Spare A Rose, Save A Child

Thursday, February 6th, 2014 | Posted under Diabetes

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In 1921, Frederick Banting and Charlest Best discovered how to make artificial insulin. Prior to this, insulin was a death sentence.

The body needs insulin to use the glucose from the food you eat. When the body doesn’t produce insulin (as in the case of type 1 diabetes — which I’ve had for 20 years), the body starts to break down fat instead. Using fat sounds good at first, but a byproduct of the process is a toxic chemical called ketones. If ketones build up in the system, you can have nausea, vomiting, coma and death. In addition, the build up of glucose in the blood stream causes complications in the kidneys, heart, eyes, and limbs.

For the past 90 years, Eli Lilly has produced insulin. Other pharmaceutical companies, like Sanofi and Novo Nordisk, have also started making different types of insulin.

But despite this amazing discovery, there are still people dying from diabetes because of lack of insulin.

Shocking, right? How can a drug that has been available for nearly a century be unavailable to people who need it? There are a lot of reasons. First, insulin is very expensive, and there are thousands of people with diabetes living in impoverished countries who can’t afford insulin. There are even people in our own country who have a difficult time budgeting for insulin. Insulin is heat-sensitive, and many of the countries that are the most needy are in very warm climates with no refrigeration. There is also a lack of education. Many families are not educated in diabetes and they don’t understand the severity of the disease. They don’t realize how often they or their child needs to take insulin.

These are just some of the reasons why children are dying from diabetes.

But we can do something to help!

The International Diabetes Federation runs a program called Life for a Child. Life for a Child provides insulin as well as other diabetes supplies and education to more than 12,000 impoverished children living in 43 developing countries. Without this help, there is a good chance they would not survive. In some areas, the life expectancy of a child with type 1 diabetes is less than one year.

In honor of Valentine’s Day, my friends in the Diabetes Online Community have has launched the “Spare a Rose, Save a Child” campaign encouraging people to spend the amount they would spend on one rose to save the life of one child. Just five dollars will help support a child for a month. A dozen roses would help a child for a year. The IDF’s goal for 2014 is to raise $10,000!

This is a tangible way that you can make the difference in the diabetes cause. No one should die from diabetes because of lack of insulin. Insulin already exists. It’s here. Now let’s get it to those who need it most. Who knows? Maybe one of these children will someday grow up to find the cure for diabetes.

Please give.

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A Shift in Direction

Wednesday, July 10th, 2013 | Posted under Diabetes, School

changing-trajectoryAlthough I haven’t blogged about it much, not getting into nursing school really hit me hard and shook my confidence. As it turns out, my final grade in Anatomy & Physiology 2 and Microbiology were not even high enough to get me into my first choice school, which I was on the wait-list at. The second school, NYU, flat out rejected me.

I had written and told many people that I knew that getting in was difficult, and that I wouldn’t surprised if I was rejected. And to be honest, I wasn’t surprised. But my feelings were still hurt. That’s just how rejection works.

After I found out I wouldn’t be going to nursing school this fall, I had to think about what my game plan would be. I planned to re-take the classes that I needed (I retook A&P 2 and raised my grade from a C to a B+!), plus my two remaining classes, Intro to Nutrition and Developmental Psychology of the Lifespan. I would also work, do freelance writing and keep working on my book (which I’m still working on and which should still be finished next spring).

What I started thinking about though was switching gears entirely. Not abandoning my plan to become a Certified Diabetes Educator. Heavens no. Come hell or high water, I will be a CDE. Eventually. But a comment from my dear friend Hannah about pursuing becoming a Registered Dietitian made me reconsider a few things.

I initially didn’t want to do the RD route because it takes longer. Plain and simple. It’ll be about 3 years, as opposed to the 18 months to complete a BSN and become an RN. There are no accelerated dietetic programs, and so I would have to do what everyone else does. The timeline wasn’t appealing, but there were also some benefits that I could see. For example, I’ve been reading more and more healthy lifestyle bloggers, and many of them are RDs. Several of them have their own practices and consulting businesses. Being an entrepreneur is something I’ve always enjoyed. There are also more ways to do dietetics in the real world than nursing. Nurses have to work in a clinic or hospital, whereas RDs have the freedom to work independently or in a group practice. I also felt that dietetics might give me more applicable experience in regards to diabetes, as opposed to general nursing. Not that nurses don’t work with people with diabetes all the time, and not that dietetics work with people with diabetes all the time either, but there seemed like stronger connection.

I’ve also been really interested lately with nutrition and exercise. I’ve been on my own path of weight loss and healthy eating, and I feel like I’m gaining a lot of knowledge while also experiencing firsthand how confusing and misleading a lot of this can be, especially in terms of diabetes. Personally, I’ve learned that I have to be really passionate about something in order to do a good job at it. Otherwise, I sort of half-ass it. The idea of having my career be so connected to the things I’m interested in (diabetes, food and exercise) is really appealing to me.

I started investigating what my options are, and I found that locally, there are several programs that would lead me to become an RD. There are two Master’s programs, one at Columbia and one at NYU, and two Bachelor’s programs, one in Queens and one in Brooklyn. I visited two schools, Queens College and Columbia University, and I was very impressed by Columbia. The student adviser there was extremely nice and answered all of my questions. She made me feel confident that I would be a great fit at the school and that being an RD was a good choice. She was also very happy to hear that I have a background in journalism, because so much of what an RD does these days is work with the public and the media, so having good communications skills is critical. However, the Master’s at Columbia is much more expensive than getting a second Bachelor’s at Queens College, so Erik and I had to do a lot of hard thinking.

After discussing the pros and cons, I’ve decided to pursue the Master’s degree at Columbia, which would allow me to start as early as January of next year. In addition, they have the required internship program integrated into their Master’s. While it’s not a guarantee that I’ll get an internship through Columbia, the odds are about 95%, compared to the 50% at the other schools. Huge difference!

I still have a few pre-requisite courses to finish, so I’ll be doing that this summer and fall. If I don’t get in at Columbia, that still leaves time and opportunity to apply to NYU and Queens College for their programs. Next Monday, I’ll start an online, self-paced course through UC Berkeley in Biochemistry. This fall, I’ll go back to my local community college to take Intro to Organic Chemistry, Intro to Nutrition, and one of the food services classes. There are two food service classes that are required for the RD but not for Columbia. I’m taking one now so that I will be a full-time student and qualify for financial aid.

I’m actually really excited about pursuing dietetics. I’m a bit hesitant about a couple things, which I’ll be blogging about later. It’s still hard to say that this is definitely “God’s path” for me, because I still haven’t been accepted into a program yet, but I feel a lot happier and confident about this direction. I hope that’s a good sign!

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New Blog on the Block

Monday, May 13th, 2013 | Posted under Diabetes

new-blogFor a few weeks, I’ve been thinking about launching a new blog about diabetes called The Blood Sugar Whisperer.

I know what you’re thinking: Why do you need to start a new blog about diabetes? Don’t you already talk about diabetes here?

Well, yes and no. Although I’ve tried for many months (years, even) to incorporate the two sides of my life, I’ve come to the realization that there are just some things that the average non-diabetic doesn’t give two hoots about and those are things that I’d like the freedom to talk about a little more frequently. I don’t necessarily want to talk about diabetes every day, but I’d like the option to post my thoughts about what’s going on in the D-community without wondering if I’m totally going to bore everyone else. Diabetes is so highly specialized that I sometimes feel awkward trying to explain what I’m saying to my non-D readers while simultaneously trying to help my D-readers. It’s just complicated and I want to try something new to see if it gets better.

In addition, I’m also working on a book and am also trying to ramp up my freelancing career, and I feel like having a place that is specifically devoted to diabetes will make my “marketability” a little better. I guess everything really does come down to branding, huh?

Of course, I’m not going to give up With Faith & Grace. Heavens no! If anything, this will help me focus a little bit more on topics on this end of the Allison spectrum. Nothing will change, actually, you just might see more things along the lines of health and fitness, personal development, and relationships with significant others, friends and family. Sound good? Good.

So if you haven’t already checked out, you can head on over. I’d love to hear what you think!

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Springing into Fitness

Thursday, April 18th, 2013 | Posted under Diabetes, Health + Fitness

5222aa3cff6f6fa0df3eb68234a35719Every month, the Diabetes Social Media Advocacy team posts a prompt for the Blog Carnival. This month, the prompt is about exercise!

Does the sunshine and warmth of Spring urge you to change up your exercise routine? If you don’t have an exercise routine, does it inspire you to start exercising? And if it’s not Spring in your corner of the world, what season are you heading into and how does it impact your fitness routine?

While I’ve been exercising pretty consistently since last fall, the warmer weather and later nights have definitely made an impact in my running schedule. It is so miserable running on a treadmill that I usually hold out for the one or two days during the winter when it might pop into the 40s. But many times, I do have to rely on strength training and the treadmill to get my fitness routine into my schedule. Otherwise it’s just too easy to let the cold and snow keep you inside!

Although I love warmer, sunnier weather, I’ve personally noticed that I run poorest during midday. There’s something about the sun beating down (even when it’s not very warm) that seems to zap me of energy. I prefer running in the early morning or in the evening, when the sunlight isn’t as intense. I can weight train at any time of day because I do it indoors at my gym. I’m not sure if anyone else is as sensitive to the light as I am, but it’s something that I’ve noticed really slows down my pace.

I can’t say that Spring totally changes up my workout, because I have tried to stay consistent with running throughout the winter and now throughout the summer, but I do think that I’m more consistent in how often I do it. I also feel like there are more options during the summer to do a variety of exercises. Cycling, for example, is something I would only consider doing during the warmer months, because the wind from cycling and the cold weather does not sound like a pleasant experience! Erik and I also enjoy hiking, which is something I’m more likely to do in the summer when the trees and plants are in bloom and everything is pretty and green. Not that you can’t hike in the winter, but I find it more enjoyable in the winter.

I suppose the warmer months also make me a little more self-conscious! With summer dresses and tank tops, there’s a lot more skin showing so I’m more inclined to try to stay fit and eat healthier. Of course, it probably makes more sense to be active and lose weight earlier in the year (which is something I’ve been trying to do), but sometimes you don’t really feel motivated until those flabby arms and spare tire are really obvious!

This post is my April entry in the DSMA Blog Carnival.  If you’d like to participate too, you can get all of the information at http://diabetessocmed.com/2013/april-dsma-blog-carnival-3/

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The Truth of the Matter

Wednesday, April 10th, 2013 | Posted under Diabetes, Personal Thoughts

28fc233377f8888b986492f018a5caf5Last week, I read an amazing post by Ashlee Gadd that stopped me in my tracks. I’ll give you a moment to read it yourself as I don’t want to paraphrase her brilliance.

Good? Good.

For the most part, Ashlee’s post is a series of rhetorical questions designed to make us think about the intentions people have when posting good news and bad news on social media. And think they made me.

I read this post two days after receiving the results of my last A1C lab test, and I have to admit, I really wanted to share the results with everyone. But last year I had written a blog post on DiabetesMine about how I wasn’t going to share my results anymore. The reason was because these results are often taken in isolation from both the work that someone is doing and also the results that came before. An A1C result of 8% might be a disappointment for someone who was 7.5% three months earlier, but if they had been 9% before, then it’s cause for celebration. Instead of sharing the actual result, I was only going to share the direction of the A1C and by how much.

I found that personally I often got upset when I would read commentary about someone’s A1C result. I remember one time someone had posted that they had never been above 7%, whereas I have never been below 7% and that really upset me. It felt like an unfair reaction to something that I should have been happy about — another PWD’s success — but I wasn’t. It was like Ashlee’s example of someone looking at Instagram and seeing only happy, beautiful pictures. An A1C result doesn’t reflect all the hard work and sacrifices that this particular person might endure. Instead, I’m only seeing a single image of an otherwise extremely complex existence with a chronic illness. Frankly, I should know better.

So then it made me think about my own attitude toward my A1C, especially my most recent one. My A1C dropped more than a full percent since my last result, and yet, as I wrote last week, I have still not accomplished my diabetes goal for the year. It doesn’t take a rocket scientist to do the math and realize that my A1C prior to this result was in the 8% range.

And the truth of the matter is that my A1C results have been in the 8% range for most of the last five years.

I have written that I don’t want to post my A1C because I don’t want to make anyone feel bad, that I don’t think it’s anyone’s business, and that I don’t think it promotes anything but unhealthy competition on who is doing better or who is perfect or who has it all figured out. (Hint: nobody has it figured out.)

My A1C results have not been something I have been proud of. Appointment after appointment have been a series of me telling my wonderful endocrinologist that I know what I need to do, that “life has been rough lately” or that “I’ve been traveling a lot” or “my apartment building flooded” and that things would be better next time. Occasionally that was true and I would knock a couple tenths of a percentage off my “score” but it has never landed me lower than a 7.8%.

The real reason that I didn’t want to share my A1C result with people isn’t because I was afraid of what people would think about themselves, I was afraid of what people would think about me. I knew my diabetes management wasn’t where I wanted it to be, and so I hid it under the guise of protecting others’ feelings on the subject. And there is some truth to that still. I do think we need to be aware of how our posts might affect other people. But at the same time, I think that we — especially the diabetes community, but also anyone else reading this blog — need to realize that being vulnerable with our struggles and our weaknesses are not bad things. They make us human, they make us real.

I’m not saying that our social media persona needs to be entirely negative or that you need to post all the skeletons in your closet, but I do think that we need to take a hard look at why we choose to omit something. Are we doing it because it’s not our place to say something about a certain topic? Are we doing it because it might be hurtful or misrepresent ourselves or someone else?

Many people have commented that blogs and other social media platforms — especially Pinterest — are feeding into the idea that bloggers lead perfect lives. But my question to you is: are we omitting the struggles and challenges in our lives for the very purpose of portraying a happy, perfect life? Are we omitting details about our lives because it’s the right thing to do, or are we doing it because it’s the false persona we want other people to believe we are?

I spent many years not sharing my A1C because I didn’t want to be the Girl with the Bad A1C. I was ashamed of it, and so I created a story that allowed me to hide it. People might not fully understand the reasons why my A1C results ended up so much higher than our target goal of under 7%, but I’m here to tell you that it did. I’m also here to tell you that I finally did something about it. I’m here to tell you that my A1C dropped from 8.3% in November 2012 to 7.2% in April 2013. I’m also here to tell you that my goal for my next appointment is to be under 7%. I’m here to tell you that I’m working diligently to do this by tracking my carbohydrates more closely, exercising regularly, logging my blood sugars using my RapidCalc app, and wearing my Dexcom CGM.

There are plenty of things that shouldn’t be shared online, for a variety of reasons. But the truth of the matter is that sometimes the one thing you don’t want anyone to know about is the one thing everyone needs to hear.

 

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Reassimilated into the Collective

Monday, April 8th, 2013 | Posted under Diabetes

It’s official, folks. I have been reassimilated back into the Collective.

Well, not completely back into the Collective. I’m still rocking shots like it’s 1999, but I have finally jumped off the bridge with everyone else and gotten myself a Dexcom continuous glucose monitor. Woohoo!

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Just call me One of Twenty-seven Million

For those of you unfamiliar with CGMs, it’s kinda-sorta-basically a device that reads your blood glucose values 24/7. Pretty nifty, huh? It actually doesn’t read blood sugar, it reads the sugar in your interstitial fluid (which is the space between your blood vessels and your cells that nutrients, like glucose, pass through — I actually learned about it last week in Anatomy & Physiology!). The Dexcom CGM is separate from a blood glucose meter, and you still have to test your blood sugar at least twice a day to calibrate the machine. The CGM is kind of like your microwave’s clock — it doesn’t know what time it is on its own, so you have to use another clock to tell it how to measure time.

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Here’s the most common analogy: A blood sugar reading from a meter is like a screen shot, whereas the continuous glucose monitor is like watching the entire movie.

I like this analogy better: Imagine that you are driving along a highway and every mile you were allowed to open your eyes. What do you think your chances are that you would run off the road? Probably pretty high, right? Because even though you felt like you were going straight, you might actually be turning slightly to the right or slightly to the left, but you wouldn’t know it until you actually crashed your car. That’s basically what it’s like when a person with diabetes goes high or low. They think what they did is going to lead them in a straight line, and it’s not until they go high or low that they realize they were slowly driving off the road.

My biggest problem is that when I’m exercising, I don’t realize I’m driving off the road until I hit a tree, roll the car five times and burst into flames. (Okay, it’s not that bad.) That being said, I am basically hypo-unaware when I’m exercising, which means my body’s normal “Mayday! Mayday!” detection is switched off. It’s kind of ironic that the one time I’m most often going to have a low blood sugar is the one time I can’t feel them. Nice one, Universe.

So why has it taken me a freaking billion years to get a Dexcom CGM? Well my adventures with CGMs is sort of long and meandering. My first one was a Medtronic CGM back in early 2010 when I was still using the Medtronic insulin pump. I used it off and on for a few months, and then stopped, and then started up again, and then stopped again. In theory, Medtronic is awesome because your CGM device and your insulin pump are one machine, although you have to have two separate insertions. However, Medtronic’s sensors are not nearly as accurate as one would hope, causing much frustration.

On top of this, I’m convinced that I am allergic to the Medtronic sensor. Not the adhesive that sticks to you. The actual sensor. More often than not I would find myself itching and writhing in pain after just a couple of days on the sensor. When I finally ripped the damn thing off, there was usually a welt or some kind of small infection at the insertion site. Not cool.

Since most CGMs work better the longer you wear them (because it gets used to you and your body), having to rip off the sensor after 2 days was sort of pointless. I eventually gave up and swore to myself that I would get on a Dexcom. Yeah…

Well, I was still hesitant about getting on a system without knowing for sure if I was allergic to it or not. Eventually I worked it out with a local Dexcom rep to wear just the sensor for a few days to gauge my body’s response to the sensor. I wore it more less comfortably for about six days, but then it started to get a little itchy and I took it out, but there was no sign of any infection. I was confident that the itchiness might have been an isolated incident (it can happen) and so I said I was interested. Unfortunately (although fortunately in the long run), we didn’t have the FSA (Flexible Spending Account) money available to buy the Dexcom system.

The reason I say fortunately is because a few weeks after this is when the newest Dexcom system came out! Woohoo! So I saved a bunch of time and money by waiting. I finally got around to ordering the system at the end of March (I’m nothing if not a huge procrastinator) and it arrived last week.

My CGM rep told me to schedule an appointment with a CDE at my diabetes clinic, which is down in the city. Not a terribly convenient place to get to, so I queried the Internets about whether or not I should just set myself up. Since I had CGM experience, everyone just told me to go for it. So I did. The first few days have been a little rough, getting used to the new system and whatnot, but for the most part I’m really liking it. It’s had its moments of being totally inaccurate (like telling me I was 135 and dropping rapidly when I was actually 175 mg/dl and spent the rest of the night in the 200s), but overall the numbers have lined up quite well. I have not had any itchiness and can see myself wearing the sensor for a number of days with ease.

I doubt I’ll write a full review of the system, since there are many reviews of the Dexcom CGM around the diabetes community. But you can be assured that it will be mentioned when appropriate.

Of course, if you have any questions, leave ‘em in the comments!

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My First Bib

Tuesday, April 2nd, 2013 | Posted under Diabetes, Health + Fitness, Race Recap

This past Saturday, Erik and I ran our very first 5K race! Earlier this spring, I scoured the Internet to find the perfect race and decided on the NYC Runs Spring Fling 5K on Roosevelt Island, which is an island located in the East River. It’s smack dab between Manhattan and Queens, so you have views of both from the island. It’s very cool! I have been running fairly regularly for the past few months, but more so since in the beginning of the year. My fastest 3 mile run so far was 40:18 so I really wanted to run my first official 5K in under 40 minutes!

The night before the race was, as you can imagine, not very restful. But it wasn’t actually from excitement. On Friday, we attended our first Christian seder, and our hosts had some delicious matzo ball soup and raspberry cheesecake for dessert. My blood sugar skyrocketed to 344 mg/dl which woke me up at 5 a.m. (because I had to pee). Yikes. I bolused and headed back to bed, but I had a hard time falling back asleep, which is typical for when I’m feeling yucky from a high blood sugar.

BGm2RdTCIAAo44g.jpg_largeThe alarm finally went off at 7 a.m. and my blood sugar was 299 mg/dl. Not what I was hoping for after two hours. Erik and I had scrambled eggs and a Larabar for breakfast, along with a big glass of water. I bolused normally for my meal, but I didn’t take any insulin for the protein as I normally would. I also corrected for the 299 mg/dl as usual. I have found that for the most part, I manage my diabetes while exercising by consuming extra carbs, and not by manipulating insulin. I planned to monitor and drink juice or eat a snack later if I needed to.

We finally arrived on Roosevelt Island at around 8:45 a.m., with the race set to start at 9 a.m. Just before checking my bag, I tested again and I was down to 210 mg/dl. That was a good number to start with and I didn’t have that much insulin left on board. In my spibelt I had a Gu if I needed it while running, but I suspected I would be fine.

Erik and I do not run at the same pace. He is much faster than me. So my first race was basically alone. I didn’t listen to music or my usual podcasts, so it was a bit of a challenge, but like most people say, you do get swept up in the noise and scenes around you. I enjoyed people-watching the other runners and of course I had a glorious view of Manhattan for the majority of the run.

BGnHqqdCEAEiD1P.jpg_largeThrough sheer force of will, I managed to run the entire length of the 5K, except for a very short water break about halfway through. It was definitely a challenge for my muscles, but I felt good. I didn’t feel at any point that my blood sugar was tanking. Although I’m more or less hypo-unaware while exercising, I have developed my own “sense” for my blood sugar to make up for the lack of traditional symptoms. Normally it’s an intense fatigue that comes on very suddenly, and I didn’t have any of that.

Not having any sense of time or distance meant the run felt a little on the long side. I had no idea how far I’d gone or how much longer I had. Eventually I could see Erik waving in the distance. My final time, which we didn’t receive until a couple hours later, was 39:52. Woohoo! I did it!

We retrieved our bags and I check my blood sugar. I rang in at 158 mg/dl! Totally thrilled about that. I took my normal Lantus dose as well. After that, Erik and I went off to get lunch and basked in the glory of finishing our first 5K. My blood sugars stayed normal the rest of the day.

I already have a second 5K lined up as well! I’ll be running The Stride 5K in a couple of weeks, which benefits a local diabetes center. My Junior League chapter are sponsors, so it’s a win-win. I’m excited to see if I improve!

 

And as if all this wasn’t good enough, I have even more awesome news! Yesterday I had an endocrinologist (diabetes doctor) appointment and I found out that my A1C (the measure of my average BG) dropped a full percent! Just to put this into context for you, A1Cs are measured by the tenth of a percent. So dropping a full percent is quite significant. I’m not sure I’ve ever dropped more than half a percent between appointments, so I could hardly believe it dropped as much as it did. Although I’m not in the 6s yet (my diabetes goal for the year), I am very close right now. I recently ordered a Dexcom continuous glucose monitor to keep even better tabs on my blood sugars throughout the day, so I have no doubt that I will be in the 6s by my next appointment later this summer.

 

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The Catch-22 of Losing Weight with Diabetes

Wednesday, March 13th, 2013 | Posted under Diabetes

rollercoasterHere’s the thing that really bugs me about trying to lose weight with diabetes:

A good portion of the insulin that PWDs (people with diabetes) take on a daily basis comes from their size. The bigger you are, the more insulin you need, and vice versa. Of course, the food you eat, hormones (like birth control or stress), and activity level also play a big role. But your size matters. So when I exercise and subsequently start dropping the pounds, the amount of insulin I need starts to drop.

Which is great. In theory.

In practice, however, it usually ends up with me having a string of low blood sugars that actually prevents (or at least temporarily interrupts) my weight loss endeavors until I get to the point where I’ve managed to figure out where my new insulin needs are. But then give it another five pounds and we start the process all over again.

In short: Exercise equals less insulin, but the current doses equals low blood sugar preventing exercise. Plus: low blood sugar means treating it with juice. Juice = calories. Calories that I neither want nor need!

Sigh. Right?

In theory, it’s great that I need less insulin. I want to take less insulin because less insulin is yet another barometer of the fact I’m getting smaller. But it isn’t so easy to just change doses. The body is a fickle thing and what prevents a low blood sugar one day might actually cause a high blood sugar on another day if you start over compensating. High blood sugars are also frowned up on when exercising, although a moderate high can be a nice buffer to prevent a low blood sugar after working out. But if those high blood sugars are popping up all over the place, then that’s bad.

When you start experimenting to find your new dose, you might actually discover that you cut too much because changing one factor in diabetes management has repercussions throughout the whole day. You might find that preventing a low blood sugar at one part of the day now causes a high blood sugar somewhere else, which has you, guess what, taking more insulin!

You see where I’m going with this?

This is why I was always really nervous about changing my basal rates. It always seemed like — again, in theory! — that my simple modifications would solve the problem. But then it would either 1) not be enough and I would still go low or 2) it was too much and I would go high. And so then the experimentation continues until you have it figured out.

But then if you’re consistently losing weight, you might have 2-3 weeks of “stability” (ha!) and then you’re back to do this all over again.

No wonder people with diabetes hate to exercise!

Right now, I’m trying to not let it get in the way. I’m trying to keep my blood sugars stable while futzing around with the right dose so that I can prevent low blood sugars. I know this will be a consistent theme of my life for the next few months, because the Allison who weighs 160 lbs. (my goal weight) needs different insulin amounts than the current Allison (who is, uh, bigger). It’s not something that will happen in one fell swoop. It will happen slowly. Obnoxiously.

 

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On Making Modifications to the Unknown

Thursday, March 7th, 2013 | Posted under Diabetes, Health + Fitness

changeDespite being 27 years old, I’m dealing with two health problems: type 1 diabetes and obesity. Obviously my obesity is not related to my diabetes, because I have the autoimmune form, and not the metabolic. Nevertheless, they are there and they are affecting my health, so everyday, I have to consider how I can manage my weight and my diabetes better.

But sometimes I just feel like saying, “I don’t know and I don’t care.”

(Not really, but sometimes.)

Over the last few weeks, I’ve noticed that my blood sugars have been stubbornly in the low 200s and high 100s. It was really just the month of February, as the month of January was when I started Paleo and was at my pre-Paleo insulin doses. As soon as I cut a lot carbs, my blood sugars started dropping. But of course, I realized I didn’t need as much insulin, and when you don’t have as much extra sitting around, your safety buffer goes out the window.

The thing with being on injections is I feel like I’m much more apt to change my doses. Maybe it’s because I have to individually draw up every single dose, but I feel like I’m always modifying how much Lantus and what my basal rates are every couple of days based on how I feel I’m doing. When I was on an insulin pump, it sort of felt like my settings were out of sight and out of mind, so I never really thought about making changes. I just sort of put up with bad results until I finally realized how ridiculous I was being. And then I would make changes.

Now I’m wondering if I’m making changes too often. How long do you stick with something before you decide it isn’t working?

This relates also to my trouble with weight loss. When I went on the Paleo diet, I was told “You don’t need to calorie count!” So I was like, “Eff yeah! Woohoo!” I figured the pounds would just melt off. But they didn’t. Sure, I lost 5 lbs. but that’s hardly anything to write home about and this was on top of exercising.

What modifications do I make now? Should I start calorie counting again? Change my workout? Keep doing what I’m doing and hope it eventually starts working? And then there are issues with calorie counting itself, because some people find that they lose weight better when they eat more, and some people find themselves doing better when they eat less, or when they eat only when they’ve worked out or when they don’t eat after they work out. There are so many options for how to change things that I sometimes feel totally overwhelmed with my options for modifying.

Which usually leads me to not doing a damn thing.

And then I have a hard time figuring out if what I did worked. Yesterday, I thought I had figured out my Lantus dose. My blood sugars were good all day and I was excited. But then I went low at 5 a.m. this morning. Of course, I realize that could be a one time occurrence and that I should be patient. Having the ability the ability to tweak my Lantus dose every single time usually leaves me with totally inadequate data because I won’t sit still. First I was sitting still for too long, and now I’m not waiting long enough to have quality information.

I realize that figuring out how to lose weight and figuring out how to manage my diabetes are slightly different in practice, but the idea is that both of these struggles that I have relate to me making modifications on something I don’t really understand. I don’t really know what my body needs to lose weight, because there are so many variables. I don’t really know what my body needs to have more stable blood sugar (never perfect, just better), because there are so many variables. I never feel like I really know when to change, what to change and how much to change. It’s very aggravating and I can see why a lot of people just stop trying to figure things out and they just go by what is easy. Because at least that I know.

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Just Call Me “Negative Nancy”

Tuesday, March 5th, 2013 | Posted under Diabetes

tumblr_md9pkd1MTW1rzx2dao1_400_largeI wasn’t planning on writing a response to the latest news from the Diabetes Research Institute. Plenty of my peers have written their two cents and for the most part, I agree with them. But then this afternoon I saw a comment to a book review I had written for a book by my CDE, Gary Scheiner, which was actually posted yesterday, the day before the DRI’s big announcement. At the very beginning of the post, I wrote, “Barring a miracle, there probably won’t be a cure within the next 10 years. So we know that managing our diabetes well is the only option if we want to live a long and healthy life.”

Honestly, I was just trying to write a catchy intro to a book review, but apparently it sparked something in a woman who then wrote at the end of her comment: “And Allison, try not to be the Negative Nancy right off the bat in the first sentence. All of us supporting fund raising and research are optimistic large strides or a cure WILL be soon!”

I was left feeling a mix of emotions, including irritation, frustration, and agreement! I have been raised money and donated my own money to the Juvenile Diabetes Research Foundation, the Diabetes Research Foundation, and even the American Diabetes Association for the last 19 years. Please do not question my commitment to Sparkle Motion — er, the cure.

That being said, I don’t necessarily think the cure is coming ’round the bend anytime soon. Hell, I’m not even sure we know where the bend actually is. A little more than two years ago, I wrote that I had lost my faith in a cure. The premise of the article was actually about the new focus of JDRF on new technology, and how an organization that was supposedly devoted to finding a cure was betraying their thousands of supporters by doing so. I — and many other — totally disagreed with this point of view, and I explained why I felt that way.

This time things are a little different. The DRI (for those unaware or not involved in the diabetes community) announced today that they are planning to develop a “BioHub,” which is essentially a little pocket to hold and protect islet cells from being destroyed. Islet cells are the cells that make insulin, which have been killed off by the immune system in every type 1 PWD. So in theory this is big news. The problem is that it was hyped by the DRI prior to the announcement that this is “what we’ve been waiting for.” And it isn’t, really. Because what we’re waiting for is the bloody cure. In fact, some people I’ve talked to are suggesting that this might be a marketing ploy just to fundraise. Plus other people have already been working on similar ideas, so this isn’t even ground-breaking. This really isn’t any different then every other announcement that has ever been made about new cure research projects. Researchers have found more than 400 ways to cure a mouse. None of them have worked in humans. I’ll reserve my excitement for the cure that is FDA-approved, and not a minute sooner.

So when someone comes up and says “Stop being such a Negative Nancy” I have to pause. Because I’m not being a Negative Nancy. I’m being a Realistic Rebecca. A Cautious Caroline. A Living-in-the-Present Lindsey. (I could go on all day.)

At the end of the day, do I think there will be a cure? Yes. When? I don’t know. My crystal ball is on back order. And they don’t know either, which is what really rankles my ire. They say something is coming in five to ten years, but can I let you in on a little secret? They don’t have a fucking clue when the cure is coming. So quit asking.

It’s okay to hope for a cure. It’s okay to work for a cure. It’s even okay to dream about what you will do when you don’t have diabetes (my plan since I was 15 years old is to eat an entire Mud Pie at Red Robins by myself! And then vomit.). But for God’s sakes, don’t plan your life around the cure. I think most people get this. I really do. I think most of my readers are very smart and they understand not to plan life around the cure. Because I remember when I was a little girl and my doctor told me that he was really sure that it was coming in the next five to ten years. And I remember giving myself a little wiggleroom and I said, “Well, as long as I have a cure before I have kids…”

I’m twenty-seven years old and married. There’s a pretty good chance even my wiggle room isn’t going to cut it.

I wish we could be certain about when the cure is coming. I wish we knew how it was going to happen so we knew what to fund. But we don’t. And I’m not going to live my life like we do. Hell, we’ve been trying to get an insulin pump approved in the United States for the last three years. If that doesn’t give you a picture about how long it will take to get a cure approved, I don’t know what will.

I would much rather say there won’t be a cure in ten years and be wrong, than to say there will be a cure in ten years and be wrong. If that makes me a Negative Nancy, then so be it. But hopefully you’ll understand a little bit better about why I am.

 

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