizations Office." 

Me:  "Well, can you transfer me to them, please?" 

CR rep:  "Oh no, they don't deal with members directly, they only deal with providers." 

Me:  "Well, can you transfer me anyway?  My provider has tried calling several times already." 

CR rep:  "I can see.  Please hold." 

*really bad elevator music plays*

CR rep:  "Yes, I'm sorry, they won't talk to members directly, they only deal with providers." 

Me:  "Yeah, I don't care, I still want to be transferred and let them know that my provider is waiting for it." 

CR rep:  "OK, but they won't want to talk to you." 

Me:  "I don't care, they're GOING to talk to me.  Please transfer me." 

CR rep:  " . . . Please hold." 

*extremely bad elevator music plays* 

AO rep:  "This is Jennifer, can I have your name, address, member ID, and left ovary please?"

Me:  "Left ovary?  Why?" 

AO rep:  "Standard procedure, ma'am." 

Me:  "Ummm, OK.  I am calling about a pre-certification for physical therapy.  I was told it is in process, but I was wondering if there was any way to speed the 'process' so I don't miss physical therapy." 

AO rep:  *clickity click click*  "I'm sorry, that request is not here." 

Me:  "No it is there, the person I talk to before you said it was.  Please check again." 

AO rep:  *click*  "I'm sorry, it's still not here.  You need to have your doctor call to request it." 

Me:  "He HAS requested it!  It is there!  Please.  Check.  Again." 

AO rep:  "I'm sorry, ma'am.  It's not there.  I have looked."  *click* 

Me:  "Hello?  HELLO?!  Son of a . . . !!!"

Yes, I was hung up on, by MY insurance company rep.  I was fuming!  This company is there to serve me!  I am their customer, and they practically spat in my face!  I was never rude or cussed, I just kept asking for answers to my problem that no one could give me.  But I learned a few things about getting some results out of dealing with calling your insurance rep: 

• Be polite, but firm.  I never cussed or raised my voice.  I always ended everything in "please" and "thank you".  This gives them no reason to refuse your request. 
• Refuse to end the call until you receive an answer.  I didn't care if I would eventually be transferred to the head of the company, I was going to talk to someone until a) this matter was resolved or b) 5:00 PM, whichever came first. 
• Have your insurance card handy.  By the end of the call, I about had my member ID memorized.  
• Be patient.  I'm saying this to myself as well, but I refused to let another day go by without an answer.  

My PT's office called me this morning at 9:00 AM and told me that the pre-certification had come in.  "I don't know if it had to do with you calling them, but we got what we needed!"  Oh, I'd like to think that I DID have something to do with it.  ;-)  

Spinning? Insane!

So I bit the bullet yesterday and attended the spinning class I talked about.  I was actually nervous all day about it, checking Constance to make sure I was going to be at a good number before the class, and taking mental notes about my knee.  I had done some lunges the night before, and my knee was (not) thanking me for it.  But I decided I was at least going to try. 

I get to the gym and take a number for a bike; apparently, you have to reserve a spot for this class.  Another guy took a number for the class, and asked me if it was my first time.  "Yeah," I said sheepishly.  Well, the very nice gentleman gave me the run down on the bikes, how to adjust my seat, and how nice the instructor was.  "If you haven't warmed up your legs yet, I'd suggest doing so.  This class can get pretty intense," he advised.  "Thanks, but I just warmed up by doing the half-mile trail outside."  Before this, I had disconnected from Arnold in order to be "unplugged" for an hour by the time the class started.  I didn't want to take any chances of going low.  I checked my blood sugar before the class:  135 mg/dL--perfect, a little high but not crazy.  And I had Constance neatly tucked into a thigh holster I had purchased for my wedding: 

Apparently my pump and CGM are the same size in spandex. 

The instructor was running late, so the rest of the class members just started pedaling at their own pace as a warm-up.  I followed suit, making sure my feet were properly strapped in.  The instructor finally shows up, and the nice gentleman who helped me pointed me out to her as "We have a new person!"  Greaaaaaat, nothing like calling me out to the whole class to make me feel welcome.  She welcomes me and proceeds to tell me that my seat is too low.  We adjust my seat together, and she takes her spot at the front of the class. 

Now, anytime I've ever seen a spinning class on TV, I've always imagined a very sweaty Nazi-type lady with a perfect physique welling at everyone, "Faster!"  Turns out the devil wasn't the trainer (she was very nice), it was that stupid resistance knob!  After we warmed up, the instructor told us "Half a turn" and we would pick up the pace, standing on the bike, sprinting like our life depended on it.  My legs felt like they were on fire!  I honestly felt like stopping at one point, then the instructor said, "Twenty more seconds, all you've got!"  I thought, "I can do 20 more seconds."  I used that mindset the whole class when I felt like it was getting to be too much, "Just keep going, a few more seconds." 

We ended the class doing "jumps", which means anytime the instructor said "Up!" we had to stand up on our bike and pedal like a gazelle until she said, "Down!"  I wasn't as quick with my "jumps" as the other class members, but I held my own.  We did these jumps for about 5 minutes, then ended the class with the lowest resistance and a "nice leisurely stroll through the countryside" as my instructor said.  I kept a water bottle close at hand during the class, but I had my little bag of glucose tabs and mini meter behind my bike, just in case.  I check my blood sugar at the end of the class:  104 mg/dL!  I decided to remain unconnected for the drive home, in case my BG decided to take a nose dive after such an aerobic workout.  My knee never gave me any trouble, either, so no worries there. 

And what better way to arrive home than to my hubby making smoked salmon in the new grill for one of my favorite low-carb meals:  Salmon Caesar Salad.  And according to myfitnesspal, I burned 374 calories during my spinning class, which earned me the right to cheesecake after dinner in order to make my minimum calories for the day.  Yum! 

Oh yeah, and thank you guys so much for all the support after my Overwhelmed post.  I've realized that it's probably not just my weight that's contributing to my blood pressure problems, but also my stressful lifestyle.  I need to get out and do things that are fun, more than worrying about burning calories.  And as much as I liked the spinning class, I'm looking forward to hitting the trails again (maybe this weekend). 

Have a great weekend! 

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.