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.

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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.

friendshipbracelet

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.

Dream Devices and High Fives

Diabetes Blog week, Wild Card/Day 7

Since I’m a day late with my Day 7 DBlog Week post, I figured I’d answer not only the Day 7 prompt, but would also throw in a wild card.  Double the love.dblogweek

I shall start with the wildcard:

Back by popular demand, let’s revisit this prompt from last year! Tell us what your fantasy diabetes device would be? Think of your dream blood glucose checker, delivery system for insulin or other meds, magic carb counter, etc etc etc. The sky is the limit – what would you love to see?

The obvious answer to this question is a cure.  A close second would be an artificial pancreas (hopefully soon-ish-y? Maybe in “five to ten years”????).  As you all know, I’ve newly re-cyborged myself with a Dexcom G4 and Animas Ping combo.  One of the main reasons for choosing this combo was the fact that Dexcom and Animas are BFFs and hopefully the new Vibe will be available within the next year-ish in the US.  It was just submitted to the FDA so one can cross her fingers, right?  Anyway…here is what I would LOVE as an option on the Ping…I would love it to ask how your BG is trending according to your CGM when it is calculating your bolus.  Are you trending up?  Slightly more insulin.  Rising rapidly?  Uh oh, a bit more insulin!  Falling rapidly, a lot less insulin.  It’d be nice if the Ping took the guess-work out of it!  I am not sure if this is even an option in the Vibe (I admittedly haven’t researched it a whole lot), but it sure would be nice!

Now, on to Day 7: Spread the Love!

As another Diabetes Blog Week draws to a close, let’s reflect on some of the great bloggers we’ve found this week. Give some love to three blog posts you’ve read and loved during Diabetes Blog Week, and tell us why they’re worth reading. Or share three blogs you’ve found this week that are new to you.

This is not an easy prompt!  There are so many great diabetes blogs out there that it is difficult to narrow it down to just 3 posts.  There are so many bloggers that inspire me, make me laugh, and challenge me.

A new blogger I have found is Paul at Type One Fun.  Paul is a 21 year-old college student who was recently diagnosed.  I was also diagnosed while attending college and it is very interesting to me to read about Paul’s experiences as a “newbie”.  He is doing a wonderful job adjusting to his new life with the D.  I especially enjoyed reading about his accomplishments!  Keep up the great work, Paul!

I really enjoy reading blogs from the Type 3-ers – the diabetic caregivers.  It is great to see things through their eyes, especially the parents of diabetics.  While posting about her most memorable diabetes day, Meri, a mother to four sons, three of whom are Type 1,  wrote of a special moment she shared with her husband in which she was able to accept their new lives as parents to three boys with type 1 diabetes.  Her husband reminded her that “We weren’t sent to this earth to be miserable”, very wise words and a wonderful reminder when we are feeling down or overcome by the emotional aspects of this disease.  Thank you for sharing such an intimate memory, Meri.  And for being an advocate not only for your sons but for all of us who have diabetes.

I also love the story Kelly at Diabetesaliciousness tells about her dad getting into a fight with a security guard at a Phillies game when the guard is a big ole moron when it comes to diabetes and bringing food into the old Vet.  Great memory sharing, Kelly!  And kudos to your dad for doing what so many of us want to do when we meet people who are ignorant about diabetes!

I really enjoyed participating in this year’s Diabetes Blog week.  I found some wonderful blogs to follow and loved hearing people’s experiences with diabetes.  I’m looking forward to next year!

Yay, team!

Diabetes Blog Week, Day 4.

We don’t always realize it, but each one of us had come a long way since diabetes first came into our life. It doesn’t matter if it’s been 5 weeks, 5 years or 50 years, you’ve done something outstanding diabetes-wise. So today let’s share the greatest accomplishment you’ve made in terms of dealing with your (or your loved one’s) diabetes. No accomplishment is too big or too small – think about self-acceptance, something you’ve mastered (pump / exercise / diet / etc.), making a tough care decision (finding a new endo or support group / choosing to use or not use a technology / etc.)dblogweek

Hmmmmm, good question!  I feel like I haven’t mastered anything when it comes to my diabetes care.  I mean, I have mastered the motions, testing my sugar when needed, changing my pump sites, bolusing, etc.  But I am still, 14 1/2 years in, not 100% confident to say “Yes! I kick ass at diabetes!”  My sugars are not perfect, I don’t exercise every day, I still enjoy a carb or 20, and I have days where I’m crying out of frustration that I have to live with this crap for the rest of my life.  Sometimes my blood sugar is just a real jerk for no reason (like last night for example – for about 4 hours I was cruising between 43 and 80 despite 20 oz of OJ and two not-so-small spoonfuls of peanut butter).  Is there anyone out there who really has mastered diabetes?  Who can go to their endo every three months and know that their A1c is going to be 6.0?  Who has the perfect attitude when it comes to living with this?

But, the question wasn’t if you’ve mastered diabetes.  It’s about diabetes-related accomplishments.  Recently I made some pretty darn important care decisions.  As the Hubs and I want to have a small human in the next year or two, I knew that the time had come where I need to get serious and get as close as I can to mastering diabetes.  I decided to end my months-long pump holiday and resume pump therapy with the help of a CGM.  This was something I thought about for weeks months before finally accepting that I’m going to have to become a cyborg again.

You see, in theory, I love the pump.  Don’t have to carry around syringes or pens, your meal schedule can be more varied, and it offers better management for most people than multiple daily injections.  Blah, blah, blah.

But in reality, the pump is a pain in the butt.  Site changes, being connected all the time, it’s expensive, it beeps at you, it’s bulky and gets in the way, and it makes wearing dresses a headache!  My pump-cation had been glorious!  However, knowing all of the negatives that come with wearing a pump, I decided the best thing for my health and the health of a future pregnancy would be to get back on the pump and to get a CGM.  So the research began.

I googled, I youtubed, I blog-stalked.  Wow, there are a lot of people online sharing their experiences with various pumps and CGM setups.  The doctors and manufacturer’s’ sites will only tell you so much, these blogs were so helpful in sharing real-world experiences and opinions.  I especially found blogs written by women who are in similar life stages as me to be very helpful and was so happy to find their sites (Texting my Pancreas and SixUntilMe especially).   With the help of my new blogger buddies and the fabulous interwebs, I decided on the Dexcom G4 Platinum CGM and Animas Ping pump.  In black and silver – stylin’.

Change is scary and although I had previously been on the MiniMed Paradigm pump, I was pretty nervous about going back on pump therapy.  I had a breakdown one night about the fears of the unknown and how much it sucks that I have to do this and think about these things a year before we even want to start trying for a baby.  He, however, reassured me that there are other ways to start a family and if I absolutely did not want to do this, I didn’t have to.  He also made the great point that if I hate it, I can quit.  He’s so smart.

Fast forward to today and I’m almost 2 weeks into my new cyborg life.  Have I mastered it?  Nope, not quite.  I’m still aware of the pump clipped to my pants and the CGM sensor and transmitter taped to my body.  I still feel dorky about my “diabetes tool belt”.  My sugars aren’t perfect and I definitely miss the freedom of not being attached.  But one thing I have mastered is my attitude that I’m just doing what I have to do.  And knowing that diabetes care is something that can be adjusted and modified to fit my needs at the time.  Not everyone needs to be on pump therapy.  It’s not the best course for every.single.person with a dead pancreas.  But for me, right now, it’s the best choice in regards to my goal of becoming a mother, and I’m cool with that.  Will it be my choice 5 years from now?  Who knows.  All we can really do in regards to our care is to make the best decision with the knowledge we have at the time.  I think a series of making the right decision and small accomplishments will lead me closer and closer to that whole mastering diabetes thing.  But for now, I feel like I’ve accomplished the right attitude.

Last day of vacation!

Whenever I go on vacation, I get what the Hubs calls the vacation blues.  I’ll get sad when we’re on like, day 2, of vacation.  “We only have 5 days left!  Wah.”  The Hubs reminds me to just relax and enjoy and I think the past few vacations we’ve gone on, I’ve been getting better at savoring the moment and not being grumpy pants that vacations don’t last forever (until we win the Powerball).

Today is my last day of my extended pump vacation.  Since my Endo’s office was able to get me in earlier than anticipated, I haven’t really had time to get the pump vacation ending blues.  But, there are definitely a few things I will miss about being un-plugged:

  1. Wearing dresses is so much easier w/out a pump.  Seriously, those leg pouches, not comfy.  Wearing the pump between your boobs, well, not so comfy either.  And it’s real attractive to go fishing for your pump in your cleavage when you’re out to dinner.  No, I’m not getting frisky with myself at the dinner table…
  2. Sexy time.  Let’s get real.  “Hold on honey, let me disconnect” isn’t exactly sexy foreplay.  It is much easier to be spontaneous when you aren’t a cyborg.
  3. Swimming, beaching, hot tubbing.  Not that I do these things often, but again, easier w/out a pump and having to disconnect.
  4. Exercising.  The bouncy-bounce-bouncy-ness of the pump while working out can get really annoying.  They need to make pump sport bras or something.
  5. I feel like diabetes isn’t as in your face when on MDI.  Granted the multiple injections every day are a reminder, but you can almost forget you have the D in between them.  The pump is connected to you 24/7, it’s visible to others, it beeps, it makes you bump into things (Am I the only one who is constantly grazing doorways?), etc.  It’s a constant reminder that you need a machine to do what your pancreas was supposed to do.  Seriously, pancreas…you had one job.  One.

However, all that being said, I’m pretty excited to go back on pump therapy.  I think I’ve made the right decision moving to the Animas Ping/Dexcom combo so I can get that elusive 7.0 (or lower) a1C.  The Ping is pretty nifty as it has a meter-remote so I can bolus right from my meter (makes wearing dresses a little easier, no boobie fishing here!).  It is water proof so swimming and such is a bit easier, although I do anticipate I will still disconnect, but this way if my Hubs wants to throw me in the pool, he can.  Exercising and sexy time…well, it is what it is.  The Hubs doesn’t make me feel any less sexy just because I have an extra step to take before getting busy.  (Thanks, honey!)  The bouncy-ness of the pump while exercising will probably always be a matter of trial and error.  I’ve found that wearing shorts/capris with compression fabric around the waist and turning the pump in towards your body helps a lot.

As far as the in your face-ness of the pump…well, I’ve been working on embracing my diabetes.  This is me.  Take it or leave it.  And, if nothing else, it’s a conversation starter.  “Why do you wear a pager?  Are you a doctor?”  “OMG, pagers are sooooooo 1996.”  “My nephew has a pump, but his is blue.”  I also like getting “the nod” from other pumpers.  We pumpers know what’s up.

And, if all else fails, there are always pump vacations to be had.  But I do imagine that once small human is created and comes into our lives, I really will be appreciative of the convenience the pump provides.  So right now, a few hours before my new cyborg life, I am feeling excited, empowered, and surprisingly not very blue.  I am going to relax and enjoy this trip!

A love letter for my Endo’s office…

I am currently on a pump-cation.  (Got hitched, sick of being a cyborg, it’s ‘spensive).  I’ve been enjoying this pump-cation for about 8 months now.  However, since the Hubs and I want to create a small human, it’s time to get back on the pump.  I’ve decided to make the switch from Minimed to Animas as I’m a new Dexcom user and Dexcom and Animas are BFFs.

BFFs

Well, my Ping (I say this in my head like “BING!!” from “Friends”.  Oh how I miss that show.) is due to arrive today!  Yay!

However, my appointment to see the Certified Diabetes Educator to train me on my new pump is not until June 28th.  That’s, like, a million years from now.

So what does any pushy patient do?  I emailed my Endo and her PA asking for my last basal rates so I could get started pumping right away as I don’t want to wait 8 weeks to resume pump therapy.  I am so excited to see what results the Dexcom/Animas Best Friends Forever-ship brings me.

But, as well all know with diabetes, nothing is ever easy.  Doc responds to my email and does not give me my basal rates and says she wants me to wait until my appointment in June.

grumpy cat

I don’t think so.  So I call and complain and some how, magically, they are able to offer me not one, but TWO options for appointments this Monday.  Imagine that?!  So my homework for the weekend is to read over the manual and get intimate with my new Ping so I am fully prepared for my appointment on monday.  I’m mostly excited, with a teeny, tiny amount of sadness that I’ll now be attached to a pump again.  But, a wanna-be Mommy’s gotta do what a wanna-be Mommy’s gotta do.  Right?

However, I do wonder if the Endo’s office had these two appointments all along and it took me being a squeaky diabetic to get in sooner.  Squeaky D gets the new Pump?  Just goes to show that it can’t hurt to ask and those of us with chronic illnesses have to be our own advocates for our healthcare.

Also, side note.  I still need to figure out what to do for a pump case for working out.  I used to have a nice case that had a clip and zipped around the pump to wear while I worked out.  It was great because it didn’t bounce around (I wear compression capris so it holds firmly when clipped towards the inside), didn’t annoy me by riding up as I imagine one of the waist pouches/spi belt things would, and the fabric zipped around the entire pump protected it from moisture (I killed 2 pumps by sweating on them.  D’oops).  Of course, my awesome case is lost and it doesn’t appear to still be offered by Minimed.  Le Sighe.  What do you use for working out?