Averages, averages...

Lately, I've seen some other DOC bloggers talking about averages.  Mine have been pretty decent, though I've been higher than I'd like the last couple of days.  (When I start the day above 130, I seem to tend to drift up...when I start the day around 100, I tend to stay there.  I like staying there.)

Machine averages are a great feature, but they're certainly not everything.  I've caught myself thinking, "Hey, do you really need to test again?  You may ruin your average."  Bad thought, bad idea.  I'm not exactly being graded on this.

I generally feel "OK" in a pretty wide swath that goes well into the "uh-oh" range.  I normally feel fine up to close to 200, and on the other side, I am usually obviously impaired at 70.  I usually feel bad enough at 85 to want to do something about it.  I've only tested below 70 once so far, and it was an odd feeling...akin to the effects of alcohol.  I feel extremely fortunate to be so sensitive to hypos, and I hope I keep that.

So, there's another side to averages too, that needs some discussion.  On days when I'm running high, and I'm doing correction boluses, I know my "actual" average is lower than what the machine would suggest.  So it would be nice if the machine could reflect that in some way.  I believe that it tends to average out over time.  In any case, it's the A1C that everyone trusts.

I know that there are continuous glucose monitors out there, but I'm not sure if my insurance would cover it, and it seems like it introduces several problems as well.  We'll see how well my next A1C (which I expect to do in February) reflects what my machine is telling me.  The techie side of me sees all kinds of opportunities to have fun with the data provided by a CGMS, but I also think I would obsess over it more than would be good for me.

Type 1 on Supernanny

Tonight's episode of Supernanny featured a five year old boy named Aiden with Type 1.  The show did a pretty good job of describing different aspects of the disease, including showing a list of famous people with Type 1.  It showed several quick clips of an insulin shot and something immediately identifiable as a glucometer.  There was some mention of how serious it was, but no specifics about complications.  They did a cute finger puppet show about the "balancing act" between carbs and insulin.

The very end of the show featured a video message from a professional snowboarder, Sean Busby, who is a proud Type 1 diabetic.  (The video message showed him prominently displaying his insulin pump.)  He had a special message for Aiden, which was very touching.  Sean's website is here; he runs regular snowboarding camps for diabetic kids.


I wish Aiden and his family the best - I couldn't imagine living with this at his age.

The Importance of Averages

There are a number of things I've always enjoyed about Thanksgiving, and now that I've got one in the rear-view mirror (so to speak) I can rest a little easier.

Two of my favorite things about thanksgiving dinner have always been stuffing and potatoes.  I did well with those; I think I've gotten pretty good at counting carbs effectively.  That's surprised me a bit because I've never been good at estimating distance or volume.  Well, now I have to be. :)

It was the cheesecake that spiked me.  Make no mistake, my wife makes the best cheesecake *EVER*.  This time, she made one with cherry topping, and really thick (from scratch!) graham cracker crust.  I love the crust.  I love it a lot.  The crust from scratch is especially good, since she makes it with real butter.

I guessed 64 and bolused 8, but I undershot.  (I told you the crust was good.)  I was on a bit of a rollercoaster for the rest of the night - I had tested 99 before the cheesecake, but tested 175, 146, and 192 that night, and finally 149 before I went to sleep.  Not ideal, but in retrospect I worried about it more than I should have, and that probably helped to keep me up.  I wound up putting in a lot of corrective, and I'm well within normal limits now.

If I had run the averages, I probably would have been a little less worried.

The other big thing was that I worked the program I was taught, and it worked for me, though a bit more slowly than I had hoped.

Though it does seem that the higher I go, the more insulin resistant I get.  I'd love to hear if anyone else has similar experiences that way, or if I'm looking at it incorrectly.

Something to be Thankful For: History of Diabetes Treatment

Here's a nice writeup on the treatment of diabetes (primarily type 1) over the course of history:

http://www.diabeteshealth.com/read/2008/12/17/715/the-history-of-diabetes/

It's shocking how little there is until 1922.

Here's the Wikipedia article on Banting, the discoverer of insulin:


http://en.wikipedia.org/wiki/Frederick_Banting

And of course, let's be thankful that Turkey is high in protein and has no carbs...leaves more space in the carb budget for stuffing and, in our case, cheesecake.

Better Numbers

Well, as we head into Thanksgiving, I am grateful for modern technology.  I am thankful to Banting and Best for their work in isolating insulin, without which my life would certainly be quite a bit more miserable than it is right now.

I am also grateful for modern glucometer technology.  I remember seeing one of the 80's vintage glucometers - my mother had it for some reason that escapes me now.  What we have today is certainly tons better than those used to be.

My numbers have been stellar these last few days.  I don't want to brag about it, and I certainly won't presume to judge anyone else.  I'm just trying to do what my CDE and GP are telling me to do, and it's working very well.

My machine average is now 122 over 7 days.  I'm learning to snack to prevent crazy liver dumping in the early afternoons.  (I seem to do that mid-morning and mid-afternoon.)  I hope things continue this way.  I am fortunate enough to lead a relatively predictable life, and I have a lot of freedom in terms of when and what I eat.  I am certainly thankful for that, too. :)

Some Battles are Worth Fighting

From http://lifeafterdx.blogspot.com/2009/11/victory-at-sea.html

Wil, who is a health care professional, writes the LifeAfterDx blog.  He is also a diabetic, and was one of the first to have a continuous glucose monitoring system.

It seems one of the major health care insurers in New Mexico decided they weren't going to cover pens anymore, so Wil wrote a letter about it.  We will have to see what happens, but I wish him the best, and I encourage you to encourage him as well.

Pens are the modern standard of insulin therapy, and they greatly simplified my own adjustment to the diabetic discipline.  They are easy to carry, easy to use, and surprisingly comfortable as well.  (Speaking as someone who has to put a needle into my body at least 10 times a day, that matters to me.)

Ice Cream and Snacking: Perspective

I have always loved ice cream.

I grew up near a Baskin-Robbins in Michigan, and we would walk down there at least once a week.  I remember being especially fond of chocolate chip and gold medal ribbon (which has a caramel stripe).  I later learned to love cookies and cream, butter pecan, and other flavors.

Ice cream was actually the main indicator of my blood sugar problems.  We usually had some around the house, but we were going through about 3/4 gallon a week, and that was largely me.  In addition, I was having the odd pint for lunch at my work cafeteria.  It was one of the major reasons my wife wanted me to get checked out - I was eating far more than a normal person should, and I was still losing weight.  Well, we know how that turned out.

Ice Cream is a tricky thing for diabetics.  Let's do a quick review of diabetic types.  Type 1 diabetes is insulin deficiency, and is much more rare.  The body doesn't produce enough insulin to process the food we eat, and our blood sugar levels climb because there's not enough insulin to bring it down.  For type 2's, which is much more common (they outnumber us about 9 to 1), they make plenty of insulin, but for some reason their bodies resist that insulin and it doesn't work.  Type 1's are (as far as I know) always treated with insulin; type 2's may or may not be.  In both cases, we have to watch what we eat and count carbs - for type 1's, to dose insulin correctly, and for type 2's, to stay within their tolerances.


This leads to significant differences in the way we handle snacking.  For a type 1, occasional snacking is no big deal - count the carbs, take the insulin, eat the snack.  Maybe an extra blood test, to make sure the levels are OK.  Since most type 2's are not on insulin, that won't work for them - they have to find something that fits within their carb budget, or change other things around.

Snacking is also important because of a process called liver dumping.  When we go for a while without eating, the liver will dump glucose into our bloodstream, counting on the pancreas to release insulin to process it.  This is often done when the body feels "hungry" so ignoring hunger pangs and not eating can actually lead to a higher blood glucose level in diabetics than eating something and not dosing.  One of the primary goals of the oral meds they give type 2's is to block this function of the liver.  Frequently, we'll look for snacks that are low in carbs.  My favorites are peanuts and almonds.  Nuts in general are excellent as low carb snacks, and most diabetics I know swear by peanut butter.

So, we still need to eat, and we still need to snack.  One thing that irritates a lot of us is when people tell us we can't eat something.  I have at least once eaten it on the spot, just to prove the point.  (And then snuck off and dosed - some people are very uncomfortable with needles, but most people have never seen the needles that fit on insulin pens.)  And of course, there's the primarily psychological problem of deprivation.  It's hard to see everyone else eating birthday cake, or drinking cider, or whatever, and feeling like you can't.  So it's important to feel that we can, within limits.

That said, it's kind of dumb to blow lots of insulin on candy and other "empty" snack foods.  For one, it's a sure way to gain weight (and now that I'm back to a healthy weight there's no need for that).  For another, there are the consequences of eating the fat and other stuff.  Blood pressure and other vascular problems a re a major class of diabetes consequences that we would all like to avoid, thank you very much.

I'll post more later on some specifics that I've found about various frozen treat things.

Ice Cream!

I had plain old ice cream today.  Ah, the things you learn to appreciate...

Interesting trivia - plain chocolate ice cream (Yarnell's, at least) is the lowest carb available of the major flavors I've seen, at 16g/half cup.  Homemade vanilla was highest at 20g/half cup.  Cookies and cream was 19g/half cup.

Sugars have been in pretty good control these last couple days.  I'm getting more aggressive about taking insulin when I'm high.  Gotta keep those numbers down...

For your amusement

The stylings of Sugasheen, with an absolutely fresh take on Beyonce's "All the Single Ladies".  It's been making the rounds in the DOC (that's Diabetes Online Community):

Ah, The Miracle of Retail Pharmacy...

I had to deal with some extra frustration today when it came time to refill my prescription for test strips.

The first time I filled it, they gave me 100.  OK, I didn't know any better.   (I actually felt pretty good that I was walking around and talking...this was the morning of Oct. 5, immediately after learning "the rules", the date my diagnosis felt real to me.)

The first time I refilled it, they adjusted it so I'd get 200 strips for my copay instead of 100.  Seemed like a good deal to me...

So I called in a refill on Monday, using the Rx number I had.  Unbeknownst to me, it's the wrong number - a new one was generated when they clarified the directions.

Thankfully, they were very good about fixing it, and I'll be good on test strips for another month.

Amazing, the things you get to learn when you're diabetic.

Marcus Luttrell: Lone Survivor

In June 2005, American special forces in Afghanistan suffered the largest loss of life in a single day ever in their history.

A four-man SEAL team, searching for a high-priority terrorist target in Northeast Afghanistan was found and attacked by a large Taliban force.  The rescue helicopter sent to rescue them was shot down as well, killing all sixteen men aboard.

Petty Officer Marcus Luttrell was the sole survivor of this operation, and Lone Survivor is his story of becoming a SEAL and what happened on that mission.

I was privileged to hear Luttrell speak and shake his hand last week, so I knew many details of the story before I read the book.  Still it is by turns inspiring, frustrating, and harrowing.  Luttrell represents the bravado and ethos of the Navy SEALs well.  It's hard to believe that people can survive the SEAL training - I know I couldn't.  The frustration comes of understanding the dilemmas our men in the field face, especially in relation to the rules of engagement they must obey.  The story of the battle itself and his subsequent evasion of the Taliban are the stuff of legend.  Scenes from Afghanistan are intercut with scenes from the Luttrell ranch in Texas, where nearly 300 people kept watch with the Luttrell family as they awaited news of Marcus' fate.

The book is well worth reading, and I highly recommend it.  It is deeply moving, especially for its depiction of the deep bonds of brotherhood that unite the men who serve in the most elite of American military forces.  It makes me proud that we have men like Marcus Luttrell defending this country.  We owe them all more than we could ever know.  We also owe the lost men of the Operation Redwing patrol - Lt. Michael Murphy, and Petty Officers Matt Axelson and Danny Dietz.  Those men are true heroes, and Luttrell does them a great honor by telling their story.

Small Victories: Pizza

Pizza is a tricky food for diabetics to eat.  It has two key attributes that make it tricky for those of us who have to worry about our blood sugar levels:

1)  High carb count due to crust and pizza sauce
2)  High fat content, which can delay digestion of the carbs

The first one means we have to push a lot of insulin to process pizza, the second means that if you push it too early, you could go low.  But I like my pizza, so it's a problem worth solving for me.  Plus, who wants to let a little thing like diabetes get in the way of enjoying one of life's more enjoyable foods?

I learned a neat trick from my CDE for dealing with pizza - push the insulin *after* eating the pizza instead of before it.  That gives your system a little margin, since your sugar will go up a little as the carbs process, which will give the insulin something to work on and hopefully won't take you low in the meantime.

This worked for me today:  Two slices of green pepper/onion/black olive/pepperoni hand-tossed pizza.  Estimated 88g carbs, blood sugar prior: 93, 2 hours later: 124.  Huzzah!

World Diabetes Day

Happy WDD, everyone.

The whole D-Blog world is saying it a lot better than I can, but I do want to at least mention that today is the day.  My favorite so far has been this video, by Kerri of sixuntilme.com:



Until we find a cure...

First Low

Well, I had my first certified hypoglycemia event today.

I should have known it was coming on when I went into the break room and saw some sugar someone had spilled on the counter and stared at it just a little too long...

I went back to my desk and felt a little faint.  I tested and...67.

I could tell I was dropping, too.  I was slurring, and having a hard time completing sentences.  I grabbed some lifesavers (I always keep some handy) and ate half a roll.

Then followed a brief walk to a meeting with a friend of mine...I remember he mentioned a movie, mathematics, and some other things but no real details.  I remember he said the movie was Friday, and I remember asking, "What day is it again?"

I started my watch timer when I took the lifesavers.  Just after 15 minutes post-lifesavers, I tested again, but I knew I'd be OK - I felt something almost like a pop at about 10 minutes and I felt normal again.

Strange thing, this disease.

After lunch (which was large, and carb-loaded, but I think I bolused correctly) - 328.

Ketone test - negative.

10 units of insulin - check.

After an hour, I was back down to 107.  And munching on lifesavers again to prevent another low.

It's a good thing I enjoy rollercoasters. :)

Veterans' Day

We had a special event today at work, to honor Veterans' Day.  Usually all the stops come out for veterans here, and this was no exception.

We had Marcus Luttrell, the author of Lone Survivor and the only survivor of Operation Redwing in Afghanistan, to tell his story.

Words do not do this story justice.  It's one thing to read the Wikipedia article, it's another to hear him tell of his BUD/S experiences, and his promise to his friends to keep their memories alive.  I think he's done an incredible job of that.  I'll read the book and post a mini-review here.

In line afterwards, waiting to get our books signed, I struck up a conversation with my previous director.  I knew he'd been in the Air Force, and that he'd flown on B-52's.  That was 20 years ago.  I joked with him that his plane was probably still flying.  Turns out the guy three further back in line had worked on the same B-52 as a mechanic (tail number 277) in 1975.  That airframe has certainly served this country well.

To all veterans:  Those of us who have never served will never fully understand the sacrifices you have made on our behalf - the things you've done, and seen.  I thank you all, from the bottom of my heart, for all the things I know and all of them that I don't.  Thank you for your service and your dedication.

Back to Sonic

I went back to Sonic today, and it was all I hoped it would be.  I got the Cheddar Peppers because they were lower carb...than the fries.

I can't remember ever actually ordering a drink from Sonic...I've always gotten the Strawberry Fresh Fruit slush.  That's not really an option for me now.  (By the book, the Route 44 strawberry slush is 188g carbs - that would be about 24 units of Novolog at my current dosage, without counting anything else.)  It's always taken me about 90 minutes to finish a Route 44, too, which would be very tricky to dose for.  Not impossible, but more of a challenge than I really want to undertake.  Well, I had a Blizzard very early in my journey, but I only took 8 units for it...should have taken at least twice that much.  I had a record high of 328 after that, which is the highest I've tested since I started insulin.  One of the key indicators my ratio was way off.

So because I'd never ordered one, and because Sonic recently changed their menu structure, I couldn't find the drink list...I asked if they had Diet Dr. Pepper, and they did.  Score!  (I can drink Diet Coke too, but prefer Dr. Pepper and Mt. Dew, because I'm a technology professional and we have to support the smaller colas, especially Dr. Pepper.)

The Cheddar Peppers were by far the tastiest I've ever had...maybe it's just me, but the food tastes better when you have to count carbs and stick yourself three times to eat it.  (Testing before and after, plus the insulin dose.)  I certainly appreciate such things more than I used to.

D-Blogger Day: Perspectives on Ability

I spent the day sick today, which wasn't an especially pleasant experience.  Still, it could have been a lot worse.  I was higher than I wanted to be but stayed more or less under control.

While resting, I watched two movies I've been meaning to see for a while:  Expelled and Murderball.

One minor point made in Expelled is that "civilized" humanity is distinguished by its care and concern for the weak and infirm.  That we care enough, for, say, people who don't have a working pancreas to make synthetic insulin for them to use, so they can live.  (Well, Expelled didn't mention us diabetics, specifically, but the idea certainly holds.)  It is something that affected me, because it says a lot about what kind of society we are and we want to be.

On the other side, we have the...fascinating young men of Murderball.  "Murderball" is the documentary of Quadriplegic Rugby, a cross between hockey, basketball, and rubgy played at the Olympic level as an official Paralympic game.  They called the game "Murderball" and found a hard time getting corporate sponsorships.

Murderball is a different sort of film.  Not at all your standard sports documentary.  The men of Murderball are completely unapologetic.  They're playing for a gold medal, not hugs, as one of them says during the film.  They neither ask nor give quarter while they're playing.  It's terrifying to watch, as collisions are common and brutal.  Getting knocked over is not a foul.

These men understand the risks they're taking, but they do it willingly as a way of reclaiming their lives post-injury.  Many of them were strong and athletic before the incidents that rendered them quadriplegic, and quad rugby is the way they can have as much of that back as their situations allow.

My favorite scene from Murderball is the one where Keith, a young man who had broken his neck in a motorcycle accident less than a year previous gets to see a rugby chair, demonstrated by the captain of the USA quad rugby team.  He gets to sit in it, to the obvious dismay of the hospital staff, and tap a little against the "everyday" chair the team captain also brought.  The possibility of doing, of competing, brings him a new lease on life.

I've looked online, but there's no indication whether Keith ever got to try out for the USA quad rugby team.  I hope he did, and I hope he made it.

To those who want to see Murderball:  it is surprisingly frank in parts, quite possibly too frank for many.  The profanity quotient is also pretty high.  I wouldn't recommend it for 5th graders, but it was definitely worth the watch for me.

Got Something for sure

Well, now I know for sure I've got something.  I'll spare my loyal readers the gory details, but I'm quite sure I'm sick this time.

I'm pushing fluids and keeping food coming in.  Fortunately I had a big lunch before the bug set in, so I've got a fair amount of stuff in my system.

I've suspected I have something waiting to descend on me because of some wonky numbers the last couple of days.  Sometimes I hate it when I'm right.

Reports!

I've been running a little high the last couple days.  Flu's been running through here, so that may be it.  I've been behaving diet-wise, honest. :)  My numbers are high, but not outrageous.  Averaging closer to 150 than 130, which is what I'm shooting for.  I had a false alarm last weekend, that I think was brought on by eating too many nuts for snacks.  This time, I haven't been snacking, and everyone around me is coughing.

So...I've been making progress in the software.

Any software project is all about compromises, and this is no different.  One approach in uncharted waters is to throw something quick together, and see how you like it.  Keep the parts you like, fix the parts you don't.  Of course, you may wind up having to do that several times.

For most applications, the thing that will control everything is the way you store your data.  I'm using PostgreSQL, which is an incredibly powerful free database system.  For the moment, I'm using a Perl CGI interface to insert data via Web forms.  One nice thing about Postgres is that it is easy to get data out of it with just about any programming language, so when I get to the graphing part, it may be in Perl or Python or even something like R.  (Since those can all interface with the data fairly easily.)

Over the next few days, I'll post some of the data I'm tracking, why I'm tracking it, etc.  (Most of them are straightforward and obvious.)  I'm looking for input about what's important to people, so if you have strong opinions, feel free to leave a comment.

Normalcy? What's that again?

So today was running great.  My 7-day and 14-day averages were creeping below 140 (and man, am I glad about that).  I was hovering in the 85-100 range all morning.

Had lunch with some friends at a local Asian restaurant - things still feeling good, I guessed 95 but clocked in at 109.  Dosed for 64g carbs (I like my rice, what can I say?), which has been successful with that place and approximate dish in the past.

Got involved in a conversation with a vendor, and didn't check my post-prandial on time.  Had grabbed some cocoa-roasted almonds, about two handfuls - should be like 6g.  Finally got to checking my glucose 3 hours after eating abd I was 254.

Yeah, 254.

Sigh.

It was a stressful conversation, a bit.  Not horribly.  I shrug, take some extra insulin, and go on from there.
Ick.

I checked again at hour intervals and last time was still over 200.  Well, I'll get back to where I need to be soon enough.  It's about supper time; I've delayed a bit so I can be a little more aggressive with my insulin.  I always feel more comfortable taking more insulin with food.

I Miss Sonic

One of my priorities after being diagnosed was to eat at all the places I used to eat, to re-establish a feeling of control over my life - to establish that I didn't have to be completely subject to the disease.

The one place I always used to enjoy eating that I haven't been back to since I've been on insulin is Sonic.  I love the strawberry slush there.  I looked right after I was diagnosed - 188g carbs for the 44oz version, which I always preferred.

One of these days, I'll have to go and have a small one, at least.  I just haven't gotten around to it, yet.

Beginnings of Normalcy

Today was remarkable for its lack of anything new or remarkable.

I woke up 172, and took a little extra insulin with my banana oat muffin.  (Yes, I've opened my mind to bananas.  It's amazing what happens when you're a little open-minded.)

Figured I was headed low in the morning, tested, and got an 87.  Three lifesavers later, I'm losing that woozy feeling.  Not four, cause that would take me up more than I need to go.

A week or two weeks ago, either of those events would have been...well, exciting, at least.  Now...not so much.

I'm starting to feel normal again, and it's a good feeling.  A very good feeling.  It reminds me a lot of learning to drive - at first, the whole experience was completely new and different, despite having ridden in cars for 18 years (I was a late bloomer for my first license, I know), all the lights, and signs, and road markings and a new and different appearance to me.  I worried a lot about stuff like when to signal turns, and how fast to try to take them.  And over time, I became less and less aware of those things and they became automatic.

I'm still very aware of my diabetes management efforts, but the results are getting more predictable, and edge of newness is wearing off.  That's part of the feeling of normalcy too, and I welcome it.  That's not at all the same thing as slacking off or not testing.

Software?

I'm a technologist by trade (specifically, a network engineer).  That means I keep the little green lights blinking. :)

I do technology for fun, too, and diabetes has afforded me the opportunity to learn more about databases and graphing.

I've written a quick CGI script that runs on my server at home and stores my carb, glucose, and insulin values in a database.

Once the data is in, the fun begins.  The beauty of a database is that you can have it automatically calculate averages and other formulas over a period of time.  I've got an A1C predictor, for example, that looks at a 90-day window of glucose averages and predicts an A1C result based on that.

Right now it's all very rough.  Build one to throw away, they say. :)  I'm using this as a kind of sandbox to try different things and see what I think works and doesn't work.  The database schema (the data structures and definitions, plus all the stuff that lives inside the database, like formulas) has been through a number of revisions already, and I'm sure it will go through more.

My next step will be to generate some HTML reports for date ranges and stuff like that (exports for spreadsheets, like Excel and OpenOffice.org Calc).  The step after that will be to start rendering graphs on demand.

So here is a question:  what statistics are useful in tracking and predicting how your diabetes needs to be treated?  One obvious thing I'm not modeling in the current schema is the ability to track multiple patients, for example.

Saying Hi to a Friend

One of my best earlier memories of diabetes (pre-diagnosis) came about four years ago when I was working on a project with an occasional collaborator from another team.

During this time, we all wore pagers.  I saw an odd-looking device on his belt that looked like a purple one.  I asked what sort of pager it was since I'd never seen one before.

Turned out it was an insulin pump, as he patiently and nicely explained.

Wow, did I feel like a jerk.

Today I sought him out and talked to him about my diagnosis.  It was a good conversation, and an interesting way to close a loop in a way.  I'd felt a desire to stop by and talk to him ever since I was diagnosed.

Odd how things like that work out.

4400+ steps on the pedometer today, and I have been very pleased with my glucose today.

Control...

Well....after *carefully* reading the nutrition label on my favorite snack food (as of late), peanuts have a few more carbs than I thought...and I've been eating them by the quarter cup.  Just enough to push me up, it seems.

Now realizing that, I'm getting ready to check my post-prandial on what may be my best control day yet, in terms of variance and overall levels.  Which is to say, I've been averaging 140, but that's because I split between 100 and 180.  Make no mistake - it beats heck out of 300+, but that's still not ideal from a control standpoint.

So...175 post-prandial.  Not too bad, within guidelines and < 50 points higher than my pre-prandial (which was 157).  Which should put me in the neighborhood of 140 for bedtime, which is about right.

And I need to read the nutrition labels on my snacks a little better. :)

Coming to Grips

I thought this post would be easier to write.  It was intended to be the second post, but others intruded, and this one...seemed to want to wait.

So my official diagnosis day was 10/2/2009.  That was around noon, when my morning blood work came back.

But I really view the beginning of my life with Diabetes as beginning on the Monday after that, 10/5.  That's when I had the followup with my doctor, and when it all really sunk in.  Also, when I got my glucometer and my first batch of insulin and insulin supplies.

But...I'm dawdling. :)  This is catharsis about my actual discovery.

In retrospect, I think some of my memories of the Friday morning and Monday morning are a bit confused, conflated.

So, on the Friday afternoon, I was told that I was, for certain, diabetic.  I had set up a followup with my physician for Monday morning, as they wanted to start treating me right away.  My test results confirmed that, with a 330 BG and an a1c of around 13.  (Need to find out exactly what it was for my records.)

The Monday appointment was one of the longest hours of my life.  In fact, I don't know exactly how long I was in the office.  Time seems to warp around significant events.

I remember hearing a lot about how to take insulin, and the use of the pen being demonstrated for me.  I got a basic formula for how much to take and how often, how much to take for correctives, the difference between Levemir and Novolog.  Stuff like that.

All I'd been hoping over the weekend (knowing that I was diabetic, but not knowing too much about what that meant) was that I wouldn't have to be on insulin.

So here was my insulin.

The big thing I remember:

Fear.  I remember being so very afraid, afraid of complications, afraid of insulin overdose, afraid of all the things I didn't know.  Which was a lot.  Still is, though I feel like I've learned an awful lot in the month that's gone by since then.

I almost broke down into tears at least three times during the appointment.  I was a mess.  I remember not being able to find my way out of the doctor's office diagnostic area, but I'm pretty sure that's a memory from Friday morning instead of Monday morning.  I've never had a great sense of direction, and it's especially bad when I'm under stress.  Ironic, since I'm a network engineer by profession.

It helped a lot that the nurse told me she was diabetic, and taking shots.  I had taken allergy shots as a kid, so giving myself injections wasn't the worst idea in the world.  Still, I wasn't looking forward to it.  I didn't know how invasive the new treatment regime would be, and I was a little afraid that people wouldn't understand, and would think less of me because of it.

I was still a mess when I left the office.  My next stop was to go to the pharmacy to pick up my first batch of prescriptions.  I waited over 2 hours, while several...discrepancies...were worked out between what my health insurance was willing to cover and what I'd been prescribed.  And the pharmacy was unusually busy.

I also remember picking up a 24-can case of Diet Mt. Dew.  I had never before in my life deliberately bought diet cola for myself, that I can remember.  But I knew that the sugar in regular would do me much more harm than good.  It was one of the first milestones in my acceptance of my condition.

I got a referral to talk to the local CDE on Tuesday afternoon - apparently someone had cancelled.  Lucky me. :)

I did my first glucose test Monday night - and took my first Levemir dose.  More on those later.  The glucose test was especially comical. :)

First Sick Day

Well, the flu's been running around here, and our house is no exception.

Two of our kids have had it so far and now my wife is having her turn.

I can feel some of the classic flu symptoms though I'm not running a temperature.  I seem to be exhibiting more insulin resistance than normal, but my last test (a couple minutes ago) had me at 103, so I'm happy about that.  (174 at wakeup and 184 after 2 hours, 30g carbs and 10 units of Novolog).

Maybe I'll get to break out the ketone test strips today. :)