Entries for the ‘Diabetes’ Category

Diabetic sick days

Friday, June 1st, 2012

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

Tuesday, May 29th, 2012

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.


Birth is only the beginning

Tuesday, February 21st, 2012

I remember crying the whole way home from the doctor’s office. Despite all my efforts, we had been sent home with an induction date. I remember sobbing to my OB telling her I felt like the only woman on the planet begging to *stay pregnant*! But as a Type 1 diabetic, I was considered “high risk” and the staff at the hospital were already concerned about letting me go past 40 weeks.

I texted my doula from the car as my husband drove us home, letting her know we had a deadline coming up. Amara was kind and supportive as always, even in 140 character increments. By the time we pulled in the driveway I was feeling better. We would get through this. I felt fine, my baby was healthy in my belly and we still had two days.

On Tuesday morning at 5am, just 12 short hours after that tearful drive home, I felt my first contraction. It was just like they said it would feel, like a squeeze coming around me from the back. It was pleasant. Comforting. It meant we were getting somewhere and we were doing it on our own! All my little guy needed was a deadline and he would get his act together!

I continued to text Amara throughout the day, occasionally timing my contractions but mostly running errands. I got my nails done. I went to the grocery store. My husband Rich and I went for many many walks. I updated Facebook. I tweeted. And I didn’t call the hospital.

As the evening wore on, the contractions continued but we were doing okay. Rich played video games while I paced the room, happy to have him near me and chatting while not hovering (I highly recommend an Xbox being an integral part of early labor for dads). Rich is a worrier and in particular when it came to his wife and his unborn child, there was plenty to worry about. He just wanted everyone to be safe, and a hospital seemed like a safe place to him. I, on the other hand, wanted to find a cardboard box like a house cat and have nothing to do with the medical profession. Having a doula was our compromise.

By 3am on Wednesday, Amara had come to our house and we’d decided to head to the hospital. My water had broken a few hours before and while I wasn’t in pain, the worry was starting to creep in for Rich. I remember lying in the back of the car on my knees with a pillow, calling my mother and telling her we were headed to the hospital. She told me that she had classes that day and joked I shouldn’t have the baby until he was done with work. Little did we know.

We arrived at the hospital three hours before my scheduled induction check-in and confused everyone there by already being in labor. But it was their turn to confound us as my arrival at the hospital brought my contractions to a screeching halt. Where was my cardboard box?! Why do I have to have all these monitors? When I was admitted I was only 1cm dilated.

I had worried that my not going to the midwifery center or staying home I would be coerced into a situation I didn’t want. But the nurses were very supportive and the doctors were patient. We didn’t necessarily agree on what to do next, but I always felt like I was being heard. Amara and Rich were there the entire time, offering support and helping me make good decisions. Despite the annoyances of fetal monitors and IVs, I still felt mostly in control.

But the day wore on and on. We arrived at the hospital 23 hours after that first contraction and didn’t realize we had a long way yet to go. I continued to update on Facebook and Twitter. It was like all my friends were cheering me on from the Internet. My brother-in-law was re-posting updates like he was a one-man news room. Everyone was ready for this baby to make an appearance but it just wasn’t happening.

The interventions trickled in. First we started on Pitocin. I labored with that for about five hours to see if things could move along. All it did was exhaust me. I remember sitting in the hospital bed with Amara’s birth ball behind me swaying back and forth and moaning like that house cat just without the cardboard box. The contractions were coming one right after the other but I had only dilated to 4cm. I still had that ridiculous external monitor strapped to me. And I still had my old nemesis the blood pressure cuff. It would only go off it seemed in the middle of a contraction. So around 11pm that night, after having been in the hospital 19 hours (Amara by my side always except for when she had to pump milk for her own baby back home), I uttered the only curse word of my labor. I was mid-moan, that damn cuff started to squeeze my arm and I blurted out “AND F#$! YOU, blood pressure cuff, seriously?!”

Right at that moment I opened my eyes and there was this tiny little doctor smiling at me with an equally friendly nurse at her side. She said she wanted to talk to me about some options for our next steps. I was certainly receptive to some plan of action that would divorce me from this dreaded blood pressure cuff, if nothing else. So in 30 second bursts we discussed a plan of actions. We would talk for a half minute and I would moan for a minute and then we’d talk for a half minute and I’d moan again. The plan was to see if my contractions were strong enough via an internal monitor (another invasion I hadn’t planned on). If the contractions had enough power then it could be the baby’s position.

After some time we agreed to try an epidural (again with the interventions I didn’t want!). But the doctor said that my body was tensing up. She said the same thing happened in her labor and an epidural helped her deliver. We were getting close to the 24 hour mark since my water had broken and I knew that was going to be an issue. We agreed.

And just before midnight I went from 4cm to 9.5cm in 20 minutes after my epidural. My nurse came in to check me and I remember her face right next to my knee breaking out in this huge grin. It’s like she was proud of me. Go me! Then she got this sly look and said, “You’re doing great, but we’re gonna keep this on the down low for a bit because if I go out there and tell those doctors that you’re dilated they’re gonna come crashin’ in here and make you start pushing and I think you could use some rest. So let’s let the baby do his thing a little longer and then we’ll get this show started.”

I could have kissed her. We all took a much needed nap. Around 2:30am (having been in the hospital about 22 hours), my mother wandered in to check on me. She wasn’t going to miss this birth after all. Right as she arrived, all these other medical folks came in and said it was time to start pushing. Mom asked what was going on and I told her, “we’re gonna have a baby!” And just like that, my mother was part of the birthing team.

I hadn’t planned on my mom being there, as awesome as she is. I figured it would be crowded. But in retrospect it was the most amazing thing to have her there. Despite being fully dilated and ready to go, I still pushed for over three hours. I remember thinking after hour two “this is gonna take longer than Lord of the Rings!” My delivering doctor and nurse were nothing short of amazing. The hospital beds didn’t have a bar to hold onto so my nurse tied a bed sheet and acted as my belay during each contraction for over two hours. I remember the doctor offering me $20 to let go so she’d go ass over tea kettle into the cabinets.

But that doctor was also busy pushing around my perineum. She was determined I wasn’t going to need a cut. My mother said her arms were shaking from pushing for so long. They had turned off the epidural once we started pushing so that I could feel to know how to push. It worked out surprisingly well in that as the epidural wore off, my endorphins ramped up.

I was so thirsty! I just remember thinking “these ice chips are bull$#!+” and wondering if I would choke on my own dry tongue. I wheezed, “I’m running out of steam.” And Amara earned everything about her job in the next two minutes. She was holding my left leg and she calmly but firmly told me that I was going to do this, that it was what my body was supposed to do and that I was a strong woman. My mother, who had taken up a place next to my head to wipe the sweat off me, added, “she’s the strongest person I know.”

And at that moment I could have lifted a car! The doctor told me I needed to give her one more good push if I wanted to avoid an episiotomy and just like my son I just needed a deadline. I pushed him out and I remember my mother elatedly saying “oh here he comes here he comes!” At 6:14am, 49 hours after that first contraction, at 41 weeks and two days, our son was born.

He was perfect – 8lb 12oz, 22 inches long and *all head*. I’ve never been so elated in my life. The next hour or so was a blur. I remember making someone take a picture of the placenta because I couldn’t see it from where I was while they stitched me up (I tore a little but nothing like if I’d been cut first). I remember asking the doctor what was taking so long with the stitches and she said she could quit now and it would look like crap or I could wait and it would look nice (I waited. She was right; it looks nice.) I remember getting a tray of breakfast that materialized what seemed like moments after the birth.

And I remember all this hubbub sort of dying down and it just being me. With my consent, they had taken my son to the nursery for observation because of his long labor. We had made our way back to our postpartum room and my poor husband promptly unfolded the recliner and passed out for several hours. And I was still full of this high of having beaten the odds and slogged my way through the absolute opposite of what I had hoped for in my birth story to get my boy. No surgery, no decisions being made without me. Just a lot of “complications”.

And it struck me that all of these courses we’d taken and books we’d read had worked hard to prepare us for all that we’d just gone through. But nothing really prepared us for the moments after birth. From that moment on, we were parents and things were going to remain “complicated” for a long time.

The lactation consultant was overbooked that day and my son was in the “special needs nursery” on oxygen for the first two days. I learned to breastfeed in a rolling office chair, surrounded by supportive NICU nurses who happened to be moms as well. I was discharged from the hospital but my son was still being kept one more day for observation so we booked a “guest room” in the hospital for $35 that looked like something out of One Flew Over the Cuckoos Nest. I had my first postpartum bowel movement in the Panera Bread downtown as we squeezed in a quick lunch between feedings. I set my iPhone alarm in three hour increments to get up, change my gigantic maxi pad and waddle down to the nursery to eek out a few ounces of colostrum.

When we were finally approved to take our son home (Ian Jacob – we took two days to name him!), we were just so happy to get out of there, we packed him up in the NICU onesie and took off. No “going home” outfit for any of us.

I didn’t get the mystical, perfect four hour labor that one might hope for. But my husband was there the whole time, I felt validated and listened to despite any stupid hospital annoyances, I had a doula there to guide me and give me a kick in the pants when I needed it most, I got this magical moment with my own mother who had never managed to witness her own births due to the practices back then and I got a beautiful, healthy, happy baby boy. I got my non-surgical birth. I got to feel like I did this versus it was done to me.

Just last week that beautiful happy boy ran face-first into our door frame and busted his forehead wide open. No one has an “ER visit plan” that they write up and bring to the hospital. We ended up at two different ERs that night and it was a very long ordeal, but everyone listened to our concerns, Rich and I made the best decisions we could, Ian was an absolute trooper and we all made it home with some stitches and Lightning McQueen stickers. In parenthood, I think that’s the best you can hope for.

This was written for my wonderful doula Amara as a birth story to share with her potential clients and others in the community.


Thanksgiving as a diabetic: a medical math problem

Friday, November 25th, 2011

I was so proud of myself for eating a reasonable meal at my in-laws on Thanksgiving. I had one plate of food and some trifle dessert. Someone mentioned how I shouldn’t really have the dessert because it was so full of sugar, but I ignored that. If I take the insulin for it, it’s no different than if I had a working pancreas to take the insulin for it. As we headed home from Richmond my blood sugar was 159 mg/dL and I patted myself on the back for a holiday meal well done. I took one unit of insulin in anticipation of that trifle still having an effect and we continued our trek home for Thanksgiving dinner number two.

Everything was going as planned with dinner #1 at 3pm (blood sugar was a perfect 79, estimated 84g of carbs, took 7 units) and dinner #2 at 7pm. But dinner #2 got complicated. We all got ready to sit down right at 7 but Ian didn’t want to sit at the table. After a bit of prodding I figured out that he wanted to have Mama Milk first in the chair before eating, so while everyone else pulled up a chair for dinner, Ian and I headed to the recliner for an appetizer of milk. I got a late start to dinner because of that but assumed I would eat my same typical plate of starches and a small dessert. But I had a small child in my lap (he wanted to eat dinner but he wanted to eat dinner WITH MOMMY) and was distracted so I didn’t actually check my blood first.

I assumed things were still on track so I estimated I would eat the same as dinner #1. Since I had 84g last time and still gave myself an extra unit, I estimated 96g this time and gave myself 8 units total. This was around 8pm.

And then Ian proceeded to eat half of my Thanksgiving dinner off my plate. I poured myself a cup of cider which has a ton of sugar in it, but never actually drank it since I think I messed it up with too much citrus and it tasted off. I did manage to eat a small piece of pumpkin pie and I felt full so I assumed all was well.

About the time everyone left to go home, though, I started feeling a little off. At 11:15pm I checked my blood and it was 56 (whoops). So I grabbed a Coke from the fridge and assumed the 38g of sugar in that would set me back on course. At 12:30 I was back up to 89 and feeling proud to have fixed that bad math from before.

But once Rich had put Ian to bed, I started feeling worse. I have this stupid head cold but my stomach was getting queasy too. I decided to just go to bed. Rich came up with me to make sure I was settled and I decided to check my blood one more time just for good measure. Crap, it was only 12:45 but I was down to 76. That explained the nausea coming on … I was going low and fast.

Rich brought me juice and I struggled to drink it (chugging juice when you feel like puking is not fun). By 1am I was still dropping to 62. More juice. More deep breaths to not puke up said juice. By 1:15, I was up to 73.

And I was wiped out. I wasn’t sure if I would really be better at that point but couldn’t bear another drop of juice. I turned my pump off for an hour and rolled over to moan quietly to myself waiting for sleep to take over. Rich stayed on high alert for another hour or so and rested in the guest room to give me and the boy some space. The last thing we needed was the boy waking up and demanding anything.

So then at 7 this morning, I got up to pee and felt that fuzzy feeling of being high (it’s a difficult thing to describe so fuzzy will have to do). I cringed as I checked my blood and it returned 384. Sigh. Time to take an assload of insulin (that’s a medical term), chug some water and wait a few hours to feel normal again. By the time we got to brunch, I was grateful to be under 200.

As I was lying in bed, stuffed up with a cold and trying not to puke, I had about 30 seconds of self-pity. I started to get all teary-eyed over how frustrating it was to have to eat or drink something I had zero interest in because it was acting as medicine. I was irritated with myself for over-estimating my appetite. They say your eyes can be bigger than your stomach, but mine were apparently bigger than my pancreas. I was jealous of people whose dinner plans don’t involve so much math.

But it was fleeting. Rich rubbed my head and I realized that tuning up to cry was only going to make me feel worse. So I counted myself thankful for a helpful husband, the wonders of apple juice, health insurance if I needed it and the confidence that at least I knew why I felt crappy, even if it would take a while to fix it.

Sometimes just knowing what you’re up against is the best you can hope for.


Under pressure

Wednesday, November 16th, 2011

The good news is that my EKG, chest x-ray and blood work all show normal. So by all accounts, I’m not at death’s door.

My blood pressure is fine. My chest is clear. My pulse is slightly elevated, though.

And my blood sugar has been through the roof for two weeks at least. So there is something wrong, but we aren’t exactly sure what. It’s actually interesting that I can use my blood sugar as this early warning detection system to know if something is out of whack. We won’t mention that the blood sugar probably wouldn’t be an issue if I wasn’t diabetic.

But after 26 years as a diabetic, I learned something today. The doctor said that if I am fighting an infection it can weaken my system overall so that simple things will make my pulse race. So it’s possible that this mysterious illness that I’m fighting is just making me have a hard time all around.

I’m ready for an easier time whenever it’s ready for me.