it was a really fun weekend. friend ruth and her bf peter came to visit, and we had a great time! and i ate A LOT! on saturday, i had quiche for brunch, which strangely cannot be found in any of the carb counting books. so i just guessed using a value for pie crust and then added a little and i actually ended up doing okay. saturday night was a totally different story. i blame the french fries at the publick house. i cannot stop eating them. i'm always like, "oh, i'll just have four." which quickly turns into fourteen and then forty-four. agh! oh well. i peaked at 258 around midnight and corrected twice and woke up back in a normal range. on sunday, i skipped bfast and just bolused for coffee and managed to make it until noon with a blood sugar of 118. so maybe was that some inadvertant basal rate testing? i think i am going to have to start up with that this week. my sugars have been going low for a week now, so i think it's time to figure out if i am bolusing too much or if my basal rate is too much, or if i do a dual wave at dinner, if i should just split the dose more and bring it out for a longer time period.
i am going to try and lose about five pounds, too. my weight has gone up over the past month by about five pounds, and i think part of it could come from lifting weights, but i think careless snacking and increased lows are doing it too. so i am going to cut back on the snacking and decrease the amount of carbs that i have for meals. now that i incorporate fat into my bolus equation, i am always bolusing for more carbs than my target of 60 per meal. i am guessing that i could also cut back on the number of carbs at breakfast and lunch, which would allow me more flexibility at dinner, so i could go over 60 if i wanted.
i guess i could try and keep some sort of food diary? maybe just something quick online? or not. i feel like i keep track of enough. i will have to think about this idea.
Monday, January 29, 2007
Thursday, January 25, 2007
cardio, cold, lows
what could it be? i've been going low for two days now, and i am not sure if it's the fact that i am stepping up the cardio that i am doing and cutting back on weight training, or if it's just that it's flippin' cold outside! meeeeeeeeeh! i cut back on my basal rate (that i raised just last week due to rising sugars) so maybe it's just that things are evening out. i hope that everyone who thinks that diabetes can be figured out like a scientific formula takes all of these caaarazy factors into consideration.
oh well, mustn't dwell. my new goal should probably be to stop making an effort. not to stop making an effort with the diabetes; obviously, that is not an option. by stopping making an effort, i am just going to do my best and stop telling myself that i need to strive to do MORE MORE MORE all the time. maybe i can just be satisfied that i am taking pretty good care of myself, and that highs and lows do happen.
perhaps i have stumbled upon a solution for my inner pain and angst! this seems awfully obvious, but i honestly cannot recall ever sitting down and admitting that i am taking good care of myself. it's always, okay, that's a good number, but what's your next one going to be? how will you keep that up? even with my a1c, i never really celebrated; i just freaked out about how i was going to keep the number down or make it lower.
this is food for thought.
also, as an aside, i am not crazy! i have always thought that lotion on your hands can throw off blood sugar readings, but i never told anyone because i figured that they would think i am insane. however, yesterday, i was doing a little blog reading and found out that many many people see their sugars thrown off by more than 100 points if they put lotion on their hands! so there, doubters and haters! (although no one has ever doubted and hated me on this topic.) i am diabetes geniussssss!
oh well, mustn't dwell. my new goal should probably be to stop making an effort. not to stop making an effort with the diabetes; obviously, that is not an option. by stopping making an effort, i am just going to do my best and stop telling myself that i need to strive to do MORE MORE MORE all the time. maybe i can just be satisfied that i am taking pretty good care of myself, and that highs and lows do happen.
perhaps i have stumbled upon a solution for my inner pain and angst! this seems awfully obvious, but i honestly cannot recall ever sitting down and admitting that i am taking good care of myself. it's always, okay, that's a good number, but what's your next one going to be? how will you keep that up? even with my a1c, i never really celebrated; i just freaked out about how i was going to keep the number down or make it lower.
this is food for thought.
also, as an aside, i am not crazy! i have always thought that lotion on your hands can throw off blood sugar readings, but i never told anyone because i figured that they would think i am insane. however, yesterday, i was doing a little blog reading and found out that many many people see their sugars thrown off by more than 100 points if they put lotion on their hands! so there, doubters and haters! (although no one has ever doubted and hated me on this topic.) i am diabetes geniussssss!
Thursday, January 11, 2007
sweat, sweat, sweat
woke up at 4:45am to make it to the gym before work. usually, this puts me in a foul mood. but i haven't done this since before christmas, so i was okay with it. i managed to roll out of bed, don several layers of fleece and a wool hat, and call pete to meet me there. i woke up with an abnormally good sugar: 95 at 4:50am. gadzooks! better yet, i had a pretty fatty dinner last night of a mozzarella and prosciutto panini, and green salad with pine nuts, so i guess that my dual wave bolus actually worked!
macadamia nut. peanut. red pisachio nut. white pistachio nut.
so all in all, that was grand to wake up like that. now here's the part that strikes me as weird: when i work out in the afternoon/early evening, i always have to have a snack of between 17-25 carbs with no insulin. and i also turn my pump off while working out. but when i exercise first thing in the am, i usually keep my pump on at a minimal basal rate of anywhere between .05 and .10 u/hr and don't eat a snack. today i had one gummi lifesaver before i went, which is 3 carbs. anything more than that, and my sugar is guaranteed to shoot through the roof.
why the remarkable difference? i think there are two main reasons. first of all, i think my lunchtime insulin still somewhat active when i do my late afternoon workout. when i do my morning workout, the only insulin that i have in my body is from my overnight basal rate. my last bolus of dinnertime or dessert insulin would have become inactive sometime during the night. secondly, i wonder if it's that dawn phenomenon of my body being more insulin resistant in the morningtime. i think it's probably more reason one than two, because if i wake up on the weekend and eat bfast before going to the gym, i significantly cut my bolus rate. the exercise helps with my insulin absorption a lot and i run the risk of going low if i don't, even in these morning hours. but i'm sure that these are not the only reasons for this morning and afternoon insulin variation. i have no clue what the other explanations are; i'm just glad that i know the variation exists.
musing about all of this brings me to the conclusion that the best kept secret of diabetes is this: you can throw the flippin' science out the window most of the time, because this disease makes no sense. it's all about the trial and error, and sometimes (okay a lot of times) making random adjustments because you know your body and what it can do.
unrelated exciting note: my sister might come to visit this weekend-- i am hoping for at least two doughnuts to celebrate the occasion!
macadamia nut. peanut. red pisachio nut. white pistachio nut.
so all in all, that was grand to wake up like that. now here's the part that strikes me as weird: when i work out in the afternoon/early evening, i always have to have a snack of between 17-25 carbs with no insulin. and i also turn my pump off while working out. but when i exercise first thing in the am, i usually keep my pump on at a minimal basal rate of anywhere between .05 and .10 u/hr and don't eat a snack. today i had one gummi lifesaver before i went, which is 3 carbs. anything more than that, and my sugar is guaranteed to shoot through the roof.
why the remarkable difference? i think there are two main reasons. first of all, i think my lunchtime insulin still somewhat active when i do my late afternoon workout. when i do my morning workout, the only insulin that i have in my body is from my overnight basal rate. my last bolus of dinnertime or dessert insulin would have become inactive sometime during the night. secondly, i wonder if it's that dawn phenomenon of my body being more insulin resistant in the morningtime. i think it's probably more reason one than two, because if i wake up on the weekend and eat bfast before going to the gym, i significantly cut my bolus rate. the exercise helps with my insulin absorption a lot and i run the risk of going low if i don't, even in these morning hours. but i'm sure that these are not the only reasons for this morning and afternoon insulin variation. i have no clue what the other explanations are; i'm just glad that i know the variation exists.
musing about all of this brings me to the conclusion that the best kept secret of diabetes is this: you can throw the flippin' science out the window most of the time, because this disease makes no sense. it's all about the trial and error, and sometimes (okay a lot of times) making random adjustments because you know your body and what it can do.
unrelated exciting note: my sister might come to visit this weekend-- i am hoping for at least two doughnuts to celebrate the occasion!
Wednesday, January 10, 2007
meh.
i can act crazy a lot. don't worry, i'm aware of this and i'm seeking help. but when mornings like this one occur, i realize that my craziness is not unfounded. woke up early to do a set change, and yet was running late before the clock struck 6. filled my reservoir, had a heck of a time connecting it to the infusion set (e says that i am just getting frustrated; i think something might really be different with the 6mm infusion sets), and then got the new set in. primed, bolused for breakfast, etc. watched my shirt obsessively while bolusing to make sure there were no insulin leaks. i do this a lot. i check check check before i eat, go to bed, and randomly throughout the day, especially on my way to work. i am a checker. and one time, my infusion set actually was leaking insulin. so i feel like maybe this checking is worth it, even though the amount that i do is obsessive.
okay, so back to devil morning. while waiting for my insulin to kick in, i made the bed, did some ironing, and dried my hair. when i finished drying, i smelled that sickening medicinal smell. my stomach dropped. ##$%! something was wrong. i raised my gigantic hooded sweatshirt, and lo and behold, my tee was speckled with three dime-sized spots of pure insulin.
#$%^! #$%^! #$%^! #$%^!
i don't really use profanity all that much. "what the mullet?!" is about as far as i go. but not this morning. you would have thought i was raised by pirates. however, i was able to keep a clear head and thought back to the last time this happened. my first step was to detach the set and reconnect. i then felt around to see if the infusion site was still leaking. my shirt was still dotted with insulin, but i was not sure if this meant that the leak was still going, or because the area underneath the the injection site was still wet with insulin from before.
#$%^! #$%^! #$%^! #$%^! i was already late for work, leaking insulin, but of course needed to eat because i'd bolused for breakfast and wasn't sure how much had actually gone into my body. but i assumed that some had, since i had watched my pump pretty closely during the actual bolus delivery.
i finished styling my hair and poured some coffee. checked my shirt again. it was dry. it seemed like the pump had stopped leaking for the time being. maybe the site just wasn't connected all the way before? oh well, i was still late and needed to eat. so i gave myself an extra boost of insulin just in case my body hadn't gotten enough before and had my eggbeaters, apple, and english muffin, with a side of massive anxiety. i probably checked my shirt 14 more times while eating and on my way here to work. (where i arrived only 9 minutes late. a true achievement on my part, considering this AM's obstacle course. it was worse than double dare.)
and then, after all that, i get here and check my sugar: 79.
is 8:52 too early for a drink?
okay, so back to devil morning. while waiting for my insulin to kick in, i made the bed, did some ironing, and dried my hair. when i finished drying, i smelled that sickening medicinal smell. my stomach dropped. ##$%! something was wrong. i raised my gigantic hooded sweatshirt, and lo and behold, my tee was speckled with three dime-sized spots of pure insulin.
#$%^! #$%^! #$%^! #$%^!
i don't really use profanity all that much. "what the mullet?!" is about as far as i go. but not this morning. you would have thought i was raised by pirates. however, i was able to keep a clear head and thought back to the last time this happened. my first step was to detach the set and reconnect. i then felt around to see if the infusion site was still leaking. my shirt was still dotted with insulin, but i was not sure if this meant that the leak was still going, or because the area underneath the the injection site was still wet with insulin from before.
#$%^! #$%^! #$%^! #$%^! i was already late for work, leaking insulin, but of course needed to eat because i'd bolused for breakfast and wasn't sure how much had actually gone into my body. but i assumed that some had, since i had watched my pump pretty closely during the actual bolus delivery.
i finished styling my hair and poured some coffee. checked my shirt again. it was dry. it seemed like the pump had stopped leaking for the time being. maybe the site just wasn't connected all the way before? oh well, i was still late and needed to eat. so i gave myself an extra boost of insulin just in case my body hadn't gotten enough before and had my eggbeaters, apple, and english muffin, with a side of massive anxiety. i probably checked my shirt 14 more times while eating and on my way here to work. (where i arrived only 9 minutes late. a true achievement on my part, considering this AM's obstacle course. it was worse than double dare.)
and then, after all that, i get here and check my sugar: 79.
is 8:52 too early for a drink?
Tuesday, January 9, 2007
backwards
new years resolutions are the devil. i might just try and stop making them, because mine are usually so vague that i end up trying to do everything and then getting mad that i can't accomplish it all. so maybe the first step here is to look back on my 2006 and see how things went.
i guess i'll do this chronologically. in january, i was pretty depressed. i had lived with diabetes for only a few months, and it was geting in the way of life. i went to the gym a lot though, and managed to get myself in pretty good shape, and had a pretty good routine with my insulin regimen: one injection of lantus at night, and then injections of novolog for meals. at the time, i was still able to get away with sneaking little snacks of under 15g of carbohydrates without having to do an insulin shot. oh, those were the days! not really. actually, looking at where i am now and contrasting it to that makes me realize that 2006 was a big year.
i don't really remember february too too much, although eric and i went out to dinner for vday, and i think it was one of the first fancy dinners out where i had dessert and everything. i remember going to the bathroom at marco a few times to shoot some insulin. inconvenient, for sure.
in march, a few friends came up and we ran a road race together. i was so nervous about going low beforehand! but i managed to run 9-minute miles and finish with a good blood sugar, hurray! this was a huge deal for me personally and gave me a big mental boost. it was one of my first experiences with putting my diabetes aside and doing what i wanted, instead of allowing it to run my life once again. eric also accompanied me to the diabetes expo, where i spent a lot of time meeting with the people from minimed, and i started to consider using the insulin pump.
april is the first time i started thinking seriously about the pump. i put the paperwork through, and actually received the pump sometime in may. may and about half of june went by without me taking too much initiative to get started, because i was in a pretty good routine with my shots and exercise. but by mid-june, i was ready to go. i went through a major hassle with my doctor's office and my nurse to get started. they gave me a huge runaround, which really upset me a lot at the time. but what i am proud of is the fact that i hounded them and made them train me and see me. but i started thinking that switching doctors might be a good move.
i started pumping with saline sometime in late june. and then on july 5, i was pumping with insulin! i was SO SCARED the night before. my mom was visiting boston at the time, and i was so glad to have her and eric there to support me, because i was a total total mess. i've realized that i don't deal with change all that well.
the first several days of the pump were great: i had excellent numbers, and after a few days, i even attempted exercise with it. things were fantastic! and then my little diabetes house of cards just came crashing down. by mid-july i was suffering from constant hypoglycemic episodes, and didn't know how to fix them. i tried everything: i was on a non-existent basal rate most of the time, setting temp basals of 0 at the drop of a hat: to get to work, to get home from work, to go grocery shopping, to clean the house. i didn't know what to do! and my nurse, depsite being a wonderful person, was not very proficient with the pump. her reaction to the lows and my non-existent basal rate was to tell me that i had gotten the wrong pump, since the minimed's smallest dosage is .05 u/hr, and that i should have gotten an animas, which pumps at .025 u/hr. (not too much of difference here if you ask me, which just shows me now how much both of us didn't know at the time.) when she told me this, i burst into tears. i had known that the transition would be hard, but i was just not ready for all that work and then to be told that i couldn't pump!
i was in a pretty big funk at the end of july. then one day, i went to go see my therapist at the joslin center, and i fell apart and told her everything about my lows and basal rate. immediately, she sent me to see a joslin pump trainer who took one look at my settings and told me that my insulin to carb ratio was giving me too much insulin, and was the reason for my constant lows. looking back, the answer was so obvious! this was the push that i needed to bite the bullet and switch doctors. i was holding a loyalty to my previous doctor and nurses because they'd helped me through diagnosis, but it became evident that the switch was necessary, especially since i wanted to keep pumping. its convenience factor has been wonderful: i can bolus to the tenth of a unit, it automatically corrects for high or low sugars, it can be stopped for exercise, it can be used at the dinner table (no more dirty bathroom injections... yessss!), it eliminates the need for shots of lantus every day-- i absolutely love it.
i met with my new doctor at the joslin center in early august, and he was an incredible help. i also broke up with my old doctor and nurse, which was hard, but necessary. i felt a little silly saying that it was not them, it was me, but hey. i had a bad blip in late august when eric and i went on vacation to the cottage in upstate ny for about 10 days. my numbers were totally out of whack, and i was feeling horrible about them. in early september, i hit a real low and realized that i needed to change my outlook on diabetes, because i was really depressed.
since then, i have been working really hard to get back to my real life, while continuing to take the best care of myself that i can. it hasn't been easy, but i've made a lot of progress with friends and social things (ahem, going out and seeing people and traveling) that i had neglected for the first year after diagnosis. i've realized that the mental aspect is just as important as the physical aspect, and sometimes, i have to loosen my control over the disease a bit, not so much with my numbers, but more in my contant quest for perfection.
i also managed to make a few important connections within the diabetes world: one of e's coworkers is married to a diabetic, and we started emailing. our communication has provided me with more help then my doctors have sometimes! he taught me how to set dual and square wave boluses on my pump, which have improved my numbers 110%! and he's just been a great sounding board for venting and questioning.
i did the diabetes walk in dc in november, and i managed to fundraise about $1,900! that was pretty exciting for me; it showed me what a great extended support network i really do have. i also attended a diabetes support group in november, which was a mixed bag. parts were very good, and others were not my favorite. but all in all, i think it was useful. and the holidays were hard, but not as hard as they were the previous year. and then i ended the year with my best a1c yet, woot!
it's good for me to type this. it forces me to look at all the ambitious changes that i have made, and i am so glad to be where i am today: pumping, exercising, eating right, and continually striving to continue that, while at the same time trying to achieve a little more mental balance.
i guess i'll do this chronologically. in january, i was pretty depressed. i had lived with diabetes for only a few months, and it was geting in the way of life. i went to the gym a lot though, and managed to get myself in pretty good shape, and had a pretty good routine with my insulin regimen: one injection of lantus at night, and then injections of novolog for meals. at the time, i was still able to get away with sneaking little snacks of under 15g of carbohydrates without having to do an insulin shot. oh, those were the days! not really. actually, looking at where i am now and contrasting it to that makes me realize that 2006 was a big year.
i don't really remember february too too much, although eric and i went out to dinner for vday, and i think it was one of the first fancy dinners out where i had dessert and everything. i remember going to the bathroom at marco a few times to shoot some insulin. inconvenient, for sure.
in march, a few friends came up and we ran a road race together. i was so nervous about going low beforehand! but i managed to run 9-minute miles and finish with a good blood sugar, hurray! this was a huge deal for me personally and gave me a big mental boost. it was one of my first experiences with putting my diabetes aside and doing what i wanted, instead of allowing it to run my life once again. eric also accompanied me to the diabetes expo, where i spent a lot of time meeting with the people from minimed, and i started to consider using the insulin pump.
april is the first time i started thinking seriously about the pump. i put the paperwork through, and actually received the pump sometime in may. may and about half of june went by without me taking too much initiative to get started, because i was in a pretty good routine with my shots and exercise. but by mid-june, i was ready to go. i went through a major hassle with my doctor's office and my nurse to get started. they gave me a huge runaround, which really upset me a lot at the time. but what i am proud of is the fact that i hounded them and made them train me and see me. but i started thinking that switching doctors might be a good move.
i started pumping with saline sometime in late june. and then on july 5, i was pumping with insulin! i was SO SCARED the night before. my mom was visiting boston at the time, and i was so glad to have her and eric there to support me, because i was a total total mess. i've realized that i don't deal with change all that well.
the first several days of the pump were great: i had excellent numbers, and after a few days, i even attempted exercise with it. things were fantastic! and then my little diabetes house of cards just came crashing down. by mid-july i was suffering from constant hypoglycemic episodes, and didn't know how to fix them. i tried everything: i was on a non-existent basal rate most of the time, setting temp basals of 0 at the drop of a hat: to get to work, to get home from work, to go grocery shopping, to clean the house. i didn't know what to do! and my nurse, depsite being a wonderful person, was not very proficient with the pump. her reaction to the lows and my non-existent basal rate was to tell me that i had gotten the wrong pump, since the minimed's smallest dosage is .05 u/hr, and that i should have gotten an animas, which pumps at .025 u/hr. (not too much of difference here if you ask me, which just shows me now how much both of us didn't know at the time.) when she told me this, i burst into tears. i had known that the transition would be hard, but i was just not ready for all that work and then to be told that i couldn't pump!
i was in a pretty big funk at the end of july. then one day, i went to go see my therapist at the joslin center, and i fell apart and told her everything about my lows and basal rate. immediately, she sent me to see a joslin pump trainer who took one look at my settings and told me that my insulin to carb ratio was giving me too much insulin, and was the reason for my constant lows. looking back, the answer was so obvious! this was the push that i needed to bite the bullet and switch doctors. i was holding a loyalty to my previous doctor and nurses because they'd helped me through diagnosis, but it became evident that the switch was necessary, especially since i wanted to keep pumping. its convenience factor has been wonderful: i can bolus to the tenth of a unit, it automatically corrects for high or low sugars, it can be stopped for exercise, it can be used at the dinner table (no more dirty bathroom injections... yessss!), it eliminates the need for shots of lantus every day-- i absolutely love it.
i met with my new doctor at the joslin center in early august, and he was an incredible help. i also broke up with my old doctor and nurse, which was hard, but necessary. i felt a little silly saying that it was not them, it was me, but hey. i had a bad blip in late august when eric and i went on vacation to the cottage in upstate ny for about 10 days. my numbers were totally out of whack, and i was feeling horrible about them. in early september, i hit a real low and realized that i needed to change my outlook on diabetes, because i was really depressed.
since then, i have been working really hard to get back to my real life, while continuing to take the best care of myself that i can. it hasn't been easy, but i've made a lot of progress with friends and social things (ahem, going out and seeing people and traveling) that i had neglected for the first year after diagnosis. i've realized that the mental aspect is just as important as the physical aspect, and sometimes, i have to loosen my control over the disease a bit, not so much with my numbers, but more in my contant quest for perfection.
i also managed to make a few important connections within the diabetes world: one of e's coworkers is married to a diabetic, and we started emailing. our communication has provided me with more help then my doctors have sometimes! he taught me how to set dual and square wave boluses on my pump, which have improved my numbers 110%! and he's just been a great sounding board for venting and questioning.
i did the diabetes walk in dc in november, and i managed to fundraise about $1,900! that was pretty exciting for me; it showed me what a great extended support network i really do have. i also attended a diabetes support group in november, which was a mixed bag. parts were very good, and others were not my favorite. but all in all, i think it was useful. and the holidays were hard, but not as hard as they were the previous year. and then i ended the year with my best a1c yet, woot!
it's good for me to type this. it forces me to look at all the ambitious changes that i have made, and i am so glad to be where i am today: pumping, exercising, eating right, and continually striving to continue that, while at the same time trying to achieve a little more mental balance.
Tuesday, January 2, 2007
my to do list
some hopes for 2007:
- to find balance. over the past several months, i have become very dedicated to a workout routine-- about 45 minutes at the gym, six days per week. i do this for my diabetes, because i am petrified by the idea of skyrocketing blood sugars that would be a result of skipping the gym for too many days in a row. so this idea, while healthy in theory, seems to be feeding my anxiety. if i miss the gym, not only do i beat myself up about getting fat, but i also worry incessantly about how my sugars are going to react. eric says i should just skip the gym for a few days to see what would happen to my sugars so that i can plan for it. i think it's the fear of the unknown that is really bothering me. this seems like a good idea, but before i can focus on that, i think i need...
- to control my eating. i don't eat poorly for the most part. i really don't. it's just that i have a hard time stopping, and sometimes i eat way too much. i gained three pounds this holiday season, which i am hoping i can work off soon. i also torture myself by thinking about eating foods that are not diabetic-friendly. i know, i know: in theory, diabetics can eat anything as long as they dose for it. but some foods are just asking for trouble. physical trouble, in terms of pizza and homemade cookies and other fatty and difficult to calculate items, but also mental trouble. i beat myself up about eating things, and then also get angry that i have diabetes in the first place and am forced to limit myself in the way that i am. so i am thinking a more concrete meal plan might be a good idea. i eat very routine breakfasts and lunches on the weekdays, and i think that the next step will be extending them to the weekends. then i need to come up with some concrete dinner ideas that treat my sugar well and aren't too fatty. and then i can try and stick to this plan. i plan to treat myself a little, maybe with the addition of a bedtime snack, and some planned splurges (i cannot shake that doughnut habit, i just can't!), but for the most part, having a plan and sticking to it hopefully will reduce my mental anguish, which is what worries me most.
- to stop putting myself down. i've always had an issue with my self esteem. but dealing with a disease that is so based on having "good" test results has heightened this issue. i think that i go to the gym and run myself ragged because if i don't, i am not a worthwhile person. there's a constant voice in my head telling me to do more more more because if i don't then i will become fat, ugly, lazy, a bad diabetic, etc. typing this out makes me realize how crazy this idea is, and yet, it dominates my time. this is a big issue, and right now, i need to incorporate concrete changes into my life to help me deal with it. like forcing myself to sit down and relax when my mental voice is commanding me to get more and more done. that's what i can focus on today. of course, i know that this is a bigger issue that i need to get help with. but for today, this is what i need to focus on.
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