My CDE is my BFF.

I had an appointment with my CDE on Friday and let me just say she is quickly becoming my new BFF of my Diabetes Team.  Like, I want to make her a friendship bracelet, ’90s summer camp style.

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I was never able to master the swirly ones!
Image from the Google.

Her awesomeness does not only stem from her coming to my Endo/PA appointment last week and giving me a hug, but she has been instrumental with determining my pump rates over the past 2 months since I’ve resumed cyborg living.  I’ve emailed her reports almost weekly and we make tweeks as needed to get me where I need to be to grow a human.  She is also totally relate-able and “gets it” as a PWD.  She makes me laugh and is super supportive when I’m annoyed with myself for not being a perfect diabetic.  I know I totally sound like I have a girl crush (my girl crushes are Megan Hilty and Jessica Simpson, TYVM), but I’d say it’s safe to say I have a definite favorite on my Diabetes Team.  Don’t tell my PA or Endo.  I know I’m supposed to love them all equally, and they can believe that I do, lest I’ll be subject to more finger pricks when I’m in the office.  (Seriously, am I the only one who hates when other people prick my finger?)

So, the appointment.  My graphs look goooood.  She pulled up some of my old graphs and the change in just a couple of months is remarkable.  Definitely happy that I’m back on the pump even after having the pump-cation blues.  For the first time since starting this “get body ready for baby” journey, I feel like I can actually do this.  It’s a good feeling friends.  And it’s motivating me to keep on trying my best to get myself in the best D-shape possible before growing our future little one.

We She noticed some patterns that we are working to correct.  I tend to go higher and stay higher with meals that are more than 60 grams of carbs.  So that means that I will try to limit my meals to less than that amount of carbs.  Easy peasy, mostly.  But if I do have the weekly occasional bowl of spaghetti, I’ll bolus as usual but try a temp basal of +20-40ish%, (depending on pre-meal BG) for 60-120 miutes post meal.  Trial and error.

Another trend is that I tend to stay higher throughout the morning if I eat breakfast earlier in the day.  So we changed my I:C ratio from 1:10 to 1:9 before 9 am and 1:10 after 9am (weekends).  I would’ve never noticed this – so happy for her trained eyes to see!

I do awesome overnight.  I average 147 from 11pm – 7am.  Good-ish number.  Would like it to be a smidge lower, but the thing I am most pleased with is that my overnight lines are typically pretty steady.  No real drops or jumps.  Sweet dreams for me.  This means naptime at work, no?  I have been pretty pro-active with setting temp basals at night when I go to bed on the higher end.  And I swear, it has nothing to do with me not wanting to hear my Dexcom all night.  It has everything to do with wanting to be all I can be with the D.  Or something.

We also changed my I:C ratio for dinner from 1:9 to 1:8.  My CDE was a little reluctant to do this because sometimes after dinner my numbers are great, however, I want them to be great most, if not all, of the time.  So I figure it’s worth a shot.

The best part of the appointment however was when she said that by looking at my graphs, she thinks my A1c is/will be very close to 7 if I keep this up.  This certainly motivates me to keep fighting the good fight.  High Five!

I kinda want to take her out for a beer.

Friday Fives – June 28

1.  I really wish the Dexcom showed your 24 hour average blood sugar on the receiver!

2.  I may have to try the side boob as a pump site.  Just to see.

3.  I love the weekly DSMA twitter chats.  So fun!

4.  My MySugr monster’s name is Dia-Butthead.  He’s not supposed to be so cute, is he?

5.  Pre-bolusing is a tricky thing when you realize that your baguette is stale.

Wordless Wednesday – Pizza Party Pooper!

Friday

Pizza is a party pooper!

 

OK, not so wordless post, but my pretty-ish little graph needs an explanation.  On Friday night the hubs was getting home from traveling and instead of being an awesome wife and cooking a home-cooked welcome home meal, I decided to order pizza.  Since Pizza + Diabetes = Pain in the bolusing behind, I decided to do a combo bolus of 75% (6 units) pre-meal and 25% (2 units) 90 minutes post meal.  Didn’t work so hot.  I think next time I’ll try a 60/40 split with the second bolus 2-2.5 hours post-meal.  Oh, pizza, why do you have to be so good but so bolus-confusion-worthy?

The Weight of it All – June 25

As you can imagine with the sudden passing of my nephew, I have been slacky McSlackerson on the weight loss front.  In fact, for the past 2 weeks I haven’t journaled a single morsel of food or put on my boxing gloves once.  Sometimes there are other, more important, things to worry about and you just have to give yourself a break.  However, this break ends for me today.  The scale has crept up to 205.4 and, just, ewww.  I have had a long enough diet hiatus.  I’m not angry at myself, but at the same time I’m not going to allow myself to continue on this path.  I think Josh would want his aunt to be healthy and happy.

The Hubs and I are back on our respective food plans today (counting calories + exercise for me, super low carb + exercise for him) and I think we are both pretty motivated to get back on track.  I am going back to boxing tonight and am looking forward to hitting the bags and getting some endorphins in my system.  I’m sure it will be pretty painful but I need to rip off that band-aid and just get my butt in the door.

I am in a wedding in early September and although I don’t like to set number goals, I’d like to lose about 10-15 pounds by then.  I am going to focus on this and even if I don’t reach that goal, hopefully I’ll be a few pounds lighter and a few inches smaller!

Here’s to a good week!

Friday Fives – June 21

1.  I’ve tested my sugar approximately 32,000 times.  I strongly feel that all endocrinologist offices should provide manicures as part of our treatment.  (Pedicures would be nice too)

2.  Waking up with a 106 → and seeing that that’s where I hung out all night makes me feel like I can conquer the world.

3.  I need to get more blue clothing for blue Friday.

4.  Overnight lows while my husband is out-of-town scare the crap out of me.  Thank goodness for my Dexcom.

5.  (Not D-related) I don’t understand why celebs can’t name their children something normal, like “John” or “Jennifer”.  Kim and Kanye have named their daughter “North West”.  Why not name her “We hate you”?  Makes my blood boil (and blood sugar rise!  Ok, not really, but….)

D Meetup!

Last night I had the pleasure of meeting up with some local women who I happen to have something in common with – we all have Type 1!  Being new-ish to the area, it was so nice to meet some nice women and share stories.  We chatted about diabetes, jobs, life, etc.  Hula-hoops even made an appearance (although mine spent the majority of the time on the ground, I am not skilled in this area!)  Lots of laughs were shared and I am looking forward to our next get together!  Thank you so much to our kind host for having us!

Endo Appointment Round Up

Today I had an appointment with my Endo’s Physician’s Assistant.  Honestly, I kinda like him more than my endo (although she’s pretty awesome too!).  He’s young, very thorough, and never seems rushed.  In fact, he spent an hour with me today, which is just unheard of.  Unfortunately I wasn’t due for an A1c test (WAH!) as I had one within the last 3 months.  Kind of a bummer because I wanted to see how my new cyborg life has affected things.  But, I go back in August so I don’t have to wait too long.

We made some adjustments to my evening basal rate so my rates are now:

12 MN – 1.0
8 am – 1.2
2 pm – 1.0
8 pm – 1.6

Insulin to Carb ratios stayed the same:
12 MN – 1:15
7 am – 1:10
11:30 am – 1:9
5:30 pm – 1:9
9:30 pm – 1:15

Insulin sensitivity factor remains at 40 with my goal BG remaining at 120 +/- 10.

So, all in all, decent appointment.  I had emailed my CDE my CGM and Animas reports yesterday and told her about my nephew and that may account for some of the wonky sugars I’ve had over the past week or so.  She asked me when my appointment was and came over today to give me a hug and chat for a few minutes.  So nice.  I am really liking Duke!  My CDE and I have been in pretty close contact since I re-started pumping, I cannot say enough good things about her.  She’s awesome.

I had the PA write me a script for AccuChek test strips and he gave me a present of a shiny new AccuChek Nano.  I’m going to be calling my insurance company to determine exactly what I need to do to get my strips for free now that all of my out-of-pocket expenses have been met.  Hopefully what they told me last month about Accuchek strips being covered 100% is true.  And I have a good supply of one touch strips so should I ever need to use that meter for remote bolusing, I can.

On a personal note, I am muddling through with everything.  Staying busy helps.  My friends and coworkers have been so kind to me and I’m very happy that my sister and her family have such a strong community of friends supporting them.   

Radio Silence

There are not really words to properly ease into a post such as this so I think the best thing to do is to explain why I’ve been missing from the online world for the past week.  Last Monday, what was a normal work day, I received the call no one wants to ever receive.  My sister, my best friend, called me to tell me that my sweet little three-month-old nephew passed away at daycare.  He simply went down for a nap and did not wake up.  I am comforted to know that he is in Heaven surrounded by those who went before him, however, as anyone can imagine, it has been the most awful week filled with many tears.

The hubs and I stepped up and helped take care of my sister’s other three children as well as overseeing the rush of visitors, maintaining the home, keeping the fridge stocked, etc.  We are so fortunate that we live close so we were able to help out when otherwise we’d feel helpless.  I can only hope that we made things just a little bit easier as my sister and her husband made arrangements for the funeral services for their son.

I am pretty numb and in shock over this loss.  My sister and I have always been extremely close and since my husband and I moved to the area a little over a year ago, our bond has only grown stronger.  I’ve loved being close by to offer a helping hand with babysitting and just to spend time with the kids doing fun things and letting them get away with stuff a little more than Mommy and Daddy might.  I eagerly anticipated my baby nephew’s arrival and even took care of my sister’s other 3 children while she and her husband were welcoming the little one into the world back in March.  Over the past 3 months I’ve gotten to spend more time with a newborn than I ever have before and I was enjoying being able to see this nephew more often than his brothers and sister while he was so little and new.  I loved talking to him and having him coo and smile at me.  His big eyes melted my heart and I was so excited to see him grow up.  And selfishly, I was excited for our hopeful future baby to have a cousin semi-close in age to play with and be friends with.

My heart aches for my sister, brother-in-law, and their three children.  If there was anything I could do to take this pain away from them, I would.  I just ask that my friends hug their children tight, be grateful for all the blessings in your lives, and keep my family in your thoughts and prayers.

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Joshua
March 2, 2013 – June 10, 2013

A Day in the Life, My #DayofDiabetes

Wow.  I don’t think I could have picked a worse day for my Twitter #DayofDiabetes.  Typically, my blood sugars behave fairly well.  Sure, I’ll have some ups and downs, but last Wednesday was a day full of all ups and all downs.  There was no stability at all.  I am quite embarrassed that this was the day I chose to share on Twitter, however, it just goes to show that Diabetes really will sometimes do what it wants despite our best efforts.

Overnight leading in to my day, I had a blood sugar of 43.  This is pretty low and even though I usually wake up on my own from my lows, it wasn’t until my Dexcom alarmed that I woke up.  I have no idea how long it was alarming for, but I sure am glad for that little device.

In typical overnight-low-blood-sugar fashion, I treated it with everything that could fit into my mouth (cereal, and more cereal, oh, and why not, some more cereal!).  Why is it so hard to stick to the 15-15-15 rule (Consume 15 grams of carbohydrates, wait 15 minutes, and your BG should come up 15) when you’re low, specifically when these lows are overnight and you also have half-asleep grogginess to contend with?  After I started to recover from my low, I even had the sense to give myself a small bolus because I knew that after eating the entire box a large bowl (or two) of corn flakes, I was bound to go high and honestly, I didn’t want to have to listen to my Dexcom beeping all night.  And I didn’t want to wake up with a high blood sugar in the morning.

In the morning, I learned that my plan failed:

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Decided to wait on eating breakfast (except for coffee.  Gotta have my coffee) and gave myself a bolus to bring my sugar down and cover the sugar-free creamer in my coffee.  As I usually level out by noon with these “over correction” highs, I still packed my gym bag in anticipation that I’d be going to boxing that evening.
AMbolustweet
After a couple of hours, my blood sugar still hadn’t come down so I gave myself a mini-bolus of 1.05U to try to get it to come down before lunch.  I always get nervous about stacking my insulin like that but it was being so super stubborn!
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Back to our regularly scheduled programming of working, despite feeling icky from the extended high blood sugar.  A couple of hours later, my sugar had slightly come down.  Time to bolus for lunch!
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Lunch wasn’t exactly the best and I broke my “No Lean Cuisines” goal for this week but sometimes you’re just rushing in the morning and don’t have time to make something.  And dealing with the “low, then high” hangover in the mornings doesn’t exactly make you feel energized and ready to take on the day.  Despite my not so hot Diabetes Day, I still was committed to entering my food into My Fitness Pal.  Yay for persistence?
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I had hoped that after lunch, my blood sugar would come down.  Nope.
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😦 But, with diabetes you must have a sense of humor!
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One of the best things about the Diabetes Online Community is the sense of support you get from people who “get it”.
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friend
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Thanks for the support, ladies!  I needed it that day.  Badly.
Finally, after a few hours, my blood sugar came down.  Although not far enough and I made the decision to skip (Sky?) the gym.
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At the suggestion of another twitter friend, I did a 200% basal rate for the remainder of the afternoon.  Finally, when I got home from work it appeared that my blood sugar decided it wanted to play nicely.
falling
Or maybe not.
crashlandingI had dinner (turkey sausage, steamed squash and zucchini, egg noodles – yum!) and my blood sugar returned to normal.
tempelevation
For a few minutes, at least.
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Hey, at least I got to eat dessert guilt free, right?  I was happy that evening was the weekly Diabetes Social Media Advocacy Twitter Chat.  I’m so happy that I discovered this weekly chat, and although sometimes it is hard to keep up for this newbie Twitter-er, it’s a great weekly event that I’ve enjoyed tremendously!  That night it was an open chat (usually the administrators ask 5 questions that we all answer) and I enjoyed getting to know some of my DOC friends better.  It also distracted me from my icky day.
DSMA
Finally, it was time for bed.  I was exhausted after the many ups and downs of my day of diabetes.  *yawn*
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What a day!
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Things I learned from my Day of Diabetes…

  • Diabetes never behaves how you want it to.  I had hoped that my Day of Diabetes would be one of those perfect days where my post meal spikes were below 180 and I stayed right around 110 all day.  Sadly, that didn’t happen.
  • BUT my day did reflect the frustrations that come with Diabetes.  Every day is different.  You can do the same exact thing 2 days in a row and get different results.  The key with dealing with it is to be patient and remember that tomorrow is a new day.
  • The Diabetes Online Community is great.  The support received from other people with diabetes is immeasurable.
  • Temporary basal rates are our friend.  I tend to always have a knee-jerk reaction to highs and bolus, bolus, bolus when I really need to use temporary basal rates so I don’t have those horrible crash landings.
  • If I always tweeted every Diabetes-related action or thought, I’d probably have zero twitter friends.  🙂
  • Every day is a day of diabetes.  And every day is a chance to learn something new about the disease and yourself.

HOB = Hubs On Board.

The Hubs and I email pretty frequently throughout the day.  On Friday afternoon, I was emailing him about some of the comments I received on my most recent Friday Fives post encouraging me to take a pregnancy test due to my wonky sugars.

Me:  Some of my internet friends are encouraing me to pee on a stick.  You’d die.

Hubs:  No, I would not have a premature death.

Me:  You’d poop your pants.  

Hubs:  I would not lose control of my bowels.

Me:  You’d vomit.

Hubs: I would not have an upset stomach.

So perhaps if I was pregnant, his level of freak out would be minimal.  We aren’t planning on trying for some time, gotta get the A1C in check, so it would be quite a shock.  I really do not think I am as we take proper precautions, I think I just had a really bad couple of diabetes days.

Still, he makes me giggle.  I kinda like him.

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