Don’t sweat it: adventures in type 1 diabetes, weight loss, fitness and bladder control

My goals are to have good blood sugar control over time, lose another 10-15 pounds, and have Michelle Obama arms. But nothing is simple, you know? I was on target Friday for a reasonable set of meals. Unfortunately, I went low twice on the plane while we were stuck on the tarmac and the only snack I had handy was pretzel M&Ms. They’re delicious, but that was 360 calories more than I had planned to have while just sitting on my ass in a plane. So I started dinner with 196 calories left for the day. That was unrealistic.

I ate reasonably and at 10pm my blood sugar was 160. I was fine with that and figured the pump would alarm if my sugar started to climb. My pump did its duty faithfully from about 1am until 7am when I woke up, but it was under the 50 pounds of covers provided by the Marriott so I never heard it. I woke up with a sugar of 331 and a low pump battery. So. Angry. I love that my Minimed sensor is built into the pump but I hate that it doesn’t have sufficient range that I can put my pump outside the covers and still have it work. I could really be tempted to get a separate sensor just for that one reason.

I grumpily put on my workout clothes and wasn’t sure how much insulin to take as a correction. I was about to get on a treadmill, but my sugar was really high. Rich was heading to breakfast and I wasn’t sure if I should eat yet and how much. I also hated that all this had put me in a foul mood first thing in the morning and my teeth felt all fuzzy and my head hurt and dammit, why didn’t my sensor work better? I opted for oatmeal, a banana and a bagel with Rich and then planned on running all that off.

I ran for 45 minutes. I didn’t turn off my pump like I normally do, but I also hadn’t taken any insulin for my breakfast which would have been probably 6-7 units. About 30 minutes in, I decided to take 3 units and see how that would fare. After running my sugar was 153 but I had two down arrows on my pump telling me it was going to possibly tank. I suspended the pump for 30 minutes or so to see what it would do, since I still intended to do some sit-ups, push ups, and other stuff in our tiny hotel room. By 11am I was at 147 and fine with that.

We walked 1.25 miles down Michigan Avenue to lunch and my sugar was 114 when we sat down. I had salad and a small steak sandwich. I only took 3 units for the bread, anticipating another 1.25 mile walk back to the hotel. My sensor has not quite recovered from this morning so it keeps thinking my sugar is around 150 (so it keeps alarming to warn me) but it’s really more like 120.

That’s all the logistics from my day so far, but I wanted to talk about some of the emotional stuff. It’s frustrating that blood sugar maintenance and calorie control can seem at odds with each other so often. I also would have loved to run down to the Navy Pier this morning versus watching Good Morning America on a tiny TV in the crowded Marriott fitness center, but I’m not willing to risk a low blood sugar miles from home and there were just too many factors this morning between a roller coaster of sugars and foods and travel.

I absolutely love running. I thought it would be boring but it’s very zen for me. I am so slow but I just don’t care. No really, however slow you are? I’m slower. I don’t have to change the pace on the treadmill between my warm up walk and my run. I rock the 15 minute mile and I’m fine with that. I don’t want to run with other people. I just want to listen to my playlist and do my thing.

And holy smokes would I love to not have to get off the treadmill every time I have to cough in order to avoid wetting my pants. It’s a little ridiculous. I would have to jump off the treadmill to the side bars, cross one leg over the other, do a little squat, cough, and then hop back on. We’ll just call it cross-training. As a few coughs snuck up on me, I failed to make it through my entire workout with my bladder control intact. I am going to make one of those Map My Run apps that rates how many of the miles I ran were with clean, dry undies. You all can click “Like” on Facebook to cheer me on through my kegels. Absolutely. Ridiculous.

But once you’ve wet your pants, you no longer are worried about if you look ridiculous singing along to your iPod.

Post workout happy

Lost and found

Losing track

You know how your favorite song comes on just as you’re going into the tunnel? But this is a song you have rocked in many a karaoke frenzy so you have got this! You’ve got the first 30 seconds or so under your belt and feel like you’ve got the tempo down.

But when you emerge back out into the sunshine, you are half a song ahead of the radio or suddenly it’s switched from Livin’ on a Prayer to Devo.

That’s how my blood sugar was last night. Around 2am or so, my sensor lost track of my pump somewhere in the covers (the Minimed is very persnickety about anything being between the pump and the sensor, like Overly Attached Girlfriend). So at 6:30am, it just said LOST SENSOR on the screen. No worries. I went to bed with a blood sugar of 77. How bad could it be?

250, you say? Well, we are not men indeed; we are devo-raciously thirsty and annoyed. I think I ate too much watermelon before bed to fix a low blood sugar. But I just feel better when all my gadgets are on the same page.

Stuck in the middle with you

This weekend, I had a zit on my chin that was so deep and intense and painful that I pulled a Tobias Funke in the shower. The only way I was able to get Ian to fall asleep for a nap Sunday was to put him in the van and drive around for 20 minutes, refusing to speak to him. Because he napped so late, he was still wide awake when we got home from our company Christmas party at 10:30pm. I finally got him to give in and fall asleep at 12:21am after we had all said some things we later regretted.

I also got my lab results back from Friday and my HbA1C is a miserable 7.5. Even typing that makes my stomach hurt. But I haven’t had much time to dwell on that number because the last few days I’ve been wrestling with blood sugars like 342, 288, 63, 362, 55, and one 99. It’s been the “30 or 300?” game all weekend and I feel like I’m hungover. Oh, and I gained about five pounds in the last week.

We finally heard back from Dr. Hausner after I sent him a note saying I was going to call him if I didn’t get an email back. For all his adorable Czech accent in person, he has a slightly less adorable sense of written English grammar so it can make reading a note from him confusing at best. We either are going to start antibody treatment soon or he just offered to refinance our home for us.

The K-Ras evaluation that we’ve been waiting on has still not happened. The lab refused to do the test because there were so few cells in the mucin and they can’t find a commercial lab that will do the laser capture microscopy. We’re not exactly sure what is happening next. We may “bite the bullet” as Hausner said and start antibody treatment without the test result but we don’t know if that’s bad. Then again, we don’t know if it’s more bad than chemotherapy is bad which is our only other option. That or we could roll initiative and see if someone has a daily power they can use. I’m not sure, his email was very confusing.

The vague email from Hausner plus finding out he still had about seven more days of Lovenox to take (that I totally would have thrown away but he’s not me) have knocked the proverbial wind out of Rich’s sails. He was feeling pretty good and could see definitive progress, but last night and today he’s just been incredibly discouraged. We’re not in the thick of things anymore. He’s going to work and driving a car. But he’s not comfortable being alone with Ian and he’s still physically weak in a lot of ways. We’re a lot better than we were four weeks ago, but we’re not back to normal by any means.

This middle part is tough. We could use some cheering up. Fart jokes, cute animals, anything like that. I’ll start …


Diabetic sick days

It’s been a rough few days and we’re not out of the woods yet. I thought we were doing okay until the middle of the night between Wednesday and Thursday when I just couldn’t get my blood sugar to go down. I was losing the battle and the high blood sugars were fogging my brain. When my sugar went over 600 and the meter couldn’t even read that high anymore, I called for reinforcements.

sick day blood sugars

It hit me when my parents came over and we were all debating if I should go to the hospital or not. I looked up to see three adults all desperate to help but no one but me knew how to work my pump. And I was not in a teaching frame of mind, if you know what I mean.

We clumsily made our way through changing out my tubing and infusion site (try doing that when your sugar is 600) and giving myself 10 units of insulin via injection to kick start this baby into action. The best I can tell is that my infusion site went bad right when I needed it most and I wasn’t thinking clearly enough to change it out and/or just go with an injection. I didn’t want to muddy the waters changing out too many things.

But it has taken over 36 hours to wrestle my blood sugar back down from those scary moments around 2am. It’s 132 right now and I am totally fine with that.

I don’t get sick often. The last time I was this sick was 15 years ago or so. I ended up in the hospital then, but that was before my insulin pump and poor Jeremy didn’t have the same resources to keep me at home versus throwing my ass in the car as soon as I told him I was Sailor Moon.

So hopefully we’ve gotten that out of our system for the next 15 years. Let’s all set our clocks and plan ahead. Next time I’m going to have a document written up that says how my pump works and which insulin in the fridge is the right one and what a reservoir is versus tubing.

I’m still sick. I’m still taking 3.2 units/hr versus my normal 1.3 units/hr to combat the infection. But I’m at least lucid and able to sit upright for more than one hour. I can keep food and water down, and that’s a big plus. (I did learn a trick, though, that if you feel dry heaves coming on, chug a bunch of water. You’ll puke it back up anyways, but it’s still cool and more soothing that plain stomach acid. That’s my tip to you.)

Here’s to feeling even better tomorrow.

Running the numbers

I’ve been working on this post for three months. Really, I’ve just been working in general for three months.

Three months ago on February 27, I went to my endocrinologist. Not only was my HbA1C a disturbing 7.6, but my weight was an alarming 193 lb. That was officially the heaviest I’ve been my adult life (I made it to 192 in college before getting my insulin pump and no longer using Pepsi to control my blood sugar).

It was a real low point for me. My doctor was awesome as always and helped me make some significant changes to my insulin pump settings. And we talked about eating less fatty foods. When I got to work that morning I signed up for LoseIt! to track all my calories. I bought a FitBit to track my activity (or at least my steps). I bought a treadmill to put on our side porch and I started Couch to 5K. I ran my first run on that Monday evening after my doctor’s appointment.

I expected the weight to just fly off. After the first week, I lost two pounds. Solid start! And the second week I lost another pound. Ok, still progress …

Then nothing. I would fluctuate between 189 and 191 depending on what I had eaten that day or what clothes I had on. Nothing seemed to change.

Undaunted, I kept doing Couch to 5K. I completed my nine weeks of training on May 5 by running for 35 minutes straight, more than I had ever run before in my life.

For my 35th birthday, I ran in my first 5K. Despite the intense headwind for the entire second half, I still finished with a respectable time of 36:55. I also did it all in my Vibram FiveFingers, meaning I was using great form and staying injury free with only a meer 3mm between me and the concrete. That felt like a real accomplishment.

But after the 5K program, I wasn’t sure what to do next on the treadmill. Should I run for longer? I’m already on there for over 45 minutes. Should I try to run faster? I scoured the internet for advice. Somewhere I read:

“If you want to run faster, run longer. If you want to run longer, run slower.”

So I just kept plugging along. I kept wondering when all this weight would fly off. I stopped weighing myself because I knew my clothes fit exactly the same if not tighter in the calves. But I held out for this morning’s doctor’s appointment that it would be a way to see real progress.

I held my breath as I got my labwork done last week. It always feels like I’m studying for a test when I get my blood drawn. I’m hoping for a “good grade” but am never sure what it will be.

This morning, I found out that my HbA1C had gone down to a passable 7.0. Not great, but still reasonable. I guess giving up all those fries and pizza showed for something.

But stepping on the scale, I was gobsmacked to find that I now weigh 196 lb. So NOW I’m the heaviest I’ve ever been in my (non-pregnant) adult life. That’s just great.

My doctor wasn’t worried, brushing it off as muscle weight. He also taught me so much in the 15 minutes I spent with him. How the liver releases insulin for up to 24 hours after a low blood sugar reaction. How the adrenaline from a run can make your blood sugar go higher but then when it wears off it goes lower so you shouldn’t correct immediately after exercise. How lifting weights lowers blood sugar a lot more than any sort of cardio work. How I probably could just reduce my insulin intake by about 25% for a workout versus turning it off and wondering when to turn it back on part way through the run.

These are all the things I’m still learning after being diabetic for 27 years. I guess when you’re eight years old they don’t teach you how to drink beers while diabetic and they don’t teach you how to run a 5K. They’re just working on keeping you alive. It’s an ongoing education.

It surprised me how upset I am about my weight. I know it’s just a number but I would like that number to not be so dangerously close to starting with a 2. I’m also annoyed that in addition to counting calories for weight loss, I’ve been counting carbs for 12 years to know how to manage my pump. I’m tired of the math. I realized when I was explaining it to a friend this weekend just how complicated it is. Even though I thought I was being very clear, he kept asking “so you would need juice if your blood sugar went high?” No, stay with me! Insulin and exercise make sugar go down. Adrenaline makes sugar go up. Wax on! Wax off!

I wish exercise with diabetes weren’t like such a mathematical word problem. If Genie starts her workout at 6:45am with a fasting blood sugar of 129 and reduces her basal rate by 50%, how many hours after her 45 minute run should she correct if she has a blood sugar of 145 afterwards and how many grams of carbohydrates should she have had before the workout? If only 35 minutes of her 45 minute workout were spent running at 4.3mph and she warmed up with a 4mph brisk walk and a 3.8mph cool down, how many calories did she burn and how long did it take her to actually travel 3.125 miles?

There are some good points to all this.

I can run for 3 miles. Let me say that again. I can RUN for THREE MILES! Pursuit by a bear not required!

I’m running injury free. That’s another big one. Last time I tried running, I decided my body was not cut out for it. I lived with frozen peas on my knees and shins. It physically hurt. I wondered why my belly and ass and boobs had to shake so much as if they might actually fall off of me. But since deciding to run barefoot, my form is amazing. I have sore muscles after a run, but I have no pain. NO PAIN. That’s monumental to me.

I finished something. I stuck with a schedule and I went out to the treadmill even on days I didn’t feel like it and I finished Couch to 5K.

I started something. I am a runner. I’m slow as hell and I still pale at the idea of running 5 miles, but I am a runner. I have found something that I enjoy and that I’m pretty good at (and getting better). I can see this continuing.

I am less stabby at work and overall. I still say work should have paid for my treadmill, but everyone at the office can just enjoy the safety of knowing they don’t risk bodily harm by replacing the toilet paper roll upside down (the paper goes OVER!), so long as they actually replace it. That’s my gift to them.

I no longer pee my pants while running. I also am less likely to pee my pants while coughing or sneezing (no promises, though). This was a delightful surprise of just working on some kegels during my runs. Anyone who has pushed a person out of their delicate lady parts can tell you that this should have its own medal to earn, maybe a tiny bronzed pair of panties on a giant ribbon to wear around your neck. Also, for anyone who asks why I got a treadmill versus just running around the neighborhood and I will direct your attention to the fact that for the first four weeks of Couch to 5K, there was a good chance I would pee my pants. That’s something you don’t need to come up at the civic league with your neighbors.

I am stronger. My belly may still be flabby, but you can bounce a quarter off my calves! Did you know you had shin muscles? Because, honey, I have some bodacious shins. I feel like an antelope! Boing! Boing!

I have less Jimmy leg at night. It’s still there, but I’m finding those random spasms in my right hip that would throw the poor cat off the bed are fewer and farther between. That’s progress.

So yeah, I’m still overweight. But I’m doing the right things and I’ll get there. While still in a bit of a funk, I pulled the trigger and signed up for the Rock and Roll Half Marathon on Labor Day weekend here in Virginia Beach. That’s 13.1 miles in case you didn’t know and let me tell you, I am more than a little nervous about it. But even if I have to walk it, it’s something to work towards.

I logged my calories today. I ordered another pair of running sandals last night to try out. I am reading my book on barefoot running to practice my form. I’ve signed up for three more 5K runs this summer and possibly a 10K. And apparently in three more months, I’m going to run/walk/hobble 13.1 miles all over Virginia Beach. My next endocrinologist appointment is the Tuesday after that run. Let’s hope I have some good numbers to show by then. If nothing else I’m wearing my finisher medal to the damn doctor’s office.