Friday Fives – August 30th

Five things only a PWD has to think about:

1.  When buying a new purse…”does this have enough room for all my D supplies”?

2.  When wearing a dress…”Is the cleavage too low for the between boobs pump clip-age?”

3.  Before a workout…”Do I need to consume calories in order to burn calories?”

4.  When purchasing a bathing suit…”Tankinis.  Need to find all the tankinis”.  (I don’t know if any other female PWD feel this way, but I feel like one piece suits are a massive PITA when it comes to the pump.)

5.  All the time…”When was the last time I ate?  Do I need to check my BG?  Is that headache because I’m annoyed with work or because my BG is off?  I’m thirsty – am I high?  Did I remember to throw those glucose tabs in my purse?  Should I rage bolus or use a temp basal to get my BG down?  Do I really have to do all this again tomorrow?”

August Blog Carnival…

Diabetes is a condition that affects more than just our bodies, it influences our emotions as well.  It can sometimes feel harder to cope with the emotional aspects of diabetes then the physical demands.  With that in mind, we revisit the “Diabetes and Mental Health”  chat from July 24th and ask:

What can a parent of a child with diabetes, or a person with diabetes, do to help reduce the emotional impact of caring for diabetes?

Oh, diabetes.  You impact my emotions on a daily basis.  On any given day you may make me feel:

  • Frustration.  But I bolused correctly…why is my BG skyrocketing?
  • Anger.  I’m going to have to do this crap for the rest of my life?  Really?
  • Disappointment.  I really wanted to work out today but my BG isn’t behaving.  Or, I just worked out and my BG has dropped causing me to consume calories making me feel like my workout was a waste of time.
  • Fear.  Will I go low overnight and not feel it?
  • Tired.  I am sick of dealing with insurance companies, BG checks, so many doctor’s appointments.  I just want to be normal.
  • Empowered.  My BG has been perfect all day.  I can do this!
  • Strong.  If I can handle diabetes, I can handle anything.

For me, in order to reduce the emotional impact of diabetes, I try to focus on my last bullet point – strength.  Diabetes sucks.  BUT, it’s not going away.  When I’m feeling particularly overwhelmed by all the disease entails emotionally, financially, and physically, I try to remind myself that I have a choice.  I can choose to be miserable and feel sorry for myself or I can choose to accept that this is my reality and I need to deal with it and keep moving forward.  Sure, the pity party sometimes wins out.  I am human, after all.  But choosing to be happy and accept this leads to many more positive days than negative.

My advice for those Type 3s in our lives – focus on the positive.  Remind your PWD how awesome they are and how proud of them you are.  Diabetes isn’t easy.  It feels good to get that pat on the back or high-five and a “you’re doing a great job”.  Don’t harp on us when we’re having a tough day or our BG is being naughty.  Let us throw our tantrum and know that tomorrow will be better and that we are doing our very best.

 

Ch-ch-ch-changes

Big, exciting (for me) news…I have accepted a job offer!  WooHoo!  I start in a couple of weeks and have been busy wrapping things up at my current job.   I’m very excited for the new challenges and increased responsibility.

What I’m not excited for…explaining to my new coworkers over and over and over that I have type 1 diabetes.  No, it’s not because I ate too much sugar as a kid.  Yes, I can participate in birthday celebrations.  No, you do not have to treat me any differently.   It’s an insulin pump, not a pager (or camera).  Oh, your grandma had diabetes and her foot fell off? That’s nice.

I’m not very shy about my diabetes, there is nothing to be ashamed of.  However, I also don’t like to be made a spectacle of or made to feel different.  It seems inevitable at new jobs that I have to tell my story, give a cliff’s notes version of what diabetes entails, and answer the same questions again and again.  I have been very lucky at my current place of employment as one of my coworkers has Type 2 so we’ve been “D buddies”.  He thinks my CGM is the coolest thing ever, by the way.

I think that it is important to let my new coworkers/supervisor know that I have diabetes just in case something happens (that’d be a good first day story, huh?), However there never seems to be a good way to say it unless it comes up in conversation.  It’s not like you can just say, “Hi new coworker friend person.  Name’s Laura.  Type 1 Diabetic.  So, tell me what you’re working on?”

How do you deal with a new job and letting people know that you have diabetes?

Writer’s block.

I feel I’ve been pretty quiet on the blog and twitter fronts.  I’ve been busy wrapping things up at work (I’m starting a new job in two weeks!) and by the time I get home, the last thing I want to do is sit back down in front of a computer to write a blog post.  Also, I’ve felt a bit of “writer’s block” when it comes to blogging.  There isn’t really anything going on in my D-life right now.  Things are going well, my blood sugars are behaving for the most part, and I’m still focusing on getting my body baby-ready.

So, I am leaving my blog open to topic suggestions.  Is there anything you’d like to know about me?  Doesn’t necessarily have to be Diabetes related.  Leave me a comment!

Have a great Monday!

I confess…

I’ve been cheating on the DOC with Reddit.  Does anyone else read the Diabetes sub-reddit?  I really enjoy it.  Check it out!

After my awesome A1c results last week I, of course, had to share with my Reddit friends.  One person asked me to list 10 changes I’ve made to make such an improvement in my A1c (I went from 7.9 in April to 6.8 now, however a year ago, I was 8.7!)  Of course the first thing I thought when this person asked was: “Blog Post!”  I love to make lists.  If you ask the hubs, I make them for him pretty frequently – 10 Reasons why I miss him while he’s away (there’s no one around to kill spiders!), 10 reasons why I am excited for the weekend (Sitting on my butt is better than working, duh!), etc.  The lists.  I make them.

So, without further ado, here are 10 changes I made to improve my A1c:

1. I switched to sugar-free flavored creamer. When I first got my CGM I noticed that I was spiking big time after breakfast, even if I was bolusing to cover the carbs. Not willing to give up coffee, I switched to SF creamer and that has helped a lot.

2. I also gave up cereal. I eat a bagel and cream cheese for breakfast most mornings. I should have more protein but so far I’m doing OK, blood sugar-wise.

3. Getting the CGM period. It’s been amazing to know what my BG is doing at any given moment. I’ve been very attentive to it and adjusting my insulin when needed to keep me in range.

4. Baby-stepping my high alert on the CGM down. It started at 200 and I’ve gradually gotten it down to 160.  I think if I started with a high alert of 160 right out of the gate, I would have gotten frustrated with all the beeping.  If Bob can do it, so can I.

5. Communicating with my CDE a lot! I’m lucky in that she is very receptive to emails. I send her my reports every couple of weeks and she makes small tweaks. She’s noticed patterns I never would have noticed before.  She has quickly become my diabetes care BFF.

6. Getting back on the pump, in general.  For me, it’s much easier to correct those pesky high numbers with a couple mini boluses or temp basal.  A little more difficult and time-consuming to do on MDI.

7. Pre-bolusing for meals. It takes me about 30 minutes to get ready in the morning and halfway through I bolus for breakfast. Since I eat the same thing every day, it makes it easy.  I also pre-bolus for lunch and dinner too and I think it really helps prevent those after meal spikes.

8. Using combo boluses when I eat high fat meals.  I will master you, pizza.  I will.

9. Trying (although not always successful) to cut back on processed foods.

10. Really paying attention to the 15-15-15 rule when I’m low. Although this doesn’t always work (especially over night!).

It honestly hasn’t been a huge lifestyle adjustment or anything. I’ve just made diabetes a priority.  I know that I feel better physically and emotionally when I’m in better control of my blood sugars.

Wordy Wednesday

I’ll get back to Wordless Wednesday next week.

Today I had my much-anticipated endocrinologist appointment.  This was the first appointment in which I’d get my a1c since going back on the pump and starting with my Dexcom CGM.

I was called back by the nurse and she took my vitals.  I told her that I was super excited about getting my a1c and was hoping it’d be around 7.0.  After doing her thing, my a1c still wasn’t ready so she sent me back to the waiting room and told me she’d come out and let me know what it was.  A few minutes later she came out with a huge smile on her face and whispered in my ear….

….

what do you think?

Did I do it?

……

Did I hit 7.0?

Well, I didn’t hit 7.0.  I knocked it out of the freaking park!  6.8!!!!!  Sixpointfreakingeight!  I haven’t had an a1c that low since…never.  I honestly can’t remember having an a1c in the sixes throughout my 14 1/2 years with diabetes.  I may have when I was first diagnosed, but not in the last 8-10 years, I know that much.

I almost started crying.

I am so happy that my a1c has shown all of my efforts.  And, I was texting with my friend and made the realization.  It has been tough, sure, but it’s not like I’ve stopped living my life in order to reach this goal.  I’ve made small adjustments and just made my diabetes management a priority.  The Dexcom has helped tremendously.  I no longer fear going low as I have faith that it will alert me if I need to take action.  And when it tells me I’m higher than I’d like to be, I adjust.  The constant contact with my CDE and her feedback have also been an enormous help.

So, back to the appointment.  My endo walked in and also had a big smile on her face.  She asked me if I wanted to hear the good news.  I said, “6.8!!!”  She was bummed that the nurse told me, haha.  She said that she is so proud of me.  When I first started with her last June, I was 8.9.  My last a1c in April, I was 7.9.  I’ve made diabetes my bitch.

I had a long list of questions for her regarding a (hopeful) upcoming pregnancy.  Here’s a rundown:

  • Given my current numbers/a1c, when can I start TTC?

    • NOW!

  • What are my pre/post meal BG goals during pregnancy?

    • Pre – 60-90

    • 1 hour post – below 140

    • 2 hours post – 100-120

  • When should I start taking pre-natal vitamins?

    • Now.  (I already did.  I win)

  • Vytorin – when should I stop taking it?

    • NOW!  She was adamant about this.  Guess I gotta lay off the steak and other cholesterol-y foods from now on.

  • What about synthroid?

    • Keep taking and call her AS SOON AS I have a positive pregnancy test.  (She said, “don’t even tell your husband, CALL ME!”)  Haha.  I guess as soon as I find out I’m pregnant, I need to take extra synthroid that week and adjust my dosage.

  • How long before we start trying should I stop taking pills?

    • She said that although “they” say it takes about 3 months, it can happen the first month so she suggested a month or two before, but “Be ready” for a positive result!

  • Caffeine/artificial sweetener intake during pregnancy?  What is safe?  When should I give it up/start limiting it?

    • She is OK with small amounts of caffeine – in her words a cup of coffee with stevia and half and half is OK.  She said one additional drink with artificial sweetener is OK.  I think I’ll switch to half caf and possibly go to decaf.

  • How often will I have to go to the DR?

    • Endo appointments – monthly.  Email BGs weekly.

    • OBGyn – probably about twice/month, more towards the end (obviously)

    • CDE – communicate via email, appointments as needed.

  • If BG is high/low, what is the best way to correct?  does the 15-15-15 rule still apply?  Bolus or increased temp basal?

    • 15-15-15 rule still applies.

    • She said most women bolus but if they remain high, then they will do a temp basal.

  • What is my carb intake goal at meals?

    • She was telling me something about the rule of nines – 2/9 of my carbs will be at each meal (so 6/9 total) and 1/9 at 3 snacks.  Although she didn’t give me my daily carb intake.  But did say that I will be meeting with a nutritionist.

  • Daily calorie range?  How much weight gain is expected/realistic?

    • 300 additional calories per day.  25-35 pounds is normal, but since I’m fat already (my words), I’ll have to be careful and shouldn’t gain as much.

  • Any foods I should stay away from other than the usual for pregnant ladies?

    • She didn’t say anything specific.

She wants me to make an eye doctor appointment within the next few months.  We also made some adjustments to my I:C ratios – lunch went from 1:9 to 1:8 and dinner went from 1:8 to 1:6 to prevent some of those mid afternoon and post-dinner spikes.

Soooo, there you have it.  As soon as the hubs and I are ready, we can get down to business.  Eeeeeeek!  I’m so excited/nervous/scared/happy/about to poop my pants!

Here’s your picture for WW – my “Oh shit!” face!

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Happy Monday!

Usually I curse Mondays.  I mean, really, weekends should be five days, work weeks two.  AmIright?

The husband has been out-of-town on a men’s fishing trip, and it’s kind of a running joke with us that whenever he’s out-of-town, I always get overnight lows (which is kind of scary, but we won’t go there) and I don’t really miss him until the lows start kicking in.  Of course they have the past three nights every night since he’s been away.  Duh.  I’ve been over-treating and then spending the following morning chasing down elevated BGs.

Until last night.  I OWNED my overnight low.  I was 60 on my meter, 53 on my Dexcom.  Drank 6 oz of OJ, spoonful of PB and woke up to a nice steady-ish line this morning.  Definitely perked me up for a Monday!

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I also have changed my high alert from 170 to 160.  Hopefully I don’t annoy my coworkers too much with the awesome tunes the Dexcom plays.  I really wish the high alerts were in increments of 5 so I could take even smaller “baby” steps (pun intended) towards better control.  Endo appointment is on Wednesday – my first a1c since I’ve rejoined the land of pumping and started on a CGM!  I’m excited and crossing everything that I’m 7.0 or lower!!!

Friday Fives: August 9, 2013

Five things that (irrationally?) worry me about a future pregnancy with Type 1

1.  What the heck am I going to drink?  This makes me sound like a lush, ha.  Seriously, though.  My CDE said I can have 2 artificial sweeteners per day.  I use Stevia, which, according to my reliable resources on the interwebs, is safe during pregnancy.  Awesome.  I can have brewed Iced Tea sweetened with Stevia (right?).  Of course I don’t want my future baby born with 3 eyes or anything, so I will do my very best to eliminate/strictly limit all artificial sweeteners and caffeine.  *gasp*.  Bye bye coffee.  Hello….water?  Milk?  What else is there?  Should I ween myself now?  I have no problems with giving up wine and beer (although, nachos just don’t taste the same with water!), but I fear that giving up coffee will make me a nightmare to live with.  It’s going to be a long 40 weeks!  Sorry in advance for the crankiness, husband.  ♥ you.

2.  Is my job going to hate me with the 900 million doctors appointments I will have?  My Endo’s and future OBgyn’s offices are a good 30-40 minutes away and as far as I know, do not offer evening appointments.  However, I’m not willing to change because I love my endocrinologist and her team and I especially love my CDE.  Luckily my CDE is very responsive via email so I am hoping that maybe, possibly, she will continue to help me adjust my rates and answer my questions via email when I am pregnant.  Taking a lot of time from work to go to the doctor is something I already feel self-conscious of.  I really am nervous that my coworkers will be frustrated when the time comes and I have so many more doctor’s appointments.  However, I think that my direct supervisors will be more than understanding, as one of them recently herself had a high risk pregnancy.  But still, I don’t want people to think I’m a slacker.

3.  Working, period.  Diabetes is a full-time job.  My job is a full-time job.  Being pregnant will be a full-time job.  I’m tired.

4.  Keeping the secret.  The hubs and I have agreed that we don’t want to tell anyone until I’m 12-16 weeks along, however this may prove difficult.  I imagine I will tell my sister sooner since she lives close by and I see her frequently.  And I was the first to know (after her husband, of course!) with all of her pregnancies.  (Neener, neener Mom! Haha!)  But there are going to be challenges, depending on when we conceive.  It could be a non-issue, in that we wouldn’t see our parents for the first 12 to 16 weeks due to schedules, when holidays fall, etc.  Or there could be lots of time spent with parents in which I’ll have to lie my tender boobies off.  It is pretty important to me that we don’t tell anyone until after the first trimester so we will just have to do our best.  I’m looking forward to having a little secret with the husband.  ♥

5.  Guilt.  I’ve read about this on so many different blogs of D-mommies/mommies-to-be.  The guilt they feel when their BGs aren’t in range.  I really want to enjoy my future pregnancy and be as laid back as a pregnant PWD can be, but knowing myself and how much I already love our future baby, I just have a feeling I will be super hard on myself if I am out of range.  I hope I can find a good balance.

6. Judgement from others.  (OK, it’s friday fives plus a bonus!).  I’ve never been pregnant.  I am scared, nervous, excited for that day when I see two lines on the pee stick.  I have no idea what it will be like, how it will feel to hear my baby’s heartbeat for the first time, to feel the flutter of movement, etc.  I am researching pregnancy with type 1 as much as I possibly can in an effort to educate myself so I can kind of know what to expect.  I know that it’s going to be hard.  I know I’ll have to make sacrifices (see #1).  I know that there’s a decent chance I’ll have to have a Cesarean section.  I just worry that people will judge me based on their experiences and what they think is right.  I know my husband will have my back and I will just remind the judgey McJudgersons that although they may have been pregnant, they’ve never been pregnant with type 1 and I’m doing the best that I can for my unborn child.  And if all else fails, I’ll break out some kickboxing moves and show them who’s boss.

I am thinking about this stuff more and more lately as the day when we start “trying” doesn’t seem as far off as it did a few months ago.  I am so inspired by the type 1 women who have had successful pregnancies and know that my pre-worrying is a bit on the cuckoo side.  But I also know it’s normal as we PWD can’t just throw caution to the wind and have to actually really plan and work hard for our pregnancies.  In the end when I hold that little life, it’ll all be worth it.

Wordless-ish Wednesday – 8/7 My Bug-Out Bag!

Inspired by my husband’s guest post about prepping with diabetes, I have made a Bug-Out Bag.  OK, fine.  I traveled last weekend and left all my supplies packed to be my B.O.B. This bag is something that has enough supplies to get me through a few days with Type 1, should there be a fire or other emergency which makes us have to escape our home quickly.  In it I have:

  • 100 test strips
  • Glucose Tabs
  • 4 infusion sets/reservoirs for pump site changes
  • Alcohol swabs
  • 2 CGM sensors
  • Syringes
  • Old box of insulin with Rx info

So should there ever be an emergency, all I really need to grab is insulin.  I used packaging that sheets came in and I really like that it’s clear so I can see what is in there, has a zipper so stuff won’t fall out, and is plastic so at least water-resistant.  And it has a handle.  Woohoo!  It would be great to also throw in a Rx for Lantus, extra battery, and glucagon.  But, this is a start and with the addition of insulin, would be enough to get me through a week or so until we received help from outside sources like the Red Cross.

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